مجله دانشگاه علوم پزشکی سبزوار
سال هفدهم شماره 2 (پیاپی 56، تابستان 1389)

Background and Some researchers believe that the treatment with glucose–insulin–potassium (GIK) in ST segment elevation myocardial infarction (STEMI) can reduce the mortality rate. Others, however, contradict this view. Therefore, the present study was designed to evaluate the clinical and paraclinical effects of GIK in STEMI patients. This triple blind clinical trial was conducted from September 2008 to July 2009 on 72 STEMI patients in the CCU of Vasei Hospital in Sabzevar, Iran. They were assigned through block randomization into standard care or additional GIK infusion (25% glucose, 50 IU of soluble insulin per liter, and 80 mmol of potassium chloride per liter at 1.5 ml/kg/hour). They were assessed for the number of MACEs (death, reinfarction and serious arrhythmias), plasma concentrations of cardiac enzymes (CK, CK-MB), and left ventricular ejection fraction. The statistical analysis was conducted in SPSS 11.5 using Fisher’s exact test, t-test and repeated measurement. P<0.05 was considered as the basis of significance. MACE rate was 30.3% for GIK and 25.6% for control patients (p=0.66). There was no significant difference in plasma concentrations of cardiac enzymes between GIK and control patients. Left ventricular ejection fraction was 39% for GIK and 41% for control patients (p=0.34). In patients with STEMI treated with streptokinase, GIK therapy offers no clinical and paraclinical effects.

Breast cancer is the most common cancer among women, and one out of 8 or 10 women is diagnosed with breast cancer. This type of cancer is an extremely heterogenous disease, which is classified into multiple categories including LCIS (Lobular carcinoma in situ), DCIS (Ductal carcinoma in situ), and invasive carcinoma. BRCA1 and BRCA2 are two major high-risk genes associated with hereditary breast cancer. Mutations in CHEK2 gene also contribute to a substantial fraction of familial breast cancer. Susceptibility alleles in other genes are also rare causes of breast cancer. More than 1000 mutations have been identified in BRCA1 and BRCA2, and molecular assays for detecting mutations in these genes are now well established. Mutations in BRCA1 and BRCA2 cause genomic instability, which leads to alterations in additional key genes including tumor suppressor genes and/or oncogenes. There is a promise of tailoring treatment programs for individual women in near future. The emergence of miRNAs as regulators of gene expression identifies them as a novel candidate for diagnostic and prognostic indicators and therapeutic targets. The ability of miRNAs to simultaneously regulates many target genes and makes them attractive candidates for regulating stem cell self-renewal and cell fate decisions. The involvement of miRNAs in the initiation and progression of human malignancy holds much potential for new developments in current diagnostic and therapeutic strategies in the management of patients with breast cancer. The identification of novel miRNAs, the elucidation of their mRNA targets, and an understanding of their functional effects will improve our knowledge of the roles of these novel biomarkers in carcinogenesis, including breast cancer, and open avenues for potential therapeutic intervention.

Background and Many studies suggest that nursing students experience high levels of stress in clinical settings. It seems that training of communicative skills can enhance the potentialities of nursing students cope with stress. Therefore, the present study was conducted to investigate the effect of communicative skills on the perceived stress of nursing students. Methods and Materials: This experimental study involved 26 cases and 30 controls from the population of nursing freshman participants from Mashad Faculty of Nursing and Midwifery in 2009-2010 (confidence interval 95%). Group allocation was conducted randomly. For the experimental group, a 10-hour workshop on communicative skills was provided. Data collection was done through a researcher-made questionnaire of stressors (r=0.834). The obtained data were analyzed in SPSS using paired t-test, independent t-test, chi-square, Kruskall-Wallis and Mann Whitney U tests. Mean perceived stress before training in the experimental and control groups were 43.69±22.24 and 47.03±14.36 respectively, which suggests no significant difference. However, after training, the corresponding figures came out to be 28±19.66 and 43.47±16.64 respectively, with a statistically significant difference (p=0.002). The results indicated that training of communicative skills reduced the perceived stress of nursing students.

