نشریه دانشگاه علوم پزشکی بیرجند
سال بیست و ششم شماره 2 (پیاپی 79، تابستان 1398)

Failure to follow the drug is common in patients with myocardial infarction. However, it has been reported in various studies that family support can improve adherence to drug in chronic diseases. The purpose of this study was to investigation the impact of education of family support behaviors on adherence to the drug in patients with Myocardial Infarction. This controlled clinical trial study was performed on 70 patients with myocardial infarction, which had criteria for entering the study. Patients were randomly divided into intervention and control groups and demographic information and adherence to the drug was completed questionnaire for two groups. Individuals who received inadequate the drug follow-up based on this questionnaire were completed their family support questionnaire. In order to intervene, in the form of at least three educational sessions, based on the needs assessment of the two previous questionnaires, training was provided to the key member of the intervention group family and three months after the intervention, the two drug and family support questionnaires were re-completed for the two groups. Finally, the data was entered into SPSS software (version 16). Descriptive statistics including frequency, mean, standard deviation for description and description of data and analytical statistics including: Chi-square, paired T-test and independent T-test were used for data analysis. The significance level was considered as (P <0.05.) The mean score of family supportive behaviors and adherence to the drug in the intervention group was significantly higher than the control group after the intervention (P <0.001). Also, the mean of changes in drug follow-up (P <0.001) and family support (P <0.001) after intervention in the intervention group were significantly higher than the control group. The teaching of family supportive behaviors can improve the adherence to the drug in patients with myocardial infarction.

Self-care behaviors are one of the effective factors in preventing symptoms and recurrence of the disease. Continuous Care Model has been introduced as a regular process for effective communication between patient and nurse. considering the feature of this model in the continuity of communication in patient care that is appropriate to the patient's condition, This study aimed to determine the effect of Continued Care Model (CCM) on self-care behaviors in patients with myocardial infarction. A randomized controlled clinical trial study was performed on patients admitted to coronary care unit (CCU) wards of the Zahedan-based teaching hospitals in 2017. Sixty patients were selected by convenience sampling method and assigned randomly into intervention and control groups (N=30 per group). The CCM in five group sessions, they performed 45-30 minutes and were followed up by telephone. Data were collected by using a demographics form and questionnaire of standard scale Self-Care Miller in a Data were collected from using a demographics form and questionnaire of standard scale Self-Care Miller in three periods of time. data were analyzed in SPSS software (Version 20) and with the help Independent t-test, Chi-square and repeated measures ANOVA with Bonferroni post hoc test, at the significant level of P<0.05 was analyzed. Two groups of control and intervention there were no significant differences in individual variables. Mean scores of diet (P<0.001), non-smoking (P=0.03), moderation of stress variable (P=0.002), physical activity (P=0.001), and total score of self-care behaviors (P <0.001) were significantly increased in the intervention group immediately after the intervention was implemented The results showed that the changes in self-care behaviors in the two groups were not the same in three time intervals and in the intervention group were statistically significant (P<0.001). The CCM can cause positive changes in self-care behaviors in patients. Therefore, using this model as a community-based approach in the health system is recommended in patients with myocardial infarction.

Non-Alcoholic Fatty Liver Disease (NAFLD) is the major cause of chronic liver disease in developed countries. In this study, we identified the most important transcription factors and biological mechanisms affecting the incidence of fatty liver disease using the promoter region data mining. In this study, at first, the marker genes associated with this disease were detected and the pattern of transcription factors was examined by the Genomatix software.  In the whole of genome, genes with a similar binding pattern for transcription factors in the promoter region were identified as potentially effective genes on the fatty liver. By using the Cytoscape software (3.6.0), the network of transcription factors and target genes was mapped. Finally, the most important biological pathways associated with genes derived from fatty liver were studied using the DAVID database. The protein network fitting showed Creb1, Jun and Max transcription factors and  Sfpi1, Ddit3 and Gsk3b genes play an important role in the development of this disease. Gene ontology analysis revealed that biological pathways including apoptosis, intracellular signals, and biosynthesis of aromatic compounds and signaling pathways of circadian rhythm, non-alcoholic fatty liver, and chemokine signals contributed to the occurrence of fatty liver disease. Increasing the expression of transcription factors and genes produced can be one of the most factors affecting the onset of the disease, also, biological pathways including apoptosis, intracellular signals, and biosynthesis of aromatic compounds and signaling pathways of circadian rhythm, non-alcoholic fatty liver, and chemokine signals are important in fatty liver phenomenon.

