JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2018 | Volume:28 | Issue:161 |Papers Count:21

Background and purpose: Destruction of insulin-producing beta cells by T cells causes type-1diabetes (T1D). Carbenoxolone has cytoprotective and anti-inflammatory effects, and has been shown tobe capable of suppressing Th17 cells that are effectively involved in the pathogenesis of type 1 diabetes, therefore, we studied the effect of Carbenoxolone on T1D in C57BL/6 mice. Materials and methods: Forty male C57BL/6 inbred strain mice were randomly divided intofour groups and in three groups diabetes was induced by streptozotocin. A positive control group wasconsidered and two other groups received 50 mg/kg/day i. p. carbenoxolone (7 and 5 doses). Then, ondays 7 and 14 after the disease induction, fasting blood sugar (FBS) level, anti-inflammatory cytokinesIL-1β , IL-6 and TNF-α , and pathological changes of the pancreas were studied during the course of thedisease. Results: Carbenoxolone increased the levels of IL-1β , IL-6, TNF-α , and FBS. Also, itsignificantly increased infiltration of inflammatory cells into the pancreatic islets (P <0. 05). Conclusion: It seems that carbenoxolone triggers a breakdown in Treg/Th17 balance byincreasing the levels of pro-inflammatory cytokines and increases the number of Th17 cells, therebycausing toxic effects on the pancreatic beta cells and increasing the severity of the disease.

Background and purpose: Multidrug resistance (MDR) phenotype is a major complication incancer chemotherapy. Gankyrin is a key point molecule in cell cycle regulation and may contribute todrug-resistance phenotype of tumor cells. The aim of this study was to compare the basal Gankyrinexpression level in ovarian and gastric drug-resistant cells with their parental drug-sensitive cells. Materials and methods: In this experimental study, the Gankyrin expression at mRNA andprotein levels in drug resistance cell lines was compared with their parental drug sensitive cell lines byreal time RT-PCR and Western blotting. Results: Gankyrin mRNA expression in A2780/RCIS cells was statistically lower than A2780cells (p= 0. 00) but their difference was not statistically significant at protein level (p= 0. 240). In addition, Gankyrin expression in EPG85-257/RDB was lower than its parental drug sensitive cell line at mRNAand protein level. Conclusion: This study found an opposite relationship between Gankyrin expression and MDRphenotype related to the overexpression of MDR transportes. This suggestes for the first time that theincidence of MDR phenotype could inhibit tumorgenisity.

Background and purpose: A long non-coding transcript Lnc-Ang362 plays critical role on theexpression of miR-221 and miR-222. Knockdown of Lnc-Ang362 reduces the expression of thesemiRNAs as well as vessel smooth muscle cell proliferation in response to vascular injury. This study, forthe first time, considered the possible association between Lnc-Ang362 rs7887062A/G polymorphismwith the risk of atherosclerotic coronary artery disease (CAD) in low risk patients. Materials and methods: In this case-control study, 299 subjects, including 150 patients withatherosclerotic CAD and 149 healthy individuals (control group) enrolled. Genotyping of the rs7887062was done using PCR-RFLP method. Data were analyzed using SPSS v. 19. Results: The frequency of heterozygote AG and G-allele carriage (GG+AG) genotypes weregreater in controls compared to the patients, supporting the protective role against CAD. The G allelereduced the risk of disease (OR: 0. 32, 95%CI: 0. 15-0. 7, P=0. 004). In cross tabulation of the studypopulation based on gender, reduced risk of CAD in the presence of AG and G-carriage genotypes wasseen in both males and females. Conclusion: Lnc-Ang362 variant could be considered as a molecular screening marker for lowrisk susceptible subjects to atherosclerotic CAD.

