Background and Objective: Bacterial nanocellulose is known as a potential carrier for a widespread spectrum of biological compounds, including antibacterial and antifungal compounds. The present study was conducted to determine the impact of bacterial nanocellulose containing Natamycin and Amphotericin B on Aspergillus flavus and Penicillium citrinum in an in vitro environment.
Methods: In this descriptive-analytical research, Aspergillus flavus-PTCC: 5006 and Penicillium citrinum-PTCC: 5304 fungi were prepared from the Fungal Collection of the Department of Microbiology, Faculty of Veterinary Medicine, Urmia University. The minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of Natamycin and Amphotericin B against Aspergillus flavus and Penicillium citrinum were evaluated by the microdilution method. Bacterial nanocellulose was prepared using Komagata xylinum bacterium, and Natamycin and Amphotericin B were added in three concentrations of 0.01%, 0.05%, and 0.1% to wet and lyophilized nanocellulose films by the immersion method. Then, the antifungal effects of the film containing the above compounds against the investigated fungi were investigated by the agar diffusion method. Parchment paper was used as a control for comparison. Spectral properties of nanocellulose film containing antifungal compounds were evaluated by the Fourier transform infrared (FTIR) method.
Results: MIC and MFC of Natamycin for Aspergillus flavus were determined as 3.9 μg/mL and 7.81 μg/mL, and for Penicillium citrinum as 7.81 μg/mL and 15.62 μg/mL, respectively. MIC and MFC of Amphotericin B for Aspergillus flavus were determined as 7.81 μg/mL and 15.62 μg/mL, and for Penicillium citrinum as 15.62 μg/mL and 31.25 μg/mL, respectively. The increased concentration had a statistically significant impact on the antifungal properties of all films (P<0.05). The best antifungal effects of the film were related to the film containing Natamycin.
Conclusion: Bacterial nanocellulose containing Natamycin showed stronger antifungal effects in an in vitro environment compared to Amphotericin B against Aspergillus flavus and Penicillium citrinum.

Background and Objective: Ankle instability is one of the most prevalent injuries among athletes. Biomechanical changes, sensory-motor impairments, and neuromuscular disorders have been reported in individuals with chronic ankle instability. The present study was conducted to compare the electrical activity of selected leg and thigh muscles during performing functional movements in female athletes with and without chronic ankle instability.
Methods: This case-control research was conducted on 40 female athletes in the age range of 18-30 years in two groups, including the case (with ankle instability, n=20) and healthy control (without ankle instability, n=20) groups. The electrical activity of selected leg and thigh muscles was recorded during three functional patterns, i.e., the overhead squat, overhead squat with heel lift, and single-legged squat, by electromyography apparatus. The investigated muscles consisted of the gastrocnemius medialis (GM) muscle, the gastrocnemius lateralis (GL) muscle, the tibialis anterior (TA) muscle, the fibularis longus (FL) muscle, the soleus (SO) muscle, the vastus lateralis (VL) muscle, the vastus mediali (VM) muscle, and the biceps femoris (BF) muscle.
Results: The activity of the VM, VL, BF, and TA muscles in the single-legged squat and the activity of the VM, VL, BF, SO, and TA muscles in the overhead squat showed a statistically significant increase in the case group compared to the control group (P<0.05). The highest difference in the muscle activity of the two groups was observed in the overhead squat with heel lift movement, which in this movement, except for the GL muscle, there was a statistically significant increase among all other muscles (P<0.05).
Conclusion: Functional movements culminate in increasing the electrical activity level of leg and thigh muscles in female athletes with ankle instability.

