JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2018 | Volume:28 | Issue:165 |Papers Count:29

Background and purpose: Hydrogels are used as carriers to control drug release. Ostrich oilhas fatty acids which plays an important role in growth, division, and health of cells and cause woundhealing and have anti-inflammatory effects. Materials and methods: In this experimental study, pH sensitive hydrogel was produced bychitosan deviation and open ring Poly-vinyl pyrrolidon (OR-PVP). The physicochemical characteristicsof ostrich oil hydrogel was studied and its analgesic effect on mice was investigated by hot plate andformalin test. Results: Compared with other formulations, formulations containing chitosan with highmolecular weight showed better results. The ratio of OR-PVP to high molecular chitosan was 0. 4 for thebest formulation. All formulations with 30% ostrich oil were found to have good analgesic effects. Conclusion: This study showed that ostrich oil hydrogel could reduce inflammation andcentral pain.

Background and purpose: Treatment of leishmaniasis is getting complicated due to multipleside effects and drug resistance to first-line drugs. Agrostemma githago is a plant with anti-cancer andcytocidal effects, so, this study was conducted to evaluate the anti leishmanial effect of its extract onLeishmania major promastigotes by MTT assay and cell count. Materials and methods: A total of 2. 5×106 Leishmania major promastigotes in their stationaryphase were plated to each well of the 96 well culture plates. Cells were then incubated with increasingconcentrations of Agrostemma githago extract (0. 05 – 2. 4 mg/ml) for 48 hours at 25° C. Glucantim wasused as standard control. Then, the supernatants were discarded and 50 μ l of MTT were added for 3hours. After centrifuge, the supernatants were replaced by 100 μ l of DMSO. The plate was read byELISA reader at 570 nm. Trypan blue staining was also performed to evaluate the effect of Agrostemmagithago extract on Leishmania major promastigotes. Results: MTT assay showed that increasing concentrations of Agrostemma extract couldsignificantly reduce cell viability of Leishmania major promastigots in a dose dependent manner(p<0. 05). IC50 of the Agrostemma and Glucantime were 0. 365 and 71. 01 mg/ml, respectively. Conclusion: Aqueous extract of Agrostemma githago was found to have stronger inhibitoryeffect than Glucantim on Leishmania major promastigots.

Background and purpose: Diabetes mellitus affects male reproductive functions at multiplelevels such as spermatogenesis, steroidogenesis, and sexual behaviors. The pleotropic protective roles ofcrocin in different pathological states have been reported, so, this study aimed at examining the protectiveeffects of crocin on spermatogenesis in experimentally-induced diabetes in rats. Materials and methods: In an experimental study, 18 male Wistar rats were randomly dividedinto three groups; normal, diabetic, and crocin-treated diabetic groups. Diabetes was induced using i. v. injection of streptozotocin (40 mg/kg) and treatment group received i. p. injection of crocin (20mg/kg/day) for 60 days. At the end of the test, we studied blood glucose level, sperm count, and testisweight, and histopathological assessment was also performed. Results: Induction of diabetes enhanced blood glucose levels in diabetic group (229± 11mg/dL)whereas crocin significantly decreased blood glucose levels of treated diabetic group (118± 4mg/dL)compared with the diabetic group (P=0. 001). Sperm number decreased considerably in diabetic group(19. 4± 24 million/mL vs. 4. 4± 10 million/mL) but crocin significantly increased that (10. 3± 14million/mL), (P=0. 037). Diabetes also developed histopathological changes in seminiferous tubules andled to reduction of testis weight in diabetic rats, whereas crocin diminished these damages. Conclusion: Our findings revealed that crocin could protect male reproductive organ againstdiabetes and improve spermatogenesis in experimentally-induced diabetes in rat.

