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Background and purpose: Management of cutaneous wounds is an important subject in medicine. Different chemical agents have been used for wound healing but each of them has side effects. In this study, we examined the effects of an experimental ointment derived from a natural product on wound healing.
Materials and Methods: Twenty-four white rabbits divided into three groups as fallows: control, Eucerin and Gazangebine. The ointment was made by Gazangebine extract (9%) and Eucerin in the laboratory. A full thickness wound (2cm ´2cm) was made on the left flank of the test animals. The ointment was applied to the wound area twice daily without any covering as an open wound. Wound area was measured every 3 days until day 18 . In this day, rabbits were biopsied to look for histopathological changes.
Results: Gazangebine ointment had no beneficial effects on wound contraction. However, it decreased inflammation and neutrophil number (P<0.05, p=0.001) and increased eosinophil number and dermal tissue healing (p<0.05, p=0.000).
Conclusion: The results suggest that Gazangebine ointment has positive effects on wound healing.

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Mycetomas are chronic granulomatous fungal diseases that involve cutaneous and subcutaneous tissues. Mycetomas are caused by fungi (Ëumycetoma) or fungus-like bacteria (Âctinomycetoma). The exogenous causative agents are geophilic organisms which introduced by traumas. We review 90 cases of mycetoma in Ïran from 1972 to 2009. There are rare reports of Mycetomas from Ïran with most cases (66.3%) being male (male to female ratio of ~ 2:1). Ït has been found that the highest incidence of Mycetoma is between the ages of 31 and 50 years (60%) while most of the patients were farmers (44.4%). Ïn Ïran, foot is the most common site of affection (73.8%) followed by leg and arm (4.8% each). The most common agents causing actinomycetoma are Âctinomadura madurae (23.5%), Nocardia asteroids (20.6%), Nocardia caviae (13.2%), and the most frequent causative agents of eumycetoma is Pseudoallescheria boydii (10.3%). The majority of reported cases are Northern (36%) and Southern (27%) provinces of Ïran. Mazandaran has the highest prevalence (59.4%) among the Northern provinces The most common prevalent agents in Northern Ïran is Âctinomadura madurae (47.8%) that caused 68.8 % of Mycetoma in Northern Ïran.

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Background and purpose: One of the biggest environmental problems of pulp and paper industries is discharge of colored wastewater containing lignin to environment. The aim of this study was to evaluate the TiO2 photocatalytic process Dap with iron in the presence of UV for lignin degradation. Materials and methods: This cross-sectional study was conducted at laboratory scale (in vitro) in a 2-liter reactor. The synthesis of nano was made by sol-gel method. Lignin absorption was done using UV/Vis spectrophotometry at 280 nm. The samples were estimated based on factorial method (72 samples). The SPSS software version 16.0 and Excel 2007 and regression test were used for statistical analysis. Results: The highest removal rate in the presence of UV was 95.4%, and in the presence of sunlight was 87.4%. The removal rate of lignin increased when the concentration increased from 0.15 to 0.3 g/l. In all of the pH, the removal rate increased with increasing in retention time from 15 to 120 minutes and remains slightly constant after 60 minutes. The optimum pH was obtained 7. The reaction rate increased when the concentration of nano increase and the pH decreased. Conclusion: Based on the findings, the removal rate was considerably above in visible light and in the presence of sunlight, which represented the Dap role of nanoparticle therefore, due to the low consumption, low power consumption and high efficiency, Doped nano can be used as an alternative for the removal of lignin from the pulp and paper industries.

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Background and purpose: Asthma is the most common chronic disease of childhood and adolescence resulting in variable restrictions in most aspects of patients’ life and decreases their quality of life (QOL). Control of the triggers could be of great benefit in the management of asthma. This study was conducted to assess the effect of education on asthma triggers and controlling them on QOL among adolescents suffering from asthma. Materials and methods: This randomized clinical trial was performed in 60 adolescents aged between 12-18 years. They were randomly assigned into intervention and control groups. Mini Pediatric Asthma Quality of Life Questionnaire (Juniper 1997) was used prior to intervention and five weeks post-intervention in both groups. The intervention group was educated regarding asthma triggers, then they were followed up through telephone calls. The data was analyzed using SPSS V.13, Chi square and t-tests. Results: Significant differences were found in the scores of QOL among both groups. Therefore, education on triggers of asthma and controlling them was effective in enhancing QOL (P≤0.001). Conclusion: This intervention was found potent in improving the QOL of adolescents with asthma. Hence, educational programs should be carried out in outpatient clinics on triggers of asthma with the participation of adolescents instead of their parents. (Clinical Trial Registry Number: IRCT201112078315N1)

