Journal of Mazandaran University of Medical Sciences
Year:2019 | Volume:29 | Issue:178|Papers Count:20

Background and purpose: The aminoglycoside modifying enzymes (AMEs) and class 1 integrons in clinical isolates of pseudomonas aeruginosa are the major factors leading to rapid spread of antibiotic resistance. The aim of the present study was to investigate the frequency of aac(6)-IIa, ant(2'')-Ia, and class 1 integrons in clinical isolates of pseudomonas aeruginosa. Materials and methods: For this descriptive-analytic study (2017-2018), 100 clinical isolates of pseudomonas aeruginosa were collected from Sari teaching hospitals and identified by differential diagnostic tests. Antibiotic susceptibility pattern of all isolates against selected antibiotics was evaluated using standard disk agar diffusion method. Subsequently, all isolates were evaluated for the presence of aac (6)-IIa, ant (2'')-Ia genes, and class I integrons using PCR method. Results: Out of 100 pseudomonas aeruginosa clinical isolates, 28%, 42%, and 39% were resistant to amikacin, gentamicin, and tobramycin, respectively, while 26 isolates were resistant to all three antibiotics. The results of PCR showed that 42% of the clinical isolates contained class 1 integrons. The prevalence of aac (6)-IIa and ant (2 '')-Ia genes in aminoglycoside resistant isolates was 41. 8% and 13. 9%, respectively. Conclusion: Aminoglycosides are the preferred drug for the combined treatment of infections caused by Pseudomonas aeruginosa and the prevalence of resistance to them is also high, so the intermittent examination of the susceptibility pattern of these antibiotics and the genes associated with this issue is necessary to prevent the prevalence of high levels of resistance in this bacterium.

Background and purpose: Polycyclic aromatic hydrocarbons (PAHs) are one of the most common environmental pollutants that are proven to be carcinogenic and mutagenic. Doogh, is a widely consumed fermented yoghurt drink in Iran. The aim of this study was to determine the presence and concentration of PAHs in different brands of Doogh in Tehran, Iran. Materials and methods: In this study, we synthesized multi-walled magnetic carbon nanotubes using iron oxide. Then synthesized magnetic nanotubes were used for absorption and extraction of PAHs from Doogh matrix. After sample preparation, concentrations of all PAHs were measured by GC-MS. Materials and methods: In this study, we synthesized multi-walled magnetic carbon nanotubes using iron oxide. Then synthesized magnetic nanotubes were used for absorption and extraction of PAHs from 24 samples of Doogh matrix (3 high-consumption brands randomly selected in all four seasons and two dates) and one sample as a control. After sample preparation, concentrations of all 16 PAHs were measured by GC-MS. Conclusion: In this study, the concentrations of PAHs in different brands of Doogh were lower than standard levels, so it would create no harmful effect to the consumers.

Background and purpose: Preeclampsia is a pregnancy complication with multiorgan involvement caused by the loss of mother's immune tolerance to the placenta and fetus antigen or the wrong adjustment. HLA-G is an immune-modulatory molecule and this study aimed at investigating the levels of HLA-G and its association with incidence and severity of preeclampsia in pregnant women in third trimester. Materials and methods: A case-control study was performed in pregnant women attending Sari Imam Khomeini Hospital and Baqban Clinic, 2015-2016. A total of 71 subjects (in third trimester) was selected meeting the study inclusion criteria. They were divided into two groups; a group with preeclampsia (n=34) and a group of pregnant women without preeclampsia (n= 37, controls). Pregnancy routine lab tests were done and demographic information, blood pressure levels, and incidence of preeclampsia were recorded in both groups. Then, blood sample (5 ml) was collected from all cases and HLA-G levels were measured in serum samples. Results: The mean serum levels of HLA-G were significantly lower in women with preeclampsia (0. 58± 0. 18 ng/L) compared to that of other group (0. 78± 0. 45 ng/L) (P=0. 02). Also, the mean serum levels of HLA-G in those with mild preeclampsia was significantly higher than that of cases with severe preeclampsia (P=0. 04). Conclusion: Decrease in production of HLA-G molecule is believed to be one of the decisive factors in development and progression of preeclampsia which could be due to abnormalities in gene expression. Therefore, HLA-G molecule and its mechanism should be further studied to prevent this condition.