Background and purpose: Chronic Rhinosinusitis (CRS) as a common disease has differentclinical signs and symptoms. In the recent decades only a few local signs and symptoms of CRS areincluded in its diagnostic criteria while many important ones seem to have been missed out. Consideringthe very close compatibility of CRS with “ Nazlah” and “ Zokam” in the manuscripts of Persian Medicine, we reviewed some signs, symptoms and consequences of CRS in the main literatures of both modernmedicine and Persian Medicine in order to suggest a more comprehensive diagnostic perspective. Materials and methods: This study reviewed medical databases and main manuscripts ofPersian Medicine using English, Arabic, and Farsi keywords including chronic rhinosinusitis, Nazlah, andZokam with no time limitation. Data were then compared, interpreted, and analyzed. Results: Studying the data available showed that a wide range of signs, symptoms, andconsequences are ob observable served in CRS. The complexity of clinical features of CRS versus thecurrent linear understanding of it, has led up to some difficulties to design a final framework for definingand semiologic description of CRS. Conclusion: Reducing the CRS diagnostic criteria just to some of its local nasosinusal featuresmay cause diagnostic ignorance of a wide spectrum of patients whose nasosinusal appearances are not soobvious while having other problems outside the organ. So we suggest a more comprehensive approach torecognize CRS through considering both local and general signs and symptoms for a better and morequalitative treatment.

Background and purpose: The purpose of this study was to evaluate the oral health status inpeople with history of drug abuse. Materials and methods: This cross-sectional study was done in five addiction treatmentcentres located in Sari, Iran 2016-2017, using random cluster sampling. The Decayed, Missing and Filledteeth (DMFT) index was calculated for 120 samples. ANOVA, T-test, and multiple linear regressionmodel were applied for statistical analysis. Results: A total of 104 men and 16 women participated in this study. The mean DMFT ofsubjects was 19. 53± 8. 30 teeth. Individuals with a lower age of the onset of drug abuse, addiction periodof ≥ 10 years, and those who brushed less than once a day and took sweet snacks more than three timesdaily had significantly higher DMFT. Statistical analysis also indicated that age, education, brushingpattern, sweet consumption, duration of drug use and the time of last dental visit showed to have asignificant relationship with changes in DT, MT, and FT indexes. Conclusion: Individuals with a history of drug dependence studied here, had a poor oral healthstatus. Therefore, appropriate educational, preventive and therapeutic actions are required to improve oralhealth and the quality of life in people with history of drug abuse.

Background and purpose: Healthy lifestyle is an important factor in prevention of chronicdiseases. The health of medical students is highly influential due to their fundamental role in every healthsystem. In this study, the health-promoting lifestyle and its determinants were evaluated in medical, dental, and pharmacy students. Materials and methods: This cross-sectional study was conducted in 650 students usingstratified sampling in Kerman, Iran 2016. The health-promoting lifestyle profile (HPLP-II) was used anddata was analyzed applying univariate and multivariate linear regression analysis in SPSS. Results: The mean score for health-promoting lifestyle was 104. 93± 22. 9 which had nosignificant relationship with gender, marital status, living condition, and the education levels. There was asignificant association between the field of study and the mean score for health-promoting lifestyle, nutrition, spiritual growth, interpersonal relationship, and stress management (P<0. 005). Conclusion: The health-promoting lifestyle is believed to be inappropriate in medical, dental andpharmacy students in Kerman University of Medical Sciences. However, medical students had a betterlifestyle compared to dental and pharmacy students. Authorities should provide university students withtraining programs on healthy lifestyle.

Background and purpose: Lung cancer is the third cause of death and amongst the fivecommon cancers in Iran. The aim of this study was to analyze the survival rate of patients with lungcancer and identifying the variables influencing their survival. Materials and methods: In a retrospective cohort study, the data was extracted from themedical records of 259 patients with lung cancer who had attended Tehran Shariati Hospital during 2005-2015. The survival rate was estimated using the Kaplan-Meier method and log-rank test was applied forcomparison of survival function. The event was specified as death due to lung cancer. The Cox’ sproportional hazard model was used to investigate the effect of various variables on patient survival timeusing the R software. Results: The mean age of the patients was 62. 86± 12. 46 and the estimated median survival timewas 2. 4 years (2. 93± 3. 33). Hundred and forty patients (54%) died. According to the Kaplan-Meiermethod, 1, 2, and 3 years survival rates were estimated to be 63%, 53%, and 46%, respectively. Based onCox proportional hazards analysis, the patient’ s survival time was significantly associated with PCO2(HR= 1. 021), age at diagnosis (HR= 0. 805), type of tumor (NSCLC vs. SCLC) (HR= 0. 567), and brainmetastasis (HR= 1. 792). Conclusion: The survival time for patients with lung cancer was found to be quite short. Thistime decreases by increase in patients’ age. Also, the risk of death in a patient either with SCLC ormetastasis was higher than other patients.

