JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2024 | Volume:34 | Issue:232|Papers Count:26

2Background and purpose: Among the accidents that threaten human life, burn accidents are one of the worst. Burns are the fourth most common trauma worldwide and cause death, disability, pain, and many other problems. Faster healing of burn wounds is one of the health priorities of countries and it's important as a principle in the science of treatment. This research aims to determine and compare the effectiveness of hydrogel dressings containing allantoin and silver nanoparticles in the treatment of second-degree burn wounds. Materials and methods: This study was designed as a randomized controlled clinical trial. A total of 86 patients were selected in the study based on the inclusion and exclusion criteria and were randomly divided into two groups: A=43 and B=43, using a block method of 4. Group A patients received hydrogel containing silver nanoparticles and allantoin with a thickness of 2 millimeters and then sterile gauze and bandage on top of it, and group B patients received the usual treatment (Vaseline gauze, 0.5% acetic acid and 1% betadine). Local treatment was performed every 48 hours, and dressing was applied after each treatment. The condition of the wounds, including the presence or absence of granulation tissue, bleeding, pain, infection, and other wound complications or healing factors, was recorded and evaluated by visiting and observing every 48 hours. Results: The average age in the intervention group was 10.2 years and in the control group was 9.9 years, and the difference was not statistically significant, P=0.456. 48% of the patients in the intervention group were male 52% were female, and in the control group, 44% were male and 56% were female, and the difference was not statistically significant, P=0.665. The average percentage of burns in the intervention group was 9.04% and in the control group was 9.58%, which was not statistically significant P=0.289. The type of burn in the intervention group was liquid 69% and flame 31%, and in the control group, liquid 65% and flame 34%, which was not statistically significant P=0.645.The intervention group had 55% of limbs and 45% of trunk and the control group had 63% of limbs and 37% of trunk, which difference was not statistically significant, P=0.510. In other words, the two groups were homogenous in age, sex, average burn percentage, burn mechanism, and location, and there were no significant differences. The average onset of epithelialization in the intervention group was 4.5 days (74% of patients on day 4 and 23% on day 6) and 6.4 days in the control group (60% of patients on day 6 and 30% on day 8), which was statistically significant P<0.001. The average intensity of pain in the intervention group was 5 out of 10 and in the control group was 7 out of 10, and this difference was statistically significant P<0.001. Conclusion: The results of this study show that patients treated with a hydrogel dressing containing silver nanoparticles and allantoin had a statistically significant difference in the onset of wound epithelialization and pain intensity, compared to the usual dressing. This dressing can be used as a suitable alternative in the treatment of second-degree burn wounds compared to routine dressings. Therefore, offering it to the medical team, who play an essential role in the treatment of patients with burns, will reduce the length of hospitalization and the costs. (Clinical Trials Registry Number: IRCT20210918052511N2)

2Background and purpose: Methamphetamine is one of the stimulant drugs that leads to the occurrence of cognitive and behavioral dysfunctions. Among the disorders that occur after methamphetamine abuse are learning and memory disorders as well as social interactions and anxiety. On the other hand, the function of sex steroids in the development of brain regions involved in reproduction has been the subject of extensive research over the years. In this context, testosterone plays an important role in neuronal and glial organization in prenatal and postnatal periods. Recent studies showed the effect of sex hormones on the nervous system and highlight the brain as a main target tissue for androgens. On the other hand, studies have shown that testosterone has neuroprotective effects against cognitive and behavioral disorders. Clinical manifestations of testosterone-related brain changes include cognitive impairments such as reduced memory efficiency related to the frontal cortex, as well as reduced long-term memory related to the hippocampus and other temporal regions of the midbrain. Androgens, especially testosterone, play an important role in memory function whereby the decrease and absence of testosterone leads to cognitive impairment and also neurodegenerative conditions such as Alzheimer's disease, Parkinson's disease, and Huntington's disease. Therefore, in this study, the role of testosterone hormone in social memory, novel object recognition memory, as well as anxiety-like behavior and brain edema induced by a neurotoxic regimen of methamphetamine were investigated. Materials and methods: This study was conducted on 48 gonadectomized rats in 6 groups including control groups, methamphetamine (6mg/kg), solvent (sesame oil), methamphetamine + testosterone (0.25mg /kg), methamphetamine + testosterone (0.5 mg/kg) and methamphetamine + testosterone (1 mg/kg) were performed. At first, mice were anesthetized and gonadectomy surgery was performed. After 2 weeks of recovery, the evaluation of social memory was done using the three-chamber social interaction test, and anxiety-like behavior index using the open field test. Finally, the animals were killed and the brain tissue was evaluated for brain edema. Results: The findings of the study showed that social memory was significantly impaired in rats that received methamphetamine compared to the control group (P<0.001). On the other hand, results showed that there was a significant increase in anxiety-like behaviors as well as brain edema in rats that received methamphetamine (P<0.001). Statistical analysis also showed that the administration of testosterone hormone was able to improve cognitive functions and reduce anxiety-like behaviors and brain edema caused by methamphetamine (P<0.05). Conclusion: Overall, the present study suggests that the male sex hormone testosterone can be effective in improving behavioral disorders and anxiety, as well as brain edema caused by the administration of methamphetamine. Further research is needed to investigate the cellular and molecular mechanisms of the effects of this hormone.

2Background and purpose: Unpredictable stressors cause changes in behavioral parameters such as motor and exploratory behaviors, feeding, and sexual and anxiety behaviors. Stress leads to the release of corticosteroids and, as a result, causes dysfunction in different parts of the nervous system. A decrease in the synaptic levels of serotonin or norepinephrine in different parts of the brain such as the prefrontal cortex and a decrease in BDNF production in the hippocampus may also contribute to stress-related complications. Posttraumatic stress disorder occurs in some people after facing a severe stressful event. In PTSD, the activity and function of many physiological systems are disturbed. Fluoxetine, or Prozac, is used to treat neurological disorders such as depression and anxiety and inhibits the reuptake of serotonin by the serotonin transporter (SERT) in neurons. Some studies have shown that females respond better to SSRI antidepressants than males, which may be due to the interaction between estrogenic and serotonergic pathways. BDNF is a member of the neurotrophin family and is expressed in several tissues and cells such as the brain and blood. Its role in several mental disorders, such as depression, anxiety, eating disorders, and PTSD, has been identified. SPS (single prolonged stress) as an animal model of PTSD decreases the mRNA expression of BDNF in hippocampus rats and causes anxiety-like behaviors. The role of gender differences in the effect of antidepressants and clinical interventions in psychotic diseases is also discussed. Sex hormones in women affect the pharmacokinetics and efficacy of antidepressants. Women respond better to fluoxetine than men during reproductive years. Considering the different results regarding the effectiveness of effective drugs in the treatment of psychotic diseases in both sexes, in this study, we aim to investigate the response of male and female rats exposed to stress to the trial of fluoxetine. Materials and methods: In this experimental study, Wistar male and female rats with an average weight of 200-250 grams were used (56 animals, 8 groups of 7). The selection of the number of animals was based on previous studies in this field. After the drug intervention period, and fear and anxiety suppression test, the animals were killed under deep anesthesia, and a blood sample was collected to prepare serum to measure BDNF and corticosterone levels (using the Eliza kit of Germany Zelbio Company and according to the kit protocol). All experiments were performed according to the laboratory animal protocol of Mazandaran University of Medical Sciences. The work steps are as follows: 1. Creation of PTSD through SPS was done in three stages, 2. Drug intervention: the drug dose for all groups is 10 mg/kg/day for 4 weeks dissolved in drinking water, 3. Evaluation of anxiety-like behaviors with the light-dark box (L/D BOX), 4. Evaluation of the ability to forget painful memories with the fear silence test, 5. Measurement of BDNF and corticosterone in serum by Eliza method. Results: In this study, it was observed that male and female rats that were exposed to single prolonged stress showed a decrease in fear extinction an increase in anxiety-like behaviors in the dark-light box test, and an increase in serum corticosterone. Fluoxetine led to an increase in the percentage of fear extinction, a decrease in the Entrance Latency in the light area, the Time in the Light Compartment, the number of rearing, and a decrease in serum corticosterone significantly in both sexes(P<0.05). The change in serum BDNF levels in both sexes before and after stress was not significant. Conclusion: The results of the study showed that exposure to stress leads to behavioral and biochemical damage in male and female rats. The use of fluoxetine 10 mg/kg for 4 weeks improved the damage caused by stress, but there was a significant difference in Response of both genders to the above treatment was not observed.

