JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:25 | Issue:134|Papers Count:53

Background and purpose: Investigating and forecasting the different methods of labor can improve the knowledge about health problems in the future and the ability to develop effective interventions and prepare relevant resources. This study aimed at determining the trend and forecasting for cesarean section (c-section) and natural child birth in Mazandaran province, Iran.Materials and methods: A longitudinal study was performed using all registered data regarding labors in governmental and private maternities in Mazandaran province. The number of childbirth from 2007 to 2014 were entered into SPSS 16 software. The best model was selected based on autocorrelation and partial autocorrelation diagrams in Ljung-Box significance level as well as the least AIC.Results: The corresponding figures for 2007 to 2021 for cesarean and natural child birth were 19245, 15770 and 14382, 16385, respectively. The growth rate in private sectors was 17.7% (from 2007-2008). These rates were also observed to be 5.8% and 12.3% in 2013 and 2014, respectively. The results of forecasting revealed delivery growth in private sectors until 2021.Conclusion: The c-section rate would decrease to 35% in 2021 if the healthcare reform interventions continue. This rate is still much more than the optimal c-section rate recommended by World Health Organization.

Background and purpose: Anthracycline is a topoisomerase-interacting agent that is used in treatment of many cancers. We investigated the effects of anthracycline in adults using conventional echocardiography and pulse tissue Doppler imaging.Materials and methods: This observational before-after study was performed in 35 patients being recently diagnosed with cancer for whom ANT therapy was planned. Echocardiography studies were performed before chemotherapy and 6 months after initiation of the study. Additionally, troponin I and creatinine kinase-MB (CK-MB) were measured one month after the initiation of chemotherapy.Results: Six months after anthracycline therapy, Changes were seen in the systolic and diastolic left ventricular (LV) function. LV ejection fraction significantly decreased (P<0.001). Additionally, LV end-diastolic volume, LV end-systolic volume and left atrial diameter significantly increased compared with the baseline measures. According to the tissue Doppler imaging, the mitral annuli early diastolic (e') velocity significantly reduced, and the E/e' ratio (the peak early diastolic velocity) significantly increased.Conclusion: Altered LV systolic and diastolic function was observed after anthracycline chemotherapy.

Background and purpose: Damage caused by ischemia/reperfusion (I/R) is one of the major causes of liver failure during surgeries. Endothelin as the main vasoconstrictor has two receptors; ETA and ETB. Increased number of ETB during ischemia-reperfusion, reduces tissue damages by sinusoidal dilation. This study investigated the effects of dexamethasone against liver endothelial glycocalyx injury and ETB receptor gene expression during hepatic ischemia/reperfusion in rats.Materials and methods: Thirty two male Wistar rats were divided into four groups; a SHAM-operated group that received normal saline, DEX; which had dexamethasone injection (10 mg/kg), the I/R; received normal saline during ischemia/reperfusion, and the DEX + IR with I/R that received dexamethasone (10 mg/kg, 60 minutes before ischemia and immediately after reperfusion). After 1 hour of ischemia and 3 hours of reperfusion the blood samples and liver tissues were collected. The relative gene expression of ETB was assessed by real time PCR. Serum samples were used to measure the level of ALT and AST and hyaluronic acid (HA).Results: The level of ALT, AST and HA significantly increased in I/R compared with those of the SHAM-operated group (P<0.001). Injection of dexamethasone in the DEX+IR caused a significant reduction in serum indicators compared to those of the I/R group (P<0.001). Elevated ETB receptor gene expression reduced by dexamethasone injection (P>0.05).Conclusion: Dexamethasone decreased ETB receptor gene expression during liver I/R. In addition, it significantly protected the parenchymal cells and sinusoidal endothelial glycocalyx. Therefore, dexamethasone could play an important role in reducing liver injury during I/R.

Background and purpose: Stress ulcer or stress related mucosal disease (SRMD) is an important cause of morbidity and mortality in intensive care units. No drug prophylaxis for SRMD increase the rate of morbidity and mortality. Unnecessary use of drugs results in adverse drug reactions and impose additional costs. The purpose of this study was to investigate the medications used for stress ulcer prophylaxis in pediatric intensive care unit (PICU) in Sari Bu-Ali Sina Hospital.Materials and methods: This cross-sectional study was done in PICU patients who received stress ulcer prophylaxis during 2014. Data and physiologic parameters related to stress ulcer prophylactic drugs, the dosage, dosing interval, and duration of medications were recorded. SPSS16 was used for data analyses.Results: Stress ulcer prophylactic drugs were used in 40 patients of all 78 cases and ranitidine was the most commonly used drug (85%). The most frequent indication to prescribe these drugs were sepsis (20%), NPO (nothing per oral) with seizure (20%), NPO (15%), intubation (12.5%), and coagulopathy (7.5%). According to the guidelines, stress ulcer prophylactic drugs were correctly prescribed only in 42.5% of the patients.Conclusion: In this study, most of the cases received stress ulcer prophylactic drugs with no true indication. Therefore, more practical notice is needed to act according the guidelines for reducing the unnecessary administration of medication.

Background and purpose: Breast cancer is the most common cause of cancer-specific mortality among women worldwide. This study aimed at investigating the epidemiological, clinical, and pathological characteristics of breast cancer among patients attending Baghban Clinic in Sari.Materials and methods: The patients’ records (2008-2014) were used and data including age, gender, marital status, menopausal status, pregnancy and breast feeding, tumor size, type of tumor, number of involved lymph nodes, and metastasis were collected using a researcher-made checklist.Results: The study population included 1019 patients (mean age: 50.1±11.5 years) with breast cancer. The menarche age was 12-16 years in 77.8% of the patients. About 61.5% of patients had been diagnosed with breast cancer before menopausal age. The first pregnancy of 6.6% of the patients occurred after 30 years of age. Familial history of cancer was reported in 237 patients, 65.4% of which were breast cancer. The most common type of breast cancer was ductal carcinoma (90.7%) with moderate differentiation among 61% of the patients. The mean tumor size was significantly higher among patients that underwent total mastectomy compared to those with history of partial mastectomy (7.7±1.4 vs. 7.4±1.6, P=0.008).Conclusion: Our study showed ductal carcinoma as the most common type of breast cancer among studied women and tumor size was found to be one of the main factors associated with total mastectomy.

Background and purpose: Saponaria officinalis is a plant from the caryophyllaceae family and there are some contradictory reports about its antimicrobial effects. Metronidazole is commonly used in treatment of trichomoniasis but it has several side effects. On the other hand, finding an alternative drug from natural sources is very important. This study aimed at evaluating the hydroalcoholic extract of Saponaria officinalis leaf plant on the growth of Trichomonas vaginalis in vitro.Materials and methods: The plant was approved in herbarium and hydro-alcoholic extracts were prepared. The experiment was done using 24 wells cell culture plate. In each well, 200 microliter of TYM culture medium and 200 microliter of different concentrations of plant extract was added. Also metronidazole was added to positive control well. Then 100 ml TYM were added to all wells containing 500,000 parasites and the plates were incubated at 37oC. The experiment was performed as double blind and triplicate. The mean number of the parasites in different concentrations and times and effect of the extract were recorded.Results: The number of parasites in 50, 100, 200, 400, 800 and 1600 micrograms per ml of the extract, during 24, 48, and 72 hr increased compared to the negative controls, while no growth of parasite was observed in positive controls (containing Metronidazole).Conclusion: Saponaria officinalis leaf extract caused growth stimulation and increased the number of Trichomonas vaginalis, therefore, it could be used for mass cultivation of the parasite in vitro. However, further investigations are needed in future.

