JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2020 | Volume:30 | Issue:187|Papers Count:20

Background and purpose: This study aimed at investigating the effects of 3, 4-Methylenedioxymethamphetamine (MDMA) on liver cytochrome 2C19 enzyme activity, which is a major liver enzyme in the metabolism of a wide range of drugs, using omeprazole as a probe of the CYP2C19 activity in isolated perfused rat liver. Materials and methods: This experimental study was done in 20 male Sprague– Dawley (SD) rats (weighing 250– 300 g). After isolating the animal liver, omeprazole was administered at 400 μ m and the concentration of omeprazole and its metabolite were determined. The liver was then washed with perfusion buffer, and MDMA was transferred at 300 ng/ml unilaterally from the same liver for 30 minutes. After re-washing the liver with perfusion buffer, omeprazole was passed through the liver for second time and the metabolic ratio was determined after exposure to MDMA. This process was also done in a group of animals at 600 ng/ml of MDMA. Results: Analysis of data from three end-time intervals after exposure to liver at 300 and 600 ng/ml of MDMA, showed 26. 6% and 20. 6% reduction in the activity of CYP2C19. Findings showed that MDMA administration could significantly reduce the activity of CYP2C19. Conclusion: According to this study, liver exposure to MDMA can significantly reduce cytochrome 2C19 activity, but, further studies are needed to examine this issue more closely.

Background and purpose: Development of biocompatible and nontoxic methods for synthesis of nanoparticles is important in bio-nanotechnology. This study aimed at biosynthesis of titanium dioxide nanoparticles (TiO2 NPs) using leaf of the native mangrove (Avicennia marina) and investigating its antibacterial activity. Materials and methods: Effect of four different solutions composed of dry extract of mangrove leaf and different amounts of chemical titanium isopropoxide in biosynthesis of TiO2 NPs was evaluated. The biosynthesized TiO2 NPs were characterized using X-ray diffraction (XRD), scanning electron microscopy (SEM), UV– visible spectrophotometry (UV-Vis), and fourier transform infrared (FTIR) spectroscopy. The antibacterial activity was assessed using well diffusion method. Results: The solution color containing dry extract of mangrove leaf and titanium isopropoxide began to change 10 min after the reaction was started, showing the reduction of Ti ions by the extract and synthesizing TiO2 NPs. Combination of 1 g dry extract and 3. 75 mL of titanium isopropoxide was considered the optimum concentration for TiO2 NPs biosynthesis. Conclusion: XRD analysis approved the formation of crystalline TiO2 NPs. SEM images identified TiO2 NPs with mean diameter of 25 nm and spherical shape. FTIR analysis distinguished Ti in NPs structure indicating the formation of TiO2 NPs. UV-Vis showed the reduction of bandgap energy in biosynthesized TiO2 NPs. Gram-negative bacteria showed more resistance against the bacterial pathogens. Gram-positive Micrococuss Sp. was recognized the most sensitive regarding the largest diameter of inhibitory zone and Gram-negative Vibrio harveyi was recognized the most resistant regarding no formation of inhibitory zone.

Background and purpose: post-operative surgical wound healing is highly important, so, it could be of great benefit to find suitable alternatives for chemical drugs through herbal remedies in Persian Medicine. The purpose of this study was to determine the effect of Arnebia euchroma ointment on surgical wound healing process. Materials and methods: In this experimental study, 24 Wistar rats were randomly divided into four groups (n=6 per group); controls (no intervention), positive controls (silver sulfadiazine cream 1%), intervention group I (Arnebia euchroma ointment), and intervention group II (mixed Arnebia euchroma and silver sulfadiazin cream1%). In all groups, an ulcer was developed in the back of the neck, then the groups were treated for 21 days. Wound healing was evaluated at days 4, 7, 14, and 21. Data were analyzed in SPSS V22 applying one-way ANOVA and Games-Howell post hoc test for normal distribution and Kruskal-Wallis test for non-normal distribution. Results: Surgical wound healing was found be significantly different between intervention group I and control group at days 4 (P= 0. 00) and 7 (P= 0. 02). Percentage of wound healing at day 14, in control group, the positive controls, and intervention groups I and II were 81. 16± 4. 4, 84± 19. 27, 94. 28± 4 and 82. 20± 19, respectively. The rate was considerably higher in intervention group I (P= 0. 07). Conclusion: Topical use of Arnebia euchroma root ointment can facilitate surgical wound healing.

