---

Background & Objective: Hemodialysis patients quality of life is a significant subject. Style of coping or adjustment among hemodialysis patients is a complicated problem that affects the quality of life status. Responses domain to these problems are different from readjustment to suicide. The object of this study was to determine the relationship between quality of life and copings the problem, which were applied by hemodialysis patients. Materials & Methods: This is a descriptive analytical and correlational study. The study has been done in hospitals of Gorgan, Gonabad and Bandar Torkaman cities. The data were collected using a questionnaire with likert scale (From 1 to 5). Sample population was 167 patients. Results: The results showed that 89 patients were male, 78 patients female, 25.74% between 35-44 years old and hemodialysis of duration of 114 patients was more than 4 years. The quality of life mean score and standard deviatior were respectively 89.58, 8.13. About 75.42% of patient’s quality of life were moderate. The emotional and problem focused strategies were used in moderate way by the hemodialysis patients. Statistic tests between quality of life and emotional focused coping was significant (P<0.05). In general there are relationship between quality of life and total coping (P<0.05). Conclusion: According to study, we conclude that emotional focused coping and total coping influence the quality of life of hemodialysis patients. Therefore hemodialysis patients must be educated and supported, to cope with the problems.

---

Background & Objective: Appendicectomy for suspected acute Appendicitis is a common procedure. The rate of normal Appendices unnecessarily removed remains high (15-30%) despite several techniques and investigations used to improve the diagnostic accuracy. Many studies investigated the role of raised C-reactive protein in improving the diagnosis of acute Appendicitis. This study emphasizes the impact of a normal serum C-reactive protein in reducing the rate of negative explorations. Materials & Methods: In a double blind study, blood for the WBC count and measurement of serum C-reactive protein (CRP) was collected pre-operatively from 100 patients just before going to the operating room for appendicectomy. The histopathology of the 100 Appendices was grouped into positive (Acute Appendicitis) and negative (Normal appendix). White blood count (WBC), CRP and the histopathology finding were correlated. Results: In-patients with histopathologically proven acute Appendicitis both the WBC count and serum CRP level were significantly raised (P=0.000 and P=0.000 respectively). Serum CRP level was normal in 16 out of 18 negative explorations (Normal appendix on histopathology). The specificity and sensitivity of serum CRP was 88.8% and 92.6% respectively. Conclusion: Normal pre-operative serum CRP measurement in-patients with suspected acute Appendicitis is most likely associated with a normal appendix. Deferring surgery in this group of patients would probably reduce the rate of unnecessary appendicectomies.

---

Background&Objective: Decrease in production of erythropoietin has been noted as one of the main factors causing anemia in ESRD patients, and administration of recombinant human erythropoietin (rhEPO) has been used to correct the anemia. Iron deficiency, including functional iron deficiency, limits the efficacy of rhEPO therapy in ESRD patients. This study examined the effects of maintenance intravenous iron sucrose (Venofer) on haemoglobin level and, optimization of erythropoietin therapy. Materials&Methods: Forty eight haemodialysis patients with haemoglobin level<9 gr/dl who were dialyzed three times weekly went under the study. Two thousands units of rhEPO were given subcutaneously at the end of each dialysis for seven weeks. At the end of the seventh week, those with haemoglobin level<9 gr/dl and with ferritin level <200 ng/dl (29 patients) were chosen for intravenous administration of 100 mg Venfor during the next five consecutive haemodialysis while maintaining the rhEPO dose at 2000 units with each dialysis. A week after the last dose of Venofer, haemoglobin and serum ferritin were determined. Results: Average haemoglobin level among the patients before administration of rhEPO was 7.5 gr/dl. After seven weeks of subcutaneous rhEPO at 2000 units with each haemodialysis, the average haemoglobin level raised to 8.5 gr/dl. The effect of maintenance IV Venofer was an increase in average haemoglobin level to 10.4 gr/dl. The same effect was seen on the ferritin level. The ferritin level of 131 ng/dl increased to 237 ng/dl a week after last dose of IV venofer. Conclusion: Intravenous (IV) iron improves haemoglobin response and, thus, optimizes rhEPO therapy.