Background and purpose: One of the main issues in cancer treatment is to reduce the sideeffects of drugs on healthy tissues. The aim of this study was to investigate the preventative effects ofcontinuous aerobic exercise on apoptosis ratio and liver fibrosis induced by doxorubicin in aging rats. Materials and methods: In this experimental research, 42 adult Wistar rats were randomlydivided into 6 groups (n= 7), including the Young, Aged, Aged+ Saline, Aged+ Dox, Aged+ Exercise+Saline, and Aged+ Exercise+ Dox. The training groups practiced on treadmill while considering theprinciple of overload (five sessions per week/ six weeks). On the last 15 days of exercise, doxorubicin orsaline solution were injected (1 mg/kg/daily). Then, 48 hours after completing the trainings, liver tissuesampling was performed to evaluate the fibrosis and expression of Bax and Bcl-2 proteins. Data analysiswas done using One-way ANOVA at a significant level of P≤ 0. 05. Results: Doxorubicin caused a significant increase in liver fibrosis, expression of Bax proteinand Bax/Bcl-2 ratio, and a significant reduction in expression of Bcl-2 protein (p≤ 0. 05). On the otherhand, aerobic training significantly reduced the expression of Bax protein, Bax/Bcl-2 ratio and hepaticfibrosis, and significantly increased the expression of Bcl-2 protein (p≤ 0. 05). Conclusion: Continuous aerobic exercises, reduce the Bax/Bcl-2 ratio which is an indicator ofincrease in survival rate and also reduce liver fibrosis against doxorubicin.

Background and purpose: Endothelin axis (endothelin or ET) including endothelin A receptor(ETA) play a major role as the regulator of vessels tone and tissue differentiation and development. Thereare evidences of the importance of endothelin axis in carcinogenesis. No data exists about comparison ofETA expression between dysplasia and oral squamous cell carcinoma (OSCC). So, the aim of this studywas to compare immunohistochemical expression of ETA between these two groups. Materials and methods: In this cross-sectional study, the paraffin-embedded tissue blocks of20 cases of dysplastic oral mucosa and 21 cases of OSCCs were investigated. Three micron sections wereprepared from tissue blocks and stained with ETA antibody using immunohistochemistry. Percentage ofstained cells and staining intensity were compared between the groups applying Mann-Whitney and Chi-Square tests. Results: In dysplasia group, 11 cases stained for ETA while in OSCC group all cases stained. Comparison of percentage of stained cells and their semi quantitative classification showed significantdifferences between the two groups (P=0. 02 and P=0. 005, respectively) such that ETA expression washigher in OSCC than dysplasia. Staining intensity for ETA was significantly higher in OSCC group(P=0. 006). There were significant differences between ETA expression in mild and moderate dysplasiawith carcinoma. Conclusion: Our results support the role of ETA receptor in progression of dysplasia toward OSCC.

Background and purpose: The aim of this study was to determine the genetic variability ofCYP1A1 m1 and m2 polymorphisms in cancer patients compared with healthy population in the west ofMazandaran province, Iran. Materials and methods: A case-control study was carried out in 120 non-relative healthyvolunteers (60 males and 60 females) and 84 non-relative patients (39 males and 46 females) withdiagnosis of cancer, attending the Hematology/Oncology ward in Ramsar Imam Sajjad Hospital between July2016 and December 2017. Peripheral blood samples (3ml) were taken from the participants and stored at-20° C. The PCR-RFLP method was used to determine the distribution of CYP1A1 gene polymorphisms. Results: Among the two gene variants m1 and m2, individuals with AG and GG genotypes ofCYP1A1 m2 polymorphism were found to have a significantly higher and increased risk for cancer(OR=3. 94, 95%CI=2. 05-7. 57, P= 0. 00, OR=9. 46, 95%CI=1. 92-46. 49, P= 0. 00, respectively) and the TCgenotype of CYP1A1 m1 polymorphism also had a significantly higher and increased risk for cancer(OR= 2. 6, 95% CI = 1. 4-4. 6, P=0. 00). The ‘ G’ allele was detected to have a strong association withcancer (P<0. 001). The ‘ C’ allele also showed strong association with the incidence of cancer (P<0. 001). Thus, both CYP1A1 m1 and m2 polymorphisms showed an increased risk for cancer. Conclusion: Our study suggested that the presence of ‘ C’ allele of m1 polymorphism and ‘ G’ allele of m2 polymorphism as the leading alleles that increase cancer susceptibility in the studiedpopulation.