Background and purpose: Cancer is one of the major health challenges in the world. The efficacy of current treatments is low but their side effects are high. Cold atmospheric plasma (CAP) is a new modality for cancer treatment. This study aimed to compare the cytotoxicity effect of CAP on the cell line models of common cancers and normal cells. Materials and methods: In this experimental study, argon based CAP was used to treat mouse melanoma (B16-F10), human breast cancer (MCF-7), human lung cancer (A549) cell lines, and compared with normal mouse fibroblast cells (L929), and human immortalized normal respiratory epithelial cell (Beas). We cultivated 4 groups in each cancer and normal cell lines: untreated cells; CAP exposed cells for 20 seconds, 30 seconds, and 40 seconds. The morphological alterations and proliferation rate of the cells were evaluated after 24 and 48 hours. Results: The viability of CAP-treated cancer cells significantly decreased compared to that of the untreated cells. The viability of A549 and MCF-7 cell lines decreased to 33. 9% and 49. 5%, 24 hours after CAP therapy for 30 seconds. In addition, 40 seconds exposure to CAP reduced viability of B16-F10 melanoma cells to 37. 9%. Whereas the CAP had no detrimental cytotoxic effect on normal L929 cells. The maintenance effect of CAP had a time dependent pattern and its cytotoxicity effect increased from 24 to 48 hour incubation. Conclusion: This study showed that the effect of CAP on cancer cells is a selective effect that is largely dependent on the radiation dose and duration of exposure of cells to compounds produced by CAP. We can use CAP in treatment of cancer because of its cytotoxicity and selectivity on cancer cells.

Background and purpose: Cancer is a serious public health problem. Some studies indicated the anti-cancer effects of mesenchymal stem cells (MSCs) associated with stem cells or their secretory mediators. The aim of this study was to evaluate the impact of conditioned medium derived from MSCs on A549 and JEG3 cancer cell lines. Materials and methods: In an experimental study, A549 and JEG3 cell lines were provided and grown in the culture media of DMEM F12 containing 10% fetal bovine serum. They were then treated with different percentages of conditioned medium from mesenchymal stem cells (5, 10, 20, 40, 50, and 100) for 48 hours. Metabolic activity was evaluated by MTT assay. Results: MTT assay showed that various percentages of condition medium from mesenchymal stem cells had inhibitory effects on A549 cell line and significant differences were observed between treated cells and control cells (P< 0. 05). Conclusion: Current study showed different effects of conditioned medium from mesenchymal stem cells, including suppressive effect on A549 cell line. Therefore, MSCs and their secretory paracrine factors could be considered as one of the treatment purposes in this cancer.

Background and purpose: The purpose of this research was to compare the effects of aerobic exercises and green coffee consumption as a supplement on serum meteorin-like, myonectin level, and insulin resistance in obese women in Isfahan, Iran. Materials and methods: A clinical trial was performed in 40 women who were randomly divided into four groups, including aerobic exercises (5 sessions per week/30-45 min/ 8 weeks), green coffee supplement (400 mg/daily), aerobic exercises (5 sessions per week/30-45 min/ 8 weeks) and green coffee supplement (400 mg/ 8 weeks), and control groups. Forty eight hr after the last exercise session, blood samples were collected (after a 12-hr overnight fast) to measure the serum meteorin-like, myonectin, insulin, and glucose levels. Data analysis was done applying dependent t-test and ANOVA. Results: The participants’ mean weight, height, and BMI were 81. 71± 6. 79 kg, 161. 01± 6. 72 cm, and 32. 4± 4. 6, respectively. ANOVA test showed significant differences in serum levels of myonectin (P=0. 001), meteorin-like (P= 0. 007), insulin (P = 0. 005), fasting glucose (P= 0. 001) and insulin resistance (P=0. 001) between the groups studied. Aerobic exercises and green coffee intake significantly increased serum myonectin and meteorin-like levels, compared to aerobic exercises (P= 0. 001) and green coffee consumption alone (P= 0. 001). Conclusion: Green coffee intake and periodic exercises can affect some glycemic indices. Current study confirms the role of serum meteorin-like and myonectin level in preventing obesity and insulin resistance.

