مجله دانشگاه علوم پزشکی مازندران
پیاپی 148 (اردیبهشت 1396)

Background and Cerebral ischemia is a general injury characterized by direct tissue damage and increasing free radicals that leads to the death of brain tissue, cerebral infarction, or ischemic stroke. Some studies have demonstrated anti-inflammatory, antipyretic and antibacterial activities of Viola odorata. However, key aspects of the effect of Viola odorata in stroke are scarce. This study investigated the effect of Viola odorata extract (VOE) on neurological deficit scores (NDS) and infarct volume (IV) in MCAO stroke model.
In this experimental study, 20 male Wistar rats weighing 200 to 300 g were assigned to 4 groups including three treatment groups and control group. After preparation of VOE, the experimental groups received different doses of VOE (25, 50 and 75 mg/kg) by gastric gavage while the control group received distilled water for 30 days by gastric gavage. Two hours after the last gavage, the rats were exposed to 60 min MCAO surgery and 24 hours later, the IV and NDS were evaluated.
Compared with the control group, reduction was seen in total IV and NDS in animals treated with VOE50. Investigation of IV in the core, penumbra and subcortex of right hemisphere demonstrated that VOE25 and VOE50 decreased IV in the subcortex and core regions, and just VOE50 decreased IV in the penumbra during the treatment. VOE75 decreased IV only in the subcortex region.
Although further studies are needed to clarify the mechanism of Viola odorata, the present study explored the potential effect of Viola odorata extract on reducing infarct volume and neurological defects in MCAO stroke model. This study could be helpful for future exploration of protective effect of V. odorata on cerebral ischemia.

Background and Chronic non-healing diabetic wounds are a major medical challenge worldwide. Stem cell therapy has been developed as a new approach in the management of such wounds that need to be explored further. In the present study we aimed to evaluate the effects of adipose derived mesenchymal stem cells (ADSCs) on gene expression level of some important inflammatory factors involved in wound healing in diabetic animal model.
ADSCs were isolated from adipose tissue of mice and their stemness was identified in terms of specific cell surface markers (CD44, CD90, and CD34) and multi-lineage differentiation potentials. Then 106 stem cells were injected in dermis area around the wounds and the wound tissues were tested for the expression level of IL-8 and IL-10 genes and histopathological analysis at 3rd, 7th, 14th, and 21st days after treatment.
Expression level of IL-10 gene at days 3, 14 and 21 increased significantly (P The present study indicated that stem cells could improve the indicators of wound healing.

Background and Osteoporosis is a common disease characterized by low bone mass that can harm health. Lactoferrin increase osteogenesis. PerFlourooctyl Bromide is a neutral particle that used as a drug carier.
In this study, lactoferrin (LF) of Camel milk were isolated. PFOB-NEP was prepared using an oil-in-water emulsion method (O/W). and then evaluated by The zeta potential measurement methods and tryptophan fluorescence spectroscopy before and after loaded by lactoferrin. The concentrations of 25, 50 and 100 µg/mL of LF were loaded on perflourooctylbromide -NEPs. The effects of standard LF, the LF, and LF loaded on PFOB-NEPs on growth of osteoblasts Cell Line (MG-63) was studied using MTT assay.
The results showed that the LF and the LF loaded on PFOB-NEPs significantly increased Osteoblast cells proliferation. But there was no significant difference between the LF and LF uploaded on PFOB-NEPs (α The results proved that LF of camel milk causes the growth of osteoblasts cells in MG-63 cell lines. It is also possible to load LF on PFOB-NEPs and this nanoparticle could be used as carriers of lactoferrin.

