نشریه دانشگاه علوم پزشکی بیرجند
سال بیست و دوم شماره 3 (پیاپی 64، پاییز 1394)

One of the notorious air pllutants on which air quality is determined is carbon monoxide (CO). The aim of the present study was to measure the concentration of CO outdoor and indoor urban environments and compare it with air quality standards within buildings and open spaces.
This research was a descriptive-analytical study of CO estimation in outdoor and indoor air of Birjand. Concentration of CO at the height of 150 cm and in the closest street leading to the specific building and also¡ inside the building (i.e.drawing room)-at the hight of 75 cm was measured using a CO meter. For data analysis¡ statistical softwares SPSS (V:18) and Excel were used applying Mann-Whitney¡ Friedman¡ and Wilcoxon statistical tests.
It was found that the highest concentrations of CO in the outdoor air in Birjand were 11 and 10 ppm in December and March¡ respectively. And highest concentrations of CO in indoor air were 11 and 9 ppm in February¡ respectively. But¡ in general¡ the average concentration of CO measured in outdoor and indoor air quality in both months were less than the standard measure air pollution outside (9ppm) and the quality of indoor air pollution (25ppm).
Regarding to results of the present study¡ concentrations of indoor and outdoor CO of Birjand air were in standard ranges.

Identifying factors associated with employees empowerment of their working centers can promote organizational performance of hospitals. The current study aimed at investigating the relationship of both organizational climate and organizational silence with psychological empowerment in the public hospitals affiliated with Birjand University of Medical Sciences (BUMS).
This cross-sectional and correlational study was carried out in 2015. Using a stratified randomized sampling, 400 employees were selected from the public. hospitals affiliated with BUMS. Data collection tools were. three self-administered questionnaires including organizational climate, organizational silence, and psychological empowerment. . Validity and reliability of the questionnaires were verified using experts judgment and Cronbach alpha coefficients more than 0.7, respectively. Data analysis was done by means of SPSS (V: 18) software using one sample t test, independent t test, Pearson correlation coefficient, and one-way ANOVA. The cut-off point of 70%.of Likert-type scale (3.5) was considered as an acceptable mean for each variable.
The mean organizational climate and organizational silence was 2.45 and 3.18, respectively which did not correspond with an acceptable mean (P It is suggested that the hospitals administrators should promote the psychological empowerment of their employees through improving organizational climate and decreasing organizational silence; and thus, increase their positive participation and employing deserved plans to improve workplace climate and eliminate the silence behavior through employee engagement and more opportunity to express their ideas.

Bioterrorism is defined as any terrorist action of intentional release or dissemination of highly pathogenic biological agents، including a variety of microorganisms or biological toxins. With the growing threat of terrorism، is necessary that the potential danger of various microorganisms – as a powerful tool of aggression and threat- to be taken seriously. This review tries to explain the concept of biological weapons and their historical development process with an emphasis on efforts to control the proliferation of these types of weapons over the last century. Potential impact of infectious diseases on people and armed forces was known from since 600 BC. Using the victims of the plague as a weapon in medieval warfare and spread of smallpox as a weapon during the war against the Indians when initially America was discovered، the development of biological weapons during the World War I، World War II and the Cold War، and even since the beginning of the third millennium، all show the strategic importance of pathogenic microorganisms as a deterrent power for the superiority of some governments and cults. Historical attempts to use infectious diseases as biological weapons reveal that the distinction between a natural outbreak of an infectious disease and that of a deliberate biological attack is very difficult. Abusing this characteristic of infectious diseases has made it possible for the purposes of superiority. International agreements to control the development of biological weapons، such as “the 1925 Geneva Protocol” and “the Convention on the Prohibition of the Development، Production and Stockpiling of Biological and Toxic Weapons” have not been able to control the development and using of biological warfare. The current paper is a classic review (Overview) article aiming at increasing the knowledge and awareness of people; especially of health authorities and government officials.

Hypertension is one of the most common and important non-communicable diseases and health problems in the world today; nevertheless, it is preventable and controllable. Theory of Planned Behavior is one of the major theories that explains the process of adopting healthy behaviors. The present study aimed atat determining the effect of the theory on components of theory in patients with hypertension. This randomized controlled field trial study was done on 110 patients with hypertension in Zirkouh city who were divided into two equal groups. Validity and reliability of the questionnaire used were determined through face and content validity and through Cronbach’s alpha and test-retest, respectively. The obtained data was analyzed by means of SPSS software (V: 16) using statistical t-test and repeated analysis of variance. Both groups were similar regarding mean score of the theory components before intervention, but after the intervention the average scores of the experimental group increased. The attitude increased from 48.7 to 64.1, subjective norm from 34.9 to 43.1, perceived behavioral control from 33.8 to 43, intention behavior from 33.9 to 41.09 and behavior from 65.6 to 82.45); and these differences were statistically significant (P<0.001).However, nosignificant difference was observed in the control group. Regarding the positive effect of education based on The Theory of Planned Behavior in controlling hypertension, planning of a curriculum based on this theory is recommended.

