Journal of Mazandaran University of Medical Sciences
Year:2023 | Volume:33 | Issue:227|Papers Count:20

Background and purpose: Liver disease is one of the global problems that are associated with high mortality. According to the WHO, about 500 million people are living with chronic hepatitis infection, which kills more than one million people a year. Medicinal plants are a vital resource, potentially used to prevent and treat liver disease. One of the plants used in traditional medicine to treat liver damage is Asparagus. It could be effective against pyrrolizidine alkaloids (PA) induced hepatotoxicity, which was investigated in this study. Materials and methods: In this experimental study, 60 male Wister rats were divided into six groups, each having ten rats. One group was considered as the control group,the second group received carbon tetrachloride, and the other four groups received Senecio vulgaris L. extract for one week to induce liver toxicity. Among four which received Senecio vulgaris extract, one was the negative control, and the others received 100, 300, and 600 mg/kg of Asparagus officinalis L. extract orally for 14 days. Three weeks after the start of the study, aspartate transaminase (AST), alkaline phosphatase (ALP), and alanine transaminase (ALT) enzymes along with the serum concentration of total protein, albumin, and bilirubin were measured. Moreover, liver tissue was assessed in all the groups. The ANOVA test was utilized to analyze the data. Results: Receiving oral Senecio vulgaris extract led to an increase in bilirubin, ALP, ALT, and AST levels and a decrease in total protein and albumin in the experimental groups compared to the control group. Moreover, Asparagus officinalis extract consumption helped these factors to become statistically closer to the control group. Histological studies indicated improvement in liver failure caused by Senecio vulgaris extract. Conclusion: Asparagus officinalis extract has protective effects against liver failures caused by Senecio vulgaris extract.

Background and purpose: The spread of cancer, coupled with the challenges posed by complex treatments, stands as one of the foremost medical issues in today's world. Researchers consistently strive to identify novel compounds with enhanced efficacy and reduced side effects. Aromatase, a pivotal enzyme in estrogen receptor-positive breast cancer, plays a significant role. Estrogens, crucial for human physiology, particularly in women, contribute to sexual development and reproduction. The adverse effects associated with specific aromatase inhibitors underscore the imperative to discover new inhibitors characterized by higher selectivity, lower toxicity, and improved potency. Materials and methods: This research is a basic study in which the semi-prepared aromatase kit was used to investigate synthetic compounds, specifically triazolyl chromanone oxime ethers. The most promising compounds were selected and subjected to molecular docking studies based on the inhibition results obtained. Results: Out of the 40 compounds examined, seven samples exhibiting the most pronounced inhibitory effects were chosen for further scrutiny and IC50 determination. Notably, derivatives 6b and 20b demonstrated the most robust inhibitory effects, with IC50 values of 0. 37 and 0. 69 μM, respectively. Examining the interactions between these compounds and the aromatase enzyme revealed a significant relationship with the enzyme's active site. Conclusion: In conclusion, the evaluation of various derivatives containing the triazolyl chromanone oxime ether structure suggests their considerable potential as aromatase enzyme inhibitors. Further exploration involving the design of structures within this category holds the promise of yielding more effective derivatives for inhibiting this enzyme.

Background and purpose: Cilostazol is a prescription medication for intermittent claudication in patients with peripheral artery disease. Previous research has demonstrated that this 2-oxoquinoline derivative possesses antithrombotic, vasodilator, antimitogenic, and antioxidant effects. Cilostazol exerts its products through the inhibition of PDE3 activity and the prevention of cAMP degradation. The present study aimed to examine the protective properties of cilostazol against carboplatin-induced cytotoxicity and genotoxicity in Beas-2B and human blood lymphocyte cells. Materials and methods: cells were pre-treated with different concentrations of cilostazol (5, 25, 50, and 100 μM) with carboplatin at an optimum cytotoxic dosage (9. 2 µM). The MTT and micronucleus assays were used to assess cytotoxicity and genotoxicity. Statistical analysis was performed using the one-way ANOVA in Prism Ver. 8 software. Results: The cytotoxic effect of carboplatin was dose-dependent, as evidenced by the 48h culture treatment with concentrations of 0. 3, 1, 3, 10, and 30 µM. Pre-treatment of cilostazol at 25, 50, and 100 µM with carboplatin at 9. 2 µM enhanced cell viability in Beas-2B cells compared to the carboplatin alone as positive control. Additionally, cilostazol at 50 and 100 µM showed its potent genoprotective effects via micronucleus assay against carboplatin at IC50 at blood lymphocyte cells. Conclusion: Cilostazol provided conceivable protective effects by modulating cytotoxicity and genotoxicity induced by carboplatin in Beas-2B and human blood lymphocyte cells.

