مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و چهارم شماره 6 (پیاپی 104، بهمن و اسفند 1398)

Common causes of dental discoloration include trauma, drugs, genetic defects, decay, and age. In order to correct discoloration of pulpless teeth, internal bleaching is recommended. The aim of this study was to compare microleakage of resin modified glass ionomer and OrthoMTA used as an intraorifice barrier in non-vital bleaching.

In this experimental study, 36 extracted mandibular premolars were selected and randomly divided into two experimental (n = 16) and two control groups (n = 2). 2mm of OrthoMTA and RMGI cements were placed as intraorifice barriers in the experimental groups. Subsequently, we placed a mixture of sodium perborate and 30% hydrogen peroxide as internal bleaching material into the canal and replaced it every three days. Leakage was measured using pH diffusion method by a digital PH meter. Data were statistically analyzed by using T- independent test and repeated measures and variance analysis (P<0.05).

The pH value of the negative control group was as same as the PH of normal saline while the PH value of positive control group was significantly higher than those of other groups. PH values of Ortho MTA and RMGI at the baseline and on the first, sixth and ninth day did not show significant differences with one another, while microleakage of OrthoMTA group was significantly lower on the third day.

In general, OrthoMTA had less leakage than RMGI but both materials can be used as suitable barriers for internal tooth bleaching.

Equitable distribution of health system resources and hospital beds is crucial for an acceptable level of health for all the people of the country. The aim of this study was to examine the equity in distribution of hospital beds in Iran.

In this descriptive and cross sectional study data were collected from Ministry of Health and Medical Education and Iranian statistics Center. The study population consisted of all Iranian hospitals in 2016. The equity in the distribution of hospitals’ beds was evaluated using the Lorenz curve and Gini coefficient. Excel software was used for data analysis.

Iranian population was 79,926,270 and there were 930 hospitals with 118,894 beds in 2016. (1.2 hospitals per 100,000 population and 1.5 hospital beds per 1000 population). Yazd, Semnan and Tehran provinces had the highest hospital beds per 1000 population. About 17% of the total hospitals and 22% of the hospital beds were located in Tehran. The Gini coefficient for hospital bed distribution among Iranian provinces was 0.107. Distribution of the hospital beds was equitable in Alborz and Yazd provinces and inequitable in North Khorasan, Sistan & Baluchestan and Charmahal & Bakhtiary provinces.

The distribution of hospital beds among Iranian provinces has been fair. However, hospital beds were not distributed equitably among the cities in the provinces and were concentrated in the capital cities of the provinces of the country. Healthcare policymakers should take appropriate measures to reduce inequality in the distribution of hospital beds.

Methotrexate (MTX) is commonly used in the treatment of diseases such as rheumatoid arthritis (RA) but, its hepatotoxicity potential, always has been a major concern. The aim of this study is to determine the rate of liver fibrosis by transient elastography (TE) method and its relationship with cumulative dose of MTX and duration of treatment, in rheumatoid arthritis patients receiving MTX.

This cross-sectional study included RA patients receiving MTX for more than 6 months. Hepatic fibrosis was determined by TE on the basis of the rate of liver stiffness. The patients were divided into 2 groups according to the results of liver stiffness measurement. Demographic, clinical and biochemical parameters were compared between the two groups. Correlation of the cumulative dose of MTX and duration of MTX treatment with the liver fibrosis was assessed.

The study included 51patients, with a mean age of 52.53)±9.95) years. 44(86.3%) patients were women. The cumulative dose of MTX was less than 4000 mg in 45 (88.2%) patients and more than 4000 mg in 6 (11.8%) patients with a mean treatment duration of 54.14±(40.94) months. The median (IQR) value of liver stiffness was 4.70 (3.60 – 5.50) kPa. The presence of liver fibrosis was detected in 11 (21.6%) patients. There were no significant relationships between liver fibrosis and cumulative dose (P= 0.21) of MTX and also duration of MTX treatment (P= 0. 30). The multivariate analysis demonstrated that only increased serum level of ALT was associated with presence of liver fibrosis (OR = 1.07; 95% CI: 1.01 to 1.13; p = 0.01).

