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Background & objectives: Bacterial antibiotic resistance is becoming a global health crisis. The aim of this descriptive, cross-sectional study was to investigate the prevalence of multidrug-resistant Pseudomonas aeruginosa strains in Ardabil.
Methods: During 9 months, between July 2019 and March 2020, 50 strains of Pseudomonas aeruginosa were collected from different clinical specimens in four hospitals of Ardabil and the prevalence of MDR, XDR and PDR strains of Pseudomonas aeruginosa were evaluated. Antibiotic susceptibility testing was assessed using the disk diffusion method.
Results: In the present study, the prevalence of MDR, XDR and PDR strains of Pseudomonas aeruginosa were 52%, 40% and 14%, respectively.
Conclusion: Due to high prevalence of multidrug-resistant strains of Pseudomonas aeruginosa in Ardabil, continuous monitoring of the antibiotic resistance trend in clinical isolates in order to select the best medication is necessary.

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Background & objectives: One of the most important causes of acute kidney injury is ischemia-reperfusion (IR). Some studies have shown that adenosine A1 receptor inhibition have protective effects against Ischemia–reperfusion induced renal injuries, while other studies have demonstrated the opposite. The aim of the present study was to review the methodology of these studies to reach a final conclusion about the effects of adenosine A1 receptor on ischemia-reperfusion-induced renal injuries.
Methods: Data base motors including Scopus, PubMed, Google Scholar, Science Direct and Embase were searched. The terms and keywords used included ischemia-reperfusion, acute kidney injury, acute renal failure, A1 adenosine receptor and their combination.
Results: Increased adenosine levels following renal Ischemia-reperfusion cause vasoconstriction in afferent arteriole and vasodilatation in efferent arteriole through A1 adenosine receptor activation, which in turn reduces glomerular filtration rate (GFR). Inhibition of A1 adenosine receptor leads to short-term correction of renal functional parameters following renal Ischemia-reperfusion, by increasing renal blood flow and thus improving GFR. But this increase in GFR exacerbates kidney damages through the kidneys workload enhancement, which will show up in the next few hours.
Conclusions: Although selective inhibition of A1 adenosine receptor in the short term improves renal function parameters, but exacerbates renal damages in the following hours. Therefore, adenosine A1 receptor stimulation has protective effects against IR-induced kidney injury.

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Background & objectives:  Fleas are clinically important parasites for affecting human health. These insects are carriers of some pathogens such as Yersinia pestis, Rickettsia typhi, Q fever, Tularemia and Bartonella henselae which are infectious for humans and animals. The aim of this cross –sectional study was to detection of Rickettsia, Bartonella and Wolbachia pathogens in infected Ctenocephalides canis and Pulex irritans using molecular method in West and Northwest of Iran.
Methods: The present study is a, descriptive, cross-sectional study (prevalence rate=10%, confidence level=95%,  error rate=5%) which  performed on samples collected from five provinces including  Kermanshah, Kurdistan, Azerbaijan Western, Lorestan and Hamedan for 13 months from May 2018 to June 2019. In this study, samples were collected by optical trap, human prey and direct isolation of the sample from the host and identified in the parasitology laboratory using valid diagnostic keys. The prevalence of Rickettsia, Bartonella and Wolbachia in the collected samples was detected using polymerase chain reaction (PCR). Amplification and sequencing of gltA, pap31 and 16SrRNA genes were used for molecular diagnosis of  Rickettsia, Bartonella, and Wolbachia respectively.
Results: The collected samples included 918(47.39%) fleas of C.canis and 1019 (52.60%) fleas of P.irritant. The PCR products of each gene was subject to sequencing. In this study, 12.9% , 5.21% and 5.21% of fleas were positive for  Wolbachia , Rickettsia and Bartonella, respectively .
Conclusion: Bartonella, Rickettsia and Welbachia are vector borne infectious agent. Due to their high pathogenicity and easily transmission among insect and human, monitoring of insects is essential for the controlling of the infection and preserving the public health in endemic area.