Background and purpose: Bacterial infections are treated with antibiotics, but the development of multi-drug resistant strains, which are growing at an increasing rate, is a phenomenon that threatens human societies. Therefore, alternative strategies are needed to combat infectious diseases. Today, compounds that reduce the pathogenicity of bacteria and do not interfere with their survival or growth are introduced as the next generation of antibiotics. Pseudomonas aeruginosa is one of the important and hazardous pathogens that employs its quorum-sensing network to regulate pathogenicity and virulence factors production. Here, we investigated the effect of a natural naphthoquinone compound, Lawsone (isolated from Henna), and its synthetic derivatives on the quorum-sensing system of P. aeruginosa PAO1. Materials and methods: First, the MIC of each compound was evaluated. Then, the effect of the selected compounds on biofilm formation and survival rate of biofilm sessile cells was investigated by colorimetric method. Finally, the virulence factors secretion of P. aeruginosa, including pyocyanin, pyoverdine, and protease was studied in the presence of the selected compounds. Results: The results indicated that Lawsone and NO2-481 reduced the production of P. aeruginosa biofilm by about 79% and 92%, respectively. Moreover, Lawsone and NO2-481 (at both concentrations, 250 and 125 µg/mL) decreased the viability of biofilm cells by about 70%. Furthermore, NO2-481 reduced the production of virulence factors including pyocyanin and pyoverdine by about 55% and 81%, respectively,however, it did not affect the protease production. Conclusion: NO2-481 derivative has the ability to reduce the pathogenicity of P. aeruginosa, and if it is proven to be non-cytotoxic, it can be assessed through animal and clinical studies, to be applied as an alternative compound along with antibiotics or disinfectants

Background and purpose: Bleeding during rhinoplasty is a complication that causes the surgeon to lose vision and will cause other complications. So far, various methods have been proposed to reduce bleeding during nose surgery. The present study aims to compare the effect of oral clonidine and tranexamic acid on intraoperative bleeding in patients undergoing rhinoplasty. Materials and methods: In this randomized, double-blind clinical trial, 120 patients who were candidates for elective rhinoplasty surgery were included. In the first group, three µg/kg of clonidine was administered orally 90 minutes before surgery. In the second group, 250 µg/kg bw tranexamic acid capsules were administered orally two hours before surgery. There was no intervention in the control group. Bleeding levels, hemodynamic parameters, and surgeons' visual satisfaction were evaluated. Results: The mean age of patients (28. 67±5. 35) years and 96 (80. 0%) were women. Regarding the effect of drug and surgeon’s visual satisfaction, there is a significant difference between the clonidine and tranexamic acid groups (P=0. 055),the mean bleeding volume in the clonidine group was 112. 0±0. 47 and in the tranexamic acid group was 132. 0±0. 36. In addition, the clonidine group (P=0. 008) and tranexamic acid (P<0. 001) showed a significant difference in terms of bleeding volume compared with the control group (195. 0±28. 1). The three variables of drug type, weight, and duration of anesthesia can explain and predict 51% of the changes (blood volume). Conclusion: The results of the present study showed that clonidine can be more effective in reducing bleeding than tranexamic acid, and by creating a relatively dry and bleeding-free environment, it can improve the quality of the surgeon’s vision and reduce the duration of rhinoplasty surgery.

