مجله دانشگاه علوم پزشکی مازندران
پیاپی 172 (اردیبهشت 1398)

Oxidative stress is implicated in the pathogenesis of various diseases, including neurological disorders. In such stressful conditions, heat shock protein 70 (HSP70) protects cells, thus its pharmacological induction can be protective. The disaccharide trehalose exhibits various beneficial effects, including antioxidative effect. However, its impact on HSP70 is not obvious. This study was conducted to investigate the effect of trehalose on HSP70 gene expression in rat pheochromocytoma PC12 cells treated with hydrogen peroxide. PC12 cells were pretreated with trehalose (12.5, 25, 50 mM) for 24 hours, and then were treated with hydrogen peroxide (100 μM) for 24 hours. Cell viability was determined via MTT assay and HSP70 gene expression was measured using Real-time polymerase chain reaction. Trehalose pretreatment increased viability of PC12 cells exposed to hydrogen peroxide in a dose dependent manner. Furthermore, HSP70 gene expression upregulated in cells that were pretreated with trehalose. The highest gene expression was at 50 mM trehalose. Current study showed that terhalose protects PC12 cells against hydrogen peroxide by increasing the expression of HSP70 gene.

Recently, increased resistance to carbapenem antibiotics among Pseudomonas aeruginosa has raised concerns. The Carba NP test is used for detection of carbapenemase types. This study aimed at applying Carba NP method for rapid detection of P. aeruginosa isolates producing carbapenemase enzymes. A total of 97 clinical specimens was collected from patients in educational hospitals between November 2017 and May 2018 in Hamadan, Iran. Antibiotic susceptibility test was performed by disc diffusion method and MIC for imipenem was done by E-test. In order to detect carbapenemases enzymes, combined disk (CDT), CarbaNP, Modified Hodge (MHT), and Polymerase chain reaction (PCR) were performed. Statistical analysis was performed using SPSS V16. The highest and lowest levels of resistance were found to be to Ceftriaxone 65 (67%) and Piperacilin/Tazobactam 38 (39.2%), respectively. Among 97 clinical isolates of P.aeruginosa,
49 (50.51%) were positive for carbapenemase genes by PCR test from which 48 (97.95%) were positive for CarbaNP test. There were 48 (49.48%) PCR negative isolates of which all (100%) showed negative results for CarbaNP test. Compared to PCR, the sensitivity and specificity of this test was 98% and 100%, respectively. This study showed that a high percentage of P. aeruginosa was resistant to Carbapenem antibiotics and the CarbaNP method was highly sensitive and specific for detection of carbapenemase enzymes.

The most common painful procedures in neonates is blood sampling and vaccination. The pain of vaccination is short and mild, but it could have long-term complications. This study aimed at comparing the effects of local cold and non-nutritive sucking on pain caused by vaccination in neonates. A clinical trial was performed in 113 term neonates. They were randomly divided into three groups. In first group, cooling gel was placed on the local site for 90 seconds and vaccination was done thereafter. In second group, sucking of finger was performed for two minutes before injection. Vaccination in control group was carried out without any intervention. Neonatal infant pain scale (NIPS) was used to measure pain and crying time was evaluated using a chronometer. Data were analyzed by Mann-Whitney, Chi-square, independent t-test, and repeated measure using SPSS V16. There were significant differences between the three groups in pain intensity at the time of needle insertion (P= 0.002) and within 30 seconds (P= 0.0001). This difference was seen between the group with cooling gel and controls and non-nutritive sucking group and controls. There was no significant difference between the three groups in duration of crying (P= 0.454). However, the mean crying time in the cooling gel group (39.8 seconds) was lower than non- nutritive sucking group (42.3 seconds) and controls (52.7 seconds). Both methods of local cold and non-nutritive sucking are helpful in reducing pain intensity. This intervention is practical and easy which could minimize the negative impact of pain in neonates.

Anti-epileptic drugs (AEDs) can affect cognitive functions. The purpose of this study was to investigate the effects of lamotrigine (LT) on cognitive functions of patients with epilepsy. A study with retrospective cohort design was carried out in which we assessed cognitive functions of 20 IGE patients attending Sari Bu Ali Hospital, and 12 healthy subjects. The control group was matched for age, sex, and educational level. Standardized neuropsychological tests were used to evaluate cognitive functions. The study was analyzed applying one-way ANOVA and Tukey Test in SPSS. Compared with the control group, LT group showed poor performance in Stroop test and verbal fluency test-semantic test (P<0.05). The group on other drugs were also found to have poor performance in verbal fluency test (phonetic and semantic), forward digit span task, and Stroop test compared with those of the control group (P<0.05). Compared with LT, other AEDs had more adverse effects on cognitive functions which could be due to their effect on channels and release changing stimulatory neurotransmitters.