Background and Objective: Dermatophytosis is a significant skin disease in humans and animals, with increasing resistance to conventional treatments. This study aimed to determine the antifungal activity of petroleum ether, dichloromethane, ethyl acetate, ethanol, and hydroethanol extracts from the aerial parts of Artemisia khorassanica, Artemisia scoparia, and Artemisia vulgaris against common dermatophytic fungi, including Trichophyton rubrum, Trichophyton verrucosum, Epidermophyton floccosum, and Microsporum canis.
Methods: This descriptive study examined the antifungal activity of various extracts from the aerial parts of Artemisia khorassanica, Artemisia scoparia, and Artemisia vulgaris against fungal isolates of Trichophyton rubrum, Trichophyton verrucosum, Microsporum canis, and Epidermophyton floccosum. The aerial parts of the three Artemisia species were extracted using five solvents: petroleum ether, dichloromethane, ethyl acetate, ethanol, and 50% hydroethanol. The extracts were screened for antidermatophytic effects against the fungi mentioned above, and the minimum inhibitory concentration (MIC) was determined using the agar dilution method. The most active extracts underwent preliminary phytochemical testing.
Results: In the initial screening, Microsporum canis and Trichophyton verrucosum showed the highest sensitivity (86.66%) and resistance (100%) to the tested extracts, respectively. Extracts from Artemisia scoparia exhibited the broadest range of activity. The most effective extracts, with an MIC of 78.12 µg/ml, were also from this plant. Hydroethanol extracts from all plant species demonstrated the least antidermatophytic activity. Preliminary phytochemical studies revealed the presence of terpenoids in all petroleum ether and dichloromethane extracts of the plant species.
Conclusion: Some lipophilic compounds, particularly in the petroleum ether and dichloromethane extracts of Artemisia scoparia, exhibit significant in vitro antidermatophytic activity.

Background and Objective: Weight regain following bariatric surgery is a significant challenge for this obesity treatment method. This study aimed to identify factors associated with weight regain after bariatric surgeries in obese patients in Gorgan, Iran.
Methods: This longitudinal study included 143 obese individuals (125 women and 18 men) with a mean age of 43.13±9.83 years who underwent bariatric surgery in Gorgan, Iran during 2013-19. Participants were invited to join the study via phone calls. Research variables (type of surgery, blood group, pre-surgery weight, and body mass index [BMI]) were extracted from patient records, and their current weight and waist circumference were measured and recorded. Weight regain was determined based on one of three different criteria: (1) regaining more than 25% of the maximum weight lost post-surgery, (2) regaining more than 10 kg from the minimum weight post-surgery, or (3) an increase of more than 5 BMI units from the lowest BMI post-surgery.
Results: Overall, 33% of individuals experienced weight regain, with 26.6% according to the first definition, 29.4% according to the second definition, and 18.2% according to the third definition. Men had a higher rate of weight regain (P<0.05). Additionally, 93.6% (44 cases) of those with weight regain had abdominal obesity. On average, 79.7% of participants who were 48 months post-bariatric surgery experienced some degree of weight regain. Individuals with a pre-surgery BMI of 50 or higher had a 2.69 times greater chance of weight regain compared to those with BMI lower 50 (P<0.05). The mean weight loss after surgery was significantly higher in individuals who experienced weight regain than those who did not (P<0.05). There was no significant statistical association between weight regain and the type of surgery, age, education level, marital status, or blood group.
Conclusion: Weight regain over time is a reality after bariatric surgery, indicating that this method is not a definitive cure for obesity. Therefore, long-term follow-up for weight control is crucial, especially for individuals with a pre-surgery BMI of 50 or higher or those who experienced significant weight loss post-surgery.

Background and Objective: Oral and dental health are crucial for nutrition intake, speech, and facial aesthetics. They also significantly influence individuals' physical, social, and psychological activities. This study aimed to determine the relationship between the Dental Caries Index (DMFT) and oral health-related quality of life.
Methods: This descriptive-analytical study was conducted on 61 patients (29 men and 32 women) aged 20-50 years who visited the Gorgan Dental School Clinic, Iran during 2019. The DMFT index, encompassing Decay (D), Missing (M), and Filled (F) teeth, was calculated. Quality of life was assessed using the 36-item DIDL (Dental Impact on Daily Living) questionnaire, which covers five domains: dental appearance and aesthetics, oral comfort, overall oral and dental function, eating limitations, and dental and jaw pain. Scores were categorized into three groups: dissatisfied (below 0), moderately satisfied (0 to 7), and satisfied (above 7).
Results: The mean score for oral health-related quality of life was 5.14±0.229, indicating a relative level of satisfaction. Pearson's correlation coefficient between DMFT and oral health-related quality of life was -0.358, suggesting a significant inverse relationship between DMFT and quality of life (P<0.05). The mean DMFT score ranged from 0 to 28, with a mean of 9.36, and the most frequent scores were 7, 11, and 13, each accounting for 11.5% of the sample. The mean decay (D) score was 3.44, the mean missing (M) score was 1.98, and the mean filled (F) score was 3.93, with ranges of 0-12, 0-19, and 0-13, respectively.
Conclusion: The results of this study indicate an inverse impact of the Dental Caries Index on patients' quality of life. Oral health-related quality of life is a multifaceted construct that affects various aspects such as appearance, oral comfort, and eating limitations, which are critical components of overall quality of life and satisfaction.

