JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:26 | Issue:143|Papers Count:35

Background and purpose: IV opioids and nonsteroidal anti-inflammatory drugs are commonly used to control pain in renal colic. Buprenorphine is a drug that is recently introduced for such cases. The aim of this study was to compare the effect of sublingual buprenorphine and intravenous morphine to control pain in acute renal colic.Materials and methods: A randomized double-blind, placebo controlled clinical trial was performed in 203 patients with acute renal colic. The samples were divided into two groups to receive either 2 mg sublingual buprenorphine and 5cc IV distilled water (experimental group) or intravenous morphine 0.1 mg/kg and a sublingual placebo (control group). Pain reduction and drug side effects were compared between the two groups. Data analysis was conducted in SPSS ver.22 using repeated measures, Chi-square, and t-test.Results: The participants included 79 (38.9%) females and the mean age of the patients in experimental and control groups were 40.50±13.50 and 39.85±13.66, respectively (P=0.73). The mean time required for pain improvement after drug administration was 30.97±19.92 min in experimental group and 34.87±18.59 min in controls (P=0.19). Significant decrease in pain severity was observed in both groups (P<0.001) but the type of drug had no significant effect in reducing pain (P=0.25). Side effects were similar in two groups except for itching that was significantly higher in patients receiving buprenorphine (P=0.007).Conclusion: The efficacy of buprenorphine in treatment of renal colic was found to be similar to that of intravenous morphine. Side effects were also similar in two groups except itching that was significantly more prevalent in experimental group.

Background and purpose: Endoscopic retrograde cholangiopancreatography (ERCP) is usually performed under deep sedation. Respiratory depression and airway obstruction are the most dangerous complications of sedatives. Dexmedetomidine is a drug that does not cause respiratory depression so, this study evaluated the efficacy of nasal dexmedetomidine in inducing moderate sedation in patients undergoing ERCP.Materials and methods: In a double blind randomized controlled trial, the patients candidate for ERCP in Firoozgar hospital, were divided into two groups. Group I received normal saline while in group II dexmedetomidine 1μg/kg was administered intranasaly. Also, intravenous midazolam and fentanyl, and if needed, propofol were used for induction of sedation. Then total use of sedative drugs, hemodynamic parameters, patient and physician satisfaction and side effects of treatment were documented.Results: There were no significant differences in age, sex and BMI between the two groups.Mean use of midazolam and fentanyl was almost similar in two groups but the use of propofol was lower in group II (P=0.002). The mean heart rate was found to be lower in the group receiving dexmedetomidine but systolic and diastolic blood pressure were almost similar in two groups (P>0.05).Compared with the results in group I, the patients and physicians in group II were more satisfied with dexmedetomidine.Conclusion: Dexmedetomidine as an adjuvant drug for sedation in patients undergoing ERCP could reduce the need for other sedatives, and also satisfy both the patients and therapists.

Background and purpose: Methicillin resistant Staphylococcus aureus (MRSA) is a community-associated pathogen that is so common in hospitals. Antibiotic resistance and poor clinical outcome provide great reasons for using immunization strategies based on antibodies. The aim of this study was to investigate passive immunity using recombinant anti-MRSA ScaF antibody in a mouse model.Materials and methods: In this study, the recombinant protein, ScaF was purified through denaturation method. This protein combined with Freund’s adjuvant was injected into a rabbit to produce antibody. Then, the antibody produced against ScaF was injected to mice infected byS. aureus by two regimens of pre- and after infection treatment. Afterwards, the mortality rate in mice was compared between the control treatment group (vancomycin therapy) and negative control group (non-immune rabbit serum).Results: Out of 10 mice in two groups of pre- and after infection treatment that received antibody against ScaF antigen 20% and 10% were protected, respectively, that did not show a significant difference compared with non-immune rabbit serum group (negative control).Conclusion: Passive immunization by antibody cannot play a considerable role in the control of infections caused byS. aureus. Therefore, other mechanisms of immune system for the protection against this bacterium including stimulating of cytokine-dependent cell-mediated immunity may be useful in prevention of infections caused byS. aureus.