Background and purpose: Colorectal cancer (CRC) is the third most common cancer in men and fourth in women. In Iran, its prevalence rate is currently growing. Many risk factors are believed to be associated with this disease, but in recent years, the role of chemokines especially CXCR4 is outstanding. This study aimed at investigating the relationship between clinicopathological characteristics of patients and the rate of recurrence, metastasis, and death due to CRC by assessing the CXCR4 expression.Materials and methods: The expression of CXCR4 was studied by immunochemistry method (IHC) on 50 CRC paraffin blocks which were qualified for both tumor and adjacent normal colorectal mucosa (as control).Results: Fifty paraffin blocks (from 25 male and 25 female, mean age: 64.57±13.9) were composed of 47 adenocarcinomas and 3 mucinous carcinomas. The CXCR4 expression was negative in 21cases (42%), cytoplasmic in 18 (36%), nuclear in 9 (18%), and both nuclear and cytoplasmic in 2 cases (4%). A significant relationship was found between CXCR4 expression and recurrence of CRC. But no association was found between the marker expression and other clinicopathologic parameters.Conclusion: During the study on the chemokine expression, a relationship was found between CXCR4 and CRC recurrence. Therefore, after assessing more specimens, this chemokine marker could be used as a predictor of tumor recurrence in the future.

Background and purpose: Nitrate and Nitrite are the pollutants of groundwater resources which are mainly associated with agricultural and wastewater disposal areas. Fluoride is beneficial to human health in proper doses. The aim of this study was to determine the spatial and temporal variations of nitrate, nitrite and fluoride in drinking water resources in Ilam, Iran, using Geographic Information System (GIS).Materials and methods: This cross- sectional study was carried out in 20 drinking water sources in Ilam. The results of a 5-year archived analysis obtained from Water and Sewage Co was analyzed in GIS version 9.3 and SPSS version 16 applying one way ANOVA. Sampling was done according to the Standard method book.Results: The best methods of interpolation for fluoride, nitrate and nitrite (considering the normal distribution of data) was ordinary Kriging and the Gaussian, exponential and spherical, respectively. Based on the maps, the highest values of all parameters in most cases were found in central and eastern regions. The results of one way ANOVA showed a significant difference in average concentration of fluoride between different seasons (P=0.025). Also, there were significant differences in mean verification parameters measured in different seasons and different years (compared to all seasons) (P<0.001). The average level of nitrate in all sources were significantly lower than the international standard level of 50 milligrams per liter (P<0.001).Conclusion: The results showed that in most regions the fluoride concentrations were lower than standard levels. According to the important role of fluoride on human health, authorities in Iran’s Ministry of Health should conduct programs for fluorination of water resources in low level area. To decrease the increasing rate of nitrate, some useful actions such as protecting the wells, construction of wastewater treatment plants, controlling the use of nitrogen fertilizers and continuous monitoring of water quality could be of great benefit.

Background and purpose: Despite increasing awareness and developments in community health, intestinal parasitic infections are still a problem. There is no accurate statistics about the prevalence rate of intestinal parasites in west of Mazandaran province. The aim of this article was to investigate the present prevalence of intestinal parasites and survey of their risk factors in this region.Materials and methods: A cross-sectional research was carried out in 880 individuals attending rural and urban health centers in west of Mazandaran (Ramsar, Tonekabon and Chalus). Written consents were obtained and fecal specimens were collected from each person and tested by direct methods, formalin-ether, trichrome, and acid fast staining.Results: The overall prevalence rate of intestinal parasitic infections was 13.8%. The prevalence rate of parasites in males and females were 6.5% (n=65) and 8.1% (n=56), respectively. The following parasitic infections were found: Blastocystishominis (6.3%), Giardia intestinalis (4.5%), Cryptosporidium (0.2%), Entamoeba histolytica/dispar (0.5%), Entamoeba coli (0.9%), Chilomastixmesnili (0.1%), Iodamoeba butchlii (0.2%), Strongyloides stercoralis (0.6%), Taenia saginata (0.2%), and Hookworm (0.1%). Also, mixed infection with Giardia and E.coli was observed in in one sample (0.1%).Conclusion: The prevalence rate of intestinal parasites in Mazandaran province was reduced compared to the rates reported in previous studies. This might be due to increasing awareness of people, improved environmental health and wastewater treatment, and reducing parasitic contamination of vegetables.

Background and purpose: Alzheimer’s disease (AD) is a neurodegenerative disorder which is the most common cause of dementia in elderly. Fibroblast growth factor 1(FGF1) selectively protects neurons against neurotoxic effects. This study aimed to evaluate the association between the G/A (rs34011) FGF1 gene polymorphism and Alzheimer’s disease in southwest of Iran.Materials and methods: A case- control study was conducted in which 89 AD patients and 73 healthy subjects enrolled. Genotypes were determined by the PCR-restriction fragment length polymorphism (PCR-RFLP) technique in two groups.Results: The AA genotype frequencies were 11% and 4.3% in patients and controls, respectively. The А allele frequencies in AD patients and controls were 38.8% and 30.1% respectively. Significant differences were seen in the frequencies of AA genotypes and A-alleles between the patients and control group (P=0.028 and P=0.015, respectively). Also, when the samples were classified according to gender, significant differences were found in the frequencies of AA genotypes (P=0.033) and A-alleles (P=0.008) between female subjects in patients with AD and controls.Conclusion: This study suggests that (G/A) (rs34011) FGF1 gene polymorphism could be associated with AD in southwest of Iran. Also, the FGF1 gene AA genotype frequency or A allele frequency might be a genetic risk factor for developing AD.

Background and purpose: Due to inadequate quantity and low quality of water resources in rural regions of Gomishan (Golestan province), local residents use cisterns for household water. Therefore, it is necessary to investigate the hygienic situation of these cisterns.Materials and methods: In this study, water samples were obtained from 31 villages using random sampling (two times; total number of samples=406). Bacteriological tests were carried out by standard methods. The relationship between hygienic situation of cisterns and bacteriological quality of water were statistically analyzed.Results: A total of 406 water samples was examined by measuring total coliform and fecal coliform, in which. 94 samples (23.14%) showed total coliform and 28 sample (6.89%) showed fecal coliform. A significant relationship was observed between hygienic status of cisterns and bacteriological pollution (P<0.05).Conclusion: Microbial contamination in the studied cisterns calls for sanitizing the cistern in the region and changing the drinking water resources.