Background and Objective: The therapeutic outcomes of amblyopia after the age range of 8-10 years are poor, and amblyopia in older individuals is resistant to treatment. Repetitive Transcranial Magnetic Stimulation (rTMS), among the efforts intended to modulate cortical excitability in the treatment of psychiatric disorders, has been believed to be associated with a specific disease. This study aimed to determine the effect of rTMS on the treatment of treatment-resistant amblyopia in adult patients.
Methods: This clinical trial was conducted on 16 patients (12 males and 4 females) with unilateral amblyopia, with a mean age of 30±5 years referring to the clinics of Khatam al-Anbia Eye Hospital, Mashhad, Iran, during 2016-17. Patients were randomly selected from those with unilateral amblyopia (refractive, strabismic, or mixed) who had not responded to conventional treatments (patching or penalization). The healthy eye was considered a control. The therapeutic intervention consisted of four rTMS sessions at two-week intervals. Visual acuity and contrast sensitivity were measured and compared three times: Before the intervention, at the first session of intervention, and at the fourth session of intervention.
Results: The mean visual acuity at baseline (0.36±0.19) was not significantly different compared to the first treatment session (0.41±0.1); however, a significant increase was observed compared to the fourth session (0.45±0.23) (P<0.05). The mean contrast sensitivity at baseline (2.02±0.74) was not significantly different compared to the first (1.97±0.63) and the fourth (2.16±0.94) treatment sessions.
Conclusion: In most follow-ups, improvement in contrast was not observed in patients with treatment-resistant amblyopia at older ages using rTMS. Only an improvement in visual acuity was observed in the last follow-up compared to the baseline in the patient group.

Background and Objective: The coronavirus disease 2019 (COVID-19) pandemic has posed a significant threat to both healthy individuals and those with chronic diseases, including liver cirrhosis. This study aimed to evaluate the clinical and laboratory manifestations and treatment outcomes of patients with liver cirrhosis who were infected with COVID-19.
Methods: This retrospective descriptive study was conducted on 9 patients (4 women and 5 men) with liver cirrhosis infected with COVID-19 hospitalized at Shahid Sayyad Shirazi Educational and Therapeutic Center in Gorgan, Iran during 2019-20. COVID-19 infection was diagnosed by a positive polymerase chain reaction (PCR) test. The Child-Pugh score was used to classify the severity of liver disease. Demographic and clinical data, including initial symptoms and complaints, laboratory results, need for intensive care unit (ICU) admission, length of hospital stay, and treatment outcomes, were extracted from patients’ medical records.
Results: The severity of liver disease was classified as Class B in 7 patients. Comorbidities included cardiovascular diseases and hypertension in 2 patients each, as well as diabetes and asthma in one patient each. Clinical manifestations at the time of COVID-19 diagnosis included ascites in 6 patients; fever in 5 patients; respiratory distress and anorexia in 4 patients each; cough, oxygen saturation less than 93%, and muscle pain in 3 patients each; nausea and vomiting in 2 patients; and abdominal pain and decreased level of consciousness in one patient each. Albumin levels were less than 4 g/dL in all patients. Hemoglobin was less than 12 g/dL in 7 patients. Thrombocytopenia was observed in 8 patients, leukocytosis in one patient, and leukopenia and pancytopenia in 4 patients each. Alanine transaminase (ALT) and aspartate transaminase (AST) levels were higher than 40 U/L in 6 and 5 patients, respectively. Only one patient died, a 60-year-old woman with a history of fatty liver disease, cardiovascular disease, and uncontrolled Class C cirrhosis.
Conclusion: The most common clinical manifestations in patients with liver cirrhosis infected with COVID-19 consisted of ascites, fever, respiratory distress, and anorexia, and the most common laboratory manifestations were hypoalbuminemia and thrombocytopenia.