Women with Polycystic Ovarian Syndrome (PCOS) suffer from sexual dysfunction that is largely ignored in health clinics. This study was conducted to assess the efficacy of Permission, Limited Information, Specific Suggestion, Intensive Therapy (PLISSIT) model on sexual function of women with PCOS.. This randomized clinical trial was performed in 66 women with PCOS aged 18-45 years old. They were divided into intervention and control groups (n=33 per group). Four weekly sessions of one hour individual counseling based on PLISSIT model were performed for the intervention group, while the control group received only routine care. Female Sexual Functioning Index questionnaire was completed at pre-test, and one month and three months after that in both groups. Data analysis was done applying Friedman, Mann–Whitney U, and Wilcoxon tests. There were homogeneity in subjects’ mean age (29.26±5.96), educational level (12.02±2.65) and BMI (25.95±3.67). Also, the two groups were similar in terms of symptoms including hirsutism, acne, alopecia, infertility and menstrual status. The mean scores for sexual functioning were 20.39±2.56, 24.40±4.70 and 23.73±1.26 at pre-test, after the intervention, and follow-up in intervention group, respectively (P<0.001), but no significant differences were seen between the scores of the control group (P=0.405).Also, the scores for lubrication were not significantly different between the two groups at post-intervention (P=0.245) and follow-up (P=0.423). The PLISSIT model improved sexual functioning in women with PCOS, therefore, it could be recommended as an assessment and management tool in investigating sexual problems at early stages in this group of women.
(Clinical Trials Registry Number: IRCT201512023034N16)

Poultry slaughterhouses produce high rates of polluted effluent. They can contaminate the environment if not treated properly. This study aimed at investigating the performance of electrocoagulation process with direct (DC) current in treatment of poultry slaughterhouse effluent using aluminum electrodes. This study was performed as an experimental study on a pilot scale on poultry slaughterhouse effluent. In this experiment, direct flow and four aluminum electrodes, which were spaced two centimeters apart, were used as monopole. We investigated the percentage of organic load waste removal (COD, BOD5) and different pH changes, at 6, 12, and 18 V, and pH 3, 5, 7, and 9, and different reaction times (10, 30, 60, 90 min). The removal efficiency of COD and BOD5 using DC current was optimally at 18 V and pH=7 that occurred in 45 min (84.86%, 88.93%, respectively). Final pH was found to be 8.47. According to current findings, electrocoagulation process can be used as a combined process with high efficiency in removal of slaughterhouse effluent contaminants, so, using this technique can produce wastewater according to the standards.

CO2 is the main cause of greenhouse effect. Previous studies have shown that CO2 in methane and coal flue gas can lead to microalgae growth. The aim of this research was to study the CO2 biofixation by Spirulina and injecting kerosene flue gas. A photo bioreactor was fabricated in which kerosene flue gas and air were separately injected. The photo bioreactor was filled by growth medium without carbon source. Light source was four fluorescent lamps (10 Klux intensity) operated in continuous and intermittent modes. The concentration of CO2 was chosen in the range of 580 to 6000 ppm that was measured by NDIR CO2 detector. The initial concentration of algae was 20 mgL-1. The algal biomass production was measured during the experiment. The maximum production of algae by air and kerosene flue gas containing 5500 ppm CO2 using artificial intermittent light was 0.07 and 0.41 gL-1 d-1 and maximum concentrations of biomass were 0.25 and 1.63 gL-1, respectively. CO2 biofixation rates were between 2.27% and 4.03% at different runs. Biomass productivity with intermittent light was 15% less than continuous light and it reached 1.91 gL-1 with 5500 ppm CO2 using continuous light. In this study, the ability of a photo bioreactor was confirmed in the removal of CO2. Also, increase in CO2 contributes to increase in biomass production.