Background and Traumatic brain injury (TBI) is a public health problem around the world. The Glasgow Coma Scale (GCS) and Full Outline of Unresponsiveness (FOUR) score are the most common tools in this patients. This study aimed to assess time-related GCS and FOUR scores evaluation in predicting outcome in TBI patients.
The present prospective cross-sectional study was conducted on 120 TBI patients admitted to an intensive care unit. GCS and FOUR scores were evaluated in four times, including the first hour, and then 24, 48, and 72 hours later. For the analysis of data, SPSS V. 22 and MedCalc v13 were used. The receiver operating characteristic (ROC) curve, sensitivity, specificity, and positive and negative predictive values of GCS and FOUR score were evaluated to predict the patient's outcome. Patient's outcome was measured two weeks after hospitalization and for patients who were discharged earlier than this time the evaluation was done at the time of discharge using modified Rankin Scale (mRS).
Sensitivity and specificity of the FOUR score in predicting the outcomes were 80% and 84.4% at first stage, 83.6% and 92.2% at second stage, 83.2% and 92.2% at third stage, and 96.4% and 79.7% at fourth stage, respectively. These values for the GCS were 81.8% and 90.6% at first stage, 87.3% and 93.8% at second stage, 85.5% and 93.8% at third stage, and 87.3% and 93.8% at fourth stage, respectively
Time-related GCS and FOUR scores evaluation did not have a considerable effect on predicting the outcome in this patients.

Background and Hemodynamic monitoring is necessary after coronary artery bypass grafting (CABG). For this purpose, the arterial line should be rinsed to prevent obstruction. There is no consensus on flushing methods. This study aimed to compare the effect of continuous and intermittent flushing on maintaining patency of the arterial line in patients after CABG.
This randomized clinical trial was performed in 60 patients in cardiac surgery ICU of Imam Reza in Mashhad, 2016. Patients were randomly assigned into two groups: continuous and intermittent flushing. In continuous group, the arterial line was continuously flushed with heparin solutionat the rate of 2cc/h under pressure 300 mmHg and in intermittent flushing group, heparin solution (5cc) was used every 3 hours. In both groups, the catheter patency was assessed for 48 hours. Data was analyzed using SPSS software and statistical tests.
The mean ages of patients in continues and intermittent flushing groups were 57.7±7.8 and 56.1 ± 9.5 years, respectively. Mean duration of patency of the arterial line in continuous group and intermittent flushing group was 46.5 ±5.7 and 39.7 ±10.7 hours, respectively. On second day after surgery, the incidence of arterial occlusion line in intermittent flushing group (46.7%) was significantly higher than that of the continuous flushing group (6.7%).
Continues flushing of the line to maintain its patency and reducing the blockage was found superior to intermittent flushing, therefore, it is suggested for washing the arterial line in these patients. Long-term follow-up is recommended.

Background and Bipolar disorder is a mood disorder and mental illness that is recognized as type I and type II. Bipolar I disorder involves at least one episode of mania and is a common chronic recurrence disease with various causes responsible for its recurrence. The aim of this study was to determine effective factors on relapsing disease in patients with bipolar I disorder using frailty model.
The information of 268 patients with bipolar I disorder who were hospitalized in Farshchian Hospital, Hamedan, Iran (2008-2014) were collected using their records. Patients hospitalized due to more than one recurrence were entered the study. The intervals between recurrence times were recorded. FrailtyPack of R software was used to fit model.
The mean age of patients was 34.10±11.56 years, and 160 patients (72.7%) were male. In total, 696 recurrences occurred in 268 patients. The number of recurrences was between 2 to 7 times. All patients experienced at least 2 recurrence episodes. The results of fragmented frailty model practice showed significant effect of age, race, place of residence, crime, and type of treatment on relapsing time (P Many factors, including demographics and illness characteristics might cause the recurrence of bipolar disorder, therefore identifying these factors can help in preventing or reducing the incidence of recurrence of this disease.

Background and Previous studies have investigated the correlation between activity of superficial trunk muscle and postural control in patients with low back pain (LBP), but the relationship between deep trunk muscle activity, as spinal stabilizer, and postural control during standing postural tasks is not clear yet. This study investigated the relationship between abdominal muscle activity (deep and superficial) and postural control during standing postural tasks in females with chronic nonspecific LBP.
In an analysis of relationships, 44 females were asked to maintain their balance during standing on the platform stability levels of Biodex Balance System (BBS) (static, levels 6 and 3) for 30 seconds and BBS data were saved. Concurrently, ultrasonography (US) data for abdominal muscles thickness measurement were recorded. Then, saved data were processed offline using Corel DRAW software.
Significant correlations were found between transversus abdominis (TrA), and external oblique (EO) muscle thickness changes and postural stability indices in all testing conditions (P Dysfunction in superficial and deep abdominal muscles activity pattern affects postural control changes in the patients with LBP. This relationship signifies the role of stabilization motor control training, especially deep abdominal muscle training, on postural control improvement in patients with LBP.