Background and Objective: Prostate cancer is one of the most common malignancies worldwide. Docetaxel (DTX) is proposed as a well-known compound for prostate tumor chemotherapy, and its function is based on inhibiting microtubule depolymerization, disrupting microtubule balance, and consequently delaying cell cycle progression. Complications of DTX include hypersensitivity reactions, red blood cell aggregation, neutropenia, neurological problems, such as paralysis, fluid retention, bronchospasm, refractory hypotension, ADRS, respiratory impairment, cardiac dysfunction, ventricular tachycardia, cystoid macular edema, optic nerve damage, conjunctivitis, and keratopathy. This study aimed to determine the effect of curcumin on DTX-induced apoptosis in the DU145 (prostate) cell line using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.
Methods: This descriptive analytical study was conducted on the DU145 (prostate) cell line, purchased from the National Genetic Resources Cell Bank, at the Cell Culture Laboratory of the F aculty of Pharmacy, Mazandaran University of Medical Sciences. Cells were passaged for exposure to the desired drugs. Groups included curcumin at concentrations of 2, 4, 6, 8, and 10 µg/mL and DTX at a concentration of 4.46 µg/mL. Cells were incubated in triplicate for 24 hours. For the MTT assay, the culture rate was 10⁴ cells per well. Apoptosis testing was designed for four groups (DTX at a concentration of 4.46 µM, curcumin at a concentration of 2 µM combined with DTX at an optimal concentration, curcumin at a concentration of 10 µM combined with DTX at an optimal concentration, and curcumin at a concentration of 10 µM alone), with the culture rate of 5×10⁵ cells per well in 6-well plates. After cell exposure, MTT and apoptosis determination assays were performed.
Results: DTX reduced the viability of DU145 (prostate) cells by approximately 50% (P<0.05). Groups treated with curcumin combined with DTX showed a dose-dependent decrease in cytotoxicity and an increase in the viability of DU145 (prostate) cells (P<0.05). Additionally, curcumin was able to reduce apoptosis in DU145 (prostate) cells by 90%.
Conclusion: Curcumin increases cell viability and reduces apoptosis in DU145 (prostate) cells.

Background and Objective: Docetaxel is an effective chemotherapy drug for treating lung cancer, but its side effects and cytotoxicity limit its use. Natural compounds like carvacrol and thymol, known for their anti-cancer and anti-inflammatory properties, have gained attention as adjunct agents to reduce toxicity and enhance the efficacy of chemotherapy drugs. This study aimed to investigate the impact of carvacrol and thymol on cell viability and function in A549 cancer cells exposed to docetaxel.
Methods: This experimental study was conducted on the epithelial cell line derived from lung cancer tissue (A549), obtained from the Pasteur Institute of Iran at the Faculty of Pharmacy, Mazandaran University of Medical Sciences in the year 1042. In this research, A549 cells were pre-treated with various concentrations of carvacrol and thymol (5, 10, 20, 40, 80, 100, and 200 µg/mL) along with a cytotoxic dose of docetaxel (8.92 µg/mL) over a period of 48 hours. Cytotoxicity was assessed using the MTT assay. Additionally, the levels of reactive oxygen species (ROS) in cells were measured using the DA-DCFH reagent, and malondialdehyde (MDA) levels were determined using the thiobarbituric acid (TBA) reagent.
Results: Carvacrol and thymol significantly reduced the cytotoxic effects of docetaxel at concentrations ranging from 5 to 200 µg/mL (P<0.05). The evaluation of cytotoxicity indicated that at a concentration of 200 µg/mL, carvacrol and thymol exhibited a more pronounced enhancing effect (98.11±1.64%) compared to the concentration of 5 µg/mL (54.64±2.03%). Furthermore, these compounds significantly mitigated the oxidative stress induced by docetaxel by decreasing the production of reactive oxygen species (ROS) and malondialdehyde (MDA) (P<0.05). Specifically, at the concentration of 200 µg/mL, the levels of ROS and MDA were (13.57±0.09%) and (0.55±0.003%), respectively, in contrast to the levels at 5 µg/mL, which were (20.50±0.59%) and (0.98±0.01%). This demonstrates a notable inhibitory effect on the growth of cancer cells by carvacrol and thymol.
Conclusion: Carvacrol and thymol demonstrate high potential as compounds to improve cell function and reduce the cytotoxicity induced by docetaxel in A549 cancer cells. These findings suggest the potential enhancement of chemotherapy regimens for cancer treatment.

