JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2019 | Volume:29 | Issue:179|Papers Count:18

Background and purpose: Post-traumatic stress disorder (PTSD) develops after major trauma that is accompanied by certain signs, including pervasive fear memories, anxiety, abnormality in spatial and cognition memory, and decrease in hippocampal brain-derived neurotrophic factor (BDNF). Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for PTSD. This study aimed at investigating the effects of moderate treadmill exercise and fluoxetine on spatial memory and serum BDNF levels in rat model of PTSD. Materials and methods: In this experimental study, single prolonged stress (SPS) animal model of PTSD was used. Male and female rats were divided into SPS and control groups (n=10 per group). After that, they were subjected to moderate treadmill running (5 days per week/four weeks) and fluoxetine (10 mg/kg/day). Then, behavioral assessment and BDNF measurement were done. Results: SPS male rats showed reduced spatial memory and hippocampal BDNF. Female rats showed more resistance to SPS than male rats. This may be due to the effects of gonadal hormones. The intervention alleviated the SPS-induced alterations in hippocampal-dependent spatial memory and BDNF serum levels in both male and female rats (P<0. 05). Conclusion: Combined exercise and fluoxetine administration are more effective in alleviating behavioral and molecular deficits in PTSD patients.

Background and purpose: In multiple sclerosis (MS) and its murine model, experimental autoimmune encephalomyelitis (EAE), chronic inflammation damages the myelin of central nervous system. Recently, interleukin-27 (IL-27) has been recognized as a feasible choice for treatment of autoimmune diseases such as MS due to its anti-inflammatory properties. However, the underlying mechanisms have not yet been specified clearly. The present study, investigated the immunomdulatory effects of IL-27 in C57BL/6 mice with EAE. Materials and methods: In this experimental study, two groups of EAE mice (test and control groups) received intraperitoneal injection of P240-mIL-27 (200 μ g) and P240 plasmid (200 μ g), respectively. The disease severity was evaluated daily for 30 days. At the end of the treatment period, the mice were sacrificed and the levels of IL-17, IFN-γ , IL-6, and IL-10 were measured in splenocytes culture media using ELISA method. Also, the percentage of CD4+Foxp3+ regulatory T cells (Treg) in spleen cells was analyzed using flow cytometry. Results: Severity of EAE significantly decreased in test group (P240-mIL27), compared to that of the control group. In test group, the levels of IL-17, IFN-γ , and IL-6 were significantly lower (P<0. 001), while IL-10 levels were significantly higher compared to those of the control group (P<0. 001). Moreover, the percentage of Treg cells in test group was significantly higher than that of the control mice (P<0. 001). Conclusion: IL-27 can be a suitable choice in treatment of inflammatory diseases such as MS via increasing Treg cells and IL-10, and suppression of inflammatory cytokines.

Background and purpose: Many studies have reported the effect of morphine on memory impairment. Evidence suggests that ghrelin enhances memory consolidation. The median septum also has a major role in memory and learning mechanisms. The present study aimed at investigating the role of median septum on the effects of ghrelin in morphine-induced amnesia. Materials and methods: In this experimental research, male Wistar rats were randomly divided into 12 groups: ghrelin groups (0, 0. 3, 1. 5, 3 nmol/μ l) plus saline (1 ml/kg) or morphine (7. 5 mg/kg) and groups treated with lidocaine (1 μ l/rat) or saline (1 μ l/rat) plus ghrelin (3 nmol/μ l) or saline (1 μ l/rat) plus morphine (7. 5 mg/kg). Cannulation was done in the lateral ventricle and median septum. Ghrelin and lidocaine were injected into the lateral ventricle and septum, respectively and morphine was injected subcutaneously. Memory was assessed by avoidant learning. Results: Post-training intra-ventricle administration of ghrelin 5 min prior to morphine (7. 5 mg/kg) prevented morphine amnesia (P= 0. 000). Injection of lidocaine into the median septum 5 min before the injection of ghrelin prevented its effect on inhibition of morphine amnesia (P= 0. 000). Conclusion: Injection of ghrelin into the lateral ventricle was found to be capable of preventing morphine-induced memory impairment. Inactivation of the median septum by injection of lidocaine reduced the effect of ghrelin on morphine-induced memory deficits. Therefore, the median septal region appears to mediate the effects of ghrelin on morphine-induced amnesia.

