JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:26 | Issue:142|Papers Count:38

Background and purpose: Medicinal plants have always been of great interest due to their natural and effective chemical components. Cardamom is one of these plants with many health benefits.In this study, hydro-alcoholic extract of cardamom fruit and its effect on serum levels of liver enzymes was investigated in male Wistar rats injected with lead acetate.Materials and methods: In this study, 36 male Wistar rats weighing 220-250 g were randomly divided into 6 groups including a control, an experimental, treatment I, II, III groups and a positive control group. Treatment and experimental groups received lead acetate (500ppm) for four weeks. Then, the experimental group was given the cardamom extract for one week. Afterwards, direct blood was taken from hearts for measuring alanine transaminase (ALT), aspartate aminotransferase (AST), and gammaglutamyl transferase (GGT). Samples of liver tissue were removed for histological studies. Data analysis was done applying ANOVA.Results: The study showed that lead acetate increased the ALT, AST and GGT levels in liver that had destructive effects. But, the cardamom extract significantly decreased the ALT, AST and GGT level (P>0.001) which in turn had a remediable effect.Conclusion: The study showed that hydro-alcoholic extract of cardamom has antioxidant and flavonoid components which protect liver against destructive increase of liver enzymes due to poisoning effects of lead acetate.

Background and purpose: Non-alcoholic fatty liver syndrome have high prevalence in Iran.Non-alcoholic fatty liver disease (NAFLD) includes clinical spectrum from simple steatosis to cirrhosis and liver carcinoma. In advanced stages NAFLD has irreversible complications, therefore early treatments especially with medicinal plants can be considered as an important strategy in its treatment.This study aimed to investigate the effect of a combined drug (herbal-marine) HESA-A on treatment of fatty liver in rats by measuring the biochemical and histological parameters.Materials and methods: In an experimental study, 28 male Wistar rats (weighing 180±20 g), were divided into two groups for eight weeks; a standard diet (n=7) and a high-fat diet (HFD) (n=21). In order to confirm the NAFLD, the control group and seven rats of the HFD group were killed and their biochemical parameters and histopathological changes were studied. The rest of the rats were divided into two groups to have either HFD+HESA-A (500 mg/kg/day) or HFD+atorvastatin (30 mg/kg/day) for 30 days. Finally, biomarker serum of liver damage, serum lipid profiles and histopathological changes were investigated.Results: After 8 weeks HFD caused harmful metabolic effects including hypertriglyceridemia, hypercholesterolemia and liver dysfunction. It also increased the activity of serum liver enzymes (p<0.05).HESA-A treatment significantly decreased parameters of liver tissue damage in serum. Histopathology of liver approved the changes caused by HFD and protective effects of HESA-A on liver.Conclusion: Compared with atorvastatin, herbal-marine compound HESA-A which is a national product, can be used as an effective therapy in treatment of NAFLD without side effects of chemical drugs.

Background and purpose: Restless legs syndrome (RLS) is a neurological disorder in hemodialysis patients. These symptoms cause distress and disability during rest, discomfort, stress and weakness, with secondary effects on performance, disruption of work and family life. This study investigated the effect of heat wrap on the severity of restless legs syndrome in hemodialysis patients.Materials and methods: A quasi-experiment (before-after design) was conducted in 40 RLS patients who were randomly selected from hemodialysis departments in three hospitals in Yazd, Iran. The restless leg syndrome International questionnaire was completed by patients before and after using hot water bags. Data analysis was done in SPSS V.17 applying descriptive statistics and Chi-square. P>0.05 was considered significant.Results: Most of the patients were ³ 60 years of age (64%).61.5% had been on dialysis for one to five years. The severity of symptoms were in moderate level before and after the intervention (69.5% and 61%, respectively). The mean score for RLS was found to be significantly different before and after the intervention (P=0.000).Conclusion: Application of hot water bag is suggested as an effective, safe, and low cost method that could be easily used by patients and their caregivers to reduce the severity of RLS in hemodialysis patients.

Background and purpose: Cytogenetic tests are used to assess the individual’s radiosensitivity and the potential to develop cancerous diseases. Our aim was to assess the radiosensitivity of patients with prostate cancer and healthy individuals based on Premature Chromosome Condensation (PCC).Materials and methods: 3.5 ml blood was collected from peripheral veins of 10 healthy individuals and 10 patients with prostate cancer and put into 7 sterile microtubes. All samples, except the controls, were irradiated to 6MV beams of a Siemens LINAC at different doses (0.25, 0.5, 1, 2, 4 and 6 Gy). Chemical PCC test was performed on each sample and the prepared slides were scored. The Kruskal-Wallis non-parametric ANOVA and Mann-Whitney statistical tests were used to compare the chromosomal aberrations resulted from different dose levels in each group (healthy/cancerous), and identical doses resulted from the two groups, respectively.Results: There was a significant correlation between irradiation dose (for doses ³0.5 Gy) and the rings in both of the healthy and prostate cancer patients indicating an increase in the number of rings with dose escalation (P<0.05). Comparing healthy individuals and cancerous patients revealed no significant difference in their ring number at the same level of radiation doses (P=0.784).Conclusion: In theory, PCC test should be capable of determining more chromosomal aberrations than dicentric test, so, if the FISH test is used simultaneously, we might be able to score dicentrics and other fragments. By these, it may also be possible to better differentiate the radiosensitivity of healthy individuals and prostate cancer patients.