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Background & objectives: Using medications that decrease postoperative pain and opioid consumption is a widely recommended approach. The aim of this study was to evaluate the efficacy of intravenous Ibuprofen and its complication in controlling pain after abdominal surgery.
Methods: This study was a randomized, double-blind, interventional clinical trial. Sixty patients aged 20 to 60 years were candidates for abdominal surgery (inguinal hernioplasty and appendectomy). Patients were divided into two equal size groups (n=30) using a random block design method. The First group received (400 mg IV) ibuprofen every 6 hours for 24 hours as well as (15 microgram/ml bolus) fentanyl pump with PCA. Second group only received (15 microgram/ml blous) fentanyl pump with PCA. 
Results: Demographic characteristics and duration of surgery, ASA class, type of anesthesia and type of surgery were similar in the two groups. Pain severity in 24 postoperative hours was significantly lower in the ibuprofen group compared with the control group. Nausea and vomiting frequency in 24 postoperative hours was significantly lower in the ibuprofen group compared with the control group. Patients belonging to ibuprofen group were significantly more satisfied with their analgesic method.
Conclusion: Results showed that using 400 mg intravenous ibuprofen every 6 hours mitigates postoperative pain, reduces fentanyl consumption and is highly tolerated by patients.

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Background & objective: Despite of significant advances in medicine, infectious diseases still threaten the health of society. A new type of Coronavirus called Covid-19 has become increasingly common in the world.  Because of quarantine, the interactive patterns between family members, especially couples with Corona was affected and changed. The main goal of this research is to study the factors affecting interactive patterns between couples in the Corona period according to the conditions of the disease and home quarantine.
Methods: This study is a qualitative research and was done by Phenomenological method. The Participants included 15 men and women coronavirus survivors in 2020 that were selected by targeted sampling method. Semi-structured interviews were used to collect data.
Results: This research findings indicated that 5 main themes included: Changing roles, experiencing negative emotions, Coping behaviors, Support and Communication problems and 22 sub-themes.
Conclusions: The results showed that the performance of couples can play an effective role in the transition from crisis and disease and the type of their behaviors in this period can affect marital satisfaction or dissatisfaction.

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Background & objectives: Research on intelligent nanomaterials that accelerate the process of nerve regeneration and treatment by different methods such as antioxidant effects, stimulation of nerve cell proliferation, modulation of the immune system and inflammatory factors is great importance. The aim of this study was to prepare cinnamon-coated cerium oxide nanoparticles and evaluate its antioxidant and cytotoxicity effects on PC12 cell line.
Methods: Cinnamon-coated cerium oxide nanoparticles were prepared and their structural properties were evaluated by transmission electron microscopy (TEM) and Fourier transform infrared spectroscopy (FTIR). To evaluate the antioxidant properties of the compounds, free radical trapping methods 2 and 2 diphenyl-1-picryl hydrazyl were used. Cell viability in the presence of compounds was measured by a toxicity test (MTT) [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]. Data were analyzed by one-way analysis of variance and Tukey's post hoc test.
Results: FTIR spectra and TEM images showed the processing of nanoparticles with an average size of less than 100 nm with cinnamon coating on their surface. Also, the antioxidant capacity of cinnamon-coated cerium oxide nanoparticles was significantly higher (*p<0.038) than extracts and nanoparticles alone at similar concentrations. Evaluation the results of cytotoxicity showed that the lowest toxicity was observed in the cinnamon-coated cerium oxide nanoparticles group.
Conclusion: Results showed higher antioxidant properties and low cytotoxic effects of cinnamon-coated cerium oxide nanoparticles compared to other groups, which leads to better efficacy, proliferation, longer cell survival, its green synthesis and coverage by cinnamon

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Background & objectives: Carbapenems are the main antibiotics for the treatment of infections caused by multidrug-resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa). The aims of this study were to determine the prevalence of gene encoding outer membrane porin protein (OprD) in carbapenem-resistant P. aeruginosa strains as well as to assess the role of insertion sequence (IS) elements in the inactivation of OprD porin and the emergence of carbapenem resistance.
Methods: In this study, 103 clinical isolates of P. aeruginosa including 58, 42 and 23 strains resistant to imipenem, meropenem, and doripenem were used, respectively. The isolates were collected from patients referred to Ardabil hospitals. The presence of oprD gene and IS elements were investigated using polymerase chain reaction (PCR) and sequencing methods. P. aeruginosa PAO1 standard isolate was used as the positive control strain for oprD gene.
Results: The frequency of oprD gene among carbapenem-resistant P. aeruginosa strains isolated from Ardabil hospitals was 96.5%. Furthermore, IS elements were not observed in the investigated isolates.
Conclusion: Based on the results of this study, the presence of IS elements did not involve in the inactivation of outer membrane porin OprD and resistance to carbapenems among P. aeruginosa clinical strains in Ardabil. Therefore, an investigation of the role of other mutations in reducing the expression of oprD gene and increasing P. aeruginosa resistance to carbapenems is recommended.
 