---

Background & Objective: In this research, we study the simultaneous effects of Nitric Oxide (NO) and stress on prefrontal cortex of rats. Nitric Oxide is an unstable small molecule that involved in many physiological and pathological conditions. Brain’s prefrontal cortex has important role on personality and mental state. Its development continues after birth and this period is the most sensitive time for brain’s cortex to response to environmental parameters such as psychological stresses. Materials & Methods: In this study Wistar male rats received L-arginine (200 mg/kg) as NO precursor, L-NAME (20mg/kg) and 7-nitroindazole (25mg/kg) as non specific and specific NO sentries inhibitors. L-arginine and L-NAME were injected intra peritoneal (IP) and 7-nitroindazole injected subcutaneously (S.C) during one month per day. Rats divided in two groups (with stress and without stress). The kind of stress was immobilization every day for one month during injection of materials. Brains were removed after this period and each brain with a coronal section manner divided in two parts .Anterior part of brain fixed by formalin and tissue processing was done. By using rotatory microtome 10? serial cross sections were obtained and stained with H & E. Posterior part of brain homogenized with such solution then amount of NO in obtained solution was measured by spectrophotometer with 540 nm wavelength. Results: Statistical analysis of light microscopic findings indicated that stress of immobilization with use of L-NAME and 7-nitroindazole result in decrease of thickness of prefrontal cortex , numbers of Betz cells and NO production in rats’ brain, it means L-NAME and 7-nitroindazole exaggerate the brain damage and from other hands L-arginine with stress can convert these results. Conclusion: On the basis of these results we believe that stress of immobilization damages prefrontal cortex and also NOS inhibitors can aggravate the cortical damage. On the other hand although NO precursor (L-arginine) decreases the cortical damage in rats that impress with stress, it can result in these changes in rat’s brain without stress.

---

Background & Objective: Tetra Carbon Cholride has been known as reference hepatotoxin because it can cause necrosis, fatty change, cirrhosis and cancer liver. Silymarin has hepatoprotective and anti hepatoxin effect. This study was done to determine the protective effect of Silymarin in acute hepatotoxicity of CCl4 in rats.

Materials & Methods: In this experimental study, we chose 25ml/kg dose of CCl4 (in mineral oil solvent) as an optimum dose. The hepatotoxic effects of intraperiotoneal injection of CCl4 for obtaining parameters of toxicity and therapeutic effects have been examined. According to enzymatic results (increase in ALT and AST) and histopathologic changes (grading the changes in liver including cytoplasmic granularity, cloudy swelling, necrosis and fatty change), the interval between prescribing silymarin and sampling  was determined. Silymarin as a suspension in propylene glycol CMC 2% (3/2 ratio) has been prescribed in 50, 200 and 800mg/kg doses and serum and liver samples were obtained. Negative control group received silymarin vehicle in CCl4 solvent, drug control received 800 mg/kg of silymarin in CCl4 solvent and positive control received silymarin vehicle after injecting CCl4.

Results: The results showed that prescribing 50mg/kg silymarin one hour after injecting CCl4, in addition to inhibiting transaminase activity, prevents progress of liver injury up to 50% of positive control group. Cellular repair and regeneration are also enhanced, So the grade 3necrosis in positive control group is decreased to grade 0.5 in silymarin gourp in 48 hours prescribing silymarin (50mg/kg).

Conclusion: This study showed that up to six hours after injecting CCl4 significantly prevents hepatotoxicity, and cause acceleration in repair of liver injuries.

---

Background and Objective: Hemodialysis is one of the common therapulic proceduce for terminal renal failure. Insufficient and low efficient hemodialysis increases the mortality rate, therefore the assessment of hemodialysis efficacy is important. This study was done to determine the hemodialysis efficacy based on urea reduction ratio (URR) model and kt/v (Clearance Time Volume) criteria in Gorgan, Northern Iran. Materials and Methods: In this descriptive and analytical study 113 heomdilysis patients were selected prior to hemodilysis and five minutes after pump stopping, arterial blood urea nitrogen (BUN) was measured and then kt/v and URR were calculated. Also kt/v relations with weight, gender, educational level, length of hemodialysis session, blood flow rate, TMP (Terans Membran Presure), filter Ku/f (Clearance Ultrafiltration), preliminary disease, time of hemodialysis per week and the type of vessel access were determined. Data analyzed using SPSS-13 and independent t-test, chi-square, fisher exact test and Pearson correlation coefficient. Results: The mean of hemodilysis history was 37 months and mean of Patient's ages were 51.6 years. 77.9% of subjects had hemodialysis efficacy according to Kt/v and URR critrial. There was a statistical significant correlation between hemodialysis efficacy and time of hemodialysis session, blood flow rate, time of hemodialysis per week and type of vessels access (P<0.05), but there was not any significant correlation between hemodialysis efficacy and weight, gender, education, TMP, filter Ku/f and preliminary disease. Conclusion: This study suggested that hemodialysis efficacy in this center was better that other studies in Iran.