Background and purpose: A bone marrow examination is necessary to diagnose some hematologic diseases. In this study, we compared the effects of acetaminophen and promethazine versus intravenous injections of midazolam and pethidine on pain reduction after bone marrow sampling. Materials and methods: In this study, 88 patients were divided into two groups. The first received one gram of acetaminophen as an infusion and 25 milligrams of promethazine syrup 30 minutes before the procedure. The second group received intravenous injections of 25 milligrams of pethidine and 5 milligrams of midazolam five minutes before the procedure. In two groups, local anesthesia with lidocaine was given before the procedure. The pain and presence of anxiety in the patients were assessed using a 10-point Likert scale. Results: We analyzed the results of 88 patients. At 30 minutes after sampling, patients in the pethidine-midazolam group reported lower pain compared to those in the promethazine-acetaminophen group (1. 18±0. 90 vs. 1. 77±0. 99) (P=0. 004). This difference was particularly notable among men (0. 90±0. 98 vs. 0. 99±1. 67) (P=0. 001). Among men, those older than 30 years showed a reduction in pain (1. 01±0. 9 vs. 0. 99±1. 46) (P=0. 049). No significant difference was observed between the two groups in terms of pain immediately after sampling. The administration of promethazine and acetaminophen showed a more positive future perspective in patients older than 46 years (P=0. 033). Additionally, the average incidence of anxiety 30 minutes after the procedure was 27. 3% in the pethidine-midazolam group and 22. 7% in the promethazine-acetaminophen group. However, there was no significant difference in the level of anxiety between the two groups (P=0. 806). Conclusion: Based on our data, the combination of promethazine and acetaminophen had similar analgesic effects to the combination of pethidine and midazolam immediately after sampling. As a result, according to the various side effects of pethidine and midazolam, especially in patients with respiratory diseases and outpatients, the combination of promethazine and acetaminophen can be used.

Background and purpose: Chronic obstructive pulmonary disease (COPD) is a progressive pulmonary ailment characterized by prolonged respiratory symptoms and airflow constriction. COPD stands as the third most prominent cause of mortality on a global scale. It is commonly linked to numerous extra-pulmonary conditions, such as cardiopulmonary disorders, musculoskeletal frailty, and anemia. Osteoporosis, regarded as one of the principal systemic complications arising from COPD, represents an elevated susceptibility to osteoporotic fractures and imposes a significant financial burden. Considering the clinical significance surrounding the emphysema phenotype in COPD, as well as the lack of investigation on this matter in the country, the objective of this study is to determine the comparative prevalence of osteoporosis and osteopenia in COPD patients, with and without emphysema, who receive medical attention at Tubi Sari Clinic and Imam Khomeini Hospital in Sari. Materials and methods: This cross-sectional study was conducted in 2021 on patients referred to the rheumatology and lung clinic, and COPD patients admitted to Imam Khomeini Hospital in Sari. In this study, 50 patients with COPD with emphysema as a case group and 50 patients with COPD without emphysema as a control group were included in the study. Then, using densitometry and examining the bone mass density of all COPD patients, the patients were divided into two groups: with and without osteoporosis. Then, the patient's information was entered into SPSS software and analyzed. Results: There was no significant difference in vitamin D serum levels, vertebral fracture score, or BMD between emphysema and non-emphysema patients (P=0. 09, P=0. 098). Multivariate analysis showed that (in a model including age, BMI, FEV1, PaO2, emphysema score, CRP, and dyspnea score) only BMI, FEV1, and PaO2 decreased as independent risk factors for low BMD. Conclusion: Our findings showed that emphysema is an independent risk factor for osteoporosis according to the multivariate model. Low BMI, severity of COPD, and hypoxia play a dominant role in the development of osteoporosis.

Background and purpose: The coronavirus epidemic has had a significant impact on people's lives and has created many problems in the economic, scientific, environmental, and personal dimensions of people's lives. Fertility in women was one of the threats addressed during the Covid-19 pandemic. The purpose of this study was to evaluate the quality of life, marital satisfaction, and anxiety, depression, and stress in women of reproductive age referring to medical centers covered by Mazandaran University of Medical Sciences during the COVID-19 pandemic. Materials and methods: The current study was descriptive and analytical in a cross-sectional manner. The statistical population included all women referred to medical centers covered by Mazandaran University of Medical Sciences from March 1399 to March 1400, who were questioned in two periods. Data were collected using a questionnaire that included demographic information, pregnancy, and COVID-19 disease. Also, the information related to the quality of life of the participants in the study was evaluated using the SF-12 questionnaire, anxiety, depression, and stress of the participants with the Lovebond scale (DASS), and marital satisfaction with the Enrich questionnaire. The collected data were analyzed using SPSS 24 software. Results: 1759 women of reproductive age participated in this study. All participants (100%) were married, with an average duration of marriage of 8. 5±1. 5 years. 14. 1% of women were infected with COVID-19 during the study. 7. 2% of women had at least one underlying disease, hypothyroidism (4. 3%), diabetes (1. 3%) and hypertension (0. 1%) being the most common cases. There were diseases. The results indicated a decrease in people's physical health and emotional problems due to the changes in their quality of life due to the outbreak of Covid-19. About 99% of women showed mild and moderate symptoms of mental disorders, including depression, anxiety, and stress, during the study. The participants' stress levels decreased over time (9. 6±8. 83 vs 8. 3±69. 7), and their marital satisfaction increased (2. 91±0. 3 vs 2. 95±0. 31, P=0. 0). Also, the findings of the research showed that people's quality of life had a negative and significant relationship with the amount of mental disorders. Conclusion: The results of the study revealed an increase in marital satisfaction during the Covid-19 period. The study participants' quality of life had a significant difference in the two time periods. Consequently, special attention to Women of reproductive age, increasing their general and sexual awareness, and providing positive psychological programs in crisis conditions are recommended in formulating health policies and programs