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Background & objectives: Acne is a chronic inflammation of pilosebaceous units and in severe form reflects a different response to treatment in an oral regime of antibiotics. The purpose of this study is to compare the effect of the combination of erythromycin and low dose oral isotretinoin with erythromycin and low dose flutamide in women suffering from severe acne.
Methods: In a randomized controlled clinical trial, 80 women suffering from severe acne participated in the study and they were studied for 2 months. The first group received 800 mg oral erythromycin, together with 20 mg oral isotretinoin every two days and the second group received 800 mg erythromycin, together with 62.5 mg flutamide daily. The treatment efficiency was evaluated by the count of acne lesions and computing the acne severity index. The data of the study were analyzed using the version 16 of spss software.
Results: In the present study, 40 patients participated in the research in each group. Finally, 61 people completed the study. The mean acne severity index in the flutamide group was 195.9±15 at the beginning of treatment and this index reduced to 52.8±5.8 at the end of treatment. The mean acne severity index in the isotretinoin group was 247.8±19.7 at the beginning of treatment and this index reduced to 76.3±12.5 at the end of treatment. The difference in reduction between the two groups was not statistically significant (p=0.15).
Conclusion: The treatment effectiveness of the above-mentioned methods in female severe acne was acceptable and this combination therapy can be presented as a better alternative compared to treatments with high dose individual treatment including oral isotretinoin and oral flutamide.

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Candida albicans is the most common cause of invasive candidiasis, but in recent years the incidence of infections caused by other species such as Candida Kruzei, Candida glabrata, Candida tropicalis, Candida parapsilosis and Candida lusitania has increased. In the last decade, the treatment methods for invasive candidiasis have changed completely, and a successful treatment depends on the timely start of treatment, the selection of an effective drug, and the lack of resistance of the fungus to that particular drug. On the other hand, the widespread use of immunosuppressive drugs as well as organ transplants has all caused widespread problems in the treatment of invasive candidiasis. Together, these observations highlight a rationale for the immediate development of new immunotherapy methods to enhance antifungal therapy in immunocompromised hosts. The past decade has seen great advances in our understanding of fungal immunobiology, leading to a number of new molecular and cellular immunotherapy methods for invasive fungal infections. Therefore, the aim of this study was to review the common and new antifungal drugs in the treatment of invasive candidiasis and to discuss the role of immunotherapy in better prevention and control of the disease.

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Background & objectives: Diabetes is a disease that requires continuous monitoring of blood glucose levels to control its complications. At present, blood glucose is measured using portable devices; most of the electrodes of these devices work using the enzyme glucose oxidase. Due to the high cost of the enzyme and its instability, non-enzymatic electrochemical sensors can significantly contribute to the emergence of new generation devices.
Methods: In this study, keywords of glucose measurement, non-enzymatic electrochemical sensors in the period 1962 -2020, were searched and studied from Elsevier, Scopus, Science Direct and PubMed databases. In this review, first, the different generations of glucose sensors and how they are made are mentioned, and the types of materials used in the preparation of enzyme-based sensors are discussed. The progress made in non-enzymatic sensors is mentioned in the following, and the advantages and challenges of these types of glucose sensors are discussed.
Results: Materials used to prepare non-enzymatic glucose electrochemical sensors are platinum, copper, platinum alloys, gold and platinum nanomaterials, and molecular mold polymers. The main problem of these compounds is the lack of selectivity of these compounds and their weak signal due to the intervention of disturbing species. However, using molecular mold polymers seems an excellent option to solve this problem.
Conclusions: Non-enzymatic glucose electrochemical sensors have the advantage of high stability and low cost, and measuring the amount of glucose in biological fluids can be helpful in controlling diabetes. Advances in nanoscience and nanotechnology and molecularly formulated polymers have made it possible to produce new nanomaterials to create enzyme-free systems for glucose detection, but several studies are needed to bring these sensors to market.

