Journal of Mazandaran University of Medical Sciences
Year:2020 | Volume:29 | Issue:180|Papers Count:20

Background and purpose: Kidney stone is a common form of kidney disease and many efforts have been made to find medications for its prevention and treatment. Current study evaluated the protective effects of Sankol herbal product in the formation of renal stone in male Balb/c mice. Materials and methods: Nephrolithiasis was induced in male Balb/C mice within 21 days by adding 75% ethylene glycol (EG) v/v and 2% Ammonium Chloride (AC) w/v in drinking water. Animals were divided into three groups (n=12 per group); a control group that received purified water, another group that was given EG/AC and the other group that received Sankol (Goldaro Company, Isfahan, Iran) 888mg/kg. Results: In EG/AC group, increased levels of serum creatinine, urea, and uric acid indicated renal damage. In the group that received Sankol, these levels decreased which could help in preventing kidney stones. Histopathologic evidence showed inflammation and renal deposition in EG/AC group. In Sankol group, a decrease in the levels of renal sediments was observed, while inflammation of kidney and tissue damage increased. Present findings did not prove the safety of Sankol. Conclusion: This study showed the beneficial effect of Sankol in preventing kidney stones but various side effects question treatment with this product.

Background and purpose: Multiple sclerosis (MS) as an autoimmune disease is the most common demyelinating inflammatory disease in young people that affects the central nervous system. Myricitrin (MYR) is known to have antioxidant and neuroprotection effects, so, the current study investigated its effect on cognitive defects in rat models of MS. Materials and methods: In this experimental study, 40 Wistar rats were divided into five groups. Intra-hippocampus injection of Ethidium bromide (3 µ L 0. 01%) was performed using Hamilton syringe to induce demyelination. MYR was injected intraperitoneally for seven days after induction of demyelination. Measurements of passive avoidance memory in shuttle box, spatial memory (using Morris water maze), balance (by rotarod task), and anxiety level (using elevated plus maze) were done. The levels of MDA, TNF-α , and total antioxidant capacity were also measured. Results: Ethidium bromide significantly increased hippocampal MDA and TNF-α levels and decreased hippocampal total antioxidant capacity activity (P< 0. 001). MYR treatment significantly prevented the decrease of antioxidant capacity and the increase in hippocampal MDA and TNF-α levels induced by ethidium bromide (P< 0. 05 and P< 0. 001, respectively). Behavioral evaluation also indicated that treatment with MYR significantly improved the ability to keep information and reminders, spatial memory, balance, and anxiety. Conclusion: Injection of ethidium bromide into the CA1 region of the hippocampus led to the induction of MS, and administration of MYR may improve memory, motor function, and anxiety in MS models, possibly through antioxidant and anti-inflammatory pathways.

Background and purpose: Herbal drug derivatives have been commonly used in management and treatment and of some infections. This study aimed at evaluating the antibacterial effects of Chondrilla juncea L, Ajuga comata Stapf, Nepeta ucrainica L, and Delphinium speciosum M. B extracts. Materials and methods: Antibacterial activity of different extracts (n-hexane, dichloromethane, and methanol) of the aerial parts of Chondrilla juncea L, Ajuga comata Stapf, Nepeta ucrainica L, and Delphinium speciosum M. B were assessed against gram positive, gram negative and fungi strains using agar diffusion method. Potent extracts were subjected to fractionation using Vacuum Liquid Chromatography (VLC). Minimum Inhibitory Concentration (MIC) values of all samples were also investigated. Results: Staphylococus aureus and Bacillus subtilis were found to be the most sensitive bacteria. In agar diffusion assays, the n-hexane extract of D. speciosum and dichloromethane extract of C. juncea were the most active extracts against S. aureus (35 and 30mm, respectively) and B. subtilis (30 and 20mm, respectively). Other extracts showed no anti-microbial activity against different bacteria. In current study, 10 and 20% VLC fractions of n-hexane extract of D. speciosum exhibited stronger antibacterial activity against S. aureus and B. subtilis. MIC of both potent fractions were 500µ g/ml and 250µ g/ml against S. ureus and B. subtilis, respectively. Conclusion: Among the plant extracts studied, n-hexane extracts and 10 and 20% VLC fractions of the n-hexane extract of Delphinium speciosum showed higher antimicrobial effects.

