Journal of Mazandaran University of Medical Sciences
Year:2023 | Volume:32 | Issue:219 |Papers Count:12

Background and purpose: This study aimed at investigating the antibacterial effects of nanoparticles synthesized with ethanol extract of Rosa damascena and Juglans regia (walnut leaves) against methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Acinetobacter baumannii. Materials and methods: In this experimental study, gold nanoparticles were synthesized by green method using ethanol extract of R. damascena and walnut leaves. Then, inhibition of biofilm formation, minimum growth inhibitory concentration (MIC), and minimum bacterial lethal concentration (MBC) were determined by micro broth dilution method. Also, inhibition of biofilm synthesis by nanoparticles was investigated against methicillin-resistant S. aureus, P. aeruginosa, and A. baumannii. Results: UV-vis spectroscopy showed that the gold nanoparticles synthesized with the ethanolic extract of R. damascena had better quality than the nanoparticles synthesized with the ethanolic extract of walnut leaf in terms of uniformity and ease of synthesis. The greatest effect of gold nanoparticle synthesized with ethanolic extract of R. damascena was on bacterial biofilm formed by Methicillinresistant S. aureus, which inhibited the biofilm of this bacteria by 100%. Conclusion: In this study, nanoparticles synthesized with ethanolic extract of R. damascena showed higher antibacterial properties than walnut leaves. These findings can provide the basis for further in vivo studies to identify, quantify and purify its effective compounds.

Background and purpose: Hypertension is a global health challenge due to its high prevalence and increased risk of cardiovascular disease. It is a multifactorial disease in which both genetic and environmental factors are involved. So far, a number of genes and pathways have been proposed to be associated with HTN, including the nitric oxide/cGMP pathway. To further clarify the role of NO /cGMP in the pathogenesis of HTN and also to find genetic determinants of predisposition to HTN in Kermanshah province, Iran, we aimed to investigate the association between three key points in nitric oxide signaling pathway, namely eNOS, GUCY1A3, and PDE1A genes, and susceptibility to hypertension. Materials and methods: In this case-control study, a total of 130 patients and 110 healthy subjects were enrolled. Three polymorphisms (rs1799983 in eNOS gene, rs13139571 in GUCY1A3 genes and rs16823124 in PDE1A gene) were investigated by PCR-RFLP method. Data were then statistically analyzed. Results: This study showed a significant association between the genotypic and allelic frequencies of the rs1799983 polymorphism in the eNOS gene and the rs13139571 gene in GUCY1A3 (P<0. 05), while there was no significant association with PDE1A (P>0. 05). However, the interaction with the other two SNPs may confer susceptibility to hypertension.

Background and purpose: There is no specific treatment for fibromyalgia. Previous studies suggest that exercise is helpful in controlling the symptoms and psychosocial aspects of the disease. Stretching exercises are emphasized less than aerobic and resistance exercises in these patients. The main reason for re-examining this issue in current study was the contradictory feedback of patients with fibromyalgia to stretching exercises which was observed during recent years in clinical treatments. The aim of this study was to evaluate the effect of stretching exercise on the quality of life of patients and the impact of fibromyalgia. Materials and methods: This study was a per-protocol randomized clinical trial. Forty-nine patients with fibromyalgia diagnosed based on 2010 diagnostic criteria for fibromyalgia who were referred to our sports medicine clinic by a rheumatologist and then a psychiatrist were studied. They were randomly divided into two groups. Twenty-five patients in the intervention group did stretching exercise and received medication while 24 patients in the control group received standard medication for five weeks. SF-36 questionnaire was used to evaluate the quality of life and Revised Fibromyalgia Impact Questionnaire (FIQR) was used to assess the disease state at the beginning of the study and also at weeks 5 and 9. Results: There are contradictory results about the effect of stretching exercises on fibromyalgia patients. The current study showed no significant differences between the two groups in the mean scores for physical health (P= 0. 4), mental health (P= 0. 88), and fibromyalgia impact (P= 0. 36). Conclusion: Isolated stretching exercises are not effective in improving fibromyalgia. Further studies are suggested to investigate the effect of more specific stretching exercises on fibromyalgia.

