Journal of Mazandaran University of Medical Sciences
Year:2023 | Volume:32 | Issue:216 |Papers Count:15

Background and purpose: Human pluripotent stem cells (hPSCs) with the ability to differentiate into adult cells have provided a new perspective for treatment of some diseases. But, the efficiency of differentiation methods to generate hematopoietic progenitor cells (HPCs) is faced with multiple challenges. In the present study, we investigated the formation of hemato-endothelial-like structures and HPCs from hPSCs. Materials and methods: To generate hemato-endothelial structures and HPCs, in first method, three-dimensional aggregations of hPSCs were co-cultured on OP9 cells. In second and third methods, embryoid bodies (EBs) were differentiated spontaneously or directly in the culture medium containing BMP4, bFGF, SCF, and VEGF. In differentiation process, cell morphology was evaluated by microscopic observation and the expression of CD34 and CD45 markers were analyzed by flow cytometry. In addition, the ability of HPCs to differentiate into various types of blood cells was evaluated using colony formation assay, Wright-Giemsa staining, and CD86 immunofluorescence staining. Results: Findings showed that all three methods generated cells with endothelial-like morphology and HPCs. These cells were able to proliferate, form cell clusters with different efficiency and differentiate into erythroid cells, macrophages, and dendritic cells. Conclusion: The use of cultured cells in defined conditions without a feeder layer is preferred in cell therapy. Therefore, despite the ability of all these methods to generate HPCs, direct differentiation of EBs under defined conditions is a better option for generatingHPCs from hPSCs.

Background and purpose: Post-traumatic stress disorder (PTSD) is a condition that occurs in some people after experiencing shocking events. In this disorder, the function of some hormonal and neurotransmitter systems are disturbed. Physical activity, by inducing beneficial effects on the brain structure, improves anxiety behaviors, increases the level of BDNF, and reduces the harmful effects of some neurological diseases. There are different perspectives on the most effective type of exercise that can have positive effects on physical and mental health. This study was carried out to investigate the effect of high and moderate exercise on healthy male and female rats and rats with PTSD. Materials and methods: Single prolonged stress (SPS) was used to induce PTSD in Wistar rats weighing (200-250 g). Moderate and high intensity exercise was performed and after four weeks, anxiety test was performed by EPM and serum levels of corticosterone, and hippocampal and serum BDNF were measured using Eliza. Results: The present study showed that SPS leads to increase in anxiety and serum corticosterone and decrease in hippocampal BDNF in male and female rats. Moderate-intensity exercise could improve these factors in male and female sham and PTSD rats, but high intensity exercise has no significant effects (P=0. 991, P=0. 999, P=0. 996, respectively). Our findings showed no significant gender-related differences in these factors (P=1. 000, P=0. 998, P=0. 984, respectively). Conclusion: Moderate intensity exercise can be a suitable type of physical activity to reduce anxiety and increase hippocampal BDNF.

Background and purpose: Tadalafil has gained wide clinical acceptance in treatment of erectile dysfunction due to its long treatment window and lower potential for visual impairment. Transdermal drug delivery prevents systemic elimination, drug-drug and food-drug interactions, and reduces side effects by reducing the dose of the drug. The aim of this study was to evaluate the effect of microemulsion formulation on dermatological drug delivery of Tadalafil in rat skin. Materials and methods: In this laboratory study, Tadalafil microemulsions were prepared using a phase-diagram method with an appropriate ratio of oil and water mixture. Factorial design with three variables in two levels was performed to prepare eight formulations. Microemulsions containing 0. 05 Tadalafil were prepared with an appropriate amount of oil phase (Oleic acid, Transcotol P), surfactant (Tween 80 and Span 20), and co-surfactant (Propylene Glycol). The drug was dissolved in the oil phase. The physicochemical properties of these microemulsions were evaluated using Franz Cells. Results: The droplet size of microemulsions ranged less than 60 nm and the viscosity ranged between 114. 2 and 239. 2 cpz. Parameters, including pH, drug release percentage in two hour and 24 hours, viscosity, Tlag and Dapp were significantly associated with independent variables (P<0. 05). Conclusion: The release kinetics of the drugs in selected microemulsions showed that compared to the Tadalafil solution, release occurs over time. All microemulsions significantly increase the flux coefficient and skin permeability.