Background and purpose: Synthesis of homogeneous and equally important nanoparticles is very popular in various sciences. Preparation and use of gold nanoparticles is very important according to their applications in biotechnology. For synthesizing homogeneous gold nanoparticles many substrates and nanostructures have been used. This study aimed at synthesis of gold nanoparticles by apoferritin to be conjugated to antibody for detection of vibrio cholera. Materials and methods: In this study, gold nanoparticles were prepared in apoferritin and compared with apoferritin free gold nanoparticles. Data were characterized by UV-Vis, DLS, and FE-SEM spectroscopy. Results: Findings showed that the synthesized gold nanoparticles in apoferritin are more homogeneous. Conclusion: The distribution of synthesizing gold nanoparticle in presence of apoferritin was so homogenous. In the following step, gold nanoparticles were separated from apoferritin and conjugated to recombinant antibody for detecting vibrio cholera. By bacteria aatchment on gold nanoparticles, red shift ocured on wavelength, which was also visible to naked eyes. So, gold nanoparticles could be considered as a colored biosensor for detection of vibrio cholera.

Background and purpose: Cytotoxic drugs are a group of chemicals that raise concerns over the health of healthcare professionals. Therefore, accurate methods are needed to investigate the traces of these drugs. This study was done to fabricate and optimize molecularly imprinted membrane as a specific absorbent in assessment of occupational exposure to 5-fluorouracil. Materials and methods: 5-FU molecularly imprinted microspheres were produced by precipitation polymerization and encapsulated into nanofibers using electrospinning. Optimization of electrospinning parameters (MIP value, electrospinning voltage, the distance between needle tip to collector, and flow rate) was performed using response surface methodology (RSM) and Experimental design software. Totally, 22 trials were done on the basis of study design. The diameter of the fiber was measured using SEM image analysis. The applicability of the synthesized membranes in absorbing 5-FU was evaluated. Results: In this study, MIP particles were successfully encapsulated into PET nanofibers. The optimization process showed that the molecularly imprinted nanofibers diameter of 276. 38 nm could be obtained in 57%W MIP, 25 kV, 13 cm, and 0. 55 ml/h. The efficacy of extracting 5-FU by synthesized membranes was 97. 2± 0. 34. Conclusion: The experimental models presented in this study can be used in further experiments to create a uniform molecularly imprinted nanofibers for specific analyte absorption in occupational and environmental monitoring.

Background and purpose: Postoperative pain management would result in increased patient’ s satisfaction and decreases their problems. This survey was performed to determine the efficacy of premedication with dextromethorphan and gabapentin alone or in combination, for postoperative pain management in anterior cruciate ligament and posterior cruciate ligament knee arthroscopy with general anesthesia. Materials and methods: In a randomized clinical trial, 114 patients under anterior cruciate ligament and posterior cruciate ligament knee arthroscopy with general anesthesia were randomly assigned to receive either dextromethorphan or gabapentin alone or in combination. The intensity of pain was assessed by numeric rating scale (NRS). Analgesic use and Ramsay score were compared among the three groups. Results: In this study, the pain (P=0. 0001) and analgesic use (P=0. 004) were significantly lower in patients who had received the combination of dextromethorphan and gabapentin. Conclusion: According to current study, premedication with combination of dextromethorphan and gabapentin is superior to each one alone for postoperative pain management in anterior cruciate ligament and posterior cruciate ligament knee arthroscopy with general anesthesia.

Background and purpose: Auditory-verbal memory decreases with age. One method to compensate this weakness is transcranial direct current stimulation. The current study investigated the effect of Anodal Transcranial Direct Current Stimulation on auditory-verbal memory performance of healthy elderly people. Materials and methods: In a randomized clinical trial, 42 healthy subjects with no history of cognitive problems were divided into experimental and control groups (n=21 per group). All participants received 10 sessions of electrical stimulation at 2 mA. In order to evaluate the auditory-verbal memory of the subjects, the Persian version of the Rey Auditory Verbal Learning Test (RAVLT) was used before and after electrical current delivery. Results: In experimental group, the mean scores for all stages of the RAVLT, were found to be significantly different after electrical stimulation compared to those before stimulation (P<0. 05). Also, the mean scores for all stages of the RAVLT showed significant differences between the control group and experimental group after electrical stimulation (P< 0. 05) except in the reminder stage after the intervention (P= 0. 075). Conclusion: Anodal Transcranial Direct Current Stimulation affects the electrical potential of nerve cells membrane in the dorsolateral prefrontal cortex (DLPFC) and increases neural activity of nerve cells in that area, which can lead to improvements in auditory-verbal memory.