---

Background and Objective: Diazinon is an organophosphate insecticide. , which inhibits the enzyme acetylcholinesterase. This study was done to evaluate the effect of Diazinon on pituitary-gonadal axis and histological alteration of seminferous tubules in adult rat testis. Methods: In this experimental study, 40 adult male Wistar rats were randomly allocated into five groups including control, sham and experimental 1, 2 and 3. Animals in experimental group 1, 2 and 3 were received 50, 100 and 150 mg/kg/bw of diazinon for 28 days, orally, respectively. Animals in control group did not receive any substance. Animals in sham group were received an equivalent amount of normal saline. The animals were euthanized after 28 days and a blood sample was collected via heart puncture and testes were removed for histological studies. Results: Diazinon significantly reduced serum testosterone concentration, sertoli cell, leydig cell count, primary spermatocyte and spermatid (P<0.05). Diazinon had no significant effect on the body and testis weight in the experimental groups compared to controls. Conclusion: Diazinon reduces the concentration of testosterone and cells in seminferous tubule in adult rat.

---

Background and Objective: Sodium Arsenite is an environmental pollutant which can generate free radicals causing tissue damage. This study was done to evaluate the effect of Green Tea (GTE), as a strong antioxidant, on kidney tissue in mice treated with Sodium Arsenite. Methods: In this experimental study 24 adult male NMRI mice were randomly allocated into four groups including: control, GTE (100mg/kg/day), Sodium Arsenite (5mg/kg/day) and Sodium Arsenite + GTE, for 34 days, orally. Animals were scarified and left kidney was taken out, fixed, sectioned, processed and stained using Heidenhain'azan method. Using stereological technique the total volume of kidney, volume of cortex, medulla, proximal and distal tubule, renal corpuscle, gelomerelus, tuft and capillary, membrane and space of Bowman's capsule and length of proximal and distal tubule were determined. Creatinine, BUN and MDA serum samples were measured. Results: The mean of total volume of cortex, proximal tubule, distal tubule, renal corpuscle and gelomerolus, taft, Bowman's capsule space, size of epithelium and lumen of proximal and distal tubule were significantly reduced in Sodium Arsenite group compared to control (P<0.05). These parameters were significantly increased in the Sodium Arsenite + GTE group in comparison with Sodium Arsenite group (P<0.05). The creatinine, Blood urea nitrogen (BUN) and MDA were significantly increased in the Sodium Arsenite group in compared to the control group (P<0.05). These parameters were significantly reduced in the Sodium Arsenite + GTE group in comparison with Sodium Arsenite group (P<0.05). Conclusion: Green tea has a protective role in Sodium Arsenite induced nephrotoxicity.

---

Background and Objective: Spirituality refers to considering the cultural-religious beliefs of the people in the therapeutic process and taking into account the transcendental dimension of the clients who lead them to the transcendental source. This study was conducted to determine the effect of spirituality therapy on the resilience of women with breast cancer in Tehran, Iran.
Methods: This quasi-experimental study was performed on 30 women with breast cancer referred to the oncology and chemotherapy clinic in Tehran, Iran during 2016. Subjects were selected by available sampling method and then non-randomly divided into two groups of 15 intervention and control groups. The intervention group was subjected to psychological intervention during 11 sessions of 60 minutes and the control group did not receive intervention. Patients completed the Conner and Davidson resiliency questionnaire (2003) before and after the end of the treatment period.
Results: The mean and standard deviation of the resiliency score of the intervention and control groups in the beginning of the study were 3.64±0.22 and 3.77±1.13, respectively. This rate was 4.30±0.41 and 3.68±0.1 in patients in intervention and control groups, respectively (P<0.05).
Conclusion: Spiritual therapy intervention increased the resiliency of women with breast cancer.

