JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2020 | Volume:29 | Issue:181|Papers Count:19

Background and purpose: Umbilical cord blood (UCB) is a source of Hematopoietic stem cells (HSCs) and has received a lot of attention due to its availability, renewal capacity, proliferation rate, and differentiation potential. The main limitation of using these cells is their low quantity in one unite of UCB. To overcome this, HSCs co-culturing with UCB derived mesenchymal cells (MSCs) is a practical approach. The purpose of this study was the expansion of HSCs together with UCB derived MSCs on a three-dimensional poly L-lactic acid coated with fibronectin. Materials and methods: In this experimental study, after isolation of CD133+ from UCB cells using MACS method, the purity of the isolated cells was carried out by flow cytometry. Then, the cells were seeded on PLLA scaffold coated with fibronectin in presence of mesenchymal cells (group I), the PLLA scaffold in presence of mesenchymal cells (group II), and PLLA scaffold (group III). The proliferation rate, colonization potential and bio-compatibility of the cells were studied using a hemocytometer, CFU assay, and MTT, respectively. Results: The cells co-cuthured with PLLA-Fn scaffold (group I) had a higher proliferation rate of CD133 stemness marker compared to other groups. Also, the colonization of the cells and scaffold ׳ s biocompatibility was significantly higher in this group compared to other groups. (P <0. 05). Conclusion: The study proved that the optimal 3D culture system in PLLA scaffold coated with fibronectin co-cultured with MSCs could reproduce minimum differentiation of CD133 + cells.

Background and purpose: Many herbs including Euphorbia have immunomodulatory properties. The aim of this study was to evaluate the immunomodulatory effects of the ethanolic extract of E. myrsinites. Materials and methods: In this experimental study, 40 Swiss albino male mice were randomly divided into 4 groups. Group A included healthy mice, group B was induced by lipopolysaccharide (LPS), group C received the ethanolic extract of E. myrsinites 7 days before LPS induction. Group D received the plant extract at the same time with LPS induction. Then, blood samples were collected (2 and 6 h after LPS induction) and IL-4, IL-10, TNF-α , and IFN-γ and nitric oxide production were evaluated. Results: Two hours after LPS induction, the levels of IL-4 and IL-10 in groups C and D increased significantly and IFN-γ level decreased significantly compared to those in group B (P=0. 0425). But, six hours after LPS induction, TNF-α level significantly increased in group B compared to that in groups C and D (P=0. 0473), but IL-4 and IL-10 levels increased significantly in groups C and D compared to those in group B (P=0. 0411). The levels of nitric oxide, 2 and 6 hours after LPS induction, significantly decreased in groups C and D compared to those in group B (P=0. 0421). Conclusion: E. myrsinites ethanolic extract has immunomodulatory effects and could be used as an effective drug in inflammatory diseases such as septic shock through reduced production of proinflammatory cytokines.

Background and purpose: Methicillin resistant Staphylococcus aureus (MRSA) have recently emerged as major causes of urinary tract infection (UTI). The aims of this study were to determine antibiotic susceptibility of S. aureus isolated from UTI and to detect the presence of mecA (causing resistance to methicillin) and SCCmec types. Materials and methods: In this cross sectional study, 44 S. aureus isolates were collected in autumn 2017 from patients with UTI in two hospitals in Sanandaj, west of Iran. Susceptibility rates to nine antibiotics and vancomycin were determined by disk diffusion method and E test, respectively. The mecA and SCCmec types were detected by polymerase chain reaction (PCR). Descriptive statistics were used to evaluate the data. Results: Vancomycin, linezolid, and trimethoprim-sulfamethoxazole showed the highest susceptibility rates (more than 90%), followed by gentamicin (86. 4%), cefoxitin (79. 5%), tetracycline (77. 3%), clindamycin (75%), ciprofloxacin (70. 4%), erythromycin (52. 3%), and penicillin (6. 8%). The isolates from inpatients were more susceptible to antibiotics compared to those from outpatients. Of the 44 isolates, 9 (20. 5%) were MRSA, of which 6 were isolated from outpatients. Five of 9 MRSA isolates carried the mecA gene, and of these, two isolates harbored SCCmec V while three were nontypeable. Conclusion: Our study suggests that trimethoprim-sulfamethoxazole, vancomycin or linezolid would be suitable agents in treatment of UTI caused by MRSA. Identification of an MRSA isolate in urine is a serious concern and highlights the need for monitoring drug resistance in S. aureus.

