JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2016 | Volume:18 | Issue:4|Papers Count:11

BACKGROUND AND OBJECTIVE: Epilepsy is one of the most common neurologic disorders that presents in a large number of drug-resistant patients. Given the presence of the anticonvulsant compounds in Cannabis and its use in traditional medicine, this study aims to evaluate the effect of Cannabis sativa extract on the treatment of seizures.METHODS: In this experimental study, 40 Syrian male rats were selected and randomly divided into five groups, including one control, one sham, and three experimental groups. The control group only received pentylentetrazol (PTZ), the sham group was administered distilled water, and the experimental groups were gavaged with 400, 600, and 800 mg/kg of body weight of the aqueous extract of Cannabis sativa for four weeks. Moreover, 45 mg/kg of PTZ was intraperitoneally administered 30 minutes later in the experimental and sham groups. Finally, the convulsive behaviors and the relevant parameters were recorded using a camera inside a specific cage for 25 minutes.FINDINGS: Aqueous extract of Cannabis sativa increased the delay of seizure onset at the dose of 800 mg/kg compared to the control group (232.87±33.76 sec vs.103.84±7.50 sec; p<0.05) and inhibited the progression of epilepsy phases equally at each three doses compared to the control group (1.91±0.5 vs.5±0; p<0.00).CONCLUSION: The results showed that cannabis extract had the maximum anticonvulsant effect on PTZ-induced seizures at the dose of 800 mg.kg of body weight. Therefore, the anticonvulsant properties of aqueous extract of cannabis are dose-dependent.

BACKGROUND AND OBJECTIVE: Medical treatment of tooth decay is associated with the possibility of allergic reactions and increased bacterial resistance to antibiotics. This study aimed to evaluate the phenolic compounds and antimicrobial effects of the hydroalcoholic extracts of Aloe vera and Glycyrrhiza glabra against four cariogenic bacteria in vitro.METHODS: In this empirical study, hydroalcoholic extracts of Aloe vera and Glycyrrhiza glabra were obtained using the percolation method. Then preparing standard strains of Streptococcus mutans, Streptococcus salivarius, Streptococcus sanguinis, Actinomyces viscosus. Antibacterial activity of extracts were determined by micro broth dilution method. Concentration of phenolic compounds, flavonols and flavonoid were determined using the optical density (OD) method.FINDINGS: In this study, total phenolic content and concentrations of flavonols and flavonoids were 3, 37 and 10 mg/g in the Aloe vera extract, respectively, while they were 36, 78 and 14 mg/g, respectively in the extract of Glycyrrhiza glabra. Regarding the frequency of cariogenic bacteria, MIC and MBC of the Glycyrrhiza glabra extract for Streptococcus mutans were 0.5 and 1 mg/ml, respectively, while they were 0.25 and 0.5 mg/ml for Streptococcus salivarius, 0.125 and 0.5 mg/ml for Streptococcus sanguinis, and 0.25 and 0.5 mg/ml for Actinomyces viscosus, respectively. Moreover, MIC and MBC of the Aloe vera extract were 4 and 16 mg/ml for Streptococcus mutans, 0.5 and 2 mg/ml for Streptococcus salivarius, 1 and 4 mg/ml for Streptococcus sanguinis, and 1 and 2 mg/ml for Actinomyces viscosus, respectively. MIC and MBC of Aloe Vera extract (4 and 16 mg/ml) was significantly higher than the Glycyrrhiza glabra extract (0.5 and 1 mg / ml) (p<0.05).CONCLUSION: According to the results of this study, the hydroalcoholic extract of Glycyrrhiza glabra exerted greater antibacterial effects against the studied bacteria compared to the Aloe vera extract due to the higher concentration of phenolic compounds. In addition, Streptococcus mutans showed higher resistance against the herbal extracts compared to the other bacteria.

BACKGROUND AND OBJECTIVE: Activity changes in the neurons of nucleus accumbens during stress have been previously identified. However, the role of nucleus accumbens in diminishing stress-induced side-effects is not fully understood. In this study, we aimed to evaluate the effects of temporary inactivation of nucleus accumbens on stress-induced metabolic changes in female mice.METHODS: This experimental study was performed on 48 female NMRI mice with an average 27±3 g. The nucleus accumbens was unilaterally and bilaterally cannulated. After one week of recovery, 2% lidocaine or saline was administered in mice for four consecutive days (5 min per day) before inducing electric shock to the sole of the foot. Plasma corticosterone level, food and water intake, and delay in eating were assessed as stress-induced metabolic parameters.FINDINGS: Stress lonely, caused an increase in plasma corticosterone (17±0.8) compared with the control group (4.5±0.3) (p<0.001). It also, caused an increase delay in eating (%218±9.8, p<0.01) and, decrease water (%80±4.5) and food (%84±5.5) intake (p<0.05). Temporary inactivation of nucleus accumbens did not affect the stress-induced changes in plasma corticosterone, and it suppressed the effect of stress on the amount of water intake; inactivation of the left nucleus accumbens was more effective (%195±7.6, p<0.01). Temporary inactivation of nucleus accumbens neutralized the effect of stress on the amount of food intake. Temporary inactivation of the right nucleus accumbens augmented the effect of stress on delay in eating (%264±10.8, p<0.01), and inactivation of the left nucleus accumbens could suppress this effect.CONCLUSION: It seems that temporary inactivation of nucleus accumbens can be effective in diminishing stress-induced metabolic changes. However, this influence is indicative of asymmetry in the function of right and left nucleus accumbens.

