فهرست مطالب maliheh dadgarmoghaddam

Information literacy, as a critical skill, is not limited to library-bibliographic skills but it includes analytic-critical thinking skills. The importance of information literacy skills and critical thinking skills in finding information, evaluation, etc. of finned resources is not well known. So this study was designed to determine the critical thinking status and its relationship with information literacy among Mashhad University of Medical Sciences (MUMS) residents.

The least sample size determined by the Cochrane formula was 195. Two instruments were used in this study: the thinking skills questionnaire, and the information literacy questionnaire. The questioner went to different wards, explained the study to residents, got the informed consent, took their questionnaires, and finally got back the filled questionnaires. The data was analyse by SPSS ver11.5.

195 clinical residents involved in this study, 66.6% of which were female and 53.3% were married. About 62.05% had a moderate level of information literacy. The best performance regarding the critical thinking domains was analysis and the poorest was evaluation. Information literacy did not have a relationship with general characteristics (p-value>0.05). But being male (p<0.002 , p<0.001)and unmarried (p<0.001 , p<0.001)had positive effects on critical thinking especially in regards to interference and deduction respectively. 

Residents did not have an acceptable level and were far from the desired level; neither in information literacy nor critical thinking. This study showed a significant correlation between critical thinking and information literacy.

Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy, resulting both maternal and fetal/neonatal negative consequences. Since health care staff in health care centers, including general practitioners and midwives encounter the condition at the first line, they should be well trained about it. This study aimed to investigate whether the problem-based learning (PBL) or the lecture-based learning (LBL) method is preferred regarding medical pedagogy. 

A descriptive test about GDM screening and diagnosis was given to the health care staff of 10 health care centers in Mashhad. 66 individuals with the lowest points were involved in the study in two groups of 33. The first group joined a lecture-based educational program about GDM, while the other group were trained using the PBL method. After a week, a test was given to them, and the results were compared between the two groups.

The scores of the gestational diabetes diagnosis test in both groups increased significantly after the training (change from 3.50±1.40 to 6.20±1.51 in the PBL group, P<0.001; and 3.32±1.64 to 5.58±1.66, P<0.001). There was no significant difference in the results between the two groups (P=0.13).

  The results of PBL educational programs about GDM are not superior to the results of the LBL method.

During the pandemic of COVID-19, Healthcare Workers (HCWs) have been at the forefront of infection; they could also carry the disease to the others. In this cross-sectional study, HCWs in five hospitals of Mashhad University of Medical Sciences were included from 20 March to 21 July, 2020. HCWs were divided into two categories of frontline and second-line. The checklist was researcher-made and was on the basis of WHO risk factors regarding COVID-19, MERS and SARS. The participants were analyzed. The participants were asked, via phone call, to answer questions in 3 sections of demographics, probable risk factors, and clinical manifestations. The need for Personal Protective Equipment (PPE) and its availability were also evaluated. From among 534 HCWs included in this study, 197(57.6%) were females; most of them were nurses, and the mean ± SD age was 36.02 ± 8.5 years. Eighteen HCWs were hospitalized due to the severity of disease, most of whom were front-line HCWs. Malaise (78.7%), fever (68.1%) and gastrointestinal symptoms (63.7%) were the most common manifestations in the participants. Smoking (OR=0.078, P=0.001) and underlying diseases (OR=2.19, P=0.025) were known as the factors predicting HCWs hospitalization. Being smoker and participating in intubation procedure were independent predictors of hospitalization in HCWs. Frontline HCWs had a significantly higher risk of COVID-19 infection, as compared to the second-line group. Although adequate supplies of PPE are necessary, they do not completely mitigate high-risk

Cardiovascular diseases are the leading cause of adult mortality in many developing countries. This study aims to compare the estimation of the ten-year relative risk of cardiovascular events using the Framingham criteria with a native model.

This population-based cross-sectional study was conducted in 2014, focusing on the adult population (≥16 years) of Mashhad. Stratified random cluster sampling was employed to gather participants' information based on Framingham's criteria. Data mining, utilizing the decision tree algorithm design, was evaluated using Rapidminer v5.3 software and the cross-validation method.