Background and purpose: Several factors are involved in caries prevention in children. One of the most effective factors is the appropriate use of fluoride. Fluoride induces its main effects in caries prevention through antibacterial effects and topical contact with enamel. In this study the inhibitory effects of sodium fluoride (NaF) and acidulated phosphate fluoride (APF) gels on cariogenic microorganisms concentrations (Streptococcus mutans and Lactobacillus) were compared using Quantitative Real-Time PCR.Materials and methods: A single blind parallel clinical trial was performed in which plaque samples were investigated twice (before and after the use of fluoride). The plaque samples of 44 children were studied by quantitative Real Time PCR and the number of bacteria (lactobacilli and Streptococcus mutans) was counted in each sample. Then, APF gel (Fluoride 1.23% +0.98% phosphoric acid, pH 5.3) was randomly used for 22 children. All the teeth (primary and permanent) were covered with fluoride by applicator. For other children 2% NaF gel (neutral pH) were used. After the use of fluoride, the numbers of bacteria were measured again by quantitative real-time PCR. Finally, the variability of microorganisms before and after the intervention was compared. Mann-Whitney test was applied for data analysis using SPSS V.18.Results: Significant reductions were observed in numbers of streptococcus mutans and lactobacillus after consumption of APF-gel (P<0.05).Conclusion: The APF gel exhibited more caries-preventive effect compared to NaF gel and could be used to benefit children’s oral health.

Background and purpose: E. coli bacteria is detected by culture, serology and molecular methods. In molecular methods PCR products are created using little random primers. The main purpose of this research was to study the genetic diversity of Escherichia coli bacteria. Also, the propinquity of isolated bacteria with two common strains of EnteroPathogenic E. coli (St.1) and EnteroHaemorrhagic E. coli (St.2) was studied.Materials and methods: An experimental study was performed in which 50 E. coli bacteria were isolated from urine samples and re-identified using biochemical tests. DNA was extracted by a kit and PCR products were evaluated after electrophoresis. The matrix of one/zero of bands was entered in Excel and studied by NTSYSPC2.02 and MVSP 3.2 programs.Results: Eight primers were used from which 129 bands were produced. The highest number of bands were produced by primer 2 (n=24). We observed 42 polymorphic bands, 10 common bands in all primers, and 22 special bands in each primer. The largest band appeared in primer 1 (17.3 kb) and the smallest band was observed in primers 7 and 8 (80 bp). Based on UPGMA dendrogram pattern and PCoA 3D ordination, four isolates including 33, 47, 48 and 50 showed relative genetic propinquity with St.1 and St.2.Conclusion: Drawing PCoA 3D ordination showed high genetic diversity in isolates, indicating different pollution centers in spreading the bacteria. Fingerprinting of isolates showed high repeatability in technique illustrating its high degree of accuracy and reliability.

Background and purpose: Nulliparous women with unplanned pregnancy experience high levels of anxiety during pregnancy. Maternal anxiety endangers the mother-infant interaction and maternal role attainment. Current study aimed at determining the effect of a maternal role training program on postpartum maternal role competence in nulliparous women with unplanned pregnancy.Materials and methods: This clinical trial was conducted in 67 nulliparous women at 33 gestational age attending the Health centers in Mashhad, 2014-2015. They were randomly divided into intervention and control groups. Data was collected using a demographic questionnaire, London Measure of Unplanned Pregnancy (LMUP), Depression Anxiety Stress Scales (DASS-21), Edinburgh Postnatal Depression Scale, Parenting Sense of Competence Scale, and General Impressions on Infant Temperament Questionnaire. The intervention group undergone training programs in groups of 4-7 during 4 sessions at gestational weeks 34, 35, and 36 and before discharge, while the control group received usual care. Maternal role competence was evaluated before the intervention and four weeks after delivery.Results: The mean scores for maternal role competence after the intervention were 39.26 ±4.598 and 35.91±5.526 in intervention group and control group, respectively, indicating a significant difference between the two groups (P=0.009).Conclusion: Training the nulliparous women about maternal role during pregnancy and postpartum period could increase the maternal role competence in those with unplanned pregnancy.

Background and purpose: Alpha- glucosidase inhibitors are used in treatment of type 2 diabetes because they decrease postprandial hyperglycemia. Consistent use of these drugs has undesirable side effects such as liver toxicity and gastrointestinal symptoms. The purpose of this study was to investigate the inhibitory effect of Ziziphus jujuba and Heracleum persicum on the activity of partial purified rat intestinal alpha-glucosidase enzyme.Materials and methods: Alpha-glucosidase enzyme was partially purified by gel filtration chromatography Sephadex G-200 from the rat intestine. The methanol extract of plants was prepared and IC50 value of extracts on alpha-glucosidase enzyme was obtained and compared with acarbose IC50. The polyphenolic content and antioxidant capacity of extracts were determined by Folin-Ciocalteu test and DPPH test, respectively.Results: The specific activity of the enzyme was 59.1 U/mg. The IC50 values of Z. jujuba, H. persicum and acarbose for alpha-glucosidase inhibition were 815, 258 and 104 mg/ml, respectively. For inhibition of DPPH radical, IC50 values of extracts were calculated as 721 and 243 mg/ml, respectively. Total phenolic content of methanol extracts were 36.06±2.1 and 68.2±2.6 mg tannic acid equivalent/mg extract, respectively.Conclusion: Z. jujuba is used in traditional medicine to treat gastrointestinal disorders, liver pain, diabetes and H. persicum is used as anti-flatulence. Antioxidant properties, polyphenolic content, saponin and remarkable inhibition of the alpha-glucosidase make them appropriate candidates in treatment of diabetic patients.

Background and purpose: Staphylococcus aureus is one of the most common nosocomial pathogens especially among burn patients. Aminoglycoside is usually used in combination with other antibiotics for treatment of serious S. aureus infections. Resistance to aminoglycoside antibiotics is one of the most important problems in treatment of S.aureus infections. The aim of the present study was to determine the frequency of aminoglycoside resistance genes in S. aureus isolated from burn patients.Materials and methods: A total of 81 isolates of S.aureus were collected from burn wounds of patients hospitalized in Taleghani hospital in Ahvaz, Iran. Conventional laboratory tests were used for identification of S. aureus at species level and then confirmed by detection of nucA gene. Antimicrobial susceptibility pattern was tested against 11 different antibiotics by Disc Agar Diffusion Method. Frequency of aminoglycoside resistance genes (aac (6’)-Ie-aph (2’’)-I, aph(3’)-IIIa, and ant (4’)-Ia) were evaluated by multiplex-PCR method.Results: Highest rate of resistance were observed against Penicillin (97.53%), Erythromycin (77.78%) and Ciprofloxacin (76.54%). None of the isolates were resistant to Vancomycin. MRSA detection rate was 87.65%. In isolates that showed resistance to Aminoglycosides, 28.57% have only aac (6’)-Ie-aph (2’’)-I gene and 46.03% have both aac (6’)-Ie-aph (2’’)-I and aph (3’)-IIIa genes simultaneously. None of the isolates were positive for ant (4’)-Ia gene.Conclusion: Considering the high prevalence of MRSA isolates and also aminoglycoside resistance gene in S. aureus, continuous surveillance in infection control policy is necessary in hospitals to prevent resistant bacteria spreading.