2Background and purpose: Due to emerging antibiotic-resistant bacteria, finding effective alternative antimicrobials to combat the bacteria is unavoidable. Bacteriophage therapy as a biologic and highly potentiated therapeutic approach was considered recently. This study aimed to isolate lytic bacteriophage(s) against multi-drug resistant clinical isolates of Klebsiella pneumonia and evaluate the morphological and biological characteristics as candidates for phage therapy. Materials and methods: Obtained clinical isolates from Shahid Madani Hospital in Tabriz, were confirmed as K. pneumoniae, and an antibiotic sensitivity test was performed using the standard disk diffusion method. Then, the isolation of lytic bacteriophages against 16 selected antibiotic-resistant bacterial isolates was carried out. Briefly, samples for phage isolating were gained from sewage water and centrifuged. The supernatant was filtered using a 0.45 µm Filter, mixed with fresh tripton soy broth medium and magnesium sulfate and incubated at room temperature. Then, the solution was mixed with chloroform and evaluation of plaque formation was performed using the agar bilayer technique. Genomes of the bacteriophages were subjected to molecular analysis using Hind III and EcoRV enzymes. Host range determination of the isolated bacteriophages was evaluated using spot test and agar bilayer techniques. Three bacteriophages with a broader host range than others were selected for more characterization. One step growth curve of the phages was drawn and their latent period and burst size were investigated. Then, the stability and survivability of the isolated lytic bacteriophages to different temperatures (-20, 37, 50℃), different rates of pH value (3,4,5,7,9,11,12), and also UV radiation were evaluated. Finally, morphological characteristics of bacteriophage with the broadest host range (PKpMa2/20) were investigated using electron microscopy. Results: 36 clinical bacterial isolates were confirmed as K. pneumoniae based on standard biochemical tests. In the antibiotic susceptibility assay, it was revealed that the highest and lowest rates of antibiotic resistance belonged to cefazoline (80%) and tobramycin (26%) respectively. Isolation of bacteriophages against all 16 selected isolates was successfully performed. After the extraction of the genomes of the phages, a high variety of genome sequences was detected according to molecular analysis. In host range determination, PKpMa2/20 had lytic activity against 11 of 15 isolates. In a study of the one-step growth curve of the phages, with a broader host range than other isolated bacteriophages, latent periods were shown 10, 10, and 15 min and their burst size were 350, 210, and 180 pfu/ml respectively. All of the phages showed appropriate stability in temperatures of -20 and 37 ℃. In the temperature of 50℃, the survivability of PKpMa2/20 was higher than two other phages. Also, PKpMa2/20 was stable in the pH range of 3-12; in the pH value of 3, two other phages stability was ceased but PKpMa2/20 showed appropriate lytic activity. In electron microscopy, PKpMa2/20 had a short tail length of 10 nm and a head with a diameter of about 60 nm that possibly belonged to the family Podoviridae.  Conclusion: Based on appropriate lytic effects, latent period, and burst size of the three isolated bacteriophages in the current study, especially PKpMa2/20, and also, their high stability to different temperatures, pH, and UV radiation, they could be considered as candidates for phage therapy to control resistant strains of K. pneumoniae infections but for the therapeutic use of theses phages, more molecular analysis is needed.

2Background and purpose: Leishmaniasis is a disease caused by the Leishmania parasite and transmitted through the bite of a specific type of mosquito. This disease appears in three forms: cutaneous, cutaneous-mucosal, and visceral. Cutaneous leishmaniasis (CL) is a tropical disease caused by an intracellular parasite of the genus Leishmania. This disease is the most important endemic disease in Iran. Changes in plasma hormone levels have been reported in many parasitic infections, and changes in hormone levels can lead to changes in cytokine profiles. The immune-endocrine system interaction plays an important role in the pathogenesis of cutaneous leishmaniasis. Also, the level of some hormones is related to the level of cytokines and clinical symptoms. The purpose of this study is to evaluate the plasma levels of hormones (cortisol, DHEA-S, estradiol, prolactin, and testosterone) and cytokines (interferon-gamma, TNF-α, IL-4, and IL-10) in patients with cutaneous leishmaniasis and the control group. Materials and methods: This study was carried out in the cities of Abadan and Khorramshahr located in Khuzestan province in the southwest of Iran. After obtaining permission from the ethics committee of Behbahan Faculty of Medical Sciences and obtaining consent from all subjects under the study, a questionnaire including demographic information was completed by all subjects participating in the study. An amount of 5 ml of blood was prepared from each person under study and after centrifugation at 4000 rpm for 10 minutes, the serum was kept at minus 20 degrees Celsius until the day of the experiment to measure hormones and cytokines. In the present study, 40 patients with cutaneous leishmaniasis and 40 healthy patients with no history of cutaneous leishmaniasis were selected. Using laboratory kits, the plasma levels of the hormones cortisol, estradiol, dehydroepiandrosterone (DHEA), prolactin, and testosterone, as well as the plasma levels of cytokines tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), interleukin 1 (IL-1) and interferon-gamma (IFN-γ) were measured.  Hormone concentration in the control group and patients was compared using the Mann-Whitney test. The relationship between the levels of cytokines and hormones was investigated by Spearman's test. All statistical tests were performed using Graph Pad software version 5 (GraphPad Software Inc., San Diego, CA, USA). Results: The results of this study showed that the plasma levels of cortisol, estradiol, DHEA, prolactin, and testosterone were lower in patients than in healthy individuals and these results were statistically significant (P<0.05). Plasma levels of TNF-α, IL-6, and IL-1 were higher in patients with cutaneous leishmaniasis compared to healthy subjects(P>0.05). In addition, the plasma level of IFN-γ was lower in patients than in healthy subjects, and these results were statistically significant(P>0.05). Conclusion: According to the results of the present study, it seems that endocrine-immune system changes in cutaneous leishmaniasis patients are beneficial for the host and helps to heal the lesions. Also, knowing as much as possible about the endocrine mechanisms involved in the regulation of the immune response in cutaneous leishmaniasis can be important for the diagnosis of the disease or the drug treatment of this disease.

2Background and purpose: Aging is a physiological process, but during this period, with the passage of time and the influence of environmental factors and unhealthy lifestyles, the prevalence of diseases, especially chronic diseases, increases. One of these chronic diseases is diabetes. It has negative effects on their physical and mental health and as a result, reduces their quality of life. A relatively new issue that is raised today regarding the quality of life is hope. Because hope can ease the process of facing life's adversities and improve the quality of life. Hope therapy is based on the hope theory of Schneider and colleagues and is based on a positive psychology approach. This study aimed to determine the effect of group hope therapy on the quality of life of elderly women with diabetes. Materials and methods: The study was designed experimentally with a before and after design in two control and intervention groups. Eligible elderly women with diabetes were selected from the diabetes clinic of Imam Khomeini Medical Education Center in Sari and were randomly assigned to intervention (20 people) and control (20 people) groups. The group hopes therapy training was conducted in 8 sessions twice a week for 90 minutes. The quality-of-life questionnaire of Thomas diabetic patients (DQOL) of two groups was measured before, immediately, and one month after the intervention. Data analysis was done using the Mann-Whitney, Friedman, Wilcoxon test and SPSS software version 16 and P<0.05. Results: The level of high quality of life increased from 35% to 50% in the control group and from 45% to 100% in the intervention group. The comparison of the average quality of life in the pre-intervention phase in the two intervention and control groups did not show a statistically significant difference (P=0.472). Comparison of the average quality of life immediately after the intervention in the two intervention groups (59.55±2.84) and control (45.90±3.69) and one month after the intervention in the two intervention groups (60.00±2.714) and the control (45.75±3.75) showed a statistically significant difference (P=0.001). Based on the results of the present study, the average quality of life of the control group was lower than the intervention group at the end of the intervention and one month after the intervention. Conclusion: The results of the research showed that group hope therapy is effective in improving the quality of life of elderly women with type 2 diabetes. Elderly women with diabetes learned that they can find the meaning of life even in the suffering and pain caused by the disease. The concept of hope in people causes their perspective to widen from the current difficult and suffering conditions. Increasing hope leads to happiness, peace, adaptation to the current situation, increased energy, meaningfulness, and success in life. As a result, group hope therapy can be implemented to increase the quality of life in the daily care programs of the elderly, especially women. (Clinical Trials Registry Number: IRCT20240130060857N1)