Background and purpose: Osteoarthritis is the most common type of arthritis. It is the maincause of chronic musculoskeletal pain and disability in elderly population. The aim of this research was tocompare the effects of low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) on painrelief and reducing disability in patients with knee osteoarthritis. Materials and methods: A total of 45 female patients participated in this randomizedcontrolled study. The patients were randomly divided into three groups of low level laser, high powerlaser, and placebo laser. All patients, received standard treatment. Pain at rest and knee function wereassessed by visual analog scale (VAS) and Western Ontario and McMaster Universities OsteoarthritisIndex (WOMAC), respectively before, immediately, and six weeks after the intervention. Results: Low-power laser and high-power laser had immediate and long-lasting effect onreducing pain and disability (p<0. 001). The immediate and lasting effect of these two interventionsbetween the two groups were not significantly different (p>0. 05). Conclusion: High power laser was found to have similar effects to low power laser. LLLT isbelieved to be more appropriate since it is more economical for both therapist and patient.

Background and purpose: Gestational diabetes mellitus (GDM) is the most common medicalcondition that causes anxiety and stress in expectant mothers. Improving self-efficacy in order to changelifestyle is of great benefit in management of this condition. This research aimed at studying the effect ofcognitive behavioral therapy (CBT) on self-efficacy of women with GDM. Materials and methods: A clinical trial was conducted in 60 women with gestational diabetes(control n=30 and intervention n= 30) attending diabetes clinic in Sanandaj, Iran using conveniencesampling. Both groups received routine care but the intervention group were divided into three subgroups(n=10 per group) and also received CBT in seven sessions (1. 5-hour per session). Diabetic Self-Efficacyscale questionnaire was administered at three times; before, immediately after, and one month after theintervention. Data analysis was done in SPSS V19. Results: The mean age of participants was 30. 25 ± 5. 0 years and the mean gestational age was26. 8 ± 3. 0 weeks. Before the intervention, there was no significant difference between the two groups inthe scores for self-efficacy (P=0. 50), but CBT was found to improve self-efficacy (P<0. 001). Conclusion: CBT in pregnant women with GDM improved self-efficacy. These women areneeded to change their lifestyle, therefore, CBT should be offered in health centers and diabetes clinics toprevent diabetes type II in women with GDM.

Background and purpose: Satisfaction of caregivers of hospitalized patients is one of thepillars of good quality in patient care. Providing appropriate trainings on this issue could lead toimprovements in patient recovery. The present study was conducted to investigate the effects of a trainingprogram on satisfaction of caregivers of patients who had Coronary Artery Bypass Grafting. Materials and methods: An interventional study was done in 69 caregivers of hospitalizedpatients in intensive care unit in Sari Fatemeh Zahra Hospital. The samples were randomly allocated intointervention and control groups. In the intervention group, the caregivers of the hospitalized patientsalongside routine information received training starting one day before their patient’ s surgery until 24 hrbefore discharge. The Family Satisfaction in the Intensive Care Unit (FSICU) was administered tomeasure the satisfaction of caregivers in both groups, 24 hr before discharge. Data were analyzed usingMann-Whitney, Independent t-test, and Chi-square. Results: Compared to the control group, a significant difference was found between the meanscore for satisfaction in intervention group after the training program (58. 3± 11. 56 vs. 81. 28± 6. 08), (P<0. 001). Caregivers reported highest level of satisfaction with medical personnel performance and thelowest with making decisions about patients. Conclusion: According to the findings, nurses can increase caregivers’ satisfaction from nursingcare by providing them with training programs and improve patient care after heart surgery.