Out of 2978 individuals, 1930 (64.9%) were women and 1041 (35.1%) were men, with a mean age of 43.5±14.7. Applying the Framingham criteria, the ten-year risk levels of cardiovascular disease were estimated as follows: 77.8% at a low-risk level, 13.4% at a medium-risk level, and 8.8% at a high-risk level. Regarding data mining, model number (1) achieved an accuracy of 79.56%, indicating that the predicted risk levels using the Framingham algorithm matched the observed values at 95.24% for the low-risk level, 90.8% for the medium-risk level, and 33.13% for the high-risk level. As for model number (2), an accuracy of 82.78% was obtained, with the matching values being 98.20% for the low-risk level, 0.42% for the medium-risk level, and 53.01% for the high-risk level.

The Framingham criteria demonstrate limited effectiveness in predicting medium and high-risk levels in the Mashhad population. According to the local model, smoking and high blood pressure in adulthood are the most significant factors in predicting the risk of cardiovascular diseases in young individuals.

Work related dermatitis is one of the most prevalent diseases, which its economic and social effects on the individual and the society is considerable. The Nordic Occupational Skin Questionnaire (NOSQ-2002) is known as a comprehensive and standardized tools for screening the occupational skin diseases.The main purpose of this study was to translate and cross-culturally adapt the NOSQ-2002/SHORT into Persian. A survey cultural translation carried out during 2018 in Mashhad, Iran. The NOSQ-2002/SHORT adaptation process included the forward translation and reconciliation, back translation and an expert panel assessment. The content validity ratio (CVR) and content validity index (CVI) were calculated according the to Lawshe formula. The Persian version of the questionnaire was tested in 30 workers attended the training courses for health ID card confirmation as a pilot study and were confirmed by physical examination. Base on the participants’ opinion, the ambiguous questions were modified by the expert panel. All the 15 questions had a CVR of 0.6 and higher. The overall content validity index of the questionnaire was equal to 0.80. Some obscure words not good understood by the pilot study participants were revised. The results of the questionnaire declaration was matched with the physical examination for each worker. The Persian version of the NOSQ-2002/SHORT questionnaire is now available for researchers for assessment hand eczema in the work settings. Further research is suggested to evaluate the validity of the Persian version of NOSQ-2002.

The pattern of bacterial infection in coronavirus disease 2019 (COVID-19) patients differ worldwide.

This study aimed to determine the patterns of bacterial infections and the antibiotic resistance profile by VITEK 2 (bioMérieux, France) in the culture of blood samples from hospitalized patients with COVID-19.

This retrospective descriptive cross-sectional was conducted on a total of 25 patients with critical COVID-19 admitted to Imam Reza Hospital in Mashhad, Iran, during the first three COVID-19 peaks (2019 - 2020).

Among Gram-positive bacteria, two strains isolated from Staphylococcus aureus were methicillin-resistant S. aureus at a concentration of > 2 μg/mL. Enterococcus was vancomycin-resistant Enterococcus at a concentration of higher than 4 μg/mL (the minimum inhibitory concentration [MIC] ≥ 32). Among Gram-negative bacteria, three strains of Acinetobacter baumannii complex were extensively drug-resistant.

There is evidence of the remarkable increase of various antibiotics’ MIC during the COVID-19 pandemic, which highlights the impact of the use of steroids on the risk of developing antimicrobial resistance during the COVID-19 pandemic.

The potential impact of the novel coronavirus pandemic on social mental health has become a great concern and the current situation can cause different mental disorders. According to the importance of mental health, we performed this study to evaluate the mental health status of the general population of Iran in Razavi Khorasan province.

The online survey was conducted and made available for the general population of Razavi Khorasan through the snowball sampling technique within a week. the demographic information, contact history with COVID-19, and physical symptoms history of COVID-19 were collected by the survey. To maintain the population's mental health status, the Depression, Anxiety, and Stress Scale (DASS-21) were used. Filling the online survey by a maximum of two members of a family was considered to reduce the risk of bias.

Finally, 461 responders from Razavi Khorasan province were included in this study. In total, 41.8% of responders investigated the depression symptoms, 32.1% were in anxiety mood and 34.5% had stress symptoms. The ratio of men to women was approximately 1:2. Most responders were in the of 30-40 years and the most frequent marital status was being single. Families with 3-5 members were organized the 81.5% of responders. Near one-third of the studied population was in bachelor as educational status.

