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Background & objectives: Construction of new service centers including hospitals is expensive and requires optimal site selection for these centers so that all citizens benefit from its increased productivity. It can also help them lower their costs. This study investigates the optimal locations for construction of hospitals in Ardabil using GIS software.

Methods: This is an applied research which incorporates a descriptive-analytic methodology. The data is made up of 11 criteria; proximity to densely populated areas, proximity to green space, closeness to main thoroughfares, proximity to fire departments and distance from existing hospitals, industrial centers, slopes, learning centers, cemetery, military bases and from sport facilities. They were all weighted using analytic network process (ANP) model.

Results: After performing the necessary calculations and evaluations, the highest and lowest weight of criteria belonged to the proximity to densely populated areas (0.229) and distance from the cemetery (0.033), respectively. According to the criteria weights and overlapping of layers, the most and least favorable locations for the establishment of hospitals were identified.

Conclusion: Results of the classification showed the best location for construction of hospitals in Ardabil city based on four municipal regions. In region one it belongs to the 8^th, 5^th, 2^nd, and 11^th districts in region two districts of 6 and 7 which cover southeastern edge of the city, in region 3 districts of 1, 2, 6, 7, 8 and 10 which contain the western part of the city, and in region four it belongs to districts of 1, 2, 6, 7, 10 and 11 that encompass the blocks in the northern and north-western route of the city. These regions can be used for construction of new hospitals in order to improve people’s access to healthcare services.

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Background & objectives: According to importance of bone marrow mesenchymal stem cells in production of different cell lines, transplantation of these cells are used for treatment of many different diseases during cell therapy. Viability and proliferation of these cells after transplantation are very important. Since infertility is as public health problem in men and women, the scientists attempt to produce germ cells from differentiation of stem cells. It is supposed to use these cells for treatment of different illnesses especially for men with lack of germ cells in testes in future. However, in using stem cells for cell therapy the culture medium should be designed to increase the number of cells and efficiency of transplantation and to guarantee the health of the cells in terms of DNA damage. This study designed a suitable culture medium in order to increase the number of colonies and decrease the cell injuries.

Methods: In this study mesenchymal stem cells isolated from bone marrow of mice and exposed to retinoic acid (RA) with concentration of 10^-6 M and Sertoli cells condition medium. Since mesenchymal stem cells (MSCs) produce fibroblastic colonies so the number of colonies was counted every 3 days after culture (days of 2, 5, 8, 11, and 15) under inverted microscope. The staining of ethidium bromide-acridine orange was also done for determination of apoptotic nucleus in days of 10 and 15 after culture.

Results: The results showed that the effects of retinoic acid on grow and viability of MSCs is related to the time. It seems that RA increased the proliferation of the cells and the number of colonies increased in low time but the apoptotic cells elevated with increasing the time of culture. Condition medium of Sertoli cells also increased the proliferation of bone marrow stem cells.

Conclusion: According to proliferative properties of condition medium, it seems that using condition medium together with RA is better than RA alone for differentiation of MSCs to germ cells.

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Background & objectives: Coronary artery disease (CAD) is the most common cause of mortality and disability around the world. Determination of the health status and spatial and temporal patterns of the disease prevalence has a major role in health planning.
This study aimed to investigate the spatiotemporal pattern of CAD in Ardabil Province.
Methods: This descriptive and cross-sectional study was performed using the data belonging to 60156 patients with history of hospital admission due to CAD in Ardabil Province during 2010-2015. Hospitalization Rate (HR) was calculated after classification of the data in terms of location and date of hospitalization. The spatiotemporal and demographic variables, including age, gender, type of CAD, periods and duration of hospitalization were analyzed by descriptive statistics, ANOVA and repeated measures in SPSS v23 statistical software. Spatial distribution maps were drawn for each month and year in ArcGIS 10.2.
Results: Of 60156 hospitalized patients with CAD diagnosis, men (58%) were more in number than women (42%). The majority of hospitalized patients fell in the age range 60-69 years (25.3%), and 92.40% of patients were hospitalized for less than 7 days. An ascending pattern was observed in temporal hospitalization trend in Khalkhal and a descending trend in Ardabil. The lowest hospitalization rate, however, was observed in Kosar city despite the ascending trend. During the research period, the greatest decline in hospitalization rate was observed in temporal trend in Bilasuvar, Meshkinshahrand Namin cities, and the largest increase was observed in Germi, Pars-Abad and Kosar cities.
Conclusion: By using the comprehensive technology, GIS, spatiotemporal distribution and CAD trend during 2011-2015 were modeled in Ardabil province. Spatiotemporal trend of CAD in Ardabil province and allied cities indicated the necessity of paying more attention and studying community for further prevention of the disease. Community-based interventions should be implemented for prevention of risk factors of CAD during childhood and adolescence especially in the districts with high risk.