Background and purpose: Breast cancer is the most common type of cancer among women. In radiation therapy for breast cancer it is important to prevent damage to normal tissues particularly to lung tissue. In this study, we investigated the incidence of damage in patients with breast cancer by clinical and dosimetric parameters to identify the predictive factors.Materials and methods: An experimental study was carried out in which 52 patients with breast cancer (stages II/III) who had mastectomy and/or modified radical mastectomy and 8 cycles of chemotherapy were studied in Mahdieh Oncology and Radiotherapy Center from February to August 2015. Treatment planning was done for delivering 50 Gy dose to PTV in 25 fractions. The risk of damage to the lung tissue was calculated using the Lyman model and its relationship with clinical and dosimetric parameters was evaluated. Finally, based on the results, an appropriate model was obtained for predicting the risk of damage to the lung tissue.Results: The results showed that MLD and IV19 parameters were significantly associated with the risk of damage to lung tissue. In contrast, CLD parameter did not represent any significant relation with incidence of damage. Based on results, the univariate logistic regression model was proposed to predict the risk of damage to the lung tissue in breast cancer patients.Conclusion: In treatment planning of breast cancer a possible reduction in CLD parameter is suggested to reduce the lung absorbed dose. Validation parameters of the proposed model showed that this model could provide a good estimation of damage to the lung tissue during breast cancer radiotherapy. Therefore, using this model before radiotherapy can result in less lung injury and consequently enhance the patients’ quality of life.

Background and purpose: Gastric cancer is the fourth most common cancer and the second leading cause of cancer death worldwide. North of Iran is a high risk area for gastric cancer. Bcl2 family is the most important regulator of apoptosis and -938C>A single nucleotide polymorphism of bcl2 gene promoter has been demonstrated to influence gastric cancer susceptibility. In this research we studied the effect of -938C>A genotype on gastric cancer.Materials and methods: This analysis was performed in 87 patients with gastric cancer who underwent surgery in Mazandaran and Golestan province along with 104 healthy individuals as controls.DNA extracted from peripheral blood samples was applied in PCR-SSCP (Polymerase chain reactionsingle strand conformation polymorphism) analysis to determine -938C>A genotype. The association of the -938C>A genotype and gastric cancer risk as well as demographic and clinicopathological characteristics were analyzed by logistic regression method.Results: Frequency of AA, CC and AC genotypes in cases were 13.79, 16.09 and 70.12% and 15.38, 23.08, and 61.54% in control group, respectively. Statistical analysis indicated that the AC genotype was significantly (P=0.0009) associated with a decreased risk for gastric cancer by 0.2 fold (OR=0.276) compared with the combined genotype of AA+CC. No significant association was found between -938C>A genotype with demographic and clinicopathological characteristics.Conclusion: The study showed that the presence of AC genotype may decrease the risk of gastric cancer. So, investigating the -938 C>A single nucleotide polymorphism of bcl2 gene promoter could be an appropriate molecular marker that could be used to determine individual sensitivity to gastric cancer and also for designing cancer prevention programs.

Background and purpose: Mast cells as the multi-functional and complex cells play a key role in tumor progression. Due to the higher malignant potential of Oral Squamous cell carcinoma (OSCC) compared with cutaneous squamous cell carcinoma (cSCC), the purpose of this study was to compare the mast cells count in squamous cell carcinoma of the skin and oral cavity and evaluate their correlation with the degree of differentiation of these tumors.Materials and methods: In this retrospective study, 30 cases of OSCC and 30 cases of cSCC were investigated. Toluidine blue staining was used to identify the number of mast cells in samples. Data was analyzed in SPSS (V.21) applying Mann-Whitney, Kruskal Wallis and Pearson correlation coefficient tests.Results: The mean count of mast cells in OSCC and cSCC were 46±29.68 and 63.66±40.85, respectively, indicating a significant difference (P=0.012). The mean counts of mast cells in grade I OSCC and grade III of cSCC were higher than those of other grades but the differences were not statistically significant (P>0.05).Conclusion: The average number of mast cells in oral squamous cell carcinoma was less than that in cutaneous squamous cell carcinoma. It seems that other factors such as cytokines and chemokines released from tumor cells and inflammatory cells other than mast cells are effective in the progression of oral squamous cell carcinoma.