Background and purpose: Endosulfan is an organochlorine insecticide that is absorbed orally, subcutaneously and by inhalation in humans and animals and disturbs the reduction process, changes the activity of antioxidant enzymes and increases the lipid peroxidation in many organs. The aim of this study was to evaluate the protective effect of myricetin against endosulfan induced liver damage.Materials and methods: In an experimental study 42 male Wister rats were randomly divided into 7 groups (n=6 per group). GroupI served as the control and the experimental groups were as follows: groupII- Ѵ received endosulfan 10 mg/kg and myricetin 5, 10, 15, and 20 mg/kg/ip for 30 days, respectively. GroupѴI was treated only by 10 mg/kg endosulfan and group ѴII as positive control received 10 mg/kg cyclophosphamide (ip, 30 days). Twenty four hours after the last injection, all rats were anesthetized using ethyl ether. Alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and superoxide dismutase (SOD) levels were measured in plasma. Liver glutathione (GSH) levels were also determined.Results: Administration of endosulfan caused elevation in ALT, AST, ALP and SOD levels, but the activity of GSH decreased in liver tissue. Receiving myricetin along with endosulfan significantly increased body antioxidant activity and normalized the liverenzyme levels (P˂ 0.05).Conclusion: Our results indicated that myricetin with antioxidant effect could protect cells against harmful free radicals. Therefore, further clinical trials are suggested.

Background and purpose: Recently, use of enzyme-linked immunosorbent assay (ELISA) and rapid Immunochromatographic test (ICT) in diagnosis and screening of patients with hepatitis B reduced the risk of hepatitis during blood transfusion. However, the incidence of hepatitis B is very high in highrisk patients such as hemodialysis, thalassemia and hemophilia which receive a lot of blood transfusions.Also, due to the infection with mutant type of hepatitis B virus (HBV) and false negative results, using molecular tests such as polymerase chain reaction (PCR) are necessary for detection of HBV. In this study we aimed to compare the efficacy of ELISA and rapid ICT kits with gold standard real time PCR for the detection of HBV in high risk patients.Materials and methods: In a cross-sectional study, 100 patients consisting of hemodialysis, thalassemia and hemophilia were assessed by real time PCR as the gold standard for detection of HBV DNA, fourth-generation ELISA kits including Dia-proÒ, PishtaztebÒ, PasteurÒ and ICT EcotestÒ were applied for detection of HBSAg.Results: Compared with real time PCR, sensitivity and specificity of fourth generation ELISA kits was 100% and positive predictive value (PPV) and negative predictive value (NPV) were 100%.Conclusion: Recent improvements in the monoclonal antibody production against mutant hepatitis B virus and their application in fourth-generation ELISA and rapid ICT kits resulted in significant increase in sensitivity and specificity of these methods. Thus, in emergency cases or lack of real-time PCR instruments, rapid ICT and ELISA kits could be suggest for detection of HBsAg.

Background and purpose: Chronic non-specific low back pain (CNLBP) is associated with decreased lumbar Multifidus (LM) muscle cross-sectional area (CSA) and Transverse abdominis (TrA) muscle strength which highly predispose the person to recurrent occurrence of disease. We compared the Pilates (PL) and McKenzie (MK) methods on LM CSA and TrA strength in these patients.Materials and methods: In this clinical trial, 47 female patients, mean age 39.7 years, with CNLBP were allocated to one of three groups including PL training (n=16), MK exercises (n=15), and control (n=16). The measurements of LM CSA and TrA muscle strength were performed using imaging ultrasonography and Bent Knee Lowering Test, respectively at baseline, following a 6-week intervention program, and a follow-up of one month. To evaluate the changes of outcome measurements over time, repeated measures ANOVA test was applied at P<0.05 in SPSS V.21.Results: Compared with MK exercises, PL training could significantly increase right and left LM CSA at L5 level (P<0.001), while there were no significant effects on this factor in other lumbar segments (P>0.05). Additionally, PL method significantly increased TrA muscle strength (P<0.001), however this efficiency was not observed for MK exercises (P>0.05). The changes were not significantly different after a one-month follow-up (P>0.05).Conclusion: PL training can lead to increase in LM CSA and also TrA muscle strength. These effective changes are persistent following one month.

Background and purpose: Balance impairment is a major cause of falls in patients with hemiplegic stroke. The purpose of this study was to compare the effects of two balance training programs in these patients.Materials and methods: A clinical trial with pretest–posttest design was conducted in 30 patients after a single hemisphere stroke that occurred at least 6 months before the study (2015). Patients were randomly assigned into either a control group or one of two balance rehabilitation groups. All groups received conventional physical therapy program. One group had a balance training program without visual cue while the other had balance training on unstable surface for 30 minutes 3 sessions per week. Patient performance was assessed before and one session after treatment using the time up and go (TUG) and four square steps (4SS) tests.Results: All the patients had a significant clinical and functional improvement (P<0.05). No significant difference was found between the control group and the group who had balance training on unstable surface. But balance improved more in the group who received balance training without visual cue.Conclusion: Balance training without visual input is more effective than balance training on unstable surface. To facilitate recovery of balance following stroke, rehabilitation programs that use visual deprivation to promote somatosensory and vestibular input are recommended.