Background and purpose: Memantine is a medication used to treat moderate to severe Alzheimer ’ s disease. Memantine targeting the glutamatergic system specifically N-Methyl-D-Aspartate offer a novel approach in treatment of psychiatric disorders such as schizophrenia and schizoaffective disorder. The purpose of this study was to evaluate the efficacy and safety of memantine in combination with antipsychotics in patients with schizophrenia and schizoaffective disorder. Materials and methods: A double-blind, placebo-controlled trial was performed in patients aged 18-65 years old with confirmed diagnosis of schizophrenia and schizoaffective disorder. Those who were pregnant, allergic to memantine, and not willing to participate in the study were excluded. Participants were assigned to receive either memantine (5-20 mg/day) (n= 29) or placebo (n= 29), in addition to antipsychotic for 90 days. The Positive and Negative Syndrome Scale (PANSS) was completed at baseline and day 30 and 90. Results: The study showed no significant difference in reduction of PANSS scores for positive sign between the treatment group (6. 32± 7. 17) and controls (4. 17± 6. 25) (P=0. 07). Conclusion: Memantine was found to have no effect on positive sign of schizophrenia and schizoaffective disorder.

Background and purpose: Surgical site infection is one of the most important complications of cardiac surgery, and in 50% of cases, is caused by Staphylococcus species. This study evaluated the effectiveness of intranasal administration of mupirocin in reducing nasal bacterial colonization, mediastinal, sternal, pulmonary, and skin infections after open-heart surgery. Materials and methods: This descriptive study investigated the records of patients who developed post-operative infection following open-heart surgery in Sari Fatemeh Zahra Hospital during 2011-2015. Treatments were done in two different periods: first period from 2011 to September 2013 and the second period from October 2013 to March 2015. In second course, intra-nasal administration of mupirocin was done to all patients, as a routine hospital care. Then, the incidence of post-operative infection, type, and site of infection were compared. Results: Frequency of infection was 78. 26% in the group that had recieved mupirocin and 46. 29% in the group that had not received mupirocin. The rate of surgical site infection in the group that had received mupirocin was 21. 74% and in the group without mupirocin it was 53. 71% (P= 0. 000). We observed significant reductions in the incidence of superficial infection of the incision (1. 85% in the group that was given mupirocin vs. 10. 9% in the group without mupirocin, P= 0. 009), foot superficial infections (23. 1% in the group that had received mupirocin vs. 27. 7% in the group without mupirocin, P= 037), and deep soft tissue infection of foot (10. 3% in the group that had received mupirocin and 18. 18% in the group that had nor received mupirocin). Conclusion: Intra-nasal administration of mupirocin could prevent cutaneous infections after cardiac surgery and also reduce hospital length of stay.

Background and purpose: Spondylitis is infection of the vertebrae and the intervertebral discs. Mycobacterium Tuberculosis, Brucella, and Pyogenic bacteria are among the major causes of this disease. There are reports on the epidemiology of this disease in Mazandaran, northern Iran. Evidence suggests differences between different types of spondylitis, but there is paucity of information on the differences between all types of spondylitis, especially Pyogenic spondylitis. The aim of this study was to investigate the clinical epidemiology of spondylitis in the region to make early diagnosis and appropriate treatments. Materials and methods: A descriptive study was done using the records of patients with spondylitis in Qaemshahr Razi Hospital, 2013-2017. Information including epidemiologic and demographic characteristics, main complaints and clinical symptoms, disease complications, radiological findings, and laboratory findings were extracted. Data were analyzed in SPSS V24. Results: The records of 39 patients (19 males and 20 females) were reviewed. Among the patients Brucellar spondylitis, tuberculous spondylitis, and pyogenic spondylitis were identified in 35. 9%, 38. 5%, and 25. 6%. Conclusion: In current study, the rate of spondylitis was higher than that in other studies, which may be due to higher rates of tuberculosis in Mazandaran. Thoracic involvement was found to be more common in tuberculosis while Brucella and pyogenic spondylitis involved lumbar vertebrae. These findings could be of great help in distinguishing between the three conditions.

