JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2020 | Volume:30 | Issue:185|Papers Count:20

Background and purpose: Cisplatin is used in chemotherapy for cancer patients. But, it has adverse effects on some organs, including the kidney and liver. P-coumaric acid is a polyphenolic substance with multiple biological properties. The present study aimed to investigate the effect of p-coumaric acid on renal and hepatic side effects of cisplatin. Materials and methods: This experimental study was performed in 21 male rats that were randomly divided into three groups. In the sham group, 20% ethanol was gavaged for 7 days. The experimental group I received 20% ethanol for 7 days + a single dose of cisplatin (8 mg/kg) at day 5. The experimental group II received cisplatin (8 mg/kg at day 5) + p-coumaric acid (100 mg/kg/day) for 7 days. The functional disturbances of kidney and liver were assessed by measuring the blood levels of creatinine, urea-nitrogen, AST, ALT, and ALP. Also, measuring MDA and FRAP levels in kidney and liver tissues were used to assess oxidative stress. The tissue damages were also assessed by studying H&E stained slides. Results: Cisplatin administration increased the concentrations of creatinine, urea-nitrogen, AST, ALT, ALP, MDA, tissue damages, and decreased FRAP. Application of p-coumaric acid led to complete or relative improvements in functional parameters of kidney and liver, and reduced tissue damages and MDA level. The FRAP level was found to increase by the p-coumaric acid. Conclusion: P-coumaric acid demonstrated a protective effect against the side effects of cisplatin in the kidneys and liver.

Background and purpose: Artificial sweeteners are increasingly used in food products, so, it is necessary to study the effects of these additives on liver. Materials and methods: In this experimental study, 30 immature male rats were divided into five groups (n=6 per group) and acesulfame k at 50, 100, 200, and 400 mg/kg were injected intraperitoneally to all groups for 30 days. One and 30 days after the last injection, blood samples were taken from the rats' eye, and the levels of FBS, HDL, LDL, AST, ALT, ALP, triglyceride, and cholesterol were measured. A number of rats were dissected in each group and their livers were removed to prepare tissue sections. The slides were examined by optical microscopy and data were analyzed applying ANOVA. Results: The study showed that acesulfame k for 30 days, at 200 and 400mg/kg caused a significant increase in glucose level (P<0. 05) and at 100, 200, and 400mg/kg significantly decreased LDL levels (P<0. 001). Also, tissue disorders such as congestion, sinusoid abnormalities, and hepatocytes lysis were observed in liver samples in a dose-dependent manner. However, no significant changes were seen in other factors. Conclusion: It seems that acesulfame k even at doses greater than 50 mg/kg for 30 days does not cause serious toxicity to immature male rats, due to the lack of changes in most liver factors, and liver tissue disorders may be restored over time.

Background and purpose: Rotational use of antibiotics can decrease antibiotic resistance in Staphylococcus aureus strains. The present study aimed to evaluate the alteration of oxacillin resistance in methicillin-resistant Staphylococcus aureus (MRSA) strain carrying SCCmec III cassette in long-term evolutionary experiments in an antibiotic-free medium. Materials and methods: In a cross-sectional study, 10 MRSA isolates were identified between September to December 2018 by conventional microbiology methods from clinical isolates of a university hospital. Then, SCCmec typing was carried out using Multiplex PCR. One strain was included in the evolutionary experiment as ancestor and was cultivated for up to 900 generations. Minimum inhibitory concentration (MIC) of oxacillin of the evolved strains was evaluated. The selected strains were compared with the ancestral strain in terms of growth characteristics such as generation time and competitive cultivation. Results: Out of ten MRSA isolates, six and four were found to harbor SCCmec type III and SCCmec type IV, respectively. One strain with SCCmec III was randomly selected as ancestral strain. The ancestor was resistant to oxacillin while the evolved strains were susceptible. Generation times in the evolved strains were 6-8 minutes shorter than those in the ancestral strain. The evolved strains, with the ratio of 1% in competition experiment, accounted for 20-48% of the final population. Conclusion: Compared to the ancestor, the evolved strains presented higher fitness in the oxacillin-free environment. The current study indicates the powerful effect of antibiotic rotation strategy on reducing methicillin resistant MRSA.