Background and purpose: About 50% of infertility in couples is related to male factors and oxidative stress is one of the main causes of infertility in men. Hydrogen peroxide has an adverse effect on male reproductive system due to its free radicals. Spirulina and phycocyanin are known to have antioxidant properties and can modify stressors. Materials and methods: In this experimental study, 36 adult male rats were randomly divided into six groups to receive the following: water and normal food, phycocyanin solution (300 mg/kg), spirulina (500 mg/kg), hydrogen peroxide solution (0. 5%), hydrogen peroxide in drinking water (0. 5%) + phycocyanin (300 mg/kg), and hydrogen peroxide in drinking water (0. 5%) + spirulina (500 mg/kg). Weighing and dissection of testicles were performed for histological study and sperm evaluation. Results: Hydrogen peroxide had negative effects on testicular tissue, leading to significant decrease in sperm count, sperm motility, and sperm morphology compared with the control group (P<0. 05). But, phycocyanin and spirulina algae improved the function of testicular tissue, by which improvement in sperm motility, morphology, and mortality was observed. In all parameters, the protective effect of phycocyanin on testicular tissue was better than spirulina. The group that received phycocyanin + hydrogen peroxide, showed no significant difference in the number of sperm and number of testicular cells when compared with the control group (P<0. 05). Conclusion: Phycocyanin and spirulina algae reduce the harmful effects of hydrogen peroxide on reproductive system of rats by improving some factors in testicle structure and semen parameters.

Background and purpose: Allicin has a wide range of pharmacological functions, all of which can be demonstrated in anti-inflammatory, antioxidant, antifungal and anti-tumor activities. In this research, we investigated the neuroprotective role of allicin in the process of diffuse traumatic brain injury and its effect on interleukin levels and histological changes in rats. Materials and methods: In this experimental study, Wistar rats (n=56) underwent diffuse controlled brain injury by Marmarou method, and 30 minutes later, the drug was injected intraperitoneally at different doses. Veterinary Coma Scale was used and Beam Walk and Beam Balance movement and balance tests were taken at pre-traumatic times, immediately after recovery from the trauma, and 24, 48, and 72 hours after the trauma. Results: Findings showed that allicin at 25 mg/kg and 50 mg/kg can reduce these differences compared to the control group (Sham and Intact) (P<0. 001). Allicin was found to be more effective at 25 mg/kg (P<0. 0001). Conclusion: Allicin showed neuroprotective effects in the brain and can affect the consequences of trauma, reduce cerebral edema, accelerate improvement of blood-brain barrier, and improve neurological scores and the function of vestibular system.

Background and purpose: Despite advances in oral health and dental industry, tooth decay remains one of the most common oral diseases. One of the new methods to combat dental plaque, which is the main cause of caries, is using specific lytic bacteriophage. This study aimed to investigate the effect of isolated specific lytic phage against growth and biofilm inhibition of Streptococcus mutans and Streptococcus sanguinis isolated from decayed dental plaque samples. Materials and methods: In this descriptive cross-sectional study, dental plaque samples were cultured in MSA-specific medium to isolate S. mutans and S. sanguinis. Suspicious isolates were examined by biochemical tests and finally confirmed molecularly by PCR. The ability to form biofilm was measured by crystal violet colorimetry on a microtiter plate. Lytic bacteriophage was isolated from urban raw sewage using double layer agar method and phage morphology was examined by TEM electron microscopy. The effect of lytic phage on the growth of S. mutans and S. sanguinis was measured by agar spot and well diffusion and its inhibition effect on biofilm was assayed by microtiter plate method. Results: Out of 150 plaque samples, S. mutans and S. sanguinis strains were isolated from 65 (43. 33%) and 40 (26. 67%) samples, respectively. S. mutans isolates showed stronger biofilm formation (OD= 0. 43). The results of TEM showed lytic bacteriophage belonging to Siphoviridae family with a good inhibitory effect on the growth of S. mutans and S. sanguinis that was able to inhibit biofilm formation up to 96%. Conclusion: Due to the small size of the phage particles that can have good penetration power to enter the biofilm layers, it can be concluded that the phage has the ability to fight dental plaque.

Background and purpose: The most common method of anesthesia in Cesarean section is spinal anesthesia (SA). Post-Dural puncture headache (PDPH) is one of the complications of SA. The aim of this study was to evaluate the effect of intravenous administration of atropine and neostigmine in prevention of PDPH following Cesarean section. Materials and methods: This study was performed in 62 candidates of elective Cesarean section with SA in Isfahan Shahid Beheshti Hospital. Patients were randomly assigned into the two groups (n= 31 per group) using Random Allocation Software. After umbilical cord clamping, experimental group received neostigmine 0. 5 mg and atropine 0. 5 mg (i. v. ), while the control group received 10 ml i. v. infusion of normal saline. The incidence and severity of headache were compared between the two groups in the first 48 hours and followed up for one week. Results: In this study, one patient in experimental group (3. 2%) and five patients in control group (16. 1%) reported PDPH which can be clinically important (P=0. 195). Headache was seen in two patients (1 in each group) at recovery and in four at ward in control group (P=0. 11). The mean severity of headache was 5 and 4. 2±, 0. 45 in experimental group and control group, respectively (P= 0. 18). The interval between spinal anesthesia and first onset of headache was one hour in experimental group and 20. 8 ±,11. 1 hours in control group (P=0. 18). Conclusion: According to the present study, the neostigmine (0. 5mg) + atropine (0. 5mg) is associated with a non-significant reduction in the incidence of headache and its severity after spinal anesthesia that are clinically important.