Background and purpose: Peroxisome proliferation-activated receptors (PPARg) are a class of ligand-dependent nuclear receptors, which act as transcription factors. In fact, the increased activity of PPARγ, can increase the expression and secretion of adiponectin but in patients with coronary artery disease these levels are reduced. This study was conducted to investigate the effect of omega-3 and vitamin E on the expression of this gene.Materials and methods: This double-blind, parallel clinical trial was conducted on 62 patients with coronary artery disease in Cardiovascular Research Center of Tehran in 2013. The patients were divided into three groups to receive n-3 fatty acids and n-3 and vitamin E combination therapy, and placebo (edible paraffin) for 8 weeks. The PPARg expression was investigated in peripheral blood mononuclear cell (PBMC) at first and after 8 weeks. As well as, Consumption data and statistical tests were analyzed using Nutritionist IV and SPSS V.18, respectively.Results: At the end of the study, the PPARg gene expression in PBMC significantly increased in the groups receiving n-3 fatty acids and n-3 and vitamin E combination therapy compared with baseline (P=0.029 and P=0.038, respectively). Also, significant differences were observed between the three groups (P=0.027) Conclusion: During eight weeks of treatment, the expression of PPARg in the groups receiving omega-3 fatty acids with or without vitamin E increased in patients with coronary artery disease.

Background and purpose: Methicillin-resistant Staphylococcus. aureus (MRSA) is specific strain of S.aureus that is a major cause of nosocomial infection. Nowadays, Vancomycin is the first-line treatment of severe MRSA infections. However, resistance to Vancomycin is reported in the form of Vancomycin-resistant Staphylococcus aureus (VRSA) too. This study aimed at determining the prevalence of MRSA and VRSA in healthcare staff and inpatients.Materials and methods: The study was performed in 447 healthcare workers and inpatients in Teaching Hospitals, in Sari, Iran, 2015. Staphylococcus aureus were isolated from the subjects using diagnostic tests. Then antibiotic resistance patterns of the isolates was determined by disk diffusion method.E-TEST was used for the methicillin and Vancomycin resistant isolates. Prevalence of mecA resistant gene in the isolates was analyzed by PCR. Finally, Induced resistance to Clindamycin was investigated.Results: E-TEST showed that 31.31% of the isolates were resistant to methicillin and 16.1% were vancomycin-intermediate S. aureus (VISA). Prevalence of mecA gene in resistant isolates was 96.8%. The highest resistance was detected against Gentamicin (45.5%) and the lowest resistance rates were found against Vancomycin (0%) and Amikacin (14.1%). We also found that 12.9% of MRSA isolates were inducible resistance to Clindamycin.Conclusion: This study revealed that MRSA isolates have a high resistance to Erythromycin, Clindamycin, Gentamicin, and Ciprofloxacin. Also, a high rate of multidrug-resistant was seen in MRSA isolates. But despite intermediate resistance to Vancomycin, this antibiotic can be used as a valuable drug in treatment of MRSA.

Background and purpose: Mastitis or infection of breast tissue is a common condition in women, especially in childbearing age and is treated on outpatient basis. Sometimes, in the evaluation of mastitis, particularly in chronic mastitis, a physician detect rare forms such as granulomatous mastitis and malignancies. The aim of this study was to evaluate some clinical characteristics of patients who were hospitalized with a primary diagnosis of mastitis.Materials and methods: In this cross-sectional analysis, data was obtained from the records of 46 females admitted in Qaemshahr Razi Hospital. The patients were initially diagnosed with mastitis and hospitalized from 2010-2015. Risk factors, patients’ history, physical examination, laboratory data, ultrasound and mammogram results, methods of diagnosis, treatments, pathology results, and final diagnosis were recorded in a checklist.Results: In this investigation 8 patients (18%) were in post monoposal period and, 38 (82%) were premonoposal. The mean age of patients was 33.18±7.08 years old. Eight patients had recurrent mastitis and 4 had a history of previous history of breast surgery. The final diagnosis in six patients (13%) was granulomatous mastitis who all had recurrent mastitis. Meanwhile two patients were diagnosed with inflammatory breast cancer.Conclusion: Mastitis can be caused by infection, granulomatous, and even malignancy. In case of recurrence, biopsy and histopathology are required to make final diagnosis.

