Journal of Mazandaran University of Medical Sciences
Year:2020 | Volume:30 | Issue:184|Papers Count:20

Background and purpose: Asthma is a chronic inflammatory disease of the airways that is associated with excessive irritation and airway obstruction. The aim of the present study was to investigate the immunomodulatory effects of betaine on experimental model of asthma in Balb/c mice. Materials and methods: The statistical population consisted of 32 Balb/c mice that were randomly divided into four groups (n=8 per group). One group (control) was not sensitized with ovalbumin to induce experimental asthma. Experimental asthma was induced in other three groups by injecting ovalbumin. These groups were treated with saline phosphate buffer, betaine (1% w/w), and prednisolone (3 mg/kg) in drinking water, for 81 days after induction of the disease, respectively. Then, blood and spleen samples were collected for biochemical studies. Results: Betaine treatment of ovalbumin-sensitized mice significantly reduced IgE antibody production, spleen cell proliferation, IL-5 and IL-17 levels, and significantly increased TGF-β and INF-γ levels (P<0. 05). Conclusion: Betaine as a naturally occurring chemical in the body has significant effects on IgE production and levels of some key cytokines of asthma. So, this substance could be considered as as a possible candidate for modulating immune responses in asthma.

Background and purpose: Dramatic increase in antibiotic-resistant bacteria highlights the need for new compounds with more effective antibacterial properties and biotechnology could be useful in producing these metabolites. The present study aimed at investigating the effects of rhamnolipid microbial surfactants in a cream-based formulation on growth inhibition of Staphylococcus aureus using in vitro and animal models. Materials and methods: The inhibitory effects of rhamnolipids produced by Pseudomonas aeruginosa MR01 on the growth of S. aureus were investigated by disk diffusion method. Then, the effects of dirhamnolipid compounds on the survival and morphology of bacteria were studied using estimation of colony forming units (CFUs) and scanning electron microscopy (SEM). The dirhamnolipid-containing cream was prepared and its effects on inhibition of the bacterial growth was evaluated in in vitro and animal subjects. Results: Disk diffusion tests showed a minimum inhibitory value of 30mg/disk for aqueous solutions of mono-and di-rhamnolipids, and 20mg/disk and 10mg/disk for mono-and di-rhamnolipid solutions in Dimethyl sulfoxide (DMSO), respectively. The aqueous solution of di-rhamnolipids at 20mg/ml resulted in lack of viable cells of S. aureus. SEM images showed changes in spherical shape of S. aureus during rhamnolipid treatments. Di-rhamnolipid-containing cream led to inhibition of bacterial growth in vitro on agar medium. Moreover, findings in rats indicated inhibition of bacterial growth in wound areas after 20 days of treatment with the cream. Conclusion: In current study, Di-rhamnolipids demonstrated inhibitory effects on the growth of S. aureus. These compounds in cream formulation could also have antibacterial effects.

Background and purpose: It is estimated that 70– 75% of women experience one episode of vulvovaginal candidiasis (VVC) during childbearing age and 40-50% suffer from recurrent VVC. Because of the resistance of Candida species to certain drugs, such as azoles, physicians tend to use complementary or alternative medicine such as vinegar in treatment of VVC. The current study aimed to determine the therapeutic effects of acetic acid vaginal gel on VVC. Materials and methods: A double-blind randomized clinical trial was done in women (n=41) with VVC in Sari, Iran. The patients were allocated into two treatment groups to receive either 2% acetic acid vaginal gel + 2% acetic acid intravaginal wash + clotrimazole vaginal cream (n=20) or 2% acetic acid intravaginal wash + clotrimazole vaginal cream (n=21) for 10 days. After treatment, clinical symptoms and mycological cure rate were assessed by culture of vaginal secretions. All yeast isolates were identified by molecular method. Results: Before the intervention, there were no significant differences in signs and symptoms (P= 0. 703), fungal burden rate (low, medium, heavy) (P= 0. 092), and causative Candida species (P= 0. 188) between the two groups. After treatment, an improvement in symptoms was seen in case group but the difference was not significant (P =0. 3512). A significant difference was found between the two groups in mycological cure rate (P= 0. 0377). Candida albicans were the most common species causing the disease. Conclusion: The study showed that acetic acid vaginal gel could have a significant effect on the definitive cure of VVC.