Background and purpose: Obesity is one of the major health problems that is highly prevalent in the world. There is controversial evidence about the association between dietary nitrate and nitrite and obesity. The aim of this study was to investigate the association between dietary nitrate and nitrite intake and incidence of obesity phenotypes. Materials and methods: A prospective approach was used in this research that was conducted in participants of the Tehran Lipid and Glucose Study. The study included 1756 males and females and their nutritional, anthropometry, and biochemical information were recorded every three years and followed for six years. Food Frequency Questionnaire (FFQ) was administered to collect the data. General obesity phenotype, abdominal obesity phenotype, Hypertriglyceridemic-Waist Phenotype (HTW), and body adiposity index phenotype were determined. Then, the incidence of obesity phenotypes across tertiles and intakes of nitrate/nitrite was assessed using regression logistic test. Results: The cumulative incidence of HTW phenotypes was 25% after 6 years. The risk of HTW in highest tertiles compared to the lowest tertiles of total nitrate intake and intake of nitrate and nitrite through fruits decreased insignificantly by 6% (OR = 0. 94, 95% CI = 0. 72-1. 17), 5% (OR = 0. 95, 95% CI = 0. 73-1. 24), and 10% (OR = 0. 90, 95% CI = 0. 69-1. 17), respectively. Conclusion: Dietary nitrate and nitrite had no effect on the occurrence of HTW, BMI, and general and abdominal obesity phenotypes.

Background and purpose: Chest pain is the most prevalent reason for referral to pediatric cardiologist. The condition is mainly associated with non-cardiac disorders such as ribs and cartilaginous problems, trauma, muscle elongation, and pulmonary causes. This study was conducted to evaluate the association between low calcium and vitamin D levels and musculoskeletal chest pain in children. Materials and methods: This age and gender matched case-control study, was conducted in 100 children (5-15 years of age) with chest pain and 100 healthy controls in Amir Kabir Hospital, Arak, Iran 2019. Informed consent was obtained from all participants and the levels of calcium and Vitamin D were evaluated. Data analysis was done in SPSS V11. Results: The mean values for age, height, and weight were not significantly different between the cases and controls. The mean calcium levels in children with chest pain and healthy control were 9. 39± 0. 83 and 9. 26± 0. 6, respectively (P=0. 206). The mean levels of Vitamin D in children with chest pain and in healthy controls were 22. 51± 4. 96 and 40. 33± 9. 81, respectively indicating significant differences between the two groups (P=0. 002). The Odds Ratio (OR) of association between vitamin D deficiency and chest pain was 7. 63 (95% CI: 3. 86-15. 23). Conclusion: The study suggests an association between vitamin D deficiency and chest pain in children, so, evaluation of Vitamin D is needed in children with musculoskeletal chest pain.

Background and purpose: Gutta-percha is generally accepted as the main canal filler. Standard gutta-percha cones are available in 2-10% tapers. The purpose of this study was to compare apical microleakage of canals obturated with different tapers of gutta-percha, using the protein penetration technique. Materials and methods: In this study, 96 maxillary anterior teeth were selected and were prepared by protaper rotary files. The teeth were divided into six experimental groups (n=15) and two control groups (n=3). All groups were obturated with different tapered master cone (2-4-6%) and accessory cone (2-4%) by lateral condensation technique. Protein microleakage was measured in each sample. Data was analyzed applying Kruskal-Wallis test and Mann Whitney test. Results: Statistical analysis showed significant differences between all experimental groups (P<0. 001). The least levels of microleakage were seen in the group treated with 2% master cone and 2% accessory cone, while the highest levels were found in teeth obturated with 4% master cone and 2% accessory cone. Conclusion: In this study, 2% master cone and 2% accessory cone caused least microleakage, but the 6% master cone and 4% accessory cone also showed good results.

Background and purpose: Periapical diseases are the result of untreated pulpitis or inadequate treatment of root canals. This study aimed to investigate the prevalence of different periapical lesions according to demographic variables in patients attending the departments of oral pathology in Mazandaran province, Iran 2012 to 2017. Materials and methods: In this cross-sectional descriptive study, 233 biopsy samples were studied. The age and sex of the patients and the location and type of periapical lesions were investigated. Data analysis was done in SPSS V24 applying Chi-square test, Fisher’ s exact test, ANOVA, and Tukey test. Results: Biopsies belonged to both males, n=118 (50. 6%) and females, n=115 (49. 4%). The mean age of the patients was 37. 8 years (12 to 84 years old). In this study, 152 (65. 2%) lesions were radicular cysts, 50 (21. 5%) were dental granulomas, 7 (3%) were osteomyelitis, 22 (9. 4%) were residual cysts, and 2 (0. 9%) were lateral cysts. The most common sites of involvement were the posterior region of the mandible (48. 8%) and the anterior region of the maxilla (24. 2%). Conclusion: Periapical lesions in teeth are highly prevalent, so it is important to increase people awareness on oral hygiene and prevent these lesions.