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Background and purpose: perceived value is defined as customer’s overall assessment of the utility of a product or service based on perceptions of what is received and what is given. The aim of this study was to investigate the relationship between service quality and perceived value by patients in private hospitals of Tehran. Materials and methods: This cross-sectional descriptive and analytic study was conducted in 2010. The study population included 969 patients selected from eight private general hospitals in Tehran. The data was collected through a questionnaire containing 18-items (service quality: 14 items and perceived value: 4 items), which its reliability and validity were confirmed. Data analysis was performed using descriptive statistics and multivariate regression in SPSS.17. Results: The mean score for patients' perception of service quality and perceived value were 4.01, and 3.43 out of 5. Regression analysis showed that about 27% of the variance in perceived value could be explained by the service quality. The interaction quality is the strongest factor influencing patient perceived value and its predictive power is about twice more than two other dimensions of service quality (process quality and environmental quality). Conclusion: Three dimensions of service quality were the key determinants of perceived value in private hospitals of Tehran. To promote the perceived value by patients, the quality improvement activities must focus on reduction and rationalizing monetary costs, accurate service scheduling, and strengthening the interpersonal relationships and communication skills of doctors, nurses and staff.

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Background and purpose: Gastric cancer is the third most common cancer in Iran and the second leading cause cancer-related death worldwide. Shark cartilage prevents angiogenesis in vivo and in vitro, however, its role on angiogenesis or anti-tumor responses in human is not clear yet. We studied the effects of oral treatment of shark cartilage on peripheral Treg frequency and TGF-β as suppressor activity and Treg cells inducer associated with TH1/TH2 cytokines pattern in patients with gastric cancer. Materials and methods: This study included 23 patients suffering from intestinal gastric cancer who were assigned into intervention (n=14) and control group (n=9). A month after conventional treatment the patients in intervention group were given three tablets (150mg) of shark cartilage daily for 20 days. Then flow cytometry was employed to determine whether the peripheral blood mononuclear cells such as CD4+CD25+Foxp3highT regulatory cells in patients with gastric cancer were changed correspondingly. Results: The results demonstrated that γ-IFN increased and IL-4 decreased in the intervention group. But, no changes were seen in Treg cells frequency and amounts of TGF-β. The evaluations for control group showed no significant difference. Conclusion: Shark cartilage amplified anti-tumor responses in patients with gastric cancer by increase in γ-IFN (TH1 immunity) and decrease in IL-4 (TH2 immunity).

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Background and purpose: Diagnostic services are very important as inherent part of modern medical care about 70% of medical diagnoses are made based on their results. This study aimed to evaluate the effect of household income, geographical access, out of pocket, physician's visits and hospitalization of Iranian Social Security Organization-insured patients on the utilization of laboratory and imaging services. Materials and methods: In analytical study, the Iranian Social Security Organization database in each province in the period of 1998-2011 was searched. Study population included 24 million people covered by this organization ferred to the direct and indirect treatment sectors for laboratory and imaging services over these years. To estimate the model the fixed effects logarithmic regression via the Eviews software was used. Results: The following factors had a significant effect on the utilization of laboratory and imaging facilities: geographical access to the laboratory (β = 0.31) and imaging (β = 0.50) facilities, household income on the utilization of the laboratory (β = 0.24) and imaging (β = 0.43) services, outpatient visits on the utilization of the laboratory (β = 0.56) and imaging (β = 0.43) services, and inpatient services on the utilization of the laboratory (β = 0.35) and imaging (β = 0.51) services. Also, amount of out of pocket for using the mentioned services and referral burden of inpatient and outpatient for direct treatment had no significant relation with utilization of the services. Conclusion: If policymakers exclusively pay attention to the out of pocket, they cannot provide the appropriate utilization of services. Sometimes, to set the used utilizations, the channels such as commands of general practitioners or specialist and/or geographical access are often forgotten.

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Background and purpose: People are exposed to various chemicals during life especially in their working environment. Some of these chemicals have potential health risks. In risk assessment of chemicals, necessary actions are recommended to protect the involved people against hazardous chemicals. This study was designed to assess the semi quantities risk of TDI and MDI in car paint shops in Alborz province, Iran.

