نشریه دانشگاه علوم پزشکی خراسان شمالی
سال هشتم شماره 1 (بهار 1395)

Kidney patients in each dialysis cycle are exposed to extremely large volume of water, which is in direct contact with the patient’s blood . Therefore, water used for this purpose should be treated with advanced methods before use for dialysis. The objective of this study was to assess the efficiency of reverse osmosis systems to improve water quality used for dialysis fluid.
Material & This is a descriptive-analytic study to Evaluation of Reverse Osmosis System of water treatment system for dialysis centers in Imam Ali Bojnurd ciry during 2015on 36 samples of water from the municipal water was reverse osmosis. Post-harvest and transport of samples to the laboratory using the latest according to the standard methods for water and wastewater examination.
The results of this study showed that the reverse osmosis systems significantly reduce the amount of sulfate, nitrate, fluoride, hardness, sodium, potassium. These amounts were lower than AAMI and EPH standards.
Reverse osmosis systems could improve the quality of water used for hemodialysis. Based on the results of this study, it can be concluded that ahh the measured parameters in the hospitals werw below the standard levels. , indicating that removal efficiency reverse osmosis system parameters is desirable.

Because of its policy implications, investigating the household health care expenditures has become an important issue . the socio-economic status of households along with access to facility, demographic structure and technological progress are factors which examined in terms of importance .
in order to explore the impact of independant variables, OLS regression technique was implemented on a panel dataset of 24 section and 30 years. The source was the database of statistical center of Iran which were analyzed by two econometrics software named Stata 11 & Eviews 7.
dependant variable had direct relationship with household economic status (household total expenditure and insurance expenditure) and household access to health service (distribution of physician over the household ) in urban and rural area. moreover, the demographic characteristics (proportion of elderly over the household) and technological improvement with healthcare expenditure in urban areas was found to be directly and indirectly related.
Inefficiency of the health insurance system, the poor surveillance over system services and increase in number of elderly had also led to increase in the average cost of household health care expenditure. against the common hypothesis for technology, the estimation results confirm the effects of technology on decreasing the health care expenditure. actions such as system integration to decrease the cost of services and Increasing the people level of knowledge toward technology specially in rural area is of priority.

Brucellosis has an important effect in public health and socioeconomic situation in the society at most regions in the world especially in developing country. Society education is one of the basic solutions for control and prevention in this disease. The aim of this study was to determine the effect of intervention on the adoption of preventive behaviors of the disease brucellosis was based on the health belief model.
Material & In this study, 196 residents of the Ghaenat and zirkoh provinces with the multi-stage random sampling method selected and divided into two groups intervention and control then the educational intervention was performed using the Health Belief Model, for gathering Data the questionnaire consisted of demographic and health belief model was used to analyze the data structures SPSS19 software and t-test, chi-square analysis, and analysis of variance was used.
The age average of the participate was in the interventions 33.2±8.8 and in the control 34.5±9.4 The two groups in terms of knowledge, severity, benefits, barriers and self-perceived differences were not significant, while after intervention the mean in all areas studied significantly higher in the intervention group than the control group. ) P This study confirm the efficacy of the educational intervention program based on health belief model on preventive behaviors in the brucellosis disease. According to the results of this study we can use the health belief model as a framework for designing educational interventions for prevention and control Zoonosis disease, particularly brucellosis.

Pathotypes of Escherichia coli, including EHEC (Enterohemorragic Escherichia coli) are an important cause of enteric disease and extra-intestinal. Shiga toxin E.coli (STEC), along with EHEC strains are known as the most common cause of diarrhea in developing countries. The purpose of this study was to evaluate the virulence genes in E.coli strain by Multiplex-PCR method isolated from diarrhea and determine antibiotic resistance.
In this cross-sectional study, after collecting 100 samples of human diarrhea of outpatient treatment centers in Tehran, culture and biochemical tests and 55 strains of Escherichia coli strains isolated and at the same time was extracted DNA. Antimicrobial susceptibility testing was performed by disk diffusion and E-test method based on CLSI guidelines with antibiotics from various groups. Statistical data were analyzed with SPSS version 19, using descriptive statistics.
Most E.coli isolates resistant to antibiotics Erythromycin (100%) and Ampicillin (94%) and were sensitive to Nitrofurantoin (96%) Amikacin (100%). The test E-Test greatest Resistance to antibiotics erythromycin (100%) and the most sensitivity was observed to antibiotics Gentamycin and Amikacin (100%). According to the results of molecular analysis of 55 human samples, was identified in 12 samples (21/8%) Stx2 gene and 4 sample (7/2%) Stx1 gene.
The results obtained in this study compared to other studies showed that involved age, sample type, geographic location, type of diet, personal hygiene, seasons, identification and isolation procedures.