Background and purpose: Autism Spectrum Disorders (ASDs) is one of the most common disorders in the group of developmental disorders. The prevalence of ASDs is 110 per 10000 individuals.The purpose of this investigation was the study of postural profile in children with ASDs.Materials and methods: A total of 15 male students with ASDs and 15 healthy children were randomly selected. Demographic characteristics of the subjects including height, weight, age, and medical conditions were obtained using their medical records. Kyphosis, lordosis, thoracic and lumbar scoliosis, genu varum, genu valgum, and flat foot were considered as postural profile. Spinal mouse was employed to assess the kyphosis, lordosis, and thoracic and lumbar scoliosis. Moreover, in order to determine the genu varum and genu valgum callipers were used, and navicular drop test was applied for flat foot measurement. Independent sample-t-test and Mann-Whitney U test were employed to compare the results.Results: The mean age of children with ASDs was 7.73±1.4 years, mean height=125±11.57 cm, mean weight=30.1±11.49 kg, and mean BMI=18.13±4.17 while the mean age of healthy children was 9 years, mean height=134±4.55 cm, mean weight=33.66±9.37 kg, and mean BMI=18±4.17. The results revealed significant differences between the two groups in kyphosis, lumbar scoliosis, and genu valgum (P=0.001). But no significant difference was found between thoracic scoliosis, genu varum, lordosis, and flat foot between the two groups (P≥ 0.05).Conclusion: The prevalence of kyphosis, lumbar scoliosis, and genu valgum was found to be high in children with ASDs, therefore, investigating the postural profile is strongly suggested in such individuals.

Background and purpose: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood that is associated with parent-child conflict and parental stress.The aim of this study was to compare the effectiveness of delivering behavioral management training to parents and narrative therapy to children on the quality of mother-child relationship in children with ADHD.Materials and methods: A quasi-experimental study with pretest-posttest and control group was performed. The research population included all children aged 7 to 12 years old with ADHD and their mothers in Sari, Iran. A total of 30 cases were selected and divided into three groups. The mothers in first group attended nine sessions of behavioral management training which were presented according to Barkley’s pattern. Group narrative therapy was done among children in second group for eight sessions, while the third group received no training. Parent-child Stress Index was used for data collection.Results: The results showed that the mean of post-test score for parent-child conflict in first group was 78.11±16.78 and in narrative therapy group was 76.9±13.92, indicating no significant difference between these two groups, but the score in control group was 96.22±22.95 that was significantly higher compared with the experimental groups (P<0.05).Conclusion: The results showed no significant difference between behavioral management training to parents and narrative therapy in improving the quality of mother-child relationship in children with ADHD and compared with the control group, both methods were found to be significantly effective in improving the quality of mother-child relationships.

Background and purpose: Quality of life (QOL) is believed to be influenced by sexual function during menopause. The aim of this study was to investigate the relationship between sexual function and QOL among post-menopausal women.Materials and methods: We performed a community-based, descriptive-analytical study of 405 post-menopausal women, aged 40 to 65 years. A multi-stage, randomized sampling was conducted. Data was obtained through interviews using the Female Sexual Function Index (FSFI), World Health Organization Quality of Life-BRIEF) WHOQOL-BREF (, and a researcher-made questionnaire. Data was then analyzed using t-test and multiple linear regression.Results: The mean age and mean duration of menopause were 52.84±3.7 years and 19.8±14.4 months, respectively. Among the subjects 324 (80%) were housewives and 369 (91.2%) had diploma or lower levels of education. The mean total score of QOL was 54.53±7.18. The highest and lowest scores were associated with physical health and psychological health domains, respectively. Overall, 61% had female sexual dysfunction (FSD). The total scores for FSFI were in a positive correlation with the total scores for WHOQOL-BREF (r=0.285, P<0.001) and the scores for all domains of QOL. The scores in all domains of FSFI, except in the domain of pain, had a positive correlation with the total score of QOL (P<0.001). Satisfaction with marital relationship in post-menopausal women was associated with an increase in QOL (P<0.001, r=0.258).Conclusion: Sexual dysfunction could have a negative impact on the quality of life in postmenopausal women. Therefore, to enhance the quality of life in this population sexual dysfunction requires more attention when implementing women’s health initiatives.