---

Background and Objective: Liver is an important organ with specific function in relation to drug metabolism. Haloperidol is a drug for the treatment of schizophrenia, mania in bipolar disorder and dizziness. This study was performed to determine the changes in tissue and hepatic enzymes in male rats born to mothers treated with haloperidol.
Methods: In this experimental study, 25 adult female Wistar rats were allocated into 5 groups. The control group, the sham group and experimental groups 1, 2, 3. Dams in experimental groups 1, 2, 3 in the pregnancy period were received 12.5, 25 ,50 mg/kg /bw of haloperidol for 21 days orally, respectively. The control groups were sham and three experimental, first, second and third experimental groups. Mothers of mice received 12.5, 25 and 50 mg/kg of haloperidol during the pregnancy as 21 days of gavage. At the end of pregnancy and 22 days of infant, all infants were weighed. Alanine aminotransferase (ALT), alkaline phosphatase (ALP) and aspartate transaminase (AST), albumin and total protein were measured by autoanalysis and liver tissues were stained using hepatoxylin-eosin method.
Results: The mean concentration of albumin and total protein in the second and third experimental groups significantly reduced in compare to control group (P<0.05). The mean concentration of AST in the second and third experimental groups significantly increased in comparsion with control group (P<0.05). The mean concentration of ALT and ALP in all experimental groups was significantly higher than the control group (P<0.05). The mean of liver indices in all experimental groups was not significant in comparison with the control group. In the tissue samples of the experimental groups, necrosis was observed with increasing dosage.
Conclusion: Haloperidol has been shown to increase liver enzymes and liver necrosis and increase liver necrosis in a dose-proportional manner.

---

Background and Objective: The diazinon insecticide is a strong acetylcholinesterase controller at the nerve terminals. This study was conducted to determine the effect of diazinon on functional tests and tissue alterations in rat liver.
Methods: In this experimental study, 40 adult male Wistar rats were allocated into 5 groups including the first, second and third experimental groups were received 50, 100 and 150 mg/kg/bw of diazinon, respectively, orally during 21 days. The control group did not receive any medication and the sham group received solvent. At the end of study, blood samples were obtained from animals and Alanine transaminase (ALT), Aspartate transaminase (AST), Alkaline phosphatase (ALP) hepatic enzymes, total protein, albumin and bilirubin were measured. After anesthesia the liver of animals were removed and evaluated by hematoxylin eosin histological staining methods.
Results: The level of AST and ALT enzymes in the experimental groups receiving 100 and 150 mg/kg/bw doses of diazinon significantly increased in compared to the control group (p<0.05). The level of ALP of animals in all groups receiving diazinon was significantly higher than the control group (P<0.05). Total protein level significantly reduced in all groups receiving diazinon compared to the control group (P<0.05). The level of albumin in the experimental group receiving 150 mg/kg/bw dose of diazinon significantly reduced in comparision with controls. In the experimental groups, tissue samples showed more necrosis with increasing doses of diazinon.
Conclusion: Diazinon increases level of liver enzymes and decreased total protein and albumin level and causes the histological alterations in rat liver.

---

Background and Objective: Silver nanoparticles are produced in large quantities in the industry and have estrogenic activities and toxic effects on different organs. This study was conducted to determine the effect of silver nanoparticles on the ovarian tissue of NMRI rats treated with alpha lipoic acid.
Methods: In this experimental study, 24 female NMRI rats were randomly divided into 4 groups of 6. The groups included the control group, oral silver nanoparticles (500 mg/kg of body weight), injected alpha lipoic acid (100 mg/kg of body weight), and silver nanoparticles (500 mg/kg of body weight) plus alpha lipoic acid (100 mg/kg body weight). The treatment was performed for 28 days. After the treatment period, blood sampling was performed from the rats’ hearts to analyze biochemical parameters (malondialdehyde, estrogen, progesterone, and total antioxidant capacity using the ferric reducing ability of plasma (FRAP) method). By dissecting the rats, the left ovaries were removed, fixed, molded, and cut, tissue passaging was performed, and the ovaries were stained using the hematoxylin-eosin method. Then, the ovarian tissue was evaluated by different stereological methods.
Results: The total mean ovarian volume, the cortex volume, the medulla volume, and the corpus luteum volume, and the total number of primordial, primary, secondary, and Graafian follicles were significantly reduced in the silver nanoparticles group compared to the control group (P<0.05). The simultaneous administration of alpha lipoic acid and silver nanoparticles compensated for the adverse effects of silver nanoparticles on the above parameters. On the other hand, the mean number of different types of follicles in the rats treated with alpha lipoic acid significantly increased compared to the control group (P<0.05). A statistically significant reduction was observed in the measurement of estrogen and progesterone hormones in the serum of the silver nanoparticles group compared to the control group (P<0.05). Moreover, in assessing the antioxidant capacity of the serum of the group treated simultaneously with silver nanoparticles + alpha lipoic acid, a statistically significant increase was observed compared to the group treated with silver nanoparticles (P<0.05).
Conclusion: Silver nanoparticles can have adverse effects on the structure of the ovary and its components, and alpha lipoic acid can largely compensate for these detrimental effects.