Heavy metals such as lead and cadmium are toxic and carcinogenic compounds that are absorbed through the skin. Therefore, the aim of this study was to determine the amount of lead and cadmium heavy metals in bulk branded cosmetic bags (mascara and tattoo) distributed in Birjand. In this descriptive-analytical study, by referring to the Birjand cosmetics and health center :::::union::::: and by using a simple random sampling method, the 12 centers are selected and by referring to them, 63 samples of mascara and eyebrow tattoos were selected. Due to the limited number of eyebrow cosmetics brands, all existing brands were sampled. The lead and cadmium levels of the samples were determined using acid digestion and atomic absorption. Data were analyzed using statistical tests of Kruskal-Wallis and Mann-Whitney. The mean lead concentration in mascara and tattoos was 51.8-227.4 μg / g and 37.5 ± 313.6 mg / g, respectively, and in all samples, the concentration of cadmium was zero. There was a significant difference among the different tattoo samples in terms of concentration of lead (P<0.05), but there was no significant difference between mascara samples (P=0.761). Due to unauthorizedness, the concentration of lead heavy metal in conventional cosmetic products and also no significant difference among famous brands, sufficient awareness of the risk of large amounts of such substances is necessary.

Selenium is an essential mineral with antioxidant properties that play a role in metabolic processes, and its relationship with lipid profile has been shown in some studies. The purpose of this study was to investigate the effect of intake selenium supplementation on lipid profile and cardio-respiratory function in rest situation and subsequent an exercise session in active men. The research method was quasi-experimental. In this study, 19 active men were selected from among soccer players in the city of Saghez and were randomly divided into two experimental (supplementation, n=10) and control (placebo, n=9) groups. The assessments were carried out in three stages (pre-taking the supplementation, after taking the supplementation, and immediately after an exercise session).  General characteristics of subjects studied, cardio-respiratory function (aerobic power), and levels of lipid profile (triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)) were measured. Consumption period of supplement was a month. (A 200 μg Selenium capsule per day). To analyze the data, one-factor analysis of variance with repeated measurements was used at a significant level of P<0.05. Selenium supplementation increased cardio-respiratory function (47.7±7.4 vs. 39.7±8.0 ml/kg/min, P=0.017), while has no effect on resting and following exercise session levels of TG (P = 0.258), TC (P=0.737), HDL (P=0.406), and LDL (P=0.312). Taking the selenium supplementation for one month does not seem to affect the components of the on lipid profile in rest situation and subsequent an exercise session, however, it can help improve the cardio-respiratory function of active men.

Hematological values ​​in people are affected by various factors such as race, environment, time, test method, sample collection site, and age. Given the fact that these factors can differ with each other in different populations, these differences can lead to differences in the results of hematological reference rates. Therefore, we decided to identify a normal range of blood factors in a large sample of the adult population living in South Khorasan. In this cross-sectional study in 2015, a crowd of 5,000 selected from cluster-based adults in Birjand in 2015 and hematological parameters were determined in 4360 healthy subjects. Finally, the data were described using descriptive statistics. The counts for the total white blood cells, red blood cells, Hemoglobin, Hematocrit, and Mean cell volume values ​​for males and females were determined. The mean Hemoglobin values ​​were 15.01 ± 3.13 and 14.01± 1.8 in male and female respectively and the mean Hematocrit was 45.81± 7.52 and 42.59± 5.99 in males and females, respectively. The minimum leukocyte counts were lower than those reported in existing references. However, a higher rate of Eosinophil and Monocyte was obtained among the subjects. Although in general, hematological factors in Southern Khorasan are similar to the values mentioned in other references, but in some cases, there are also differences that can be useful in evaluating them.