2Background and purpose: COVID-19 is one of the biggest pathogens that mainly targets the human respiratory system. Among the preventive methods against contracting COVID-19, vaccination has had an important effect in preventing COVID-19 and is an essential component in prevention. Various vaccines were provided to prevent COVID-19, one of these vaccines was Sinopharm, which was used for cancer patients in Iran, so this study aimed to determine the antibody response following the injection of Sinopharm vaccine in cancer patients in Iran in 2021. Materials and methods: This cross-sectional study was conducted in 2021 on 74 patients with various types of cancers in Amol and Sari cities who received two doses of the Sinopharm vaccine. Subjects participated in the study after obtaining informed consent. Cancer patients who were referred to vaccination centers were asked to refer to the reference laboratory 4 to 6 weeks after the second dose if they wished to determine the antibody level. A 5 cc blood sample was taken 4-6 weeks after receiving the second dose of the vaccine, and then the serum was separated from the samples and stored at -20. The level of SARS-CoV-2 Neutralizing antibody, Anti-RBD, and Anti-Spike IgG were provided by Kit Eliza, Pishtaz Tab Company. The sensitivity and specificity of the kits used for neutralizing antibodies are 100% and 99% respectively, for Anti-RBD 98.4% and 97.7%, and Anti-Spike IgG 98.16% and 99.01% respectively. Finally, according to the instructions of the kit, neutralizing antibody values greater than 2.5 Mg/ml and optical absorption greater than 1.1 for RDB antibody and anti-spike antibody values greater than 8 RU/ml were considered positive. Results: The average age of the subjects was 57.1±11.7 years. In terms of gender distribution, 45 people (60.8%) were women. The neutralizing antibody status was positive in 41 people (55.4%). There was no significant relationship between the presence of neutralizing antibodies and gender (P=0.811) and age (P=0.443). Antibody against RDB antigen was positive in 31 people (41.9%). There was no significant relation between the presence of antibodies against RDB antigen with gender (P=0.091) and age (P=0.336). Antibody against Spike virus antigen was positive in 20 people (27%). A significant relationship was observed between the presence of antibodies against the Spike antigen and gender (P=0.008) and the proportion of women who produced antibodies against the Spike virus antigen was more than men, but there was no significant relationship between the presence of antibodies against the Spike gene and age (P=0.336). Conclusion: The results of the present study showed that the vaccination of COVID-19 by Sinopharm in immunocompromised patients such as cancer patients can induce an antibody response, although the percentage is not high. Also, no significant relationship was observed between antibody production and age.

2Background and purpose: Premature birth is common worldwide and can affect the development of brain structures, such as the optic nerve. Eye diseases are very common in low birth weight children and premature children. Vision defects associated with premature birth include Retinopathy of premature babies (ROP), decreased visual acuity, strabismus, amblyopia, and various types of refractive errors. Studies have shown that the occurrence of myopia in children born prematurely is negatively correlated with gestational age and birth weight and is directly related to the severity of retinopathy of prematurity(ROP). Advances in neonatal intensive care unit services have led to a significant increase in the survival rate of premature infants and subsequent medical problems in these children. This study was designed to determine the prevalence of refractive errors in 4-6-year-old children born with a birth weight of less than 2000 grams and gestational age of less than 34 weeks and normal children admitted to the neonatal department of Bou-Ali Sina Hospital in Sari in 2016-2018. Materials and methods: This study was a cross-sectional descriptive study on 43 children aged 4-6 years who were born with a weight of less than 2000 grams and gestational age of less than 34 weeks, and 17 normal children who were admitted in the neonatal department of Bou-Ali Sina Hospital due to neonatal jaundice. The study subjects were in four groups: 12 subjects in group A (ROP cases without injection), 14 subjects in group B (ROP cases with injection), 17 subjects in group C (cases with birth weight less than 2000 grams and gestational age less than 34 weeks without ROP), and 17 normal subjects in group D. Uncorrected distance visual acuity was measured using E-chart. Dry and cyclo refraction (using cyclopentolate 1%) were measured using an autorefractometer. Finally, the fundus was examined using a biomicroscope and 90 diopter lens. Statistical analysis was performed using SPSS software, version 26. Results: of the 60 studied subjects, 46.67% were females and 53.33% were males, and there was no significant difference in the prevalence of the two sexes between the groups (P=0.146). In total, 12.1% of the studied subjects were myopie, 34.5% were emmetrope, and 53/4% were hypermetrope. Although the prevalence of hypermetropia was higher than other types of refractive errors in all groups, the prevalence of myopia was higher in those with ROP than in groups without ROP, and there was a significant difference in the prevalence of refractive errors in different groups (P=0.025). There was no significant difference between the prevalence of the different types of astigmatism in the studied groups (P=0.304) and with the rule astigmatism was the most common type among all groups. There was a significant and direct relationship between gestational age and birth weight with cyclo-equivalent sphere, which means that the lesser gestational age (P=0.356, r=0.006) and birth weight (P=0.002, r=0.387), the higher the probability of myopia. Conclusion: Considering the higher prevalence of myopia in low birth weight children, especially in children with ROP, it is necessary to formulate a regular program to screen this category of children to prevent refractive errors, especially myopia in the future.

2Background and purpose: Anxiety and depression are determinants of the prognosis of coronary artery disease(CAD). Spiritual well-being and religious commitment affect people's mental well-being. Due to the limitations of previous similar studies in the difference in demographic characteristics of participants with CAD patients, it was necessary to repeat these studies in coronary artery disease patients. In this study, the state of spiritual well-being and religious commitment and their relationship with anxiety and depression in coronary artery disease patients referred to Fatemeh Zahra Hospital (Mazandaran Cardiology Center) in 1400 and 1401 were investigated. Materials and methods: In this cross-sectional descriptive-analytical study, 159 heart and CAD patients referred to Fatemeh Zahra Hospital (Mazandaran Cardiology Center) were selected by conventional sampling method. Demographic and well-being variables including age, gender, marital status, education level, employment status, and history of psychiatric diseases and substance abuse were measured using the data collection form. The participants answered the questionnaires of the Hospital Anxiety and Depression Scale (HADS) (with validity in the anxiety component t260=21.32 and depression t260=23.41 and reliability in the anxiety component r=0.75 and depression r=0.71), the scale of the practice of religious beliefs (Mabad) (reliability confirmed with Cronbach's alpha coefficient of 91.0 and criterion-related validity coefficient of .0.84) and Palutzian Ellison's spiritual well-being (validity confirmed by content validity and reliability with Cronbach's alpha coefficient of 0.89). Data were analyzed with the help of Stata 14 statistical software at the significance level of P<0.05. Independent T-test and ANOVA tests were used to compare quantitative scores between study groups, and the Chi-square test was used to compare the frequency of qualitative variables between groups. The relationship between the variables was measured by Pearson's correlation coefficient test. Results: Findings: The average age of the participants was 57.82±14.0 and 33.33% of the sample were men. The religious commitment score of the participants was in the range of 97-10 with an average of 63.73±19.10 (high commitment level). 23% of participants had low religious commitment and 77% had high religious commitment. The religious well-being score of the participants was in the range of 60-34 with an average of 55.28±6.38 and the existential well-being score of the participants was in the range of 60-13 with an average of 43.07±11.24. Also, the spiritual well-being score of the participants was at the average level with a range of 120-54 and an average of 98.35±14.54. 51% of the participants had average spiritual well-being and 49% had high spiritual well-being. The hospital anxiety score of the participants was in the range of 0-21 with an average of 8.23±5.67 (at the level of mild anxiety). 44.2% of the participants had no anxiety, 16% had mild anxiety, 19.2% had moderate anxiety, and 20.5% had severe anxiety. The hospital depression score of the participants was in the range of 0-21 with an average of 7.35±5.06 (at the level of mild depression). 46.4% of the participants had no depression, 14.6% had mild depression, 12.1% had moderate depression, and 26.7% had severe depression. A negative correlation was found between the severity of spiritual well-being and the severity of depression with a Pearson coefficient of -0.62 (P<0.001) and the severity of anxiety (-0.48, P<0.001). The relationship between the intensity of religious commitment with the intensity of anxiety (P=0.87) and the intensity of depression (P=0.12) was not significant. Conclusion: Considering the reduction of anxiety and depression scores in samples with higher spiritual well-being scores, it is recommended to focus more on improving the spiritual well-being level of CAD patients by medical staff, as well as group training programs and spiritual self-care training programs after discharge. Follow. Psychotherapy sessions with a spiritual approach can also be useful.