Background and Hospitals are needed to have enough readiness for apt reaction toward unexpected disasters, therefore, it is important to identify developed healthcare centers in different regions. This study aimed to investigate the developmental levels of educational hospitals for facing unexpected disasters in Mazandaran Province, Iran.
In a cross-sectional study in Mazandaran educational hospitals in 2015, 56 individuals including the heads, chief managers and the officials for unexpected crisis were selected via purposive sampling. Data was collected using a researcher-made questionnaire consisting of 222 items. Data analysis was performed by numerical taxonomy.
The participants were 88.5% males (n=23) and the mean age was 46.33±4.47 years. The educational level was Master in 5 (19%), while 21 (81%) hold a PhD degree. Results showed that Imam Khomeini hospital was relatively developed (0≤Fi≤0.5), Bu Ali, Fateme Zahra, Zare, Ayatollah Ruhani, and Amirkola pediatric hospitals were developing (0.5≤Fi≤0.7), and Razi and Shahid Beheshti hospitals were undeveloped (0.7≤Fi).
This study showed that most of the educational hospitals in Mazandaran Province are in inappropriate developmental state for facing the unexpected disasters. So, policy-makers must identify developed healthcare centers and enhance all medical centers for confronting the unexpected disasters.

Background and Bisphenol A is an estrogenic substance that can cause endocrine dysfunction, which extensively enters water resources due to its large use in industry. The aim of this study was to synthesis modified magnetic nanoparticles with sodium alginate and study of its efficiency for removal of Bisphenol A from aqueous solutions using heterogeneous fenton process.
In present study, sodium alginate magnetic beads were synthesized by nanotechnology and chemical precipitation method and the removal of Bisphenol A was evaluated in a pilot-scale batch reactor. In addition, the effect of environmental factors, including pH, reaction time, catalyst dosage, initial concentration of Bisphenol A, and the concentration of H2O2 on removal efficiency of Bisphenol A was studied. The concentration of Bisphenol A in samples was measured by spectrophotometry instrument and the XRD method was applied to identify the characteristics of modified nanoparticles.
In this study synthesized modified magnetic nanoparticles with sodium alginate had complete magnetism properties, and XRD analysis confirmed the presence of Fe3O4. The results showed that the highest removal efficiency of Bisphenol A was obtained at pH=5, reaction time= 120 min, catalyst dose= 5 g/L, and initial concentration= 20 mg/L which was about 95%.
According to our results, the magnetic nanoparticles modified with sodium alginate in a heterogeneous Fenton oxidation process are highly efficient in removing Bisphenol A.

Background and Nitrobenzene (NB) as the main material of synthetic fuels, cleaners, rubber and explosives is discharged into the environment and groundwater in large-scale. This compound is considered as a persistent organic pollutant with high toxicity and stable chemical structure which can cause serious risks for human health and ecosystem even in low concentrations. Therefore, the aim of present study was to synthesize polyaniline/zero-valent iron composite nano-fiber (CNFs) and its ability in degradation of nitrobenzene from aqueous solution.
Characterization of CNFs was determined using scanning electron microscopy, transmission electron microscopy, X-ray diffraction and vibrating sample magnetometer. The effect of operational parameters such as pH, NB concentration and nanocomposite dosage on nitrobenzene degradation were analyzed by response surface methodology. Box Behnken model was used to investigate the interaction among variables. Analysis of variance was considered as statistical method for responses analyzes.
ANOVA test showed a significant relationship between statistical model and test data. The observations also revealed that the distribution of residuals were normal and parameters i.e. pH, NB concentration, nanocamposite dosage and interaction of nano-composite and NB concentration had significant effect on removal of NB. The degradation efficiency was over 98% in optimized conditions (pH=2, NB concentration= 40 mg/l, and nanocomposite dosage= 0.88 g/l) that was achieved in 45 minutes. Limit of Detection (LOD) and Limit of Quantification (LOQ) were calculated as 1.5 and 5 mg/l, respectively.
According to the results, polyaniline nanofiber composite/zero-valent iron has a good efficiency in NB degradation. NB kinetic studies showed that the NB degradation process by nanocomposite followed the one order kinetic model. In addition, the nano-composite separation is simple due to its magnetism properties that it can improve its application.