Background and purpose: Beta-thalassemia major is a genetic disorder with known globin defect that leads to chronic hemolytic anemia. Due to the need for recurrent blood transfusion, the risk of infectious diseases such as hepatitis is higher in these patients. Materials and methods: This cross-sectional study recruited 518 patients with thalassemia major in Amirkola Thalassemia Center, 2013-2014 who were selected via census sampling. Patients' blood samples were analyzed for HBsAb, HBsAg, and HCVAb by ELISA test. Data were analyzed in SPSS V22. Results: The patients included 268 (51. 7%) females and 250 (48. 3%) males with the mean age of 27. 93± 9. 88 years. The study showed that 5. 79% of patients with thalassemia major were infected with HCV, including 11 (4. 4%) males and 19 (7. 1%) females and only one male patient was found to be HBsAg positive. Conclusion: The study showed lower incidence of hepatitis C compared to previous reports from Amirkola Thalassemia Center. In current study the prevalence of HBsAg was also found to be low.

Background and purpose: Background radiation exists naturally in the environment and human has been always exposed to it. These rays can affect living creatures and cause chromosomal damage, and genetic and somatic diseases. Hot water springs are a major source of background radiation. This study aimed at investigating the absorbed dose of environmental gamma and determining the annual effective dose of hot water springs in South Khorasan province, Iran, during summer and autumn of 2018. Materials and methods: In order to measure the peripheral gamma of hot springs, the X5C PLUS dosimeter was used. Dosimetry was performed for all outdoor and indoor hot springs in two seasons (summer and autumn). The data for gamma irradiation were calculated and reported as nanosievert per hour and annual effective dose in milli-sievert per year. Data analysis was done in Excel and SPSS applying ANOVA. Results: In current study, the highest and lowest mean gamma radiation were found in Dig Rostam and Tabas hot springs, respectively. The mean effective dose in all outdoor hot springs was significantly lower than that in indoor hot springs (P <0. 001). Conclusion: The average gamma background radiation and the annual effective dose was lower than international standards in all outdoor hot springs, but in Ferdos and Sarbisheh hot springs (indoor) the mean values were higher than the standards which could be a threat for their customers and staff.

Background and purpose: There is paucity of information on the effect of acceptance and commitment therapy on emotional dysregulation and sleep quality. So, the present study was done to evaluate the effectiveness of acceptance and commitment therapy on emotional dysregulation and sleep quality in patients with chronic insomnia. Materials and methods: A quasi-experimental research with one-group pretest-posttest design was performed in 15 individuals with chronic insomnia attending Sleep Disorders Research Center affiliated to Kermanshah University of Medical Sciences, 2018. Insomnia had been confirmed by polysomnography and diagnostic interview. Then, acceptance and commitment therapy was delivered in eight weekly individual sessions. Pittsburgh Sleep Quality Index and Difficulties in Emotion Regulation Scale were administered. Data were analyzed applying Repeated Measures Analysis of Variance (ANOVA). Results: Linear trends in changes in sleep quality and emotional dysregulation were found to be significant at pretest, post-test, and follow-up (P<0. 001). The results also indicated that acceptance and commitment treatment had a significant effect on the subscales of emotional dysregulation (P <0. 05) which could even persist through time. Conclusion: According to current study, acceptance and commitment therapy can improve sleep quality in patients with chronic insomnia and also reduce emotional dysregulation in these patients.