Satisfaction measurement of health service recipients and providers is a major indicator of health care assessment. The purpose of this study was to investigate service recipients and providers satisfaction in health centers with urban family physician (UFP) services and health centers without this service. A descriptive cross-sectional study was conducted in 15 family physicians, 47 healthcare staff, and 270 patients in 2017. The healthcare team and patients were selected via census and simple random sampling, respectively. Data was collected using a researcher-made questionnaire. The healthcare team completed the questionnaire and trained researchers completed the questionnaire for patients. Data analysis was done in SPSS. Patients' satisfaction was found to be significantly different in health centers providing UFP services and health centers without UFP services (P<0.05). The highest satisfaction level was seen in providing care and the relationship between family physician and patients in health centers running UFP program (4.59±0.6) and the least satisfaction level was observed in the right to choose the physician in health centers without UFP services (2.43±1.4). The satisfaction of physicians was not significantly different between the centers investigated and the highest rate was seen in health centers not providing UFP services with electronic health record and recording the services (3.67±1.3) and the least in UFP-run health centers about referral system (2.27±0.8). We did not find any significant difference in satisfaction level between the staff in health centers studied and the highest and lowest satisfaction was reported to be on management and the health team (3.75±0.7), and welfare facilities in health centers without UFP services, respectively (1.86±0.1). Implementation of family physician program is believed to satisfy the patients, but it was not successful in satisfying the healthcare personnel. Therefore, interventional programs are needed to motivate and satisfy the healthcare staff.

Patient safety is one of the most important indicators of primary healthcare settings. There is a direct association between patient safety culture and improvement in healthcare outcomes. Also, identifying the factors that enhance client satisfaction could be of great help in improving quality of care. This research was done to investigate patient safety culture in health centers in Amol, Iran and evaluating patient satisfaction attending these centers. A descriptive study was carried out in 422 individuals including healthcare staff (n=211) and patients (n=211) selected from health centers in Amol, Iran between March and June 2018. The Medical Office Survey on Patient Safety Culture (MOSPSC) was administered among the healthcare staff. The scale measures 12 dimensions of patient safety culture. The patients responded to service quality (SERVQUAL) scale which evaluates the quality of services received. Statistical analysis was performed in SPSS V22. Positive attitude in all dimensions was 82% among the staff. The highest rate of positive attitudes were seen towards patient follow up (85%) and the lowest rate was found towards total quality assessment and safety (59%). Total patient satisfaction was 79%. The highest level of satisfaction was in dimension of trust (88%) and the lowest was found to be in accessing to the physician (18%). Adequate number of staff and providing them with standard working conditions alongside allocating sufficient resources to improve quality and care could be of great benefit in improving safety culture in healthcare settings. Moreover, managers could adopt collaborative approaches and recognize client perceptions and expectations to enhance their satisfaction.

Activation-induced cytidine deaminase (AID) is a B-cell specific enzyme responsible for somatic hypermutation (SHM) and class switch recombination (CSR) of antibody genes within the B-cell follicle of peripheral lymphoid organs. Ectopic overexpression of the enzyme leads to mutations in non-B cells and Escherichia coli (E.coli) genes. However, induction of mutations in E.coli by expression of AID requires highly regulated conditions. Therefore, the aim of this study was to construct a plasmid expressing AID under the control of tightly regulated temperature-sensitive promoter of bacteriophage lambda.. The AID gene was isolated from PGEMT recombinant plasmid, containing AID and cloned into PTG19-T vector. Then, AID was ligated to an expression plasmid under the control of left promoter of bacteriophage lambda and mutant thermolabile cI857 repressor. Finally, the resistance marker of the engineered plasmid was replaced by tetracycline resistance gene. The whole open reading frame of AID was ligated into a plasmid containing a cI857-sensitive receptor lambda bacteriophage. The sequence and reading frame accuracy of the cloning was confirmed by electrophoresis of PCR products on agarose gel, restriction enzyme digestion, and nucleotide sequencing methods. In current study, the AID was successfully cloned into an expression plasmid containing thermo-sensitive promoter of bacteriophage lambda. The recombinant plasmid could be used in different strains of E.coli to produce mutator strains.

The aim of this study was to identify the factors affecting the progression of retinopathy in patients with type 2 diabetes. In this historical prospective cohort study, 728 patients with type 2 diabetes, attending Sari Tooba Clinic, were followed up for retinopathy. Data analysis was performed using accelerated failure time Weibull regression model in Stata V12. The mean and median times until retinopathy progression was 17.24 and 15 years, respectively. A total of 304 (41.8%) patients developed retinopathy and 424 (58.2%) were considered as right censoring observations. The incidence of retinopathy was 40.5 per 1000 in person per year, and 5-year incidence rate from 5 to 25-year follow up were 7%, 15%, 24%, 41%, and 49%, respectively. The accelerated failure time Weibull regression showed age at the time of diagnosis of diabetes (P< 0.001) and at first referral (P< 0.001), nephropathy (P= 0.122), hypertension (P< 0.001), and hemoglobin A1c level (P= 0.034) as the factors affecting the progression of retinopathy.  Early diagnosis of diabetes and controlling hypertension and blood glucose as well as periodic examinations for early detection of nephropathy can delay the progression of retinopathy.