Background and purpose: Women's satisfaction with childbirth may influence their transitionto motherhood. Training interventions during pregnancy may improve the ability of expectant mothers tocope with stress, promote the maternal role competence, and increase mothers’ satisfaction. This studyaimed at investigating the effect of prenatal psychological trainings on satisfaction with childbirth andmaternal role competence in primiparous women. Materials and methods: This clinical trial was conducted in 122 primigravid women at 14-28gestational age attending the Healthcare Centers in Mashhad, Iran 2015-2016. The subjects were dividedinto two groups of intervention and control using drawing. The intervention group received psychologicaltrainings in three sessions. Mackey Childbirth Satisfaction Rating Scale, The Parenting Sense ofCompetence Scale, and Edinburgh Postnatal Depression Scale were administered. Data were analyzedapplying descriptive and analytical statistics. Results: Satisfaction with childbirth experiences was significantly higher in the interventiongroup compared to that in the control group (23. 3% and 12. 9%, respectively, P= 0. 046). The mean scoresfor maternal role competence in intervention group and controls were the values61 (10) and 54/5 (12), respectively, indicating significant differences between the two groups (P= 0. 003). Conclusion: According to current findings, prenatal psychological trainings increased mothers’ satisfaction with childbirth and enhanced maternal role competence.

Background and purpose: Metabolic syndrome includes a series of risk factors for cardiovasculardiseases. The aim of this study was to identify the changes in various indicators of this syndrome duringhospitalization in a psychiatric department. Identifying these changes could help in reducing the risk ofthis syndrome. Materials and methods: A cross-sectional study was conducted in 152 patients withpsychiatric disorders who were admitted in Sari Zare Hospital, winter 2016. Fasting blood glucose (FBS), HDL-cholesterol, triglyceride (TG), weight, waist circumference, and blood pressure were recorded at thetime of hospital admission and discharge. Results: Compared to the time of hospital admission, significant changes were seen in waistcircumference (p=0. 000) and TG (p=0. 010) among schizophrenic patients at the time of hospitaldischarge. In patients with bipolar disorder, significant changes were found in waist circumference, TG, and also HDL at the time of hospital discharge (p= 0. 017, 0. 004, 0. 045). Moreover, we found significantchanges in FBS and waist circumference in patients with schizoaffective disorder (p=0. 013 and p=0. 018, respectively). In patients with substance use, no significant changes were seen in any of the indicatorswhen being discharged from hospital. But patients with brief psychotic disorder showed significantchanges only in waist circumference (p=0. 005). Conclusion: Changes in the indicators of metabolic syndrome are much more common than theprevalence of metabolic syndrome. Indicators that are more likely to change during hospitalization and couldbe used in screening for prevention of metabolic syndrome include waist circumference and TG levels.

Background and purpose: Despite appropriate prevention and therapeutic activities in recentyears, Pulmonary Tuberculosis (TB) is still one of the top ten causes of mortality in the world. Thepurpose of this study was to analyze the distribution of pulmonary tuberculosis in cities of Golestanprovince, Iran and identifying the major determinants of this disease. Materials and methods: from 8374 TB cases was recorded in TB Registry Program inGolestan province between 2007 and 2016 we analyzed the information of 5648 new cases. Data wasanalyzed in SPSS 24 and Stata 13. Mean ± SD and frequency table were applied for quantitative andqualitative variables, respectively. Results: The standardized incidence rate of TB in 100, 000 population in Golestan province was41. 29 and in males and females it was 41. 40 and 41. 22, respectively, indicating no significant differencesbetween them (p< 0. 34). TB hazard ratio was found to be 62% higher in rural areas (p<0. 001). Thestandardized incidence rates in urban and rural areas were 31. 63 and 51. 36 in 100, 000 population, respectively. Ramyan and Gomishan had the highest and lowest incidence rats of TB, respectively (77. 68and 14. 88 in 100, 000 population, respectively). Conclusion: According to current findings, screening for TB in rural areas in Golestan provinceis highly recommended. Eastern regions of the province are at greater risk for TB infection due to theirethnic composition (Sistan and Baluchestan immigrants).