Background and purpose: High quality of working life (QWL) is recognized as a fundamental factor in empowerment of human resources and health care system. Nursing is a profession in which having a good quality of working life plays a major role in delivering good quality care to patients. The aim of this study was to evaluate the QWL and related factors in critical care unit (ICU) nurses.Materials and methods: We conducted a descriptive-analytical study in 180 nurses working in intensive care unit in Sari teaching hospitals affiliated to Mazandaran University of Medical Sciences (2016) via quota sampling. The most important inclusion criterion was one year working experience in ICU. Data was obtained using demographic questionnaire and Walton’s quality of work life. Data was analyzed by descriptive statistics, one-way ANOVA, and t-test.Results: The nurses were relatively satisfied with most components of their work life; low, medium, and high levels of QWL were reported by 27.2%, 66.1%, and 6.7% of the participants, respectively. QWL was found to be significantly associated with hours of overtime, frequency of night shifts per month, and income (P<0.001).Conclusion: In this study nurses reported medium levels of QWL. But, they were dissatisfied with unfair salary and benefits payments and lack of a safe and healthy environment, low promotion and job security, constitutionalism in the work organization, and social dependency.

Background and purpose: Simultaneous exposure of nanoparticles can cause serious damage to aquatic organisms including fish. The aim of this study was to investigate the toxicity effect of subchronic exposure of copper oxide nanoparticles (CuO NPs) in presence of titanium dioxide nanoparticles (TiO2 NPs) on the histopathology of gill and kidney tissues of fish model in vivo exposure.Materials and methods: In this study, one non-lethal concentration of TiO2 NPs, two nonlethal concentrations of CuO NPs, two concentrations of TiO2 NPs and CuO NPs mixture, and a control group (no chemicals) were used. After 10 days of exposure to these materials, samples of gill and kidney tissues were collected. In order to study classical histology the samples were prepared by hematoxylineosin staining and the slides were photographed by optical microscopy.Results: The damages caused in gill were as following: secondary curved blades, increased mucus secretion, increase in the agglomeration of secondary lamellae, and aneurism and hyperplasia.Also, blood vessels dilation, vacuoles, necrosis, focal tubule degeneration, and increase in melanomacrophage were observed in kidney tissue of common carp.Conclusion: The study suggested that toxic effects of CuO NPs on tissues of common carp in the joint presence of TiO2 NPs were synergistic.

Background and purpose: Catechol is a ring form organic compound with high toxicity that is used in petrochemical, pharmaceutical and manufacturing of pesticide. It has adverse effects on human and environmental health if discharged into the environment. The purpose of this study was removal of catechol using catalytic ozonation using core-shell magnetic nanoparticles of iron oxide doped with silica and titanium dioxide from aqueous solution.Materials and methods: We conducted a basic-applied study in which magnetic nanoparticle Fe3O4@SiO2@TiO2 was synthesized using sol-gel method. To determine the characteristics of nanoparticle, XRD, SEM and EDX tests were used. Then effect of different parameters on removal efficiency were investigated. These included solution pH (2-10), reaction time (0-60 min), dose of catalyst (0.2-3 gr/L), initial concentration of catechol (50-1000 mg/L), recycled test (7 times), and determining the mineralization and scavenger effect. The residual concentration of catechol was measured using high-performance liquid chromatography at 275 nm.Results: The optimal pH for the catalytic ozonation process was 8. The maximum efficiency of the process in optimal conditions (catechol concentration 1000 mg/l, pH=8, catalyst dosage 3 gr/L and dose of ozone 0.38 gr/hr) was 100% after 60 minutes of contact time. Kinetics of degradation of catechol followed first degree model. After reaction time the amount of mineralization was 91.5%. Reusability of catalyst was done 7 times and its efficiency decreased by about 4%. Scavenger (1 gr/l tert-butanol) decreased removal of catechol by 4.16%.Conclusion: The catalytic ozonation process using Fe3O4@SiO2@TiO2 nanoparticles in an alkaline pH was found to be capable of eliminating high concentrations of catechol effectively.

Background and purpose: Bottled water is widely packaged and distributed in PolyethyleneTerphthalate (PET) bottles with plastic caps. Plastic materials in bottles, and other additives such as heavy metals, can leak into water during manufacturing or storage process in different ambient conditions. The main objective of this study was to investigate the effect of sunlight and environmental temperature on the release of heavy metals from PET bottles into water.Materials and methods: The study was conducted in six brands of bottled water (0.5 L) in five provinces of Iran, 2015. The levels of Pb, Ni, Cd and Sb were determined in bottled waters in different conditions including room-temperature of 27±2oC, sun exposure to 45±3°C, and with/without foil coating. Different temperatures (45oC, 60oC and 75oC) were also used in specified time ranges from 5 to 50 days. Measurement was done by ICP- AES and data was analyzed in Minitab.Results: Concentrations of Pb, Ni and Cd in bottled water did not show any significant changes in direct sunlight exposure and ambient temperature but Sb concentration was found to be higher in all samples when storage duration increased. In some samples, it even exceeded the maximum allowed value (5 ppb).Conclusion: Direct radiation exposure to sunlight, increasing the ambient temperature and storage duration, lead to increase in concentration of antimony in bottled water.