Background and purpose: Aging is accompanied by a decline in quality of life. Horticulture is one of the activities that most elderly enjoy and can help preserve their physical and mental activity. The aim of this study was to determine the effect of horticultural therapy on the quality of life of elderly people attending daily care centers. Materials and methods: A quasi-experimental study was carried out with pre-test and post-test design in two groups of intervention and control in 60 elderly people in Sari, Iran 2017. In the intervention group, horticultural treatments were held in groups for 6 weeks in 12 sessions of 30-45 minutes. Quality of life was assessed using Leipad quality of life questionnaire before and after the intervention. Data were analyzed in SPSS V20 applying descriptive and inferential statistics. Results: The mean scores for quality of life in intervention group and controls before the horticultural therapy were 79. 93± 14. 88 and 79. 30± 12. 75 (P= 0. 001) but after the intervention the scores were 86. 03± 11. 87 and 80. 36± 12. 54 (P= 0. 001), respectively. In fact, horticultural therapy was found to significantly improve quality of life in intervention group (P = 0. 001). Conclusion: The intervention was effective in improving the overall quality of life of the elderly studied. Therefore, it could be introduced as an easy, non-invasive, delightful, and helpful method.

Background and purpose: AIDS, can cause psychological and social problems in patients and affects their quality of life. Therefore, infected people need more care. This study was conducted to investigate the effect of different care methods in quality of life of HIV+ patients. Materials and methods: HIV-positive patients in Mazandaran were divided into two groups of intervention (n=34) and control (n=17). Patients in intervention group received medical and social care for one year. Quality of life was assessed in both groups before and after the intervention using WHOQOL-Brief and a researcher-made questionnaire. Results: The study population included 49 patients including 56. 67% males and 43. 33% females. Before the intervention there was no significant difference in quality of life between the two groups. But after the intervention, satisfaction from personal relationships decreased significantly while socialoccupational worries and concerns about the disease showed significant increase in intervention group. Compared to the control group, after one year, satisfaction from current treatment (P=0. 02), concerns about the disease (P=0. 0009), and quality of social life (P=0. 02), showed significant increases in the intervention group. Conclusion: The participants in this study had low levels of quality of life and physical and mental health care could be of great benefit in improving quality of life of HIV+ patients. In designing care protocols for these patients, all aspects of life should be considered.

Background and purpose: Chemotherapy with platinum-base cytotoxic drugs (PBCDs) are commonly used in treatment of different types of cancers. Significant amounts of these drugs enter the hospital effluent via urinary exertion of patients and could adversely affect the environment and different ecosystems. Materials and methods: The samples (n=7) of 24 hours' hospital effluent were collected from a central cancer hospital in Isfahan, Iran using an autosampler for one week. After preparation of the samples, platinum levels were determined by inductive coupled plasma spectrophotometry (ICP-OES). Data on annual PBCDs consumption were obtained from the hospital pharmacy. Data analysis was done applying ANOVA. Results: Annual consumption of PBCDs was 366. 47 gr. Maximum and minimum concentrations of platinum in hospital effluent were 857 and 102 ng/L, respectively (mean concentration: 482. 5± 257 ng/L). Mean effluent platinum levels were found to be significantly correlated with daily administration of PBCDs (P<0. 01). Conclusion: Daily platinum release of the hospital’ s effluent was about 1gr. The incidence of cancer has been increasing in recent years and many private clinics also offer chemotherapy treatments which could exacerbate polluting the environment. So, further studies are needed to evaluate the environmental effects of platinum from hospital effluents.

Background and purpose: In experimental studies, proper choice of anesthesia method is important for both validity of results and improving the rate of success and mortality. In current study, we examined the effects of lidocaine combined with chloral hydrate for induction of anesthesia in a rat model of ischemic stroke. Materials and methods: In this research, 30 male rats were studied as sham, chloral hydrate, and chloral hydrate + lidocaine groups. Focal cerebral ischemia was induced by intraluminal filament method. Twenty four hours following ischemia, the animals were assessed for sensorimotor neurological deficits and infarct volume. Coronal sections of the brain tissue were stained using triphenyltetrazolium chloride and quantified by an image analysis system. Results: Combination of lidocaine and chloral hydrate for induction of anesthesia resulted in better sensorimotor performance compared with chloral hydrate alone (P<0. 01), while no significant different was found between these two groups in infarct volume (P=0. 41). Additionally, combination of lidocaine with chloral hydrate produced safe anesthesia in animals with low mortality rate. Conclusion: Combination of lidocaine with chloral hydrate produced safe anesthesia and analgesia, better sensorimotor performance, and low mortality rate in the animals studied.