Background and Application of low-frequency stimulation (LFS) induces anticonvulsant effects. In this study, the effect of changes in LFS frequencies on its anticonvulsant effects in kindling model of epilepsy was investigated by determining the behavioral and ultrastructural changes. Methods and Materials: In this experimental study, 45 Wistar rats weighing 250-280 g were used. For induction of kindled seizures, stimulating and recording electrodes were implanted in perforant path and dentate gyrus respectively. Animals were stimulated in a rapid kindling manner. Different groups of animals received LFS at different frequencies (0.5, 1 and 5 Hz) following kindling stimulations and their effects on kindling rate were determined using behavioral and electrophysiological studies. After stimulating the animals for 7 days, they were killed and their dentate gyri were sampled for ultrastructural studies under electron microscopy. For data analysis, one-way and two-way ANOVA, LSD, Kruskal Wallis and Mann Whitney U were used in Statistica 2. Different LFS frequencies had a significant inhibitory effect on kindling rate and decreased after-discharge duration and the number of stimulations to achieve stage 4 and 5 seizures significantly. In addition, application of LFS prevented the increase in the post-synaptic density and induction of concave synaptic vesicles following kindling. There was not any significant change between anticonvulsant effects of LFS at different frequencies. Obtained results show that LFS application can prevent the neuronal hyper-excitability by preventing the ultrastructural changes during kindling, and can exert its anticonvulsant effects.

Background and Appetite is one of the factors affecting the energy intake equation and has different control and regulatory levels. One of the probable factors affecting it is physical activity. The purpose of the present study was to examine the effects of moderate and heavy resistance exercise on appetite, glucose, glycerol and lactate of the serum in healthy men. Methods and Materials: In this experimental study, out of the university employees, 13 male volunteers were recruited for the study by their own written informed consent, and were assigned into three modes of control, moderate resistance exercise (with intensity of 70% of 1RM) and heavy resistance exercise (with intensity of 80% of 1RM) groups. The process consisted of 8 different movements arranged in 3 sets with 10 repetitions within 90 minutes. The participant's appetite parameter was recorded by appetite questionnaire before collecting blood samples. Data was analyzed using repeated measures ANOVA in SPSS 13 at a significance level of P<0/05. After correcting the results of plasma volume, no significant changes were observed in the appetite, glycerol and glucose of the serum As caused by moderate and heavy resistance exercise. Appetite decreased immediately after the exercise protocol by 33%, but increased 3 hours after the exercise by 12%, and finally decreased 9-hours after exercise by 26% compared to pre-exercise levels (P<0.05). The results of the study indicate that a one-session moderate and heavy resistance exercise has no significant effect on the appetite if food deprivation and significant negative energy balance do not exist.

Background and According to the World Health Organization report, mental disorders are among the major causes of disabilities worldwide, which can decrease the success rate of educational progress in students and prevent their further achievements. Physicians believe that physical fitness is a suitable field to access good mental status. This study intended to compare the mental health of athlete and non-athlete students. Methods and Materials: This cross-sectional study involved 74 university students who were randomly selected. The Goldberg General Health Questionnaire (GHQ 28) and Demographic Characteristics Questionnaire were used for data collection. Statistical analysis was performed using descriptive statistics (frequency, mean and standard deviation) as well as the independent t-test in SPSS. 13. The total prevalence of mental disorders was 61.76%; but it was 9.4% among athlete students and 30.2 among non-athletes; the observed difference was significant (p<0.001). Athlete students enjoy a better mental health status than non- athletes do.