Background and Objective: Given the prevalence of genu valgum deformity and its impact on static and dynamic balance in growing adolescents, this study aimed to determine the effectiveness of neuromuscular exercises on static and dynamic balance of male adolescents with genu valgum deformity.
Methods: This quasi-experimental study was conducted on 24 non-athlete students aged 12 to 14 years with genu valgum deformity. The participants were recruited from corrective exercise centers in District 1 of Velenjak and District 20 of the city of Rey in 2023. Subjects were divided into two groups of 12: A control group and an exercise group. The single-leg balance test and the Y-balance test were used to assess static and dynamic balance in various directions. The corrective exercise program consisted of 12 weeks of neuromuscular exercises, designed in three phases based on varying repetitions, sets, and intensities.
Results: The static and dynamic balance of the exercise group exhibited a statistically significant improvement in the anterior, posteromedial, and posterolateral directions compared to the control group (P<0.05).
Conclusion: The neuromuscular corrective exercise program led to an improvement in both static and dynamic balance in adolescents with genu valgum deformity.

Background and Objective: Evaluating the agreement among various corneal imaging devices is crucial due to their varying technologies in diagnosing corneal parameters. This study aimed to assess the agreement of Advanced Corneal Explorer (ACE) with Pentacam and Orbscan in myopic individuals with healthy corneas.
Methods: This descriptive-analytical study was conducted on 45 myopic individuals (25 women and 20 men; mean age=30.37±6.13 years) referring to Al-Zahra Ophthalmology Hospital in Zahedan, Iran, during 2023. Anterior segment imaging was performed using three devices: ACE, Pentacam, and Orbscan. Corneal parameters, including topography, tomography, and corneal aberrations, were examined. The intraclass correlation coefficient (ICC) and 95% limits of agreement (LoA) were used to evaluate the agreement of ACE data with the data obtained from the other two devices.
Results: ACE exhibited good agreement with Pentacam for the mean power (ICC=0.97), maximum power (ICC=0.98), and minimum power of the anterior corneal surface (ICC=0.97) (P<0.05). Additionally, ACE exhibited good statistical agreement with Orbscan for the mean power of the anterior corneal surface due to an ICC of 0.98 (P<0.05). The ICC values for central corneal thickness and thinnest corneal thickness with the ACE and Pentacam devices were 0.99 and 0.95, respectively, indicating significant statistical agreement (P<0.05). White-to-white distance, pupil size, and corneal aberrations did not show good agreement among the three devices (ICC<0.75).
Conclusion: Topography values and corneal thickness measured with ACE showed good agreement with Pentacam; therefore, they can be used interchangeably. Other measured variables from ACE did not show good agreement with Pentacam and Orbscan and are not interchangeable.