Background and purpose: Decrease in the number of oral microorganisms leads to reduction in caries score. Bacterial therapy, such as using probiotic bacteria, is an alternative procedure in treatment of infections caused by microorganisms. The purpose of this study was to compare the effect of probiotic and non-probiotic yogurt-drink on two common oral microorganisms. Materials and methods: In this experimental study, the minimum inhibitory concentration (MIC) of yogurt drinks and diameter of the growth inhibition zone of Streptococcus mutans and Enterococcus faecalis in probiotic and non-probiotic yogurt drinks were measured using micro broth dilution and disk agar diffusion methods, respectively. Data analysis was done in SPSS V22 applying Mann-Whitney test. Results: The MIC of non-probiotic yogurt drink against Enterococcus faecalis and Streptococcus mutans was significantly higher than the probiotic yogurt drink (P= 0. 002). The two yogurt drinks did not show any significant differences in the diameter of growth inhibition zone for S. mutans (P= 0. 061) and E. faecalis (P= 0. 99). Conclusion: The study showed that probiotic yogurt drink can inhibit E. faecalis and S. mutans more than the non-probiotic yogurt drink, and it may be considered as a preventive agent for oral and dental diseases.

Background and purpose: Opioid analgesics cause bradycardia and respiratory depression. The aim of this study was to investigate the efficacy of diclofenac suppository on pain and dose reduction of injectable fentanyl in patients undergoing colonoscopy. Materials and methods: In a clinical trial, 500 patients undergoing colonoscopy were randomly divided into two groups to receive either diclofenac or glycerin (placebo) administered 30 min before colonoscopy. Five minutes before colonoscopy, fentanyl (50 μ g/iv) was administered, and then, if pain persisted during colonoscopy, fentanyl 50 μ g was administered as a rescue. Baseline demographic and clinical data and other information, including cecal arrival time, patients’ and gastroenterologist’ s satisfaction, pain intensity based on visual analogue scale (VAS), rescue dose of fentanyl, frequency of hypotension and apnea were compared between the two groups. Results: The groups were similar in age, sex, and baseline clinical parameters (P> 0. 05). Cecal arrival time was shorter in the group that received diclofenac (10. 59± 3. 8 min) than the placebo group (12. 41± 2. 5 min) (P= 0. 035). Mean pain score was found to be lower in diclofenac group (3. 2± 54. 2) than the placebo group (5. 10± 2. 8) (P <0. 0001). Frequency of fentanyl administration in diclofenac group (6%) was lower than that in placebo group (24. 8%) (P <0. 0001). Frequency of hypotension and apnea events were observed to be lower in the group that received diclofenac (P< 0. 05). Conclusion: In this study, diclofenac suppository had positive effects on reducing the pain intensity, the dose of fentanyl, and side effects, therefore, it is recommended in colonoscopy analgesia protocols.

Background and purpose: Beta thalassemia major is one of the most common inherited blood diseases and patients with this condition require regular blood transfusions. The resulting iron overload deposition causes endocrine gland disorders, including growth hormone (GH) abnormality. In this study, we examined the effects of recombinant growth hormone (rGH) in these patients. Materials and methods: This retrospective study was performed in thalassemia major patients in Amirkola Thalassemia Center, using the medical records (2011-2018), to evaluate the therapeutic effects of rGH on growth velocity of six short stature patients aged 7-15 years (four boys and two girls). On the basis of abnormal or normal response to GH provocation test, the patients were included in GH deficiency (GHD) group (n=3) and idiopathic short stature (ISS) group (n=3), respectively. The data were analyzed in SPSS-18. Results: The mean age of patients was 11. 00 ± 2. 75 years old. The mean values for growth velocity before and after the treatment were 4. 00± 0. 86 and 7. 83 ± 1. 25 cm/year in GHD group (P=0. 057) and 4. 06 ± 0. 81 and 6. 00 ± 1. 50 cm/year in ISS group, respectively (P=0. 023). Conclusion: In this study, the positive therapeutic effects of rGh in improvement of growth velocity were seen in thalassemia major patients (both GHD and ISS groups).