Background and purpose: Diabetes is a multifactorial disease in which genetic factors, environmental and immunological factors are involved in its pathogenesis. Due to the immunological role of blood groups, this study aimed to evaluate the distribution of ABO blood groups and Rh types in patients with type 2 diabetes in north of Iran.Materials and methods: This cross-sectional study was performed in type 2 diabetic patients referring to academic endocrine clinics in Sari, Iran, 2015. Relevant information including age, sex, history of hypertension, dyslipidemia and diabetes chronic complications were extracted from patients’files. The red blood cell surface antigens were detected by direct standard slide agglutination technique.Results: We studied 1500 diabetic patients of whom 590 (39.3%) had O blood type. The distribution of other blood groups were as follows: A: 26.2%, B: 26.7%, and AB: 7.8%. Compared with the society, in patients with type 2 diabetes, the distribution of A blood group was found to be lower but the distribution of type B was higher (P=0.000 and P=0.009, respectively). The prevalence of D antigen was significantly higher in diabetic people (P=0.000).Conclusion: In current study, blood group B was associated with type 2 diabetes, therefore, this type should be considered as a risk factor for developing diabetes; for which screening programs should be done in this community. Also, it seems that blood group genotyping could be a valuable guide in evaluating the mechanism of diabetes.

Background and purpose: Calcium hydroxide and Chlorhexidine are among common intracanal medications. Recently an herbal composition named Carvacrol has been suggested as an intracanal medication. The purpose of this study was to compare antimicrobial effect of Carvacrol, Chlorhexidine and Calcium hydroxide onEnterococcus faecalis.Materials and methods: In this experimental study, 56 single-rooted teeth were extracted and after canal preparation, they were randomly divided into three groups (n=16) and 2 positive and negative control groups (n=4 per group). After sterilization by autoclave, all samples except negative control group were contaminated withEnterococcus faecalis. The root canals in group 1 were filled by Calcium hydroxide paste. Paper cones impregnated by 0.2% Chlorhexidine and 94% Carvacrol were placed in working length of root canals in group 2 and 3, respectively.Negative control group was assessed without contamination and no medication was used in positive control group. After incubation of specimens for 48 hours and canal irrigation, a sample was taken from each canal and bacterial colony growth was assessed in BHI agar. Data analysis was done in SPSS ver.20 applying Chi-square and Fishers exact test.Results: All three groups were found effective in eliminating Enterococcus faecalis and there were no significant differences in antibacterial effect between these groups (P=0.99).Conclusion: Carvacrol can be recommended as an effective herbal medication for intracanal irrigation.

Background and purpose: Temporomandibular disorders (TMD) are manifested as a group of signs and symptoms diagnosed by pain, malfunction of temporomandibular joint (TMJ) and masticatory muscles. The need to determine the prevalence and factors associated with their communities is emphasized in studies. The present study investigated the incidence of TMD and its symptoms in individuals attending Sari Dental School Clinic, 2014-2015.Materials and methods: A descriptive-analytical study was conducted in 68 individuals (41 females; 27 males) who were selected by random sampling. Demographic and clinical data were obtained by asking questions and examining the patient. The relation between TMD and other variables were analyzed by Chi-square and exact fisher tests. Data was analyzed in SPSS V.22.Results: A total of 68 patients was investigated of whom 51 (75%) had TMD. Among these five people had headache (P<0.0001) and 46 were healthy. Also, 5 had muscle pain (P=1), 2 had accident (P<0.0001), 25 had click (p=1), and 2 people had joint pain (P=0.0001). Clinical examination showed 39 individuals with joint sound (P=0.03), 10 with joint pain (P=0.0001) and 34 patents with muscle pain (P=0.64).Conclusion: A high incidence of TDM was detected in the population attending Sari Dental School Clinic. Significant relation was found between symptoms and TMD.

