JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2020 | Volume:30 | Issue:186|Papers Count:20

Background and purpose: Methamphetamine (METH) is one of the most powerful drugs that leads to many cognitive and behavioral side effects such as anxiety. On the other hand, studies have shown that ovarian hormones such as estrogen and progesterone have neuroprotective effects on a wide range of cognitive and behavioral disorders. The aim of this study was to investigate the role of estrogen and progesterone on anxiety-like behaviors, body temperature, brain edema, and neuronal death induced by neurotoxic regimen of methamphetamine. Materials and methods: This study was performed in 48 ovariectomized rats divided into six groups including: control, METH (6mg / kg), vehicle (sesame oil), METH + estrogen (1mg / kg), METH + progesterone (8mg / kg), and METH + estrogen + progesterone. Body temperature and anxiety-like behaviors were investigated, then, the animals were killed and brain tissues were harvested to evaluate brain edema and neuronal death in hippocampal CA1. Results: Body temperature, brain water content, motor activity, and anxiety-related behaviors significantly increased in animals that received METH (P<0. 001), but, treatment with estrogen and progesterone attenuated motor activity, and anxiety-related behaviors induced by METH. Brain edema, body temperature, and neuronal cell death in hippocampal CA1 area partially decreased in METH+estrogen and METH + progesterone groups. Conclusion: This study suggests that ovarian hormones such as estrogen and progesterone are effective in improving behavioral deficits and neuronal death induced by METH in ovariectomized rats.

Background and purpose: Morphine as an opioid compound has different and sometimes conflicting effects on memory and learning process. Bile duct ligation causes cholestasis, which disrupts liver function. It is known that opioid systems are involved in cholestasis. The aim of this study was to investigate the possible effect of morphine on the memory of cholestatic rats. Materials and methods: In this experimental study, the cholestatic model in male Wistar rats (weighing 200-250 g) was induced by bile duct ligation (BDL). The animals were injected with morphine (4 and 6 mg/kg, ip), naloxone (0. 6 and 0. 8 mg/kg, ip), and morphine and naloxone in different groups. Passive avoidance memory was evaluated on day 7 after BDL by shuttle box test. Data were analyzed by PRISM software and ANOVA. Results: Naloxone (0. 6 and 0. 8 mg/kg), 30 min before the test, did not show significant changes in the memory of the cholestatic rats compared to the BDL group, whereas, morphine (4 and 6 mg/kg) showed significant increase in step-through latency (P<0. 05). Also, naloxone (0. 6 mg/kg, ip) 15 minutes before injection of morphine (6 mg/kg) showed a significant increase in acquired memory on day 7 after BDL (P<0. 0001). Conclusion: According to findings, morphine had a protective effect on memory impairment induced by cholestasis.

Background and purpose: Hyperglycemia contributes to type 2 diabetes and diabetes vascular complications by reduction of the activity of glyoxalase-I (GLO-I) and elevation of glycation, oxidative stress, and inflammatory markers. Linalool is reported to have beneficial effects on glucose metabolism in animal models of diabetes, so, this study aimed at investigating the effect of linalool on the activity of GLO-1 and inflammatory markers in rats with type 2 diabetes. Materials and methods: In this experimental study, type 2 diabetes was induced by nicotinamide and streptozotocin (210 + 55 mg/kg). The animals were divided into a control group and diabetic groups treated by linalool and those that received no treatment (n=10 per group). Linalool 25 mg/kg was administered by gavage daily for two months. Fasting blood sugar, insulin resistance index, lipid profile, the activity of GLO-I, markers of glycation (glycated albumin, methylglyoxal, and advanced glycation end products), oxidative stress (advanced oxidation end products and malondialdehyde), inflammation (interleukine-1β ) as well as serum creatinine and 24-h urinary protein excretion (renal dysfunction markers) were measured in all groups. Results: Linalool had reductive effects on serum fasting glucose, insulin resistance, dyslipidaemia, glycation oxidative stress, inflammatory markers, and renal dysfunction indices. GLO-I activity was found to be significantly higher in animals treated with linalool compared to the un-treated experimental group (P < 0. 001). Conclusion: Linalool could reduce the risk of developing diabetes vascular complications owing to raising the GLO-I activity and improving the antioxidant, anti-glycation, and antiinflammatory properties and has beneficial effects on glucose and lipid metabolism.

