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Background and purpose: Apoptosis is a physiological mechanism of programmed cell death that dysregulation in this process may lead to carcinogenesis. Functional gene polymorphism in Fas can alter transcriptional activities and thus change the risks of cancer. A to G substitution in Fas -670 promoter region disrupts the binding site of STAT1 transcription factor. This study aimed to assess the association of genetic variants of Fas -A670G polymorphism with the potential risk of gastric cancer. Materials and methods: Genomic DNA was extracted from 159 patients with gastric adenocarcinoma and 170 healthy people as control group. Two groups had similar age, sex and ethnic background. Gastric cancer was diagnosed based on clinical and endoscopic findings, and pathological confirmations. Genotyping was done according to PCR-RFLP method. The association of genotypes or allele with disease was analyzed by logistic regression model and odd ratio was obtained at confidence level of 0.05. Results: Results showed that the mean age of patients was not significantly different with that of control group. (62.14 + 12, and 58.93 + 14.2, P= 0.9). Also, allele frequency in the patients and controls was not significantly different (58.6% vs. 61.8%, P=0.47). Meanwhile, the genotype frequencies of –A670G polymorphism were significantly different in two groups. The A/G heterozygosity was significantly less frequent in the patients than that of controls (42.4% vs. 51.8%, P=0.041). On the other hand, the presence of heterozygous A670G decreased the cancer risk (R= 0.5 and CI 0.26-0.94). Conclusion: Our findings indicated that A670G polymorphism in Fas promoter region might be associated with the risk of gastric cancer. Therefore, genetic variation in Fas/FasL system may contribute to etiology of gastric cancer due to corruption in apoptotic process.

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Background and purpose: Brucellosis is a zoonotic disease with worldwide distribution. Humans are usually infected through contact with infected animals or unpasteurized dairy products. We observed contradictory diagnostic value of ELISA and Standard tubal agglutination test (wright) in other studies. Therefore, we designed this study to compare the diagnostic value of ELISA and Standard tubal agglutination test (wright) in patients with positive PCR brucellosis. Material and Methods: We designed a diagnostic study and selected 59 suspected patients and 45 healthy individuals during March 2012 to March 2013 in Razi Hospital at Ghaemshahr City. We did all the tests including: PCR, 2-Mercaptoethanol, Wright, Coombs and Wright and Elisa for all patients and healthy subjects. Clinical manifestation and laboratory data were collected. Data were analyzed by SPSS version 16. Results: The patients’ mean age was 37.98±13.79 years and 71.2% were males. All patients had previous exposure to risk factors. The most common signs were fever (86.4%), sweating (71.2%) and arthralgia (71.2%). On the base of PCR, sensitivity, specificity, positive predict value (PPV), negative predict value (NPV) and the overall accuracy of Wright test was 94.73%, 63.63%, 60%, 95.45% and 75%, Elisa IgM test 57.89%, 77.27%, 59.45%, 76.11% and 70.19% and Elisa IgG test 78.94%, 71.21%, 61.22%, 85.45% and 74%. Conclusion: In our study, Wright test has higher sensitivity, NPV and overall accuracy in comparison with ELISA. In ELISA test, ELISA IgG has higher sensitivity, PPV, NPV and overall accuracy in comparison with ELISA IgM.

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Background and purpose: Prostate cancer is one of the most prevalent diseases among men. The role of heredity in prostate cancer has been proved by epidemiologic studies. By utilization of prostate specific antigen (PSA) and digital rectal exam (DRE) we could diagnose the disease before the clinical manifestation and implement screening programs. The purpose of this study was to screen the prostate cancer in individuals over 40 years of age who were first degree relatives of prostate cancer patients. Materials and methods: This cross-sectional study was conducted in relatives of confirmed prostate cancer patients during 2010-2011 in Babol. After giving verbal informed consent, 103 individuals (brothers and sons) were recruited. We examined PSA and DRE during the screening program. Quadrant biopsies were performed if the PSA level was greater than 4 ng/ml or DRE was suspicious. Results: The participants aged between 40-60 years old and the mean age was 51± 8.88. The screening tests results showed that 15 cases were abnormal in which six cases (5.8%) had a PSA level of greater than 4 ng/ml, six (5.8%) had a suspicious DRE and 2.9% were found with suspicious findings on both tests. At the second stage of the study, biopsy was done for those who had abnormal screening results. However, eight people refused to continue the study and the biopsy was taken from others. According to pathology results, malignancy was confirmed in three cases and the detection rate of prostate cancer was 2.9% (95% CI: 0-6.1). Conclusion: Our results emphasize the usefulness of PSA and DRE to detect early prostate cancer in high risk families.