2Background and purpose: In recent years, there has been a decrease in the fertility rate in the country, including in Mazandaran province. A reduction in population growth led to economic, social, and cultural changes and a decrease in the political and military power of the country. Therefore, the goal of this study is to analyze the mixed regression model of the factors related to the motivation of childbearing in couples referring to the health centers of Mazandaran province. Materials and methods: This cross-sectional-analytical study was conducted in four cities of Mazandaran province between October and March 2022 on 468 couples using a multi-stage sampling method. Data collection was done with socio-demographic questionnaires, Naghibi et al. motivation childbearing, and Rammstedt and John Neo Personality Questionnaire. Data analysis was done with SPSS version 22 software. The significance level was considered 0.05 in all tests. Statistical indicators of number and percentage were used to describe qualitative variables, and mean and standard deviation were used for quantitative variables. To investigate the effect of all factors on the couple's motivation to have children, given that the study is a couple, a mixed linear regression model was used using the regression method. Results: In this study, the response rate was 93.2%, and the final analysis was performed on the information obtained from 468 couples. The mean and standard deviation of the age of women and men were 35.64±6.76 and 39.75±8.29, respectively, and the length of marriage was 12.85±7.81. In this study, 261 (55.8%) housewives, 167 (35.7%) working men, 329 (71.3%) of women with a history of cesarean section, 54 (11.5%) of childless couples and 372 (79.5 percent) of the couples lived in the urban. The mean score of motivation childbearing for women and men was 60.82±9.36 and 60.58±8.29, respectively. Based on the adapted regression coefficient, couples with favorable socioeconomic status (P<0.001, β=-4.89) and somewhat favorable (P<0.001, β=-2.29) compared to people with unfavorable socioeconomic status have less motivation for childbearing. Also, people with extroverted personality traits (P<0.001, β=-50.0) had less motivation for childbearing than people with other personality traits. The results showed that with the increase in the years of life together, the couple's motivation for childbearing decreases (P<0.001, β=-0.11). While the couples who expressed that they wanted more children (P<0.001, β=14.63) and had a preference for a son (P<0.05, β=1.41) had more motivation for childbearing. In this study, there was no statistically significant difference between the score of motivation childbearing of urban and rural couples. Conclusion: This study has shown that individual and social factors such as socioeconomic status, length of the marriage, and personality traits affect the motivation to have children, so that in extroverted couples with a favorable socioeconomic status, the motivation to have children decreases with increasing years of marriage, so policymakers and Health planners should pay more attention to extroverted couples in the first years of marriage.

2Background and purpose: Aging is said to be a special pattern of natural changes in life that occurs as people age With increasing age, the elderly suffer from several problems, including a decrease in hope, happiness, and self-esteem, which may affect self-care, especially nutrition. Therefore, the present study was conducted to investigate the relationship between nutrition and self-esteem and happiness of the elderly Materials and methods: The present study was a descriptive-analytical study of the correlation type, and following the ethical standards and obtaining informed consent from the company. The research began Research sampling in this study was by multi-stage method (proportional and simple random). First, among the 18 health centers of Amel city, 7 centers were randomly selected, then again, by simple random and lottery method from among the target population (elderly people), until reaching the desired volume of the study, in 1401 became Simple random sampling was done by preparing a list of people eligible for the study in the selected health care center, then we selected the required number of samples by lottery. The inclusion criteria included being over 60 years old, living in Amel City, the absence of problems such as acute mental disability, the absence of cognitive impairment (using AMT, Alzheimer's, and cancer), and the ability to communicate. Non-cooperation during the implementation of the study was considered as an exit criterion. The tools used included demographic questionnaires, cognitive status assessment, elderly depression, happiness, self-esteem, and instrumental activities. The data were analyzed with descriptive (frequency, mean, and standard deviation) and inferential (focal correlation and parameter estimates) tests. Results: The results showed that the average age of the participants (60 to 81 years) was equal to 65.92±4.64 and the average body mass index of the participants was 23.75±2.54. 14% of the elderly were underweight and 33% were overweight. 12% were at risk of malnutrition. Most of the elderly had high happiness (99%) and high self-esteem (59%). The correlation coefficient of happiness and self-esteem is 0.378. As a result, in this study, nutrition had no significant relationship with the self-esteem and happiness of the elderly. Also, the results showed that the happiness and self-esteem of the elderly had a significant positive relationship with each other(P<0.001). According to the value of P>0.050, there is no relationship between the self-esteem of the elderly and the total score of the supplementary examination and nutrition. According to the value of P<0.050, it means that there is a relationship between the self-esteem of the elderly and happiness, but by observing the value of R square=0.045, this relationship is very insignificant. It can be said that only 4% of self-esteem changes are due to happiness There is no statistically significant relationship between the family self-esteem component and happiness(P>0.05). In other components of self-esteem, there is a statistically significant relationship with happiness(P<0.05). Also, there is no relationship between happiness with the total score of the supplementary examination and the total score of nutrition, P>0.050 Conclusion: This research was a descriptive-analytical correlation study. The results of this study showed that there is a relationship between happiness and self-esteem of the elderly. However, there was no statistically significant relationship between self-esteem and nutrition of the elderly. In general, according to the results of this research, it is suggested to pay attention to the role of general self-esteem, social self-esteem, and occupational self-esteem in the happiness of the elderly. Considering the expansion of the elderly population in Iran and the importance of paying attention to the physical and mental health of the elderly, the results of this research can be useful for planning to improve the capabilities of the elderly.

2Background and purpose: Fear of falling is considered an important factor in reducing the daily life activities of the elderly with diabetes. It seems that the fear of falling can play a decisive role in creating a sense of loneliness and social isolation in the elderly with diabetes by creating functional limitations and reducing the social activities of the elderly. Therefore, the direct relationship between fear of falling and social isolation and loneliness in diabetic elderly has not been investigated. The present study was conducted to determine the relationship between fear of falling social isolation and feelings of loneliness in elderly diabetics who were referred to health centers in Faridunknar City in 2023. Materials and methods: The current study was a descriptive-analytical study that was conducted cross-sectionally on elderly people with type 2 diabetes referring to health centers in Faridonkanar City in 2023. In this study, 398 elderly people with diabetes participated, who were selected by simple random method. The research tools included the demographic information form, the international fall efficiency scale in the elderly, the emotional and social loneliness scale of adults, and the social isolation questionnaire of the Yazdi school. Data analysis was done using descriptive statistics and analytical statistics such as one-way analysis of variance, independent t-test, Pearson's correlation coefficient, and multiple linear regression in SPSS21 software. Results: The mean age of the participants was 67.6±28.6 years, with more than half of them being female (66.8%). The mean scores and standard deviations of fear of falling, social isolation, and loneliness in the elderly were 51.53±11.60, 48.66±6.30, and 64.53±2.96, respectively. 94.7% of the elderly participants had severe concerns about falling. There was a significant positive relationship between the fear of falling and feelings of loneliness (r=0.389, P=0.001) and social isolation (r=0.156, P=0.002). The results of the multivariable model also showed that for each unit increase in fear of falling score, there was a 0.05 increase in social isolation score in elderly diabetic patients (P≥0.05). Conclusion: The results of the present study showed that there is a significant relationship between the fear of falling and social isolation and loneliness. The more seniors are afraid of falling, the more they feel alone and socially isolated. Given that improving health in the elderly requires improving healthy lifestyles and controlling and managing psychological factors, including feelings of loneliness and social isolation. Knowing the factors related to them is considered one of the important pillars of interventions in target groups in the key concept of "healthy and successful aging ". Effective planning in this area requires full knowledge and awareness of the fear of falling in the elderly and eliminating the factors that can be related to it. For this reason, it is necessary to adopt appropriate intervention strategies to reduce the fear of falling and increase the sense of security in diabetic elderly to improve their participation and social presence.

