مجله دانشگاه علوم پزشکی مازندران
پیاپی 149 (خرداد 1396)

Background and Among different cancers, breast cancer has a high prevalence among women and radiotherapy is used as a treatment modality in which radio sensitizers are used to increase its efficiency. Nanoparticles are such sensitizers that enhance the efficiency of radiotherapy via creation of free radicals and induction of oxidative stress. This study aimed at evaluating the synergistic effect of radiation therapy and TiO2 nanoparticles on animal models of breast cancer.
After induction of breast adenocarcinoma tumors in Balb/C, the animals were divided into several groups as control, rutile and anatase injections at 5mg/kg and 10mg/kg doses/with and without radiotherapy. Then, the efficiency of treatment was evaluated.
In groups receiving anatase nanoparticles with and without radiation, the values for tumor volume, relative volume and relative volume percentage showed a small increase and a considerable reduction, respectively. In rutile groups with and without radiation, these values showed a small increase and a considerable increase, respectively. IR value reduced to negative value and then increased to zero and positive in anatase groups with and without radiation. This parameter had little changes in rutile groups with and without radiation.
Titanium dioxide nanoparticles increased sensitivity of tumor cells to radiation therapy due to ROS production. Compared with rutile crystals, anatase crystals have intense effect because of having a larger surface area and higher photocatalytic activity.

Background and Shigella species cause shigellosis in humans. Considering the high frequency of illness and antibiotic resistance, development of an effective immunogen against bacteria is a major goal. Invasion Plasmid Antigen such as IpaD and IpaC are the major bacterial virulence agents of Shigella. Encapsulation of antigens in particular carriers such as chitosanic nanogels, not only protects them from degradation in environmental elements but also provides the effective concentrations of antigens in targets, hence increasing bioactivity. The aim of this study was to investigate the immunogenic properties of IpaC protein encapsulated in chitosanic nanogels.
The protein was expressed in E.coli and purified by affinity chromatography. Chitosan nanogels were prepared by ionic gelation method using tripolyphosphate (TPP) as a crosslinking agent. The nanogels were loaded with IpaC and their structures were characterized by SEM and DLS. Encapsulated protein was introduced in guinea pigs by oral and parenteral routes. Antibody titers were determined by ELISA. Animals were challenged By Sereny test with wild-type S. flexneri.
Expression of recombinant protein in E.coli led to the production of IpaC with 60 kDa molecular weight. Loading efficiency of nanogel was 98% after 48h of incubation. The average particle size was 418 nm. Immunization of mice induced serum antibody response.
The productivity of encapsulated protein via oral route was better than parenteral route.

Background and Increasing entry of heavy metals into the environment and its effects on social structure of soil organisms disturbs the soil ecosystem. Study of molecular and cellular soil invertebrate responses as biomarkers of environmental health can provide useful information in relation to the effect of pollutants on them. Accordingly the aim of this research was to study the effects of cadmium and lead on Biomass, lipid peroxidation (LPo) and total antioxidant capacity (TAC), as cell physiology markers, in Eisenia fetida earthworm.
In this study, acute toxicity test was carried out according to the Organization for Economic Co-Operation and Development (OECD) guidelines (NO 207). TAC and LPo levels were assayed by ferric reducing antioxidant power and thiobarbituric acid methods, respectively.
LC50 as a viability marker, for Cd and Pb (µg/cm2) were 54.84 and 14.18 in 24h, and 34.1 and 8.4 in 48h, respectively. By increase in concentrations of lead and cadmium the rate of mortality, weight loss, LPo and TAC increased. E. fetida was found to be more sensitive to Cd than Pb (P According to the results, in presence of lead and cadmium LPo and TAC increase significantly in E. fetida earthworm. Therefore, measurement of MDA and TAC as cell physiology markers could be used to evaluate the sensitivity of E. fetida earthworm to Cd and Pb in management of pollution resources and environmental health.