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Background and purpose: Despite the proven effectiveness of propofol on reducing smooth muscle tone, the effect of this drug on ureteral spasm has not been investigated yet. This study was designed to investigate the effect of propofol on transurethral lithotripsy (TUL) and its influence on reducing acute ureteral spasm.

Materials and methods: A double-blind clinical trial was conducted in 122 patients. Initially, all patients were given 0.02mg/kg midazolam and 2μg/kg fentanyl. The subjects were then randomly divided into two groups. The first group (n=65) received 2.5mg/kg propofol and for the second group
(n= 57) 5mg/kg thiopental was injected. TUL was performed using pneumatic method. Duration of TUL, hemodynamic condition, and success rate of lithotripsy, using ESWL, ureteral stent, Double J and any complications were recorded.

Results: There were no significant differences in terms of gender, age, weight and stone size between the two groups (P> 0.05). Duration of TUL (P=0.004) and the mean of SBP, DBP and HR in one and five minutes were significantly lower in the propofol group (P< 0.01). The success rate of TUL was 96.9% and 89.5% in propofol and thiopental groups, respectively (P= 0.097). Stent and double J replacement were observed in 17.5% and 22.8% of thiopental group and 20% and 16.9% of the propofol group, respectively (P= 0.415).

Conclusion: Propofol was associated with higher reduction in systolic and diastolic blood pressure, less changes in heart rate, reducing the duration of TUL, increasing the success rate of TUL, and less need to Double J and ESWL.

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Background and purpose: Intensive care unit (ICU) nurses play an important role in non-pharmacological prevention of ventilator-associated pneumonia (VAP). The aim of this study was to assess the knowledge of nurses in ICU about non-pharmacological prevention of ventilator-associated pneumonia.

Materials and methods: In a descriptive cross-sectional study, 120 ICU nurses were studied in teaching hospitals of Mazandaran University of Medical Sciences, 2015. Demographic information of nurses were recorded including age, sex, duration of being in ICU and their educational level. An authentic multiple-choice questionnaire was administered to assess the nurses' knowledge about the prevention of VAP.

Results: 120 nurses including 96 females and 24 males (mean age: 32.39±5.57, mean work experience: 5.94±4.5 years) were studied. The average number of beds in the studied ICUs was 9.53±1.97 beds (Median=9). Percentage of correct answers of nurses on the oral route for intubation, frequency of ventilator circuit changes, type of airway humidifier, frequency of humidifier changes, type of suction system, frequency of change in suction systems, drainage of subglottic secretions, kinetic vs. standard beds, and patients positioning were 81.7%, 53.3%, 42.5%, 6.7%, 62.5%, 38.3%, 30%, 46.7%, and 85.8%, respectively. The average score of the participants was 4.48±1.69 out of 9.

Conclusion: ICU nurses' knowledge about the type of humidifier, switching frequency of humidifier, switching frequency of suction system, subglottic secretion drainage, and the type of bed was found to be very low. These findings call for continuous training and assessment to promote the knowledge of nurses in ICUs for non-pharmaceutical prevention of VAP

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Background and purpose: Fentanyl is commonly used for spinal analgesia during labor, but it is associated with high incidence of pruritus. This study was performed to evaluate the effect of intravenous injection of prophylactic granisetron on the incidence and severity of pruritus induced by intrathecal fentanyl among the parturients undergoing cesarean section under spinal anesthesia.