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Background& objectives: Renal ischemia-reperfusion (IR) damage occurs during renal transplantation in end-stage renal disease (ESRD) patients which activate immune responses. Inflammatory responses by increased levels of cytokines can lead to acute kidney injury (AKI) that contributes to the loss of renal grafts and graft dysfunction. The purpose of this study was to review the therapeutic effects of nanoparticles in AKI.
Methods: A comprehensive search strategy was identified relevant studies on AKI models, using the Scopus, PubMed and Google Scholar databases, from 2000 until 2020. The search strategy included keywords like ischemia-reperfusion and nanoparticles.
Results: Oxygen free radicals are produced during the reperfusion phase, which cause lipid peroxidation and promote tissue damage. Oxidative damage to DNA and proteins and lipid membrane peroxidation can cause cell death and apoptosis. Some strategies to reduce the tissue damage caused by ischemia-reperfusion are nanoscale materials. Antioxidant nanoparticles reduce oxidative stress in tissues. Also, they have flexibility in the delivery of therapeutic agents and drugs to the ischemic cells, and imaging of the ischemic regions at the molecular or cellular level.
Conclusion: This potential of antioxidant and anti-inflammatory nanoparticles in the diagnosis and treatment of renal ischemic regions is an innovation in the development of new therapies and a unique achievement in recent medical advances.
 

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Intraosseous mucoepidermoid carcinoma is a rare lesion that is mostly seen in the mandible and in the premolar and molar region. In some cases, clear cells can be seen, which makes it difficult to diagnose.
The purpose of this case report is the clinical and histopathological evaluation of the clear cell variant of hntraosseous mucoepidermoid carcinoma in the anterior region of the lower jaw that was referred to the dentistry faculty of Ardabil University of Medical Sciences.


 

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Background & objectives: This research has been carried out in order to optimize technology development policies and reduce the costs of health technology development centers in universities of medical sciences. Identifying the influential factors in the growth of technology units helps the growth centers to more efficiently use the growth of knowledge-based companies and the development and progress of innovative entrepreneurs as a host environment for technology growth.
Methods: The current study is a qualitative research that was conducted by extracting qualitative data through semi-structured interviews with 31 managers of growth centers and managers of units located in growth centers and experts in the field of health entrepreneurship. It has been coded and categorized in three stages and the main and subcategories have been identified.
Results: The results show that for the growth of technology units in health technology growth centers, two basic variables of the growth center program and infrastructure have an effect on the efficiency of the centers and the growth of the units. This is despite the fact that according to the regional capacities of Type 3 medical sciences universities in the country, growth program factors have introduced more categories and less focus has been placed on infrastructure, so the growth plan is good. It can have a bigger share.
Conclusion: This research shows what categories are expected from the growth plan and infrastructures of health technology growth centers in few universities.
 

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Background & objectives: Menopause and especially acute menopause due to surgery is associated with many complications in women. The aim of this study was to determine the effects of genistein and regular swimming exercise (alone/or in combination) on pain through a possible mechanism of inflammation and oxidative stress in ovariectomized rats.
Methods: In this study, rats were divided into six groups, including: control, sham, ovariectomy (OVX), ovariectomized with eight weeks of swimming exercise training (OVX.E), ovariectomized with eight weeks of genistein administration (OVX.G), and ovariectomized with eight weeks of combined treatment (OVX.G.E). The effects of genistein and/or exercise were evaluated by examining the pain intensity with tail-flick and formalin tests. The serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), total antioxidant capacity (TAC), total oxidant status (TOS), and malondialdehyde (MDA) were also evaluated by ELISA and spectrophotometer.
Results: In the OVX group compared to the control group, tail-flick and formalin tests showed an increase in pain response. Also, a significant increase in the serum levels of IL-1β, TNF-α, MDA, TOS and a decrease in TAC was observed in the OVX group, however, in the OVX.E, OVX.G and especially OVX.E.G groups, pro-inflammatory cytokines and oxidative stress as well as pain responses showed a significant decrease compared to the OVX group.
Conclusion: A combination of genistein and regular swimming exercise was synergistically more effective in reducing acute and chronic pain than using them alone in the postmenopausal period.
 

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Background & objectives: The pathophysiology of depression is very complex. Rosa canina L fruit contains various antioxidant compounds. The aim of this study was to investigate the anti-depressant and anti-anxiety effects of the aqueous- alcoholic extract of the Rosa canina L fruit in the behavioral tests including forced swimming, tail suspension, maze, and sucrose preference tests, as well as biochemical tests such as antioxidant capacity and malondialdehyde levels. Rosa canina L with high amounts of vitamin C, has anti-depressant and anxiety effects.
Methods: In this experimental study, 60 Syrian male mice were divided into 5 groups of 12, including the control group, the bisphenol A group, and three groups treated with oral bisphenol A at a dose of 125 mg/kg per day and the aqueous- alcoholic extract of the Rosa canina L fruit at doses of 100, 200, 400 mg/kg/day was administered from day 50 to 120 after birth. The data were analyzed using SPSS statistical software and the One Way ANOVA test. The level of significance was set at p<0.05.
Results: The findings showed that bisphenol A significantly increased the duration of immobility in the forced swimming and tail suspension test. The extract at the level of 400 mg/kg decreased the duration of immobility in both tests. Bisphenol A significantly reduced the antioxidant capacity of serum and brain. The extract at the level of 400 mg/kg significantly increased the antioxidant capacity of both the brain and serum.
Conclusion: The findings of this research showed that the fruit of the Rosa canina L has antioxidant effects, and with a significant decrease in antioxidant capacity and immobility in Syrian mice treated with the extract, therefore it has anti-depressant and anxiety effects.
 