Background and purpose: Increase in cesarean section (C-Section) is a health system problemaround the world. The aim of this study was to compare the rate of C-Section and indications for thatbefore and after implementation of Health System Reform in the hospitals of Mazandaran province, Iran. Materials and methods: This descriptive cross-sectional study was conducted analytically. Theindications for C-Section were recorded based on curative treatment checklist before implementation ofthe Health System Reform (2013) and after that (2016). Data were analyzed in SPSS V21 applying t-testand Chi-square. Results: The rate of C-Section was significantly lower only in governmental hospitals afterimplementation of the Health System Reform (P< 0. 05). Among the indications of C-Section, only theprevious C-Section had a significant difference before and after the Health System Reform in totalhospitals in the province (P<0. 002). Significant differences were found between previous C-Section(P<0. 025) and its increasing trend, and post-term pregnancy (P<0. 027) and decreasing trend before andafter the Health System Reform in governmental hospitals. Other indices were not significantly differentbetween public, private, and Social Security Organization hospitals (P<0. 05). Conclusion: Implementation of Health System Reform was effective in decreasing the rate of Csectionin governmental hospitals. It is hoped that with appropriate implementation of the program, alongwith cultural and social programs, we could get closer to Iran’ s scientific goals and decrease the rate of CSectionaccording to global standards.

Background and purpose: Bilingualism is a common phenomenon in many countries whichcould increase consonant errors in the speech produced by bilingual children. The aim of this study was toevaluate phonological skills such as occurrence proportion, and the frequency and type of phonologicalprocesses in Persian-Arabic speaking children in Ahvaz, Iran. Materials and methods: A descriptive-analytical cross-sectional study was performed in 28children aged 36-48 months. The subjects were randomly selected from nurseries in Ahvaz and weredivided into two groups (n=14 per group), according to being Persian monolingual or Persian-Arabicbilingual. We used the Persian Phonological Test (PPT), a subtest of Persian Diagnostic EvaluationArticulation and Phonological test which includes 54 one-four phoneme words. The phonologicalprocesses were investigated in two groups: structure and substitution processes. Data were analyzed inSPSS applying Mann-Whitney U test. Results: The results showed that occurrence proportion of substitution process was significantlydifferent between the two groups (P=0. 05), but the type of phonological processes did not show anysignificant difference between the two groups. Frequency of phonological processes was found to behigher in bilingual children. Conclusion: In this study bilingualism was found to have no effect on type of phonologicalprocesses, but could be effective on frequency of processes. The type of phonological processes inbilingual children is similar to that of monolingual children, so the phonological system in Persian-Arabicbilingual children is similar to that of the monolingual children.

Background and purpose: Author-assigned keywords at the end of the abstracts in scientificarticles are the words most relevant to the content of the article. They are the main sources for indexingand storing the articles in databases, and help to retrieve related articles. Therefore, any mistake orambiguity in keywords lead to disruption of both data storage and retrieval processes. This study aimed atinvestigating the types of errors made in author-assigned keywords of articles in the field of medicaleducation. Materials and methods: In this descriptive research, the keywords in 13 journals publishingarticles in medical education were studied. Out of 3194 articles reviewed, 10965 entries were extracted. The English and Persian keywords were compared using Excel. Results: In the journals studied, the mistakes associated with keywords were made mainly on notwriting the equivalent keywords for English keywords and Persian keywords (70. 31%). Conclusion: According to current study, the authors, reviewers, and editors are suggested to paymore attention on keywords to prevent disturbance in storing and retrieving the articles.

Background and purpose: Staphylococcus aureus (S. aureus) produces various toxins. One ofthe most important toxins is enterotoxin. Enterotoxin A and B play a major role in food poisoning. Thisresearch was conducted to determine the enterotoxin A and B genes in S. aureus strains. Materials and methods: In this study, 223 specimens were collected from the skin and nose ofpatients, medical personnel and kitchen staff in Imam Khomeini and Bouali Sina hospitals, Sari, Iran. Culture of samples and biochemical tests were used to detect S. aureus. Polymerase Chain Reaction(PCR) was used to detect enterotoxin A and B genes. Results: Out of 223 specimens, 49 (21. 97%) were positive for S. aureus, from which 17 (34. 7%)isolates were positive for enterotoxin A gene, while none contained enterotoxin B gene. Conclusion: In this study, isolates of S. aureus were positive for presence of enterotoxin A gene. This bacterium has a major role in causing food poisoning, therefore, its prevalence in hospital strains canlead to secondary infections in patients and should be regarded as a serious threat to community health.