Background and purpose: Stroke is the most common and debilitating neurologic lesion in adults. Early family-centered stimulation have positive outcomes in stroke patients. The present study was designed to investigate the effect of early family-centered sensory stimulation on restoring function and recognition in stroke patients. Materials and methods: A clinical trial was done in 60 patients with impaired consciousness due to stroke (GCS=5-10) admitted in intensive care unit (ICU). The participants were assigned into control and experimental groups (n=30 per group) using randomized block design. The experimental group received sensory stimulations of the five senses in the first 48-72 hours after the stroke by family members for 14 days. The control group received ICU routine care. At days 5, 10, and 15, the consciousness level was assessed by GCS and FOUR and cognitive function was assessed by Disability Rating Scale. Results: Sensory stimulations significantly increased the mean score for cognitive function in the experimental group compared to the control group (P<0. 001). The effect sizes of cognitive function at days 5, 10 and 15 were 0. 45, 0. 95, and 1. 09, respectively. The effect sizes were small at day 5 and large at days 10 and 15. No significant differences were observed in the level of consciousness (P=0. 601) and function (P=0. 710). Conclusion: In current study, early family-centered sensory stimulation in patients with impaired consciousness due to stroke improved their cognitive function but did not significantly influence their disability score.

Background and purpose: One of the new areas of research in emotion regulation is interpersonal emotion regulation. This concept refers to individual’ s willingness to share emotional states with others to reduce own negative emotions. This study was conducted to investigate the psychometric properties of Interpersonal Emotion Regulation Questionnaire (IERQ) in students. Materials and methods: A methodological study was carried out and the research population included all student studying in Tehran state universities. A total of 602 students were selected using multistage cluster sampling. Interpersonal Emotion Regulation Questionnaire (IERQ), Emotion Regulation Questionnaire (ERQ), Emotion Regulation Skills (ERSQ), Emotion Regulation of Others and Self (EROS), SCL-25 scale, and Difficulties in Emotion Regulation Scale Short Form (DER-SF) were administered. Eighty-five cases were excluded from the study and statistical analysis was performed for 517 individuals. Results: The findings showed satisfactory results for the psychometric properties of the IERQ. Exploratory and confirmatory factor analysis confirmed the 3-factor model for this questionnaire. Cronbach's alpha coefficient was 0. 90 for the whole questionnaire and 0. 84, 0. 82, 0. 80 and 0. 81 for items of enhancing positive affect, soothing, social modeling, and perspective, respectively. Conclusion: Interpersonal Emotion Regulation Questionnaire has good psychometric properties and adaptation in Persian. Therefore, it can be used in future researches on emotion regulation.

Background and purpose: Ethical intelligence is highly important in improving interpersonal relationships, especially in medical and nursing staff. The purpose of this study was to determine the relationship between ethical intelligence and professional behavior in nurses working in educational hospitals affiliated to Mazandaran University of Medical Sciences. Materials and methods: In this descriptive correlational study 260 nurses working in educational hospitals of Mazandaran Medical Sciences University in 2018, were selected through stratified random sampling method. Data were collected using demographic questionnaire, modified Nursing Students Professional Behaviors Scale (NSPBS), and Lennick and Kiel's Ethical Intelligence Questionnaire (2005) In order to analyze the data, descriptive and inferential statistics were applied in SPSS V18. Results: The mean scores for professional behavior and moral intelligence were 113. 33 ± 13. 66 and 151. 56± 20. 86, respectively. Spearman correlation coefficient showed a significant positive correlation between moral intelligence and professional behavior (r= 0. 523, P= 0. 001). Conclusion: This study showed that high moral intelligence leads to better professional behavior in nurses. Therefore, it seems that professional behavior of nursing staff could be predicted according to their ethical intelligence. Moreover, enhancing the knowledge of nurses about ethical intelligence, improves ethical aspects in patient care and increases patient satisfaction in health care settings.