Materials and methods: This double-blind clinical trial was performed in 136 ASA I or II (based on the American Society of Anesthesiology Classification) women undergoing elective caesarean section under spinal anesthesia with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (25 µg). After parturition and clamping of the umbilical cord, the subjects were randomized to receive 1 mg of IV granisetron (group G) or 0.9% saline (group S). To compare the incidence and severity of pruritus between the two groups, Fisher’s exact test and t-test were performed, respectively, using SPSS version 21.

Results: The overall incidence of pruritus was 3.74% (group S=5.76% and group G=1.72%). In the G group, the incidence of pruritus was significantly different and lower in recovery (P=0.01). There were significant differences between the groups in terms of severity of pruritus during surgery, which was lower in the G group (P=0.005).

Conclusion: This study showed that granisetron as the 5-hydroxytryptamine (serotonin) subtype 3 antagonists may reduce the incidence and severity of pruritus induced by intrathecal opioid.

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Background and purpose: Population aging is rising in Iran, and information about the quality of life of the elderly and the factors influencing that can provide a basis for appropriate planning to promote the health of this age group. The purpose of this study was to determine the quality of life in elderly population in Amol, Iran, and its related demographic factors.
Materials and methods: This cross-sectional study was carried out in 450 elderly over 60 years of age in health centers in Amol, Iran 2017. Sampling was done using multi-stage cluster sampling based on residence place (urban/rural), gender, and age. Quality of life questionnaire (SF-36) was used to collect the data which were then analyzed by independent sample t-test, One–Way ANOVA, and multiple regression in SPSS V24.
Results: Multiple regression test (enter method) showed that occupation, age, sex, education, and income source had significant roles in the changes in quality of life (P <0.05).
Conclusion: Quality of life was good but physical health level was found to be lower compared to metal health. Elderly aged 60-69 years old, married, men, employed, heads of households, those with higher education, financially independent, and elderly with companions had a higher quality of life.
 
 

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Background and purpose: The COVID-19 pandemic has widely forced universities to provide electronic education, so, it is necessary to examine the quality of this type of education. The aim of this study was to investigate the quality of virtual learning during COVID-19 pandemic from the perspective of dental students in Mazandaran University of Medical Sciences.
Materials and methods: A descriptive-analytical cross-sectional study was performed and dental students in Mazandaran University of Medical Sciences who studied via on-line courses in 2020/21 academic year were included. A researcher-made questionnaire was used consisting of five components: implementation method, facilities and technology, content, strategies and methods, and evaluation.
Results: In this study, 128 students completed the questionnaire. According to findings, in first semester, the status of some components, including implementation method, content, strategies and methods, and evaluation were unfavorable, but facilities and technology were found to be relatively favorable. Also, in second semester, the situation of strategies and methods was unfavorable, and the rest of the components had a relatively favorable condition. Female students were more satisfied with the quality of virtual learning.
Conclusion: In general, the quality of virtual learning in Mazandaran School of dentistry was unfavorable in 2020, but became relatively favorable later. Despite improvements in 2021, special attention should be paid to this modern educational method.

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 Background and purpose: Asthma is a prevalent disease that affects oral health-related quality of life (OHQoL). There is no study on this issue in Iran, so this study investigated the OHQoL in asthmatic patients.
Materials and methods: In this descriptive analytical study, 54 asthmatic patients in Sari Tuba Medical Center were examined. They were selected by convenience sampling. The Oral Health Impact Profile-14 (OHIP-14) was administered and Ramfjord teeth were selected to examine the OHI-S index. Data analysis was done applying descriptive statistics and Kolmogorov Smirnov test in SPSS V25.
Results: The mean age of patients was 38.05±12.57 and 75.9% were women. The mean scores for OHIP-14 and OHI-S were 2.40±1.14. The highest score in the quality of life questionnaire was related to physical discomfort (1.17±0.96). There were no significant differences between gender, DI, and CI in OHQoL (P=0.893), and OHI-S and OHQoL (P=0.690).
Conclusion: In current study, no relationship was found between oral health of asthma patients and the OHQoL, but dentists are recommended to consider the impact of oral problems on patients' quality of life in addition to professional measures.
 