Background and purpose: Spinal anesthesia is commonly used in transurethral resection of the prostate (TURP). To reduce the complications of spinal anesthesia, opioids could be helpful in decreasing the amount of anesthetic drug. The aim of this study was to evaluate the effect of low doses of bupivacaine and fentanyl on the levels of sensory block and motor block. Materials and methods: A clinical trial was conducted in 80 TURP candidates in Babol Rouhani Hospital, 2016-2017. They were randomly divided into two groups (n= 40 per group) to receive either 7. 5 mg bupivacaine 0. 5% and 25 mcg of fentanyl (BF group) or 10mg bupivacaine 0. 5% (B group). Duration of anesthesia, motor block (using Bromage score), pain intensity during the operation, and mean arterial pressure were recorded. Data were analyzed in SPSS V20. Results: There were no significant differences between the two groups in duration of anesthesia and mean arterial pressure (P<0. 05). The mean score for pain was significantly lower in BF group than the B group (P=0. 007). The levels of sensory block in group B were significantly higher than the BF group (P<0. 001). Also, motor block return time and recovery time were significantly shorter in BF group than those in B group (P<0. 001). Conclusion: According to the current study, administration of bupivacaine and fentanyl can cause appropriate level of sensory block and could relief pain during TURP. Also, some complications such as long-term motor block and long-term staying in recovery would reduce.

Background and purpose: Emotional dysregulations are associated with a wide range of mental disorders. This research aimed at investigating the effectiveness of affect regulation training group therapy on the symptoms of anxiety and depression. Materials and methods: An experimental research with control group was performed in 32 people with subclinical symptoms of anxiety and depression, selected through convenient sampling and randomly assigned to either the experimental group or control group. Experimental group attended 12 sessions of ART, while no intervention was performed in the control group. The participants were assessed before and after the study using Depression Anxiety Stress Scales (DASS), Positive and Negative Affect Scale (PANAS), Emotion Regulation Skills Questionnaire (ERSQ), and Work and Social Adjustment Scale (WSAS). All data analyses were performed using SPSS V16. Results: The experimental group showed significant decrease in subclinical symptoms of anxiety (P=0. 01), depression (P=0. 01), and stress (P= 0. 01), and significant increase in emotion regulation skills (P=0. 01) and social adjustment (P=0. 01). Conclusion: In general, ART can be used as an effective transdiagnostic approach in reducing the symptoms of anxiety and depression.

Background and purpose: Mental health is one of the main aspects that is directly related to the quality of life of pregnant women. The purpose of this study was to determine the effect of group counseling on quality of life in pregnant women applying positive psychology. Materials and methods: In a randomized clinical trial, 56 pregnant women were selected by convenience sampling and were divided into intervention (n=28) and control (n=28) groups using randomized block design. The health-related quality of life questionnaire SF-36 was administered at pretest, post-test, and six weeks after the intervention. Positive psychology interventions were performed twice weekly for 60 min per session during four weeks. Data were analyzed using descriptive statistics and Chi-square, independent t-test, and repeated measures ANOVA. Results: After the intervention, there was a significant difference in the mean score for quality of life between the intervention group (76. 78± 11. 9) and control group (67. 90± 13. 06) (P= 0. 01). The mean scores for physical and psychological dimensions also showed significant differences between the two groups at post-test (P <0. 05). Six weeks after the intervention, there was a significant difference between the two groups in the psychological dimension (P= 0. 043), but the mean score for total quality of life (P= 0. 058) and its physical dimension (P=0. 093) were not significantly different. Repeated measures ANOVA showed significant differences between all variables in the intervention group (P<0. 001). Conclusion: Positive counseling can improve the quality of life and mental health of pregnant women, but quality of life is a multidimensional issue and its maintenance requires attention to all aspects of health and consistent counseling.