The preservation of mahramiyyah (permissibility) in medical examinations has always been a challenging issue from the perspective of fiqh (Islamic jurisprudence). This matter becomes particularly significant in cases where medical necessities conflict with religious rulings. This analytical-research study, with a comparative approach, was conducted to provide a new framework to establish a balance between medical necessities and fiqh rulings. First, the theoretical foundations and research background were first extracted using reliable library sources, fiqh texts, and scholarly medical books and articles. Sources were searched in the following databases: PubMed, Scopus, Web of Science, Scientific Information Database (SID), Magiran, NoorMags, the Computer Research Center of Islamic Sciences (Noor), and the Comprehensive Jurisprudence Database. The keywords used included “Medical Mahramiyyah,” “Medical Fiqh,” “Medical Necessity,” “Non-Same-Sex Examination,” “Patient Privacy,” “Islamic Telemedicine,” and “Medical Religious Rulings” in Persian, English, and Arabic. Selected sources spanning the period during 1981-2024 were evaluated. The inclusion criteria comprised direct relevance to the topic, peer review, and appropriate content quality. The exclusion criteria included irrelevance to the topic, non-peer reviewed, replicate sources, studies with low quality or without valid data, public or news reports lacking scientific basis. Ultimately, 37 sources were selected and analyzed based on thematic analysis and fiqh deductive reasoning to identify common principles and points of conflict between the fiqh data and medical requirements. Emerging challenges in medical fields, such as telemedicine, were also evaluated. Although the primary principle in Shia fiqh is the prohibition of looking at (except for the face and hands up to the wrist) and touching a person of the opposite sex, whether for treatment or otherwise, there is a consensus among faqihs (Islamic jurists) that, in cases of necessity, this principle is suspended. As a result, examinations requiring touching and looking, even of the genitals, by a physician of the opposite sex are permissible. In both fiqh and medicine, necessity is defined as an urgent need for treatment or medical procedures that, if not performed, could lead to a serious threat to the patient's health. However, some faqihs, based on the rational rule of “Irtikāb Aqall al-Qabīḥayn” (committing the lesser of the two detestable things), deem direct touch and direct viewing to fall under the primary prohibition in instances where telemedicine and indirect examinations suffice for the aforementioned necessity. This research offers practical solutions to maximize the preservation of mahramiyyah in medical examinations, aiming to improve the quality of medical services in Islamic societies while adhering to religious principles.
 

Background and Objective: Chlamydia, a zoonotic bacterial agent, is a major concern for both human and avian public health. This bacterium belongs to the family Chlamydiaceae, with 11 identified species. The Chlamydia psittaci (C. psittaci) species is shared between animal hosts and humans. Ornamental birds are among the hosts of C. psittaci. This bacterium causes respiratory and gastrointestinal problems in these birds. This study aimed to determine the prevalence of chlamydial infection in ornamental birds in Urmia, Iran.
Methods: This descriptive study was conducted on 60 fecal swabs collected from 60 ornamental birds in Urmia. Giemsa staining and molecular polymerase chain reaction (PCR) testing, using genus-specific primers to amplify a 580-base pair (bp) fragment of the ompA gene, were performed on the samples.
Results: The Chlamydia molecule was detected in 11.7% of budgerigars with gastrointestinal symptoms and in 5.88% of apparently healthy budgerigars. Additionally, the infection was detected in 11.11% of cockatiels, 14.28% of mynahs, 20% of canaries, and 11.11% of finches, but not in other species.
Conclusion: The results of this study demonstrate the presence of the Chlamydia bacterium in ornamental birds in Urmia, which can be considered a source of infection for gastrointestinal diseases.
 

Background and Objective: Bariatric surgeries are among the most effective methods for treating obesity. A key postoperative challenge is insufficient weight loss or weight regain, which may be associated with eating disorders after surgery. This study was conducted to evaluate the prevalence of binge eating (BE) disorder following bariatric surgery in Gorgan, Iran.
Methods: This descriptive analytical study was performed on 133 patients (mean age = 42.65±9.78 years) who underwent bariatric surgery performed by a single surgeon for the treatment of obesity at Dr. Mousavi Hospital in Gorgan, Iran, during 2013-2019. Patients were invited for an interview, physical examination, and to complete a questionnaire via a phone call. After obtaining informed consent, participants' current height and weight were measured using a standard method, and the Binge Eating Disorder Scale (BEDS) was completed. Variables, such as the type of surgery and preoperative height and weight were extracted and recorded from patients' medical records. The prevalence of BE disorder was compared between patients with and without weight regain.
Results: Out of 133 participants, 44 (33.1%) experienced weight regain. Moderate or severe BE disorder was identified in 59 individuals (44.4%). The prevalence of BE disorder was significantly higher in patients with weight regain compared to those without (P<0.05). The odds of ratios (ORs) for weight regain were 3.7 and 3.9 times higher in individuals with moderate and severe BE disorder, respectively, compared to those without the disorder. No statistically significant association was observed between BE disorder and variables, such as gender, education, occupation, and marital status. However, among individuals who experienced weight regain, being a housewife had a statistically significant association with the disorder (P<0.05).
Conclusion: BE disorder is a significant factor in patient weight regain in the years following surgery, particularly among housewives.