Background and purpose: Population aging is rising in Iran, and information about the quality of life of the elderly and the factors influencing that can provide a basis for appropriate planning to promote the health of this age group. The purpose of this study was to determine the quality of life in elderly population in Amol, Iran, and its related demographic factors. Materials and methods: This cross-sectional study was carried out in 450 elderly over 60 years of age in health centers in Amol, Iran 2017. Sampling was done using multi-stage cluster sampling based on residence place (urban/rural), gender, and age. Quality of life questionnaire (SF-36) was used to collect the data which were then analyzed by independent sample t-test, One– Way ANOVA, and multiple regression in SPSS V24. Results: Multiple regression test (enter method) showed that occupation, age, sex, education, and income source had significant roles in the changes in quality of life (P <0. 05). Conclusion: Quality of life was good but physical health level was found to be lower compared to metal health. Elderly aged 60-69 years old, married, men, employed, heads of households, those with higher education, financially independent, and elderly with companions had a higher quality of life.

Background and purpose: Delirium is an acute mental disorder that has been less considered in children. The Cornell Assessment of Pediatric Delirium (CAPD) is designed to detect delirium in children by non-specialist personnel. The purpose of this study was to translate and evaluate the validity and reliability of this scale in Persian language. Materials and methods: In this study, after translation and back-translation, corrections were performed. Then, face validity was assessed by 10 clinical nurses using qualitative method. After the final correction, the scale was tested by three nurses in 72 patients in pediatric intensive care unit, Sari, Iran. Kendall index and Kappa correlation coefficient were used to verify the reliability of the scale. Results: The mean age of the patients was 3. 88± 2. 11 years and 39 (54. 2%) were males. The delirium score was 6. 22± 2. 95. The mean delirium sore was 6. 22± 2. 95. The most common cause of admission was respiratory problems and 18 (25%) cases had delirium. In Kendall coefficient reliability test, the total score was 0. 046. There were no significant differences between the three evaluators in the scores for questions and the total score (P< 0. 05). The Kappa correlation coefficient was more than 0. 4 when the opinion of evaluaters were compared to one another. Conclusion: In this study the prevalence of delirium was similar to that of other international studies. The Persian translation of CAPD showed good reliability. The CAPD could be easily administered to detect delirium.

Background and purpose: Reducing estrogen levels in perimenopausal period cause menopause-like symptoms. Hormonal and non-hormonal treatments are done to improve these symptoms. The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy on menopausal symptoms in perimenopausal women. Materials and methods: A randomized clinical trial was conducted in which 73 perimenopausal women were recruited in Yazd, Iran 2017. Samples were randomly divided into two groups [intervention (n=36) and control (n=37)]. The intervention group received Mindfulness-based cognitive therapy (MBCT) once a week during eight two-hour sessions, while no intervention was done in the control group. Demographic questionnaire, Cooperman's index, the Menopause Rating Scale (MRS) were completed by both groups before, immediately, and one month after the intervention. Results: The mean scores for overall menopausal symptoms and its dimensions (except for the uro-genital dimension) in intervention group, decreased significantly after the intervention compared to those of the control group (P<0. 001). The repeated measure showed that overall menopausal symptoms and its dimensions mean scores in intervention group changed significantly in three intervals of the study (P<0. 001). Conclusion: MBCT was found to be effective in improving menopausal symptoms, so, it can be considered as a supporting method in management of symptoms associated with perimenopausal period.

Background and purpose: Gingivitis is a multifactorial disease caused by the interaction between pathogenic bacteria and different levels of host immune response. Plaque induced gingivitis is the most common form of gingivitis. There are some mechanical and chemical methods to attain plaque control. Due to the adverse effects of chlorhexidine, the aim of this study was to clinically compare the efficacy of Rosa damascena and vinegar mouthwash, and chlorhexidine on plaque induced gingivitis. Materials and methods: A double-blind randomized clinical trial was done in 112 individuals selected based on pilot data. The subjects were divided into three groups (2 case groups and 1 control group) and treated with chlorhexidine and Rosa damascena and vinegar mouthwash. Gingival index (GI), periodontal index (PI), and bleeding on probing (BOP) were recorded initially and later evaluated at weeks one and three. Data were analyzed by SPSS V20. Results: Reduction in PI, GI, and BOP was greater in chlorhexidine group followed by Rosa damascena and vinegar groups, while, the lowest rate of changes in the aforementioned indices was seen in placebo group. There were significant differences in BOP and GI between Rosa damascena and vinegar mouthwash and placebo (P<0. 001). Conclusion: Rosa damascena and vinegar mouthwash are effective in treating gingivitis, but less effective than oral chlorhexidine mouthwash. Therefore, further longitudinal studies are needed to clarify the long term effect of Rosa damascena and vinegar mouthwash on gingivitis and other conditions such as periodontitis.