Background and purpose: Mizaj (temperament) is an important concept in Persian medicine that has many applications in the diagnosis, prevention, care, and treatment of many diseases. This study aimed to determine the relationship between placenta accreta and the state of the general and uterine temperament and Apgar score of newborns in mothers candidates for cesarean section. Materials and methods: A case-control study was performed in mothers who were candidates for caesarean section. The subjects included expectant mothers with placenta accreta (n= 33) and a control group (n= 66). Current general and uterine temperament were measured using Mojahedi and Tansas questionnaire. Demographic variables and Apgar score of newborns was measured using the Apgar International Standard Checklist Score. T-test and Chi-square were used to compare the data. Results: Demographic characteristics were similar between the two groups. In pregnant mothers with placenta accreta the mean scores for total warm-cold and wet-dry temperaments were 14. 81±, 1. 55 and 3. 72±, 1. 23, respectively. In the control group, these scores were 16. 81±, 4. 38 and 3. 39±, 0. 65, respectively (P<0. 002). The chance of placenta accreta in cold-tempered mothers was 8. 571 compared to warm-tempered mothers. The chance of placenta accreta in pregnant women with cold-tempered uterine was 15. 385 times higher compared to pregnant women with warm-tempered uterine. Those with dry uterus were 10. 35 times more likely to develop placenta accreta compared to mothers with wet temperament. The mean score for warm-cold tempered uterine in the placenta accreta group was 33. 27±, 2. 21 and for wet-dry tempered uterine was 11. 45±, 1. 58 and in the control group the scores were 39. 60±, 5. 20 and 13. 71±, 2. 16, respectively (P<0. 001). Conclusion: The chances of developing placenta accreta is higher in mothers candidate for Caesarean section with general and cold uterine temperament than in other temperamental conditions. Also, the chance of contracting placenta accreta is higher in mothers with wet general temperament and dry uterine temperament. Applying necessary measures based on the principles of Persian medicine is suggested for pregnant mothers in the early stages of pregnancy.

Background and purpose: Multisystem Inflammatory Syndrome in Children (MIS-C) occurs after having COVID-19. The severity and outcomes of COVID-19 with gastrointestinal symptoms are higher. The aim of this study was to investigate gastrointestinal manifestations in MIS-C patients in selected referral hospitals in Iran to obtain comprehensive information about the treatment and prevention of MIS-C. Materials and methods: In this cross-sectional study, all MIS-C patients <21 years in Dec 2019 to Oct 2021 were included. The patients were identified by the Centers for Disease Control and Prevention (CDC) checklist and data were analyzed applying t-test and Chi-square in STATA11. Results: There were 225 patients with a median age of 55 months (26-96 months), including 59. 56% boys and all had fever on admission. At least one gastrointestinal symptom was seen in 200 patients and the most common symptoms were vomiting (60. 9%) and abdominal pain (45. 77%). Almost 60% of the patients had positive RT-PCR results. Among the patients with and without gastrointestinal symptoms 85. 5% and 48% were admitted to intensive care unit (ICU), respectively. There were significant differences between the two groups in respiratory symptoms, ALT, AST, NT-pro BNP, ESR, and PLT (P<0. 05). All patients without gastrointestinal symptoms were discharged but nine patients in the group with gastrointestinal symptoms deceased. Conclusion: According to the current study, gastrointestinal symptoms are common in MIS-C patients and are associated with higher rates of death and intensive care unit admission. Therefore, in providing services to COVID-19 patients, all typical and atypical signs and symptoms should be considered to prevent unnecessary interventions.

Background and purpose: The present study investigated the effect of six weeks of endurance and resistance training on pulmonary indices, physical performance, and quality of life in COVID-19 patients after discharge from hospital. Materials and methods: Thirty six patients with COVID-19 (mean age: 38. 76±, 0. 98 years, mean weight: 81. 86±, 2. 88 kg) were selected. At the beginning and end of the study, pulmonary (FEV1, FVC, FEV1/FVC, and MVV), physical (6-minute walk test), quality of life (SF-36), and anthropometry tests were performed. The patients were divided into three groups: Endurance training (45 minutes at 60-75% estimated HR), Resistance training (45 minutes at 40-70% of I-RM), and controls. The intervention was conducted for 6 weeks (3 sessions). One-way ANOVA test was used for statistical analysis. Results: Findings indicated a significant increase in FEV1 (P=0. 029), FVC (P=0. 047), FEV1/FVC (P=0. 043) in the endurance training group compared to the control group, while difference was observed in MVV (P=0. 041) and FEV1/FVC (P=0. 022) between endurance training and resistance training groups. The 6-minute test distance increased in the endurance training (P=0. 0001) and resistance training (P=0. 001) groups compared to the control group, but no difference was observed between the training groups (P=0. 48). Endurance and resistance training programs induced significant improvements in physical performance (P=0. 024 and P=0. 09, respectively) and general health (P=0. 022 and P=0. 015, respectively) dimensions compared to the control group. Conclusion: Moderate-intensity endurance training can improve pulmonary function, physical performance, and quality of life in patients with COVID-19 after discharge from hospital and can be used in rehabilitation programs of these patients.