Natural products extracted from medicinal plants can play an important role in cancer treatment. This study was designed to investigate antibacterial activity and cytotoxicity of ethanolic extract of Lilium ledebourii (Baker) Boiss bulbs on HeLa cell line.
In this experimental study, ethanolic extract of Lilium ledebourii bulbs was prepared and its cytotoxicity on HeLa cell line was investigated. Hela cell line was treated with various concentrations of extract (0.156-10.0 mg ml-1) for 72 hours and growth inhibition was assayed using MTT test. In addition, antibacterial activity of the extract was examined using disc diffusion method against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Bacillus subtilis. Statistical analysis was performed using SPSS software.
The results showed that the ethanolic extract at different concentrations significantly reduced the growth of HeLa cell compared to the control group. The most pronounced growth inhibition was %87.42 at the concentration of 1.25 mg ml-1. In addition, the results indicated that ethanolic extract of Lilium ledebourii bulbs possessed antibacterial activity. Among the aforementioned bacteria, the highest antibacterial activity was seen against S. aureus and the lowest activity against P. aeruginosa.
The results of this study revealed that the ethanolic extract of Lilium ledebourii bulbs possesses antibacterial activity and cytotoxicity against Hela cell line. In order to find the underlying mechanism of this activity, further research should be done.

Honey and Aloe vera have traditionally used for its healing effects on burn wounds. The aim of this study was to investigate the effect of honey and aloe vera on the burn wound healing process in rat.
This was an experimental study performed on 24 adult male rats. Following ether anesthesia, a second degree burn wound of 250mm2 was made on back of each rat. After confirming burns, the rats were divided into 4 groups (6 in each group).Control group, group 1 treated with Honey and Aloe vera, group 2 treated with Aloe vera and group 3 treated with Honey three times per day. Evaluation was made through measuring the area of the healed region and data were analyzed using one way ANOVA test.
This study was indicated of a decrease of 123 ±34/024 mm2 in burn wounds size after treatment in honey and Aloe vera group which was greater than those in others(P-value =0/009) and honey group was only shown to have decreased the burn wounds size greater than the Aloe vera group.
Combination of honey and aloe vera was found to have more healing potential on second-degree burn wound. Faster healing process, less complications and easy availability of honey and Aloe vera are among the reasons suggesting more clinical trials using this preparation.

In Iran, road traffic collisions are the first cause of disease burden. Driving is not means just applying technical skills to control the vehicle, but rather reflects the driver’s classification of character. One of including variables related to driving is aggression. And causes a lot of dangers in driving. Based on our surveys through the world, questionnaire is the practical tool to assess driving behavior. The aim of this study is to assess the validity and reliability of DVQ’s Persian version.
The 15-item DVQ was translated to Persian according to retranslation method. In the revised version, 3 new items were added and then completed by 400 staffs of North Khorasan University of Medical Sciences. Finally, we employed retranslation method and Cronbach's alpha coefficient to validity assessment.
The mean age of the subjects was 35.88 years old. 301 Participants were male and 99 were female. We recognized in PCA Test 2 subscales which showed variance of 36.5% that their Cronbach’s Alpha was between 0.68 to 0.78.ICC Test for 2 subscales and total questionnaire were from 0.75 to 0.87. There were significant correlation among factors such as DVQ score, sex and age.
The results indicated that the 18-item Persian version of DVQ is a suitable criterion to recognize driver revenge-seeking behavior.

Alzheimer's is a progressive brain disease that destroys brain cells to be causing impairment in memory and cognitive processes. Accordingly, the purpose of this study was the evaluation of cognitive function deficit in elderly patients with and without Alzheimer's disease using the dual task.
Material and This study was a quasi-experimental and between subject and within subject design was used in it. The 23 subjects (11 females and 12 males) with an age range of 62 to 81 years; 13 patients with Alzheimer's disease (AD) and 10 healthy elderly subjects (EC) with normal cognitive function participated in this study. Identifying people with Alzheimer's disease and healthy people was performed based on physician diagnoses and the Short Portable Mental Status Questionnaire (SPMSQ). After obtaining the average number of correct counting of months of the year in both simple and difficult cognitive task, each person was performed 10 tasks simultaneously (under Dual-task) in both simple and difficult condition.
The results showed that the AD group compared to the matched controls (EC) in the difficult condition of cognitive task, more errors were committed. Also level of difficulty and AD disease effect on drop in the average number of months counted at dual-task condition was significant (p It seems that attentional tasks is appropriate to separate patients with AD and healthy elderly individuals. But for a more detailed explanation of this issue, there is a need for further researches.