Background and purpose: Leveling of health services and resources is implemented in Iran topromote the health situation and preventing unnecessary visits and waste of human and financialresources. The relationship between these levels is built through referral system. The aim of this studywas to analyze the patient referral system at all levels of the health system using Strengths, Weaknesses, Opportunities and Threats (SWOT) approach. Materials and methods: This qualitative study was done by semi-structured and in-depthinterviews in 2016. The sample size consisted of 20 people including administrative officers, familyphysicians, executive managers, and individuals working in insurance sector and 10 people receivinginsurance services who were selected purposefully. Data was analyzed using content and structural analysis. Results: The strengths included: reducing the costs, providing equitable access to health services, promoting the health level, and providing services in an evolutionary level. The weaknesses included notinforming the people, physician issues, poor monitoring and evaluation, management issues, paymentmechanisms, electronic health records, insurance organizations, and inadequate facilities and equipmentof health centers. Opportunities included: the importance of health and health care for the leadership andthe parliament, job creation, active participation of the private sector, the high level of literacy of thetarget group (people), and the cooperation of insurance organizations. The threats included lack ofcoordination and alignment between policy makers and planners, the therapeutic focus of health system, lack of attention of people to health care, and the influences of private sector. Conclusion: The appropriate implementation of referral system promotes the health of society andincreases the healthcare burden. But today, it does not follow its own rules which is caused by differentfactors. Therefore, health authorities should address these by appropriate planning and timely actions.

Background and purpose: Identification of risk in hospital waste management have a majorrole in reducing the cost of surplus and preventing the spread of diseases. In this quantitative analysis, weaimed at determining waste components, evaluating hospital waste management, and prioritizing the risksin Sari Fatemeh Zahra Hospital. Materials and methods: We performed a descriptive-cross-sectional study in 2015. Tchobanoglous method was used for quantitative-physical analysis of the waste. The individualized rapidassessment tool was applied to evaluate waste management. Preliminary Hazard Analysis and failuremode and effect analysis models were used to identify and prioritize the risks. Results: Total waste production, general waste, infectious wastes, and sharp objects were1011. 54, 600. 45, 384. 94, and 26. 15 kg/day, respectively. Plastics, organic materials, and textilesconstituted the highest amount of waste products. According to the individualized rapid assessment tool, the score obtained by the hospital was 82. 15% indicating an excellent waste management. In preliminaryhazard analysis, failure mode, and effect analysis models, 23 errors were observed, of which 9 had apriority number greater than 100. Conclusion: The models studied showed that mixing the sharp waste material with othergarbage, disposal of non-infectious and semi-household waste in infectious bins and vice versa are ofhigh risk and need corrective measures.

Background and purpose: Cervical cancer is the third leading cause of cancer-related death inwomen. There are not enough information about the trends of this cancer in Iran, so, this study aimed toinvestigate the incidence and trends of changes in incidence of cervical cancer in Iran. Materials and methods: This study was a reanalysis of existing data (2003-2009) obtainedfrom the National Cancer Registry in Iran. The incidence rates were standardized based on population assuggested by World Health Organization. Then, the incidence trend of cervical cancer was determined bySTATA. Results: An increasing trend of cervical cancer was seen between 2003 and 2008 while adescending trend of the disease was observed in 2008-2009. A total of 4273 cases of cervical cancer wereregistered in Iran. The number of people who developed the disease raised from 394 in 2003 to 907 in2009, showing a three-fold increase. Conclusion: According to current study, the incidence of cervical cancer is increasing in Iran, especially in central regions. Therefore, early detection through screening programs and trainings, particularly in patients at higher risk of cervical cancer is recommended.