---

Background and Objective: Considering the increasing use of silver nanoparticles in various products, including industrial and medical products, serious worries have been created regarding the potential dangers of silver nanoparticles. This study was conducted to determine the effect of silver nanoparticles on the kidney tissues of quercetin-treated NMRI rats.
Methods: In this experimental study, 24 adult male NMRI rats were randomly divided into 4 groups of 6. The groups included the control group, the silver nanoparticles group (500 mg/kg/bw), the quercetin group (50 mg/kg/bw), and the silver nanoparticles (500 mg/kg/bw) + quercetin (50 mg/kg/bw) group. Silver nanoparticles were fed orally on a daily basis for 35 days. Quercetin was injected intraperitoneally on a daily basis for 42 days. At the end of the study, after taking blood from the rats, the dissection, tissue passaging, and Heidenhain’s Azan staining stages were carried out. The total volumes of the kidney, cortex and medulla, renal corpuscle, and glomerulus were evaluated by a stereological method. A qualitative assessment of apoptotic cells was performed using the tunnel method. The amount of malondialdehyde (MDA) in blood serum was specified as an indicator of lipid peroxidation by the Buege and Aust method.
Results: Comparing the body weight and kidneys, and the total kidney, cortex, and medulla volumes showed no statistically significant difference between the silver nanoparticles group and the control group. The silver nanoparticles group showed a significant increase in the total mean renal corpuscle volume, glomerular volume, tuft volume, Bowman’s capsule membrane volume, and the amount of MDA compared to the control group (P<0.05). Also, a statistically significant reduction was observed in the silver nanoparticles group in the total mean volume of Bowman’s capsule and capillary spaces compared to the control group (P<0.05). Quercetin could reduce the detrimental effects of silver nanoparticles on kidney cells as much as the control group; however, apoptosis was not shown in kidney cells in the group treated with quercetin. Assessing the cells in the silver nanoparticles group indicated the creation of apoptosis. The amount of serum MDA in the silver nanoparticles group showed a statistically significant increase compared to other groups (P<0.05).
Conclusion: The results of this study demonstrated that quercetin could reduce the detrimental effects of silver nanoparticles on kidney cells as much as the control group.

---

Background and Objective: In the post-coronavirus disease 2019 (COVID-19) era, messages and video calls with loved ones, family, and friends have brought individuals closer together and made social isolation more bearable. Although the utilization of these tools has numerous positive aspects, there are also negative ones. The present study was conducted to determine the prevalence of Internet addiction among medical students at Golestan University of Medical Sciences and its association with psychiatric disorders.
Methods: This descriptive-analytical study was conducted on 189 medical students (73 males and 116 females; mean age=23.35±3.03 years) at Golestan University of Medical Sciences in 2021. A convenience sampling method was used, and all students were taken into account as the statistical population. Data collection tools included Young’s Internet Addiction Test (IAT) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) short form, which were completed by the students.
Results: Fifty (26.45%) medical students were identified as being at risk of Internet addiction, and 3 (1.58%) students were classified as having Internet addiction. Less than 4% of the students had severe psychiatric disorders, while 9.5% to 19.6% exhibited various psychiatric disorders of moderate severity. Beyond the area of hypochondriasis symptoms, significant positive correlations were found between Internet addiction and increased psychiatric disorders in other areas, including depression (r=0.285, P<0.001), hysteria (r=0.170, P<0.019), psychopathy (r=0.338, P<0.001), paranoia (r=0.384, P<0.001), mania (r=0.336, P<0.001), psychasthenia (r=0.432, P<0.001), and schizophrenia (r=0.415, P<0.001). With increasing Internet addiction, the severity of psychiatric disorders also increased.
Conclusion: The prevalence of Internet addiction among medical students was shown to be at a low level, but the severity of psychiatric disorders increased with higher levels of Internet addiction.