Ulcerative Colitis is an idiopathic inflammatory bowel disease that is common in adults. Although corticosteroids are the most effective preservative treatment for Ulcerative Colitis. However, due to the dependence of these drugs and their serious complications, the use of an immunosuppressive drug or surgery should be taken seriously. Thus the aim of the study was the evaluation of the efficiency of low doses of azathioprine (AZA) in reducing relapse and corticosteroid-dependence in Ulcerative colitis patients. In this cross-sectional study, 96 patients with ulcerative colitis were followed for one year. Patients who indicated by corticosteroid therapy not able to reduce the dose of corticosteroid, at second relapse was treated with 1- 1.5 mg/kg of (AZA). Demographic characteristics, the severity of disease at the beginning of the study and response to treatment, recurrence of the disease, and drug side effects during the study. Data were analyzed using the Chi-square test in SPSS software. At the beginning of the study, over 50% of patients had high symptoms of the disease. In the patients under study, 40 (41.7%) patients had corticosteroid dependence, all of them being treated with (AZA). Of the 96 patients during the one-year follow-up 24 patients are relapses and 72 patients did not have relapses. 97.8% of corticosteroid patients with (AZA)prescription, Corticosteroid was discontinued and only one patient did not response to AZA and was underwent surgery. Given the prevalence of use of corticosteroids, prescription of low doses of (AZA) can be considered as one of the effective therapies to reduce the rate of relapse of the disease and to avoid frequent use of corticosteroids.

Mothers are the main key to improving the oral health of children, and their beliefs in this area are very influential on the way children's oral care works. The aim of this study was to determine the status of knowledge, attitude and performance of mothers about the preventive behaviors of dental caries in 4-6 year old children based on integrated behavioral model. This descriptive analytic cross sectional study was conducted on 275 mothers with 4-6-year-old children referring to Birjand Comprehensive Health Services Centers in 2018. They were selected through randomized multi-stage cluster sampling method. The research tool was a researcher-made questionnaire based on the constructs of the integrated behavioral model, whose validity and reliability were checked and verified (Cronbach's alpha = 0.99). Data were analyzed by SPSS software (Version 19) using one-way ANOVA, Tukey's post hoc test, linear regression and Pearson correlation coefficient. Mean score of mothers' knowledge was 5.03 ± 2.48 and mean score of mothers' performance was 2.64 ± 2.11. There was a positive and significant correlation between performance scores and the mean scores of different constructs of the integrated behavioral model (P <0.001). Regression analysis indicated that the variables of knowledge and behavioral control were effective variables on performing preventive behaviors of dental caries. Based on the results of this study, knowledge and behavioral control constructs was predictor of the preventive behaviors of dental caries. It is suggested that this model be used to examine other health behaviors.

Children due to specific physiological and behavioral characteristics, more than others are at risk of accidents and need care by an adult; therefore, the present study aims to investigate the effect of education in two methods, storytelling and self-learning have been done on the ability of mothers to prevent children's accidents. The present research is a randomized field trial study which was performed on 60 mothers with children aged 1 to 59 months. The research tool is a researcher-made questionnaire whose validity and reliability have been proven. Meetings for training the principles of preventing the common accidents in the province in two "storytelling" and "self-learning" methods were held in 24 training sessions. data analysis was performed by Chi-square, Fisher test, independent t-test, Bonferroni post hoc and repeated ANOVA tests at α = 0.05 Both training methods significantly enhanced the empowerment score of the mothers compared to before (P<0.001). Comparing two methods, although there was no significant difference in the mean of power score changes before and the immediately after the intervention, but the average of changes in the score three months later showed a significant difference before and immediately after that and storytelling could have a more effective effect on improving the ability of mothers three months after intervention (P = 0.02) and immediately thereafter (P = 0.04). Education in both ways can lead to mothers' ability; however, due to reduced ability score after three months in the self-learning group, storytelling is more effective in mothers.