Background and purpose: Mifepristone is an oral synthetic steroid with antiglucocorticoidand antiprogesterone activities. Therefore, it could be dangerous during pregnancy since it causescytogenetic damage and, consequently, abortion. Flavonoid compounds such as naringin have antioxidantproperties and eliminate various free radicals. Naringin is abundantly found in Iran, so, we investigated itscellular effects against cytogenetic damage caused by mifepristone on blood lymphocyte usingmicronucleus method. Materials and Methods: In this experimental study, 5ml Venous blood were collected from 5healthy and non-smokers using heparin syringe. Different naringin concentrations followed by 43μ g/mldamage dose of mifepristone were injected to the cells. To evaluate the production of micronucleus inrestrained binucleated lymphocytes in cytokine, the slides were prepared and evaluated by opticalmicroscopy. The mean values were compared applying ANOVA test (posttest: Tukey) in SPSS andp<0. 05 was regarded significant. Results: The highest frequency of micronucleus was observed in the positive control group(17. 67± 1. 528) and the lowest was seen in the naringin group at 232μ g/ml (1. 33+0. 5774) (P<0. 05). Naringin (232μ g/ml) with mifepristone led to significant changes in the number of micronucleus nucleicompared to the sample without naringin. Conclusion: Naringin is a potent antigenotoxin against the damage caused by mifepristonethan, therefore, it could be used as a protective agent against the toxic effects of mifepristone.

Background and purpose: Fast diagnosis of pneumococcal infections is of great importance inachieving successful outcomes. The aim of this study was to use PCR process based on capsular encodinggenes of Streptococcus pneumonia. Materials and methods: In this experimental study, specific primers were designed based onthe reference sequences of the Streptococcus pneumoniae cpsB, cpsD, aroE, and psaA genes. All bacteriawere subjected to DNA extraction separately. Then, the PCR protocol was performed. Sequencing of thePCR products was done and data was analyzed descriptively. Results: The primer pairs against the cpsB, cpsD, aroE, and psaA genes amplified 159, 202, 254, and 286 bp fragments, respectively. The alignments and comparison of amplified sequences showed ahigh homology (100%) with the reference genes. Conclusion: According to this study, it is possible to diagnose Streptococcus pneumoniae basedon virulence genes, and differentiate the pathogenic Streptococcus pneumoniae from nonpathogenic strainsand also viridans groups. Therefore, this method is suggested in diagnosis of pathogenic Streptococcuspneumoniae strains.

Background and purpose: Restless Legs Syndrome (RLS) is a neurological disorder which canreduce the duration and quality of sleep and consequently affect quality of life. Understanding theprevalence of this syndrome in patients with multiple sclerosis (MS) and its associated factors could be ofgreat benefit in enhancing their quality of life. Materials and methods: This cross-sectional study was conducted in 300 MS patientsattending an MS clinic. They were selected using random sampling. After clinical examination, demographic information and disease characteristics were recorded and RLS rating scale was used foreach patient. Results: The prevalence of RLS was 43. 3% in MS patients. Some factors were found to beresponsible including older age, longer MS duration, pattern of disease and the level of disability causedby MS. Conclusion: RLS evaluations should be done regularly in MS patients especially in those withsleep disorders. This could cause timely diagnosis and treatment, thereby leading to a better quality of lifein these patients.

Background and purpose: Cyclophosphamide and ifosfamide are two most widely used andhazardous drugs in chemotherapy centers. This study aimed at determining surface contamination withcyclophosphamide and iphosphamide in chemotherapy centers. Materials and methods: This descriptive cross-sectional study was carried out in threechemotherapy centers affiliated with Hamedan University of Medical Sciences, Iran 2016. Twenty eightsamples were collected from contaminated surfaces. The samples were then prepared by solid phaseextraction and analyzed by HPLC/UV apparatus. Results: The mean values for surface contamination of cyclophosphamide and ifosfamide were57. 28 ± 63. 8 and 44. 15 ± 5. 5 ng/cm2, respectively. The highest levels of contamination with both drugswere observed at exhaust hood surfaces and the lowest level of contamination was seen in nursing stationand staff resting place. The clothes and gloves of nurses were also found to be contaminated. Conclusion: Daily number of medications, the location of drug preparation room and injectionroom, nursing station, staff resting place, daily cleaning programs, and repairing and maintenance ofventilation systems were amongst the major factors affecting surface contamination in chemotherapycenters.