Background and purpose: Cancers are the third leading cause of death in Iran. Cancer reduces functional aspects of quality of life (QOL). This study aimed to determine the effect of dignity therapy on functional dimensions of quality of life in cancer patients. Materials and methods: A randomized controlled clinical trial was carried out in 76 patients with cancer in Birjand Iranmehr Hospital, 2019. Information, including demographic characteristics, was obtained, and EORTC QLQ-C30 was completed before the intervention. The participants were randomly allocated to either an intervention group or a control group. Dignity therapy was administered in the intervention group in 3-4 sessions of 30-45 minutes, while the control group received no intervention. Four weeks after the intervention, the EORTC QLQ-C30 was completed again in both groups. Results: Mann-Whitney test showed no significant difference between the intervention and control groups in functional aspects of QOL before the intervention (P> 0. 05). After the intervention, the mean scores for emotional and social functioning and their changes significantly increased in the intervention group compared to the control group (P< 0. 05). However, the mean scores for physical, role, and cognitive functioning in the intervention group did not significantly change compared to the control group (P> 0. 05). After the intervention, total mean score for functional aspects showed a significant increase in the intervention group compared to the control group (P <0. 05). Conclusion: Dignity therapy could be considered as one of the supportive-palliative methods for improving the functional aspects of QOL in cancer patients.

Background and purpose: Femoral neck fracture is associated with a high rate of side effects, especially in young people, who are usually affected by severe energy shocks. Results after injury depend on some factors, including displacement, fragility, bleeding rate, proper placement, and stable and strong fixation. The aim of this study was to compare dynamic hip screw (DHS) or multiple cannulated screws (MCS) in fractures of the femoral neck base. Materials and methods: In this cross-sectional study, 78 patients with femoral neck fracture were treated by internal fixation: MCS (n= 26) and DHS (n= 52) in Babol Shahid Beheshti Hospital, 2016-2018. Complications, including pain and lameness, infection, avascular necrosis (AVN), and nonunion were investigated in both groups. The visual analog scale (VAS) score and Harris Hip Score (HHS) were also compared between the two groups. Results: Mean ages of the patients in MCS group and DHS group were 54. 19 ± 23. 35 and 58. 50 ± 21. 06 years, respectively. In patients treated by MCS, infection, AVN, no welding, and pain and lameness were seen in 3, 2, 3, and 6 patients, respectively, while these complication were observed in 1, 1, 1, and 4 patients in the DHS group, respectively. The rate of complications were not found to be significantly different between the two group (P>0. 05). The mean VAS score was significantly lower in the DHS group compared to that in the MCS group (P<0. 05). The HHS scores were not significantly different between the two groups (P<0. 05). Conclusion: According to this study, MCS is more appropriate in the treatment of femoral neck fractures due to less bleeding and shorter operation time.

Background and purpose: Excessive intake of heavy metals has adverse health effects and smoking is one of the sources of these elements. The aim of this study was to investigate the concentrations of 11 heavy metals in tobacco of different widely-consumed brands of cigarettes and hookahs in Iran. Materials and methods: Concentrations of nine types of cigarettes and four types of hookah tobacco were measured using inductively coupled plasma mass spectrometry (ICP-MS). Statistical analyses were performed using Shapiro-Wilk pre-test, independent t-test, one-way analysis of variance, and Tukey Post Hoc Test. Results: Manganese and selenium had the highest and the lowest concentrations in cigarette and hookah tobacco, respectively. One-way analysis of variance showed significant differences in concentrations of manganese, barium, and antimony between tobacco of different types of cigarettes (P<0. 05). The mean concentrations of the elements in cigarettes were higher than the hookah. Tukey and Mann-Whitney test showed that the mean concentrations of all elements were not significantly different between different types of tobacco in cigarette and hookah (P> 0. 05). Conclusion: High levels of heavy metals were found in cigarette and hookah tobacco in Iranian market. The dangers of these elements to human health, requires enforcing strict regulations to reduce consumption and informing people about their harmful effects.