Background and purpose: The most common primary tumors of the central nervous system are gliomas. The gold standard choice to determine grade of glial tumor is biopsy which is an invasive method. Accurate assessment of tumor grade is important for determination of appropriate treatment strategies. The purpose of this study was to evaluate the role of Diffusion Tensor imaging (as a non-invasive method) by fractional anisotropy (FA) in glial tumor grading.Materials and methods: A prospective study was performed in 20 patients with histologically confirmed gliomas. Patients underwent Diffusion Tensor Imaging by a 1.5-Tesla magnetic resonance scanner. In this study we defined two regions of interest (ROIs); white matter adjacent to the tumor and the homologous fiber tracts to first ROI in the contralateral hemisphere. The fractional anisotropy in these regions was calculated in SPSS and the relationship between FA and gliomas grade was determined.Results: FAt values and ratio of the low-grade gliomas tended to be higher than those of the high-grade gliomas in the peritumoral fibers (P-value FAt=0.006 and,P-value FAt/n=0.02).Conclusion: Our findings suggest that FA could be helpful in tumor grading.

Background and purpose: Adsorption is considered as one of the promising treatment methods for removal of heavy metals from aqueous solutions. The aim of this study was to determine the efficiency of Padina sanctae crucis in removal of manganese (Mn) from aqueous solutions.Materials and methods: Biosorption was studied in a series of batch experiments at room temperature and the effects of experimental parameters such as biosorbent dose (0.1-10 g/L), contact time (3-120 min), pH (3, 5, 7, 8) and initial Mn concentration (0.5-100 mg/L) were studied.Results: The highest removal biosorption of Mn was reached at 5 g/L biosorbent dose, 20 min contact time, and 20 mg/L initial Mn concentration (100% removal). Langmuir model was better fitted than Freundlich model that showed homogeneous biosorption surface and the possibility of monolayer biosorption of Mn by biosorbent. The biosorption kinetics was controlled by the pseudo- second order.Conclusion: According to the results, Padina sanctae crucis could be used as an effective and low-cost biosorbent for Mn removal from aqueous solutions.

Background and purpose: Pregnancy has tremendous influence on sexual satisfaction and qualification of women's life, especially in third trimester of pregnancy. The aim of this research was to determine the level of sexual satisfaction and related factors in women during third trimester of pregnancy.Materials and methods: This descriptive cross-sectional study was conducted in 110 nulliparous Iranian women with no history of illness and complications during pregnancy attending Tehran hospitals, 2013-2014. Data was collected by the adjusted version of Index of Sexual Satisfaction (ISS) and a demographic-obstetric questionnaire. Data was analyzed in SPSS V. 19 using ANOVA test, Pearson and spearman correlation.Results: The mean ages of women and their husbands and the median duration of marriages were 25.89±4.38, 30.96±6.22 and 3.22±2.23 years, respectively. The rates of sexual dissatisfaction was 0.9%, while low, moderate and high levels of sexual satisfaction were observed in 2.7%, 45.5%, and 50.9%, respectively. The results showed significant associations between levels of sexual satisfaction in third trimester and some factors such as age of women and their spouses, educational level of women, family economic situation, employment status, a planned pregnancy, and sexual desire (P<0.05).Conclusion: According to the relation between sexual satisfaction and level of education, a planned pregnancy, employment status, and economic status of the family, free and accessible training in sex education is recommended to increase the level of knowledge in women and enhance prenatal care.

Background and purpose: Pesticides are used in agriculture to increase crop production. Organophosphate pesticides are used more than other pesticides since they are inexpensive and more influential on a wide range of pests. Fish containing pesticides have significant human health consequences. In this study, three types of most consumed fish in the Caspian Sea were evaluated for Diazinon organophosphate levels.Materials and methods: Twenty seven samples of three species of fish (Rutilus frisii kutum, Cyprinus carpio, leaping mullet) were randomly collected from three stations in central coast of Caspian Sea. The samples were digested and extracted and Diazinon residues were extracted. Diazinon concentrations were determined using a Gas chromatography (GC-MS) method. All results were statistically analyzed using One-way analysis of variance (ANOVA) and t-test. Then Tukey-post test was applied to compare the pesticide residues levels in the samples.Results: Diazinon was found detected in all samples. The leaping mullet samples collected from Babolsar and Khazarabad stations showed higher levels of Diazinon (55.25±48.03, 55.17±52.5 mg/kg, respectively) compared to others. ANOVA did not show any significant difference between all three types of fish in concentration of diazinon (P=0.33).Conclusion: In this study, Diazinon was found at a high level in all samples (115.78 m mg/kg) in leaping mullet sample from Babolsar region. However, it was not more than acceptable level determined by WHO (0.01 mg/kg). Hence, the three investigated species fish are considered to be safe for human consumption.

Background and purpose: The aim of the present research was to investigate the mediating role of self-esteem, emotional eating and self- control in relation with attachment, anxiety, depression and parenting style on obesity and overweight in adolescent girls.Materials and methods: A descriptive study was conducted in all female students aged 14-17 years old living in Tehran. Cluster sampling was done by which 440 students were selected. Data was collected using Depression Anxiety Stress Scales (DASS), Baumrind parenting styles questionnaire, Harry self-esteem scale, Self-control scale, Inventory of parent and peer attachment (IPPA), and Emotional Eating Scale (EES). Data was analyzed applying Pearson's correlation, path analysis and structural equation model.Results: The findings indicated a positive correlation between emotional eating style and obesity (0.84) and a negative correlation between mother, father, and peer attachments and obesity (-0.72, -0.71, and 0.70, respectively). An indirect relationship was found between reactionary parenting style and obesity. The results of path analysis indicate emotional eating as the mediator variant between parenting style, anxiety and depression with obesity and overweight and self- esteem is a mediator variant between parenting style with obesity.Conclusion: This study showed cognitive mechanisms in incidence of obesity and overweight in adolescent girls. Therefore, considering these factors could help researchers and psychologists in preventing such problems and using appropriate treatments.

Background and purpose: Heart failure is one of the most common chronic diseases with high mortality rate. Self- care training is effective in reducing the number of hospitalizations and improves the quality of life in these patients. However, the influence of such training was not found to be viable in previous interventions. This study was conducted to determine the effect of training based on teach back method on self-care in patients with heart failure.Materials and methods: In this clinical trial, 62 hospitalized patients with heart failure in Imam Reza and Ghaem hospitals in Mashhad (2014-2015) were randomly allocated into experimental and control groups. Subjects in the experimental group received individual self- care training for 3-4 days based on teach back method and the control group received usual self- care training. Self-care was measured using the European Heart Failure Self-Care Behaviour Scale (EHFScB Scale) before and one month after discharge. Data was analyzed using independent- samples t-test and paired t-test.Results: Before the intervention no significant difference was seen in the mean score for self- care between the two groups, but after intervention, it significantly increased in the experimental group (P<0.001). This increase was also significant compared to that of the experimental group before the intervention (P<0.001); but in the control group this difference was not significant (P=0.138).Conclusion: Training based on teach back method was found to be more effective than usual training in promoting self-care among patients with heart failure. Therefore, it is recommended in care planning for these patients.