2Background and purpose: Being Overweight is a global health problem and is related to important underlying diseases such as cardiovascular disease, malignancy, diabetes, fatty liver, etc. Over the past three decades, obesity has increased globally, especially in low-and middle-income countries. Numerous studies have shown that obesity increases the risk of developing chronic and threatening diseases including diabetes, cardiovascular diseases, blood pressure, and reduces life expectancy. On the other hand, chronic inflammation around fat cells plays an important role in obesity-related diseases. Also, changes in blood parameters are associated with increased body mass and chronic inflammation in obesity, and peripheral blood cells, such as the number of platelets, neutrophils, lymphocytes, and monocytes, are related to the progression of various types of diseases and inflammatory conditions. Therefore, the purpose of this study is to find the relationship between blood count biomarkers and anthropometric indicators in the adult group according to the Tabari cohort data. Materials and methods In the present study, cross-sectional data from a population-based cohort study called "Tabari Cohort Study" collected from 2014 to 2016 were used. This study is part of a nationwide study called "Epidemiological Prospective Study Group in Iran (Persian Cohort)". In the first phase of the Tabari cohort study, 10,255 participants aged between 35-70 years from urban and rural areas of Sari city were registered. Exclusion criteria in this study were inflammatory diseases, autoimmunity, malignancy, cardiovascular diseases, transplantation, and receiving any type of immunosuppressive drug, and finally 9939 people including 4043 men and 5896 women were included in the study. Age, height, weight, anthropometric measurements (BMI, waist circumference), CBC parameters including leukocytes, platelets, neutrophils, lymphocytes, and monocytes), and platelet distribution width (PDW) were recorded from the participants. By using the histogram drawing method to check whether the variables follow the normal distribution to decide between parametric or non-parametric analysis, T-test and ANOVA statistical tests, and SPSS 21 software, the results were extracted. The significance level in this study was considered to be 0.05 or less. Results: Waist-to-hip ratio was associated with higher WBC (P<0.001), platelet (P<0.001), and lymphocyte percentage (P<0.001). Higher waist-to-hip ratio was associated with higher WBC (P<0.001), platelet (P<0.001), lymphocyte percentage (P<0.001), and monocyte percentage (P<0.001). Higher BMI values were associated with higher WBC (P<0.001), platelet (P<0.001), lymphocyte (P<0.001) and monocyte (P<0.001) percentages. WBC, platelet, lymphocyte, and monocyte percentage were significantly higher in people who had a higher ratio of waist circumference to height (P<0.001). Conclusion: The results showed that the relationship between anthropometric indicators and blood findings in favor of inflammatory conditions and obesity can affect indicators related to whole blood count.

2Background and purpose: Influenza virus is scattered around the world and causes epidemics of varying severity annually. Mortality caused by influenza is more common in cardiovascular patients than in other chronic diseases. Paying attention to this is very important in preventing the disease and its complications in children and adults with cardiovascular diseases. Therefore, this study was conducted with the aim of epidemiological investigation of hospitalized cases caused by influenza in cardiovascular patients and its effect on the health of these patients in Mazandaran Heart Center. Materials and methods: The present study is a cross-sectional descriptive study that was conducted on patients who were admitted to the Mazandaran Heart Center between 2016 and 2018. All patients who were hospitalized with the initial and final diagnosis of influenza and were treated with all flu medicine were included in the study. Since the PCR test was not available for all these patients, as the value of clinical diagnosis was based on symptoms and initial laboratory findings during the epidemic, in addition to PCR-positive cases, cases with clinical diagnosis were also included in the study. All data analysis with SPSS version 16 software was used. Results: In this study, 113 patients with an average age and standard deviation of 63.3+15 years were included. Among these patients, the highest frequency of history of heart disease was related to congestive heart failure (35.4%) and angioplasty (292%), and the lowest frequency was related to valve replacement 8.0%. Among other underlying diseases, the highest frequency was related to hypertension (65.5%), diabetes mellitus (41.6%), and hyperlipidemia (31.0%), and the lowest frequency was related to thyroid disorders (2.7%). Also, 31.9% of patients had diabetes and hypertension and 16.8% had diabetes and hyperlipidemia. Examining the signs and symptoms of influenza among the patients also showed that the highest frequency related to fever (76.1%), sputum (66.4%), cough (64.6%), shortness of breath (611%) and myalgia (548%) and the lowest frequency was related to diarrhea (5.3%). Only 7% of patients had a recent history of flu vaccination. In the chest radiography report, 25.7% of the patients had increased bronchial marking and 17.7% had evidence of pneumonia. Finally, 82.3% of patients were discharged after complete recovery. Also, only 12 cases (10.6%) of the patients died. Heart failure was the most common underlying disease among deceased patients. Conclusion: The results of this study revealed that the symptoms of influenza in heart patients are similar to other patients and the type of underlying disease has no effect on the disease presentation and its initial manifestations, but persisting of the symptoms and progression towards severe disease were more common. Most of the deaths were due to heart failure, and this issue highlights the importance of these patients' adherence to the flu vaccine. Unfortunately, the results of the study indicated that this high-risk population had little adherence to influenza and pneumococcal vaccinations.

2Background and purpose: Art education is one of the areas of the curriculum in the development of various individual characteristics and capabilities. Art, with its profound impact and appeal, can serve as an effective tool for gaining a deeper understanding of basic medical science courses, including anatomical sciences (anatomy, histology, and embryology). The study was designed to assess the influence of creative painting on the teaching of anatomical sciences, emphasizing a social, individual, and spiritual approach to encourage forward-thinking and imaginative skills in medical students. It seems that when students of medical sciences become familiar with the clinical considerations and personal, social, and spiritual consequences of the subject while teaching their course material, they will try to learn the material more accurately and multi-dimensionally. Materials and methods The present research-educational study was designed with a qualitative-quantitative approach and in it the art of painting was used as an educational intervention. At first, after the introduction of anatomical sciences and the presentation of the objectives of the lesson, interested medical and pharmacy students of Ramsar Medical Sciences Campus were asked to choose a topic from anatomical sciences in a group or individually. Then, by connecting it with the clinical points in the textbooks, the following personal, social, and spiritual challenges are displayed by maintaining the scientific content in the form of a purposeful painting. After several meetings about the topics, the paintings meeting the desired criteria were selected and the paintings were displayed to the public. During the exhibition, the correctness of the way of conveying the target message was interpreted and analyzed from the point of view of the audience. Finally, the attractiveness of education and the level of learning among students were investigated. The evaluation of the results was done in two quantitative and qualitative methods, and in the quantitative method, a researcher-made questionnaire was used. The quantitative part was descriptive-analytical and the qualitative part was based on content analysis. To check the validity of the conducted study, Anderson et al.'s five-step criteria including study validity, democratic validity, results validity, dialogue validity, and persuasive validity were used. Results: The results showed that the integration of art and education can be useful. Most of the students believed that with this method, the educational atmosphere was happier and more attractive for them (54%). 90% of students had increased learning of anatomical concepts. Students stated that they had more enthusiasm (81%) and motivation to learn (72%) lessons and learned the concepts of anatomical sciences in a more permanent way (63%). While learning the material, they were more curious to know, on the one hand, what clinical challenges are significant in the topic in question, and on the other hand, what social, personal, and spiritual consequences these problems will face the patient. All this made them more analytical thinking (79%). This method increased creativity (75%) and spirit of cooperation (75%) in most students, and 77% of students preferred it to other educational methods. Also, students' motivational, team, and communication skills increased by changing the study method and creating a multi-dimensional view of issues. Conclusion: The use of creative drawing in the teaching of anatomical science concepts was able to encourage the students of medical sciences to learn and increase their enthusiasm by creating a happy and attractive educational environment, raising the spirit of teamwork in them and increasing creativity, communication skills, and analytical thinking in them.

2Background and purpose: Since 2013, Iran's health system reform has been implemented at the national level with goals such as increasing people's access to health services, reducing direct payments to patients, and improving the quality of services. As this initiative has been associated with significant changes in the financing of hospitals, this study aims to investigate the changes in income and expenses of public hospitals in Mazandaran province, as two important indicators of key hospital financial performance, before and after the implementation of the reform. Materials and methods: This is a retrospective study that was conducted in 2018. Since this study deals with the impact of the intervention carried out by the public sector by comparing the changes before and after the implementation of the intervention, it is therefore considered a type of quasi-experimental study. The statistical population includes all government hospitals in Mazandaran province. The sampling method was census and covered all 24 public hospitals of Mazandaran province. The time frame of the study covers from 2009 to 2016, that is, 4 years before and 4 years after the implementation of the reform. Secondary data that is routinely recorded in the information system of the country's hospital system has been used in this study. To collect the data, a researcher-made checklist was used based on the objectives of the study and the availability of data in the routine information recording system of hospitals, which mainly included the variables of staff cost, non-staff cost, cash income, insurance income, and working year. After collecting the data from the comprehensive and centralized Electronic Information System (HIS), which contains all the financial and functional information of all hospitals in the province, the data were extracted and analyzed using SPSS software and appropriate statistical methods. Results: In general, after the implementation of the reform, the average costs in the studied hospitals increased from 249,613 to 771,552 million Tomans (2.61 times) and the average incomes increased from 152,738 to 534,804 million Tomans (3.50 times). Therefore, both the average cost and the average income in the 4-year periods before and after the implementation of the initiative have generally increased, but the growth rate of costs and incomes in the period before the implementation of the reform was lower than the period after its implementation, although, in the same period, the gap between expenses and incomes has been widening. In the period after the implementation of reform, due to the rapid increase in income at the beginning of the implementation, the gap between cost and income has decreased relatively, but gradually the rate of income growth has decreased compared to the rate of cost growth, and as a result, the gap between the cost and income of the hospitals studied in the end of the study period has experienced an unprecedented gap. It has also been found that during the years of the study, the staff cost has continued to rise with more or less trends, while the non-staff cost has started to decrease sharply and unprecedentedly since 1995. Conclusion: Although the implementation of the reform has increased the financial turnover of government hospitals, due to the increase in the average cost compared to the increase in their average income, the implementation of this plan has increased the financial pressure on the hospitals and widened the income deficit compared to their cost. Therefore, the gap between cost and income and the rising trend of this gap in government hospitals can be a challenge for funding hospitals and guaranteeing the relative access of people to these services now and in the future.