Background and purpose: Cutaneous leishmaniasis is a skin disease manifested as chronic ulcerative skin lesions. Current standard therapies for this disease are associated with some problems such as high cost, numerous side effects, need for injections, and drug resistance. Sambucus ebulus is used in treatment of skin inflammation. This study aimed at investigating the effects of S. ebulus leaf extract on cutaneous leishmanisis. Materials and methods: This clinical trial was performed in 110 patients who were divided into intervention (n=55) and control groups (n=55). All patients received the standard treatment for leishmanisis. In addition, the intervention group received topical treatment of S. ebulus leaf extract 5%, while the control group received placebo. The therapy was continued until complete epithelialization of the lesions. Before the intervention and at the end of each week (until complete epithelialization of the lesions), healing progress and clinical characteristics of the lesions, including the size, induration, and degree of epithelialization were recorded. Results: The intervention accelerated the decrease in mean diameter of lesions (P<0. 05) but had no significant effect on the mean duration of therapy (P=0. 31), treatment outcome (P=0. 87), degree of recovery (P= 0. 95). Conclusion: The use of S. ebulus leaf extract ointment (5%) along with the standard therapy showed no effect on the treatment outcome of lesions caused by cutaneous leishmaniasis.

Background and purpose: Cutaneous leishmaniasis is the second most important tropical disease after malaria which is endemic in many countries, including Iran. This study was conducted to investigate the epidemiology and geographical distribution of cutaneous leishmaniasis in Golestan province, Iran. Materials and methods: This descriptive cross-sectional study was carried out in patients with the signs of cutaneous leishmaniasis attending Golestan health-care centers, 2014-2016. Two thin smears were prepared from the margin of lesions and stained using Giemsa stain. They were then studied by light microscope. Data were analyzed applying ANOVA in SPSS V21. Results: There were 1823 cases, of whom 1815 (99. 56%) were found positive for the presence of amastigotes. The highest incidence rate of cutaneous leishmaniasis was in fall and in children younger than 9 years of age. Spatial distribution of the disease showed hotspots in Kalaleh and Maraveh Tappeh (P<0. 05). Conclusion: In this study, the prevalence of cutaneous leishmaniasis was higher in rural areas. Also, some areas such as Kalaleh and Maraveh Tappeh require urgent attention of prevention sector.

Background and purpose: Sexual dysfunction (SD) is a common symptom of multiple sclerosis (MS). This study was conducted to determine the frequency of sexual dysfunction and its types in women with MS and identifying the related factors. Materials and methods: A descriptive cross-sectional study was done in female patients (n= 114) attending an outpatient MS clinic in Sari, Iran 2018. The participants included female married patients with no history of relapse and pulse therapy during the past three months, no history of hepatic problem, no history of pschyciateric diseases and pschyciateric medications. Information was collected using the Female Sexual Functioning Index (FSFI). Data analysis was done in SPSS V16 applying correlation test. Results: All patients (100%) reported sexual dysfunction, including painful intercourse (93%), decreased lubrication (80. 7%), lack of arousal (43. 9%), lack of desire (38%), difficulty in reaching orgasm (36. 8%), and lack of satisfaction (36. 8%). In this study, 63. 1% of the patients experienced mild depression. Significant associations were seen between depression (P=0. 007), sphincter problems (P=0. 02), and sexual dysfunction. Conclusion: Awareness on the high frequency of sexual dysfunction in MS patients helps to eliminate the underlying causes and improving the quality of life in these patients.