Background and purpose: Food insecurity is a major public health problem, especially among older adults living in developing countries. The present study aimed at examining the prevalence, and risk and protective factors for severe food insecurity among elderly in Tehran, Iran. Materials and methods: In this cross-sectional study, 384 elderly people aged 60 years and older were selected from five different socioeconomic zones in Tehran, 2019, using multi-stage sampling. Food security status was assessed by the Household Food Insecurity Access Scale (HFIAS). Data were analyzed using simple and multiple logistic regression models in SPSS. Results: Among the people investigated, 37. 8% were completely food secure, 24. 1% were found with mild food insecurity, 22. 7% reported moderate food insecurity, and 15. 2% were severely food insecure. Low levels of physical activity (OR=8. 7, CI 95%: 2. 96-25. 57), low educational levels (OR=6. 15, CI 95%: 1. 54-24. 64), low monthly income (OR=5. 63, CI 95%: 2. 71-11. 67), low levels of social capital (OR=3. 13, CI 95%: 1. 09-9. 03), having oral and dental diseases (OR=2. 51, CI 95%: 1. 02-6. 17), and male gender (OR=1. 92, CI 95%: 0. 89-4. 11) were the risk factors, while having more children (OR=0. 26, CI 95%: 0. 04-1. 36) was the protective factor for severe food insecurity in elderly. The predictors entered into the model could explain between 44. 2% and 60. 3% of the variance of the outcome. Conclusion: Only one-third of the elderly were adequately food secure. Current findings could be beneficial in designing and implementing early interventions to provide food security for the elderly.

Background and purpose: Acinetobacter is a pathogen that could cause nosocomial infections. The present study aimed at determining Acinetobacter cases in clinical cultures of patients hospitalized in Tabriz Imam Reza Hospital to determine the frequency of the most common oxa genes causing drug resistance in these specimens. Materials and methods: In this descriptive cross-sectional study, clinical specimens including the blood, urine, tracheal secretions, ulcers, and throat specimens were collected from July to October 2017. The bacteria were isolated and identified using standard bacteriological methods. The Clinical and Laboratory Standards Institute (CLSI, 2016) guideline was used to determine bacterial susceptibility and resistance. Bacterial DNA extraction was done and the OXA genes (23, 24, 48, 58) were identified using specific primers and PCR method. Results: We identified 66 (72. 52) multiple drug-resistant (MDR) Acinetobacter strains. These isolates showed 100% resistance to cefepime, cefotaxime, piperacillin-tazobactam, and meropenem. In 100% of the samples, sensitivity to colistin was observed. According to findings, there was a significant relationship between the presence of oxa24 gene and resistance to tobramycin and amikacin (P= 0. 005). Conclusion: This study showed high rate of MDR Acinetobacter strains, so, nosocomial infection control is highly necessary. Strategies such as identifying infected patients, detecting bacterial colonization, sterilizing equipment and units, and controlling antibiotic use in the hospital are recommended to prevent the development of multidrug-resistant bacteria and to control nosocomial infections.