Background and purpose: Septic arthritis is a serious orthopedic surgery and delayed management causes irreparable damages. The knee is the most common site involved in septic arthritis. The purpose of this study was to determine mortality rate, adverse joint outcome and prognostic factors in adult patients diagnosed with septic arthritis of the knee who had undergone debridement surgery. Materials and methods: This retrospective cohort study was carried out using the medical records of all adult patients admitted to Sari Imam Khomeini Hospital and Sari BuAliSina Hospital between 2009 and 2019 who were treated with either arthrotomy or arthroscopic irrigation for acute septic arthritis of the knee. Patients with prosthetic joints were excluded. The rate of mortality was determined. Clinical findings, laboratory evidence, knee radiographs, and the Knee injury and Osteoarthritis Outcome Scores (KOOS) were compared through statistical analysis to identify possible prognostic factors. Radiographic severity was classified based on the Kellgren-Lawrence grading. Results: We included 31 patients and there were 41. 9% female patients (mean age= 51. 1±, 20. 56). The most common underlying diseases were hypertension (29%) and diabetes mellitus (25. 8%). Staphylococcus aureus was identified in 16. 1% of synovial fluid cultures. The mortality rate was 22. 6%. Factors influencing mortality included older age (P=0. 003), diabetes mellitus (P=0. 031), fever (P=0. 038), length of hospital stay (P=0. 019), high C-reactive protein levels (P=0. 002), low creatinine clearance (P=0. 003), and type of pathogenic microorganisms (P=0. 028). Age was the only factor significantly associated with higher radiographic severity (P=0. 014). Conclusion: Septic arthritis is an infectious orthopedic emergency that is associated with a high mortality rate even after joint surgery and debridement. Therefore, proper management and updating information about this disease and its treatment methods are necessary.

Background and purpose: Osteoporosis and periodontitis are two diseases associated with bone loss and are common among postmenopausal women. There are many contradictory results on the effect of osteoporosis on periodontal tissue. This study aimed to determine the association between osteoporosis and periodontal status in postmenopausal women. Materials and methods: This cross-sectional study was part of the second phase of the Amir kola Health and Aging Project (AHAP), in which 210 postmenopausal women were randomly divided into three groups (n=70 per group),normal bone density group, osteopenic group, and osteoporotic group. Periodontal status was measured using Periodontal Disease Index (PDI), Plaque Index (PI), and Simplified Oral Hygiene Index (OHI-S). Bone mineral density (BMD) was measured by Dual-energy Xray absorptiometry (DEXA). Data were analyzed in SPSS V17 applying ANOVA, Kruskal-Wallis, and Pearson correlation coefficient. Results: The average age of the participants was 65. 24±, 4. 36 years. There were no statistically significant differences between the mean OHI (2. 26±, 1. 40), PDI (2. 76±, 1. 42), and PI (1. 23±, 0. 87) in the osteoporotic group, and the mean OHI (2. 01±, 1. 62), PDI (2. 56±, 1. 61), and PI (1. 35±, 0. 91) in the osteopenia group, and mean OHI (1. 73±, 1. 37), PDI (2. 47±, 1. 43), and PI (1. 23±, 0. 87) in the normal group (P>0. 05). The OHI, PDI, and PI had a slight but insignificant negative correlation with BMD. Conclusion: According to this study, there is no link between osteoporosis and periodontal status in postmenopausal women.

Background and purpose: Fatty liver is one of the most common liver diseases. Some treatments used in breast cancer may be associated with development of fatty liver. The present study aimed at investigating the prevalence of fatty liver in breast cancer patients. Materials and methods: In this cross-sectional study, 117 patients with breast cancer attending Ramsar Imam Sajjad Hospital in 2017-2022 were selected using available sampling. Patients who had fatty liver before the treatment or had a history of alcohol consumption were excluded from the study. Relevant information, including age, BMI, underlying diseases, time since cancer diagnosis, type of treatment/s, and liver enzyme levels were obtained. Liver ultrasound and measurement of liver enzyme levels were done to study fatty liver. Data were analyzed in SPSS V26 applying Chi-square test. Results: According to findings, 54. 7% of the patients were suffering from fatty liver. The majority had Grade I fatty liver. Among the patients 53. 8% received all four types of treatments (surgery, chemotherapy, hormone therapy, and radiotherapy). The study showed significant relationships between the incidence of fatty liver and type of treatment, underlying disease, liver enzyme levels, and duration of breast cancer (P<0. 05). Conclusion: Non-alcoholic fatty liver is seen in many patients with breast cancer. Treatment methods used in these patients are associated with the development of fatty liver. Therefore, clinicians are suggested to use appropriate diagnostic and treatment methods for fatty liver to reduce the incidence of complications caused by this condition in patients with breast cancer.