Background and purpose: Inflammatory bowel disease (IBD) is a group of mucosal inflammatory problems affecting the small or large intestine. Since last century, the incidence of IBD has been constantly increasing, afflicting the majority of urban population in developed societies. The aim of this study was to investigate the relationship between using detergents and the risk of ulcerative colitis (UC). Materials and methods: In this case-control trial, 65 patients with new-onset UC and 135 healthy people were examined during 2014-17 in Sari Imam Khomeinin Hospital. Demographic features and information about exposure to detergents and bleaches were recorded using a researceher-made questionnaire. SPSS V20 was used to investigate the association between exposure to detergents and development of UC and the logistic regression model was used to adjust for potential confounding factors. Results: According to findings, gender (P= 0. 012), age (P= 0. 009), job (P<0. 001), and using detergents (P<0. 001) were associated with UC. Compared to those who were occasional consumers of detergents, the chances of UC, after adjustment for potential confounding factors such as gender, age, and job, were 4, 23, 26, and 104 times higher in patients who used detergents monthly, every other week, weekly, and daily, respectively. Conclusion: Frequent exposure to detergents can be among the factors influencing the development of UC.

Background and purpose: Inflammatory markers of A-FABP and HsCRP play an important role in progression of cardiovascular disease. Anti-inflammatory and anti-platelet aggregation effects of omega-3 fatty acids are known. The aim of this study was to investigate the effects of omega-3 and omega-3+ vitamin E supplements on serum levels of these inflammatory markers. Materials and methods: This double-blind parallel trial was performed in 62 patients with coronary artery disease in Tehran Heart Center. Patients were divided into three groups to receive omega3 fatty acids, omega-3+ vitamin E supplements, and placebo (oral paraffin) for 8 weeks. At the beginning of the study and end of week eight the serum levels of A-FABP and HsCRP were measured and the ratio of adiponectin to A-FAPP was calculated. Nutrition data were analyzed using Nutritionist IV and data analysis was done using SPSS V18. Results: At the end of the trial, serum level of FABP4 decreased significantly in the groups that received Omega-3 fatty acids+ vitamin E and Omega-3 fatty acids (P= 0. 02 and P= 0. 04, respectively) and its value was similar between the three groups (P= 0. 34). The ratio of adiponectin to FABP4 (P= 0. 009) and serum HsCRP (P = 0. 002) were found to be different between the three groups. Conclusion: According to this study, using omega-3 fatty acids+ vitamin E reduces the level of HsCRP and increases the ratio of adiponectin to FABP4 without any effect on the levels of FABP4. Consequently, this regimen will reduce inflammatory parameters and improve the complications of coronary artery disease.

Background and purpose: Contrast-induced nephropathy (CIN) as a common complication of administration of contrast media (CM) is a major source of hospital morbidity and mortality. The aim of this study was to determine the incidence of CIN after contrast-enhanced CT scan and identifying the related risk factors. Materials and methods: A cross-sectional study was carried out in 100 patients attending Sari Imam Khomeini Hospital who underwent contrast-enhanced CT scan in 2016. Predictors of CIN were evaluated in four general categories, including demographic variables, underlying diseases, concomitant medications, and laboratory findings. Data were analyzed in SPSS V20. Results: In this study, increase in the concentration baseline serum creatinine of more than 25% or 0. 5 mg/dl within 48 hours after the injection of contrast material was considered as an indicator of the incidence of CIN. Accordingly, the incidence rate was 7%. The incidence of CIN was significantly different in patients with and without hypertension (P= 0. 028) and patients taking angiotensin II receptor blocking drugs (ARBs) (P= 0. 019). Compared to creatinine, BUN and eGFR were both observed to be more accurate in predicting the incidence of CIN. BUN was found to have higher sensitivity and lower specificity while eGFR showed higher specificity and lower sensitivity. Conclusion: In addition to hypertension and the use of ARBs as the major risk factors for the incidence of CIN, BUN was observed to be a better predictor for CIN than eGFR. Higher Efficacy of BUN could have been due to its larger size and therefore fewer laboratory errors.