Background and purpose: Ethyl benzene is a toxic aromatic compound derived from petroleum hydrocarbons which usually enters the environment through leakage of oil industries and activities, wastes and effluents released by pharmaceutical industry, plastics, resins and petrochemicals.This study aimed to examine the feasibility of the use of MgO nanoparticles as catalysts in the ozonation process for ethyl-benzene removal from the aqueous environments under laboratory conditions.Materials and methods: This experimental study was performed on a laboratory scale in a semi-continuous reactor. We studied the effect of different variables such as pH values (3, 5, 7, 12, and 13), ozonation time (5, 10, 20, 30 and 50 min), the dose of MgO nanoparticles (0.1, 0.2, 0.3, 0.4, and 0.5 g), and initial concentration of ethylbenzene (10, 50, 100, 150 and 200 mg/L) on ethyl benzene degradation under catalytic ozonation process. In order to achieve the optimal experimental conditions, response surface methodology (RSM) model was designed and applied. Also, gas chromatography method was used for measuring the residual amounts of ethyl benzene at the end of process.Results: The results of data analysis showed that the pH (P=0.0063) and catalyst dose (P= 0.0004) had the greatest impact on the response variable (percent removal of ethyl benzene). Also, optimum removal condition based on suitable analysis of variance and model was achieved at 50 min reaction time, pH 12, initial concentration lower than 50 mg/L, and 0.5 g/L catalyst dose. Under these conditions, the removal efficiency of 99.99% was achieved.Conclusion: Catalytic ozonation process in the presence of MgO nanoparticles has a high efficiency in the removal of ethylbenzene from aqueous environments.

Background and purpose: Textile dye effluents have some potential risks which require effective treatment before discharging into the environment. Advanced oxidation processes can remove pollutants faster than other processes due to active hydroxyl radical production; therefore, increase the efficiency of dye removal. This study was aimed at investigating dye removal process using UVA/ZnO and UVA/TiO2 nanocatalysts.Materials and methods: This study was done in a batch reactor on synthetic and real samples and the effects of initial dye concentrations, TiO2 and ZnO nanoparticles dosage, time, pH and interference compounds on efficiency of dye removal was investigated. The Daphnia Magna was used for bioassay test.Results: The removal rates of dye in optimum conditions were 69% and 95.5% by UVA/ZnO and UVA/TiO2 processes, respectively and the optimum pH in the process was 9 and 2, respectively. In this study, the initial concentration of dye and COD were found to have adverse relation with removal rate of dye in two processes (p<0.05, r2 ZnO=0.99, r2 TiO2=0.94). With increasing the catalyst and exposure time at both processes the dye removal rate increased. In this study, LC50 96 h decreased from 96.7 to 44.7 mg/l.Conclusion: The current study showed that TiO2/UVA process with effective optimization of operational factors, has high performance in R.B 86 dye decolorization and reducing toxicity.

Background and purpose: Metronidazole is a serious environmental pollutant due to high consumption and persistence in biological degradation. This study aimed at removal of metronidazole using ozone (O3) activated persulfate (PS) in presence of ultrasound (US).Materials and methods: A laboratory scale study was carried out in batch reactor using US irradiation and O3 generator apparatuses. The effects of operating parameters such as pH of the solution, different initial concentrations of persulfate, initial metronidazole concentration, different ion strength, and radical scavenger were evaluated. Metronidazole concentration was determined using DR-5000 Spectrophotometer in 320 nm wavelength.Results: The results showed that removal of metronidazole decreased by increasing the pH of solution from 3 to 11. The removal rate of metronidazole was dependent on initial PS dosages and the highest rate of removal was found in 500 mg/l (94.7%), but in higher concentrations the removal rate decreased. Also, the metronidazole removal rate decreased by increase in initial concentration of metronidazole. The COD removal rate in optimum condition was 56%.Conclusion: Activation of PS by US/O3 process could serve as a novel treatment for removal of metronidazole in aqueous solution.

Background and purpose: The aim of this study was to investigate the efficiency of Fe3O4 nanoparticles synthesized by the chemical co-precipitation method for removal of black acid 1 from aquatic solutions.Materials and methods: In an experimental study, the Fe3O4 nanoparticle was synthesized by the chemical co-precipitation method using Fe+2 and Fe+3 solution in the presence of N2. The effect of different parameters including initial pH, adsorbent dose, contact time, initial dye concentration, temperature, and EC and also intervening variables such as nitrate, sulfate, fluoride, chloride and hardness were investigated. In addition, equilibrium data was fitted into Langmuir and Freundlich isotherm model, and pseudo-second order and pseudo-first order kinetic models.Results: We found that the adsorption capacities of nanoparticle increased when pH and adsorbent dose decreased. But the removal efficiency decreased by increase in temperature and dye concentration. Also intervening variables (nitrate, sulfate, fluoride, chloride, and hardness) were found to have low effect on decreasing the color absorption capacity by Fe3O4 nanoparticles. The removal of dye using Fe3O4 nanoparticle complies with Freundlich isotherm model (R2=0.991). Also, the equilibrium adsorption data fitted with pseudo-second order kinetic (R2=0.992).Conclusion: This study showed that the Fe3O4 nanoparticle is highly capable of removing black acid 1 dye from aqueous solutions in low contact time. Therefore, the Fe3O4 nanoparticle can be considered as an effective adsorbent in dye removal.