Background and purpose: Chronic kidney disease is among the common diseases in the world. Studies show that women are more protected against renal diseases compared to men. On the other hand, vasodilatory axises of renin angiotensin system (angiotensin 1-7 (Ang 1-7)-Mas receptor (MasR)), kallikrein-kinin, and nitric oxide (NO) play key roles in kidney function and circulation in females. Therefore, the purpose of this study was to examine the effect of bradykinin in renal blood flow (RBF) response to Ang 1-7 when MasR was blocked in female rats. Materials and methods: Female Wistar rats were divided into three groups (control, Bradykinine, and Bradykinin + MasR antagonist (A779)). The animals were anesthetized and catheterized in the carotid and femoral arteries and jugular vein to measure mean arterial pressure (MAP), renal perfusion pressure (RPP), and drug administration, respectively. The left kidney was exposed (in situ) and placed in a kidney cup to measure RBF. After the equilibration period, A779 and bradykinin (50 μ g/kg/h, 150 μ g/kg/h, respectively) were injected and vascular responses to Ang1-7 (100, 300, and 1000 ng kg− 1min− 1) infusion were determined. At the end of the experiment, blood samples were collected for measuring the level of nitrite. Results: The MAP and RPP were not significantly different between the three groups. Bradykinin exhibited vasodilatory effect on RBF in response to Ang 1-7 in female rats, however, A779 administration increased RBF at low dose of Ang 1-7(Pdose=0. 001). The serum level of nitrite significantly decreased when the MasR was blocked (P= 0. 04). Conclusion: Bradykinin enhanced RBF response to Ang 1-7 infusion. The effect of bradykinin on RBF response to Ang 1-7 may be modulated via the NO pathway. Interaction of these factors might help to broaden our vision for treatment strategy in future.

Background and purpose: The aim of the present study was to investigate the effects of endurance training and resistance programs on sperm parameters and spermatogenesis in diabetic rats. Materials and methods: In this experimental study, in one group, 24 healthy male Wistar rats were assigned into three subgroups (control, endurance training, and resistance training). The next group (n=24) consisted of male rats, in which diabetes was induced by intraperitoneal injection of nicotinamide (120mg/kg) + streptozotocin (65mg/kg) after 12 hours of starvation. This group was divided into three subgroups (diabetic control, diabetic endurance training, and diabetic resistance training). One week after the induction of diabetes, resistance, and endurance training protocols were performed in all groups for 10 weeks. Twenty-four hours after the last training session, the left epididymis was removed to examine sperm parameters. Results: Blood glucose levels significantly reduced in diabetic group with endurance and resistance trainings (P<0. 0001). Sperm parameters (count, motility, and morphology) did not significantly increase in the diabetic group with endurance and resistance training programs compared with those in the diabetic control group (P<0. 05). Spermatogenesis indexes (tubul differentiated index, spermiogenesis index, and repopulation index) significantly increased in the diabetic group with endurance and resistance training programs compared with those in the diabetic control group (P<0. 0001). Conclusion: Both types of exercises improved spermatogenesis indexes, but further experiments are needed to evaluate the role of moderate-intensity exercise on the oxidative stress in fertility of diabetic rats.

Background and purpose: Contamination of food with mycotoxins is among the major threats to food security, and human and animal health that cause significant economic losses in countries. This contamination is found in poultry and animal products and can pose risks to human health. Despite the mass production and consumption of egg, this product has not been well evaluated for the presence of mycotoxins. According to previous studies, there is high possibility of fungal infections and consequently production of mycotoxins in poultry feed. Here, we aimed to perform a quality control study on the safety of this product in Mazandaran province market by developing current techniques. Materials and methods: In this experimental study, 45 egg samples were collected from three cities in summer 2019, during two phases. Aflatoxin and ochratoxin were extracted using appropriate solvents. In the ELISA method, the extracted samples were directly analyzed while being purified by immunoaffinity column for HPLC measurement. Results: Among the samples examined, aflatoxin G2 (0. 010 to 4. 726 μ g/Kg) was found in 36 cases. These values are lower than maximum residue limit allowed for foods. Ochratoxin was not detected in any sample. Conclusion: According to current study, there were low levels of aflatoxin in the eggs and they can be considered as a safe food in terms of aflatoxin contamination.