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Background and purpose: Diabetes is one of the most common diseases in the world, and blood sugar control and periodontal diseases are mutually related. The aim of this study was to investigate the periodontal status of people with type 2 diabetes referred to Imam Khomeini and Touba Medical Centers in Sari during 2018-2019.
Materials and methods: This descriptive cross-sectional study included 107 randomly selected patients who were diagnosed with type 2 diabetes (controlled and uncontrolled). HbA1C values were evaluated to check the diabetes status of the patients, and Community Periodontal Index (CPI) was evaluated to check the periodontal status. Statistical analysis was performed using SPSS V24.
Results: All the 107 patients were females, with an average age of 49.7±11.2. Diabetes was controlled in 46.7% of the patients, while 37.4% of the patients had uncontrolled diabetes. In the examination of periodontal condition, 40.2% were healthy, 30.8% had gingivitis, and 29% had periodontitis. The value of CPI was 1.8 ± 0.5, and code 3 (envelope 4-5 mm) was the most frequent index.
Conclusion: Since the highest frequency of Community Periodontal Index of Treatment Needs (CPITN) was related to code 3 (4-5 mm packet depth), it is recommended that diabetic patients fulfill their oral hygiene and make regular visits to the dentist for follow up examinations.
 

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Background and purpose: Mental health problems in adolescence have a high prevalence and students are also affected by these problems as an active segment of society. In this context, mental health literacy and seeking professional psychological help are important components in the prevention, diagnosis, and timely treatment of mental disorders. the present study aims to examine the relationship between mental health literacy and attitude towards seeking professional psychological help in high school students of Amol City during the academic year 2022-2023.
Materials and methods: This is a descriptive-analytical cross-sectional study conducted on high school students of Amol City during the academic year 2022-2023. With multi-stage random sampling, 416 students participated in the research, and considering the inclusion and exclusion criteria, 357 were analyzed. Data were collected using the demographic and educational form, mental health literacy scale (MHLS), and short form of attitude towards seeking professional psychological help scale (ATSPPH-S). Data analysis was performed using SPSS V22, employing descriptive statistics tests, univariate and multiple generalized linear regression models.
Results: In this study, the mean age of the participants was 16.62±0.645 years and 52.4% of them were males. Also, most of them were in the 11th grade and studying technical and professional fields. The results of the study showed that the average mental health literacy and attitude towards seeking professional psychological help in students were 78.32±9.17 and 15.70±4.31 respectively which were almost in the middle range. The ability to identify mental disorders had the highest average (23.34) and the awareness of risk factors had the lowest average (5.12) among the components of mental health literacy. The result of univariate generalized linear regression indicated that there was a significant relationship between attitude towards seeking professional psychological help and students' mental health literacy (P<0.05). Moreover, multiple generalized linear regression’s results showed that attitude towards seeking professional psychological help, gender and mothers' education had a significant relationship with students' mental health literacy(P<0.05). Other demographic and educational variables had no significant relationship with mental health literacy(P<0.05).
Conclusion: Considering the direct and meaningful relationship between mental health literacy and attitude towards seeking professional psychological help in students, it is suggested that managers and educational and health officials make decisions to improve the mental health literacy of students. This can increase their willingness to seek psychological support when necessary. It is also important to create suitable conditions for training and improving the mental health literacy of the parents of students so that they can play an effective role in improving the mental health of themselves and their children.


 