Materials and methods: A cross-sectional study was performed in 2013. Singapore's Workplace Safety and Health framework was used for risk assessment of TDI and MDI in car paint shops. The samples were collected from car paint shops using NIOSH 5522 method and analyzed by HPLC.

Results: Hazardous rate of TDI and MDI were 2 and 3 and the exposure rate of materials was 5. Risk factor of TDI and MDI were 3.8 and 3.1. Risk ratings for TDI and MDI were high and average, respectively.

Conclusion: In risk assessment the Singapore's Workplace Safety and Health framework is used for prioritizing control actions. The main drawbacks of this method are lack of risk evaluation (determining acceptable or unacceptable risks) and not considering the effect of high concentrations in measuring the exposure rate.

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Background and purpose: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

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Background and purpose: Carbon monoxide (CO) is one of the most common causes of death due to poisoning in Iran. This study is an epidemiological survey of death due to CO poisoning in Golestan province, Iran.

Materials and methods: This cross-sectional study was carried out on all profiles of referential bodies to Golestan Department of Forensic Medicine who died due to CO poisoning between 2010 and 2015. Data, including information on demography, poisoning and death condition, were analyzed using SPSS V16.

Results: A total of 420 deaths was recorded due to poisoning, of whom 59 (14%) died from CO poisoning which was the third cause of death after opium and rice tablet. The CO poisoning cases included 71.2% (n=42) males. The cases were mainly aged 20–39 years (67.8%, n=40), 64.4% (n=38) were married, and 72.9% (n=43) lived in urban areas. Poisoning occurred mostly in winter (49.2%, n=29). Most CO poisoning incidents happened at home (62.7%, n=37) especially in living room (44.1%, n=26) and bathroom (13.6%, n=8), and gas heaters were the source of poisoning in majority of cases (37.3%, n=22).

Conclusion: CO was the third cause of death due to poisoning in Golestan province that was found to be more common among men and in homes with gas heaters. So, more attention on safety of gas heaters and other sources of CO generation is needed especially in winter and residential places without suitable ventilation.

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Background and purpose: H1N1 influenza circulate worldwide and affects the world population in case of pandemic. The aim of this study was to evaluate the awareness of urban family physicians in Mazandaran province, Iran about H1N1 influenza.
Materials and methods: In a descriptive study, 373 urban family physicians were questioned. A standard questionnaire including different items were completed by participants. The items included epidemiology (7 questions), treatment (5 questions), virology and diagnosis (5 questions), clinical manifestations (6 questions), and prevention (4 questions) of H1N1 influenza. Data was then coded and analyzed in SPSS V18 applying Chi-square, t-test, and Fisher's exact test.
Results: The participants were 47.5% females and 52.5% males. The levels of knowledge about H1N1 influenza were poor in 0.8%, fair in 11.3% and good in 60.3%. Also, 27.6% of the participants had excellent levels of knowledge on this type of influenza. The average scores of participants for epidemiology, virology and diagnostics, clinical manifestations, prevention, and treatment were 4.30, 3.38, 4.59, 2.79, and 3.67, respectively. The mean scores for knowledge in epidemiology and treatment were found to be higher in female physicians compared to those of their male counterparts. Our results indicated a direct correlation between experience and knowledge on virology, diagnosis, clinical symptoms, and prevention and treatment, while it was inversely related with knowledge on epidemiology of H1N1 influenza.
Conclusion: This study showed a relatively high level of knowledge among urban family physicians in Mazandaran province about H1N1 influenza. But they are strongly recommended to participate in continues education programs that increase their awareness and enhance their knowledge.
 

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Background and purpose: Contamination of food materials such as rice to mycotoxins (aflatoxin B1 and Ochratoxin A) is a major health concern. This causes more concerns especially in countries that rice is the main food. Nephrotoxic, immunotoxic, mutagenic, teratogenic, and carcinogenic effects of such mycotoxins to human are reported by WHO and EPA. The main objective of current study was to determine the contamination of rice produced in Kohgiluyeh and boyer Ahmad and Khuzestan provinces to aflatoxin B₁ and Ochratoxin A.
Materials and methods: In a cross-sectional study, 85 samples were randomly collected from rice farms in Basht, Yasuj, Gachsaran and Dena in Kohgiluyeh and Boyer Ahmad province and Ramhormoz in Khuzestan province. Contaminations to Aflatoxin B₁ and Ochratoxin A were quantified using ELISA method and data was statistically analyzed by SPSS V18.
Results: The concentration of aflatoxin B1 was less than the limits specified by the Iran National standard and the :union: of Europe standard value in 80.58% of the samples. Also, the levels of Ochratoxin A in 100% of the samples were less than standard limits. The average concentrations of aflatoxin B₁ and Ochratoxin were 4.70 ng/g and 2.02 ng/g in all samples, respectively. In addition, there was a positive correlation between Aflatoxin B₁ and temperature and humidity P=0.001.
Conclusion: This research showed a potential contamination to fungi and its toxins in rice. Increase in temperature and humidity directly increased aflatoxin B₁ levels.
 