Background and purpose: Some skin injuries are caused by occupational skin exposures that are resulted from production of reactive oxygen species and oxidative stress (ROS). Thus, protecting the skin is a key issue. Recently, several surveys have introduced novel alternatives such as nanofibers for skin protection. In this research, Poly (ε-caprolactone) (PCL)/gelatin (Gt)/ Vitamin E (VE) was investigated as a nanofiber antioxidant protective layer in occupational skin exposures. Materials and methods: Vitamin E was combined with PCL/Gt nanofiber mats by electrospinning method. The diameter of nanofibers and chemical characteristics were determined using scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). Adhesion characteristics and proliferation of human dermal fibroblast cells (HDFC) on nanofibers were analyzed by Methylthiazol Tetrazolium (MTT) assay. Finally, we studied the application of PCL/Gt/VE nanofibers against oxidation stress induced by tert-butyl hydroperoxide (t-BHP). Results: With increase in Vitamin E levels, the PCL/Gt/VE nanofibers were found to be thiner. The culture of HDF cells on nanofibers showed that adding Vitamin E to PCL/Gt mats caused increased attachment and proliferation of the cells. PCL/Gt/VE nanofibers significantly assisted human skin cells against ROS (P< 0. 001). Conclusion: According to current study, PCL/Gt/VE nanofibers could be an appropriate candidate for protecting skin against ROS as a novel method to maintain workers’ health.

Background and purpose: Internal bleaching is recommended to correct the discoloration of pulpless teeth. This study aimed to compare the microleakage of biodentine and mineral trioxide aggregate (MTA) used as an intracanal barrier in non-vital bleaching. Materials and methods: An experimental study was performed in which 36 extracted mandibular premolars were randomly divided into two experimental groups (n= 16) and two control groups (n= 2). In experimental groups, 2mm of OrthoMTA and biodentine cement were placed as intracanal barriers. The control groups were prepared similar to experimental groups, except that in positive control group the orifice barrier material was not used and in negative control group the whole root surface was covered with nail polish and orifice barrier material was not used. Subsequently a mixture containing sodium perborate and 30% hydrogen peroxide was placed into the pulp chambers and replaced every three days. Microleakage was measured using a pH diffusion method by digital pH meter. pH was checked before placement and at days 1, 3, 6, and 9 after placement. Data analysis was done in SPSS V24. Results: The pH value in negative control group was similar to that in normal saline group, while the pH value in positive control group was found to be significantly higher than other groups (P< 0. 05). No significant differences were seen in pH values between the experimental groups at baseline and days 1 and 6, but pH values of biodentine were significantly higher than orthoMTA at days 3 and 9 (P< 0. 05). Conclusion: MTA can be used as an efficient orifice barrier during internal bleaching, specifically in cases where there is probability for cervical root resorption.

Background and purpose: Sleep disorders after heart surgery lead to increased heart rate, increased myocardial oxygen demand, and cause dysrhythmia that worsen heart ischemia. The purpose of this study was to compare the effect of acupressure and reflexology on sleep condition following coronary artery bypass graft surgery. Materials and methods: A randomized controlled trial was performed in 60 patients. They were randomly assigned into three groups. Two intervention groups; reflexology (n=20) and acupressure (n=20), and a control group (n=20). For three to six days after the surgery, foot reflexology and acupressure were done for 30 min and 21 min, respectively. St. Mary's Hospital Sleep Questionnaire was administered for five consecutive days for each group. Data was analyzed in SPSS V25. Results: The General Estimated Equation (GEE) showed that, compared to acupressure, reflexology significantly improved duration of the last day sleep (P<0. 001). The depth of sleep and last night's sleep satisfaction were significantly higher in acupressure group than reflexology group (P<0. 001). Conclusion: In this study, reflexology and acupressure led to higher last night's sleep satisfaction. Compared to reflexology, acupressure is performed in less time and is more effective. Therefore, it can be an appropriate non pharmacological treatment following open heart surgery.