Background and purpose: Breast cancer is the most common type of cancer in women and thesecond cause of cancer death in Iran. Widespread use of mammography and sonography could increasesurvival in patients with early detection. Sensitivity and specificity of mammography and sonography aredifferent in various sources. This study aimed at assessing the concordance of mammography-sonographyreports with pathology reports in tumor size among patients with breast cancer. Materials and methods: This research studied 100 women with pathologically proven invasivebreast cancer attending Ramsar Imam Sadjad Hospital, 2016-2017. The concordance of mammographysonographyreports with pathology report was studied. Pearson correlation coefficient was applied toinvestigate the correlations. Results: The mean age of the patients was 48± 7. 45. Most of them were married with history oflabor and breastfeeding. Many patients had BMI>25. In most cases left breast and external upperquadrant were involved and most tumors had ductal pathology. The correlation coefficient between tumorsize in mammography and pathology was 0. 80 (p<0. 0001) and between ultrasonography and pathologywas 0. 81 (p<0. 0001). Conclusion: In most cases, tumor size in mammography and sonography was found to be similarto that reported by pathology. Compared to mammography, sonography was found to be more sensitive inmeasuring the tumor size which was also more concordant with pathology results.

Background and purpose: Mortality in HIV-positive patients is due to various reasons such asprogression to AIDS or co-infection with AIDS and TB or other causes. In survival analysis, competingrisk methods are used if there are different reasons for death. The purpose of this article was to identifythe factors affecting various causes of death using competing risk methods. Materials and methods: This study was performed in 1231 HIV/AIDS patients attending DiseasesConsulting Centers in Tehran between 2004 and 2013. The cause-specific hazard model was used to studythe effect of factors on death due to co-infection with TB and AIDS and death by other causes. Dataanalysis was performed in R software and cmprsk package. Results: There were 181 patients who were co-infected with tuberculosis and AIDS. The mediansurvival rate in AIDS-TB patients at the time of diagnosis was 6. 51 ± 0. 66 years and in those with AIDSalone was 11. 56 ± 0. 98 years. The effects of gender (12. 94 [2. 81-59. 97]), CD4 (0. 22 [0. 08-0. 54]), ARTtreatment (0. 42 [0. 24-0. 75]), and isoniazid drug prophylaxis (0. 08 [0. 01-0. 6]) were found to be significanton death due to co-infection with AIDS and TB. Also, the effects of sex (3. 39 [2. 03-5. 66]), CD4 (0. 34[0. 22-0. 51]), ART treatment (0. 32 [0. 23-0. 45]), isoniazid drug prophylaxis (0. 5 [0. 29-0. 85]), and Cotrimoxazoledrug prophylaxis (0. 34 [0. 2-0. 6]) were seen to be significant on death due to other reasons. Conclusion: In this study, the cause-specific hazard model was applied to identify the riskfactors for all causes of death. Therefore, this method could be used to identify the factors influencingcauses of death (separately) and provide solutions to prevent the risks.

