Ardabil University of Medical Sciences
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Carvedilol prevents pancreatic β-cell damage and the development of type 1 diabetes in mice by the inhibition of proinflammatory cytokines, NF-κB, COX-2, iNOS and oxidative stress
No full textInflammation is one of the main mechanisms of pancreatic β-cell damage and the development of type 1 diabetes (T1D). Carvedilol, a beta-adrenergic receptor blocker, has been demonstrated to have anti-inflammatory and antioxidant effects. The aim of this study was to investigate the protective effect of carvedilol against pancreatic β-cell damage and the development of T1D in an experimental model. T1D was induced in mice by multiple low-dose streptozotocin (STZ) injections. Diabetic mice were treated with carvedilol (15 and 20 mg/kg/day, orally) for 14 days. Results showed that blood glucose levels, diabetes incidence, body weight loss and insulitis in the pancreatic tissue were significantly reduced in mice treated with carvedilol. Treatment of mice with carvedilol significantly increased the levels of antioxidants glutathione (GSH), superoxide dismutase (SOD), and catalase and decreased the levels of malondialdehyde (MDA), nitric oxide (NO) and myeloperoxidase (MPO) in the pancreatic tissue as compared with those in the STZ-induced diabetic mice. Carvedilol decreased the expression of nuclear factor kappa B (NF-κB), cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) as important modulators of inflammation and β-cell damage in the pancreatic tissue. In addition, carvedilol significantly reduced the levels of proinflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 IL-12, IL-17, interferon (IFN)-γ and chemokine MCP-1, while increased the anti-inflammatory cytokine IL-10 in the pancreatic tissue. In conclusion, these findings suggest that carvedilol is able to prevent pancreatic β-cell damage and the development of T1D in mice by the inhibition of inflammatory and oxidative mediators
In vitro antibacterial evaluation of self adhesive flowable composite against streptococcus mutans
No full textIntroduction: The presence of antibacterial properties in restorative materials has a great advantage for them by controlling the progression of tooth decay. Class V lesions caused by caries and incorrect brushing methods are very common. Today, the use of flowable composites is very common to restore the class V lesions; also the use of self-adhesive composite materials has advantages such as easier application and reduced treatment time. Considering that the antibacterial properties of restorative materials can play an important role in preventing secondary caries, especially in cervical restorations, this study was designed to evaluate the in vitro antibacterial activity of self adhesive flowable composite against Streptococcus mutans..
Materials and Methods: The present study was a laboratory study performed on 9 disks per each group of composites and glass ionomer. These discs were prepared in three groups: microhybrid flowable composite samples, self adhesive flowable composite samples and self curing glass ionomer samples.Direct contact test was used to compare the antibacterial properties of the discs. Data were collected using direct contact test and visual enumeration of grown bacterial colonies. After collecting the data, they were recorded in a checklist prepared in accordance with the objectives of the study and analyzed using one-way ANOVA and independent T-test in SPSS software version 22 (P-value<0.05).
Results: The results showed that the antibacterial effect of glass ionomer was higher than microhybrid flowable composite and self adhesive flowable. Also, a significant difference was observed between the antibacterial activity of microhybrid flowable composite and self adhesive flowable against Streptococcus mutans (P<0.05).
Conclusion: Due to the fact that glass ionomer and self adhesive composite have a higher antibacterial effect against Streptococcus mutans, so they can be used as alternatives to treat tooth decay
Correlation between mental well being and family caregiver burden in patients with cancer
No full textEconomic burden of cardiovascular diseases before and after Iran’s health transformation plan: evidence from a referral hospital of Iran
No full textBackground
Different countries have set different policies to control and decrease the costs of cardiovascular diseases (CVDs). Iran was aiming to reduce the economic burden of different disease by a recent reform from named as health transformation plan (HTP). This study aimed to examine the economic burden of CVDs before and after of HTP.
Methods
This cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using the cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran’s Ministry of Cooperatives, Labor, and Social Welfare, the central bank of Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials (IRR).
Results
Total costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after (62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p = 0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2 to 36.7%. All hospitalization costs, except patients’ OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively.
Conclusion
Economic burden of CVDs increased in the north-west of Iran after the HTP due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to unsustainable resources of the HTP. So, no results of this study can be attributed solely to the HTP. Therefore, more detailed studies should be carried out on the reasons for the significant increase in CVDs costs in the region
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019
No full textBackground
Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019.
Methods
8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric.
Findings
The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019.
Interpretation
Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
No full textBackground
In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries.
Methods
GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution.
Findings
Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI.
Interpretation
As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve
Evaluation Outcomes of early discharge of mothers after cesarean delivery in Alavi hospital in 2019-2020
No full textBackground: In many gynecological hospitals in country including Ardabil province mothers who have undergone cesarean section will be discharged if they have stable vital signs and good general condition during the first day after cesarean section. So far, this method is used to discharge patients one day after cesarean section if the symptoms are stable; No study has been done.
Aim: The aim of this study was to evaluate the consequences of early discharge in patients who have undergone cesarean section.