Background and P53 gene is one of the genes which undergoes mutations in breast cancer. The rate of p53 gene mutation has been variously reported. However, its mutation is considered resistant to chemotherapy. This study is intended to determine p53 gene overexpression with histopathological parameters in breast cancer. Methods and Materials: This descriptive analytical research was conducted on 80 samples of non-randomized breast cancer cases admitted to hospitals in Sabzevar, Iran from 2007 to 2010. After samples were fixed in formalin, they underwent tissue processing and were stained by H&E. After malignancy diagnosis, the p53 gene overexpression was detected by immunohistochemical methods in the samples after fixation, tissue processing and antigen retrieval. The obtained data were analyzed in SPSS 11.5 using chi-square test. Out of 80 specimens of breast cancer, p53 gene expression was observed in 39 specimens (48.8%), which was one positive (+) in 21 cases, two positive (++) in 10 cases and three positive (+++) in 8 cases. No significant relationships were observed between p53 protein stability with tumor stages, as well as age groups of over 45 years and below with tumor stages. P53 protein stability was detected in about half of the samples, which can signify the high rate of mutation of p53 gene in breast cancer in Sabzevar, Iran

Background and Measuring the student's satisfaction from the university departments and educational system can have a paramount role in assessing the educational performance and activities. The aim of this study was to investigate the educational facilities and equipments. This descriptive analytical study was conducted in 2008 on 414 university students were selected through stratified random sampling. A researcher-made questionnaire was administered to collect data on facilities and educational services. The validity of the questionnaire had been confirmed by the faculty members and by Cronbach alpha coefficient. The obtained data were analyzed in SPSS 16 at first by descriptive analysis and then by ANOVA and t-test. The satisfaction rate was grouped into good, average and poor. The study indicated that student's satisfaction from facilities and educational services were 41.4% in seven fields. Also, the overall satisfaction rate of male (34.4%) was higher than that of the female participants (20.9%); and the difference was significant (P<0.01). Also, the satisfaction rate was higher in students of 2-year programs (30.4%) than in 4-year program students (18.8%) (P<0.006). But a comparison between the satisfaction rate of students of health (29.3%) and medical majors (24%) revealed no significant difference. The overall satisfaction rate of students from the current services and equipments of the university is average.

Background and

In order to artificially process, to fasten the process of production and to make up for deficiencies of the natural fermentation, most bakeries opt to use chemicals such as sodium bicarbonate, sodium hydrosulfate, and additional salt (for reducing gluten sylait and increasing the dough resistance). This produces further problems and chronic health outcomes such as malnutrition, disturbance in digestion, hypertension, allergy and so on. Therefore, this study was conducted to determine the levels of these chemicals used by bakeries. Methods and Materials: This cross sectional descriptive analytical study was conducted in Sabzevar, Iran during 2006-2007. Out of a total of 168 bakeries, 62 were sampled by a two-stage stratified method. PH and salt of the bread were measured by the standard method. The obtained data were analyzed t-test in SPSS 11.5.

Based on the results, mean PH across the four seasons was 5.76±0.39. Manual taftoon bakeries showed a higher PH than the mechanical bakeries. The independent t-test indicated that mean PH across four seasons was not statistically different for the two types of bakeries (p>0.05). Mean salt use in mechanical and manual bakeries was different but the difference was not significant across fall and winter.

Mean PH in the bakeries is around the standard level but the salt use is a little higher than the standard level, which may be affected by the oven and flour quality.

Background and Osteosarcoma is among primary bone tumors, seen mostly in long bones among young adults. Therapeutic approach to this disease consists of surgery and chemotherapy. Unfortunately, there is no access to information on its early symptoms and the high risk group. Therefore, in this study we have assessed the epidemiologic, clinical and paraclinical characteristics of osteosarcoma. Methods and Materials: This cross sectional descriptive study involved 100 cases of osteosarcoma with various ages admitted to academic hospitals in Mashad, Iran. The obtained data were analyzed statistically in SPSS 11.5. There were 69 male and 29 female patients, with a mean age of 17.6±7.04 years. The most common tumor sites were femur (46%) and tibia (41%). Bone pain (56 cases), swelling (18 cases) and pathologic fractures (11 cases) were the most common complaints. Osteosarcoma can be recognized as a malignancy in young male adults, which is characterized mainly with pain.