Background and purpose: Violet is a plant that has received interest in complementary medicine due to its anti-inflammatory, antipyretic, and antimicrobial effects. Fever is one of the major symptoms of COVID-19. This study was conducted to determine the effect of violet extract in the form of syrup on fever in patients with COVID-19. Materials and methods: In this randomized clinical trial, 52 patients with COVID-19 were studied in Intensive Care Unit in Amol Imam Khomeini Hospital (2021). In intervention group in addition to an injection of acetaminophen, 5 cc of violet extract syrup prepared from the aqueous extract of the plant was taken. The temperature was recorded after 30 and 60 minutes and four hours. The follow-up of the patients continued for three days and the temperature was recorded every six hours. Results: There was a significant difference between the intervention group (36. 84±, 0. 37) and control group (37. 13±, 0. 62) in mean temperature at second time in second day of follow-up (P=0. 04). Also, the mean temperature was found to be significantly different between the two groups at 30 (P=0. 001) and 60 minutes (P=0. 05) after the intervention. At other groups, there was no significant difference between the intervention and control groups. Conclusion: The aqueous extract of violet plant in the form of syrup reduces fever in patients with COVID-19 causing no complication. Due to the ease of access to this herbal product, it can be used to prevent problems caused by fever.

Background and purpose: Depression is one of the most common psychiatric disorders in diabetic patients that could change the disease prognosis in addition to affecting the treatment path. The aim of this study was to evaluate the effectiveness of mindfulness-based cognitive therapy (MBCT) on life expectancy, fear of death, and glycemic control in diabetic patients suffering from depression. Materials and methods: A quasi-experimental research with pre-test/post-test design and control group was conducted. The statistical population included 867 patients. The study inclusion criteria were type 2 diabetes, 20-65 years of age, secondary school education, and HbA1c below 7. Beck Depression Inventory-II (BDI-II) was completed and patients with moderate to severe depression were selected (n= 30). They were randomly assigned into two groups. Data were collected using Miller Hope Scale, Templer Death Anxiety Scale (1970), BDI-II, and measurement of HbA1c level. MBCT was performed for eight weekly sessions of 90 minutes, while the control group received no specific training. Data analysis was carried out applying Analysis of covariance (ANCOVA). Results: Findings showed significant improvements in life expectancy (P= 0. 000, F= 25. 21), death anxiety (P= 0. 000, F= 157. 77), and HbA1c level (P= 0. 000, F= 151. 61) after the intervention. Conclusion: MBCT is effective in improving life expectancy, fear of death, and HbA1c level in diabetic patients with depression. Therefore, attention should be paid to diagnose depressive disorders in diabetic patients and their follow-up and non-pharmacological treatments such as MBCT which could be of great benefit in controlling blood sugar level and reducing the severity of chronic complications.

Background and purpose: Insomnia is a common sleep disorder with negative consequences such as decreased quality of life. In this study, the effect of sleep deprivation on memory in both young and older adults was investigated using functional magnetic resonance imaging (fMRI). Materials and methods: In this retrospective study, fMRI data of 40 healthy subjects (17 young and 23 older people) who had a one-month sleep deprivation period (during the experiment they woke up three hours earlier than usual) were obtained. Then, pre-processing was done to remove artifacts and noise. Finally, data processing was completed in order to extract the brain activity map focusing on brain areas related to memory. Results: Findings showed that the brain activity of most areas are reduced due to insomnia. In the young group, 17 functional connections were obtained at the beginning of the study which decreased to only one connection after the insomnia period. In older adults there were seven connections at the beginning of the study that decreased to four after the insomnia period (P< 0. 05). Conclusion: Brain map analysis, including connections and activity levels of memory-related areas, showed that sleep deprivation affects the brains of young and old people. Our findings can pave the way for future studies to understand the effect of insomnia on memory and brain.

Background and purpose: Considering the pathologic importance of oxidative stress in osteoarthritis (OA), this study aimed to investigate the association between dietary total antioxidant capacity (DTAC) and oxidative stress markers in patients with knee OA. Materials and methods: In a cross-sectional study, dietary intakes of 152 patients with knee OA attending health centers in Zabol, Iran (January-May 2022) were evaluated using food frequency questionnaire (FFQ). Demographic and anthropometric data were collected and DTAC was calculated using ferric-reducing antioxidant power (FRAP) assay. Then, serum concentrations of malondialdehyde (MDA), total oxidant status (TOS), total antioxidant capacity (TAC), erythrocyte activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were measured. The oxidative stress index (OSI) was also calculated by dividing TOS by TAC. Results: The mean serum concentrations of MDA (P< 0. 001), TOS (P-trend< 0. 001), and OSI (P-trend= 0. 001) showed decreasing trends by increase in DTAC after adjustment for potential confounders. Serum TAC concentrations had increasing trend when DTAC increased (P-trend=0. 027). No significant trend was found between erythrocyte activities of SOD, GPx, and DTAC. Conclusion: Higher DTAC was favorably associated with oxidative stress markers in patients with knee OA. Further prospective studies are required to confirm these findings.