Background and purpose: This study investigated the oral health-related quality of life (OHRQoL) in patients with ulcerative colitis. Materials and methods: This descriptive-analytical cross-sectional study was conducted on 77 patients with ulcerative colitis in the Tooba dental clinic in 2023, with inclusion and exclusion criteria investigated. The OHIP-14 questionnaire was prepared from the patients and scored using two different methods. Dry mouth, DMFT, PI, GI, and SBI indices were recorded during the clinical examination. Finally, the data are analyzed statistically. Results: In this study, the participants were categorized according to the use or non-use of removable prostheses. Statistically, women used removable prostheses significantly more (P=0. 021). The average age of patients with removable prostheses was higher (P=0. 003). Also, the OHRQoL score increased by 0. 24 (P=0. 034) as the age of the patients increased each year. OHRQoL score was higher in patients with removable dental prostheses (P=0. 020). In general, patients had a higher OHRQoL score with alcohol consumption (P=0. 007). In patients with removable prostheses, the average OHRQoL was significantly higher in patients with dry mouth (P=0. 038). Conclusion: In the studied population of patients with ulcerative colitis, overall oral health-related quality of life (OHRQoL) was found to be worse in individuals with removable prostheses, older age, and alcohol consumption. Additionally, no significant relationship was observed between OHRQoL and smoking, dry mouth, or oral-dental indices (PI, GI, DMFT, and SBI).

Background and purpose: Pedestrians are the most vulnerable people in the traffic system, and every year, thousands of pedestrians are injured or killed due to traffic accidents. The behavior of pedestrians is one of the human factors involved in traffic accidents. In the meantime, the damage is more in the age groups of 60 years and older. Therefore, the present study was conducted to determine the relationship between fear of falling and functional status with the traffic behavior of older pedestrians in Sari City. Materials and methods: The present study is a descriptive-analytical cross-sectional study conducted in Sari City in 2022-2023. The research population included all the older adults aged 60 years and above receiving care in the health centers of Sari City. Considering the inclusion and exclusion criteria and using multistage random sampling, 630 people were determined as the sample size. In order to collect information, a demographic characteristics questionnaire, Womac functional status questionnaire, fear of falling (FES), and traffic behavior were used. The data was analyzed using SPSS-22 statistical software. The significance level of the tests was considered to be 0. 05. Results: The average age of the older participants was 67. 34±7. 61 years. 53. 2% of the participants were male, and 71. 4% were married. The mean and standard deviation of functional state scores, fear of falling, and traffic behavior were 56. 65±17. 62, 30. 69±12. 56, and 106. 06±12. 01, respectively. Correlation results showed that functional status has a significant inverse correlation with fear of falling (P<0. 001 and r=-0. 22) and a positive significant correlation with traffic behavior (P<0. 001 and r=0. 32). No significant relationship was observed between fear of falling and traffic behavior. Gender, marital status, duration of walking, means of transportation, and age had a significant relationship with fear of falling and functional status (P<0. 001). Walking time was significantly related to traffic behavior (P<0. 001). Conclusion: According to the results of the study, the fear of falling and the physical condition of the older have an effect on their traffic behavior, which may increase the number of accidents in this group, so it is important to pay attention to this issue among drivers.