Background and purpose: Adverse drug reaction (ADR) is one of the major causes of mortality and morbidity in patients that results in high healthcare costs. This study was conducted in Food and Drug Deputy at Mazandaran University to evaluate ADRs in Mazandaran province. Materials and methods: The analysis was performed during 2004-2018, based on the frequency of the drugs that had side effects, routes of administration, the number of reports per year, patient characteristics (gender, age), the frequency of the organ damaged, and the reporter. Results: A total of 4425 reports of ADRs were submitted to Adverse Drug Reactions Center in Food and Drug Department, Mazandaran province, Iran. More than half of the reports (61%) were reported by nurses and 58. 4% of the ADRs occurred in women. Injectable drugs were found with more adverse effects (75. 7%) and the most prevalent were skin and hair disorders (50. 6%). Anti-infective agents were the top drugs that caused ADRs (52. 2%) and ceftriaxone was the most prevalent. Conclusion: Due to the low number of ADRs in Mazandaran province and its low concordance with international standards, it seems that trainings based on the needs and preferences of medical groups about pharmacovigilance and focuses on how to report, can increase their awareness and knowledge about ADR and bring the data closer to world standards.

Background and purpose: The purpose of mechanical cleaning of the root canal is to clean the canal walls, create a conical shape to facilitate access, effective washing, and filling all areas of the root canal. Errors such as root canal transportation are cuased by excessive dentin removal from the canal. The objective of this study was to investigate root canal transportation by a BT Race rotary and manual file with Cone Beam Computed Tomography (CBCT). Materials and methods: An Ex-vivo study was conducted in 54 extracted first molars. Root curvature was measured by Schneider's method. Preparation was performed in two groups (n= 27 per group) with manual and rotary files. CBCT images were prepared pre and post instrumentation of the canals. SPSS 18 Software was used to measure the amount of canal transportation. Results: The mean differences of canal transportation between the two groups were 0. 24 ± 0. 16, 0. 19 ± 0. 13mm, and 0. 17± 0. 12mm at T1 (1 mm from apical foramen), T2 (2 mm from apical foramen), and T3 (3 mm from the apical foramen), respectively. The total deviation was 0. 022mm in this study. The rotary and manual files at T1 (P=0. 51) and T3 (P=0. 57) were not significantly different in causing transportation but T2 was found to cause significant canal transportation (P=0. 027). Conclusion: The average canal transportation in 2mm canal from the apical foramen by manual files was lesser than the rotary files. BT race and K-flexo file instruments can preserve the curvature of the root canals. Therefore, both systems can be used in clinical settings with minimal apical transportation.

Background and purpose: Nowadays, the side effects of chemical drugs such as dexamethasone, as a steroidal anti-inflammatory factor, is considered on reducing male reproductive potential. The aim of this study was to evaluate the effect of pentoxifylline on sperm parameters and biochemical factors in mice treated with dexamethasone. Materials and methods: In this study, 24 adult male NMRI mice (35± 2gr) were randomly divided into four groups (n=6 per group): control, dexamethasone (7mg/kg/day), pentoxifylline (200mg/kg/day), and dexamethasone + pentoxifylline. After 7 days of intraperitoneal treatments, sperm parameters and oxidative stress factors were measured. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey’ s test. Results: Compared to the control group, sperm count, progressive motility percentage, viability, sperm tail length (STL), daily sperm production (DSP), and total antioxidant capacity (TAC) significantly decreased in dexamethasone group (P<0. 001), while plasma MDA level showed significant increase (P<0. 001). These parameters did not show significant differences between the control group and the group that received dexamethasone + pentoxifylline (P> 0. 05). Assessment of DNA integrity showed that dexamethasone had no effect on denaturation of the sperm DNA double-stranded structure. Conclusion: According to this study, pentoxifylline could prevent the adverse effects of dexamethasone on sperm parameters, biochemical factors, and daily sperm production by reducing oxidative stress.