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women during reproductive ages. This syndrome is associated with disruption of sex hormone levels. Studies have shown that endurance of the heart to ischemia-reperfusion (I/R) injury can be affected by sex hormones. In the present study, the rate of cardiac tolerance against I/R injury in the PCOS rat model was compared with normal (control) rats. Materials and Methods: The rats were randomly divided into two groups; PCOS and control (n=8 per group). The hearts were isolated in Langendorff isolated heart system. Cardiac perfusion was performed in a retrograde flow in the aorta at constant pressure (75 mmHg) by Krebs-Henslit buffer. A pressure (5-10 mmHg) was put to the left ventricle, using an intraventricular balloon, to measure the hemodynamic parameters of the heart. Cardiac signals were recorded while being transmitted through the catheter to the Powerbull system. Results: Before I/R, the values for cardiac hemodynamic parameters including HR, LVDP, RPP and ± dp/dt, increased in the rat model of PCOS compared to controls, although these increases were not statistically significant (P>0. 05). These parameters had decreasing trends after I/R in PCOS rats compared to controls which were not statistically significant (P>0. 05). Conclusion: Cardiac resistance to I/R injury was found to be similar in both PCOS and control animals, which could be due to the cardioprotective role of sex hormones such as estrogens.

Background and purpose: Emergency department is one of the most important and risky areas in the hospital. Adherence to safety standards significantly contributes to increased patient satisfaction and service quality. The aim of this study was to evaluate the patient safety dimensions in emergency departments in educational hospitals affiliated with Mazandaran University of Medical Sciences applying operational planning. Materials and methods: This descriptive-analytical study was carried out in 2019 and data was collected using the National Health Accreditation Standard Questionnaire. Questionnaire items were categorized according to the operational modeling into input, process, outcome, control, and contextual dimensions. Statistical analysis was performed in SPSS V21. Results: The total mean score for patient safety in emergency departments was 3. 82 ± 0. 20 which was relatively good. The highest and lowest scores were in the control (4. 36 ± 0. 10) and contextual dimensions (3. 02 ± 0. 77), respectively. Educational hospitals had higher scores in overall patient safety and safety in structural, process, and outcome dimensions. Non-educational hospitals were found to be better in control and contextual dimensions. Conclusion: According to current study, patient safety should reach a more desirable level in emergency departments. Operational planning is a useful model in identifying the major stages of service delivery and designing appropriate interventions.

Background and purpose: Pain in labor causes stress and reduces self-steem. Effective support is a key factor in reducing stress during delivery. The present study aimed to investigate and compare the effects of standard maternity care, continuous supports from private midwife, and female relatives on type and process of delivery, maternal satisfaction, and breastfeeding. Materials and methods: A clinical trial was done in 165 primiparous women attending Amol Imam Ali Hospital, Iran 2018. They were randomly classified into three groups to recieve standard maternity care during delivery (n=55), continuous supports from private midwife (n=55), and female relatives (n=55). The following parameters were compared between all groups: duration and severity of labor pain, type of delivery, maternal satisfaction, Apgar scores, and the start of lactation and continuation of breastfeeding. Results: The duration (P<0. 001) and pain severity (P<0. 001) of active phase of labor were significantly lower in groups that received continuous support by private midwife and female relatives. In these groups, the satisfaction rates of delivery (P<0. 001) and breastfeeding (P=0. 01) were significantly higher than the control group in 6 months after delivery. No significant differences were found between the groups in length (P=0. 92) and severity of pain (P=0. 99) at the second stage of delivery, cesarean delivery (P=0. 20), Apgar score (P=0. 87), start of lactation (P=0. 35), and breastfeeding in three months after the delivery (P=0. 34). Severity of pain in active phase of delivery was significantly lower in the group that received continuous support by private midwife, than that of those who received supports from female relatives (P= 0. 019). Conclusion: Continuous supports by relatives or private midwife have positive effects on duration and severity of pain in active phase of labor and breastfeeding and could influence mothers' decisions for future pregnancies.