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Background & objectives: Diabetes mellitus belongs to a group of common metabolic disorders characterized by hyperglycemia phenotypes. Diabetes mellitus causes secondary pathophysiological disorders in multiple organs of the body such as nephropathy, which causes many problems for patients and the health care system. In this study, the effect of pentoxifylline, a nonselective phosphodiesterase inhibitor, on reducing urinary protein excretion in diabetic patients was assessed.
Methods: In this clinical trial, 72 diabetic patients with proteinuria who were admitted to the endocrine and nephrology clinic were selected and divided into two groups. Checklists, including demographic data, etc. were completed. In group (A), Angiotensin-converting enzyme inhibitors (ACEI) or Angiotensin II receptor blockers (ARBs) were prescribed to reduce proteinuria, and in another group (B), in addition to ACEI or ARB drugs, pentoxifylline was prescribed. In the end, the results in both groups were compared in terms of further reduction of proteinuria.
Results: Most of the studied patients were male. There was a significant correlation between proteinuria (mean urinary protein excretion in 24 hours) and the effect of pentoxifylline on reducing proteinuria in patients with type II diabetes. Also, there was not a significant difference in systolic and diastolic blood pressure changes and HbA1c between the two groups at the beginning and end of the study.
Conclusion: Pentoxifylline, independent of lowering blood pressure or reducing the improvement of metabolic control, can significantly decrease proteinuria and protein excretion

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Background & objectives: One of the main problems in the control of nosocomial infections due to Klebsiella pneumoniae is increase of antimicrobial resistance and prevalence of extended spectrum β-lactamase (ESBLs) producing isolates. The aim of this study was to investigate the correlation of antibiotics resistance with SHV, CTX-M and TEM extended-spectrum beta lactamases genes among Klebsiella pneumoniae isolates isolated from the patients in Kermanshah hospital.
Methods: The clinical isolates of Klebsiella pneumoniae were collected during the spring from Kermanshah hospitals, and identification of Klebsiella pneumoniae strains was performed using standard microbiological and biochemical tests. Antibiotic resistance of Klebsiella pneumoniae isolates was determined using disk diffusion method. Then, the presence of CTX-M, SHV, and TEM was investigated using multiplex-PCR method. Finally, the relationship between variables was analyzed by SPSS-22 software using logistic regression and chi-square.
Results: A total of 98 isolates out of 112 samples were identified as Klebsiella pneumonia. Also, 82.8% of isolates were resistant to cefotaxime, 40.2% to ceftriaxone, 62.88% to ceftazidime, 3.9% to imipenem, 39.17% to cefepime, 64.94% to cefixime and 26.8% to amikacin. Further, 35.55% of isolates had CTX-M gene, 63.91% of isolates had SHV gene and 9.27% of samples had TEM gene.
Conclusion: The presence of CTX-M, SHV and TEM genes along with high antibiotic resistance are very concerning, indicating the importance of rational use of antibiotic for the treatment of infectious diseases.
 