Background and Tuberculosis is among the leading causes of death from infectious diseases in the world. According to World Health Organization (WHO), the estimated rate of TB in Iran was 21 per 100,000 populations in 2015. The present study was designed to evaluate the genetic diversity and transmission dynamics of Mycobacterium tuberculosis in Tehran, Iran.
A total of 80 isolates of Mycobacterium tuberculosis was cultured from TB patients attending a teaching hospital in Tehran, Iran from January 2015 to December 2016. Standard 15-locus Mycobacterial Interspersed Repeat Units/Variable Numbers of Tandem Repeat (MIRU-VNTR) typing was applied to genotype clinical isolates.
There were 78 different VNTR profiles comprising 2 clusters and 76 unique patterns. The Hunter – Gaston discriminatory index (HGDI) was 0.990, indicating a high power of discrimination for MIRU-VNTR typing. The QUB26 and MTUB21 loci were designated as highly discriminative.
The high genetic diversity among Mycobacterium tuberculosis isolates suggests that transmission may have been caused by different sources.

Background and Methyl tertiary-butyl (MTBE) is an organic volatile compound that is used to improve gasoline as the replacement of tetraethyl lead. This compound can be absorbed into the blood in different ways and leave toxic effects. This study aimed to investigate the effects of MTBE on blood parameters and liver tissue in NMRI albino female mice.
This study was conducted in 45 mature NMRI albino mice, which were placed into three groups, including two experimental groups (groups A and B) and a control group. Group A received 0.4 cc of MTBE (0.06 cc of MTBE and 0.04 cc of distilled water) at graded dose of 1600 mg/kg body weight once a day. Group B received the same compound along with 0.1 cc of physiological serum. After weighing and anesthetizing the mice, their blood samples were collected. Then, the liver and blood parameters were measured by MOTIC software as well as macroscopic and microscopic observations, using slides.
The number of red blood cells, hematocrit, and plasma density elevated in group A, but hemoglobin level showed no increase, which indicate the toxic effects of this substance. In group A, hyperemia and liver inflammation were considerably associated with the increase in the diameter of lobular and interlobular central veins as well as sinusoids. The mean ratio of nucleus to cell size decreased; on the other hand, compared to mononuclear cells, the number of binuclear hepatocytes raised. There were statistically significant differences between the two experimental groups and between the control group and group A in most cases (P According to our findings, the variations in blood parameters and liver tissue were due to the toxic effects of MTBE. As indicated, the use of physiological serum in group B reduced these changes. Hence, alternative compounds with lower risk should be used to improve gasoline.

Background and Measurement of DPPH free radical scavenging is a valid, accurate, and easy method with high repeatability in evaluating the in vitro antioxidant activity of plant extracts. A positive correlation is reported between antioxidant activity and antimicrobial activity. The aim of this study was to evaluate the correlation between antioxidant and antimicrobial activity of medicinal plant extracts.
The extracts were prepared and DPPH was used to determine free radical-scavenging activity. Antimicrobial effects of hydro-ethanol extract on the bacteria was surveyed using diffusion method in a culture medium Mueller-Hinton agar by paper discs (6 mm) based on Bauer and Kirby instructions.
The ability of medicinal plant extracts in scavenging free radicals was found to be higher in the extracts of Myrtus (89.583 µg/mL) and rosemary (80.921 µg/mL). The antioxidant activity of the extracts increased by increase in concentration of the extract. Meanwhile, in low concentrations of the extract (16 and 32 µg/mL) the highest antioxidant activity of the extract was found in Myrtus and then Rosemary, but at high concentrations (64 µg/mL) it was seen in Teucrium polium extract. Rosemary extract was found to be effective against Escherichia coli and Myrtus extract was the most effective on Listeria bacteria, Salmonella typhimurium, and Staphylococcus aureus.
The results showed that plants with high antioxidant properties have high antimicrobial activity too, such as the extract of Myrtus and rosemary that were the most effective extracts on bacteria.