Background and purpose: Renal colic is one of the most common causes of referral to emergency departments. The aim of this study was to determine the outcome and predictive factors for invasive management and readmission in these patients. Materials and methods: A cross-sectional cohort study was performed in all patients with renal colic who were admitted in Emergency Department in Sari Imam Khomeini Hospital, 2016-2017. Diagnostic and therapeutic procedures, the patients’ clinical and paraclinical information, and disease outcome after a month (the need for invasive urologic intervention, recurrence, and readmission) were recorded. Data analysis was done in SPSS V18. Results: There were 581 patients in this study (mean age: 39. 88 ± 14. 49 years). The most common symptoms were flank pain (88. 1%) and sudden onset pain (69. 2%). Invasive treatment was carried out for 140 (24. 1%) patients. Nausea (P = 0. 002) and vomiting (P = 0. 001) were found to be significantly higher in patients requiring invasive procedure. Abnormal ultrasound findings in patients requiring invasive procedure were significantly higher (P = 0. 00). Renal colic recurrence was significantly higher in patients of older age (P = 0. 002), those with abdominal pain (P = 0. 004), genital area pain (P = 0. 041), fever and chill (P = 0. 037), history of underlying diseases (P = 0. 033) and higher white blood cell counts (P = 0. 00). Conclusion: Factors such as age, underlying diseases, fever and chills, nausea, vomiting, white blood cell count, and ultrasound findings in these patients should be considered in order to choose the best treatment option.

Background and purpose: Basal cell carcinoma (BCC) is the most common form of skin cancer. Previous studies have shown that the prevalence of the disease is increasing and the age of the disease is decreasing. This type of cancer can have devastating effects. The aim of this study was to determine the prevalence of BCC in Head and Neck Malignancy Center in Mazandaran, Iran 2017-2018. Materials and methods: In this retrospective descriptive study, 4532 files in pathology department were studied and 70 records of BCC were extracted. Data were analyzed applying Chi-square test in SPSS V16. Results: A total of 70 cases were studied. The patients included 47 males and 23 females, mean age 64. 7 years old. The most common site of the disease was head and face (64. 28%) and larynx (22. 85%). There was a significant relationship between the disease outbreak and age (P= 0. 40) and sex (P= 0. 035). Conclusion: The prevalence of BCC in the present study was much higher than that in other studies in the region.

Background and purpose: Chronic neck pain is a common problem in musculoskeletal disorders and limitation of neck and shoulder movements can reduce quality of life. The aim of this study was to evaluate the effect of Dalk and Ghamz massage on range of neck and shoulder motions and quality of life in patients with chronic non-specific neck pain. Materials and methods: This quasi-experimental study was conducted in Tehran, Iran 2018. The intervention was performed in 4 successive stages. The study outcomes in relation to quality of life were measured before the intervention, after the intervention, and one month after the intervention. Restrictions of neck and shoulder and movements were measured before and after each intervention and one month after the last intervention. Data analysis was done in SPSS. Results: Findings showed significant differences between the scores for quality of life and range of motion in neck region before and after the intervention (P<0. 05). These values did not reveal any significant differences in one-month follow-up (P> 0. 05). Conclusion: The Dalk and the Ghamz massage improved the quality of life and range of motion in shoulder and neck region in patients with chronic non-specific neck pain.

Inflammatory Myofibroblastic Tumor (IMT) is an uncommon benign neoplasm with unknown etiology that rarely affect parotid gland. Clinical and pathologic diagnosis of this neoplasm is difficult and is occasionally misdiagnosed as malignant. This reports presents the case of a 42 year old woman with IMT in the right parotid gland. Using fine needle aspiration cytology, pleomorphic adenoma and mucoepidermoid carcinoma were suggested as differential diagnosis and right parotidectomy was performed. Histopathologic examination along with immunohistochemical analysis confirmed an IMT. During microscopic examination of parotid mass, especially in presence of myxoid background along with inflammatory cells infiltration, inflammatory myofibroblastic tumor should also be considered.

Background and purpose: Human health and disease are as old as human history. Today, the concept of health is tied to the components of social capital which can act as a shield against stress, depression, anxiety, accident, aging, and various diseases. The present study aimed to review the effect of social capital on women's health. Materials and methods: A scoping review was carried out in five stages: 1-Designing a research question, 2-Searching and extracting research-dependent studies, 3-Selecting related studies, 4-Organizing and summarizing information and data, and 5. Reporting the results. Data collection was done in electronic databases, including MagIran, SID, Iran Doc, IranMedex, Scopus, Google scholar, PubMed, Science Direct, and Embase. The search keywords were women, female, feminine, lady, wife, Iran, Persian, Social capital, health, physical health, mental health, and social health in both Persian and English. Results: Overall, 15 related articles were included in this review study. These studies were reviewed to organize the findings into three categories: the relationship between social capital with physical health, mental health, and social health. Conclusion: According to current findings, women's health improves by increasing their social capital which is also increased by more health and education facilities, social participation, trust, and communication with family and friends.