Background and purpose: Malignant pleural effusion have significant impacts on patients live. This study was designed to determine the effect of Ethanolamine, Povidone-iodine, and talcum powder on pleurodesis in rats. Materials and methods: This experimental study was conducted in 36 adult male rats in Neuroscience Research Center affiliated to Kerman University of Medical Sciences, Iran 2018. The rats were randomly divided into four groups: Ethanolamine, Povidone-iodine, talcum Powder, and Salin (control group). The sclerosing agent was injected in each group. Then, microscopic and macroscopic effects of the drugs were compared. Data were analyzed applying Fisher’ s exact test and multivariate analysis in SPSS. Results: The most severe fibrosis was seen in groups that had received Ethanolamine (85. 6% severe fibrosis), while the group that received Povidone-iodine and talcum powder showed moderate fibrosis (61. 5% and 38. 5%, respectively). The rate of fibrosis was significantly higher in control group (72. 7% mild fibrosis, P<0. 001). Compared with the control group, more chronic inflammation was seen in the group that received Ethanolamine (P=0. 004). Conclusion: According to this study Ethanolamine and Povidone-iodine could be used as effective agents for inducing pleurodesis. Their low cost and availability make them good alternatives to other materials.

Background and purpose: Listeria monocytogenes is a foodborne pathogen and a pothential risk to public health. Listeriosis is one of the most serious infectious diseases in most developed countries. Consumption of raw milk and unpasteurized traditional dairy products such as cheese can be a major reason for listeriosis in humans. This reaserch aimed at investigating Listeria monocytogenes contamination in unpasteurized cheese products by using culture and Polymerase Chain Reaction (PCR) in Qazvin, Iran. Materials and methods: In this research, 128 samples of traditional cheese products were collected from different traditional shopping centers in Qazvin, between October 2017 and September 2018. They were transported to the laboratory under controlled conditions. All isolates were analysed to biochemical test. L. monocytogenes strains were further confirmed by PCR amplification. Results: Findings showed that 14 samples (10. 9%) were contaminated with L. monocytogenes. The highest prevalence of L. monocytogenes was found in white cheese samples (7%). The highest rate of contamination was reported in spring and winter (3. 1%). Conclusion: Listeria contamination in cheese samples studied can pose a serious risk to consumers of non-pasteurized dairy products. Therefore, food safety and health practitioners should apply effective methods and standards.

Background and purpose: In tooth selection for dentures, the size of the tooth is really important. To estimate the size, a group of landmarks of the face have been investigated. This study evaluated the relationship between the length and width of maxillary central incisors and measurable indices of the face in patients with complete denture. Materials and methods: A descriptive-analytic cross-sectional study was done in 40 people (mean age: 55 years old) with complete denture in Dental Department affiliated with Mazandaran University of Medical Sciences, 2018. The width of the anterior maxillary teeth in the prostheses was determined based on the corners of the lips and the height of the teeth was determined based on the height of the wax-rim. We also investigated how close was the size of teeth arranged in dentures to interzygomatic width and face height. Results: The mean inter-zygomatic width was 118 mm in males and 120 mm in females, and the mean widths of the maxillary central incisors on dentures in males and females were 8. 155 and 7. 895 mm, respectively. There was no significant correlation between inter-zygomatic and maxillary central incisor width in dentures among males (P=0. 204) and females (P=0. 508). In this study, the teeth selected were wider and shorter than inter-zygomatic indices and facial height. Conclusion: The correlation between maxillary central incisor width and bizygomatic width could differ based on gender and genetic and geographical variations. Therefore, these indices should be investigated in different genetic populations.