BACKGROUND AND OBJECTIVE: Vesicoureteral reflux (VUR) followed by urinary tract infection (UTI) is a major contributing factor to kidney failure, especially during early childhood. This study aimed to evaluate the possibility of spontaneous high-grade VUR resolution in infants aged less than one year.METHODS: This cross-sectional study was conducted at Amirkola Children’s Hospital of Babol, Iran on all the infants aged less than one year with high-grade VUR (III-V). Infants were followed-up in terms of at least one kidney per age, reflux grade, and kidney failure for two years. Evaluation of reflux resolution was performed using voiding cystourethrography (VCUG) and radionuclide cystography (RNC) each year. In addition, presence of kidney failure was assessed via dimercaptosuccinic acid (DMSA) scan within at least 4-6 months after the last UTI diagnosis. Data analysis was performed in SPSS V.22 using Chi-square and Kaplan-Meier survival analysis, and P value of less than 0.05 was considered statistically significant.FINDINGS: In total, 97 kidneys in 49 infants were evaluated (one infant had only one kidney). Among the studied patients, 29 infants (59.2%) were female, and mean age of the study population was 5.9±3.66 months. Out of 49 infants with VUR, complete recovery was observed in 33 cases (67.3%), while partial resolution (reduced grade of reflux) was reported in 13 cases (26.5%), and lack of resolution was observed in 3 cases (6.1%).CONCLUSION: According to the results of this study, spontaneous resolution of high-grade VUR could occur in a high percentage of infants aged less than one year. Therefore, it is recommended that early surgical operation be reconsidered for this patient population.

BACKGROUND AND OBJECTIVE: Clinical decision-making is fundamental for professional nurses, which establishes professional identity. Given the importance of clinical decision-making for perioperative nurses, this study aimed to investigate nurses’ experience and their clinical decision-making skill in operating theatre based on Benner's novice to expert model.METHODS: This cross-sectional study was performed in 186 perioperative nurses working in university hospitals in Tabriz, Iran, 2014. The data were collected using a demographic form and the Clinical Decision Making in Nursing Scale (CDMNS) (Jenkins, 1985), and then were analyzed. This tool includes 40 items and four sub-scales of 1) search for alternatives or options, 2) canvassing of objectives and values, 3) evaluation and reevaluation of consequences, and 4) search for information and unbiased assimilation of new information. The highest and lowest possible scores are 40 and 200, with higher scores showing higher clinical decision-making skill.FINDINGS: Mean of clinical decision-making total score was 102.3±15.3, with the highest mean (35.3±6.2) belonging to the second sub-scale (canvassing of objectives and values). There was a significant direct correlation between clinical decision-making and age (r=0.67, p<0.004) and working experience in operating room (r=0.77, p=0.7). However, there was no correlation between clinical decision-making and working experience in other departments (r=0, p=0.7).CONCLUSION: Our results demonstrated that as clinical experience of perioperative nurses increases, their decision-making skill improves. Thus, Benner's novice to expert model is confirmed.

BACKGROUND AND OBJECTIVES: Cytomegalovirus (CMV) infection is one of the most frequent infectious complications, which results in renal transplant failure. In this study, we aimed to evaluate the demographic characteristics and risk factors associated with the incidence period of CMV infection after renal transplant.METHODS: This cross-sectional study was conducted in renal transplant recipients during 2010-2015 in kidney transplant unit of Shahid Beheshti Hospital of Babol, Iran. The evaluated demographics included body mass index (BMI), smoking status, type of underlying disease leading to end-stage renal disease, hepatitis B, hepatitis C, and type of dialysis. Data analysis was performed using Kaplan-Meier estimator, log-rank test, and Cox regression.FINDINGS: In total, 242 patients received renal transplant, among whom 73 (30.2%) cases had CMV infection with median and mean survival of 41 and 48.09±23.50, respectively. In this study, there was no correlation between demographic variables (e.g., gender, place of residence, marital status, educational level, BMI, smoking status, hepatitis B, and type of dialysis) and incidence period of CMV. However, a significant relationship was observed between the incidence period of CMV and age (mean: 45 years, P=0.04), as well as etiology of ESRD urology (P=0.03).CONCLUSION: The prevalence of CMV infection is reported to be high in elderly patients with history of urologic diseases. Therefore, performing short-term follow-ups four months after transplantation, with emphasis on the first two months is recommended.