The purpose of this study was to investigate the effects of crocin (Cr) on brain oxidative stress indices in animal model demyelinated with intracerebroventricular ethidium bromide (EB). In an interventional study, female Wistar rats were randomly divided into 7 groups. Crocin administration was done 1 day after EB injection for 21 days. The values ​​for Glutathione peroxidase (GPx), Superoxide dismutase (SOD), and Malondialdehyde (MDA) were measured before and after receiving Cr and analyzed using Paired t test and ANOVA. The levels of GPx, SOD, and MDA significantly reduced in the group that received Cr100 mg/kg (P<0.05). The effects of crocin were dose-dependent and other doses did not demonstrate significant effects on oxidative stress indices (P< 0.05). The antioxidant effects of Crocin were dose-dependent, and it could be used as a strong antioxidant in management of patients with multiple sclerosis.

Hepatocellular carcinoma (HCC) is one of the most fatal cancers, so, proposing new anticancer agents is highly valuable. Production of reactive oxygen species (ROS) is increased in majority of cancers. Increase in ROS leads to cell damage and death. Aminoguanidine (AG) (pimagedine) is one of the compounds that can produce ROS at high concentrations. The present study was conducted to evaluate the effect of aminoguanidine on HepG-2 cell survival and ROS production. HepG-2 cell were cultured in complete culture medium. To evaluate the viability, MTT assay was done through spectrophotometry. ROS production was measured by fluorimetry using DCFDA dye, and photographs were taken using fluorescent microscope. MTT assay showed 50% decrease in metabolic activity in the cells treated with aminoguanidine 40 mM (54.8±5.2) after 24 hours. Additionally, the results of ROS measurements showed that ROS formation increased by the elevation of aminoguanidine at concentrations above 40 mM. Aminoguanidine could increase ROS production and decrease the cell viability at 40 mM and higher concentrations, therefore, it can induce other cellular pathways including oxidative and nitrosative stress, apoptosis, and necrosis in HepG-2 cells. Interestingly, AG showed antioxidant potentials in concentrations lower than 40 mM and further investigations are needed to clarify this pattern.

Pesticides cause general concern due to their possible adverse results on human health. The aim of this study was to investigate different pesticides and also estimating daily intake of their residues in melon and watermelon samples in Kashan, Iran. In this cross-sectional study, 62 melon and watermelon samples were collected from different fruit distribution centers in Kashan, 2016-2017. After preparation, the samples were analyzed for 118 various pesticides using Gas chromatography–mass spectrometry (GC-MS). Also, chronic daily intake (CDI) of pesticides was calculated. In this study, 7 (11.29 %) melon and watermelon samples were contaminated with pesticides. Only fludioxonil residue was detected in 1 (2.3 %) watermelon sample which was higher than standard range. The CDI of fludioxonil was less than standard of codex Alimentarius. In melon samples, diazinon in 3 (15.79%) and tridemorph in 2 (10.52%) samples were the most common residues detected. Also, CDI of diazinon and tridemorph in melon samples were more than the standard of codex Alimentarius. Current findings showed the presence of agricultural pesticides in melon and watermelon samples. Therefore, regular monitoring of the pesticide residues is necessary.

Coronary artery bypass grafting (CABG) is used in treating coronary artery disease. The aim of this study was to determine the frequency of mortality for CABG and its associated factors in Mazandaran Heart Center, Iran. This cross-sectional study was carried out in 600 patients. Incidence of death was recorded during CABG and before discharge. Associated factors and surgery complications were also investigated. The patients were 52.7% males and mean age of the subjects was 62 ± 11 years old. About 65% of the patients were overweight and obese. Hypertension and diabetes were seen in 57.2% and 52%, respectively. Death occurred in eight (33.1%) cases within one month following CABG, and there was no significant difference in incidence of death between males and females (P< 0.578). Among the patients 12.2% developed kidney failure and 3.7% had surgical site infection. We observed significant association between mortality and surgical site infection (P <0.031). In this study, surgical site infection was an important risk factor for post-CABG mortality. Infection was the major risk factor for death in first few days after CABG. Therefore, healthcare team should take appropriate actions to prevent surgical site infection following CABG.