Background and purpose: Studies on neurological diseases in Ramadan reported different incidence rates, diurnal pattern, and risk factors. This study aimed at comparing the incidence of neurological diseases and their related factors in Ramadan and Shaval. Materials and methods: This cross-sectional study was performed in patients ≥ 16 years of age attending the Emergency Department in Sari Bu Ali Sina Hospital, from the 1st of Ramadan until the 30th of Shaval in 2015. Demographic data and other information associated with neurologic disorders were recorded using face-to-face interviews and the patient’ s files. Results: In this study, the number of people hospitalized with neurological disorders was 166 during Ramadan and 150 in Shaval. There was no significant difference between the two months studied in frequency of admissions due to neurologic diseases (P=0. 68). The most common diseases in Ramadan and Shaval were ischemic stroke (36. 7% and 40%), seizure (27. 1% and 23. 3%), and headache (12% and 14. 7%), respectively. We did not find any significant differences in gender, age, marital state, incidence and admission time, and risk factors for neurologic diseases between Ramadan and Shaval (P >0. 05). Conclusion: In this study, the admission rate of most of neurological diseases were not significantly different in Ramadan and Shaval. Providing appropriate medical advices could considerably prevent neurological disorders in Ramadan.

Background and purpose: Patients with thalassemia major need more dental care because of their special health conditions. The purpose of this study was to evaluate dental health and therapeutic needs of these patients in Sari, Iran 2018. Materials and methods: A descriptive cross-sectional study was done using a researcher-made form and direct observation in 144 cases attending Sari Thalassemia Center. The subjects included thalassemia patients (41 males and 34 females) and 69 individuals as the control group. The needs for dental treatment and prevalence of dental problems were recorded using Decayed, Missing, and Filled Teeth (DMFT) index. Data analysis was done in SPSS V24. Results: There were significant differences between the two groups in DMFT index (P< 0. 001), decayed teeth (P= 0. 004), and missing teeth (P=0. 001). In fact, the values except the mean number of filled teeth were higher in thalassemia patients (P=0. 150). Pulp therapy was the most common treatment needed in thalassemia patients while dental filling was more needed in control group. Conclusion: High prevalence of dental caries in patients with thalassemia major highlights the need for effective preventive measures, appropriate health trainings, and dental treatments in this group.

Background and purpose: Vaginal examination is an essential part of obstetric care. Due to cultural influences and the sensitive nature of the subject, there is a need for a precise tool to evaluate that in Iranian women. This study aimed to develop a scale for investigating iranian pregnant women’ s perceptions of vaginal examination during labor and evaluate its psychometric properties. Materials and methods: This methodological study was performed in two phases. First, the items were extracted by reviewing relevant literature. Then, the psychometric properties of the instrument were determined by face validity and content validity (qualitative and quantitative assessments), construct validity (exploratory factor analysis and known-group validation), and internal consistency and stability. All data analyses were done in SPSS V19. 0. Results: Thirty five items were extracted. After assessing the face and content validity, the items reduced to 29. After exploratory factor analysis the items of the instrument were 26 that indictated five factors. Finally, internal consistency )α = 0. 754( and stability )ICC== 0. 79( were determined for reliability evaluation by test-retest. Conclusion: According to this study, the Persian Version of Women’ s Perceptions of Vaginal Examination (26 items) could be used as a an acceptable instrument for investigating women’ s perceptions of vaginal examination during labor, due to good development process and suitable validity and reliability.

Background and purpose: Studies on the function of referral system in Iran had not covered all aspects and structures of the referral system. This could be due to lack of an appropriate tool that could investigate referral system in Iran. The current study was done to translate and investigate the validation of Referral Systems Assessment and Monitoring (RSAM) Toolkit based on family physician in Iran. Materials and methods: The English version of RSAM was translated into Farsi. Content validity was assessed by calculating content validity ratio (CVR) and content validity index (CVI). For this purpose we used 20 informed individuals familiar with family physician program and referral system. Then, the tool was used in 52 family physician units in Mazandaran province and its reliability was investigated. Data were analyzed in SPSS V24 and LISREL 8. 8. Results: The coefficients of CVR and CVI were 70% and 90%, respectively, which were higher than the acceptable values. The Chrocbach’ s alpha coefficient for reliability of multiple choice items was 0. 89 (good) and the Kudar-Ricahrson coefficient for two-choice items was 0. 83. (acceptable). Conclusion: The RSAM tool for Family Physician Program in Iran has the necessary scientific features and could be efficient in investigating this form of referral system.