2Background and purpose: In universities, the issue of attracting and retaining faculty members is of great importance. If this is not possible for any reason, it can lead to the academic stagnation of academic staff members the loss of motivation in their career path, and interruption in the implementation of their seven duties. Considering the importance of the advancement of academic staff members as educational and research elites of the country and their significant role in training skilled human resources, especially the role of academic staff members of the Ministry of Health and Medical Education in training graduates of medical sciences that are related to the general health of the society, are related, this study was carried out to identify, diagnosing the factors and ways to prevent their scientific stagnation. Materials and methods: This study was conducted with a qualitative method from January to December 2023. In this research, according to the nature of qualitative research, to explain the perceptions, attitudes, and behaviors of the participants, the purposeful sampling method with maximum diversity was used, as well as the snowball sampling method because the goal was to select participants, Which was a rich source of information and helped the researcher to better understand the concept of scientific stagnation. The participants were faculty members who had been faculty members for at least 10 years. In addition to conducting in-depth and semi-structured interviews, upstream documents and the results of similar studies were also examined. Results: In total, 3 themes, 18 categories, and 118 codes were extracted as follows: The main themes of this study are the causes of scientific stagnation, the challenges of the advancement path, and the strategies to prevent scientific stagnation. The theme of scientific stagnation includes 47 codes and 6 categories (individual, organizational, psychological, skill, job, and research factors). The content of the challenges of the promotion path, including 33 codes and 6 categories (the challenges of the path of the promotion regulations, challenges in cultural, educational, research, executive activities, and challenges of examining cases for promotion of scientific rank). The content of the solutions to prevent scientific stagnation includes 38 codes and 6 categories (the solution to prevent scientific stagnation in connection with the regulation of promotion, cultural, educational, research, executive activities, and the review of files for the promotion of scientific rank.) Conclusion: Based on the results of the present study, the researchers identified the causes of scientific stagnation; also, they believe that revising the promotion regulations is the most important way to prevent scientific stagnation. They stated that in the revision of the bylaws, in addition to the quantitative indicators, in each of the scoring factors, their quality can also be addressed. In terms of education, the quality and innovation of education should be considered. In the research section, pay attention to the applicability of the research. They believed that scientific stagnation is preventable and can be countered through broader scientific productivity measures and reward systems that encourage innovative and exploratory projects. In the executive department, the quality of work and useful changes and developments during the executive activity should be the criteria. In cultural activities, pay attention to social and quality activities; also, they brought up the faster process of promotion cases and the existence of elite human resources to handle possible problems. They stated that with the approach of delegating authority to the country's medical sciences universities and revising the promotion and promotion bylaws, it is possible to deal with the factors causing scientific stagnation and take a step towards a responsive university.

2Background and purpose: Considering the progress made in the field of diagnosis and treatment of heart diseases, one of the heart diseases that has a high prevalence today is congenital heart disease. These people have their own special needs because they are getting older with medical treatments. Various studies have shown that at least 50% of patients with heart disease do not take the treatment recommendations made by the treatment staff seriously and do not follow them, which can cause complications or re-hospitalization. One of the important things to prevent this problem is to raise awareness and meet the information needs of patients about possible complications. Hence, the purpose of this study is to identify and categorize the information needs of adults suffering from one of the types of congenital heart disease. Materials and methods: This study was conducted with nineteen patients with congenital heart disease in the first six months of 2023, using conventional qualitative content analysis (Granheim method). The participants were selected from the referrals to the specialized clinic of congenital heart diseases of Kerman University of Medical Sciences. In the interview sessions, the interviewer explained about the audio recording and obtained permission to conduct the interview. Each interview was implemented verbatim after the end. The main codes were extracted by carefully reading the text of the interviews and the necessary categories were made. Lincoln and Goba's four criteria including acceptability, transferability, reliability, and confirmability were used to ensure the robustness of qualitative data. To analyze the data, the conventional content analysis approach with Granheim and Lundman's approach was used. For this purpose, the following steps were taken to analyze the data: a. Implementation. 2. Study the general text. 3. Extraction of primary codes. 4. Identification of subclasses. 5. Identify the hidden content in the data. Results: Nineteen patients were interviewed in this study. The age range of the patients was between 18 and 48 years, and ten of the study participants were female and nine were male. Analysis of the content of the interviews led to the identification of 3 main topics including information needs related to the disease, information needs to be related to personal life, and information needs to be related to social life, and 14 sub-topics including how to control the symptoms of the disease, when to see a doctor, drug interactions, and necessary measures for dentistry, performing non-cardiac surgeries, type of diet, smoking and drug use, driving, using beauty services such as body tattoos, finding a suitable job, getting married and having children and the possibility of transmitting the disease to children, marital relationship, participating in competitions, sports and contraceptive methods were done. Conclusion: Considering the increase in the number of adult patients with congenital heart disease on the one hand and the awareness of important information needs, it is necessary to know the different needs of these patients to better provide different sources of access to this information to the patients.

2Background and purpose: Hypoxia is a decrease in available oxygen reaching the tissues of the body which can lead to body function impairment. It is linked to the pathology of acute mountain sickness, cardiovascular disease, and stroke. Hypoxia causes oxidative stress involving the production of reactive oxygen species (ROS). Naringenin and naringin are widely found in Citrus spp. These compounds have many biological effects, potent antioxidant activities, and influential effects in ischemia/reperfusion. Nothing is found about the anti-hypoxic activities of these compounds. This study aimed to investigate the anti-hypoxia activities of these compounds in mice. Materials and methods: In this experimental study, the protective effects of these compounds at 5-20 mg/kg were evaluated against hypoxia-induced lethality in mice by three experimental models of hypoxia, i.e. asphyctic, haemic, and circulatory hypoxia.  The latencies for death for mice in minutes were recorded. All the experimental procedures were conducted by the NIH guidelines of the Laboratory Animal Care and Use. The Institutional Animal Ethical Committee of Mazandaran University of Medical Sciences also approved the experimental protocol. In the asphyctic hypoxic model, phenytoin (50 mg/kg, i.p.) and in the next two tests, propranolol (20 and 30 mg/kg, i.p.) were used as the positive controls. In all tests, Normal saline (0.5 ml, i.p.) was used as the negative control. Analysis of variance was performed followed by Newman-Keuls multiple comparisons (by GraphPad Prism 8) were used to determine the differences in means. Results: In the circulatory model, both compounds showed very good effects. The effects were completely dose-dependent. Naringin at a dose of 5 mg/kg increased the death time by approximately 7.3 minutes (P<0.01). Naringenin at 10 mg/kg significantly increased the death time by 3.2 minutes (P<0.01). These compounds in these doses showed a similar effect to propranolol, which was used as a positive control. In the haemic model, only naringin showed a very good and dose-dependent effect. These compounds at 5 mg/kg increased the survival time by about 4.5 minutes (P<0.01). Naringenin had no effect in this model even at a dose of 40 mg/kg. Naringin at 5 mg/kg and naringenin at 40 mg/kg showed a similar effect to propranolol. In the asphyctic model, both compounds showed great effects. Their effects were completely dose-dependent. Naringin at 5 mg/kg increased the time to death by 7.2 minutes (P<0.001). At the dose of 10 mg/kg, the death time was increased by 10 minutes and reached 29 minutes (P<0.0001). Naringenin at 5 mg/kg increased the survival time of mice by 4.2 minutes (P<0.05). At the dose of 10 mg/kg, the death time was increased by 10 minutes and reached 27 minutes (P<0.0001). Naringenin at 5 and naringenin at 10 mg/kg produced a similar effect to phenytoin, which was used as a positive control (P>0.05). Conclusion: According to the results of this study, it was found that Naringin has very good protective activities in all models. Naringenin was not effective in the haemic model. The result of this research can be responsible for cardiovascular effects and their good effects on ischemia/reperfusion.