Background and purpose: Deltamethrin is one of the major pesticides used in agriculture to control pests. Oxidative stress is one of the deltamethrin toxicity mechanisms. Different antioxidants have been investigated to deal with the oxidative damage of toxic substances. The purpose of this study was to evaluate the protective effect of Salvia officinalis extract against deltamethrin-induced hepatotoxicity in rats. Materials and methods: In an experimental study, 30 Wistar rats weighing 200-220 g were randomly divided into 5 groups (n=6 per group); group I was the control, group II received deltamethrin (15 mg/kg), group III received both deltamethrin (15 mg/kg) and S. officinalis extract (100 mg/kg), group IV received both deltamethrin (15 mg/kg) and S. officinalis extract (200 mg/kg), and group V received merely S. officinalis extract. After 30 consecutive days, liver tissues were evaluated for the levels of malondialdehyde and glutathione peroxidase levels and histopathological changes. Results: According to findings, Salvia extract could considerably reduce malondialdehyde levels, improve the glutathione peroxidase activity, and reduce the liver damage caused by deltamethrin. Conclusion: S. officinalis extract showed antioxidant properties and reduced the toxic effects of deltamethrin, so, it can be used as a strong antioxidant in preventing and improving the effects of deltamethrin.

Background and purpose: In order to achieve a successful root canal treatment, knowledge on root canal morphology and anatomy is essential. This study investigated the prevalence and morphology of the C-shaped canal in the mandibular second molar. Materials and methods: In this cross sectional study, we used cone-beam computed tomography (CBCT) images of 260 patients obtained from a radiology center in Sari, north of Iran (2018). The patients attended the center for diagnostic and therapeutic purposes. Root canal images of mandibular second molar were examined in cross sections of each 1 mm of root canal. Teeth with Cshaped canal were classified according to Fan et al. Statistical analysis was performed applying Chisquare test and t-test. Results: Among the images of 260 mandibular second molars studied, 30 teeth (11. 5%) were found with C-shaped canals and C1 was the most common form. In this study, gender had a significant impact on the prevalence of C-shaped canals and women were identified with much higher prevalence of the condition. Conclusion: The prevalence of C-shaped canals among molar teeth was relatively high in north of Iran, therefore, dentists should have enough knowledge on this root canal anatomy and consider an endodontic referral.

Background and purpose: Cancer is highly prevalent in modern societies and approximately one in three or four people is diagnosed with cancer. Oral cancer is one of the 10 primary causes of mortality due to late detection for many reasons, including being asymptomatic in initial stages, clinical presentation similar to other lesions, and variation in clinical manifestations. This study aimed at investigating the two-year prevalence of squamous cell carcinoma (SCC) in Mazandaran province, north of Iran 2016-18. Materials and methods: In this qualitative sociological study, all 4532 records available in the head and neck malignancy center in Mazandaran province were reviewed and 88 records of SCC were extracted. Descriptive statistics were used to calculate the frequency and frequency percentage. Data analysis was done in SPSS V16 applying Chi-square test. Results: Patients with SCC were found to be 57 males (65%) and 31 females (35%). Head and face were the highest prevalence sites for this malignancy (82. 3%) followed by the neck (12. 7%). There was a significant relationship between the patients’ age and the prevalence of SCC (P= 0. 40). Conclusion: The prevalence of squamous cell carcinoma in this study was higher than that reported in similar studies.

Epiploic appendagitis is one of the self-limiting rare causes of acute abdominal pain that is caused by torsion or accidental necrosis of one of the epiploic appendix of the colon. Due to the absence of specific clinical findings for this disease, it is usually diagnosed by chance in examinations for the cause. The use of radiologic methods in diagnosis is very helpful. The importance of the topic is that, with appropriate diagnosis, unnecessary surgeries are prevented and the patient will fully recover with conservative treatment. This study introduces a 32-year-old man attending emergency department in Sari Imam Khomeini Hospital because of acute lowe left abdominal pain. In examination abdominal tenderness was found in the superficial and deep palpation of the left lower quadrant of the abdomen. Ultrasound scan showed an echogenic mass without vascular flow adjacent to the descending colon. Also, CT scan revealed an ipsilateral fat-density elliptical lesion along the sigmoid colon with fat stranding around the lesion without increase in thickness of the adjacent intestinal wall. The findings were diagnostic of epiploic appendagitis, and the patient's symptoms improved with medical treatment. According to this report, epiploic appendagitis should be considered in differential diagnosis of abdominal pain in relatively young patients with acute abdominal pain.