Background and purpose: One of the major challenges for dentists is providing the patients with a crown of appropriate marginal fit and marginal gap. Preparation of a 135° finish line has some advantages such as technical ease and appropriate finish line record. Nevertheless, few studies investigated this type of finish line. The current study aimed at comparing marginal fit and marginal gap in 135° finish line and shoulder bevel finish line. Materials and methods: In this quasi-experiment study, 135° finish line and shoulder bevel finish line were performed in two first mandibular molars with healthy coronal tissue and similar size. Impression was taken from each tooth and 31 crowns were made on each die. Samples plastered with fit checker were pressed under 40 N for three minutes in universal testing machine. They were measured and recorded under a loop with 40x power at three points on each side. To analyze the data, Wilcoxon and Kolmogorov-Smirnov tests were applied in SPSS V24. Results: Mean values for the marginal fit in shoulder bevel and 135° finish line were 55. 0907 µ and 55. 2587 µ , respectively. The mean values for marginal gap were 19. 7245 µ and 0. 9745, respectively (P=0. 000). Conclusion: According to current study, a 135° finish line may have better clinical efficacy than a shoulder bevel.

Background and purpose: The purpose of this study was to analyze the user interface environment of some databases (Science Direct, Springer, Clinical Key, and Wiley online library) from the perspective of users applying Dervin's sense-making theory. Materials and methods: A cross-sectional descriptive study was conducted in 100 PhD students and research-based PhD students in Mazandaran University of Medical Sciences. Quantitative data were analyzed using SPSS and qualitative data were analyzed by content analysis. Results: The components of Dervin's sense-making theory are applicable in the user interface environment of the databases investigated. The highest mean score was found in the aid/use component in Science Direct (2. 11) and the lowest mean score was associated with the split component in Clinical Key (2. 02). There were differences between the mean scores for the components of the Dervin's model between PhD student users (1. 99) and the research-based PhD student users (2. 33). Conclusion: The study showed that the user interface environments of the databases moderately support users' information seeking behavior. Dervin's sense-making theory could help users in difficult and ambiguous situations.

Background and purpose: Autistic children have many behavioral problems. This situation causes a lot of stress for their mothers. The purpose of this study was to investigate the effect of positive psychotherapy on perceived stress and reasons for living in mothers of autistic children. Materials and methods: This quasi-experimental study with pre-test and post-test design was performed in 24 mothers of autistic children attending Sari Nikandishan Children's Autism Center, 2017. The samples were randomly assigned into two groups of intervention (n=12) and control (n=12). Positive clinical program was performed for the intervention group in eight sessions of 90 minutes twice a week. Demographic characteristics were recorded and Perceived Stress Scale and The Linehan Reasons for Living Inventory were administered to collect the data. Statistical analysis was done applying Covariance analysis. Results: Before the intervention, the mean score for perceived stress was not significantly different between the experimental and control groups, but after the intervention the score deresaed singnificantly in intervention group (21. 00± 7. 6 vs. 27. 83± 7. 5 in control group) (P< 0. 0001). The mean scores of reasons for living were not significantly different between the two groups before the intervention. But after the intervention the score showed significant increase in experimental group (177. 50 ± 15. 0) compared to that of the control group (159. 17± 17. 9) (P <0. 0001). Conclusion: Positive psychotherapy seems to be effective in decreasing the mental health problems of mothers of children with autism, including high levels of perceived stress and improving their reasons for living. This intervention would also be beneficial in improving treatment results and reducing child maintenance.