Background and purpose: Breast cancer is one of the most common cancers among women. Abnormal expression of microRNAs is associated with cancer. Therefore, this study aimed to evaluate the expression of miRNA-210 in the serum of breast cancer patients. Materials and methods: The studied population included 49 breast cancer patients and 55 healthy individuals, and the samples were evaluated using Real Time PCR. Results: The data analysis of this study revealed that the expression level of miR-210 in the blood of breast cancer patients is significantly higher compared to the blood of healthy people. Also, there is a negative correlation between the age of breast cancer patients and the expression of miR-210 (r=-0. 309, P=0. 031) and a significant positive correlation between the increase in the expression of mir-210 and the expression of the Ki-67 marker (r=0. 412, P = 0. 004).

Background and purpose: Today, scorpion stings are one of Iran's most significant health and medical problems. Regarding the favorable weather conditions, Shush created a suitable environment for scorpions. Given the importance of this question, a study was conducted on the species composition, temporal distribution, and degree of dependence of scorpion species on the environment regarding soil texture and moisture level in Shush in 2019. Materials and methods: In this fundamentally applied research, scorpion samples were collected in designated areas using an active search method during the day and night. The samples were identified under a stereomicroscope using valid keys. Results: The species Mesobuthus eupeus (61/6%), Androctonus crassicauda (5. 3%), Hottentotta saulcyi (1. 2%), Compsobuthus matthiesseni (11. 1%), Razianus zarudny (0. 62%), Hemiscorpius leptorus (18. 3%), and Scorpio maurus (1. 9%) belonging to the families Buthidae, Scorpionidae, and Hemiscorpiidae have been identified. Mesobuthus eupeus, Hemiscorpius leptorus, and Compsobuthus Matthiessen prefer loamy, silty, sandy loam soils. Androctonus crassicauda species prefer the silty loamy, loam, and sandy loam soils. Conclusion: Based on the findings, it can be concluded that due to the temporal distribution of scorpion abundance, which gradually peaks from April to September, actions to control the scorpions and prevent their stings should be carried out as a function of their mass over the months, along with the characteristics of their habitats.

Background and purpose: Selenium, a rare and essential element, is crucial in various skin diseases. Given its significance, this study aimed to investigate the serum selenium levels in patients with genital warts and compare them with those of healthy individuals. Materials and methods: This case-control study involved 40 patients with genital warts and 40 healthy individuals. Serum selenium levels were measured using a Calbiotech laboratory kit with two cc of intravenous blood samples. Demographic characteristics and disease-related factors, including disease duration, severity of genital warts, and areas of skin involvement, were recorded. Data were analyzed using SPSS software version 20. Results: In the case group, the average age was 30. 68±9. 38 years, and in the control group, it was 34. 30±6. 90 years (P=0. 060). The mean serum selenium level in the case group was lower than in the control group (83. 92±35. 43 vs. 93. 62±26. 29 ng/ml, respectively, P=0. 168). Notably, there was no statistically significant difference in serum selenium levels with age (P=0. 051), gender (P=0. 062), number of lesions (P=0. 750), disease duration (P=0. 938), disease severity (P=0. 618), or areas of skin involvement (P=0. 349). Conclusion: Patients with genital warts exhibited lower serum selenium levels than their healthy counterparts, suggesting a potential correlation between weakened immune system strength and increased inflammatory conditions. Future studies are imperative to delve deeper into the immunomodulatory role of trace elements, such as selenium, in human papillomavirus infections and various skin wart types.

Background and purpose: Depression is one of the significant and common disorders in the elderly. Considering that nutrition plays a crucial role not only in the onset but also in the severity and duration of the depressive episode, the aim of the present study is to investigate the relationship between the Healthy Eating Index (HEI) as an alternative indicator of healthy eating and the dietary quality score with depression in the elderly residents of Shiraz. Materials and methods: In this cross-sectional study on 80 older adults living in Shiraz, information regarding people's dietary intake was gathered with a 147-item food frequency questionnaire (FFQ). Adherence to healthy eating patterns was assessed using HEI. Diet quality was assessed by DQI-I, which includes four main components of the diet. For evaluating depression, the Beck Depression test was used. The association between food indices and depression was assessed by linear regression in two crude and adjusted models. Results: Of the 80 people studied, 50% were women. The mean and standard deviation of the age of the studied subjects were 66. 18±5. 67 and 65. 18±6. 9 years, respectively. The relationship between the diet quality index and depression score showed an inverse and significant relationship, so an increase in the diet quality index was associated with a decrease in depression score (beta coefficient:-0. 281 and P=0. 036). This index remained significant after adjusting for age, gender, level of education, body mass index, and energy (P= 0. 049). Conclusion: The findings of the current study revealed that Adhering to a diet with higher DQI-I had an inverse association with the risk of depression in the elderly. Further research is needed, especially prospective studies, to confirm these findings in Middle Eastern societies.