Addiction is a physical illness, mental, social and spiritual and one serious injury seeking drug a brain injury. The main aim of the present study was to compare of long-term and short-term memory in male addict Opium, have left addicts, and healthy.
The study method was descriptive, causal-comparative. The target population of this study were male addict, have left addicts, and healthy that 35 addicted, 32 have left addicts, 35 healthy selected by purposive sampling. For data collecting prospective and retrospective memory Questionnaire (PRMQ) were used. Data were analyzed by using of multivariate (MANOVA) and Tukey test.
The results showed that there were significant differences in long-term memory performance between male addicts, have left addicts, and healthy (0.05> P), but there was no significant difference in short-term memory performance. Tukey test results also showed that long-term memory mean more than in addicts and have left addicts, and healthy.
Thus, The increase duration of drug further impairs long-term memory impairs and therefore makes it more difficult to quit drugs.

The widespread use of dyes leads to create problems such as environmental pollution in form of color wastewater discharges to environment and also lead to entering of color effluent into receiving waters. The dye lead to prevent of penetration of sunlight into water and thus photosynthetic processes in surface water were disordered. Therefore the aim of this study is determined the efficiency and effectiveness of magnesium oxide nanoparticles in removal of reactive yellow 3 dyestuff from aqueous.
This study was experimental that effects of variables affecting on the efficiency of dye removal from synthetic wastewater was studied and survived effect of The parameters: pH(5,7,9), reaction time(30,60,90), adsorbent dose (0.1,0.2,0.3 g) and initial dye concentration(30,50,100,150 mg/l).
The results showed that with increasing contact time, adsorbent concentration and color decreasing, removal efficiency increased, as The most efficiency of dye removal was obtained at Ph= 7(55%), adsorbent amount 0.3 g (96.36%), dye concentration 30 mg/l (86%), and contact time of 90 minute (62.2%).
The efficiency more than 90% prepared absorbent in the removal of dyes from aqueous was shown that it can be used as adsorbent effective in treatment processes. So use this technique to remove colored contaminants from aqueous solutions have been proposed.

Given constipation as one of the common digestive problems in pediatric patients, the psychiatric comorbidities together with chronic constipation may result in some disorders in children’s life quality. This study aims to evaluate the life quality and psychiatric comorbidities in 2 to 18 years old children and teens with constipation.
Material & This study, as a case control study was conducted through many children and teens who were homogeneous in terms of sex and age, 55 patients with functional constipation and 55 people without it. The parents and children were provided with questionnaires of the demographic particulars, QOL and SQD, following collection of their history and physical examinations. The analysis of the collected data was done based on the statistical tests of Chi-Squared test, one sided variance analysis and T-test through SPSS 16 software.
The average scores of the life quality obtained from the children and parents were 54.67%.9 and 49.86%.2 in the case group and 63.26%.0 and 66.09%.4 in the control group, with a significant difference in the score reported by the parents (P=0.014). A difference has been observed between these two groups due to emotional performance (P=0.024 for parents and P=0.016 for children). The total estimated score of SDQ questionnaire employed for these two groups indicated abnormality of 93% in the case group and 83% in the control group which were statistically not significant (P=0.631). There was no difference through the subgroups mentioned in this questionnaire and the impact scores of these two groups (P>0.05).
The life quality based on the parents’ reports and the emotional performance in the children with constipation are too low; and screening through children is recommended to help them in the treatment and the control of the constipation and its severity by referring to the child psychiatrists.

In adolescence, amount and type of fatty acids intake is one of the factors affecting dyslipidemia in adulthood. The aim of the present study was to evaluate serum lipids and lipoproteins concentration in adolescents and its relationship with the amount and type of fat intake.
This cross-sectional study was conducted on 717 adolescents, aged 10-19 years, within the fourth framework of Tehran Lipid and Glucose Study. Usual dietary intakes were assessed by a valid and reliable food frequency questionnaire. To measured concentration of serum lipid profile a fasting venous blood sample were obtained from all participants.
Serum triglyceride concentration was significantly higher in boys than in girls (90.5 vs 79.0 mg/dl; P=0.005). After adjustment for age, triglyceride showed a significant decreasing trend according to quartiles of percent of energy intake from PUFA, in both sexes (6.0 and 23.2 mg/dl respectively, P It seems that the percentage energy intake from total fat and variety of fatty acids is not the most important factor influencing the level of serum lipids and lipoproteins and the role of other factors must also be assessed.