Background and : Klebsiella pneumoniae has emerged as a significant opportunistic pathogen responsible for nosocomial infections. This bacteria is frequently resistant to multiple classes of antibiotics such as family of beta-lactam antibiotics. β-lactamases enzyme represent the main mechanism of bacterial resistance to β-lactam antibiotics. This study was conducted to determine the prevalence of TEM-1and CTX β-lactamases in Klebsiella pneumoniae isolates from the hospitals in sari, Iran.
The study included 45 Klebsiella pneumoniae isolates that were isolated from various clinical specimens. Susceptibility of isolates to antibiotics was determined by standard disk diffusion method. ESBL production was determined by combination disk method. The resistance of TEM and CTX types of ESBL producing genes was identified by PCR test using specific primers. Data analysis was done in SPSS V16 applying Chi-square test.
Among all Klebsiella pneumoniae isolates, the highest resistance was seen against cefotaxime (100%) and ceftazidim (100%), while the highest susceptibility was observed to gentamycin (63%). According to the results, 60% of isolates were ESBL positive and among them 55% and 45% were positive for blaTEM and blaCTX genes, respectively.
: In this study drug resistance of Klebsiella pneumoniae isolates was observed in 60% of blaTEM and blaCTX genes, therefore, other mechanisms such as efflux pumps and biofilm formation can have a role in drug resistance.

Background and Vertigo is one of the most common principal complaints of patients in emergency departments. Therefore, this study investigated the effect of Diazepam as benzodiazepine and Promethazine in patients with acute peripheral vertigo.
A double blind randomized clinical trial was done in which 150 patients were randomly divided into two groups (n=75 per group) to receive either 5mg IV injection of Diazepam (group A) or 25mg IV injection of promethazine (group B). The severity of vertigo was scored before treatment and within four hours after receiving the drugs.
Excellent improvements were seen in 71 (94.7%) patients receiving promethazine while good improvements were observed in 13 (17.3%) patients receiving Diazepam. The mean VAS score was 9.69 before the intervention. While the mean scores for VAS1 (30 minutes after treatment), VAS2 (after two hours), and VAS3 (after four hours) were 7.14, 5.06, and 2.45, respectively. The results showed a reduction over time in both groups in VAS score. The Fisher’s exact test showed significant difference in efficacy of promethazine between the two groups. (P According to this result, promethazine improved peripheral vertigo better than Diazepam. So, it could be used in patients with acute peripheral vertigo.

Background and Balance impairment is one of the major health problems in elderly. Kinsiotaping and stretching techniques are effective in balance improvement. To the best of our knowledge, no study have compared the effects of kinesiotaping and stretching of gastrocnemius on balance in elderly. So, we aimed at comparing the effects of these two methods on balance in elderly.
In this randomized clinical trial, 40 elderly women and men were randomly assigned into 2 groups of kinesiotaping and stretching. Inhibitory tape was applied on the gastrocnemius while in stretching group, the muscle was stretched for 60 seconds in 4 times. The static balance was examined before and after the interventions, using single leg stance test and checking the changes of center of pressure by force plate. According to normal distribution of data, Independent t-test was used to compare the means between groups and paired t-test was used for within group analysis.
Despite progress in time of unilateral standing after the interventions, the changes were not significant (P>0.05). Mediolateral changes of center of pressure in females were significantly lower after the use of stretching rather than kinesiotaping (P=0.04). Moreover, elderly women showed significant decrease in mediolateral changes of center of pressure after the use of stretching compared with that before the use (P=0.02).
The short term effect of gastrocnemius stretching could lead to significant improvement of mediolateral balance in elderly female. Also, the decreasing trend in changes of center of body mass in men after the stretching may indicate the effectiveness of this treatment.