Apert syndrome is a rare kind of craniosynostosis which is identified with fusion of cranial sutures during prematurity period and causes physical and intellectual disorders in younger ages. These patients may show symptoms of obstructive sleep apnea due to abnormal craniofacial shape. This article introduces a patient with Apert syndrome, with apnea symptoms, cyanosis, snoring, restlessness, night sweating, repeated sleep interrupts, and daytime irritability. Polysomnography was used due to a suspicious obstructive sleep apnea. The results were as follows: Arousal index: 3. 27/h, RDI: 6. 51/h, and Lowest oxygen saturation: 46%. CPAP with EPAP: 8cmH2o was used for the patient in sleeping time. Later test results and symptoms of the condition improved remarkably. Approximately 40% of patients with Apert syndrome have the symptoms of obstructive sleep apnea mainly because of mid face hypoplasia, but it can be related to changes of laryngopharynx, larynx, tracheobronchomalacia, and other abnormalities. If the condition is left untreated, obstructive sleep apnea can cause interruptive sleeping, repeated infections, delay in growth and cognition, and more importantly Cor pulmonale and sudden death in sleeping. Therefore, polysomnography must be considered and the patient should be under supervision.

Background and purpose: Stress management of patients with breast cancer, especially patients receiving chemotherapy is one the goals of service providers all over the world. This review aimed at investigating the effect of non-pharmacological interventions on stress of women with breast cancer undergoing chemotherapy. Materials and methods: In this systematic review, electronic databases including Google Scholar, PubMed, Scopus, Springer, Web of Science, Science Direct, Cochrane Library, Magiran, Scientific Information Database, and Iranian Registry of Clinical Trials were searched. The search keywords were Distress, Stress, Chemotherapy, Breast Cancer, and Non-Pharmacological Intervention in both Persian and English. A total of 74, 590 articles were found from which nine were selected after removing the duplicate and irrelevant articles and using Jadad scale to screen the methodological quality of the articles. Results: Findings were classified into two main categories: psychological interventions, including Problem solving and Cognitive Behavioral Therapy and Complementary medicine interventions including: music therapy, Reiki therapy, yoga, and physical exercise. Most of the modalities reduced the stress in patients studied. Conclusion: Non-pharmacological interventions could reduce stress in breast cancer women undergoing chemotherapy, therefore, they should be informed with the benefits of this approach and have the right to select an appropriate method. To achieve this goal care providers empowerment is highly necessary.

Recently, there is an increasing trend in the diversity of pathogenic yeasts isolated from clinical samples. However, Candida albicans is even now the major cause of yeast infections. Candida albicans is one of the members of the mucosal microbiota which can cause cutaneous, mucosal, and disseminated invasive infections in susceptible individuals. For persistence in the host, the yeast must have the ability to adhere to both biotic and abiotic surfaces following host tissue invasion, and obtain iron. One of the important properties of this pathogenic yeast is dimorphism which is its ability to switch from a unicellular to a hyphal mode of growth. Dimorphism is triggered in response to certain environmental conditions, such as pH alternation, temperature, or serum availability. These changes which allow the yeast to invade are associated with the expression of several genes involving in its pathogenesis, including SAP genes family encoding the secreted aspartic proteinases (Saps), the agglutinin-like sequence (ALS) family encoding the adhessive proteins, and phenotypic and morphologic switching systems. This review aimed at summarizing recent data on the regulation and relevant signal transduction of some important essential genes associated with virulence factors in Candid albicans. Surely, understanding the genetic of the virulence factors would be of great benefit in effective combating the yeast and also in designing new antifungal agents.