Background and purpose: Sulfur is an essential element used in the amino acids cysteine and methionine. Sulfur toxicity occurs due to its high concentration and volatile compounds in the environment. In various stages of human life, sulfur contaminants cause a variety of disorders in different parts of the body including the immune system. The embryonic period is the most critical stage of life cycle, so, this study investigated the effects of sulfur intoxication in pregnant rats on serum levels of immunoglobulin in their neonates.Materials and methods: In this experimental study, 36 adult female Wistar rats were divided into three groups: a control, experimental group I with mild poisoning and experimental group II with severe intoxication. Before and during pregnancy the experimental groups I and II received a daily dose of 500mg/kg.bw sodium sulfide dissolved in drinking water for 15 and 30 days, respectively. Blood samples were taken from male and female newborns, 40 days after birth, and the serum levels of IgG and IgM were measured using nephelometric technique. Data was analyzed in SPSS ver. 17.Results: The results indicated a significant increase in serum levels of immunoglobulin IgG and IgM in male and female neonates with severe maternal toxicity compared to the control group (P<0.05). On the other hand, there was no significant difference in the concentration of immunoglobulins in female newborns of all groups compared to the corresponding male group. (P>0.05)Conclusion: Sulfur contaminants or their metabolites can cross the placental barrier during pregnancy and increase serum levels of IgG and IgM in neonates through changes in the function of fetal immune system. Furthermore, these alterations are believed to be gender independent.

Background and purpose: Cyclophosphamide (CP) as a teratogen can lead to congenital abnormalities in animals and humans. Many reports have shown the influence of antioxidant drugs in reducing the adverse effects of CP. Galbanum has antioxidant effects and Mesna (Sodium 2-mercaptoethane sulfonate) is used for decreasing the side effects of CP, especially hemorrhagic cystitis. This study aimed at investigating the effects of galbanum and mesna on cyclophosphamide-induced teratogenicity in rat fetuses.Materials and methods: This study was performed in 33 pregnant rats that were divided into five groups. A control group received normal saline and test groups received CP (15 mg/kg), CP plus mesna (100 mg/kg), CP plus galbanum (200 mg/kg) and CP plus mesna (100 mg/kg) plus galbanum (200 mg/kg) intraperitoneally on the 13th day of gestation, respectively. Fetuses were extracted on 20th day of gestation. Then, the weight and length of fetuses were measured and staining was done using Alizarin red- Alcian blue method. The teratogenic effects were investigated by stereomicroscope.Results: The results showed that the incidence of cleft palate, exencephaly, micromelia, and omphalocele were 37.50%, 62.50%, 16.62%, and 9.37% in fetuses that received only CP which decreased to 28.57%, 28.57%, 3.57%, and 7.14% in the group that had received CP plus mesna (75 mg/kg) and to 18.51%, 14.81%, 3.7%, and 0% in the group which received CP plus galbanum (200 mg/kg), respectively. In treatment group that received CP plus mesna and galbanum the incidence of aforementioned abnormalities decreased to 18.64%, 11.86%, 3.38%, and 0%, respectively.Conclusion: In this study galbanum significantly decreased teratogenicity induced by CP.

Background and purpose: Colorectal cancer is one of the most common types of cancers worldwide. Most of the times it is superimposed on an adenomatous polyp. Today, colonoscopy is the gold standard screening test for diagnosis of colorectal cancer which prevents developing cancer on the adenocarcinoma sequence path way. The goal of this study was to evaluate the gross and microscopic characteristics and the type of colonic polyps.Materials and methods: A descriptive cross-sectional study was performed using the information available in pathology department in Sari Imam Khomeini Hospital, 2004-2014. Data including age, gender, site of polyp, size and histologic type was recorded.Results: There were 548 polyps of which 56.7% were seen in male patients. The patients were between 14 to 88 years of age. More than half of the polyps were found in those aged 50 to 70 years of old, but 15.1% were observed in cases under 40 years of age. 54.8% of the polyps were located in rectosigmoid and 16.5% were found in left part of the colon before splenic flexture. Histologic studies revealed different types of polyps including adenomatous (57.6%), hyperplastic (16.4%), juvenile (6%), retention (5.8%), adenocarcinoma (4%), high grade dysplasia (3.9%), no polyp (3.3%), and mixed hyperplastic adenomatous polyps (3.2%). Among adenomatous polyp, there were tubular (83.1%), tubulovillous (16.3%), and villous (2.4%) adenomas.Conclusion: Adenomatous polyp, especially tubular adenoma was the most common colonic polyp and it was more common in rectosigmoid area among male patients aged 50-70 years old.

 Background and purpose: Laundry is one of the main wastewater producing units in hospitals. Most of detergent materials are hardly degradable and cannot be broken fast in the conventional treatment facilities. This research aimed at studying the possibility of hospital laundry wastewater pretreatment by electrocoagulation method using aluminum electrodes.Materials and methods: Using composite sampling method, a total of 72 samples was taken from the effluent of a hospital laundry wastewater in Gorgan. The samples were analyzed according to standard methods of water and wastewater examination. After determining the quality of raw laundry wastewater, the wastewater was treated by electrocoagulation method with aluminum electrodes in different circumstances of pH, voltage and times. Process efficiency concerning the removal of COD, color, phosphate and surfactant was examined.Results: In this study the mean density of COD, phosphate and surfactants in hospital laundry waste water were 848.8±109.4, 1.03±0.06 and 4.81±0.93 mg per liter, respectively and the mean concentration of color was 759.3 ± 152.8 TCU. In optimal conditions, this process could remove 86, 98.8, 94.98, and 66.6% of COD, color, phosphate and surfactant, respectively. The efficiency removal of all parameters increased as the voltage and the contact time increased.Conclusion: This study showed that laundry waste water was highly polluted and electrocoagulation process could be an efficient procedure in its pre- treatment.

Background and purpose: In urban health care system, pre-hospital emergency medical services are the first line to deal with critical patients. If a fast and accurate medical care is delivered, deaths and disabilities resulting from diseases reduce and trust of people to this system will increase. The purpose of this study was to determine the factors influencing the readiness of pre-hospital emergency care in Mazandaran province.Materials and methods: In this descriptive cross sectional study the population included 362 staff in pre-hospital emergency settings in Mazandaran province of whom 191 were selected by simple random sampling. Data was collected using a researcher-made questionnaire. Data was analyzed applying one sample t-test and Friedman’s test.Results: The most important effective factors on readiness of pre-hospital emergency care in Mazandaran province included human resources, equipment and logistics, training courses, information and communication technology, management and organization, and motivation. According to the staff in pre-hospital emergency care settings two factors including motivation (4.37 from 5) and human resources (2.26 from 5) had the most and least effects. Other effective factors included equipment and logistics (4.36), information and communication technology (3.30), training courses (3.19), and management and organization (3.15).|Conclusion: Motivation was found to be the most influencing factor affecting the readiness of pre-hospital emergency staff in Mazandaran province, therefore, policy-makers and managers should pay more attention to the incentives and all factors affecting the quality of services delivered.