Background and purpose: Patients with hardiness personality could better control the psychological distress induced by multiple diseases. The present study aimed to clarify the concept of health related hardiness in older individuals with multiple diseases. Materials and methods: A hybrid method was used to analyze the concept of health related hardiness. This model consists of theoretical review, field work, and final analysis. After first phase, nine older people with multiple diseases were selected via purposive sampling from Ramsar Imam Sajjad Hospital and Tonekabon Shahid Rajaee Hospital and interviewed in autumn-winter 2019-2020. In third phase, information from the theoretical phase was combined with the fieldwork phase, and the concept of health related hardiness was clarified. Results: Health-related hardiness in older individuals with multiple diseases means that they could achieve the expected health-related outcomes (successful control of the disease, reduced disease burden, and adaptation to disease) by purposeful management of health-related stressors, simultaneous management of several diseases, and personality traits such as stubbornness, patience, tolerance, and having cognitive abilities. Meanwhile, family and social supports, as facilitators, are of great benefit in reducing physical and psychological pressures induced by diseases burden. Conclusion: The health-related hardiness model could be applied in further studies and used to implement promotion protocols in older people with multiple diseases and development of health-related hardiness scales.

Background and purpose: Increasing prevalence of diabetes and its complications, including cardiovascular problems increase the cost of health care which could be diminished with proper planning to change lifestyle. The present study investigated the effect of aerobic and resistance trainings on blood GDF15 level as a protective marker on cardiovascular cells in patients with type 1 diabetes. Materials and methods: In this quasi-experimental study, 32 patients with type 1 diabetes were divided into aerobic training group and resistance exercise training group. Serum GDF15 levels were measured in all patients before and after the exercises. Data were analyzed using Mann-Whitney and Bootstrap in SPSS. Results: In this study, the GDF-15 levels significantly increased after the exercises (P <0. 05) and the effect size was 15%. The GDF-15 levels were found to be significantly higher in aerobic training group than resistance exercise training group (P <0. 05). Conclusion: There is a positive relationship between exercise and GDF15 level in type 1 diabetic patients which is more significant in aerobic training group.

Background and purpose: Imbalance between low oxygen supply and oxygen demand determines organ hypoxia. It occurs especially in heart diseases and ischemia and causes death. Compounds with antioxidant activity could exhibit antihypoxic properties. Hibiscus rosa sinensis has good antioxidant activity, but there is no information about the antihypoxic activities of this plant. This study was designed to evaluate antihypoxic activities of H. rosa extract. Materials and methods: Protective effects of the methanolic extract of H. rosa against hypoxia-induced lethality in mice were evaluated by experimental models of hypoxia i. e. asphyctic, haemic, and circulatory models. This experimental study was carried out in 15 groups of male mice (n= 6 per group). Data analysis was done applying Analysis of variance and Tukey's multiple comparisons test. Results: Findings showed significant protective activities in all three models. Antihypoxic activity was considerably high in asphyctic and haemic models. In asphyctic model, the extract at 125 mg/kg showed similar activity to positive control, phenytoin (P>0. 05), but at 250 mg/kg it was stronger than phenytoin (P<0. 05). In haemic model, the extract demonstrated similar activity to propranolol at 125 mg/kg (P>0. 05) and greater protective activity at 250 mg/kg (P<0. 001). In circulatory model, the H. rosa extract was found to be effective at 62. 5 mg/kg (P<0. 05). At 125 mg/kg it significantly prolonged survival time to 14. 04 ± 1. 36 vs 11. 37 ± 1. 53 min in control group (P<0. 01). The extract at 250 mg/kg showed the same activity as propranolol (P>0. 05). Conclusion: H. rosa extract showed strong protective effects against hypoxia in all three tested models. Compared to the control group, the extract significantly prolonged survival time in a dose dependent manner.