Background and purpose: One step 75gr glucose tolerance test is introduced as a replacement for classic two step GTT for diagnosis of gestational diabetes (GDM). This study was designed to evaluate the prevalence of gestational diabetes based on new criteria and its related fetomaternal adverse effects.Materials and methods: An analytic-descriptive study was performed in 271 pregnant women attending Tehran Javaheri Hospital in 2015. They underwent a 75-g glucose tolerance test. The frequency of GDM was calculated with CI95% and data was analyzed in SPSS 21 applying student t test for quantitative variables and Chi square for qualitative variables.Results: The mean age of the participants was 30.5±4.6 years. The frequency of GDM was 24% of whom 15.4% required medication. Significant correlation was found between age, BMI, positive family history of diabetes mellitus and history of GDM in previous pregnancies and GDM (P<0.05). In this study the frequency of gestational hypertension was significantly higher in mothers with GDM compared with the normal group (P=0.003). There was no any significant difference between the two groups in other fetomaternal complications.Conclusion: GDM was found to be highly prevalent but only few cases required medication. Also, no significant difference was seen in fetal complications between the two groups, therefore, larger studies are suggested to consider the benefits and cost effectiveness of new criteria.

Background and purpose: Closure of the alveolar cleft using bone grafts is very important in patients with alveolar cleft. Adjunct use of platelet rich fibrin (PRF) with bone graft enhances the bone volume. The aim of the present study was to evaluate the efficacy of grafting by allografts with PRF in stability of bone volume following alveolar cleft grafting using radiographic scales.Materials and methods: A clinical trial was conducted in 10 patients (6 females and 4 males) with unilateral alveolar cleft. After applying Freeze Demineralized Bone Allograft (FDBA) in the cleft site, half of the patients received PRF on the graft site while the rest (control group) did not receive it.Prior the surgery, 6 months, and 1 year after surgery CBCT radiographs were obtained to evaluate the changes in bone volume. Data was analyzed in SPSS with 95% of confidence interval. Shapiro- wilk, Bonferroni, and Spearman analytical tests were used in this study.Results: Both the control and intervention groups included 2 males and 3 females (mean age: 9.25±1.83 years). No significant difference was observed in the mean age of participants (P>0.05).Changes in bone volume during the study period were significant in both groups (P<0.001); in fact the bone volume decreased after 6 months and increased after 12 months. Baseline bone volume was not significantly different between the two groups (P>0.05). But, 6 and 12 month follow-ups showed significantly higher bone volume in intervention group compared with the control group (P<0.05).Conclusion: Using PRF in combination with FDBA could enhance the process of bone augmentation and decrease bone loss in the alveolar cleft sites.

Background and purpose: The cost of health care has an increasing trend worldwide.Therefore, governments aim at analyzing the economic aspects of health services and make interventions in improving the financial performance of health care systems. This study was conducted to assess the new financial system of medical universities in Iran using SWOT analysis.Materials and methods: This cross sectional study was done in 2013. The study population included the financial managers and experts in Iran’s health system. They were selected by census sampling and the Board of Health Budget Committee including 20 people were recruited. In order to assess the viewpoints of participants, strategic planning model was investigated using the SWOT matrix [strengths, weakness (internal factors), opportunities, and threats (external factors)]. Analytical hierarchy process was applied to weight and prioritize the items.Results: Four items in strengths, 15 in weakness, 7 in opportunities and 6 items in threats were extracted by the committee members. The score for internal factors (strengths and weakness) in SWOT table was 1.98 and the score for external factors (opportunities and threats) was 4.23.Conclusion: According to the results, external factors were found to have more effect on shaping the financial system in health care services in Iran which indicates a powerful impact of external organizations. Therefore, permanent finance subcommittees should be formed for effective and constant communication with external bodies.

Background and purpose: Dyslexia is a common disorder in students which results in many educational problems. The aim of this study was to determine the effect of attention training on working memory and reading components of pupils with dyslexia.Materials and methods: The study design was a single subject (ABA type) and included a control group. Eight dyslexic students with cognitive problems were selected via convenience sampling and were randomly divided into control and experimental groups. The intervention was conducted for 15 sessions (3 sessions a week, for 30 minutes to an hour). The subjects were evaluated during three stages (3 times in every stage) and once in a period of four months by (N-BACK) and Assessment of Persian Reading Ability (APRA). Excel software was used for qualitative analysis of data and MBD was applied for quantitative analysis.Results: The statistical analysis (visual analysis and effect size) showed that the scores for working memory and reading ability improved in experimental group.Conclusion: Attention training is effective in improving reading skills in students with dyslexia.According to current results cognitive rehabilitation tools such as computer programs are of great use in enhancing and recovering reading skills in dyslexic students.