Background and purpose: Trihalomethanes and haloacetic acids are formed throughchlorination of waters containing natural organic matters and pose potential health problems. So, it is necessary to remove humic acid as the most significant natural organic matter in water. The aim of this study was to evaluate the efficiency of catalytic ozonation in removal of humic acid in presence of local green and red montmorillonite.Materials and methods: Green and red soils were collected from Sarcham area in Ardabil, Iran and used as catalysts after cleaning up. The variables in this study included initial pH of the solution, catalyst dosage, reaction time, and initial concentration of the pollutant.Results: The efficiency of catalytic ozonation process increased by increase in contact time, pH, and doses of catalysts and also by decrease in initial concentration of humic acid. In COP process, 100% removal of humic acid (10mg/l) was achieved at natural pH in 15 and 20 min in presence of green and red soils, respectively. Compared with conventional ozonation, presence of radical scavengers such as nitrate, chloride, sulphate and carbonate at high concentrations were found to have minor effects on reducing the efficiency of catalytic ozonation process.Conclusion: Based on this study, green and red soils highly increase the efficiency of catalytic ozonation process. Due to the low cost and availability of these soils, they can be used as catalysts to remove humic acid in catalytic ozonation process or other similar processes.

Background and purpose: Intentional drug poisoning is one of the most common methods of suicide attempt. The purpose of this study was to determine the demographic characteristics of suicide attempters and identifying the pattern of intentional drug poisoning.Materials and methods: We conducted a descriptive-analytical study in which data was collected from the medical records of suicide attempts by drug poisoning in 5Azar Hospital in Gorgan, Iran, 2008-2015. Data was analyzed by Stata V.11 and Pearson’s Chi-squared test.Results: During these seven years, 442 cases of suicide attempts by drug poisoning were recorded in which there were 244 (55.2%) females and 229 individuals (51.8%) aged 20-29 years. Their mean age was 24.54 ± 8.14 and the majority (79%) lived in urban areas. Also, 224 (55.2%) patients were single and 248 (56.1%) had high school education. Poisoning occurred mostly in summer (28.7%).Among the pharmaceuticals, sedative-hypnotic drugs especially benzodiazepines were used more often (47.5%) followed by narcotic drugs (26.5%) and antidepressants (17.4%). Death occurred in three patients (0.68%) died. Family quarrel was found to be the main cause of suicide attempts (46.8%).Conclusion: Sedative-hypnotic drugs especially benzodiazepines were the most common agents used in intentional drug poisoning that were seen most commonly among younger individuals, single persons and people with family quarrel.

Background and purpose: Heavy metals in tea causes harmful effects on the health of consumers. The aim of this study was to determine the concentrations of arsenic, lead, cadmium, chromium, cobalt and nickel in black tea and their infusions, and evaluation of their health hazards in Rasht, Iran.Materials and methods: A cross-sectional study was carried out in 54 samples of nine brands of black tea and their infusions including six Iranian and three foreign products that were selected randomly in 2014. After sample preparation, the concentration of heavy metals were determined by inductively coupled plasma atomic emission spectrometer (ICP-AES).Results: The range of concentrations of arsenic, lead, cadmium, chromium, cobalt, and nickel in black tea were 0.03-0.1, 0.5-3.5, 0.07-0.6, 0.9-3.9, 1.8-6.7, and 1.7 to 8.9 mg per kg and in their infusions were 0.01-0.03, 0.1-0.4, 0.04-0.2, 0.4-0.8, 0.2-1.2, and 0.6-2.1 mg per kg, respectively. The concentrations of arsenic and cadmium (22%) and lead (11%) were reported to be below the detection limit in black tea samples.Conclusion: Despite the high concentration of heavy metals in some samples of tea and their infusions, the estimated values of PTWI and THQ cause no consumer health risks according to the guidelines suggested by WHO and FAO. Nevertheless, continuous monitoring of heavy metals contamination in black tea and their infusions is highly necessary.