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Background and purpose: One of the main complications of diabetes is psychological problems, such as reduced stamina and psychological well-being. The use of muscle relaxation is a simple, safe, and non-pharmacological method. Therefore, the present study was designed to investigate the effect of Jacobson's muscle relaxation technique on psychological well-being and resilience in patients with type 2 diabetes.
Materials and methods: The current study is a two-group randomized clinical trial with a pre-test and post-test design conducted on 40 patients with type 2 diabetes at the Khayyam Diabetes Clinic in 2021. Eligibility criteria included minimum literacy, acceptable hearing, and speaking ability, age between 25 and 65 years, no history of relaxation training, type 2 diabetes for at least 6 months, no smoking and no alcohol, ability to use a computer, poor psychological well-being and resilience (psychological well-being score equal to or less than 63, resilience score equal to or less than 50), and no definite psychiatric disorders. Exclusion criteria included: special medical conditions (such as hospitalization or medical inability to continue treatment), withdrawal from the research, death, unwillingness to cooperate, incomplete completion of questionnaires by members, and failure to perform sedation for more than 4 sessions. The samples were selected using the available methods and then randomly allocated with permutation blocks to two intervention and two control groups. The relaxation technique was then practiced at home by the intervention group once a day for 8 weeks. Rif's psychological well-being questionnaire and Connor's resilience questionnaire were completed by the intervention and control groups at the beginning and end of the intervention. Data were analyzed using the Shapiro-Wilk test for normality, Fisher's exact test, chi-square, and analysis of covariance using SPSS 25 software.
Results: The results of the research showed that the two groups were homogeneous in terms of gender, marriage, age, education, history of chronic diseases, history of neuro medications, insulin history, exercise history, peer history, dietary compliance, income, and occupation and there was a statistically significant difference. There was no difference in these variables between the two groups (P>0.05). The results of the covariance test show that the means of the experimental and control groups are the same in terms of patient resilience (P=0.49, eta=0.02). Therefore, it can be concluded that there is no significant difference between the experimental and control groups in terms of patient endurance, controlling for the effect of pre-test means. Also, the means of the experimental and control groups differ in psychological well-being (P=0.00, eta=0.44). Therefore, It can be concluded that there were statistically significant differences between the groups. More specifically, there was a significant difference between the experimental and control groups in terms of psychological well-being, controlling for the effect of pre-test means.
Conclusion:  Results of the study showed that muscle relaxation training was an effective, practical, and inexpensive method of improving and preventing psychological problems in people with diabetes in the intervention group compared with the control group.

(Clinical Trials Registry Number: IRCT20220110053682N1)
 

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Background and purpose: Regenerative treatments in endodontics are biological treatments to manage immature teeth, remove inflamed and necrotic tissue, and create a suitable environment for tissue repair. In these treatments, substances with reparative properties of dental pulp and dentin are placed on the pulpal tissue. Interleukin-6 is one of the cytokines secreted in response to various immune activities of the body and studies have demonstrated its vital role in mineralization induction and hard tissue formation. Recently, calcium silicate-based materials have been widely implemented in dentistry due to their great biocompatibility and hard tissue formation induction. Considering the role of IL-6 in the regulation of stem cells, the purpose of this study is to compare the effect of CEM cement, Biodentine, TheraCal LC, and MTA on the level of IL-6 secretion by dental pulp stem cells.
Materials and methods: In this laboratory study, 4 types of cement were used as the main groups, and 1 control group contained culture medium without cement. Discs were prepared under sterile conditions in six-well plates with a diameter of 35 mm and a height of 2 mm and they were given time to set for 48 hours. Human pulp stem cells were obtained from Iran's Center for Biological Resources and cultured in a culture medium containing DMEM with 15% FBS and 1% penicillin-streptomycin (10,000 units/ml) as antibiotics. Pulp stem cells at passages 3-5 were used for experiments. Discs of each cement were prepared under sterile conditions and according to the manufacturer's instructions. To prepare the extract of each cement, the DMEM cell culture medium was placed near these discs for 24 hours. Then, human dental pulp stem cells (hDPSCs) were cultured in the vicinity of the disc extract for 72 hours. After that, this extract was collected and the level of IL-6 secretion in it was measured by the ELISA method. The experiments were repeated 3 times. Then the obtained data were entered into SPSS 16 software and analyzed using analysis of variance and the Kruskal-Wallis test.
Results: The results showed that the highest level of IL-6 secretion by cells was in the presence of TheraCal LC, Biodentine, and CEM, respectively; But there was no significant difference between the groups. The average level of IL-6 secretion in the presence of MTA was lower than in other groups and this difference was significant (P<0.01).
Conclusion: The results of the present study showed a lower level of IL-6 cytokine secretion by pulpal stem cells in the presence of MTA compared to TheraCal, CEM, and Biodentine types of cement. Considering the role that IL-6 can have in osteogenic and odontogenic activities, the results of this study can be useful in establishing information in the field of introducing the most suitable cements for clinical procedures.