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Background & objectives: Mesenchymal stem cells have been known as hypo-immunogenic and immunosuppressive cells. Exposure of mesenchymal stem cells to interferon γ (IFN-γ) may influence their immunomodulatory properties. In the present study, the expression level of adenosine producing CD39 and CD73 ectonucleotides as an immunosuppressant were evaluated in Wharton’s Jelly- derived Mesenchymal Stem Cells (WJ-MSCs) in the presence and absence of IFN-g.
Methods: In this experimental study, MSCs were isolated, cultured, and propagated from Wharton's jelly obtained from human umbilical cord. The phenotypic characterization of these cells was performed via analysis of their surface markers using flow cytometry. Then, the cultured mesenchymal stem cells were treated with IFN-g. After 24 hours, the expression levels of CD39 and CD73 genes were analyzed using qPCR in control and IFN-g-treated cells.
Results: Flow cytometric analysis of stem cells revealed morphological similarity to fibroblastic cells and expression of CD105 and CD73 markers in these cells. The results of qPCR showed that the expression level of CD39 was significantly increased in IFN-g-treated cells compared to non-treated cells, while there was no significant difference in CD73 expression level between control and IFN-g - treated cells.
Conclusion: The results indicated the possible role of IFN-g in development of the immunoregulatory capacity of mesenchymal stem cells through expression of target genes. However this should be studied precisely.

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Background & objectives: Artemisia absinthium (known as wormwood) is used as an antihelminthical, antimalarial, antiseptic and  anti-inflammatory agent, and is used for treatment of gastric pain in the traditional medicine. In the present study, we evaluated the effects of hydroalcoholic extract of A. absinthium on the ovary tissues and pituitary_gonadal axis of the adult female NMRI mice.
Methods: In this experimental study, intraperitoneally (IP) injections of hydroalcoholic extract of A. absinthium, were performed over 30 days on 50 mice with 50 (first group), 100 (second group), and 150 mg/kg.bw (third group) doses.  The sham group was received distilled water and control group received no injection. After 30 days of injections, the animals were dissected, and blood samples were collected by heart aspiration.  The levels of LH, FSH, estrogen and progesterone of serum were measured by ELISA method. Seven µm sections of ovary were prepared by a microtome and stained by H&E method. Data were analyzed by One-Way ANOVA and Tukey post- hoc test. The Significance level was set at p<0.05.       
Results: Our findings indicated a significant reduction (p<0.05) in the body weight in all experimental groups compared with sham and control groups. In parameters such as: large and small diameters of the ovary , number of primary, secondary, growing, graafian follicles, and corpus luteum, a significant decrease was observed in 100 and 150 mg/kg doses (p<0.05). In all experimental groups, no significant changes were observed in estradiol and progesterone levels. However, FSH and LH showed a significant decrease in 100 and 150 mg/kg doses (p<0.05).
Conclusion: Therefore, it can be concluded that Artemisia absinthium hydroalcohlic extract in high doses has damaging effects on the process of oogenesis, which may be due to α and β Thujoun, Alkaloid and Saponin constituents in this plant. 
 

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Background & objectives: Local systemic filling pressure measurement can be used to determine other hemodynamic parameters such as venous return and the stressed volume. The aim of the present study was to evaluate the relationship between local systemic filling pressures and central venous pressure.
Methods: In this study, candidate patients of cardiac surgery in Imam Khomeini hospital of Ardabil, in the first half of the 1397, were chosen and studied by their satisfaction, then an intra-arterial catheter inserted to the upper limb, a tourniquet closed to the same arm.  The arterial pressure measured during the surgery. Central vein pressure was also measured simultaneously. Finally, other variables obtained from transesophageal echocardiography and demographic data were recorded in each patient's checklist.
Results: 43 patients (71.7%) were man and 17 (28.3%) were women. The Mean CVP, MSFP, CO, and CI were 8.3±4.5 mmHg, 17.0±6.1, 3.27±1.1, and 1.89±0.7, respectively. Ten patients (16.7%) had mild heart failure, 42 patients (70%) had a moderate heart failure and 8 patients (13.3%) had severe heart failure. There were positive and significant relationship between CVP and MSFP (r=0.478: p=0.001). The EF status has no significant effects on CVP with SBP, DBP, MAP, CO and CI. There was significant and reverse correlation between PSF value with CO, and CI in severe heart failure (p<0.05).
Conclusion: we concluded that the local MSFP is a good and valuable substitute for CVP measurement, especially in severe heart failure