Background and purpose: Glycation products, oxidative stress, and inflammation contribute to the development of diabetic nephropathy (DN) due to the elevation of transforming growth factor-β 1 (TGF-β 1). This study aimed at investigating the effect of Cysteine (Cys) on TGFβ in DN rat model. Materials and methods: In this experimental study, 40 male Wistar rats were randomly divided into four groups (n=10 per group): control, Cys, DN, and DN + Cys. DN was induced in rats by nephrectomy of the left kidney and injection of streptozotocin. The Cys and DN groups were treated with Cys (0. 05% in dirking water) for three months. Glucose, insulin, diverse glycation products, lipid profile, oxidative stress markers, TNF-α , proteinuria, and serum creatinine levels were determined in all rats. Data analysis was done in SPSS V16. Results: Cys decreased the sera level of TGF-β 1, renal dysfunction parameters, diverse Glycation, oxidative stress, and inflammatory markers in DN rats. Furthermore, the treatment improved glycemia and dyslipidemia (P> 0. 001). Conclusion: Cysteine with antioxidant, anti-glycating, and anti-inflammatory properties ameliorated DN owing to advantageous effects on glucose and lipid metabolism in rats with diabetic nephropathy. Furthermore, this treatment showed multiple protective effects on kidney by reducing the TGF-β 1 levels.

Background and purpose: In this study, we aimed to evaluate the anticancer activity of Physalis alkekengi extract encapsulated into chitosan nanoparticles on HT29 cell line. Materials and methods: The fruits of the P. alkekengi were collected from Kohgiluyeh Boyerahmad province in south-west of Iran and dried in a dark environment. Then, the hydroalcoholic extract of the plant was extracted by percolation and encapsulated into chitosan nanoparticles. The toxicity effect of three samples; chitosan alone, chitosan containing the extract and the extract of P. alkekengi was investigated using MTT assay. Finally, Annxin V/propidium iodide (PI) kit was used to study the apoptotic effect of samples. Results: According to the MTT assay, during 72 hours, the cytotoxicity effect of chitosan nanoparticles of 160 nm containing the extract increased significantly (P< 0. 05). Moreover, the apoptosis assay indicated that chitosan nanoparticles containing the extract had more apoptotic effects than the extract alone (71% vs. 43%). Conclusion: P. alkekengi extract encapsulated into chitosan nanoparticles had more anticancer activity compared with that of the extract alone.

Background and purpose: Recurrent aphthous stomatitis (RAS) or oral aphthous are among the most common problems in adults. Stressful events could cause these ulcers. The purpose of this study was to determine the prevalence of recurrent aphthous stomatitis among students in Mazandaran University of Medical Sciences and its relationship with anxiety. Materials and methods: In this analytical cross-sectional study, 683 students in Mazandaran University of Medical Sciences (2018) were selected via random classification. Data were collected using Cattle Anxiety Scale and RAS history form. Data analysis was done in SPSS V22 applying descriptive and analytical tests. Results: The prevalence of RAS in this study was 21. 8%. A significant relationship was found between the history of RAS and anxiety level in students (P= 0. 04). Conclusion: Students investigated showed different degrees of anxiety that affected the rate of RAS. Therefore, appropriate planning and strategies are needed to control anxiety and subsequent problems such as RAS.

Background and purpose: Musculoskeletal disorders (MSDs) are among the major causes of occupational injuries and disability in industrialized and developing countries. The aim of this study was to compare MSDs in female staff working in radiology department of Imam Khomeini and Bouali Sina hospitals in Sari, Iran, 2018. Materials and methods: The research population, in this cross-sectional study, included 45 female staff working in radiology departments who were selected via census sampling. Then, 20 subjects who met the study inclusion criteria were studied. The Nordic Musculoskeletal Questionnaire (NMQ) was administered to collect the data. Statistical analysis was performed in SPSS V16. Results: The mean age of participants was 37. 7 years. Findings showed that during the past 12 months, musculoskeletal disorders were more prevalent in shoulder area (65%), wrists and hands (64. 7%), and elbows (55%). There was no significant correlation between acute skeletal disorders and age, height, weight, and BMI. Conclusion: The prevalence of musculoskeletal disorders has an increasing rate in radiography staff. Lack of appropriate trainings result in more occupational disabilities, therefore, improving working conditions and use of electronic systems rather than mechanical systems for radiation chamber door are suggested.