Nowadays, social networks are considered as the major communication tools in communities and throughout the world. This study aimed at investigating the pattern of social network use in medical students who will have important occupations in healthcare system. This descriptive-analytical study was carried out in 715 medical students in Mazandaran University of Medical Sciences, Sari, Iran 2018. Information on the frequency and pattern of social network use were collected and data were analyzed in SPSS V21. The mean age of students was 21.59±2.7 years old and 711 students (99.4%) were engaged with social networks. The daily median use of social networks was 3 hours. The most common reason for using these networks were communication with friends (40.45%). The average hours of using these networks were significantly higher in single students compared with those of married ones (P <0.001). This study showed high rates of social network use among medical students. Considering the emergence of social networks in recent years and their potential risks, further researches are needed on other aspects affecting students' study and health status.

Idiopathic normal pressure hydrocephalus (iNPH) is a chronic disease in adults. The standard treatment in this type of hydrocephalus is shunting which is accompanied by some complications and there is also uncertainty about response to treatment. Therefore, surgery is performed in only 10-20% of the cases with iNPH. Currently, oral acetazolamide and repetitive lumbar puncture for drainage of the cerebrospinal fluid are recommended in many patients. In this case report, a 34-year-old female patient with iNPH is introduced who received acetazolamide for the past two years, and repetitive lumbar punctures. These treatments reduced her symptoms for a short time, but had never disappeared the symptoms and after a while they intensified again. The patient was treated by Persian medicine and nutrition modification was also done. Within one year, there was no recurrence of the disease and no need for lumbar puncture. This case report highlights the need for further research on Persian medicine in treatment of iNPH. It is believed that Persian medicine could be of great benefit along with current treatments of hydrocephalus.

Problems in oral feeding are common in infants, especially in preterm infants. Therefore, assessment of infants feeding could be of great help in making appropriate diagnosis for rehabilitation of swallowing. Therefore, comprehensive and accurate assessment tools are needed. The aim of this study was to review assessment tools used for infants oral feeding. Electronic databases including Google scholar, Pubmed, Scopus, Science Direct, and Medline were searched using the following keywords: Infant OR Preterm infant OR Premature infant, Evaluation or Assessment tool, Dysphagia OR Oral motor feeding or Swallowing or Feeding behavior. Articles published between 2000 and 2018 were reviewed and information including the manufacturer's name and country, purpose of the test, population, age, feeding method, examiner, psychometric properties, scoring criteria, and number of test items was collected. In studies reviewed, 14 tools were used. Among the tools, two were used for assessment of bottle and breast feeding, 10 evaluated only breast feeding and only one tool was used for bottle feeding. There was also one tool that assessed the pre-feeding skills. Speech therapists usually use the tools that could accurately evaluate breast feeding or bottle feeding at a shorter time. Current review suggests Early Feeding Skills Assessment (EFS) and Neonatal Oral-motor Assessment scale (NOMAS) as the tools that have the features desired, and also have suitable psychometric properties and could be used in this group of infants.

The emerging pathogen “Candida auris” is attracting considerable international attention due to its rising reports, transmission through health professionals, high rate of treatment failure and resistance to multiple antifungal agents, particularly fluconazole. In spite of the global emergence of C. auris, epidemiological data and true prevalence of infections due to this organism are not clearly determined due to incapability of conventional and biochemical identification methods. Consequently, this species is erroneously identified as C. haemulonii or Rhodotorula glutinis because of their close phenotypical and biochemical resemblance. Therefore, awareness of serious menace posed by C. auris is of great importance for physicians and health laboratory personnel. This awareness could play a beneficial role in prevention of healthcare-associated outbreaks, timely and definite diagnosis, prompt initiation of C. auris-targeted therapy, and subsequently improving treatment outcomes. This review aimed to discuss the epidemiology, drug resistance, diagnostic challenges, the mode of transmission, and the strategies for prevention of C. auris-related infections.

Epilepsy is a neurological condition characterized by recurrent seizures influencing about 1% of the worldwide population. Despite much progress in understanding the pathogenesis of epilepsy, the molecular basis of human epilepsy still remains unclear. Common approaches for pharmacotherapy of epilepsy are still directed towards controlling the symptoms and suppression of seizures. Clinical use of Antiepileptic Drugs (AEDs) is currently limited due to their resistance and central nervous system (CNS)-related adverse effects. Therefore, a major goal in novel antiepileptic drug development is introducing AEDs that act through new molecular targets and those that could also improve seizure control and lower drug-resistance. So, it is necessary to find novel targets with different mechanisms of actions in seizure occurrence. Usually, studies on epilepsy focus on the mechanisms that control neuronal excitatory process in brain but recent attentions almost focus on finding novel targets. This review summarizes several experimental and clinical findings about new targets for epilepsy treatment.