Background and purpose: The purpose of this study was to investigate the state of anxiety as one of the indicators for determining the mental health of Sari dental students during the COVID-19 virus epidemic. Materials and methods: This cross-sectional study was conducted in the year 1400 among all incoming students from 95 to 97, selected by census method, including 143 people in the Faculty of Dentistry of Mazandaran University of Medical Sciences in Sari City. The tools for collecting the required information are a demographic questionnaire and a researcher-made questionnaire on anxiety caused by COVID-19. Based on the score obtained by the participants in this questionnaire, they were divided into three anxiety levels, which included low, medium, and high. Data analysis was done with a chi-square test in SPSS software. Results: 143 people, including 47 (32. 9%) people from the 2016 entry, 55 (38. 5%) people from the 2017 entry and 41 (28. 7%) people from the 2018 entry participated in this study. 73 (51%) of the participants were women. The results of this study showed that 50. 3% of students experience a low level of anxiety, 46. 9% experience a moderate level of anxiety, and 2. 8% experience a high level of anxiety. Also, a significant relationship between the academic year and the level of anxiety was observed so that the students of the newer year showed a higher level of anxiety. There was no significant relationship between gender and place of residence with anxiety level (P>0. 05). Conclusion: There is a significant relationship between the level of anxiety and the academic year of the students. In this way, the stress level is higher in the newer entries. To reduce the anxiety level of students, there is a need to revise the management of infection control, improve the work environment, and learn how to deal with patients to protect everyone, as well as education and support from academic institutions.

Background and purpose: Coronavirus disease 2019 (COVID-19) is a multi-organ illness characterized by significant involvement of the coagulation cascade, immune response, and inflammation. This investigation aimed to explore the significance of various biomarkers, such as interleukin 6 (IL-6), lactate dehydrogenase (LDH), D-dimer, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP), concerning lung complications in COVID-19 patients. Materials and methods: This retrospective study was conducted at Imam-Sajjad Hospital in Ramsar, Mazandaran, from May to August 2021 and focused on all COVID-19 patients with lung involvement who were admitted. An experienced radiologist assessed each patient's computed tomography (CT) scans and assigned a lung involvement score ranging from zero to 10 for each lung. These scores were categorized as mild (0-10), moderate (10-15), or severe (15-20). In addition to demographic data, serum levels of IL-6, LDH, D-dimer, and NT-proBNP were obtained from patient records, and all the achieved data were statistically analyzed. Results: A total of 154 patients were included. The distribution across mild (27. 3%), moderate (33. 7%), and severe (39%) lung involvement in COVID-19 was observed. Notably, levels of IL-6 (P=0. 002), D-dimer (P=0. 035), and LDH (P<0. 001) exhibited variations among these three groups of COVID-19 lung involvement. Furthermore, statistically significant positive correlations were observed between the calculated lung involvement score and plasma levels of IL-6 (P=0. 008, r= 0. 280), D-dimer (P=0. 008, r= 0. 307), and LDH (P<0. 001, r= 0. 320). Conclusion: This study suggests that plasma levels of biomarkers, including IL-6, D-dimer, and LDH, may be associated with lung involvement in COVID-19 patients.

Background and purpose: Sexual health is a vital part of the life of infertile couples and is influenced by many factors. The psychological consequences of infertility can negatively affect sexual function. Several medical societies have strongly recommended psychological interventions, including counseling and education, to help infertile couples. Therefore, the purpose of this study is to investigate the effect of sexual counseling and education approaches on improving the sexual function of infertile women in Iran. Materials and methods: The present systematic review, conducted based on the PRISMA guide, Embase, Cochrane Library, PubMed, Scopus, web of Sciences, Magiran, and SID databases, was searched until April 2023 by English and Persian languages. All randomized clinical trials that evaluated the effect of educational or counseling interventions on improving the sexual function of infertile women in Iran were included in this review. The outcome measure was the Female Sexual Function Index (FSFI). Results: From a total of 365 studies found through the search, 13 randomized clinical trials involving 693 infertile women were systematically reviewed. According to the review of studies, cognitive-behavioral therapy, acceptance and commitment therapy, sexual health model, PLISSIT model, BETTER model, communication skills training, and transactional analysis therapy have been used in the field of improving the sexual function of infertile women. Conclusion: Counseling and sexual education approaches improve sexual performance. But according to the type of counseling or education, the improvement of sexual function dimensions is different. It is suggested that more studies be conducted in the future in the field of comparing these approaches with each other and their long-term effects on infertile women in Iran.