Background and purpose: Diazinon (Dz) is a widely used insecticide. It can causenephrotoxicity and neurotoxicity by induction of oxidative stress. Edaravone is a drug with antioxidanteffect that is used in treatment of acute infraction disorders. In this study we used edaravone forameliorating diazinon induced kidney and brain damage. Materials and methods: Twenty four male Wistar rats were divided into the following groups: Control (normal saline), Dz (150mg/kg) and edaravone (10mg/kg and 20mg/kg) that were injected 30minbefore Dz. After 24 hr, the animals were anesthetized and the brain and kidney tissues were separated. Then oxidative stress factors were evaluated. Blood serum samples were also taken to determine thelevels of BUN, creatinine, and nitric oxide. Results: Dz significantly increased oxidative stress markers such as reactive oxygen species(ROS), lipid peroxidation, protein carbonyl, and glutathione oxidation in kidney and brain tissues. Also, the levels of BUN, creatinine and nitric oxide increased after Dz injection. Interestingly, ederavoneadministration significantly decreased ROS production in rats’ kidney and brain tissues (p<0. 05). It alsosignificantly protected kidney and brain against lipid peroxidation and glutathione oxidation (p<0. 05). Edaravone treatment could noticeably inhibit diazinon induced protein carbonyl production in bothtissues. Furthermore, edaravone significantly ameliorated the increased levels of BUN, creatinine, andnitric oxide due to Dz administration (p<0. 05). Conclusion: These data suggested that edaravone can prevent nephrotoxicity, neurotoxicity andacute toxicity of diazinon via reducing oxidative stress.

Dentinogenesis imperfecta (DI) is an inherited disorder affecting dentin. Defective dentinformation results in discolored teeth that are prone to attrition and fracture. Mutation in dentinand the main gene in this disease is DSPP. Heterozygous mutations in this gene cause toothsialophosphoprotein (DSPP) causes dentin disorders DI I and II. Imperfecta is a dominant autosomal traitthat affects both dual and permanent dental systems. In both sexes, there are clinically yellow-brown teethand in radiography images, structural defects such as canopy crown and small chamomile pulp are seen. Often, the underlying mineralization defects (bone softness) cause the enamel to wear, which in thesecond place causes dentin cavitation and abrasion. This study, reports a 9-year-old child with hearing loss attending the Rasad Laboratory. Thepatient's blood was studied by the NGS method and the DSPP mutation was identified. To confirm themutation, a primer was designed for the mutation point and DNA extraction and PCR technique wereperformed. Afterwards, DSPP gene was sequenced. Following the sequencing of the genome by the NGS method, heterozygous mutations were foundin the DSPP gene. The patient had a defect in dental gene but had completely healthy teeth and a lowfrequency of hearing. The father of the child was then studied and was found with a heterozygousmutation in the DSPP gene. The disease is dominant autosomal defect and can also cause deafness in some cases. In thisreport, the patient had only hearing loss without any symptoms of dental defects.

Testosterone is one of the most important male steroid hormones that plays a key role in thedevelopment of male reproductive tissues. The secretion of this hormone decreases rapidly after age 50. Hypogonadism in men is a clinical syndrome that is caused by a defect in the production of testosterone, sperm, or both. Several alternative therapies are approved and prescribed according to their efficacy, patient's priorities, and costs. One of these treatments is the transdermal administration of testosterone. Inthis route, the drug is introduced through attached patch with a drug reservoir, through a permeablemembrane, or applied directly on the skin in the form of a gel or lotion. In different countries, testosteronetherapy by transdermal administration is rising progressively. Transdermal testosterone delivery by gelsor lotions is the preferred method of some men. The pricing level of these transdermal preparations isgenerally higher than commonly available short-acting injectables, but these user friendly methods arestill preferred by many patients. In this study, different types of transdermal preparations, mainly patch, gel, and lotion, as well as a brief overview of buccal and intranasal methods are discussed in details.

Background and purpose: Infections caused by multidrug-resistant gram-negative bacteria arerising. Phage therapy is an effective treatment in infections resistant to treatment and progress has beenmade with its use and development in recent years. Phage therapy in treatment of gram-negative bacterialinfections is not well investigated in clinical trials. Therefore, the aim of this study was to systematicallyreview studies on phage therapy against gram-negative bacterial infections. Methods & Materials: This review was done using electronic databases, including Scopus, PubMed, Google Scholar, and Web of science and articles published from 1968 to 2017 wereinvestigated. Studies meeting the inclusion criteria were selected and estimated using a review method. Results: A total of 128, 009 articles were indexed from which 320 were selected based on theirabstracts. Then, some were excluded including experimental studies and In vitro and In vivo studies. Finally, clinical trials (n=23) that met the inclusion criteria and published in English were selected. Conclusion: This review showed that phage therapy is an effective treatment against gramnegativebacterial infections in humans orally, topically, and subcutaneously injected.