The endurance and strength of lumbar paraspinal muscles play an important role in the spinal column’s stability and mobility. It seems that the people who feel weak in these muscles have difficulties including instability and pain in the spinal column. Therefore, the aim of this research was to study the effects of exercise in water on endurance of trunk extensor muscles in people with chronic non-specific back pain.
In this semi Experimental research, 30 men with chronic non-specific back pain with the age range between 20 and 35 were selected by convenience and randomly divided into experimental and control groups. Then, the experiment group was presented 24 sessions of exercise in water for (6 weeks, each week 4 sessions of 45 to 60 minutes). Quebec standard questionnaire was used to determine the severity of pain and lumbar muscle strength were measured using the Sorensen test. The data analysis was performed using SPSS version 20 and independent dependent tests were used.
The results showed that the exercises in water a significant decrease reduction of pain severity and also increase in endurance of the lumbar extensor muscles in patients with chronic non-specific back pain (p≤0.005).
The patients with chronic non-specific back pain have a lower degree of trunk extensor muscle endurance compared to healthy people. These patients do exercises in water can significantly increase the strength of the muscles through, the amount of pain and functional disability in activities of everyday improved.

Effect of stress on acne is still challenging, but some studies deny this hypothesis. This study aimed to determine the relationship between stress and Acne among high school girl students in Bojnurd.
Material & This analytical cross-sectional study. Two hundred (200) students were selected by simple random. A tool used was the standardized stress questionnaire of Harry. Having or not acne was clinically diagnosed by a dermatologist Data was analyzed using independent sample t test and chi square test, and SPSS software package (version 21).
Of participants, 167 girl students (83.5%) suffered from stress and tension. Almost 33 students (16.5%) were normal. The mean score of stress was 155.71 in the group of Acne and 155.75 in the control group. The mean difference was not significant between two groups (p=0.991). The ratio of tension in the Acne group was 82% and in the control group 85%. There was no significant ratio between groups (p=0.568).
Our findings showed that the prevalence of Acne was high in theses girl students, and the stress level was high in high school girl students in both groups, but there was no significant relationship between stress and Acne in them. It is suggested to perform further studies.

The standard rate of cesarean delivery, from the perspective of the World Health Organization is 15 percent, which in most places is very different from the amount recommended by the World Health Organization. One of the most effective solutions to reduce the incidence of cesarean section is vaginal delivery after cesarean and reduce repeat cesarean. Therefore, the present study is done to prevalence and some maternal and neonatal outcomes of vaginal delivery after cesarean and Repeat Cesarean in a hospital repeated Bentolhoda Bojnoord.
Descriptive and analytical study on 180 mothers eligible performed, in 1392 and in North Khorasan University of Medical Sciences, Bentolhoda Hospital. Demographic questionnaire, details of delivery, maternal& neonatal outcomes are Study Tools. Spss software, version 18 descriptive statistics for tables, mean, Charts, variance, standard deviation, was used.
% 47/8 of mothers were able to do a vaginal birth after cesarean. Bleeding and fever from mother outcom and neonatal outcomes with Fisher test was not significant, but in vaginal delivery after cesarean group ,uterin rupture in first stage and hysterectomy constipation was less than repeat cesarean that in constipation the difference between groups was significant.
With careful selection to reduce unnecessary cesarean, can used vaginal delivery after cesarean.

Since diabetes is a lifelong disease with no cure, this disease is a life-long self-care needs. Diabetic foot is a significant problem in patients with type II diabetes, which can be in some cases lead to amputation.
Material & This cross - sectional study was conducted on patients referred to the clinic diabetes in 2014 was a city of Sabzevar. Non-probability sampling method of sampling was available to collect data, a questionnaire developed parallel process model development and verification of the reliability and validity of the 400 patients (diabetics) were also used. Data analysis was performed using SPSS version 17 and regression testing
The mean age history of diabetes 45/11 ± 7/51, 65/6 ± 74/9 year knowledge score of 2/60 were a hundred. The perceived sensitivity of patients to the risk of diabetic foot and its consequences 67 percent, the perceived effectiveness of the strategies recommended to hygiene 1/72 of hundred variable The severity of diabetic foot infection 9/60 hundred 4/73 and 8/69 respectively performance and self-care variable and score a hundred
The results showed that the most influential factor in increasing severity of structural self-care behavior in patients with diabetes is to develop effective interventions to increase self-care behavior must be considered.

Peripheral Ameloblastoma (PA) is a rare extraosseous counterpart of central ameloblastoma that occures in soft tissuses and may cause bone crest resorption.the most frequent onset site is the mandibular premolar region especially the lingual gingiva. The incidence of peripheral ameloblastoma in the sixth decade of life and the prevalence have been reported in men than in women. Peripheral ameloblastoma compared to the intraosseous type later in life happens. we report a case of peripheral aneloblastoma in the maxillary gingiva in a 28-year-old woman.