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Background and purpose: Pharmaceutical products, particularly antibiotics are emerging contaminants that cause major environmental challenges due to cumulative effects, different adverse effects, and leading to drug resistance. The aim of this experimental study was to evaluate the efficiency of advanced oxidation process by persulfate activated by UV in removal of ofloxacin from aqueous solutions.
Materials and methods: In order to investigate the removal efficiency of ofloxacin, major operating parameters including initial pH of solution (2-12), the concentration of persulfate (50-3500 mg/l), concentrations of ofloxacin (2-100 mg/l), reaction time (6-30 min), and UV radiation (8,15,30 Watt) were studied.
Results: Maximum removal efficiency of ofloxacin and COD in optimal conditions (pH =6, persulfate concentration = 350 mg/l, ofloxacin concentration = 40 mg/l, reaction time =20 min and UV radiation = 8 watt) were 94.35% and 79.17%, respectively. Advanced oxidation with activated persulfate by UV, deceased the concentrations of ofloxacin and COD to 2.26 and 37.21 mg/l, respectively.
Conclusion: The results showed that using UV activated persulfate is an efficient method in removal of ofloxacin from aqueous solutions.
 

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Background and purpose: Lack of healthy air in classrooms and homes will reduce the level of health and disrupts students’ learning. The aim of this study was to determine the relationship between CO₂ concentration and other environmental parameters with sick building syndrome in schools and homes in Babol, north of Iran, 2018.
Materials and methods: To measure carbon dioxide, temperature, and humidity, the TES 1370 was used. This study was conducted among 85 students in five primary, secondary, and high schools. Selection of schools, classrooms, and students was performed using a multistage random sampling. Data were collected through interviews using MM040EA questionnaire. Chi-square, ANOVA, and T-test were used to determine the relationship between sick building syndrome and environmental parameters.
Results: The most common symptoms of building syndrome were fatigue (45.8%) in winter and headache (35.3%) in spring. T-test showed significant relationships between carbon dioxide and building syndrome signs in winter (P= 0.02) and spring (P= 0.01) in classrooms and homes. But there was no significant relationship between the syndrome and moisture and temperature. Among the risk factors investigated in winter and spring, noise was reported as an annoying risk factor.
Conclusion: The study showed that concentration of carbon dioxide has a significant relationship with development of sick building syndrome in students. The symptoms of sick building syndrome were found to be mild in our samples, but due to poor physical conditions in some schools and even in home settings, optimization of these spaces should be done.

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          Background and purpose: 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.
Materials and methods: 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).
Results: 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.
Conclusion: 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.

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Correction to: Investigation of Electrocoagulation Process Performance with DC Current in Treatment of Poultry Slaughterhouse Wastewater Using Aluminum Electrodes
 
 
Zabiholllah Yousefi¹,
Hossein Sahebian²,
Abdoliman Amouei³,
Reza Ali Mohammadpour⁴,
Ebrahim Zarei^5
 
1 Professor, Department of Environmental Health Engineering, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
² MSc Student in Environmental Health Engineering, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
³ Professor, Department of Environmental Health Engineering, Faculty of Health, Babol University of Medical Sciences, Babol, Iran
⁴ Associate Professor, Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
⁵ Assistant Professor, Department of Basic Sciences, Farhangian University, Tehran, Iran
 
 
    

In the article published in volume 29, issue 172, 2019, the title was published incorrectly, which is now corrected.
 