Background and Waiting period in fertility treatments lead to distress in infertile women. Current study aimed at comparing the effect of positive reappraisal coping intervention and problem-solving skills training on anxiety of waiting period in women going through IUI treatment.
This clinical trial was conducted in 108 women attending Milad infertility center in Mashhad, Iran. In problem solving group three training sessions were held. In positive reappraisal coping group, two training sessions were held to accustom the participants to the components of positive reappraisal coping. The subjects in this group were asked to read the positive reappraisal coping cards (daily) and complete the monitoring form. Meanwhile, the control group received usual care. The mean score for anxiety was compared between all groups applying Spielberger anxiety Inventory on day 10 of the waiting period.
The mean scores for anxiety showed significant differences between the control group (52.46±11.70), the group receiving problem-solving skills trainings (46.03±11.25), and the cases in positive reappraisal coping intervention group (47.34±10.5), (P =0.039). But the mean scores for trait anxiety was not significantly different between the control group (47.55±6.98) those in problem-solving skills group (45.02±8.84), and individuals receiving positive reappraisal coping intervention (45.92±8.89), (P =0.426).
According to the positive influence of both interventions, they are recommended for reducing anxiety in waiting period of IUI treatment.

Background and So far, several studies have been done on the prevalence of intestinal parasites in Mazandaran province, Iran, but no comprehensive study used Geographic Information System (GIS) to investigate all effective factors on the epidemiology of these parasites. The aim of this study was to investigate the intestinal parasites in people residing in West of Mazandaran province using GIS.
This study was conducted in 1120 individuals attending the health centers in West of Mazandaran province. The samples were analyzed using direct methods, formalin - ether, trichrome staining, and modified acid fast. Data analysis was done in SPSS V18 and Arc GIS 9.3.
The prevalence of intestinal parasites was 12.8% in the population studied. The most prevalent protozoa were Blastocystis hominis (5.8%) and among helminthic infections Strongyloides stercoralis (0.53%) were found to be more prevalent. Statistical analysis showed a significant relationship between the prevalence of intestinal parasites and geographic and demographic risk factors including location, drinking water, income level, temperature, and altitude. Prevalence mapping showed Tonekabon as a high-risk region for intestinal parasites.
Temperature and altitude along with demographic factors play an important role in the spread of parasitic diseases. Water purification system, improving sanitation in high risk areas, and basic health training especially in rural areas can help in decreasing the rate of this public health problem.

Background and Microbial desalination cells are the new technologies that can be used for wastewater treatment, desalination of seawater and electricity production simultaneously.
This experimental study was performed on a laboratory scale as a batch mode. The anode was flat carbon graphite that were heat treated, and the cathode was carbon cloth with 0.5 mg/cm2 of Pt on the water side and four PTFE diffusion layers on the air side. Output voltage was measured and power and current density were calculated. Changes in pH, COD, EC and chloride in the solution of the reactor vessel were evaluated and based on these changes, the parameters such as efficiency in COD reducing, the rate reduction of EC of salt-water and COD of wastewater and then columbic efficiency were calculated.
About half of EC in saltwater was reduced. Change percent in chloride ion in 25, 50 mM PBS and municipal wastewater was 175±21, 217±2 and 311±53 respectively. COD removal efficiency in 25, 50 mM PBS and municipal wastewater was 86±1, 80± 1and 76±4 mg / L, and the rate of COD removal was 10.74 ± 0.62, 6.95 ± 0.74 and 6.77 ± 0.25 mg / L.hr respectively. Columbic efficiency in 25, 50 mM PBS and municipal wastewater was 24±2, 51± 3and 25±0 respectively.
Due to the significant reduction in COD and about half of the EC in wastewater, this technology can be used for municipal wastewater treatment and water desalination without the need to use energy.

Background and Paraquat (PQ) is a bipyridinium herbicide that is very soluble in water. This non-selective contact herbicide is widely used in agriculture for weed control. In addition to the environmental impact, paraquat affects the entire body, especially the respiratory system, central nervous system and lymph nodes. In this study degradation of paraquat was investigated using Fenton and Fenton like processes.
This research was an experimental study in laboratory scale batch reactor (1L). During these processes, the effects of pH, Fenton and Fenton like agent concentrations (Fe2 , Fe3橷 H2O2) and initial concentration of paraquat in the removal efficiency were studied. The residual PQ concentration and the amount of organic carbon removal were measured by HPLC (259nm) and TOC measurement device, respectively.
Fenton like and Fenton processes could remove 86.44% and 84.53% of paraquat under optimal condition (pH=3, H2O2=29.4 mM, Fe=0.9 mM, PQ=0.194 mM) in 120 minutes, respectively. The TOC removal in Fenton like and Fenton processes was 52.15% and 45%, respectively. The PQ removal by Fenton and Fenton like process followed a pseudo-first order reaction kinetic model.
Fenton process showed better performance in removal of PQ than Fenton process. So, it can be used as an appropriate and a supplementary treatment process in removing PQ from aqueous solution or final purification in a longer reaction time.