Background and purpose: Root therapy will be successful if it is done based on a correct diagnosis and appropriate treatment plan with the knowledge of morphology and tooth anatomy, debridement, disinfection, and obturation of the entire root canal system. This study aimed to investigate the number and morphology of canals in root canals mandibular anterior using cone beam computed tomography (CBCT). Materials and methods: A cross-sectional descriptive study was performed in a private office in Tehran, Iran 2018, and 902 anterior teeth were evaluated. Teeth were selected according to the following criteria: complete evolved roots, absence of periapical lesion, and no history of root healing. CBCT images were evaluated from three dimensions of sagittal (root number, canal type, and apical foramen deviation from radiographic apex), coronal (apical foramen deviation from radiographic apex), and axial (canal type and apical foramen diameter). Data analysis was done in SPSS V16. Results: The mean apical foramen diameter was 0. 21 ± 0. 55 and the mean apical foramen deviation from the radiographic apex was 0. 66 ± 0. 48 mm. Class 1 and 3 morphologies were the most frequent classes observed in anterior teeth and other classes accounted for about 5% of the samples. Conclusion: In this study, there was no relationship between gender and the number of roots and in males the number of canals were higher than that in females.

Background and purpose: Antithyroid drugs (ATD) are the preferred treatment for hyperthyroidism and identification of factors associated with lack of response or recurrence are highly important. The present study was done to evaluate the therapeutic outcomes of hyperthyroid patients attending Sari Academic Endocrine Clinic 2006-2016. Materials and methods: This descriptive study included all hyperthyroid patients. All therapeutic results were recorded and analyzed. Results: In this study, 329 records were studied and 104 patients met the study inclusion criteria. Graves' disease (GD) and toxic adenoma were reported in 94% and 6%, respectively. Among the patients with GD, 30. 5% (21. 7-40. 3%) did not respond to initial ATD treatment and 20% had recurrent GD despite appropriate initial response. Overall, antithyroid drugs failure occurred in 50. 5% (40. 45-60. 55%) of the patients. Lower age, lower body mass index (BMI), high thyroid weight, and higher baseline thyroid hormone levels were associated with ATD failure (P <0. 05). Patients with toxic adenomas and patients who did not respond to ATD or those who experienced relapse of hyperthyroidism received radioactive iodine or underwent surgery. Hypothyroidism occurred in 13. 1% of patients with ATD alone, in 66. 7% of those with surgery, and in 79. 4% of the patients who received radioactive iodine (P= 0. 0001). Conclusion: A significant proportion of hyperthyroid patients experience drug failure. Age, BMI, thyroid weight, and basal levels of thyroid hormones are associated with drug treatment failure. Prevalence of hypothyroidism after treatment with radioactive iodine is higher than the drug treatment alone or surgery groups.

Background and purpose: Job stress is one of the main factors that reduce productivity in organizations and leads to physical and psychological complications in personnel. This study aimed to investigate the relationship between job stressors and quality of life in nurses. Materials and methods: A descriptive cross-sectional study was performed in all nurses (n=394) working in Sari Imam Khomini Hospital. In this study, 196 individuals (155 females and 41 males) were selected by stratified random sampling. Expanded Nursing Stress Scale (ENSS) and World Health Organization Quality of Life questionnaire were used to collect the data. Statistical analysis was done in SPSS V20. Results: According to findings, 79% of changes in quality of life were predicted by occupational stressors. There was a significant relationship between quality of life variables and job stressors (P =0. 001). Also, the total mean score for quality of life was more favourable in morning shifts (37. 77, P<0. 001). The results showed that high levels of work-related stress would decrease quality of life and its reduction improves quality of life. Conclusion: Job stress in respondents had negative effects on some aspects of their quality of life. Therefore, nurse managers should build appropriate relationships with nurses and support them to reduce their physical needs and psychological pressures. Staff participation in making decisions could also be of great benefit in reducing job stress and improve the quality of life of nurses.