2Background and purpose: Due to the absence of a conclusive cure for a severely painful mouth ulcer, the creation of a medication to regulate this ailment is greatly advantageous. Folinic acid is a derivative of 5-formyl tetrahydrofolic acid. Unlike folic acid (the synthetic form of folate), folinic acid is a form of folate found naturally in foods. Folinic acid can be converted to other active forms of folate in the body and has the activity of the complete vitamin folic acid. Since folinic acid has wound-healing effects, it may play an important role in accelerating the healing of aphthous wounds. By determining the optimal dose, folinic acid can be suggested as a recommended treatment option for people with oral ulcers such as aphthous wounds. The purpose of this study is to investigate the effect of folinic acid on the growth of gingival fibroblast cells as a treatment for mouth ulcers. Materials and methods: During this experimental study, human gingival fibroblast cell lines were cultured in sterile conditions in a DMEM culture medium of 10% bovine serum and 1% penicillin and tetracycline antibiotics at 37 degrees. These cells were exposed to different concentrations of folinic acid drug (5, 20, 25, 30, 40, 50, 80, 100 μM). The MTT method was used to evaluate cell viability and determine IC50 (inhibitory concentration). In this experiment, due to the uncertainty of its range of toxicity on cells, the relative toxicity was determined in a pilot phase and with few repetitions. Each concentration was repeated four times and incubated at different times (24, 48, and 72 hours). After the incubation time, the supernatant of each well was discarded and 100 μl of MTT solution was added to each well. After four hours of incubation, the supernatant was discarded and 100 μL of DMSO was added. Then, using an ELISA reader, the optical absorbance of each well was measured at a wavelength of 540-690 nm. Finally, IC50, which indicates the drug concentration necessary to inhibit 50% of cell growth, was calculated using the growth curve, and the results were analyzed using SPSS software version 19. Results: In this study, the effect of folinic acid cytotoxicity on human gingival fibroblast cell line (HGF1) in a cell culture medium was investigated three times in different concentrations. The results showed that 70% of the cells were still alive in 24 hours up to a concentration of 100 μM, which can indicate the effective use of this drug for the treatment of pest damage. In 48 hours, IC50= 1.78 μM was obtained, which indicates that in studies with a time limit of 48 hours, up to a dose of 80 μM of folinic acid can be used to use the therapeutic effects of this drug. In 72 hours, IC50 was calculated as 66.7 μM. Conclusion: These findings provide valuable information about the dose-response relationship and the impact of folic acid on HGF1 cells. It indicates that higher concentrations of folic acid are needed initially to achieve a significant reduction in cell growth, but with longer exposure, lower concentrations can be effective.

2Background and purpose: Pseudomonas aeruginosa is an opportunistic nosocomial pathogen, which is resistant to different groups of antibiotics. Infections caused by this organism due to antibiotic resistance may ultimately cause high mortality. The ability of this microorganism to produce pathogenic factors such as alginate, proteases, pyocyanin, rhamnolipid, phospholipase C, the presence of pili, and the ability to form biofilm and colonization have made this bacterium one of the most important pathogens. Considering that alginate is one of the important pathogenic factors of this microorganism which mainly algA, algC, and algD genes encode enzymes necessary for the leading biosynthesis pathway of alginate-GDP-mannuronic acid. Therefore, in the current study, we investigated the frequency of the algD gene in P. aeruginosa isolated from patients hospitalized in Mazandaran hospitals using specific primers by PCR method. Materials and methods: According to the results of past studies and using the sample size formula to calculate the prevalence and considering the maximum error of 0.05, the confidence level of 0.95, the ratio of 0.97, and the sample size of the unlimited population was estimated to be 100 isolates. Clinical isolates of P. aeruginosa were collected from different laboratories of Mazandaran educational hospitals. After collecting the clinical isolates of P. aeruginosa and definitively identifying the bacteria by performing routine biochemical tests, the antibiotic resistance pattern of the isolates was checked with Agar Diffusion Disk. In the next step, we extracted the DNA of P aeruginosa strains by alkaline lysis method by adding sodium dodecyl sulfate and NaOH. Finally, a PCR test was performed using the specific primer of the algD gene. Then, the PCR product was evaluated using a UV Transilluminator device. Data were analyzed using SPSS software. Results: 100 isolates of P. aeruginosa were isolated from 100 hospitalized patients. These isolates were collected from five medical educational hospitals of Mazandaran province, which were as follows: Imam Khomeini Hospital in Sari (40 isolates), Razi Hospital in Qaemshahr (22 isolates), Bo Ali Sina Hospital in Sari (17 isolates), Zare Psychiatric and Burn hospital in Sari (11 isolates), and Fatemeh Zahra heart hospital in Sari (10 isolates). Most of the clinical isolates of P. aeruginosa in the present study were obtained from sputum samples (37/100) and in second place from urine samples (26/100) of patients. 98 isolates had the algD gene. 26% of isolates were resistant to Piperacillin, 39% of isolates to Aztreonam, 27% of isolates to Ceftazidime, 31% of isolates to Imipenem, 39% to Tobramycin and 41% to Ciprofloxacin. All clinical isolates resistant to studied antibiotics carried the algD gene. Only two isolates of the sensitive strains of this organism in each group of antibiotics lacked the desired gene. Conclusion: The results of the present study show that the algD gene is present in most of the clinical isolates of the P. aeruginosa strain obtained from medical education centers in Mazandaran. On the other hand, the high prevalence of this organism and the high resistance to antibiotics and multiple drugs observed in the current study and previous studies have turned the treatment of infections caused by P. aeruginosa into a serious and complex problem. Finally, considering that the algD gene plays a significant role in the formation of biofilm and antibiotic resistance, the results of the current study also confirm this finding.

2Background and purpose: Intestinal helminth parasites in dogs, especially zoonotic parasites, are one of the health and economic problems of developing countries, including Iran. Toxocara canis is one of the zoonotic helminth parasites that causes serious damage to human health. According to the close relationship that humans have with dogs today, it is necessary to investigate worm parasites in these animals. The present study was conducted to investigate the prevalence of intestinal helminth parasites in urban and domestic stray dogs with two modified methods of sedimentation and flotation in the central part of Mazandaran province. Materials and methods: The study was carried out in three regions of Mazandaran province (Sari, Qaemshahr, and Babolsar) in 2022. We examined fecal samples from 110 dogs, comprising 78 stray dogs and 32 home dogs, to determine the presence of intestinal helminth parasites. We utilized a customized concentrates technique that incorporated flotation and sedimentation. 4 cc of 10% formalin was added to the sample container for sampling. Stool samples weighing approximately 50 to 100 grams were collected using an applicator and transferred into labeled containers. In the flotation and sedimentation method, a sufficient amount of stool sample was poured into the test tube, and then 7 cc of physiological serum was added to it. After the sample is completely dissolved by the applicator, the solution is filtered to remove excess material and transferred to a new tube. The obtained solution is centrifuged at 1000 rpm for 3-5 minutes, then the upper liquid is separated. 7 cc of saturated zinc sulfate solution was added to it and centrifuged again at 1000 rpm for 2 minutes. The resulting sediment was examined with a light microscope with X10 and X40 magnification to identify parasite contamination. Traps were set in the shelters of stray dogs to collect feces samples directly from their rectums. Labeled containers with preservatives (10% formalin) were distributed to clinics and dog owners for collecting samples from domestic dogs. A questionnaire was designed to assess the gender and age of domestic dogs based on dental characteristics, location of residence, deworming practices, and knowledge of zoonotic intestinal parasite diseases in dogs among their owners. The experiment was conducted at Mazandaran University of Medical Sciences and was approved by the Animal Ethics Committee under the reference number IR.MAZUMS.REC.1400.528. Results: Results indicated that 44 samples (40%) were contaminated with parasites, while 66 samples (60%) were free of worm infestation. The infected samples harbored parasite eggs including Hookworms, Toxocara, Taenia, and Dipylidium. The study found no significant difference in the distribution of helminth parasite infection among the three sampling areas in terms of the frequency of infected dogs. Further research in the field of parasite epidemiology and expanding the study to include more areas may help address this issue. Conclusion: The research findings suggest that stray dogs are more significant in transmitting pollutants than domestic dogs. Urban stray dogs pose a potential public health danger because they are released post-treatment. Controlling and gathering these animals is crucial in managing parasite diseases that can be passed on to humans.