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Leishmaniasis is a tropical parasitic disease that has become a major health challenge in many countries of the world. Not only has not been found any effective vaccine or treatment for the disease eradication, but also the advent of drug resistance is also increasing. Therefore, it is vital to take a precise attention to the physiochemical cycles of the Leishmania parasite and to identify its biochemical pathways. One of the most important biochemical pathways of host and parasite is the arginase and nitric oxide cycles. By using L-arginine, arginase plays an important role in the metabolic pathways, particularly in ornithine production, polyamines biosynthesis and cellular activities, including proliferation and cell survival. Furthermore, L-arginine, can act as a substrate for inducible nitric oxide synthase (iNOS), which leads to the synthesis of nitric oxide (NO), thereby activating the cellular immune system and clearing intracellular parasites. High Arginase activity reduces the parasite load inside the host cell, and since lymphocytes need L-arginine for their activity, its deficiency impairs the response of host immune cells. Also, parasites arginase alone can determine the fate of Leishmania parasite within the host cell. The aim of this study was to provide a comprehensive overview of various studies on the arginase activity of both parasite and host and its direct impacts on the immune system and pathogenicity of the Leishmania parasite.
 

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Introduction & objectives: Vaginismus is an uncontrolled contraction of the outer third muscle of the vagina that prevents intercourse. Based on the DSM-V-TR system, this disorder is associated with dyspareunia and "Genito-pelvic pain/penetration disorder". The purpose of this overview was to summarize population-based studies that reported the prevalence of vaginismus in the general population and to discover the discrepancies between studies.
Methods: This systematic review study was conducted on published articles on the prevalence of vaginismus in the world and in English. In selecting the articles, the keywords including Vaginismus, Prevalence, Incidence, Sexual Dysfunction, Genito-Pelvic Pain, Penetration Disorder with all possible combinations were systematically searched in the google scholar, science direct, PubMed, Cochrane databases. No search time limit was set to retrieve all relevant articles published by September 21, 2018.
Results: Of the 10 studies, 4 articles reported prevalence of vaginismus in the general population. In selected studies, the incidence of vaginismus in the general population of women was reported 0.4% to 8%.
Conclusion: Different prevalence rates have been reported in different studies for vaginismus. In this review study, it was not possible to Meta-analyze and determines the overall prevalence due to the heterogeneity of the prevalence reports and different study methods.
 

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Considering the pandemic of the COVID-19 disease, the use of various drugs in patients has been investigated. Recently, numerous studies have been done on the effectiveness of drugs which used to treat the underlying disease such as congestive heart failure, hypertension, as well as coronary artery disease in various countries, because the patients with underlying conditions are more likely to develop COVID-19 disease.
Two classes of the most commonly used drugs in these underlying diseases are angiotensin converting enzyme inhibitor and angiotensin-receptor-blocking drugs. Because the two classes of drugs that mentioned above increase the levels of enzyme-converting enzyme receptor-2, it has been hypothesized that the initiation or continuation of such drugs will play some roles in initiation, progression or acceleration of the COVID-19 disease. In the case of a COVID-19 pandemic, there are some questions; which method should be chosen? start, continue or stop of the two classes of drugs as well as which one should be chosen to have a lower risk in patients suffering from COVID-19?. Accordingly, the studies reported from different countries which conducted with the aim of investigating this assumption, was reviewed in this article. As a result, all of those studies have announced this common result that the start-up order for these two groups of drugs in patients with COVID-19, who have underlying cardiovascular disease, should be treated in the same way as other patients, based on valid and accepted current guidelines. Furthermore, do not discontinue these medications if the patient has taken any of them before having COVID-19 disease.