Stroke is one of the most important factors of mortality and disability in the world. Free radicals are produced following ischemic stroke and they play a central role in breaking the blood-brain barrier and causing brain edema formation.The aim of the current study was to evaluate the effect of hydro- alcoholic extract of Origanum vulgare on brain edema and neurologic deficit in a rat stroke model. In thisexperimental study, 35 male Wistar rats were randomly divided into 5 equal groups. The first two groups (control and Sham)) received distilled water, while three treatment groups received oral Origanum vulgare extract for 30days (50,75and 100 mg/kgdaily, respectively). Two hours after the last dose of Origanum vulgare extract,each main group underwent a 60 min middle cerebral artery occlusion. Then, the assessment of blood brain edema, and neurologic deficits analysis were done. Brain edema (brain water content) was analyzed by One-Way ANOVA using LSD method and neurologic deficits analysis by means of Mann-Whitney U, and P<0.05 was taken as the significant level. Origanum vulgare extract reduced brain edema in the experimental groups of 50 (82.49±0.47), 75 (80.89±0.63) and 100 mg/kg/day (80.80±0.66) compared to the control group (84.46±0.67). The neurologic deficit scores in the experimental groups of 75and 100mg/kg/day, compared with control group, but neurologic deficit scores did not affect the group receiving the dose 50 mg/kg. The obtained data indicate that Origanum vulgar extract via reduction of brain edema and neurologic deficits scorescan have a protective effect on the stroke model.

Regarding the widespread use of silver nanoparticles in medecine and lack of a detailed study of toxicity effects of these particles on fetus, this study was carried out to investigate histopathological changes of the kidneys and also embryonic development following exposure to silver nanoparticles. In this experimental study, thirty five female NMRI mice were randomly divided into five equal groups; i.e. one control group and four experimental groups. The experimental groups intraperitoneally (IP) received silver nanoparticles at concentrations of 50, 100, 200 and 400 mg/ kg. .every other day. On the 17th day of pregnancy, the mice were dissected and their kidneys and embryos tissues were separated and stained with hematoxylin and eosin for histopathological examinations.. Finally, the obtained data was fed into SPSS software (V:16) using statistical tests including Kolmogrof-Smearnof, one-way variance analysis, Dante, Mann-Whitney and Kruskal-Wallis; and P<0.05 was taken as the significant level. Histopathological assessment of kidney tissue following IP administration of silver nanoparticle indicated pathological changes including congestion, necrosis, inflammatory cell infiltration, vacuolar degeneration compared to the control group. Our findings showed that silver nanoparticles during the gestation period affects fetal organogenesis, evolution of neural structure, liver lobulation and fetal growth retardation. Mean number of somites in groups receiving doses of 200 and 400 mg kg,. significantly reduced compared to the control group (P<0.05). The obtained results suggest that passing of silver nanoparticles through placenta is possible and damage caused by the particles could lead to the deformity or developmental retardation of the fetus.

A lot of biological investigations are aimed to find pain decreasing or relieving substances that appear in various diseases. Parabrachial nucleus plays an important role in cognitive and emotional aspects of pain. The present study was designed to evaluate the inhibitory effect of bicuculine- as a GABA A receptor antagonist- on the number of multiform neurons in Parabrachial region of adult male rats in tonic pain model. This experimental study was carried out on 40 Wistar male rats. Based on the pain induction, the animals were divided into 8 groups (n=5). Bicuculine was administrated in doses of 50, 100, and 200 ng/rat. Using stereotaxic method, Bicuculine was administrated to the rats` brain parabrachial area. The present study utilized Formalin test as a standard method for pain stimulations. Thereafter, Gimsa staining method was applied for histological determination of multiform cells. The obtained data was analyzed using statistical testsincluding Student-t and one-way ANOVA. Our data showed no significant changes in the number of multiform cells in Parabrachial nucleus between the animals administrated by bicuculine at the dose of 50 AWT IMAGE compared with the controls (P>0.05). Nevertheless, the number of these cells was decreased significantly in the animals administrated by bicuculine at the doses of 100 and 200 AWT IMAGE when compared to the controls (p<0.05). It was found that nociceptive stimulations cause changes in the number of multiform neurons in para- brachial nucleus. Nevertheless, higher dose administration of GABA A receptor antagonist has preventive effects on neuronal dysmorphogenesis at this brain area.