According to the results of this study severe hepatic fibrosis was not common in the patients who had received methotrexate. Increasing the duration of methotrexate administration and the cumulative dose of the drug had no effect on the incidence of hepatic fibrosis. Increased serum ALT levels in RA patients were associated with high rate of liver stiffness and increased risk of hepatic fibrosis.

Alzheimer’s disease is the most common cause of dementia in old people. AD is a progressive and irreversible neurodegenerative brain disorder. Sortilin receptor 1 (SORL1) is involved in cellular trafficking of amyloid precursor protein and plays an essential role in amyloid-beta peptide generation in the AD. The purpose of the present study was to evaluate the association of SORL1 rs2282649 and rs12285364 polymorphism with AD in Azeri population in the northwest of Iran.

This case- control study included 100 Alzheimer’s disease patients as our case and 83 healthy subjects as our control group. Genotypes were determined by (PCR- RFLP) technique.

In rs2282649 SNP the frequency of homozygous CC genotype was 36% in the case and 38.55% % in the control groups (P= 0.70). The frequencies of TT genotype were 12% and 7.23% in the case and control groups respectively (P = 0.25). The frequency of heterozygote CT genotype was 52% in the cases and 54.22% in the control group (P = 0.75). Also, in rs12285364 polymorphism the frequencies of homozygous CC genotype in the cases and the control groups were 93% and 90.36 % respectively (P= 0.5). The frequency of TT genotype was 0% in both case and control groups (P = 0.00). The frequencies of heterozygote CT genotype were 7% in the case and 9.64% in the control groups (P = 0.49).            

No statistically significant difference was observed between the case and control groups in regard to the frequencies of the genotypes. Therefore we can conclude that these polymorphisms are not associated with Alzheimer’s disease among the people in the northwest of Iran.

Infection by drug resistant Pseudomonas aeruginosa causes important therapeutic problems. The present study was performed to investigate the antibiotic susceptibility and prevalence of antimicrobial resistance genes in P. aeruginosa.

In this cross sectional study, 61 clinical P. aeruginosa isolates were collected in Sanandaj between April and September 2017. Isolates were examined by disk diffusion method to determine susceptibility to 8 antibiotics and by polymerase chain reaction to detect the presence of extended-spectrum beta lactamase blaCTX-M gene and plasmid-mediated quinolone resistance determinants, qnrA, qnrB, and qnrS. We also evaluated the effect of resistance to quinolones on cross resistance to other antibiotics. We used descriptive statistics for data analysis.

Meropenem showed the highest susceptibility rate (88.5%), followed by piperacillin (85.2%), ceftazidime and amikacin (80.3%, each), imipenem (77%), cefepime (73.8%), ciprofloxacin (49.2%), and gentamicin (39.3%). Among 61 isolates, 32.8% showed multidrug resistance. Ciprofloxacin-resistant isolates had cross resistance to gentamicin (93.5%), cefepime (45.2%), ceftazidime and imipenem (38.7%, each), amikacin (35.5%), piperacillin (29%), and meropenem (22.6%). We detected qnrS in three isolates (4.9%). blaCTX-M, qnrB and qnrA were not identified.

Our results suggested that ciprofloxacin may not be effective against P. aeruginosa. According to our knowledge, this is the first report of presence of qnr in P. aeruginosa from Kurdistan which highlights the need for continuous monitoring for prevention of the transmission of qnr.

Genetic changes and mutations in the genes involved in spermatogenesis can occur by environmental and congenital factors. Considering, the extensive use of diazinon in the farms and because we found no study on the effects of diazinon on the expression of CatSper1 gene, a key element of male fertility, we decided to perform this study in order to determine the effects of different doses of diazinon on CatSper1 gene expression, sperm motility and thickness of seminiferous tubules in adult male mice.

Twenty-four adult male Balb/c mice were randomly divided into four groups. The control group did not receive any injection. The sham group received diazinon solvent. Diazinon1 group received 7.5 mg/kg and, diazinon group 2 received 30 mg/kg of diazinon intraperitoneally, once a day for 2 weeks. After 35 days, we studied the sperms from the molecular and histological aspects and sperm motility was evaluated.

Sperm motility was significantly decreased in diazinon 1 (P-value = 0.001) and diazinon 2 (P-value = 0.001) groups compared to that in the control group. Gene expression in diazinon group 1 and diazinone group 2 (P-value = 0.002) was significantly lower than that in the control group. Histological examination also showed that diazinon treatment reduced germinal epithelium thickness and led to vacuole formation and degeneration. Epithelial thickness was significantly decreased in diazinon group 1 (P-value = 0.003) and diazinon group 2 (P-value = 0.006) in comparison to that in the control group.