Background and Chromium hexavalent compounds are carcinogens that are found in groundwater as chromate and dichromate negative ions. The aim of this study was to remove Cr (VI) from water by activated carbon modified with cationic surfactant alkyl dimethyl benzyl ammonium chloride (Benzalkonium chloride).
In terms of the Critical Micelle Concentration (CMC) of surfactant, three concentrations of Benzalkonium Chloride (BZK) including half, one and two fold of CMC were used to modify activated carbon. Modification was performed by contacting activated carbon and surfactant for 24h on the shaker. Ordinary and modified activated carbons were used as sorbents for Cr(VI) removal from aqeoues solutions. Modified Activated Carbon (MAC) by cationic surfactant and Unmodified Activated Carbon (UAC) were examined as adsorbents for Cr (VI) from aqueous solutions. Experiments were conducted in batch and continuous mode in acid (pH=4), natural (pH=7) and alkaline conditions (pH=10). Cr (VI) was measured by spectrophotometer.
Time to reach Cr (VI) adsorption equilibrium for UAC and MAC were 180 and 120 min, respectively. Cr (VI) adsorption capacity for UAC was 1.79 mg/g but in MAC the value increased to 8.87 mg/g. 5g/L of MAC modified with 2cmc of surfactant showed greatest Cr (VI) adsorption capacity in natural pH condition. Breakthrough point in the column packed with MAC enhanced 3 times compared with UAC. Adsorption isotherm was best fitted with Langmuir model and adsorption kinetics was determined as pseudo second order.
Modification of activated carbon by cationic surfactant causes increase in adsorption capacity of Cr (VI) from aqueous solution. Therefore, it could be used in removal of toxic Cr (VI) compounds from water.

Background and Antibiotic resistance has prompted the use of medicinal plants with low side effects instead of common drugs. The aim of this study was to identify the contamination level of industrial hamburgers to salmonella, detecting their antibiotic resistance pattern, and their sensitivity to Ferula gummosa, Citrus limon, Rosmarinus officinalis, Pelargonium roseum, Zataria multiflora, Bunium persicum, Mentha piperita, Eucalyptus globulus, Lavandula angustifolia, Rosa damascene, Artemisia dracunculus, and Ocimum basilicum essential oils.
In a cross-sectional study, 100 samples were randomly purchased from local markets in Kashan and evaluated for occurrence of Salmonella by culture media. Antimicrobial susceptibility of the isolates was evaluated using disc diffusion. Also, susceptibility of the isolates to 12 plant essential oils was evaluated by disc diffusion and microdilution methods.
Two samples (2%) were contaminated with Salmonella that one was Salmonella serogroup C2 (antigen O8) and the other isolate was not in any serogroup. Disk diffusion method showed that the two isolates were 100% resistant to at least one antibiotic or more. The isolates were resistant to most of the antibiotics such as chloramphenicol, kanamycin, ceftriaxone, ceftazidime, and amoxicillin/clavulanic acid. The inhibitory effect of Zataria multiflora essential oil on growth of Salmonella was the highest with minimum inhibitory concentration and minimum bactericidal concentration of 0.39 and 0.78 mg/mL, respectively, and the mean zone of inhibition growth of 23.67±1.18 mm.
Antibiotic resistance of Salmonella isolated from hamburgers was high. The essential oils used in this study exhibited high anti-Salmonella properties compared to common antibiotics and could be used as a beneficial medicinal plant.

Background and Blastocystis hominis is a common intestinal protozoon with worldwide distribution. The prevalence of this parasite varies between different countries. This study aimed at investigating the prevalence of Blastocystis in individuals attending health centers in Sari, Iran, 2014.
We conducted a descriptive study in which 420 stool samples were obtained. Samples were examined using direct method, parasite test (formalin-ether), and Giemsa staining.
The samples included 245 males and 175 females. Among the male and female patients 48 (11.4%) and 12 (2.8%) were Blastocystis positive, respectively.The overall prevalence of Blastocystis hominis was 14.3%. Significant relationships were observed between the prevalence of Blastocystis and gender, age, occupation, contact with animals, educational level, and place of residency (P Enhancing the individual and public levels of health knowledge, improving environmental health and safety of water supplies could help in reducing the rate of Blastocystis infection. Clinical investigation of human cases, identifying subtypes of parasites and further studies to determine the factors affecting the virulence of the parasite are recommended for future studies.