Background and purpose: Accurate diagnosis of suspicious oral lesions is made by appropriate sampling and pathology examinations. Inappropriate biopsy can lead to diagnostic errors in histopathological examination of samples. The aim of this study was to evaluate the knowledge of general dentists in Sari, Iran and final-year dental students in Mazandaran University of Medical Sciences on transport and processing of oral biopsies.Materials and methods: This analytical cross-sectional study was carried out in 150 dentists and final-year dental students, 2015. Data was obtained using a researcher made questionnaire consisting of demographic characteristics and questions on transport and processing of oral biopsies. Data analysis was done in SPSS V.17 applying t-test, ANOVA, and Spearman correlation coefficients.Results: The questionnaires were completed by 150 people, including 106 dentists (50% males and 50% females, mean age: 39.9±6.2) and 44 final-year dental students (50% males and 50% females, mean age: 24.6±2.6). No significant difference was found between dentists and dentistry students in levels of awareness (54.4% and 55.1%, respectively, P=0.862). Attending retraining courses of oral pathology showed significant positive correlation with the level of awareness (P=0.017, r=0.219).Conclusion: The knowledge of dentists and dental students on transport and processing of oral biopsies was poor, therefore, retraining programs are needed to enhance this knowledge.

Background and purpose: Estimation of the risks of radiation would be possible by identifying the dose received. Introducing the dose level from diagnostic procedures can be effective in reducing the patient dose, improving the quality of treatment, and increasing the safety of patients and staff. This study evaluated patient entrance surface dose (ESD), effective dose, and cumulative dose from most common radiography procedures.Materials and methods: A descriptive study was conducted in which patient dose level from most common radiography procedures in two referral hospitals (Imam Khomeini and Bu-Ali Sina, Sari, Iran) were evaluated in 2015. X-ray tube output was measured in 1m from the tube focal spot in several kVp. ESD (mGy) value in every procedure was calculated while considering its radiographic conditions (kV, mAs and FFD). The effective dose (ED) (mSv) per examination was also calculated from appropriate ED/ESD conversion factor and the cumulative dose (man-sivert) of annual number of examinations was calculated.Results: The mean effective dose from all radiographic procedures in Imam Khomeini and Bu-ali hospitals were 0.3 mSv and 0.28 mSv, respectively. Lumbar spine radiography had the most ED in both hospitals. Compared with national threshold level, the mean values for ESD (mGy) from all radiographic procedures in both hospitals were higher. The highest cumulative doses (man-sivert) in Imam Khomeini and Bu-ali hospitals were associated with lumbar spine (AP) and chest radiography, respectively.Conclusion: Standardization of chest radiography in Bu-ali and lumbar spine in Imam Khomeini hospitals could reduce radiation dose to the patient. Radiographic procedures that include higher cumulative dose and lower frequency require more attention by medical authorities and healthcare staff for radiation dose reduction strategies.

Background and purpose: In many countries, measurements are taken to support cancer patients. In Iran the high costs of cancers and increasing incidence of cancer have made health system authorities to plan for this issue as a top priority of healthcare reform program. The aim of this study was to evaluate the performance of this program in cancer patients in Sari Imam Khomeini teaching hospital, Iran.Materials and methods: An analytical study was performed in which the costs of leukemia patients admitted in Sari Imam Khomeini Hospital (in two six-month periods, April-October 2013 and 2014) were obtained using their medical and billing records. Data analysis was done in SPSS V.21 applying t-test.Results: Percentage of direct patient costs were 17.12% and 3.02% in 2013 and 2014, respectively.The portion of the medicine fee paid by patients reduced to 7.7% in 2014 (after implementing the healthcare reform program) from 16.8% in 2013.Conclusion: Implementation of healthcare reform program has dramatically reduced the direct patient costs in 2014. Also, the fee paid by patients for medicine has reduced by 9% following the program. Therefore, adopting new policies that could reduce the costs of medications can be of great benefit in reducing financial barriers to patients.

Background and purpose: Personality disorders may lead to addiction and viral diseases. On the other hand, addiction and viral infections also cause mental and personality disorders. This research aimed at comparing personality disorders and clinical symptoms between male prisoners.Materials and methods: A cross–sectional study was conducted in male prisoners in Quchan, Iran, 2014. Three groups (healthy, addict, and viral infection) including 200 prisoners were selected using systematic sampling. Millon Clinical Multiaxial Inventory (MCMI-III) was administered. The multivariate analysis (MANOVA) was applied in SPSS V.11.5.Results: There was significant differences between the three groups in schizoid, dependent, histrionic, narcissistic, antisocial, sadistic, and masochistic personality disorders (P<0.001). Significant differences were found between patients and addicts, and healthy prisoners in avoidance, OCD, passiveaggressive, schizotypal and borderline disorders (P<0.001), but this difference were not significant between patients and addicts (P>0.001). In paranoid scale, there was a significant difference between addicts and healthy prisoners (P<0.001), but the difference between other groups was not significant (P>0.001).Conclusion: Mental disorders were found to be more prevalent in addict prisoners and those with viral infections, therefore, effective psychological interventions are highly recommended for prisoners.