Background and purpose: Nonlinear analysis methods for quantitative structure– activity relationship (QSAR) studies better describe molecular behaviors, than linear analysis. Artificial neural networks are mathematical models and algorithms which imitate the information process and learning of human brain. Some S-alkyl derivatives of thiosemicarbazone are shown to be beneficial in prevention and treatment of mycobacterial infections and this study seeks to find out the relationship between structural features and the anti-tuberculosis activity of these compounds. Materials and methods: Multiple linear regression and Bayesian regularized artificial neural network (BRANN) for 47 compounds of thiosemicarbazone derivatives were designed using QSAR approaches. Descriptors were selected from a pool of 343 descriptors by stepwise selection and backward elimination. A three layer Bayesian regularized back-propagation feed-forward network was designed, optimized, and evaluated using MATLAB version R2009a. Results: The best model with 6 descriptors was found using multiple linear regression analysis: Log MIC= 2. 592 + (0. 067 ± 0. 018) PMIX – (0. 066 ± 0. 017) PMIZ – (1. 706 ± 1. 600) Qneg – (0. 235 ± 0. 039) RDF030p + (0. 118 ± 0. 026) RDF 140u – (0. 064 ± 0. 021) RDF060p. The best BRANN model was a threelayer network with three nodes in its hidden layer. Conclusion: The BRANN model has a better predictive power than linear models and may better predict the anti-tuberculosis activity of new compounds with similar backbone of thiosemicarbazone moiety.

Background and purpose: Drugs are essential components of health services in all communities and pharmacists play a major role in delivering appropriate health care. There are lack of comprehensive studies on the knowledge, attitude, and practice of pharmacists in dealing with prescription drugs in Mazandaran province, Iran, so, this study aimed at assessing the performance of pharmacists on these issues. Materials and methods: A cross-sectional study was carried out in 179 community pharmacies in Mazandaran province selected via random sampling. A trained shopper with a prescription attended the pharmacy and based on researcher-made flowchart and questionnaire, the pharmacist's performance on drug interactions, side effects, etc. was evaluated. Results: Among the pharmacies investigated (n=179), pharmacists were available in 154 (86%) and pharmacist consultations were observed in 67 (37%) pharmacies. Right medications were given in 157 (88%) pharmacies and in 166 (93%) instructions for use were completely correct and in accordance with the prescription. Conclusion: At the community pharmacy, pharmacists usually focus on dispensing correct medication and pay less attention to pharmacy counseling. Trainings on drug interactions and adverse drug reactions could increase the awareness and knowledge of pharmacists.

Background and purpose: Colchicum kurdicum (Bornm. ) Stef. is a monocotyledon plant which is endemic to Iran. The corm and seeds of this plant have some bioactive compounds, especially tropolone alkaloids that are used in treatment of inflammations, rheumatoid arthritis, gout, joint pains, and cancers. This study aimed at optimization of colchicine extraction from the corms of C. kurdicum and evaluating anti-inflammatory and anti-oxidant activities of the extracts. Materials and methods: The extraction of colchicine from C. kurdicum was optimized by the ultrasonic-assisted extraction method in methanol/deionized water (70: 30) solvent system. The responsesurface method was also used for analysis and optimization of the extraction. The effects of extraction time, solvent/plant ratio, and temperature were analyzed. Moreover, the extracted colchicine was assayed by HPLC. Finally, anti-inflammatory and anti-oxidant activities of the extracts were evaluated. Results: Colchicine/g corm (0. 98± 0. 04 mg) was achieved in optimum condition; extraction time of 180 min, solvent/plant ratio of 20 ml/g, and temperature of 60 oC. Also, increase in temperature decreased the extraction time and solvent/plant ratio. The highest anti-inflammatory and anti-oxidant activities were found in extracts 7 and 12. Conclusion: In this study, ultrasonic-assisted extraction was found as an effective method for extraction of colchicine from C. kurdicum.