Background and purpose: Artificial intelligence (AI), as a novel technology, has a wide range of applications in pharmaceutical education, one of the most important being improving the learning and teaching process. However, using AI in pharmaceutical education requires attention to ethical and legal issues. This review article explores the applications of AI in pharmaceutical education and discusses the legal and ethical challenges associated with its use. Materials and methods: This study reviews the application of AI in pharmaceutical science, particularly its various aspects in teaching pharmacy students. It also describes the legal and ethical challenges of using AI in this field. Results: The most important applications of AI in pharmaceutical education include increased personalization, improved efficiency, and effectiveness of the learning process. Additionally, using virtual assistants and AI chatbots to increase interaction and motivation, speeding up exam processes and grading, and using simulation technologies to enhance laboratory and clinical skills are effective. The most significant ethical challenges in the functioning of AI include inequality, racial discrimination, inaccurate data processing, and more. From a legal perspective, concerns such as insufficient protection of personal information, lack of privacy protection, responsibility, and liability identification mechanisms in case of damage caused by the tool's performance exist. Conclusion: Despite the useful applications of AI in personalized education and increasing efficiency and motivation of pharmacy students, ethical and legal challenges such as privacy protection, elimination of discrimination, intellectual property rights, and transparency in accountability can be addressed to alleviate concerns associated with the use of this new technology.

Microplastics (MPs) and nanoplastics (NPs) have attracted significant attention due to their ubiquitous environmental presence and unique physical and chemical properties. MPs refer to plastic particles with sizes smaller than 5 micrometers, while NPs are particles with sizes smaller than 100 nanometers. Both types exist in the environment, can sediment, traverse biological barriers, and transport chemicals. Confirming their presence in human feces, meconium, and placenta underscores their potential impact on human health. These particles can enter the human body through inhalation, food and water consumption, mucus, skin, and ingestion of microplastic products. They can negatively affect the health of children, infants, and pregnant women. This can be particularly concerning and damaging to this group of individuals due to their immature immune systems and developing organs, and can lead to further harm. Pregnancy, infancy, and childhood are sensitive periods for environmental exposure. Therefore, further research on the effects of microplastics on children, infants, and pregnant women is necessary, and appropriate policies should be developed to reduce plastic use and protect the health of these groups.

Toxoplasma gondii (T. gondii) is the cause of toxoplasmosis, an infection with worldwide distribution. Considering the burden of congenital toxoplasmosis, opportunistic toxoplasmosis infection in immunocompromised patients, and the increasing of these patients, regarding the variety of weather conditions and social factors in Iran, evaluation and improvement of the methods of controlling and preventing toxoplasmosis is necessary in the country. The lack of a mandatory national program for the control and prevention of toxoplasmosis, the failure to implement a regular screening program during pregnancy, the lack of a national network for registering positive cases of congenital toxoplasmosis, and the need to improve the quality of educational programs are among the most important challenges in the future. In this regard, the researchers of the Toxoplasmosis Research Center have introduced and proposed new programs for the control and prevention of toxoplasmosis in Iran and presented solutions to the mentioned challenges to be given to the policymakers for the Ministry of Health and the universities of medical sciences in the current policy summary report. To develop a control and prevention program for toxoplasmosis in Iran, the following goals should be considered: prevention of congenital toxoplasmosis, regular screening during pregnancy and follow-up of seronegative cases, secondary prevention of congenital toxoplasmosis based on screening and treatment before the birth of the baby, follow-up of treatment in IgG and IgM positive infants to prevent ocular toxoplasmosis in the future, health education for women in reproductive age, examination of knowledge and awareness of pregnant women about toxoplasma and its transmission routes, prevention of toxoplasmosis in other patients, the establishment of a reference laboratory for toxoplasmosis diagnosis, prevention of infection in animals and disinfection in meat, reduction of environmental pollution and public education