Local block and awake intubation are the choice for airway management in patients withanticipated difficult airways. This paper reports a case of a 67 year old man with snoring and hoarsenessand laryngeal mass in stroboscopy (12X12X10), candidate for elective surgery. He was intubated awakeand the mass was resected. Therefore, patients with horseness and snoring should not be anesthetizedimmediately since the mass might be large and intubation would be difficult.

Background and purpose: Carpal Tunnel Syndrome is the most common entrapmentneuropathy caused by increased pressure of median nerve in the wrist area. The results of electronicsearches in several studies have shown different prevalence rates of this syndrome in Iran in differentpopulations. So, the purpose of this study was to estimate the prevalence of carpal tunnel syndrome inIran using meta-analysis. Materials and methods: Relevant keywords were searched in national and internationaldatabases. The articles were then selected based on inclusion/ exclusion criteria and quality assessment. Data including author names, year of publication, sample size, sample descriptions, assessment criteria, and the prevalence rate of carpal tunnel syndrome were entered in Excel. The standard error of theprevalence of carpal tunnel syndrome in each study was calculated based on the formula for binomialdistribution. According to the I-squared heterogeneity and Q indices, the random or fixed effect modelwere used to estimate the overall prevalence. Also, sensitivity analysis, meta-regression, and survey ofpublication bias were carried out. Results: A systematic search was completed and 10 articles met the inclusion criteria with 11evidence of the prevalence of carpal tunnel syndrome in Iran. A total of 14525 people had been studied inwhom the prevalence of carpal tunnel syndrome varied from 1. 82% to 64. 6%. The overall prevalence ofcarpal tunnel syndrome with physical examination based on the random effect model was estimated to be17. 53% (95% CI, 13. 74-21. 31%). Conclusion: This meta-analysis showed a relatively high prevalence of carpal tunnel syndromein Iran. But, the frequency of this syndrome in different target groups requires further investigations.

Leishmaniasis is a major public health problem, but so far there are no effective commerciallyavailable vaccines for this disease. Its control strategy is only reliant on therapy, but currently the drugsavailable for the treatment of leishmaniasis are also limited and a great concern is the rapid rate ofresistance to common drugs. The first step in discovery and development of new drugs is to identify anappropriate drug target. Accordingly, it is important to recognize the metabolic pathways in which theleishmania parasites live and selecting a target in the parasite biological pathway, absent in the host ordifferent from the host homolog. Discovery of new drugs requires high costs and takes a lot of time (up to15 years). Therefore, choosing the approved drugs in the market for various diseases, includingleishmaniasis is very cost-effective considering the mechanism of drug action and other aspects. Miltefosin is an effective anti-cancer agent that is also used for different types of leishmaniasis. In recentyears, researchers have focused on the anti-leishmanial effects of pharmaceutical compounds or anticancerdrugs to find more effective compounds with lower side effects. The present article mainly reviews theanticancer drugs that have been tested for their anti-leishmanial effects in both in vitro and in vivoconditions.

Completion of the human genome project revealed that the molecular mechanisms of cellularresponses to different situations cannot be predicted from the sequence of their genes. Hence, mostbiological researches are focused on the roles of proteins which are much more challenging tasks. Omicstechnologies, instead of analyzing individual components of an organism by conventional biochemicalmethods such as the function of a gene, protein or biochemical reaction, study all the components andtheir interactions within a global site. In the past two decades, omics technologies have been used asefficient and powerful tools in almost all aspects of clinical and pharmaceutical researches, includingbiomarker discovery, drug target discovery, evaluation of the efficacy of drugs, safety assessment, andpersonalized medicine. In this article, omics technologies such as genomics, transcriptomics, proteomicsand metabolomics, and their advances are reviewed and their applications in clinical and pharmaceuticalresearches, particularly in the areas of drug targets, biomarkers, and personalized medicine are discussed.