 

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Hair loss is a common hair disorder in human population. It affects quality of life and there are ongoing attempts to find permanent treatment for this condition. But, today there is no completely safe and protective treatment for all. Hair follicle stem cells are alive, but quiescence in androgenetic alopecia and are potentially active and can proliferate and differentiate, then regenerate hair follicles. Currently, research is more focussed on mesenchymal stem cells, hair follicle progenitor cells, and dermal papilla cells implantation which act like hair follicle stem cells. Therefore, activating the hair follicle stem cells signaling pathways such as Wnt/β-catenin can stimulate these cells for proliferation and differentiation and lead to hair regeneration. Nowadays, this treatment strategy has shown promising horizon to treat androgenetic alopecia. This paper reviews latest findings in treatment of androgenetic alopecia using re-activation Wnt/β-catenin signaling pathway in hair follicle stem cells.
 

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Background and purpose: Healing burn wounds is considered to be a prominent medical issue, and the identification of a drug or substance that can effectively heal these wounds with minimal side effects is of great importance. The aim of the present study was to investigate the anti-inflammatory, antioxidant and restorative effects of the glandular sorrel plant on the experimental burn wound model in BALB/C mice.
Materials and methods: In this experimental-laboratory study, a total of 60 BALB/C mice were randomly assigned to 5 groups, each consisting of 12 mice. These groups included the control group, the cold cream sham group, the cream group containing the extract of the glandular sorrel plant, the Laagex cream group, and the group of the glandular sorrel leaf group. After second degree burns on days 3, 7, 14 and 21, wound healing variables include comparison of wound closure speed, inflammation, vascularization, epithelial regeneration, number of hair follicles, and number of strands. Collagen levels, inflammatory cytokines, antioxidant enzymes and liver enzymes were also examined.
Results: The results of the study indicated that the average inflammation, vascularization, epithelial regeneration, the number of hair follicles, the amount of collagen fibers and also the average of apparent wound closure in the groups treated with the cream containing the extract and leaves of the Rumex Tuberosus L. And Lajex cream has a significant difference (P<0.05) compared to the sham and control groups. In addition, the results showed a significant difference (P<0.05) in the serum level of inflammatory cytokines and antioxidant enzymes in the groups treated with the cream containing the extract and leaves of the Rumex Tuberosus L. and the Lajex cream compared to Sham and control groups. With regard to the liver enzymes, no significant changes were found between the studied groups (P<0.05).
Conclusion: Based on the findings of the study, it can be concluded that the tuberous sorrel plant is very efficient in the treatment of second degree burns and can be a good substitute for the currently available product.
 

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 Background and purpose: Cancer diagnosis is a threatening and traumatic experience. Confusion caused by distressing thoughts about cancer can lead to additional suffering and, along with avoidance, can be a key factor in maintenance of traumatic reactions. The current research aimed at comparing the effectiveness of Unified Protocol (UP) of transdiagnostic intervention and mindfulness based schema therapy (MBST) on posttraumatic avoidance (PA) and chronic illness-related cognitive fusion (CICF) in patients with breast cancer (BC).
Materials and methods: A semi-experimental study with pretest-posttest design and a follow-up period of 45 days was performed. Statistical population included all female patients with BC in Mashhad, Iran 2018-2021. Cognitive Fusion Questionnaire-Chronic Illness (CFQ-CI) and Posttraumatic Avoidance Scale (PAS) were administered. Forty one patients were selected using purposive sampling and were randomly divided into two experimental groups and a control group. UP of transdiagnostic intervention and MBST were applied in intervention groups for 10 weekly sessions. The control group attended two educational sessions. Data analysis was done using multivariate covariance analysis and Bonferroni post hoc test.
Results: The mean scores for CICF and PA were significantly different between the intervention groups and the control group at post-test and follow-up (P<0.001). Findings showed no significant difference between the effectiveness of UP and MBST at post-test and follow-up (P>0.05).
Conclusion: MBST and UP are suggested to be applied in patients with BC to reduce their psychological problems.
 (Clinical Trials Registry Number: IRCT20211012128050165N1)

 

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Zabihollah Yousefi¹,
 Hossein Sahebian²,
 Abdoliman Amouei³,
 Reza Ali Mohammadpour⁴,
 Ebrahim Zarei<sup>5

1</sup> Professor, Department of Environmental Health Engineering, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
² MSc Student in Environmental Health Engineering, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
³ Professor, Department of Environmental Health Engineering, Faculty of Health, Babol University of Medical Sciences, Babol, Iran
⁴ Associate Professor, Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
⁵ Assistant Professor, Department of Basic Sciences, Farhangian University, Tehran, Iran




In the article published in volume 29, issue 172, 2019, the first author’s name was incorrect. It should have been Zabihollah Yousefi, which is now corrected.