Methods and material: The study was a case series study. The study population included all women between 18 and 40 years old with a gestational age of 37 weeks or more who were admitted to Alavi Hospital in Ardabil due to cesarean section. Four hundred patients were included in the study. These pregnant mothers are without any preference to the two groups that group 1 is visited one day and group 2 is visited two days after cesarean section and they were discharged if the vital signs were stable and there is no bleeding and life-threatening symptoms and according to the taste of the treating physician and the individuals in both groups were followed up by telephone one and six weeks later and a checklist was filled out for them. Group 1 included 157 people and group 2 included 243 people.
Results: In the present study 400 people were included in the study with a mean age of 29.77 years. 243 patients were discharged 2 days after cesarean section with a mean age of 29.61. The first group which was discharged one day after cesarean section also included 157 people with a mean age of 30.05. There were no significant differences in age group. There was no significant difference between the two groups in terms of body mass index. At one and 6 weeks after discharge; There was no significant difference between the two groups in terms of fever after discharge, readmission, symptoms of infection after discharge (pain, redness, purulent discharge) and use of antibiotics since discharge.
Conclusion: After cesarean section, if the patient's vital signs are stable the patient can be discharged after 24 hours
Effect of Ceratonia siliqua L. extract on DNA Fragmentation of Sperm in Adult Male Mice Treated with Cyclophosphamide
No full textThis study was conducted to determine the effects of Ceratonia siliqua L. (CS) extract on sperm parameters and DNA damage in adult male mice treated with cyclophosphamide (CP). Based on an initial dose response experiment on Ceratonia siliqua L. extract, five treatment groups were set up: control, sham (normal saline: 0.2 ml per day, IP), CP (15 mg kg-1 per week; IP), Ceratonia siliqua L. (100mg l-1 per day; IP), and group of Ceratonia siliqua L. along with CP for 35 days. After euthanizing the animals, sperms from caudal part of epididymis were collected, and their parameters, Malone Di-Aldehyde (MDA) level, and DNA fragmentation were analyzed. In the mice exposed to cyclophosphamide, reduction in the sperm count and viability and increase in the abnormal sperm and MDA levels were detected (p < .05). In addition, an increase in sperms with damaged DNA was detected in CP group, while the use of Ceratonia siliqua L. Extract significantly recovered these disturbances in the treatment group (p < .05). This study suggested the competence of Ceratonia siliqua L. extract in the improvement of sperm parameters and DNA fragmentation in animals treated with CP
Comparison effect of Entonox and Dexamethasone versus Remifentanil and Dexamethasone on the control of painless delivery
No full textBackground: Labor pain is often severe. Unrelieved labor pain can have an adverse effect on the physiologic status of women. Pain during labor is accompanied by fear, which is related to slower progress of labor. Accurate measurement and appropriate management of pain is a significant problem for attendant medical and nursing personnel. There are choices to be made during labor about options available for pain relief in labor; each method has its own risks and benefits, with variations in effectiveness, availability and acceptability.
AIM: The purpose of this study was to Comparison effect of Entonox and Dexamethasone versus Remifentanil and Dexamethasone on the control of painless delivery in the delivery room of Alavi Hospital in Ardebil
Materials and Methods: In this clinical trial study, 100 women with term pregnancy were observed. In all of the cases, labor pains started spontaneously and had fetal and maternal indication for normal vaginal delivery. They were divided into two groups randomly. The A group received Entonox and Dexamethasone and the B group received the Remifentanil and Dexamethasone. Data of labor pain and outcome of delivery collected by means of questionnaires.
Results: Pain severity according to VAS score was significantly lower in patient received remifentanil and dexamethasone after 30, 60, 120 and 180 min after intervention VS subjects with Entonox and Dexamethasone. There is no significantly different regard to duration of labor's active phase, the number of uterine contractions, apgar score and fetal heart rate between two groups. Concerning maternal complications between the two groups, dry mouth which was lower in the remifentanil and dexamethasone group than in the entonox and dexamethasone group. The rest of the cases showed no statistically significant differences between the two groups. There is no significant difference about mean diastolic blood pressure and maternal respiratory rate between the two treatment groups.
Conclusions: Concomitant use of remifentanil and dexamethasone is recommended compared with Entonox and Dexamethasone because it is safe for the mother and child and provides more favorable analgesia during labo
Investigation of the impact pattern of maxillary third molars in Ardabil population
No full textPurpose: The aim of present investigation was to evaluate frequency of different angles, numbers of roots, depth of impaction in maxillary third molarsand their damages to nearby structuresby analyzing panoramic radiography.
Materials and Methods: This study was conducted by analyzing panoramic radiography
382 (124 men & 258 women) patients who referred to baser radiography center, rad radiography
center and Ardabil dental school between year 2014 to 2015.
Results:The most frequent angle of impacted teeth in maxillary third molar in both genders was
vertical (48/9%), and the most frequent depth was class C according Winter Classification System
(46/8%), in approximately 85% of cases No space between teeth and sinus was observed and according to numbers of roots 54% of teeth had 2 roots, 22% 3 roots and 8% had only one root. The
most important damage to nearby structures was angular periodontal lesions which were demonstrated in radiography (52%), making caries on second molars (100%), root resorption on second
molars (6%) and in 18% no harmful lesions on molar 2 or radiographic lesions were detected.
Conclusions: Within the limitations of this study, most of third impacted maxillary molars
had enough space to maxillary sinus and most of them were vertically, thus extraction of these
impacted teeth seems simple and possible