Background and purpose: Heart failure (HF) is characterized by decreased ability of the heart to provide sufficient blood flow or fill with the blood. Hyponatremia is the most commonly seen electrolyte abnormality in patients with heart failure that is associated with increased morbidity and mortality. The aim of this study was to assess the correlation between hyponatremia and high risk clinical and echocardiographic features in patients with acute HF. Materials and methods: This cross-sectional analytic study was performed in 271 patients with acute systolic heart failure admitted to Sari Fatemeh Zahra hospital, 2018-2019. Patients were divided into two groups: hyponatremic and normonatremic groups. Vital signs, echocardiographic variables, body mass index (BMI), and common cardiovascular risk factors were compared between the two groups using SPSS V18. Results: This study included 130 males (48%) and 141 females (52%) and the patients’ mean age was 69. 90± 14. 02 years. Patients with hyponatremia had lower BMI and systolic and diastolic blood pressure levels and higher platelet counts compared to other group (P =0. 01, 0. 002, 0. 005, and 0. 047, respectively). Also, these patients, were found with higher frequency of moderate to severe functional mitral regurgitation (P= 0. 076). Linear regression analysis showed hyponatremia as an independent predictor of hypotension and hemodynamic instability in patients with hyponatremia. Conclusion: This study showed that patients with acute HF and hyponatremia are at higher risk of developing hypotension, cachexia, and increased platelet counts which put them at greater risk for cardiovascular morbidity and mortality.

Background and purpose: Burn is one of the most devastating injuries which is considered as a critical health issue in the world. Rapid and effective post-burn first aid can significantly affect the burn outcomes. The purpose of this study was to evaluate the level of knowledge and attitude of the Medical Community Mobilization on burn injuries. Materials and methods: This cross-sectional study was conducted in members of the Medical Community Mobilization including 1173 individuals in Rasht, Iran 2015. A total of 562 people was selected using random sampling. A researcher-made questionnaire was used to assess their awareness and attitude. Data were analyzed in SPSS V18. Results: The mean age of participants was 38. 21 ± 8 8. 06 years old. Seventy-three (13%) individuals reported receiving first aid trainings for burn injuries during the past year. The correct answers of the participants about chemical, electrical, and thermal burns were 3%, 10. 1%, and 47%, respectively. Among the members of the Medical Community Mobilization studied, 241 (42. 9%) were found with moderate attitude and 254 (45. 2%) had a good attitude towards receiving first aid trainings in burn injuries. Conclusion: The rate of response to all questions and the education received were lower in this study than other studies, but the participants had positive attitudes towards receiving appropriate trainings, so, holding training courses of high quality and quantity could be of great benefit.

Background and purpose: Drug utilization evaluation (DUE) is one of the most effective methods to assess the correct administration of drugs. Enoxaparin is one of the most commonly used anticoagulant which is widely used as prophylactic or curative treatment. The aim of this study was to evaluate the rational use of enoxaparin in Mazandaran Heart Center. Materials and methods: In a retrospective study, demographic and clinical data of 200 patients who had received enoxaparin in 2017 were collected on the basis of American Hospital Formulary Service (AHFS) drug information, UpToDate, and Medscape guidelines. Results: The mean age of patients was 61. 52 ± 13. 62 years. The dosing of enoxaparin was according to guidelines in 163 (81. 5%) patients and outside the target ranges in 37 (18. 5%). Conclusion: In this study, the administration of enoxaparin for therapeutic or prophylactic purposes was not according to guidelines in about one-fifth of the patients and it is necessary to determine the precise dosage.