Background and purpose: Angiogenesis provides proper nutrition and helps to the development and spread of cancer cells. Cancer stem cells are a rare population of tumor cells responsible for initiation, spreading and growth of cancer. Angiogenesis occurs more in cancer stem cells compared with other cancer cells. Ibuprofen, as a member of nonsteroidal anti-inflammatory drugs (NSAIDs) group is used for prevention and treatment of certain cancers. In the present study, we investigated the effect of ibuprofen on angiogenesis in gastric cancer stem cells.Materials and methods: Gastric cancer stem cells of MKN45 cell line was isolated by spheroid colony formation technique. Gastric cancer stem cells were treated with various concentrations of ibuprofen. The angiogenic properties in gastric cancer stem cells treated with ibuprofen was compared with control cells using two-dimensional angiogenesis.Results: Angiogenesis reduced in the cancer stem cells treated with ibuprofen compared with the control cancer stem cells.Conclusion: Ibuprofen decreased angiogenesis in gastric cancer stem cells.

Background and purpose: HILA-G is an immunomodulatory molecule and alteration of its expression is prevalent during viral infections. HLA-G expression in HIV-positive patients has been inconsistent between different studies and some suggest that Interleukin-10 (IL-10) influences the expression of HLA-G. The aim of this research was to investigate the expression of IL-10 in HIV-positive patients and its relation with TCD4+lymphocytes.Materials and methods: In a case-control study, 20 HIV-positive patients, attending the Behavioral Consultation Center affiliated with Mazandaran University of Medical Sciences, were selected and 20 healthy volunteers were also enrolled. Expression of HLA-G was determined by Real-Time PCR.TCD4+count and IL-10 concentration were evaluated by flow cytometry and ELISA, respectively.Results: HLA-G gene expression was significantly different between the two groups (P<0.05).IL-10 concentration increased in patients and a revers relation was seen between TCD4+cell count and IL-10 (r=-0.4, P=0.1).Conclusion: The results showed that the expression of HLA-G is deregulated during HIV infection and IL-10 could be considered as a biomarker of disease progression.

Background and purpose: Low birth weight (LBW) is a serious health problem of neonates in the world. Most of these babies need to stay in hospital and may not have enough calories and protein intake that leads to inappropriate weight gain. This study aimed at investigating the amount of calories and protein intake in neonates admitted in neonatal intensive care unit (NICU) in Sari Bu-Ali Sina Hospital.Materials and methods: This cross sectional study was carried out in 100 newborns admitted to NICU in 2015. All information including relevant demographic characteristics and calories, dextrose and lipid intake was calculated. SPSS V.16 was used for data analysis.Results: The newborns were 68% male and 32% female. Exclusively breastfed infants included 51% of the cases and 42% had combination feeding (dietary supplements and breast milk). Mean intake of daily calorie was 63.2±22.6 calories per kilogram per day.Conclusion: Despite the efforts of NICU staff to promote breastfeeding, calorie and protein intake was less than standard amounts due to many reasons and this requires more attention.

Background and purpose: Recently, sporadic cases of cutaneous leishmaniasis (CL) has been reported in some parts of Pakdasht district, in southeast of Tehran, Iran. The aim of this study was to determine the prevalence of CL and identification of Leishmania spp. in Pakdasht district.Materials and methods: We conducted a cross-sectional study in suspected individuals of CL attending Pakdasht Health Center from March 2009 to November 2014. Diagnosis of disease was made based on direct smear of skin lesions and Giemsa staining. The kinetoplast DNA (kDNA) was then extracted by phenol-chloroform-isoamyl alcohol (PCI) and the species were identified using specific PCR method.Results: Direct smears identified 57 (59.4%) positive cases (out of 96 suspected subjects).Among the subjects 37 (64.9%) were male and 20 (35.1%) were female. The majority of CL cases (54.4%) were detected in 2012, specially in October and November. The disease was more prevalent in those younger than 10 years of age (30.2%) and less prevalent in individuals aged 10-20 (13.6%). The majority of patients had a history of travel to Sabzevar district as an endemic area in Khorasan Razavi province and most of them were laborer.L.major was the predominant species isolated from all cases.Conclusion: According to this study, Pakdasht district is not believed to be a CL focus since most cases were affected due to the travelling to the main endemic foci of CL.