Background and Due to the poor performance of industrial dye settings about 50% of the washing dye liquor is discharged into the environment. Inappropriate discharge of dye-containing effluents is undesirable because of their color, resistance to biological treatment systems, toxic, and their carcinogenic or mutagenic nature to life forms. In the present study we investigated the photocatalytic degradation of reactive yellow 147 using magnetic Fe3O4@SiO2@TiO2.
A central composite design (CCD) under response surface methodology (RSM) was employed to study the interaction between some parameters, including photocatalyst dose, solution pH, and temperature in order to optimize the removal condition of Reactive Yellow 147 via photocatalytic process. Therefore, 20 tests were designed in Design Expert Software (version 7.0.0). All of these Factors were classified in 5 levels α, , 0, -1, -α.
There was an increase in removal efficiency with increase in the photocatalyst dosage of Fe3O4@SiO2@TiO2 and with decrease in the temperature. Under acidic conditions, the photocatalytic process was more efficient than that under alkaline conditions. The results also indicated that the application of RSM method not only helped to find the optimum levels of experimental parameters, but also proved that the role of initial pH of the solution and temperature were much more dominant than that of photocatalyst dosage in the photodegradation Reactive Yellow 147 under UV light exposure.
Current study showed that photocatalytic process with optimization of effective operational factors, is highly efficient in removal of Reactive Yellow 147. The regenerated as-synthesized photocatalyst shows high stability and high efficiency in the degradation of Reactive Yellow 147 even after ten times of successive reuse without a significant drop in removal efficiency which makes this process economical.

Background and Studying the expression of P16 gene which is a tumor suppressor in breast cancer is beneficial for clinical and pathological studies. The purpose of this study was to determine the expression of P16 gene in breast cancer samples using histological and immunohistochemical analyses.
This descriptive analytical research was conducted in 100 breast cancer samples obtained from Eemdad Shhid Beheshti Hospital in Sabzevar, Iran. The samples were fixed in formalin and sections were processed, then, the slides were stained. The diagnosis was made by two pathologists. Data analysis was done in SPSS V16 using Chi- square test.
A total of 100 specimens was studied in which the overexpression of P16 gene was detected in 82 (82%), while in 18 (18%) malignant samples no overexpression was found. Overexpression of the gene was not found in normal samples too. There were significant relationships between high grade tumors and stage of tumors with overexpression of P16 (P In current study, the P16 overexpression was observed more in patients with high grade tumors. Therefore, the overexpression of this gene indicates a poor prognosis in breast cancer.

Background and Strongyloidiasis is a nematode infection of humans with a worldwide distribution which is more prevalent in tropical and subtropical regions. Infected people are often clinically asymptomatic, however, in untreated immunosuppressed patients, it causes more than 80% mortality. So, the accurate and timely diagnosis of infection can prevent patient's death. This study was conducted to determine the prevalence of strongyloidiasis in patients under chemotherapy and hemodialysis in Bushehr, Iran.
We performed a cross-sectional study in 2011-2012 in which all chemotherapy and hemodialysis patients were evaluated by ELISA method to determine the presence of anti-Strongyloides stercoralis IgG antibody.
A total of 214 individuals were studied from whom 4 (1.9%) patients under chemotherapy and 3 (1.4%) hemodialysis patients were positive for IgG antibody.
Strongyloidiasis is as a life-threatening risk factor in people under chemotherapy and hemodialysis, therefore, strongyloidiasis screening is suggested in these patients before administering immunosuppressive drugs, dialysis, and kidney transplant.