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Background & objectives: Even though clinical empathy is one of the clinical competencies of medical students and there is a high emphasis on teaching and learning, it decreases during medical education. This study investigated the relationship between burnout, quality of life and clinical empathy in medical students.
Methods: this exploratory cross-sectional study used the Jefferson empathy questionnaire, WHO quality of life questionnaire and burnout inventory. All three questionnaires are standard, and their validity and reliability have been confirmed in various studies in Iran. The research population was the Ardabil University of Medical Sciences internship medical students, for which the census sampling method was used. Various statistical tests, such as Pearson and spearman correlation, Chi-square, etc., were used for data analysis.
Results: Out of 130 students, 128 (98.4%) completed all of the questionnaires. Data analysis showed that 98% of students suffered from moderate burnout and 2% of them had severe burnout. About 44% of students were satisfied or very satisfied with their health status and 33% of students were dissatisfied or very dissatisfied. The mean score of clinical empathy in students was 79.46±9.82. Data analysis showed a statistically significant inverse relationship between quality of life and burnout (p=0.0001).
Conclusions: Considering that the situation of students was not very favorable in terms of all three variables, non-curricular programs seem to be essential for improving student adaptation mechanisms to the job-related situations in medical students and promoting clinical empathy.
 

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Background & Objectives: Early warning scores are commonly used by hospital care teams to assess patients and diagnose early signs of their deterioration and initiate further treatment. Due to the existing studies and the lack of sufficient evidence for burned patients, we decided to investigate the value of initial NEWS and MEWS in predicting mortality in burned patients.
Methods: After obtaining permission from the Ethics Committee of TUMS, patients who were candidates for hospitalization in the burn wards of Sina Hospital from July to March 1998 were included. All demographic information including age, sex, APACHE Type of discharge, comorbidities, percentage of burns, initial hospitalization in the burn ward, type and time of initiation and duration of antibiotic use, amount of serum and NEWS and MEWS scores for all patients were enrolled immediately after admission to the ward as well as before discharge from the ward. Data were analyzed after registration in SPSS software version 23.
Results: In this study, 80 cases of burned patients were studied with a mean age of 37.94±18.85 years. The initial NEWS and MEWS indices have a good ability to diagnose burned patients (Area=0.79 and 0.78, p<0.001). The best cut- point based on the Youden index, for the initial NEWS and MEWS indices were obtained at 4.50 and 1.50, respectively.
Conclusion: In this study, for the first time, NEWS and MEWS were examined in predicting mortality in burned patients and it was found that these criteria can predict the prognosis of burned patients.
 

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Background: despite the many benefits of dental implants, their cost remains a controversial issue. No study in Iran evaluated the costs and benefits of this treatment accurately, so the present study aimed to investigate the economic burden of implant surgery on the urban households of Ardabil province in 2021.
Methods: in this descriptive-analytical, cross-sectional study, the economic burden of implant surgery was estimated using the cost of illness method and human capital method. In this study, based on the content and purpose, the prevalence-based approach was used and a suitable checklist was prepared.  The statistical population was patients referred to public and private centers providing dental services in Ardabil city. The sample size was calculated to be 160 people and a random sampling method was used for sampling. . Data analysis was done with SPSS version 21 software and Excel software.
Results: The results of the investigation showed that the total cost of implant surgery per unit was (118680744 Rials), 82.11% of these costs were related to direct medical costs, 10.92% were related to non-medical direct costs, and 6.97% were related to indirect medical expenses. Also, the economic burden of implant surgery on Ardabil society was estimated at 71 trillion 467 billion 62 million 235 thousand 635 Rials.
Conclusion: Implant surgery imposes a huge cost on society, so by planning the essential preventive tooth decay strategy, the economic burden imposed by implant surgery on the society of Ardabil can be reduced in the future.
 

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