Background and purpose: Considering the global spread of COVID-19, it seems that correct information obtained from reliable sources and training based on the need for self-care behaviors are useful solutions to reduce the harm caused by the disease. This study aimed at assessing the educational needs of people in Mazandaran province about COVID-19. Materials and methods: In a cross-sectional study, 1220 people were recruited via convenience sampling in 2020. A researcher-made questionnaire was administered and information such as demographic characteristics, disease condition, and educational needs for COVID-19 were recorded. Data were analyzed using descriptive statistics and parametric tests, correlation, analysis of variance, and t-test. Results: The mean age of the participants was 39. 34 ±,8. 74. Educational level included diploma (42. 5%) and university education (38. 9%). About 73. 3% of the participants were women. According to findings the main sources of information about COVID-19 were social networks (68. 4%), satellite programs (20. 9%), Ministry of Health notices (8. 1%), national media (1. 6%), other sources (0. 6%), and family members (0. 4%). Online methods were the most desirable educational methods (94. 6%) reported by the people living in Mazandaran province. The overall mean score for educational needs was 3. 89±, 0. 96. The educational need for the disease (3. 76±, 0. 84) and self-care needs (4. 03±, 1. 07) indicated high needs for educational trainings and significant differences between these areas (P=001). Conclusion: In this study, social networks and media were the primary sources of information about COVID-19. Designing and implementing self-management and self-care training programs could improve the health of people in Mazandaran province and prevent the spread of COVID-19.

Background and purpose: Heavy metals in urban air are major health threats and increase the risk of respiratory, cardiovascular, and cancers in humans. An efficient and low-cost method for monitoring these pollutants is using tree bark as a bioindicator. The purpose of this study was to measure the concentration of heavy metals by pine tree bark as a bioindicator in Neishabur, north-east of Iran and the ecological risk of these pollutants. Materials and methods: Twenty seven locations were determined on Neishabour map using GIS. Concentrations of heavy metals, including silver (Ag), arsenic (As), cobalt (Co), cesium (Cs), manganese (Mn), lead (Pb), copper (Cu), zinc (Zn), chromium (Cr), and cadmium (Cd) were measured using Inductivity Coupled Plasma-Mass Spectrometry. Ecological risk potential index, total ecological risk, and Spearman correlation coefficient were examined. Results: In this study, Cr and Zn had the highest average concentrations (34. 7 mg/kg and 10. 2 mg/kg, respectively) and other heavy metals in the bark were in the following order: Mn>Cu>Co>Pb>As>Ag>Cd>Cs. The average ecological risk potential decreases as Cd>As>Pb>Zn>Cu>Cr. Ecological risk potential index for all heavy metals except As and Cd (medium risk) was found to be at low-risk levels. The total ecological risk index showed that the concentrations of the studied heavy metals are at low-risk levels. Spearman correlation analysis showed that Cs and As had the highest correlation among the elements and there is a considerable relationship between these heavy metals which indicates the same source of pollution. Cr and Cd also have a strong correlation and have the same source of contamination. Conclusion: The present study showed low risk of heavy metal pollution according to the average ecological risk potential in pine bark samples in Neishabour.

Background and purpose: Metabolic syndrome refers to a set of diseases including insulin resistance, high blood glucose levels, obesity, high blood pressure, and dyslipidemia. The cinnamon plant is a member of the Lauraceae family and is considered a universal medicinal plant. Traditional medicine studies reported the therapeutic effects of this plant in the reduction of blood glucose levels, blood pressure, obesity, and improving dyslipidemia. The present study aimed to review the effect of cinnamon and its active compounds on metabolic syndrome. Materials and methods: The search was carried out in Science Direct, Google Scholar, Pub Med, Scopus, and SID using the following keywords: cinnamon, cinnamaldehyde, obesity, high blood pressure, diabetes, and blood lipid profiles. Relevant articles published in May 2007 to September 2022 were selected. Results: Data obtained from different studies (clinical studies, in vivo) on the effects of cinnamon and its active ingredients showed the protective effects of this plant in metabolic syndrome in different ways. Conclusion: Cinnamon could decrease the rate of complications and mortality caused by metabolic syndrome.