Background and purpose: Obsessive compulsive disorder (OCD) has negative impacts on patients and their families. This research was conducted to determine the effect of family and patient oriented education program on obsessive-compulsive symptoms in patients with OCD. Materials and methods: This semi-experimental study was carried out in 50 patients and their primary caregivers in Sari, Iran 2018. The intervention group attended eight educational sessions and the control group received usual treatment. Data were collected using Maudsley Obsessive-Compulsive Inventory and Goldberg General Health Questionnaire and analyzed in SPSS V21. Results: The mean scores for OCD symptoms in the intervention group were 17. 52± 3. 74, 17. 16 ± 3. 50, and 13. 28± 4. 17 before the intervention, after one month, and after the intervention, respectively. The scores in the control group were 15. 08± 1. 99, 13. 42 ± 2. 79, and 12. 84± 2. 59, respectively. Findings showed that the mean score for OCD symptoms decreased significantly in both groups over time (P<0. 001). Decrease in the scores for OCD symptoms before and one month after the intervention was found to be significantly different between the two groups (P= 0. 025). Conclusion: The mean scores for obsessive-compulsive symptoms declined in both groups over time. This decline in the intervention group could be associated with education alongside routine treatment.

Background and purpose: Parents of children with attention deficit hyperactivity disorder (ADHD) have more problems than parents of normal children due to the prevalence of behavioral abnormalities in children with ADHD. Mood disorders in parents, including mothers can lead to lower tolerance thresholds and the use of punitive methods to control the children, which can cause other complications. Therefore, evaluation of mood disorders and timely treatment could be of great help in treating these children and improving the prognosis of the disease. Materials and methods: This cross-sectional study was conducted in 125 mothers of children with ADHD attending two psychiatric clinics in Babol, Iran 2014-2016. Data were collected using the Conners' Parent Rating Scales-Revised (CPRS-R) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Data analysis was done in SPSS V22. Results: The prevalence of mood disorders in mothers of 6-14 year-old children with ADHD was 44% (n=55). Among the mood disorders, dysthymia (27%) was the most common disorder. Forty-five mothers (36%) had depression and 9 (7. 2%) had bipolar disorder. Conclusion: According to current study, depression was the most common mood disorder in mothers. Maternal depression influences the management of a child with ADHD, so, early diagnosis and treatment of maternal depression play major roles in the prognosis of ADHD in a child with this disorder.

Background and purpose: Nurses working in intensive care units (ICUs) are sometimes faced with ethical decision making which requires ethical sensitivity and moral intelligence. The purpose of this study was to investigate the relationship between moral sensitivity and moral intelligence in nurses working in intensive care units. Materials and methods: This cross-sectional correlational study was conducted in 112 nurses working in adult ICUs who were selected by census sampling in Amol, Iran 2019. The Moral Sensitivity Questionnaire and Moral Intelligence Questionnaire were administered and data were analyzed applying descriptive and analytical statistics. Results: No significant relationship was found between moral intelligence and moral sensitivity (r= 0. 14, P= 0. 15). But, there was a significant positive relationship between moral intelligence and the dimension of knowing how to communicate with the patient as one of the areas of moral sensitivity (P<0. 05). Conclusion: According to current study, high levels of moral intelligence would help nurses in having better relationships with patients. Therefore, developing appropriate programs are suggested to improve ethical sensitivity in nurses.