Background and purpose: Sometimes, some symptoms do not respond to usual treatments, or are not justified by classical medicine. In such cases, Persian Medicine can be helpful to better understand and treat the diseases. Endogenous gases (wind or Rih) are among the causes that should be investigated. The purpose of this study was to introduce endogenous gases and etiology of their production in the body as one of the pathological causes of diseases (alongside compound dystempraments) in Persian medicine. Materials and methods: A qualitative study (summative content analysis) based on authentic Persian Medicine books was carried out using library and electronic resources. Results: The concept of wind is also found in traditional Chinese and Tibetan medicine, but in Persian medicine it is a gas-like substance produced in the body and its useful form facilitates physiologic processes such as defecation, erection, etc. The harmful type of wind is one of the main causes of up to 90 diseases, including certain kinds of headaches, dizziness, epilepsy, dyspnea, and pain in joints, kidneys, and bladder, etc. In this study, the definition, causes, types, symptoms, and signs of wind were explained. Conclusion: According to Persian medicine and the concept of gasotransmitter in modern medicine, many diseases are caused by wind or gas. Therefore, all physicians should consider their role in diseases and use appropriate treatments.

Background and purpose: Squamous cell carcinoma (SCC) is the eighth most common cancer in men and the fifteenth in women. Localized recurrence and metastasis to regional lymph nodes are major problems in these patients. Fascin is a 55-kDa protein from the family of actin-binding proteins that is expressed in cells with membranous bronchial tubes. The aim of this study was to evaluate the expression of fascin in oral SCC. Materials and methods: A descriptive cross-sectional study was performed in 60 patients with OSCC attending Yazd Shahid Sadoughi Hospital, 2017. After preparing four-micrometer sections from paraffin blocks, the immunohistochemistry was performed using Fascin (as a tumor marker). Data were analyzed in SPSS V23 applying Chi-square test, Mann-Whitney test, and Kruskal-Wallis test. Results: Most of the samples showed poor to moderate expression of fascin, and there were significant relationships between expression level of fascin and age, sex, and degree of microscopic grading (P=0. 002, P=0. 009, P=0. 011). High expression of fascin was seen in samples with recurrence and metastasis, but no significant relationship was detected (P=0. 525, P=0. 769). Conclusion: The expression level of fascin in SCC probably indicates its role in increasing the movement and migration of cancer cells and the likelihood of recurrence and metastasis.

Background and purpose: Sinusitis is a common disease in children that can lead to acute and chronic problems and sometimes severe complications. There is lack of evidence on underlying causes of chronic sinusitis in children in Iran, so, this study aimed to investigate the prevalence of humoral immune deficiency in patients with chronic sinusitis. Materials and methods: This cross-sectional study was performed in all children aged 3 to 14 years old with allergic reactions of the upper respiratory tract for more than 12 weeks who attended Amirkola Children Hospital. All patients were evaluated for serum immunoglobulin concentrations (IgM, IgE, IgA, and IgG) by immunoturbidimetric technique. Results: Out of 120 children studied, 79 were males and the patients’ mean age was 6. 9 ± 2. 9 years. Humoral immunity was found in 49% of children with chronic sinusitis. Elevated IgE was seen in 54 (45%) patients and 12 patients were observed with low levels of IgA (10%). Seven patients had both IgE and IgA deficiency and 10% of immunocompromised patients had IgA deficiency. Sinusitis was more prevalent in fall. The highest incidence was in patients aged 5-9 years old. There was a significant relationship between elevated IgE and season (P=0. 013). Conclusion: Our study showed that immunoglobulin abnormality is relatively common and expected in children with sinusitis.

Background and purpose: Adherence to the principles of professional ethics in medical groups, in addition to influence patient satisfaction, plays a key role in improving and restoring their health. The aim of this study was to evaluate professional ethics from the perspective of recipients and service providers in hospitals affiliated with Mazandaran University of Medical Sciences. Materials and methods: This descriptive analytic study was performed in employees (n= 241), patients (n= 309), and managers (n= 25) in Mazandaran province hospitals, Iran, 2019. The sampling methods for patients, staff, and managers were simple random, systematic, and census random, respectively. Data were collected using a researcher-made questionnaire. The content and face validity of the questionnaire were determined by experts. The construct validity was confirmed by confirming factor analysis and its reliability was assessed by Cronbach's alpha coefficient and compound reliability. Data analysis was performed applying descriptive statistics and one-way analysis of variance (ANOVA). Results: The mean score for medical ethics was higher from the perspective of staff (4. 17± 0. 64) compared to managers (4. 15± 0. 52) and patients (3. 95± 0. 71) (P <0. 05). Communication with colleagues and respecting patient rights were found with the highest and lowest scores (4. 34 ± 0. 55 and 4. 09 ± 0. 68, respectively). Conclusion: Medical ethics was favorable in hospitals of Mazandaran province. But, continuous evaluation of different dimensions of medical ethics is needed to identify weaknesses and strengths, thereby making appropriate decisions to provide enhanced services.