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most popular psychiatric medications that are approved for several neuropsychiatric conditions such as depression and obsessive-compulsive disorder (OCD). On the other hand, clomipramine is a tricyclic anti-depressant which is the only approved medication, among this class, to treat OCD due to its substantial effects on serotonergic system. Combination of SSRIs and clomipramine is uncommon in routine psychiatric practice because it can increase the risk of serotonin syndrome which is characterized by myoclonus, headache, nausea, confusion, diarrhea, tremor, twitching muscles, and agitation. However, it could be useful in patients suffering from treatment-resistant OCD. Here, we describe three cases of OCD patients, treated by combination of SSRIs and clomipramine who showed only myoclonic movements in initial week without any other manifestations of the serotonin syndrome. In less than one week after initiation of medication, abnormal movements disappeared, and in six month follow-up evaluation, the patients were observed with considerable improvements. Indeed, myoclonic movements is not a predictor of full-blown serotonin syndrome when combination of SSRIs and clomipramine is used. Therefore, the combination could be a considerable approach in treatment of refractory OCD.

Menstrual disorders are common in puberty, but they are of great concern to patients when presented with primary amenorrhea. This paper reports the case of a 17-year-old single female with secondary sexual characteristics and a suspicious mass in pelvic floor. She also complained from chronic pelvic pain. In laboratory tests, the hormone levels were normal and ultrasound scan showed a 50 to 89 mm hypoechoic adnexal mass. Computerized Tomography scan and Magnetic resonance imaging also confirmed the ultrasound findings. Due to the suspicious nature of the mass and chronic pain, the patient was subject to laparotomy, but was unwilling to undergo surgery, so, she was treated with oral estrogen and progesterone for 21 days. After discontinuation of medication, the first menstrual bleeding occurred. After the bleeding period (nine days), ultrasound scan was performed and no lump or lesion were reported. In cases where the patient has primary amenorrhea, despite the presence of pelvic mass, in case of normal laboratory tests and physical examination, a short term period with contraceptive pills is recommended.

Background and purpose: Acute viral hepatitis is one of the world's health problems today. An outbreak of hepatitis A virus occurred in a rural area in Mazandaran province, north of Iran, 2019. This research aimed at examining this outbreak in detail in order to study the epidemiological and economic burden, and the possible source of pollution. Materials and methods: This descriptive case report study presents the cases of seven members of a family of nine with acute symptoms of hepatitis. Results: In this family, seven members were found with clinical and laboratory symptoms of acute hepatitis, all of whom were positive for HAV Igm serology tests. According to the short incubation period and contamination of common origin, the most probable route of transmission, considering the health condition and residence of the people studied, was contaminated water. Conclusion: According to the investigation on water plumbing system and location of the residential building (at the end of the village), contamination entered the water plumbing system through sewage and drinking water is regarded as the main cause of the disease.

Modes of transmission of the COVID-19 virus are still unclear. The virus could spread through direct routes, including aerosols and saliva, and indirect transmission through contaminated surfaces. Dental practitioners produce airborne infectious particles especially when using rotary instruments during treatment. Oral fluids, blood, and oral mucosa are also sources of infection, so dentists are exposed to coronavirus more than other medical staff. Indeed, designing appropriate protocols and prevention strategies are highly important. In this review paper, we will explain and review the transmission pathways of the coronavirus, clinical signs of infected patients, dental office infection control, and dental treatment considerations.

Over recent years, nosocomial infections, and the morbidity and mortality associated with pathogenic bacteria have dramatically increased due to antibiotic resistance and imposed significant burdens on the global health system. Critical shortage of effective therapeutics against multidrug-resistant bacteria highlights the need for development of novel antibiotics. Actinobacteria are well-known sources of natural bioactive compounds, especially antibiotics. Nearly two-thirds of the antibiotics on the market have actinobacterial origins. Endophytic actinobacteria residing within plants contribute to the plant growth and survival by producing plethora of secondary metabolites. Therefore, isolation, cultivation, and identification of new strains, as well as their potential to produce antimicrobial compounds, are of great importance. Lack of published research in this field highlights the importance of this review in Iran. The aim of this review was to present the latest methods for the isolation and identification of endophytic actinobacteria and introducing relevant databases. We also studied the most recent isolated strains, chemical structure of 51 newly identified secondary metabolites, and their potential medical-pharmaceutical applications. This study revealed that endophytic actinobacteria are prolific sources of bioactive secondary metabolites with high levels of structural diversity and potent pharmaceutical and medicinal applications.