Background and purpose: The prevalence of maxillary missing lateral incisor (MMLI) is 1-2% which is responsible for 20% of all missing teeth. Increased knowledge about causes and clinical manifestations of cases with this situation can be helpful for diagnosis and treatment planning. The aim of the present study was to determine dental and skeletal features of patients with missing maxillary lateral incisors.Materials and methods: The material consisted of pre-treatment dental casts and cephalograms of 26 patients with unilateral or bilateral MMLI. The following parameters were measured on dental casts: the maxillary and mandibular intercanine width (ICW) and intermolar width (IMW), overjet, overbite, missing or anomalous of other teeth. Parameters that were measured on cephalogram included: SNA, SNB and ANB angle and Wits. The parameters were finally compared to a control group with normal occlusion using paired t-test.Results: Eight subjects with MMLI had bilateral missing and in 18 subjects with unilateral missing, 66.67% (n=12) had lateral missing on the right side. MMLI was associated with other anomalies or congenital tooth absence in 12 subjects. The overject was significantly lower compared to that in the control group (P=0.05) and upper and lower ICW were smaller. Both ANB angle and Wits significantly decreased in this group (P=0.05).Conclusion: Absence of maxillary lateral incisor was highly correlated with other tooth anomalies. Most of patients with this situation had skeletal and dental Class III tendency.

Background and purpose: Body dysmorphic disorder is one of the common disorders in which adolescents pay excessive attention to their appearances. It causes disruptions to both individual and social life. This study investigated the efficacy of acceptance and commitment therapy (ACT) on body dissatisfaction and fear of negative evaluation in high school girls with body dysmorphic disorder.Materials and methods: An experimental study (pre-test, post-test design) was performed in which 30 female high school students with body dysmorphic disorder were recruited. The participants were selected using multistage random sampling and divided into experimental (n=15) and control (n=15) groups. The experimental group attended an eight-week ACT programme (1.5 hr) while the control group received no intervention. Structured Clinical Interview for DSM IV (SCID-I), body dissatisfaction questionnaire, and fear of negative evaluation questionnaire were used in pre-test and posttest stages.Results: ACT produced significant reductions in body dissatisfaction (P<0.01) and fear of negative evaluation (P<0.01) in post-test.Conclusion: Based on this study, ACT therapy could be used as an efficient intervention for reduction of body dissatisfaction and fear of negative evaluation in high school girls with body dysmorphic disorder.

Background and purpose: Hypotonia and delay in gross motor are usually seen in toddlers with celiac disease. This study aimed at investigating the effect of a developmental stimulation program on toddlers’ gross motor development.Materials and methods: A clinical trial was performed in Ghaem and Doctor Sheikh hospitals, Mashhad, in which 50 children, aged 1-3 years, were randomly assigned into intervention and control groups (n=25 per group). Then, the developmental stimulation program was conducted in the intervention group for three seesions a week which lasted for 2 hr. Gross motor developmental age of the children was assessed by Bayley Scales of Infant and toddler Development, before the intervention, two and four months after the intervention. Data was analyzed using independent t-test, Mann- Whitney U and repeated measures in SPSS V.11.5.Results: The mean age of the samples was 20.6±4.4. The median age of the gross motor in the intervention group (16±4.3 month) and control group (14.7±4.2 month) were not significantly different (P=0.312). After 2 months, there were significant differences in the average ages at which gross motor development were observed between the intervention (20.2±3.9 month) and control group (17.1±3.8 month) (P=0.015).Conclusion: The developmental stimulation program was found to be effective on gross motor development in children, therefore, it could be administered in toddlers at risk of developmental delay such as those with celiac disease.

Background and purpose: Previous studies have shown that smokers are deficient in social skills and it is possible that they have deficits in theory of mind. The aim of this study was to compare theory of mind and symptoms of attention deficit- hyperactivity between smokers and non- smokers.Materials and methods: This study was conducted in 160 man (80 smokers and 80 non-smokers) who were selected by convenience sampling. Data was collected using the Persian version of Reading Mind from Voice (FVRMFV), Conners' Adult ADHD Rating Scale and a demographic questionnaire. Data was analysed in SPSS V. 16 applying multivariate analysis of variance and independent t-test.Results: The findings showed higher scores of smokers in attention deficit (P<0.005), hyperactivity (P<0.006), impulsivity (P<0.007), problems in self-imagination (P<0.004), and whole range of ADHD symptoms (P<0.001) compared to non-smokers, but in mind reading test, smokers performed significantly weaker than non-smokers (P<0.001).Conclusion: Deficits in theory of mind is seen in smokers, therefore, deficits in social skills could be due to this reason in such groups.

Background and purpose: Seroma formation is the most common complication after breast cancer surgery that cause prolonged therapy duration, increases the costs and infection rates. This study aimed at investigating the efficacy of local phenytoin application on reduction of serous fluid and drainage duration and seroma formation following modified radical mastectomy (MRM).Materials and methods: A randomized clinical trial was performed in 31 patients who had MRM and axillary lymph node dissection (ALND). They were divided into two groups. A placebo group received normal saline (15ml) under the skin flap whereas 1% phenytoin was locally used in treatment group one day after the surgery. In further examinations, the patients were evaluated for seroma formation, surgery site infection and other complications such as hematoma or necrosis.Results: The mean duration of drain use in experimental group and placebo group were 3.94 and 5.92 days, respectively (P=0.01). The mean levels of serous fluid drainage were 128.3 and 210.7 ml in the group receiving phenytoin and placebo group, respectively (P=0.01). In a two-week follow-up, seroma formation were observed in both groups (treatment group: n=3 (16.7%) and placebos n=9 (69.2%)) (P=0.004).Conclusion: Application of local phenytoin 1% following MRM could be effective in preventing seroma formation, reducing the amount of serous drainage and shortening the drainage duration.

Background and purpose: Infections are responsible for 30% of deaths in geriatric population. This study was conducted to investigate the epidemiology, etiology, and clinical and laboratory findings in geriatrics hospitalized due to infectious diseases.Materials and methods: In this descriptive study, the records of patients over 65 years of age who were admitted to Razi Hospital (during 2012 -2013) have been studied. Data was collected including personal information, clinical findings, laboratory findings, and diagnoses. Data was then analyzed in SPSS V.16 applying t-test and Chi-square.Results: A total of 447 patients’ records was investigated. The patients were 239 males (53.5%). The mean age of the patients was 77.82±6.77 years. The most common presenting complaints of patients were cough, sputum, and fever. Pneumonia was found to be the most common diagnosis (39.14%), followed by skin and soft tissue infections (8.9%). Among the cases, 65.3% had an underlying disease. Diabetes was the most common underlying disease in 19% of the patients.Conclusion: Due to the increasing number of geriatric people, screening of predisposing factors to infectious diseases such as diabetes and kidney failure are necessary. Also, awareness of the most common and major symptoms of the involved organs could be of great benefit in making a quick diagnosis and appropriate treatments and reducing the rate of fatalities in this population.