Background and purpose: Social capital is one of the factors affecting the health of diabetic patients which will also affect their quality of life. The purpose of this study was to investigate the relationship between social capital, psychological well-being, and quality of life in diabetes patients. Materials and methods: A cross-sectional study was conducted in 275 diabetic patients attending Qaemshahr Razi Hospital in north of Iran. They were selected via convenience sampling. Data were collected using a demographic checklist, the Social Capital Questionnaire (SCQ), Diabetes Quality of Life questionnaire (DQOL), and World Health Organization Well-Being Index. Data were analyzed in SPSS V22. Results: The mean values for social capital, psychological well-being, and quality of life were 103. 74 ± 19. 56, 13. 19 ± 5. 47, and 43. 59 ± 7. 2, respectively. The study showed that social capital was positively and significantly associated with psychological well-being and quality of life (P<0. 05). In this study, psychological well-being, social capital, more children, and higher educational backgrounds explained 34% of the variance in quality of life of diabetic patients. Conclusion: Appropriate interventions on psychological well-being and social capital are needed to improve the quality of life of diabetes patients.

Lichen planus (LP) is a relatively uncommon, chronic inflammatory disease with idiopathic pathogenesis that usually involves skin, nails, and mucous membranes. Esophageal involvement in LP is rarely seen, despite the classification of the esophagus as a mucous membrane. Esophageal lichen planus is common in middle aged women, with symptoms such as dysphagia and odynophagia. This paper presents the case of a middle aged woman with dysphagia to solid foods. She underwent diagnostic measures including upper esophagogastroduodenoscopy which showed severe stenosis in upper and middle third of the esophagus. In multiple times, the patient underwent endoscopic dilation due to recurrence of stenosis but the effect was slight and transient. Fibrosis was reported in repeated biopsies taken from esophagus. According to clinical and endoscopic findings and a high suspicion of LP, biopsy of the lip was done which confirmed lichen planus. Due to frequent recurrence of stenosis in this area, along steroid therapy, removable fully covered stent was placed for four weeks. The patient was under follow-up for two years and the stenosis did not recur.

Background and purpose: COVID-19 is an emerging viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Bacterial or fungal superinfections of the lung may cause complications in clinical manifestations, treatment, and increase the mortality rate. In this article, we reviewed previous studies on invasive aspergillosis (IA) in viral infections and in adjustment with COVID-19. Also, the necessity of IA diagnosis to increase the survival rate in involved patients is discussed. Materials and methods: Electronic databases, including Pubmed, Google Scholar, and Web of Science were searched using the following keywords: COVID-19, SARS-CoV-2, influenza, invasive aspergillosis, and invasive fungal infections. Results: Reports from China showed 3. 2% to 27. 1% fungal co-infection in COVID-19 patients. Patients with COVID-19 who developed severe pneumonia were found with considerably higher rates of viral, bacterial, and fungal co-infections than those with mild pneumonia. Also, intestinal normal fungal flora was reported to be significantly different between COVID-19 patients and normal subjects. Conclusion: While the main focus of physicians is on bacterial superinfection control in COVID-19, ignoring life threatening fungal infections may increase the mortality rate. Therefore, we profoundly recommend early diagnosis of invasive fungal infections in COVID-19 patients.

Leishmaniasis is a vector-borne zoonotic disease caused by various species of the genus Leishmania, (trypanosomatidae family) that is transmitted by phlebotomine sandflies. The disease can present in a range of clinical forms, including dermal lesions, metastasis mucocutaneous forms, and fatal visceral forms. In this non-systematic review, we aimed at introducing the role of kinetoplast DNA (kDNA) and dependent topoisomerases (TPI) as potential chemotherapeutic targets for treatment of leishmaniasis. The Leishmania parasite has a mitochondrial DNA located in the attached circles. KDNA replication process is very complex and a large number of proteins are involved. Some of them are classified as topoisomerases, which play major biological roles in the effective cell processes in the topology, synthesis, and organization of kDNA and constitute the main drug target in kinetoplast for leishmaniasis cure. Several studies have shown that the inhibitors of TPI exchange these enzymes into intracellular cell toxins and provide an appropriate tool for killing the parasite in the host. DNA binding drugs have also been reported as therapeutic agents against leishmanial infections.