Diazinon affects male fertility by reduction in sperm motility and degenerative changes in germinal epithelium. It also, decreases expression of CatSper1 gene, a key gene in fertility.

The hippocampus is a region of the brain that plays an important role in learning activities, including conditioned place preference (CPP). This area is widely used as the target of the studies on the reinforcing effects of the drugs and narcotics. Considering the wide distribution of GABAB receptors in the hippocampus CA1 region, these receptors are likely to play an important role in drug reward learning.

Wistar female rats were divided into 17 groups (N=7). Different amounts of morphine (0.5, 2.5, 5, 7.5, and 10 mg/kg) were injected subcutaneously to determine the effective dose of morphine. 3 days before induction of conditioned place preference, the animals received morphine injection (12.5 mg/kg) in order to induce tolerance. Then, baclofen as a stimulant (agonist) of GABAB receptors; and also, CGP35348 as an inhibitor of these receptors (antagonists) were injected into the CA1 region of the hippocampus.

5 mg/kg of morphine was considered as the effective dose at the significance level of P< 0.001. Baclofen at the doses of 6 mg/kg and 1/5 mg/kg increased tolerance to morphine (P <0.01 and P <0.05 respectively). CGP35348 at a dose of 6 mg/kg significantly reduced morphine tolerance (P <0.05).

The results of this study confirmed the importance of GABAB receptors in the CA1 region of the hippocampus in morphine tolerance in female rats.

Water crisis in many regions of the world especially arid and semi-arid areas such as Iran, is an important obstacle for socioeconomic development and food security. Under such circumstances, wastewater reuse in agriculture can be regarded an important alternative water source. However, treated wastewater may contain some types of pathogenic microorganisms which can threaten human health. In the present study we compared the impacts of treated wastewater (TWW) and tap water irrigation on microbiological quality of soil and crops (maize and maize leaves) through a furrow irrigation system in an experimental field.

Total and fecal coliforms and Escherichia coli were monitored as indicator bacteria in TWW, irrigated soil and harvested maize and maize leaves. We investigated the presence of Salmonella and Shigella by using a combination of culture and molecular methods. Statistical analyses were performed by SPSS 22.0 software. P<0.05 was considered statistically significant. The Mann-Whitney test was used to evaluate the difference of microbial parameters in the plots irrigated with the two types of water.

The microbiological quality of wastewater in terms of mean concentration of E. coli (3.5 Log MPN/100 ml) was compatible with that recommended by the world health organization (WHO) for irrigation of fast-growing crops (≤ 105 E. coli per 100 ml). Although, the microbiological quality of soil was affected by TWW irrigation (p < 0.05), a relatively low concentration of E. coli was detected in soil. Harvested maize had no microbial contamination with E. coli. However, one sample of wastewater-irrigated maize leaves was contaminated with E. coli. The TWW, soil and crop samples were not positive for pathogenic bacteria.

According to the results, TWW could be used as an alternative source for irrigation of maize.

Quality of care in the health system is one of the most important issues and one of the most important indicators in organizational accreditation. Use of managerial principles, such as the division of labor among nurses, can affect the quality of care.

This was a randomized double-blind clinical trial which included 44 nurses and 59 patients in 4 CCU wards. The intervention included 3 sessions of 2-hour workshops and then implementing the two above-mentioned care methods for the patients. After the intervention and at the time of discharge, the quality of care provided was assessed from the patients' point of view by means of quality care patient scale. Data were analyzed by Mann-Whitney test.

The results showed after the intervention, the mean values for general quality of patient care in the primary group and case method group were (14.2 ± 1.9) and (11.2 ± 2.8) respectively. Also the quality of professional care in the primary group and case method group were (18.2 ± 2.2) and (3.5 ± 14.2) respectively. Mann-Whitney test in both aspects showed that the quality of general and professional care was significantly higher in the primary group than in the case-method group (p <0.05).

The results of this study indicated that the primary method can be used in some wards, and was more effective than the case-method. Therefore, paying more attention to nursing care management planning is recommended.