Background and purpose: ExjadeÒ is developed by Novartis pharmaceutical company and contains the active substance deferasirox, an orally active iron chelator for treatment of chronic iron overload following blood transfusions such as beta thalassemia. The aim of this study was to compare the physicochemical characteristics of branded generic product of deferasirox, OsveralÒ, produced by Osveh pharmaceutical company (in Iran) with the original brand.Materials and methods: Three doses (125, 250 and 500 mg) of deferasirox reference tablets (ExjadeÒ) were compared with the same doses of OsveralÒ. Three batches of each product were randomly selected and physicochemical evaluations including appearance, disintegration time, hardness, assay, in vitro drug release and content uniformity were determined. Also, the similarity factor was calculated based on ICH (International Conference Harmonization) and Food and Drug Administration (FDA) guidelines. The drug entrapped in the tablets was determined by HPLC. The dissolution rates were measured in solution media (phosphate buffered and sodium Lauryl sulfate at 37oC) within 30 min by USP apparatus II (Paddle) at 50 RPM speed after 5, 10, 20 and 30 min intervals.Results: The results indicated that physicochemical properties of OsveralÒ were similar to those of ExjadeÒ. Disintegration time for both products was less than 1 min and drug assay was between 90 – 110%. In addition, the similarity factor was more than 50% for all doses.Conclusion: OsveralÒ is a reliable branded generic formulation of deferasirox for treatment of chronic iron overload states.

Background and purpose: This study aimed at investigating the relationship between eating disorders with perfectionism and cognitive distortions in female students.Materials and methods: The study population included 6289 female students in Sari Islamic Azad University. We performed a descriptive correlational study in 500 female students who were selected by random cluster sampling. The research instrument included the Eating Habits Questionnaire (EHQ; Coker and Roger 1990), Positive and Negative Perfectionism Scale (PANPS; Terry-Short et al., 1995) and Albert Ellis`s Cognitive distortions questionnaire. Data analysis was done applying descriptive statistics methods, Pearson's correlation and multivariate regression test in SPSS ver.17.Results: The results showed no significant relationship between concerns about weight and anorexia nervosa with perfectionism (r=-0.005, r=0.05, p>0.05). There was a positive relationship between bulimia nervosa and perfectionism (P<0.01, r=0.203). There was a positive relationship between worries about weight, anorexia nervosa and anorexia nervosa with cognitive distortions (r =0.268, r=0.505, r=0.224, respectively, P<0.01). There was a positive relationship between negative perfectionism and eating disorders (r=0.303, P<0.01), and a negative relationship between positive perfectionism and eating disorders (r=-0.10, P<0.05). Perfectionism and cognitive distortions were able to predict eating disorders (β=0.483, b=0.075, respectively, P<0.01).Conclusion: Eating disorders are directly associated with individual’s thoughts and cognition, therefore, cognitive therapy could be of great use in treating these patients.

Background and purpose: Pancytopenia, is a great group of hematological diseases. Determining the etiology and pathology of the disease is of paramount importance for timely and proper treatment.This study aimed at investigating the clinical and hematological findings in patients with pancytopenia.Materials and methods: We conducted a cross-sectional study in which relevant information was extracted from 126 records of patients with pancytopenia in Ramsar Imam Sajjad Hospital and Sari Imam Khomeini Hospital in Mazandaran province, Iran (2009-2014). Data was analyzed in SPSS V.21.Results: The patients were 56 females and 70 males. The study population included 60 patients in the center and 66 in the west of Mazandaran province. Preliminary clinical findings showed lymphadenopathy in 42 patients (33.3%), splenomegaly in 34 (26.9%), and hepatomegaly in 15 patients (11.9%) and there were 35 cases (27.7%) with no clinical findings. The causes of pancytopenia according to biopsy and aspiration results were megaloblastic anemia in 34 patients (27%), HL in 29 (23%), aplastic anemia in 15 (11.9%), NHL in 14 (11.1%), MDS in 13 (10.3%), normal biopsy in 10 (7.9%), Erythroid hyperplasia in 9 (7.1 %), and Hairy cell leukemia in 2 patients (1.6%).Conclusion: The most common causes of pancytopenia in this study were lymphoma and megaloblastic anemia. Therefore, complete examination of patients with blood abnormalities is required for early treatment and reducing the mortality and morbidity rates.