2Currently, sleeve gastrectomy (SG) is a surgical procedure performed for the treatment of obesity. Post-operative leakage is considered a rare but devastating complication of this surgery, with an incidence of gastric leakage and fistula after sleeve gastrectomy ranging from 1 to 2. 4%. Most cases respond well to supportive treatment and rarely require surgery. This research presents a rare case of gastrocutaneous fistula caused by sleeve surgery, which did not respond to supportive treatment and ultimately required fistulogenostomy. The research was approved by the Research Ethics Board of the University, with the ethics code IR. AJUMS. HGOLESTAN. REC. 1402. 466. A 30-year-old female patient who underwent sleeve gastrectomy surgery experienced severe epigastric pain two days post-operation and was admitted to the hospital five days later. Endoscopic findings revealed a large defect filled with pus at the site of the previous sleeve. Initially, collection drainage was performed under CT scan guidance, followed by the placement of a Double Pigtail Stent in the leakage area. As the patient did not respond to supportive and endoscopic treatments, laparotomy fistulojejunostomy and jejunostomy tube insertion were performed with a diagnosis of gastroesophageal junction (GEJ) leakage. Following the operation, the patient was transferred to the special care department of the hospital. The day after the procedure, the patient was conscious with stable vital signs and showed no signs of bleeding, hemoglobin drop, or sepsis. One week later, the patient was discharged in good general condition with the necessary recommendations. This study highlights the importance of considering surgical treatments for gastrocutaneous fistulas caused by sleeve surgery if they do not respond well to supportive and endoscopic interventions

2Ingestion of dental appliances is a rare situation in dentistry, making up 6.6 percent of all ingested objects, but it can lead to severe complications, especially among adults, elderly patients, and people with mental disabilities. Devices such as flipper prostheses, prostheses, and restorations may become dislodged and result in foreign body impingement. Clinical examinations, including laryngo-pharyngoscopy, esophagoscopy, and radiography may be required in such cases. Swallowed prostheses may also be found using computed tomography. However, prosthetic elements may not be detected on CT scan. It is estimated that approximately 92% of these swallowed objects go through the gastrointestinal tract, and 60% of them reach the stomach. However, those that remain in the oropharynx can cause edema, esophageal erosions, perforation, airway obstruction, and even death. In addition, clips attached to the denture increase the risk of the perforation of the esophagus or intestine. Swallowing dentures may occur in adults as the sensitivity of the oral cavity and laryngopharynx decreases by using dentures for a long time. The current paper presents a case report about ingesting a removable flipper prosthesis in a 48-year-old woman without any severe problems. The woman with epigastric pain was referred to the emergency department due to swallowing her flipper prosthesis. She mentioned that she was eating dinner and after swallowing, she suddenly noticed that her flipper prosthesis was missing from her upper jaw. The arc was observed in her esophagus and removed using Esophagogastroduodenoscopy (EGD). This paper emphasizes designing a removable flipper prosthesis with enough retention and stability to prevent them from being swallowed. Furthermore, patients should be recommended not to use these objects while sleeping.

2Background and purpose: Reducing the desire to have children is one of the most important concerns and challenges in developed and developing countries. Also, the current policies in these countries try to understand the factors related to it, and until today, through this way, it has led to an increase in the population in countries with an aging population. Considering the importance of this issue, we decided to prepare and compile a study to determine the factors related to the desire to have children systematically. Materials and methods: This study was conducted in 2024, which is a systematic review, and was conducted in five stages, which included designing the study question, searching, extracting related studies, selecting related studies, tabulating information, and reporting the results. Was. Searching in domestic and foreign databases including SID, PubMed, magician, Iran doc, Science Direct, Scopus, and Google Scholar search engine with keywords such as "related factors", "childbearing", "psychological factors", "social factors", Cultural factors, "physical factors", "individual factors", "religious factors", "decrease", "Iran" and "tendency" and their English equivalents were carried out. Studies were reviewed in the period from 2012 to 2024 (the last twelve years, due to major changes in the world). To select studies, inclusion or exclusion criteria were considered. Also, the quality screening of the studies was done by the Newcastle checklist. After selecting and checking the quality, the data in the studies were classified. Results: Based on the answer to the main research question, the findings were classified into three categories: social and environmental factors, psycho-physical factors, and demographic factors. The review of 16 cross-sectional studies showed that factors such as sex, age, marriage, education, race, and place of residence are included in the demographic class. Among other relevant factors is the desire to have children. Religion and religion, technological progress, life experiences, culture and politics governing the society, family structure, peers and economic issues, and access to the media are among other related issues that are included in the category of social and environmental factors and are mentioned in 6 studies. became. The analysis of 7 other cross-sectional studies pointed to the connection of the next class, i.e. psycho-physical factors. In these studies, factors such as personality, depression, self-esteem, underlying disease, and fertility and infertility records were related to having children. It should be noted that some studies were placed in several classes and the classes overlapped. Conclusion: Based on the findings of this study, it can be concluded that there are many factors related to people's desire to have children, which the studies in this research are not sufficient in expressing. But it is possible to take help from these factors that have been mentioned in various studies as a guide to know the related factors and by planning to manage or strengthen some of them, help to increase the desire to have children.

2Background and purpose: Aedes mosquitoes, especially Aedes aegypti and A. albopictus, due to their special biological and ecological characteristics, have high adaptability and establishment power in different weather conditions, including Iran, and for this reason, they are called invasive mosquitoes. These mosquitoes, which are known as a serious problem for human health, are very important in terms of transmission of very important arboviral diseases such as dengue fever, chikungunya, Zika virus, and yellow fever. Considering the importance of these diseases on the health system and human health, as well as numerous reports of the spread of arboviral diseases through Aedes mosquitoes in different countries, various programs have been proposed to control Aedes mosquitoes. As a result, introducing suitable methods to control Aedes mosquitoes can play a significant role in reducing the transmission of these diseases and maintaining human health. Therefore, in this review, we evaluate the use of each of the Aedes mosquito control methods. Materials and methods: This article is a narrative review of the introduction and effectiveness of different methods of controlling Aedes mosquitoes. Collecting information about control methods of A. aegypti and A. albopictus has been compiled without time and language restrictions from international scientific databases including Pub Med, Web of Science, Google Scholar, (ScienceDirect, Scopus, Elsevier, Lilacs) and Internal databases including, Scientific Information Database(SID), Iranian Medical Library(MedLib), Magiran, Civilica. The information collected based on the performance of each of the mentioned methods was extracted, categorized, analyzed, and used in compiling this article. Finally, out of a total of 10202 extracted articles, 123 articles were used in this research considering the inclusion and exclusion criteria. Results: In general, the goals related to the use of different methods of controlling Aedes mosquitoes are different depending on the country, epidemiological conditions, resources, and local priorities. But overall, disease prevention, reduction of mosquito population, stopping of disease transmission, prevention of mosquito establishment, disease spread, reduction of nuisances and finally identification of new invasive species are prioritized. The most appropriate methods of controlling Aedes are divided into five categories: 1. Environmental methods that include reducing the habitats and growth resources of mosquitoes 2. Chemical methods that are based on the use of various insecticides chemicals and insect growth regulators 3. Mechanical methods that include the use of various traps 4. Biological methods that include the use of natural enemies 5. Genetic methods include genetic engineering and mosquito sterilization techniques. It should be noted that each of these methods can play a significant role in the establishment of Aedes mosquitoes and the spread of arboviral diseases, and as a result, reducing the number of cases of infection and death in the health system. Conclusion: Considering the introduction of different control methods for A. aegypti and A. albopictus and the priority of each of the control methods presented; it is important to mention that the method of controlling Aedes depends a lot on the environmental conditions of the region, the stage of mosquito establishment,  the population phase of mosquitoes and diseases caused by it. Therefore implementation of Aedes mosquito control programs through integrated vector management strategy is recommended, which requires the effective collaboration and coordination of national and local authorities and the general public for cost-effective control and lasting effects.