BACKGROUND AND OBJECTIVE: Hepatitis B virus (HBV) reactivation is a major risk factor for hepatic dysfunction, acute or chronic hepatitis, cirrhosis, or hepatocellular carcinoma after kidney transplantation (KTP). The present article summarizes some of published articles about prevention of HBV reactivation in renal transplant recipients METHODS: Many articles published in English language as full-text manuscripts reviewed in a variety of sources such as Scopus, Pub Med and Google Scholar with key words of hepatitis B and kidney transplantation to collect current data about this issue.FINDINGS: The risk of reactivation of HBV followingKTP is related to the status of serologic markers of HBV at the time of KTP.KTP candidate patients who are hepatitis B surface antigen (HBsAg) positivehave higher risk for reactivation especially those who are hepatitis B e antibody positive or have high levels of HBV DNA in serum. Lamivudine has been most extensively used for prevention of HBV reactivation, but it is associated with a high rate of drug resistance.It seems that the optimal antiviral agent for prevention of HBV reactivation is entecavir which is associated with the lowest risk of drug resistance, however lamivudine-resistant HBV is less sensitive to entecavir. The preferred antiviral agent for lamivudine-resistant HBV is tenofovir which should be added to lamivudine rather than stopping lamivudine. It is reported that combination therapy in this sitting may reduce the development of resistance to the second drug.CONCLUSION: There is sufficient evidence to recommend routine antiviral prophylaxis for all HBsAg-positive patients who are undergoing kidney transplantation.

BACKGROUND AND OBJECTIVE: Patient satisfaction in emergency departments is an indicator of healthcare quality, evaluation of which can promote awareness of the relevant authorities regarding its status. This study aimed to evaluate patient satisfaction in emergency departments in hospitals affiliated to Babol University of Medical Sciences.METHODS: This cross-sectional study was performed in patients admitted to emergency departments in hospitals affiliated to Babol University of Medical Sciences, Babol, Iran, during a period of eight months (2013-2014). The participants were chosen through convenience sampling. Information regarding hospital environment, facilities, and nursing team was collected using a standard questionnaire. Standard questionnaire responses were classified to” don’t happen, dissatisfied, low, medium and high satisfaction”. Then medium and high responses classified to favorable satisfaction (above average) and low or dissatisfied responses were classified to unfavorable satisfaction. In case the patients were unable to fill-out the questionnaire, their companion completed it for them.FINDINGS: Overall, 444 (87.9%) patients expressed optimum satisfaction. The highest rate of dissatisfaction (14.8%, n=74) was related to environment and services, while the highest rate of satisfaction (49.3%, n=246) was pertinent to nursing staff. The results indicated that the rate of satisfaction in residents of rural areas was 0.55 times higher than in urban residents (OR: 1.55, 95% CI: 1.12-2.70, p=0.02), 50% lower in patients compared to companions (OR: 0.55, 95% CI: 0.36-0.83, p=0.05), and in the evening shift was 0.65 times higher than in those admitted in the morning (OR: 1.65, 95% CI: 1.06-2.58, p=0.03). Moreover, this rate in patients admitted at night shift was 0.74 times higher than in those admitted in the morning (OR: 1.74, 95% CI: 1.12-2.70, p=0.01).CONCLUSION: This study demonstrated optimum patient satisfaction in emergency departments in hospitals affiliated to Babol University of Medical Sciences.

BACKGROUND AND OBJECTIVE: Peptic ulcer is one of the most common gastrointestinal diseases. Among the three recommended surgical methods for this problem, highly selective vagotomy with less than 0.5% mortality rate, has the fewest side effects. Due to absence of documented reports, this study aims to investigate the risk factors and promote prognosis in patients undergoing proximal vagotomy during a 10-year period.METHODS: Highly selective vagotomy was performed in 45 patients during 10 years. Endoscopy was carried out three to six months after surgery. Thereafter, endoscopy results and the patients’ symptoms such as abdominal pain, bleeding, gastric outlet obstruction, weight gain or loss, patients’ demographics, and the reason for referral were gathered and analyzed.FINDINGS: Generally, 36 out of 45 patients were male (80%), and the mean age of the patients was 39.29±11.51 years. Among these patients, 40 (88%) suffered from obstruction and in 40 (88%) of them, no signs were detected during reexamination. Marginal ulcers were observed in two (4.4%) patients and a new duodenal ulcer was observed in one (2.2%) of the participants. The final diagnosis for two patients (2.2%) who underwent surgery due to obstruction was cancer.CONCLUSION: Our study shows that highly selective vagotomy has low side effects and rate of recurrence, and in spite of negative biopsy results for elderly patients, the likelihood of cancer must be considered.