Background and purpose: Blood transfusion is one of the essential and important parts of modern medicine. Blood transfusions are life saving for some patients, but some risks such as body's response should always be considered. This study was conducted to determine the incidence of transfusion outcomes and identifying the relationship between demographic profile of patients and some properties of blood products.Materials and methods: This descriptive study was carried out in all patients being admitted to the emergency department in Sari Imam Khomeini hospital whom underwent blood transfusions (in 2014). After recording demographic data, the history of transfusion reactions, clinical signs and symptoms, severity of side effects, the numbers of blood infusion packs over the last 24 hours were evaluated. Statistical analyses were performed in SPSS ver. 16 applying T-test and Chi square test.Results: A total of 961 patients had blood transfusion including 529 (55%) males and 432 (45%) females. Twelve patients (1.24%) developed acute blood transfusion complications. The most common reactions included chills (83%, n=10), fever (58%, n=7), and dyspnea (58 %, n=7). There were no significant correlations between the incidence of complications and other variables such as age, sex, initial hemoglobin level, previous medical history, and the age and number of injected blood products (P>0.05).Conclusion: In this study, the incidence of acute transfusion reactions was lower than that in other studies in Iran. Reduction in the number of red blood cell packs injected into patients can be one of the reasons for reducing the risk of acute transfusion reactions.

Background and purpose: Emotional intelligence skills could create and improve marital satisfaction. This study sought to evaluate the effect of skill-based emotional intelligence training program on marital satisfaction in married students.Materials and methods: A semi-experimental study was conducted in which 60 married students (in Mazandaran University, Iran) studying in undergraduate courses were randomly selected and assigned into experimental and control groups. The subjects in the experimental group received skill-based emotional intelligence training for 15 sessions. The ENRICH Marital Satisfaction Scale and emotional intelligence (EI) questionnaire were used and the results were evaluated in both groups, before and after the intervention.Results: The mean level of emotional intelligence in experimental group significantly improved (343.70±43.21) compared to that before the intervention (327.76±44.66) and compared to that of the subjects who did not attend the training sessions (336.63±35.39) (P=0.000). Also, the training program increased the participants' marital satisfaction (P=0.002).Conclusion: Acquiring skill-based emotional intelligence can greatly decrease the worries and concerns associated with the growth of marital problems and divorce among students and increase their marital satisfaction.

Background and purpose: This study aimed to investigate the relationship between job stress, social support, and job satisfaction in the personnel of Mazandaran University of Medical Sciences, Iran.Materials and methods: In this study, 302 individuals were selected from 1400 staff in Mazandaran University of Medical Sciences using stratified random sampling. Data was collected using Berry Field and Ruth questionnaire of job satisfaction, Occupational Stress Inventory (OSI), and Social Support Appraisals (SS-A).Results: There were inverse relationships between job satisfaction and job stress (r=-0.15), gender (r=-0.106), and marital status (r=-0.10). Positive relationships were observed between type of employment (r=0.07) and social support (r=0.80) and job satisfaction among employees. Job stress and social support were found to be responsible for 0.75% and 64% of the changes in job satisfaction.Conclusion: According to the findings, incentives and social supports could increase job satisfaction and reduce job stress in the personnel of Mazandaran University of Medical Sciences.

Background and purpose: Basal cell carcinoma (BCC) is the most common malignancy in human. The lesions are more prevalent in areas exposed to ultraviolet (UV) light and covered areas of the body. The purpose of this study was to investigate the clinical and histopathological subtype of BCC adjusted to anatomical location in Iranian patients (in west of the country).Materials and methods: A descriptive cross-sectional study was performed in patients who had BCC biopsy in Hamedan Farshchian Hospital, 2009-2011. Different data such as age, sex, duration of disease, anatomic location, size of lesions and risk factors were recorded using a questionnaire.Results: There were 223 BCC patients (mean age: 62.90±13.45) including 57.3% males and 42.7% females. Face and scalp were the most affected anatomical locations (92%) and 71.3% were nodular lesions.Conclusion: According to this study, BCC occurred in areas exposed to sunlight, mainly head and face. This signifies the need for sun protection.

Background and purpose: Microcephaly is reduced head circumference more than two standard deviation below the mean for the age and sex. Genetic microcephaly disorder is divided into two categories; isolated and syndromic microcephaly. The incidence of autosomal recessive primary microcephaly in consanguineous population is more than that in non-consanguineous population. So far, few studies are conducted on the common genes in microcephaly in Iran. The present study, reveals the necessity to study, and implementing programs for genetical and clinical prenatal diagnosis.Materials and methods: In this study, the records of more than 1500 families participating in genetic counseling (2003-2014 in Ahvaz Welfare Organization) were used. Depending on the type of disease and drawn pedigree, the frequency of isolated microcephaly was calculated among autosomal recessive patients. Data was analyzed applying Chi-square test.Results: Microcephaly and isolated microcephaly were observed in 5.51% and 3.29% of autosomal recessive patients, respectively. The risk of isolated microcephaly in non-Arab ethnic was 3.56 times more than the risk in Arab ethnic. The risk of isolated microcephaly in double first cousin and first cousin offspring was 4.44 times more than the risk of it in the first cousin once removed and other consanguineous marriages offsprings.Conclusion: Consultation for risk of isolated microcephaly is more necessary in non-Arab ethnic and in double first cousin and first cousin offspring.

Background and purpose: Anxiety will increase the risk of postpartum depression if it persists too long thereby, affecting marital relationship. The present study was performed to determine the relationship between postpartum anxiety and depression and marital satisfaction.Materials and methods: A cross-sectional study was conducted in which 270 mothers (8 weeks postpartum) attending healthcare center in Tabriz, 2014-2015 were recruited. Marital satisfaction, Edinburgh Postnatal Depression Scale (EPDS) and the Spielberger State-Trait Anxiety Inventory (STAI) were used to collect the data. Pearson correlation test was used to determine the relationship between marital satisfaction and postpartum depression and anxiety.Results: The mean scores for depression, and state and trait anxiety in women were 9.7±7.4, 52.2±5.2, and 47.2±4.8, respectively. Mean marital satisfaction score was 111.0±27.6. There was a reverse correlation between total score of marital satisfaction and its aspects with depression, state and trait anxiety(r=0.976 to 0.647; P<0.001).Conclusion: The results indicated lower levels of marital satisfaction in women with higher scores in depression and anxiety, therefore, to increase the level of marital satisfaction and strengthening the family relationships interventions are needed so that depression and anxiety are prevented in women during pregnancy and postpartum period.