Background and purpose: Poisoning is one of the main reasons for hospital admissions and even death. In recent years the incidence of poisoning has increased due to development of new drugs and chemical compounds. We performed an epidemiological study of acute poisoning in patients admitted to Qaemshahr Razi Hospital, Iran.Materials and methods: This research is a retrospective epidemiological study of acute poisoning that included 915 patients admitted to Qaemshahr Razi Hospital in 2014. Data was collected in a checklist and the results were analyzed by statistical tests.Results: The mean age of patients admitted to hospital was 27±12 years old including 54.86% males and 45.14% females. Among these 52% were married. Suicidal poisoning was found in 71.80%, of whom 4.8% have had a previous suicide attempt. The main cause of poisoning was drug intake (78.30%) and death occurred in 1.42% among the cases admitted to hospital.Conclusion: Most of the cases were intentional suicidal poisoning. Women and young individuals are at higher risk of poisoning. Therefore, these groups need to receive more attention and supports for which creating safe and peaceful family environments could be an effective factor.

Background and purpose: Patient satisfaction is a complex phenomenon that is influenced by several factors, amongst which nursing care is one of the most important one. The aim of this study was to evaluate the patients' satisfaction with nursing care in Behshahr public hospitals, Iran, 2014.Materials and methods: This cross-sectional study was performed in 300 patients using available sampling. Data was collected by Patient Satisfaction Instrument (PSI) and analyzed by SPSS applying descriptive and inferential statistics (Fisher’s exact test).Results: The results showed that only 3% of patients were completely satisfied with services delivered, 20% were moderately satisfied and 77% were dissatisfied with nursing care. The highest level of satisfaction with nursing care was found to be in cardiac intensive care unit and the lowest satisfaction level was observed in internal medicine ward for women. Among different variables, the type of ward was found to be significantly correlated with patients’ satisfaction level (P<0.01).Conclusion: Our investigation revealed low levels of patients' satisfaction with nursing care.There is a direct correlation between health organizations and patient satisfaction, therefore, constant evaluation of services delivered seems to be essential. Moreover, identifying related factors and presenting operational strategies would be helpful in eliminating the factors causing patient dissatisfaction.

Background and purpose: High-energy photon beams above 8-10 MV used in external radiation therapy produce neutron in dealing with the linear accelerator components and other parts in radiation field. The weakening of neutrons due to the closing jaws collimator angle, in smaller field sizes can also be a contributing factor in changing the neutron spectrum. Since a direct measurement of the neutron flux and spectrum require complex measurements in treatment room, the Monte Carlo is an alternative method for determining the true environmental neutron spectrum.Materials and methods: Geometry of linear accelerator Elekta SL75/25 was designed in FLUKA simulation code and its validation was tested. Spectrum of neutrons produced in the accelerator was determined in the center of four field sizes of 20 × 20, 15 × 15, 10 × 10, and 5 × 5 cm2. Data analysis was done applying Mann-Whitney test.Results: In the condition with flattening filter, significant differences was found in the neutron spectrum only in 5 × 5 to 15 × 15 cm2 and 5 × 5 to 20 × 20 cm2 field sizes (P<0.05).Conclusion: Our results of the neutron spectrum using FLUKA simulation code are in a good conformity with the results of practical dosimetry of other researchers; therefore, checking the neutron flux in radiotherapy by simulation can be an appropriate solution to improve patient treatment and protection issues. Since neutron dose increases with an increase in field size, so, we can conclude that field size influences secondary effects of treatment.

Background and purpose: Physical analysis of solid waste is the first step in waste management. In Iran, no data is available about rural solid wastes in the country. The aim of this study was to determine qualitative and quantitative analysis of rural solid wastes in Iran.Materials and methods: In this cross-sectional study, the data for national rural solid waste in 2012 was obtained from Iranian State Municipalities and Village Assistance Offices organization. Then the generation, per capita and physical composition of solid waste in rural areas in Iran were compared.Excel and SPSS V.17 were applied to analyze the data.Results: The average solid waste generation per capita was 444 g per day and total wastes in Iran's rural areas was estimated at around 3.5 million tons per year. The majority of country’s rural solid wastes consisted of organic materials (52.53%) and plastics (16%) were the most valuable dry solid wastes.Conclusion: By applying composting method, not only the fertilizing capacity of the waste is used but also leachate, offensive odor and toxic gas generation would decrease. Recycling of dry solid waste in rural areas would reduce their cost of collection and disposal and also increases the profit from selling recycled materials.