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Background & objectives: Caffeine can affect many physiological functions of the body. The aim of this study was to investigate the response of aerobic function, blood pressure and some immune system factors of trained men to acute caffeine consumption in dehydrated condition and warm and humid environment.
Methods: Thirty male athletes with a mean age of 26.6±3.9 years in dehydrated conditions voluntarily participated in this study, which was performed in a double-blind manner. Subjects were divided into three groups: caffeine consumption group (n=10), placebo group (n=10) and control group (n=10). The Caffeine group consumed 6 mg/kg body weight of caffeine. Sixty minutes later, the subjects performed an increasingly exhausting exercise. Blood samples collecting and blood pressure measuring took place before, immediately after and 24 hours after exercise. Analysis of variance with repeated measures (group * time) and one-way analysis of variance were used for statistical calculations.
Results: The duration of the exhaustion test in the caffeine consumption group was significantly longer than the control (p≤0.01) and placebo (p≤0.05) groups. In the blood sampling immediately after exercise, the level of leukocytes, neutrophils and lymphocytes in the exercise groups were significantly higher than the control group (p≤0.001). Also, the caffeine group experienced a lower increase in leukocytes and neutrophils compared to the placebo group (p≤0.001). Blood pressure values ​​in the exercise groups were significantly higher than the control group (p≤0.001). Also, the caffeine group experienced a greater increase in systolic blood pressure at baseline and immediately after exercise compared to the placebo group (p≤0.001).
Conclusion: In general, exhausting exercise in a warm environment and dehydrated condition increases the number of immune system cells and blood pressure. In addition to improving aerobic function, caffeine seems to prevent further increases in the number of immune system cells, while increasing blood pressure in the normal range in warm and humid environment.

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Background & objectives: Low immunogenicity and targeted migration of mesenchymal stem cells to inflammatory sites have introduced these cells as the best vehicle for the delivery of gene or therapeutic products. Lentiviral vectors can be used as an efficient vehicle for inserting ectopic genes into stem cells. Therefore, the evaluation of the effect of lentiviral vectors on the identity, behavior and functional characteristics of the stem cells can show that vectors are safe tools in cell manipulation and gene therapy.
Methods: At first, three vectors of lentivirus were added to HEK-293T cells using calcium phosphate method. After confirming the expression of GFP protein in more than 80% of HEK-293T cells, viral supernatant was collected and concentrated. Human adipose-derived mesenchymal stem cells (hASCs) were transduced with condensed viruses. After the elimination of the non-transduced cells by puromycin, transduced hASCs were evaluated for immunophenotyping and differentiation to adipocyte and osteocyte. Behavioral characteristics such as viability, migration and invasion were analyzed using MTT and transwell methods, respectively.
Results: In the current study, there was no significant difference in the expression of CD29, CD34, CD73 and differentiation to adipocyte and osteocyte in the test group when compared to the control group. Moreover, there was no significant difference between two study groups in the behavioral characteristics such as proliferation, invasion and migration.
Discussion: The findings of this study declare that lentiviral vectors do not have adverse effects on the identity and functional characteristics of stem cells. Therefore, they can be used in gene manipulation of the target cell.
 

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Background & objectives: Due to the existence of various issues and limitations associated with traditional buccal drug delivery systems such as the disability to consume food whilst using topical drugs in the mouth cavity, unpredictable drug release profile, undesirable taste, low patient adherence to therapy, and accelerated drug removal with saliva, these conventional methods are now rapidly becoming replaced with oral thin films as more precise and novel oral drug delivery platforms. The current study aims to discuss the design and characterization of betamethasone-loaded oral thin films with the aim of improved drug delivery in mouth cavity diseases.
Methods: In this study, oral thin films with and without betamethasone were fabricated through the solvent casting method as a common, fast, and affordable technique prior to being evaluated for different physiochemical characteristics including weight, width, surface pH, disintegration period in vitro conditions, and swelling rates as well as drug release profiles at different intervals.
Results: Obtained oral films were demonstrated to possess adequate homogeneity, flexibility, and mechanical resistance. Accordingly, the average surface pH for films without and with betamethasone was equal to 6.75 and 6.66, respectively, which are in notable compatibility with the neutral pH of the oral cavity. Betamethasone-loaded films’ disintegration duration appeared to be superior to that of films without betamethasone and was in close correlation with their higher swelling rates. Further experiments revealed 25-30% drug release in the initial 20 minutes, followed by more than 90% betamethasone release in 360 minutes in a sustained manner.
Conclusion: These results are indicative of betamethasone oral films’ satisfactory physiochemical properties and potential applicability as a sufficient oral drug delivery platform in mouth cavity diseases such as oral lichen planus or recurrent mouth sores. By sticking to the mouth mucosa, these films can significantly reduce drug removal with saliva and thus ameliorate sufficient delivery of therapeutic agents to specific mouth lesions. Moreover, they can alleviate some of the issues and limitations of traditional topical oral drug delivery and improve treatment or control of disease symptoms.
 