Background and purpose: Carpal tunnel syndrome is the most prevalent neuropathy caused by trapping and median nerve compression in the wrist. This study aimed at comparing the effects of minimal incision and double incision in treatment of patients with carpal tunnel syndrome. Materials and methods: This randomized controlled trial was performed in 50 patients with carpal tunnel syndrome attending Shahid Beheshti and Ayatollah Rouhani hospitals in Babol, Iran, candidates for surgery. The patients were divided into two groups using random number table to have either minimal incision (n=25) or double incision (n=25). All patients completed the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and Visual Analogue Scale (VAS) before and three months after the surgery. Results: The patients included 40 (80%) males and 10 (20%) females. The mean age of the patients was 51. 78± 8. 22 years old. The mean scores for paresthesia, numbness, pain, weakness, nighttime symptoms and functional status (according to BCTQ), and also mean VAS score significantly reduced after the intervention in both groups (P<0. 001). The mean scores for these parameters were not significantly different between the two groups neither before nor after the treatment. Conclusion: The results of treatment with minimal incision and double incision were not different, but minimal incision is suggested as a selective therapeutic approach due to smaller cut.

Background and purpose: Association between vitamin D and anterior cruciate ligament injury (ACLI) in male athletes is poorly understood, and current data are not sufficient and consistent. The present study investigated the association between vitamin D and ACLI in some Iranian male athletes. Materials and methods: This cross-sectional study was carried out in 100 male athletes with knee pain attending Sari Imam Khomeini Hospital, Iran 2016. They were evaluated into two groups: male athletes with ACL injury (AI group; n=50) and without ACL injury (WAI group; n=50). ACL injury was verified according to physical examination and MRI findings. Data, including the age, serum 25 (OH) D concentrations, body mass index (BMI), and previous history of exercise were recorded and analyzed in SPSS V20. Results: The mean age of participants and their serum 25 (OH) D levels were 28± 6 years and 25. 07± 1. 02 ng/dl, respectively. There were no significant differences between the two groups in mean age, BMI, and previous history of exercise (P> 0. 05). The mean serum 25 (OH) D levels were found to be significantly lower in AI group than those in WAI group (P< 0. 001). Conclusion: The current study showed that lower serum concentrations of 25 (OH) D are associated with the risk of ACLI in male athletes.

Background and purpose: Diabetes Mellitus is one of the most common endocrine diseases. The prevalence of type 2 diabetes is higher than other types, accounting for 85-90% of all diabetic cases. The current research aimed at investigating the association between rs4541843 in miR-182 and type 2 diabetes. Materials and methods: In this case-control study, healthy individuals (n=196) and type 2 diabetic patients (n=199) were randomly selected from a target population in Isfahan, Iran. The genotypes for the polymorphism were determined by PCR-RFLP method and the results were confirmed by sequencing. Then, the frequency of the genotypes and alleles were analyzed to determine the association between rs4541843 in miR-182 and the risk of type 2 diabetes, sex, and age at disease onset. Results: The study showed no significant difference between different genotypes in healthy individuals and diabetic patients (P<0. 05). Also, no significant association was found between different genotypes of this polymorphism and risk of diabetes considering GG genotype as the reference genotype (P< 0. 05). Conclusion: Due to the lack of association between the rs4541843 in miR-182 and risk of diabetes in this population, this polymorphism cannot be used to screen diabetic patients in the target population. Further studies are needed to evaluate the importance of this polymorphism in different populations.

Background and purpose: Oral chronic lesions (OCLs) are challenging inflammatory diseases. Clobetasol is the most effective corticosteroid in treatment of OCLs. Clinical studies showed positive effects of aloe vera gel in improving the signs of inflammation and ulcer in OCLs. The aim of the present study was to design a mouthwash containing aloe vera gel and clobetasol and evaluating its stability and antifungal efficacy. Materials and methods: Aloe vera gel was standardized and clobetasol was analyzed using a validated HPLC method. They were then mixed with suitable excipients to formulate a mouthwash. At days one and 45 after preparation, the pH, clearness, clobetasol assay, and microbial control (preservative test and limit test) of the mouthwash were tested. The efficacy of the optimized mouthwash on Candida albicans was tested and compared with two natural and chemical commercial mouthwashes. Results: Aloe vera gel 100ml contained 36 mg glucomannan. Quality control test confirmed physical, chemical and microbial stability of the mouthwashes after 45 days. The optimized mouthwash showed considerable effects on Candida albicans even at 1: 10 and 1: 100 dilutions. Conclusion: Considering anti-inflammatory effects of aloe vera gel, it seems that the optimized mouthwash, in addition to having wound healing effects, may prevent candidiasis induced by Candida albicans in patients with OCLs.