Background and purpose: Drug interactions are one of the serious subsets of medication errors and occur when the effects or toxicity of one drug are affected by another. This study aimed to investigate drug interactions and the role of pharmacist in reducing drug interactions in Ramsar Imam Sajjad Hospital, Iran. Materials and methods: This cross-sectional study was performed in all prescriptions of medicinal products by specialist physicians in Ramsar Special Clinic from March to May 2019. Drug interactions were determined based on Drug Interaction Facts (2014) and Drugs website (www. drugs. com). A list of drug interactions prescribed by each physician was compiled and discussed in face-to-face visits with physicians. They were then provided with a list of unsafe combinations of medications. Prescriptions of physicians who had previous history of prescriptions with drug interactions were reviewed within two months in January and February 2020. Results: In first phase, 2864 prescriptions were studied of which 268 (9. 3%) were detected with drug interactions. There were 40 (14. 9%) cases of major drug interactions and 228 (85%) cases of moderate drug interactions. After providing feedback to physicians about drug interactions, the rate of drug-drug interactions decreased from 9. 3% to 6. 4%. Conclusion: Many drug interactions are preventable and communications between physicians and pharmacists can help identifying drug interactions and minimizing their incidence.

Subcutaneous calcinosis consists of abnormal calcium deposition in soft tissues and is one of the complications of scleroderma, especially in limited systemic sclerosis. It is one of the criteria of CREST syndrome (calcinosis cutis, Raynaud phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia). A 44-year-old woman with systemic scleroderma for 20 years was presented with pain in the elbow, fingers and toes, and extensive calcinosis in soft tissue. The patient was treated with immunosuppressive medications due to lung parenchymal involvement and received various drug and surgical treatments for soft tissue calcinosis. In situations of poor response to medication, surgical treatment could be the only option for treating symptomatic lesions.

Background and purpose: Pulmonary arteriovenous malformations (PAVM) are lung lesions that affect most of the periphery of the lower lobes, and are manifested by dyspnea, hemoptysis, and hemothorax. Pregnancy is one of the conditions in which these malformations appear due to hemodynamic changes and hormonal factors such as increased levels of estrogen. This paper presents the case of a pregnant woman at 28 weeks of gestation who received first-aid treatment for symptoms of respiratory distress and hemothorax. Then, she was transferred to the operating room and thoracotomy was performed and the vascular lesion was resected. After that, the patient had stable hemodynamic conditions and was transferred to the ward. Our patient was eligible for thoracotomy due to pulmonary manifestations of the disease. In dealing with these situations, immediate counseling and collaboration of gynecologists with thoracic surgeons can save the lives of mother and her fetus.

Urticaria is a pruritic skin lesion characterized by rapid onset of blanchable central wheals and marginal flare. Urticaria diseases are categorized on the basis of their duration, etiology, and causes. In this review, a thorough search was conducted in electronic databases such as Scopus, Pubmed, and Google Scholar using the following keywords: urticaria, acute urticaria, chronic urticaria, etiology of urticaria, diagnosis of urticaria, and treatment of urticaria. Search was limited to the articles published in January 2006 to December 2019. Urticaria is a highly prevalent disease that is experienced by 10-20% of general population during their lifetime. Acute urticarial is more common and affects about 1-5% of the population. Patients with urticaria, especially chronic urticaria are prone to stress, excitement, or obsession and have low quality of life. The etiology of urticaria is still unknown in most cases and usually a complete history and physical examination helps in making diagnosis. Antihistamines are the first-line treatment of both acute and chronic urticaria. This study aimed to review the latest etiologies of urticaria and its diagnostic and therapeutic approaches.