Background and Middle Trapezius Muscle (MTM) is a key muscle in maintaining postural stability of the shoulder but it has received less attention in research. This study aimed to measure the ultrasonic thickness of the MTM in non-athlete healthy young men. Also, inter-rater repeatability in measuring ultrasonic thickness of this muscle was calculated.
A fundamental applied study was carried out by voluntary participation of 60 healthy young men aged 18-28 years. Demographic characteristics of the participants were recorded and ultrasonic thickness of both left and right MTM was measured by two examiners when the muscle was at rest. The measurements were repeated for three times. Data analysis was conducted in SPSS V18 using Intraclass Correlation Coefficients (ICC) between the first and third measurements to assess intra-rater reliability. In addition, Standard Error Measurement (SEM) with a 95% confidence interval (CI=95%) was estimated.
Average ultrasonic thickness of the left and right MTM was 8.03 ± 1.55 and 8.10 ± 1.54 mm, respectively. The ICC between the measurements from the first and second rater was 0.86. Inter tester reliability showed ICC 0.95 and 0.98 for right and left MTM respectively.
Measurement of ultrasonic thickness of MTM at rest, showed a high intra reliability. Further studies are recommended to measure MTM ultrasonic thickness in patients suffering from neck and shoulder dysfunctions.

Children are the victims of a spectrum of pathological lesions which usually lead to varying degrees of jaw swelling. Dentigerous cyst is the most prevalent type of odontogenic cyst and is associated with crown of an unerupted or developing tooth. Radicular cyst is one of cysts in association with non vital teeth. Radicular cysts arising from deciduous teeth are rare. This report presents a case of radicular cyst associated with a primary molar following pulp therapy and a case of dentigerous cyst in right maxillary region in a 10-year-old child. Diagnosis and early treatment of these lesions in children is of great importance, especially in cases where the lesions enclose permanent teeth. The purpose of this case report was to describe the management of two odontogenic cysts in children

Background and The unique characteristics and potency of stem cells have attracted interest for their use in cell therapy. However, the use of these cells has some limitations and problems such as ethical issues. The aim of this study was to perform a systematic review on the use of embryonic stem cell for clinical therapy targets and investigating its advantages and limitations.
Data was collected from electronic databases including PubMed, Science direct, Medline, Clinical trial.gov, SID, etc. The search keywords included pluripotent stem cell, Embryonic stem cell (eSC), and stem cell therapy.
Study of published articles and ongoing studies showed that pluripotency, cell viability and low immunogenicity of eSC are amongst the major reasons for their use.
Recent developments in clinical application of eSC make them a major candidate in using stem cells alongside MSC and iPS. But, further studies are needed due to its importance in many aspects.

Background and In recent years, the importance of human cloning is discussed by researchers. But its scientific and legal advantages and disadvantages have received less attention. Therefore, the aim of this study was to evaluate the advantages and disadvantages of human cloning according to sporadic legal and scientific viewpoints and Islamic jurisprudence.
In this review, data was collected using relevant keywords form university libraries, Qom and Najaf Hawzas and electronic databases (Persian and English). The search results were categorized according to the views on human cloning and its advantages and disadvantages.
The advantages and drawbacks of cloning was defined according to scientific and legal perspectives. None of the different views investigated in this study accept human cloning, because of its negative implications.
Human cloning is an important subject since it has many complications and impacts, therefore, its procedures should be done under the supervision of scientific committees and reliable jurists.

Invasive candidiasis and aspergillosis are amongst major medical concerns with high mortality among immunocompromised patients. Management of these infections is dependent on early and efficient antifungal therapy, as well as drug resistance monitoring. Decreased sensitivity of these pathogens to antifungal drugs during recent decades calls for rapid detection/identification of drug resistance associated mutations in pathogenic fungal species. Generally, a study for identification of drug resistance associated mutations requires complicated and expensive methods such as PCR or sequencing. However, nowadays application of accurate, fast and highly sensitive techniques, including Rolling Circle Amplification (RCA), PCR-RFLP, Real-Time PCR, and ARMS-PCR provide the possibility for detection of target sequence containing nucleotide polymorphisms even at the one base pair level. In this review we aimed to discuss the usage, advantages and disadvantages of these techniques in order to identify the mutations of the azole-resistant strains.