Background and Reducing maternal mortality by 75% between 1990 and 2015 was the fifth goal of the Millennium Development Goals Declaration in 2000 (MDG 5) and all countries were committed to achieve this goal. This study aimed to assess Iran’s success in achieving this target.
Data was obtained from national data sources and international reports or estimations including World Report from United Nations on maternal mortality trends, the World Bank database, World Health Organization and UNICEF reports, Maternal Mortality Surveillance System, Demographic and Health Surveys 2000 and 2010, and yearbooks of National Organization for Civil Registration and Statistical Center of Iran. Data was analyzed using Excel software to produce descriptive statistics.
Findings showed that Islamic Republic of Iran with an average annual reduction of 6.4% between 1990 and 2015 and a total reduction of 80% in maternal mortality during the past 25 years is one of the nine countries that have fully achieved the fifth Millennium Development Goal.
Coordinated efforts of Iran for reducing maternal mortality during the last 25 years could be an inspiration for other countries to reduce preventable maternal mortality.

Background and Trichomonas vaginalis, is one the most common sexually transmitted diseases (STD) in women. Although metronidazole is the drug of choice for trichomoniasis, but due to its side effects attempts have been made to explore an alternative drug particularly with herbal source. Therefore, this study aimed to determine in vitro activity of hydroalcoholic extracts of Chenopodium album (C. album) leaf on the growth of Trichomonas vaginalis.
The plant (C.album) was approved in herbarium and hydro-alcoholic extracts were prepared. The experiment was done using 24 wells cell culture plate. In each well, 200 µl of modified axenic TYM culture medium and 200 µl of different concentrations (5, 37, 75, 150, 300, 600, 1200 μg/mL) of the plant extract was added. They were incubated for 24 and 48 hours and then the plates were incubated at 37 ° C. The experiment was performed as a double blind design and in triplicate. Then growth inhibition percent (GI%) of the parasites was evaluated in both times and in different concentrations of plant leaf extract.
Compared with metronidazole, the 600 and 1200 μg/mL concentrations of hydro alcoholic leaf extracts of C. album showed 96% and 100% inhibitory effects on the growth of trophozoeites of T. vaginalis in 48 hours, respectively.
C. album as an herbal native plant with ant-trichomonas activity is favorable and could be a candidate for in vivo researches on trichomoniasis in future.

Gestational Diabetes Mellitus (GDM) as the main metabolic disorder in pregnancy has had an increasing prevalence in recent years. Nowadays intrauterine metabolic condition is considered as a critical risk factor for diabetes and cardiovascular diseases. Evidence of fetal programming and its contribution as one of the evolutionary roots of human diseases provides a reason for improvements in controlling glucose metabolism in pregnant women, determining other nutrients, weight loss prior to pregnancy, having healthy diet, and preventing excessive weight gain during pregnancy. Medical Nutrition Therapy (MNT) is the initial treatment of GDM and obesity is a major challenge for dietary intervention during pregnancy consultations. Today, a high proportion of women are seen with high body mass index (BMI) before pregnancy and higher weight gain during pregnancy. In this paper, we provide a brief review on dietary intake and dietary interventions in GDM from the perspective of nutrition science scrutinizing the physiopathology and etiology of the disease.

The repeated exposure of a normal cell to carcinogenic agents may lead to its mutation, which changes into a cancer cell. In this case, the structure and function of the cells would alter, and they do not act normally. Chemicals, sun exposure, shortwaves, viruses, and bacteria play a significant role in cancer. Among the infectious and bacterial agents causing cancer, Helicobacter pylori (H. pylori) is the most important bacterium involved in carcinogenesis. H. pylori causes chronic gastritis, peptic ulceration, and gastric cancer. Recently, this bacterium has been classified as class I carcinogen (i.e., a definite cause of cancer in humans). Despite the pathogenic effect of this bacterium, it has been recently affirmed to induce apoptosis in cancer cell line and affect the reduction of tumor size in animal models. This result suggests that some factors of H. pylori can be used as a new tool in future therapeutic strategies implemented in cancer immunotherapy.