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Background & Objective: Hepatitis B virus [HBV] infection is one of the most important public health concerns. The present study was conducted to provide a descriptive analysis of detected HBV infection in Ardabil province.
Methods: In this retrospective longitudinal study, the hepatitis B surveillance database of Ardabil province was examined from 2014 to 2018. The frequency of hepatitis B virus infections was presented based on age, gender, marital status, place of residence, primary symptoms, and reporting sources. Also, the trend of changes in the number of detected cases over time was investigated using time series analysis.
Results: A total of 817 positive cases with a mean age of 43.1 years were reported. Most of them were male [n=503, 61.5]. The Frequency of identified positive cases decreased over time. Most of the infections were asymptomatic [87.5%]. Almost 90.0% of patients with HBV were married and the majority of the identified patients were resided in urban settings [n=598, 73.2%]. Most diagnostic tests were done voluntarily [n=219, 26.8%] or during prenatal care [n=109, 13.3%]. Most cases were identified and reported by the health network [n=292, 35.7%] and blood transfusion organization [n=190, 23.2%].
Conclusion: Decision-makers of the health sector of the province can use this information as a source for evidence-based decision-making in the effective management of the disease.

Corresponding Author:
Eslam moradi-Asl, Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
google scholar
pubmed
 

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Premature Ovarian Insufficiency (POI) refers to the loss of ovarian function before the age of 40. This condition can be attributed to various factors including X chromosome abnormalities, autoimmune disorders, and chemotherapy drugs. Hormone therapy is a commonly used treatment for POI, but due to side effects and low fertility rates, alternative treatment options are needed. In recent years, stem cell transplantation has emerged as a promising treatment approach, offering hope for improving and restoring ovarian function. Stem cells possess the unique ability of self-renewal and regeneration, making them potentially effective in addressing ovarian failure and subsequent infertility. Different types of stem cells have been investigated for the treatment of POI, including mesenchymal stem cells (MSCs), stem cells from extraembryonic tissues, induced pluripotent stem cells (iPSCs), and ovarian stem cells. This article aims to provide an overview of the causes and treatment options for Premature Ovarian Insufficiency, with a particular focus on stem cell therapy as suggested by previous studies.
 Corresponding Author: Hossein Kalarestaghy,  Department of Anatomical Sciences, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Email: h.kalarestaghy111@gmail.com
google scholar
pubmed


 

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Background: Systemic lupus erythematosus is an autoimmune disease in which organs and cells are damaged in the initial stages by tissue-binding autoantibodies and immune complexes. Clinical, demographic and laboratory information of patients with SLE in Ardabil province is the aim of this study.
Methods: The present study is a cross-sectional descriptive study that examines demographic data (age, gender), clinical information such as the first manifestation of the disease, clinical symptoms, etc., and laboratory findings such as CBC, ESR, CRP, proteinuria, FANA, Anti dsDNA, C3, C4, Anti RO and APS Ab of patients who referred to the rheumatology clinic of Imam Khomeini Hospital (RA) in 2021.
Results: Information related to the clinical characteristics of 50 patients, including 46 women (92%) and 4 men (8%), with an average age of 12.14 ± 40.78 years (range: 21-73) and age at diagnosis of 10.62 ± 31.76 years were investigated. The most common initial complaint in the studied patients was related to isolated joint symptoms (28%). The most common clinical symptoms observed in the examined patients were related to joint symptoms along with sensitivity to light with a frequency of 20%. ANA, anti-dsDNA tests positivity and reduced C3 and C4 levels were observed in 88%, 70% and 26% of patients, respectively.
Conclusion: The establishment of a registry system for the structured registration of information of patients with systemic lupus erythematosus in each region is necessary to a better understanding of the characteristics of the disease and better management policy of patients.
 

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