Background and purpose: There are some strengths and weaknesses in current indicators of scientometrics. This study aimed to present a new index of scientometrics in evaluating scientific output of Iranian medical journals. Materials and methods: This exploratory analytical study was done with a scientometric approach in scientific output of 108 medical science journals indexed in Scopus and 63 scientific output of the universities of medical sciences in Iran, 2018. Data were collected using a checklist that included scientometric factors. The inclusion criteria was to have at least two articles indexed in the Scopus database and at least one citation. The index to be calculated was the ratio of the number of articles with at least one citation to zero according to the Odds index. Results: Findings showed that the mean h-index of journals was 14. 06 and the mean O-index was 2. 29. In universities, the highest mean values of O-index, h-index, and h5-index were 2. 724, 85. 8, and 45. 7, respectively belonging to type I universities. There were significant relationships in O, h, and h5 indices between the three types of universities (P= 0. 000). Conclusion: According to this study, the O-index was correlated with the h-index and could be very useful in evaluating the scientific output of universities and journals alongside other indices.

Background and purpose: Introduction of antiretroviral therapy has led to decline in AIDSassociated cancers. In recent years, the rate of non-AIDS associated cancers has increased. Current prevalence of AIDS-associated cancers in Iran is unknown, so we aimed to investigate the prevalence of different cancers among HIV-infected patients in Iran. Materials and methods: A cross-sectional survey was done using the records of 1243 HIVpositive patients between 2004 and 2017 in Tehran Imam Khomeini Hospital. Convenient sampling was done and the only inclusion criteria was confirmation of positive HIV by ELISA and Western blot. Results: There were 39 (3. 1%) patients with cancers, including 16 (41%) males and 23 (59%) females. Twenty five (2%) patients had AIDS-associated cancers and 14 (1. 1%) had non-AIDS associated cancers. HIV infected patients were found with cervical cancer (n=14, 1. 1%), non-Hodgkin lymphoma (n=7, 0. 6%), and Kaposi sarcoma (n=4, 0. 3%). Conclusion: The prevalence of AIDS-associated cancers such as cervical cancer appeared to be higher than that of non-AIDS associated cancers. Timely screening and antiretroviral therapy are crucial for early diagnosis and treatment of AIDS-associated cancers. Similar to developed countries, the incidence of non-AIDS associated cancers would increase in future in Iran too.

Background and purpose: Lead is a metal present in nature that does not play a role in physiological processes of the body. Today, the use of lead in many materials and industries causes environmental contamination. But, the prevalence is unclear among people and the concentration of lead in the blood has never been tested in general. This study was conducted to compare clinical observations and laboratory results in patients with lead poisoning. Materials and methods: In this retrospective, descriptive cross-sectional study, the records of 99 patients admitted to the poisoning department in Ghaemshahr Razi Hospital between 2011 and 2016 were studied. None of the patients had occupational exposure to lead and all consumed opium. Results: The most common symptoms were abdominal pain (91%), constipation (54%), and weakness due to anemia (53%). The mean lead level was 95. 03 mg/dl before treatment and 56. 33 mg/dl after treatment, indicating the effect of chelation therapy. Conclusion: The opium sold illegally in the market could be contaminated with lead. The level of lead poisoning is different in individuals according to the concentration of lead added to the opium. Opioid users with abdominal pain, constipation, anemia, weakness, and lethargy should be tested for blood lead levels.

Background and purpose: Nutritional behavior of children depends largely on the behavior of their parents, especially their mothers. Therefore, this study was conducted to determine and compare the nutritional behaviors of mothers of overweight and obese children with those of normal weight children. Materials and methods: This descriptive-analytical case-control study was performed in elementary school students and their mothers in Sari, Iran 2017. Hundred and sixty five students were selected through multistage random sampling, including overweight and obese students (n=82) and normal weight students (n=83). Students' heights and weights were recorded and anthropometric indices were calculated by WHO AnthroPlus 4 software. Then, the nutritional behavior of the mothers was assessed by Comprehensive Feeding Practices Questionnaire. Data analysis was performed in SPSS V20. Results: Nutritional behaviors in mothers of children with normal weight, and overweight and obese children were not significantly different (61. 25± 9. 36 and 62. 17± 7. 91, respectively, P=0. 20). Compared to the mothers of normal-weight students, the mothers of overweight and obese students had more restrictions to control children’ s weight (P=0. 009) but less encouraged balance and variety of food (P=0. 020). Fast-eating was more prevalent in overweight and obese students (P=0. 026). Conclusion: There were similar nutritional behaviors in the mothers studied, but there were some differences in feeding practices which could be among the causes of differences in students' weights.