Background and purpose: Oral health during pregnancy is effective on fetal and maternal health. Dental treatments in this period should have no side effects on the fetus and mother. The aim of this study was to evaluate the knowledge and practice of general dentists about dental management during pregnancy in Sari, Iran.Materials and methods: This study was conducted in 114 dentists in Sari, 2015. The participants completed a questionnaire consisting of twenty questions (14 questions about knowledge and 6 questions about practice) for dental procedures during pregnancy. SPSS V.16 was applied to analyze the data.Results: The final mean score of dentists was 51.84%. The mean final score had a significant correlation with age, gender, and working experience (P<0.05). The rate of awareness was higher in women compared with men, also the rate of awareness decreased with aging and increase in working years.Conclusion: In this study, the knowledge about dental managements decreased in older dentists and those with more working experiences. Therefore, training programs are necessary to enhance the knowledge of this group of dentists.

Background and purpose: The office of disaster management and emergency medical service is one of the most important subdivisions of the Ministry of health. Analyzing the tasks and functions of this office is critical to its evaluation. This study aimed at analyzing the information needs of this office to develop statistical indicators required.Materials and methods: This qualitative-quantitative study was carried out during 2015. The study population included the managers and expert panels in disaster management and emergency medical service in the Ministry of Health and Medical Education of Iran. We interviewed 14 individuals in different departments within the office and reviewed the administrative tasks and the available documents. After analyzing the data, different information needs of all departments were identified and classified.Results: According to the administrative tasks and practices, 69 groups of information needs were identified of which 17.4% are not met.45.3% of the information needs did not have any standard sources or forms to collect the data required.Conclusion: Lack of standard sources for the most identified information needs, decentralized information systems, and out-of-date information are the major problems of managers and expert panels.So, designing national standard forms to collect data, designing a comprehensive statistics and information system and reviewing current paper forms and databases seem to be essential.

Gordon syndrome is a familial autosomal dominant syndrome with hyperkalemia, increased extracellular volume, hypertension, normal kidney function, and metabolic acidosis. It is also called type II Pseudohypoaldosteronism due to usually normal aldosterone and low renin levels. In this report a 35 years old woman is presented with 2-year history of hypertension, eclampsia, and fetal death. Laboratory tests showed hyperkalemia and metabolic acidosis. After evaluation, thiazide was administrated according to Gordon syndrome diagnosis. Interestingly, after reciving low dose of hydrochlorothiazide the patient had a successful full term pregnancy and a healthy baby. In patients with high blood pressure and hyperkalemia and Gordon syndrome can control blood pressure and hyperkalemia well with low dose thiazide and have healthy pregnancy without materno - fetal complication.

Pemphigus vulgaris is an autoimmune and rare mucocutaneous disease with outbreak of 1 to 5 patients per 1 million people. The average age at onset of disease is usually 50 years. In this study four young females (mean age: 27.75 years) with pemphigus vulgaris are presented.The first patient was a 28-year-old female complaining from various oral sores. She was diagnosed with pemphigus vulgaris based on biopsy. After treatment for 12 months, no sores were seen in other parts of her body. The second case was a 23-year-old woman with facial desquamation of upper and lower jaws. In pathology of oral lesions the diagnosis of pemphigus vulgaris was made and within 11 months follow-up after treatment, only the oral sores improved. The next patient was 30 years of age who had desquamated gingivitis and exclusive oral sores. She was also diagnosed with the same disease. After 12 months follow-up, oral lesions were controlled and no sores were seen in other parts of the body. The last case was a 36-year-old female with severe sores in the mouth associated with pemphigus vulgaris.But within 11 months of follow-up, despite treatments, the disease developed and large sores and blisters were seen throughout her body.Pemphigus vulgaris is a serious disease that can lead to death if left untreated. The oral lesions are the first symptoms of this disease, but the clinical appearance of these lesions are not sores, therefore, biopsy and early diagnoses are required to prevent further complications.

Magnetic nanomaterials are making significant impact on improving the quality of human health that is tangible from a wide range of applications in various fields of medicine and biology. In recent years, nanoparticles successfully demonstrated outstanding applications due to having excellent magnetic properties of the iron oxide nanoparticles-based counterparts. Zero-valent iron nanoparticles toxicity is less than the toxicity of other nanoparticles. These nanoparticles are considerably potential for functionalization due to their highly reactive surfaces and this feature can facilitate targeted functionalization. This is very promising for various applications in different fields. Use of polymers as a protective agent is increasing sharply. Polymer magnetic field of zero-valent metal nanoparticles is still in its early stages. In this study, the syntheses of zero-valent iron nanoparticles are presented in different ways. Nanoparticles can be identified and evaluated through their size, shape, morphology, syntax, and various laboratory methods. In this context, magnetic nanoparticles can be potentially used in hyperthermia, magnetic resonance imaging (MRI), diagnosis and treatment of tumor diseases or cancer, labeling, biological separation, biotechnology, and eliminating major organic, inorganic and radioactive pollutants because of their high biocompatibility. With respect to the importance and the need to draw the attention of researchers to zero-valent iron magnetic nanoparticles, a brief description of various methods of synthesis, characterization, and their application in medicine and biology are reviewed.