Background and purpose: Multiple Sclerosis (MS) is a common neurological disease in young adults. This study was performed to determine the prevalence of headache in these patients. Materials and methods: This descriptive-analytic study was carried out using convenient sampling in patients attending neurology clinics affiliated to Mazandaran University of Medical Sciences, 2017. Data analysis was done in SPSS V24. Results: There were 129 MS patients with history of headache, of whom 41. 1% had migraine and 56. 6% had tension headache. Severe types of headaches were reported by 47% of the patients and migraine was found to have the highest incidence. There were significant correlations between relapsingremitting MS and tension and migraine headaches (P=0. 001). About half of the patients did not mention a history of headache before MS, and there was no relationship between the new migraine headache and its aura (P>0. 05). Conclusion: In current study, tension headaches were found to be the most common types of headaches in MS patients. In relapsing-remitting MS, the most common type of headache was migraine. Given the adverse effects of headache on quality of life, awareness on the common types of headache could help in improving the quality of life of MS patients.

Pompe disease or type II glycogen storage disease is a rare autosomal hereditary disease. The prevalence of the disease is about 1 in 40, 000 to 1 in 300, 000 population. It usually occurs as a result of glycogen accretion following acid maltase deficiency. The current treatment is enzyme replacement therapy, which may slow down the disease progression. Sometimes, the clinical presentation can be atypical and lead to late recognition. This article reports a 32-year-old female with persistent fatigue and mild elevated liver transaminase levels. Biochemical analysis initially did not result in a diagnosis. Years later, increased Creatine kinase (CK) and lactate dehydrogenase (LDH) were observed. A muscle biopsy exhibited unusual glycogen accretion, followed by dried blood spot, indicative of Pompe disease. Notably, persistent raised levels of hepatic transaminases are not exclusive to liver pathology and clinicians should also consider extrahepatic causes.

Pan-hypopituitarism is a rare but life threatening disorder that occurs due to reduction of anterior pituitary hormones. In this condition, major depressive disorders are presented by depressed mood and markedly diminished interest in many activities during a day. Some disorders are associated with psychiatric symptoms at presentation, therefore, the diagnosis of mood disorder due to a medical condition should also be considered. This study presents a middle aged man admitted with symptoms of major depressive disorder involving suicidal ideation whose condition did not improve despite treatment with different antidepressant agents. He had past history of brain tumor surgery, chemotherapy, and radiotherapy. Due to the possibility of pituitary axis deficits since the time that radiotherapy was initiated, the patient was evaluated for these axes and the decrease in adrenal, thyroid, gonad and growth hormone axis function was confirmed by lab tests. In patients with persistent and severe depression, underlying medical causes such as endocrine disorders especially hypo-pituitarism should also be considered.

Background and purpose: A safe food system provides the conditions for consumers to decide about and choose the food products. This systematic review describes the alternatives in order to achieve a healthy nutrition pattern in a food system that can be used to make changes in current policies. Materials and methods: An electronic literature search was done in Google Scholar, Web of Science, PubMed, Scopus, Science Direct, Springer, ProQuest, Ovid, Magiran, Irandoc, Iranmedex using the following keywords: food and nutrition policy, evidence, food system, sustainability, healthy food, and sustainable food and nutrition system. Articles published between 2000 and 2018 in Persian and English that met the study inclusion criteria were selected. Results: In order to establish evidence-based policy four factors should be considered, including situation analysis, policy illustrations, analyzing the policy’ s framework, and changes in policy. Conclusion: The food environments and systems are the basis for food choices of people. Indeed, guiding the food system toward safe and affordable approaches affect consumers’ nutrition patterns. In Iran, changes in food policy should be also socio-culturally appropriate.