MicroRNAs (miRNAs) are small non-coding RNAs that regulate the expression of about 60% of humangenomes. Silibinin or mixture of silybin A and B is a flavonolignans that constitute 70-80% Silymarin whichis considered to be its main effective ingredient. Silibinin revealed antioxidant and anti-inflammatory effectsby scavenging free radicals, improving antioxidant enzymatic activities, and suppressing NF-к β activation. One of the recent discoveries about the functions of silibinin, is its ability to change different miRNAsexpression, especially in cancer. For instance, silibinin decreases Bcl2 level by inhibiting miR-21 expressionin breast cancer cells that leads to apoptosis. Silibinin elevates miR-203 expression in lung cancer cells thatcauses stimulation of E-cadherin. The component can differentiate mesenchymal phonotype to epithelial. Also, treatment of glioblastoma cancer cells with silibinin diminishes anti-apoptosis factor XIAP byupregulation of miR-7 that causes prevention of autophagia in these cells. Therefore, silibinin could induceapoptosis and differentiation and inhibit proliferation in different cancer cells via regulation of variousmiRNAs expression. In this review study we aimed to summarize the studies about the effects of silibinin ondifferent miRNAs expression in various types of cancer cells to distinguish the exact mechanism of silibininanti-cancer effects.

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children. With increasing prevalence of childhood obesity, NAFLD is increasingly seen in children. The prevalencevaries according to the population studied (race and ethnicity) and the definition of NAFLD used in thestudy. In Iran, the prevalence of NAFLD in obese children ranges from 50% to 55% and in the generalpopulation of children is about 17%. Most patients with NAFLD are asymptomatic. However, abdominalpain may be present in the right and upper extremity, and hepatomegaly or non-specific symptoms suchas abdominal discomfort, weakness, fatigue or attention disorder may also be seen. Diagnostic methods ofNAFLD include laboratory tests, biomarkers, biopsy, and imaging studies such as ultrasound, CT, MRI. There is no definitive treatment for non-alcoholic liver disease. Modification of some risk factors such asobesity, diabetes, and hyperlipidemia are often recommended, but weight loss is more beneficial. Earlydiagnosis of NAFLD in children and its management can reduce further complications. Therefore, in thisstudy, we reviewed the articles published on NAFLD in children (until 2017) using electronic databases, including PubMed, ProQuest, Scopus, and Google Scholar. We reviewed the signs of NAFLD, itsepidemiology, etiology, complications, laboratory findings, different diagnostic methods, treatments, andfollow up procedures.

Background and purpose: Breast cancer is the most common cause of death due to cancer inwomen throughout the world. There is no absolute way to prevent this cancer, so, screening for earlydiagnosis is essential. The aim of this study was to review the strategies that promote breast cancerscreening behaviors in women. Materials and methods: In this review study, Persian and English articles (published 1985-2017) were searched in electronic databases including Google scholar, SID, Magiran, Pubmed, and ScienceDirect using the following keywords: strategy, screening behavior, cancer, breast cancer, and women. Results: In this study, 438 articles were found and after screening the title, abstract, and originaltext, 39 articles were selected. Based on the findings, effective strategies for promoting screeningbehaviors in women included self-care trainings in breast cancer, designing cost-effective publicscreening programs, using reminders to invite women to screen, eliminating fear, and anxiety aboutscreening for breast cancer. Conclusion: Screening for early diagnosis of breast cancer is of great benefit in performing fastand appropriate treatments, so various strategies should be used to increase screening behaviors inwomen. These strategies should be promoted using human resources, educational materials, healthpolicies, and psychosocial supports.