Background and purpose: Quality of surface waters is important for different uses and identification of contaminated sites and pollutants leads to appropriate use of water. So, the aim of this study was to evaluate the quality of water Babolrood.Materials and methods: In this cross- sectional study, sampling was conducted in ten stations during summer 2013. Data was analyzed using National Sanitation Foundation Water Quality Index (NSFWQI) and SPSS, and then the river’s path was zoned by Geographic Information System (GIS). Results: Based on NSFWQI, the best status was found in second station (79, good) and the worst was observed in station 10 (52, moderate).Conclusion: Based on NSFWQI, the quality of river was good in upstream and moderate in downstream, indicating human as the main responsible for low quality of water.

Background and purpose: Rice is one of the most widely consumed cereal, and one of the major components of the food basket of approximately 2.4 billion people in the world. In Iran it is the second staple crop after wheat. This study aimed at investigating the level of different heavy metals (cadmium, arsenic, and lead) in rice consumed in Hormozgan province, 2014.Materials and methods: An analytical cross-sectional study that was carried out in 75 samples of Iranian, Pakistani, and Indian rice consumed in Hormozgan province in 2014. The samples were randomly selected and analyzed.Results: The mean concentrations of arsenic, lead and cadmium were 0.045, 0.057 and 0.022 mg/kg, respectively. The maximum level of arsenic was found in unauthorized Indian rice (0.033 mg/kg) and the maximum lead content was observed in unauthorized Pakistani rice (0.070 mg/kg).Conclusion: Due to the high consumption of rice in the country and contamination of rice with heavy metals, it is important to choose safe products to avoid accumulative effect of these metals on human health.

This case report describes the healing of a large periapical lesion without apical surgery. In this paper, s 35 year-old female with a large lesion from the apices of her teeth 22-27 is presented. During treatment procedure 2.5% sodium hypoclorite solution was used for irrigation and calcium–hydroxide was used as intracanal anti-microbial dressing. Periapical healing was observed in radiographic examinations at 6-month and 1 and 2 year-follow-up visits.

Background and purpose: Good nutrition is an important part of healthy lifestyle. Guidelines on nutrition are correlated with individual and public health and prevention or treatment of various diseases. Quran that covers all aspects of human life, provides guidance on nutrition too. Pomegranate is mentioned three times in Quran under the name of “Ar-Rumman”. The main aim of this study was to review the Quran and hadith quotes on pomegranate and its participation in traditional medicine, therapeutic effects and possible mechanisms of actions.Materials and methods: Electronic databases including Google scholar, Ovid, PubMed, ISI, and Medline were searched using the following keywords: pomegranate, Holy Quran, nutrition, traditional medicine, and medicinal plants. Relevant studies published until 2015 were identified. Therapeutic effects of pomegranate were extracted from traditional medicine and herbal remedies books such as Makhzan-al-Advia, Tohfeh al-Momenin, Ghanoun fi Alteb, and Al-AbniehAn-Hadaegh Al-Advieh. Islamic hadith and narrations were also collected from Islamic resources like Mostadrekol vasael.Results: Pomegranate seeds, juice, and peels are rich in beneficial compounds. Pomegranate is a source of antioxidants which potentially prevent cancers (breast, prostate, lung, colon, and skin), cardiovascular diseases, dental plaque and gum diseases, Alzheimer, diabetes, bacterial and viral infection, and other diseases.Conclusion: Islamic notifications and traditional remedies were found to be consistent with modern scientific findings. This signifies the truth of holy Quran’s scientific miracles and calls for more attention to Quran and its concepts and commentary.

Background and purpose: Anopheles mosquitoes are of particular importance because they transmit malaria. Implementing the malaria elimination program reduced its incidence in recent years in Iran. However, in the last decade, almost an annual average of 15 thousand cases was recorded. So far 24 species of Anopheles are collected in Iran of which 8 species are confirmed as malaria vectors. Despite the implementation of programs to combat malaria, it is still endemic in Iran due to various reasons including insecticide resistance among Anopheles.Materials and methods: A review of published literature (1921-2015) was performed in electronic databases including Google Scholar, PubMed, SID, Ovid Medline, Web of Science, Irandoc, and the World Health Organization (WHO) web site. The search keywords were Anopheles, malaria, resistance, vectors, and mechanisms. A total of 160 articles and thesis were found from which 60 met the inclusion criteria.Results: Anopheles stephensi was found resistant to DDT, Dieldrin and Malathion and becoming resistant against deltamethrin. However, no reports have been found on resistance in An. Fluviatilis, An. Superpictus, and An. Sacharovi against DDT, Dieldrin, Malathion, and Deltamethrin. Different studies indicated that An. Maculipennis, An. Dthali, and An. culicifacies are resistant to DDT.Conclusion: Insecticide resistance is becoming a serious thtreat to the effectiveness of malaria control measures, this is specially crucial as the country embarked on the malaria elimination programme, therefore, monitoring insecticide resistance in the main malaria vectors in Iran is of paramound importance.

Identification of materials at the nanometer scale using microscope tools or nanoscopy helps in better understanding of cell physiology. It is one of the available methods in evaluating the changes caused by physico-chemical agents. In recent years, nanoscopic tools have developed greatly in ultrastructural studies or diagnostic purposes and drug screening for human protozoan infections including plasmodium spp. and Leishmania spp. The present study aimed at evaluating the application of nanoscopic technologies in studies carried out on protozoal infections, especially Leishmania parasite. A non-systematic review of published articles (1998-2014) was performed in electronic databases as PubMed, Google scholar, Scopus, Magiran, Iranmedex, and Web of Science. The search keywords included STM, AFM, protozoan pathogens, Leishmania, and nanotechnology. Our study revealed that nanoscopic technologies and on top of them atomic force microscopy (AFM) are effective and powerful tools for structural distinction of protozoan parasites, particularly Leishmania, which could be used alongside old methods such as Scanning Electron Microscopy (SEM) and Transmission electron microscopy (TEM).

Background and purpose: In recent years the role of nutrition and herbal medicine are considered in the control of cardiovascular risk factors. The aim of this review was to evaluate the effect of nigella sativa on glycemic indices, lipid profiles, markers of inflammation, oxidative stress, and anthropometric indices.Materials and methods: An electronic literature search was conducted on websites such as Science direct, Google scholar, SID, Iranmedex, and Scopus using the following keywords: nigella sativa, Timokinon, type 2 diabetes, insulin resistance, blood glucose, lipid profile, metabolic syndrome, body weight, inflammation, and antioxidant. Published articles (until August 2014) in English and Persian were selected.Results: Nigella sativa in various interventions improved insulin resistance, lowered blood sugar and HbA1c, increased insulin production, and decreased hepatic gluconeogenesis and glucose absorption in the intestine. Nigella sativa also showed improvements in lipid profile. It can improve the inflammatory status (by reducing the inflammatory cytokine and anti-inflammatory increase in the inhibition of NF-KB factor and Nitric oxide) and oxidative stress (by increasing the activity of antioxidant enzymes and reducing free radicals, such as Malondialdehyde) in treatment of diabetes. Nigella sativa modifies the metabolic syndrome associated with type 2 diabetes by improving anthropometric parameters.Conclusion: Nigella sativa have a favorable effect on management of cardiovascular risk factors such as dyslipidemia, inflammatory markers, and oxidative stress.