Background and purpose: Influenza is one of the viral infections of the respiratory system, which causes death in high-risk groups every year. The genomic changes of influenza virus make it susceptible to drug resistance, therefore, continuous monitoring of the influenza virus is highly important in order to recognize the efficacy of available drugs. The current study investigated the neuraminidase gene mutations of Influenza A/H3N2 in Mazandaran province between 2016 and 2018. Materials and methods: Twenty Influenza A/H3N2 samples of patients hospitalized in Mazandaran province were included in the study. PCR and electrophoresis tests were performed using primers designed for the region of the neuraminidase gene that contained the desired mutations. Then, the PCR product was sequenced to determine the mutations. Results: A total of 57 mutations were detected at the level of nucleotides, among which 19 were observed in all isolates, 13 were seen in most isolates, and 25 single mutations that were identified in some isolates. A total of 28 mutations were detected at the amino acid level, among which 13 mutations were observed in all isolates, 6 were detected in most isolates, and 9 single mutations seen in some isolates. Conclusion: Although the sequence of the active site region is conserved in different subtypes of the neuraminidase gene, this region is still subject to mutation and genomic changes, which indicates changes in the active site region of the neuraminidase gene.

Background and purpose: The primary health care program for the suburbs is being implemented in Iran after the Health Transformation Plan where services are delivered with the priority of outsourcing and purchasing services from non-governmental sectors. In this program, different payment methods have been used. This study aimed at addressing the challenges associated with payments made to urban primary health care providers in Iran. Materials and methods: This qualitative study was conducted using a framework analysis approach through semi-structured interviews with 30 experts and service providers. Data were analyzed using MAXQDA. 10 and Gale framework analysis method. Results: The study showed that lack of proper financing of the program is one of the most important challenges of the payment system. Other challenges included insufficient and late payments to providers, impossibility of recording all activities and inability to exchange data between electronic information registration systems (both horizontally and vertically), improper contracting method, incompatibility of service package volume with the amount of payment, the impossibility of applying the monitoring result on the amount of payment due to paying the minimum amount of labor law payment, and inflexibility of payment instructions. Conclusion: The payment system for urban primary care providers does not have a suitable structure in various dimensions, including financing, payment, contracting method, data registration system, and monitoring and evaluation system. If these problems continue to exist, providers would leave the service system and the quantity and quality of services are reduced.

Background and purpose: Early diagnosis of jaw lesions is of great importance, especially in children. The aim of the present study was to investigate the frequency of jaw lesions in panoramic radiography of children (5-12 years old) in north of Iran. Materials and methods: In this study, 1000 panoramic images of children attending oral radiology centers (2012-2019) in north of Iran were studied during one year. Information, including the age, gender, and presence or absence of any jaw lesion were extracted from the radiographic images of patients. Data analysis was carried out in SPSS V22 applying Chi-square. Results: Out of 1000 panoramic images, 188 (18. 8%) were found with jaw lesions. The mean age of children with these lesions was 8. 64±, 2 years. Radiolucent lesions (in 185 images) were more frequent than radiopaque lesions. Conclusion: Radiolucent lesions were more of periapical lesions.

Background and purpose: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis and the most complex deformity of the spine and trunk with significant complications. In this systematic review, the effectiveness of core stability exercises (CSE) in improving this disorder is discussed. Materials and methods: This review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. Adolescent Idiopathic Scoliosis, Cobb angles, and core stability exercise were our search terms in PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar. The search was limited to articles published in Persian and English between 2005 and 2022. Researches on AIS carried out in adolescents aged 10-18 were studied. In one of the groups, only CSE was done and the size of Cobb's angle (an indicator of the severity of scoliosis) was used as one of the dependent variables. The PEDro scale was used to evaluate the quality of articles in terms of risk of bias. Results: In initial search, 268 articles were found. After removing irrelevant articles and those that did not met the study’, s inclusion criteria and also qualitative evaluation of the remaining articles, seven articles with an average PEDro score of 6. 2 (moderate quality), including 297 participants, were selected. A statistically significant decrease was reported in the Cobb angle in all articles, but only in four articles this decrease was clinically significant (greater than 5˚, ). Conclusion: CSE are safe, easy and accessible that can be effective in improving AIS, but there is not sufficient evidence to support this hypothesis. Further high-quality studies are required to draw a definite conclusion and making clinical decisions.