Background and purpose: Microbial fuel cell is one of the sustainable development technologies that can be used simultaneously for removal of many pollutants and generate electricity. The aim of this study was to determine the removal rate of high concentrations of phenol in a microbial fuel cell. Materials and methods: A dual chamber microbial fuel cell having Nafion proton exchange membrane and carbon cloth as anode and cathode was fabricated and operated in batch mode in incubator at 30° C for 12 weeks. Anode was put in anaerobic chamber containing minimum growth medium and phenol (50-1000ppm) was added as the sole carbon source. Phenol degrading bacterial seed that was supplied by wastewater treatment plant of Tehran Petroleum Refinery was adapted to phenol and used in anaerobic anode chamber. Cathode was put in aerobic chamber containing phosphate buffer. Concentration of remained phenol in different times was analyzed by HPLC method. Results: Maximum amount of phenol degradation occurred in the first 24h of each run. Phenol concentrations up to 800 ppm were completely removed during 96 h, but time to complete removal of 1000 ppm phenol was 120h. Conclusion: By using sludge from wastewater treatment plant of oil refinery adapted to phenol in a microbial fuel cell, it is possible to remove 1000 ppm phenol.

The production and consumption of genetically modified (GM) products are highly controversial due to their environmental, health, and ethical impacts. Most of these disputes are caused by distrust of regulatory authorities, scientists, and technocratic decisions. Among all these concerns, health issues, allergenicity and antibiotic resistance are more important. Many of today's social development problems, including public health, energy, water scarcity, and economic problems are associated with the nutrition system. So, this article provides useful solutions for appropriate utilization of GM products at present and future and aims to improve the people's attitudes towards the impacts of biotechnology on food and agriculture. The current study was carried out in electronic databases, including Google Scholar, Pubmed, Scopus, Science direct, SID and Civilica using the following keywords: Genetically modified plants, GMOs safety, and Health risks. Information about biotechnology, transgenic products, technical methods for the assessment of these products, the organizations involved, and the benefits and disadvantages of GM products were recorded. Safe use of GM products could be achieved by approving specific rules in biotechnology, while respecting the safety principles, continuous evaluation and dissemination of information, and upgrading the public knowledge about these products.

There is a high prevalence of infections caused by Leishmania parasites and increasing rate of drug resistance. Lack of successful treatment with existing drugs calls for new therapeutic approaches. The main strategy in treatment of leishmaniasis is creating apoptosis and eliminating different forms of the parasite. So far, numerous drugs with specific mechanisms including 14-α-demethylase enzyme inhibition, inhibition of tubulin polymerization and cell division, radical formation, inhibiting the glycolytic and hydrolysis of fatty acids, and reducing the parasite's access to energy reserves such as ATP have been introduced. Moreover, different mineral compounds especially iron are needed for metabolism and survival of the parasite. This review article introduces iron-chelating compounds as a new therapeutic approach in treatment of leishmaniasis.

In the recent decade, liver diseases with high mortality rate have became one of the major health problems worldwide. Liver transplantation is the most effective and the standard treatment for decompensated liver disease, but, shortage of available organs and inaccuracy in modeling of the liver diseases are the most limiting issues in treatment. Regenerative medicine and cell based therapy strategies have provided promising results through cooperating in natural liver regeneration ability or providing liver function support as a bridge before transplantation. Induction of differentiation in different types of stem cells such as embryonic, induced pluripotent stem cells, mesenchymal and hematopoietic stem cells are the most common methods that provide a functional population of hepatocytes to be used in diseases like cirrhosis, cancer and all types of fatty liver diseases, and significantly restore the normal levels of hepatic factors. In addition, mesenchymal and hematopoietic stem cells improve the symptoms of autoimmune diseases by modulatation of immune responces and reduction of inflammation. Other cell treatment strategies are isolating the patient's own hepatocytes in the lab, in vito correction of defected genes and transplanting them back to the patient that can improve the symptoms of genetic disorders. In this study, we first reviewed the basic concepts related to liver diseases, then highlighted the most recent advances in cellbased therapies and regenerative medicine for the treatment of liver disease, along with tissue engineering and bio-artificial liver devices.