Dysmenorrhea is one of the most common problems in females. “Theory of Planned Behavior” is one of the important theories that explains the main process of adopting health behaviors. The present study assessed applying “the Theory of Planned Behavior in relaxation training regarding the severity and duration of painful dysmenorrhea in Mashhad girl students. In this Semi-experimental study, 160 first year intermediate students of Mashhad city who suffered from dysmenorrhea were assessed.They had been randomly selected from 5 girl high- schools in the 6th educational district. They were divided into equal groups “case” and “control”. Intervention was made in four sessions. The requisite data was gathered by means of a researcher designed questionnaire before and 3 months after the education of the students. Finally, the obtained data was fed into SPSS software (v:16); using statistical tests including Wilcoxon, Mann-Whitney, Independent T-test, Paired T and X2. After educational intervention, mean level of knowledge, attitude, perceived behavioral control, and willed performance of relaxation techniques significantly increased in the case group (P<0.05). These changes were not significant in the control group. Besides, no statistically significant difference in subjective norms was observed between the two groups after intervention. Meditation education group was increased significantly (P<0.05). Education of relaxation base on the Theory of Planned Behavior is effective in reduced pain intensity and its duration.

Abdominal aortic aneurysm is an important mortality factor especially in old men. The present study aimed at investigating prevalence of abdominal aortic aneurysm in people over 65 years old who referred to the ultrasonic centers in Birjand educational hospitals in 2014. In this cross-sectional study, 1451 individuals were willingly selected from over 65 patients over 65 years old, with no history of abdominal aortic aneurysm who had referred to the ultrasonic centers of Imam Reza and Vali-e- Asr hospitals in 2014,. using simple non-probability sampling method. A Canadian ultrasonic device with 3.5 MHz Linea spherical probe was used for the measurement of aortic diameter while a questionnaire was used in order to record demographic information as well as risk factors. The obtained data was analyzed by SPSS (V:16) statistical software; using Chi-square and independent-T tests at the significance level of P≤ 0.05. It was found that out of 1451 patients. , 99 cases (6.8%) suffered from abdominal aortic aneurysm. Relative frequency of abdominal aortic aneurysm did notreveal a significant difference regarding the sex. However, prevalence of the risk of abdominal aortic aneurysm had a significant relationship with the. variables of age, diabetes, and dyslipidemia. Due to high prevalence of abdominal aortic aneurysm in people over 65 years, screening for of abdominal aortic aneurysm is suggested for the lederly.

The emergence of nonfermenter bacteria that are resistant to multidrug resistant ESBL are nowadays a principal problem for hospitalized patients. The present study aimed at surveying the emergence of nonfermenter bacteria resistant to multi-drug ESBL producing isolated from patients blood samples using BACTEC 9240 automatic system in Shiraz. In this cross-sectional study, 4825 blood specimens were collected from hospitalized patients in Shiraz (Iran), and positive samples were detected by means of BACTEC 9240 automatic system. The isolates containing nonfermenter bacteria were identified based on biochemical tests embedded in the API-20E system. Antibiotic sensitivity test was performed and identification of ESBL producing strains were done using phenotypic detection of extended spectrum beta-lactamase producing isolates(DDST) according to CLSI(2013) guidelines. Out of 4825 blood samples, 1145 (24%) specimen were gram-positive using BACTEC system. Among all isolated microorganisms, 206 isolates were non-fermenting gram- negative bacteria. The most common non-fermenter isolates were Pseudomonas spp. (48%), Acinetobacter spp. (41.7%), and Stenotrophomonas spp. (8.2%). Seventy of them (81.4%) were Acinetobacter spp. which were ESBL positive. Among β-lactam antibiotics, Pseudomonas spp. showed the best sensitivity to piperacillin-tazobactam (46.5%). It was found that β-lactam antibiotics are not effective against more than 40% of Pseudomonas spp. infections and 78% Acinetobacter infections. Emergence of multi-drug resistant strains that are resistant to most antibiotic classes is a major public health problem in Iran. To resolve this problem using of practical guidelines is critical.

Phenylketonuria (PKU., OMIM261600) is the most common genetic disorder autosomal recessive mode of inheritance and the metabolism of amino-acids, which is due to deficiency of the liver enzyme phenylalanine - hydroxylase as a result of mutations in the gene encoding it is achieved. The present study aimed at investigating the incidence of PKU n the South Khorasan province between June 2012 and June 2014. This study uses data from a national screening for phenylketonuria in South Khorasan Province was conducted. The present study was a retrospective descriptive one. Our data gathering tool included a researcher designed questionnaire and sampling consisted of all live births in the South Khorasan Province from June 2012 to June 2014. Finally, all the data was analyzed using the software SPSS version18.0. The total population screened was 30,368 people. Frequency of confirmed cases was 32 females and 1 male, whose parents were relatives. Incidence of mental retardation in the newborns was zero at the screening time. Incidence of the mentioned disease in Iranian subjects of the province was 0.996:10000 and in all the births, i.e both Iranians and the Afghans, it was0.987: 100000. Occurrence of the disorder in Ghaen was 3.68: 10000; and in the rest of the cities of the province equal to zero. The results show that the incidence of phenylketonuria in the South Khorasan isvery low between 2012 and 2014, although there are considerable numbers of suspected cases. Therefore, continuing of the national screening program of newborns at birth is particularly important.