The aim of this study was to investigate the effects of backward gait training protocol on knee adduction moment and impulse in male patients with medial knee osteoarthritis.

This quasi-experimental study with a pretest-posttest design included two control groups (healthy and patient) and an experimental group (subjects with medial knee osteoarthritis). The subjects were 21 healthy men and 42 male patients with knee osteoarthritis who were divided into experimental and control groups according to the Kellgren and Lawrence radiologic scale and visual analogue scale. The experimental group performed backward gait training for six weeks. The dependent variables included 1st peak knee adduction moment, normalized 1st peak KAM, 2nd peak knee adduction moment and normalized 2nd peak KAM. A Vicon (130 Hz) motion analysis system with four T-Series cameras and two Kistler force plates (1000Hz) were used for data registration. Using Vicon Nexus 1.8.5 and polygon 4.1.2 softwares, data analysis was performed by paired sample t-test and one-way ANOVA (p<0.05).

Before and after training, we found no significant differences between the patients with osteoarthritis and healthy subjects in regard to peak knee adduction moment (P>0.05). However, before training significant differences were observe in knee adduction moment impulse between the healthy subjects and patients (P=0.014, P=0.004). After exercise we found decreased mean value for normalized knee adduction moment impulse in the experimental group compared to that in the healthy control group (p=0.067).

Knee adduction moment impulse can be regarded as a predictive index with high sensitivity for evaluation of the severity of knee OA. Implementation of backward gait training protocol led to decreased knee adduction moment impulse in the experimental group.

Osteoporosis is one of the most common bone diseases that is caused by an imbalance between the activity of osteoblasts and osteoclasts. Osteoprotegerin (OPG) plays an active role in inhibiting osteoclasts by binding to the receptor activator of nuclear factor kappa-B ligand (RANKL). The balance in the OPG/RANKL ratio is important in bone remodeling. The current study investigated and compared the effects of mumie extract and chemical drugs on cell proliferation, expression of OPG and RANKL in MG63 cells.

The effects of 100, 200 and 300 μg/ml of mumie extract on cell proliferation, expression of OPG and RANKL in MG63 cells were investigated in experimental groups, positive and negative control groups. Data were analyzed by ANOVA test.

Significant increases were observed in the proliferation of MG63 cells after exposure to 100 and 200 μg/ml concentrations of mumie extract. 200 μg/ml concentration of the extract significantly decreased the expression of RANKL and increased the expression of OPG. It also increased OPG/RANKL ratio significantly in the experimental groups, compared to those in the negative control groups. Although the effects of 100 μg/ml and 200 μg/ml concentrations were similar to each other, they showed no significant effects on the variables. 300 μg/ml concentration of the extract showed a reverse and insignificant effect.

200 μg/ml concentration of mumie extract had a significant effect on the expression of two important factors in bone remodeling. Therefore, individuals susceptible to osteoporosis can use mumie extract as an alternative to chemical drugs.

one of the known complications of phototherapy in the treatment of jaundice in newborns is the reduction of serum calcium and the cause of this phenomenon is still not well defined. The aim of this study was to investigate the effect of phototherapy on increasing calcium urinary excretion and to answer the question whether phototherapy can be associated with increased urinary excretion of calcium as a risk factor for nephrolithiasis?

In this cross-sectional study 77 infants less than 2 weeks of age with normal weight who were hospitalized for non-physiologic jaundice were enrolled in a sampling study. These infants lack systemic underlying disease and were not treated with Antibiotics - No serum therapy and blood transfusion. Urine specimens were taken at the time of admission and 48 hours after phototherapy of newborns and ca, cr in urine was measured. Then, the ratio Ca/Cr was calculated. Finally, the obtained data was entered into SPSS 19 software and analyzed.

Average random urine Ca/Cr ratio before phototherapy was 0.38± 0.03 and the average random urine of ca/cr after phototherapy was 0.674 ± 0.26. The difference between the mean of Ca/Cr ratio of neonates with jaundice before and after phototherapy was significant (P <0.001) in 49.4% of neonates hypercalciuria was seen (Ca/Cr > 0.8).

According to the findings of this study, which indicates an increase in urinary excretion of calcium, phototherapy in newborns can be considered as a risk factor for the incidence of hypercalciurea and nephrolithiasis.