According to our study paying attention to the general population’s mental health status is important during the COVID-19 pandemic and conducting protocols to prevent or reduce the risk of mental disorders that can be caused by the current situation.

Students' mental health has a strong relation to their quality of life and their academic success. This study aims to assess the mental health of medical students throughout different educational courses including pre-clinical, externship, and internship, and its association with students' academic performance at Mashhad University of Medical Sciences. This cross-sectional analytical study was performed on all medical students studying in the first semester of pre-clinical course, at the beginning of the externship, and the beginning of the internship at Mashhad University of Medical Sciences in 2019. In this study, a general mental health questionnaire containing 12 questions (GHQ-12) was used. Data analysis was performed using chi-square and t-test using SPSS 16. The mean age of students was 22.61 + 1.79. In this study, approximately 40% of students scored higher than the threshold for the GHQ-12 questionnaire, indicating that they experienced more psychological distress than others. The highest score was related to the and the lowest score was related to externs. In addition, although students with higher academic scores have lower psychological stress and better mental health status than other students, these differences were not significant. The results showed that overall nearly half of medical students based on the GHQ-12 questionnaire are subject to psychological stress. These stresses not only affect their mental health but also affect their academic performance.

Tuberculosis (TB) is a major global health problem, so for better planning in the health sector, it is necessary to know the real burden of tuberculosis in our country. The main aim of this study was to calculate the burden of TB for the Iranian population in 2001-2012. 

The Disability Adjusted Life Years (DALYs) index was calculated using a computer model (DisMod version II) in Iran between the years 2001 and 2012. DALYs are age-weighted (β= 0.04) and are discounted for time preference (r= 0.03).

The trend was decreasing from 2001 till 2006, and after it, there is an increasing trend. The incidence was more in younger age groups and in female, and the YLL is higher in men (11744 in male vs 7897 in female in 2012); it showed that the life lost is higher in men. The YLD in men and women are very close. In comparison, the DALY of TB was higher in men than women.

In the present investigation, it has been found that the overall tendency to get TB was higher in the female population. It shows that the incidence was higher in the younger age groups but the mortality was higher in the elderly   groups. It that shows the significant success of the country in controlling the disease.

Staphylococcus aureus is an important cause of resistant infection with high mortality and morbidity.

We aimed to evaluate the clinical characteristics and comorbidities of patients with S. aureus infection to define the predictors of adverse outcomes.

In this cross-sectional study, patients (aged ≥ 15 years) with positive S. aureus blood cultures were included. Their demographic and clinical characteristics were recorded, and their association with the main adverse outcomes (methicillin-resistant S. aureus [MRSA], infective endocarditis, source of infection, and the final outcome were analyzed using SPSS software version 16.

The male-to-female ratio was 54/51. The mean age was 55.13 years (women: 58.45 ± 20.4 and men: 53.6 ± 17.6). Of 105 cases analyzed, 40% had hospital-, 25.7% community-, and 34.3% healthcare-associated bacteremia. The median duration of hospital admission was 13 days. Thirty-two percent had MRSA, differently based on the source of infection (P = 0.029). Twenty-eight patients had infective endocarditis, differently based on the source of infection, prosthetics, considerable foci of infection, and receipt of blood and its derivatives (P < 0.05). Most patients with neurological and end-stage renal disease (both P = 0.001) did not have infective endocarditis. Finally, 61.9% of the patients were discharged with good condition, 38.1% died, and 9% left the hospital before a definite diagnosis.

Vascular catheters and cardiovascular diseases, including hypertension, are among the most common factors associated with S. aureus bacteremia, and it is necessary to carefully examine the presence of these factors, as well as infective endocarditis in these patients.

Translation of research findings into the language of the audience and stakeholders is one of the most important parts of knowledge research. Knowledge transfer, indeed, is the method to use theoretical knowledge produced by universities to improve training processes and decisions based on observation. This study examines the status of knowledge translation among faculty members.

The study population consisted of all faculty members of Mashhad University of Medical Sciences in 2019. The research tool was the Knowledge Translation Questionnaire, which has been compiled and approved by the Knowledge Translation Committee of Tehran University of Medical Sciences whose validity and reliability of the questionnaire were also confirmed in the present study. Following the explaining, the objectives, data were collected using research tools that were completed by the faculty members and analyzed afterward.

As to the results, compared to the total average of each influential parameter in knowledge translation, the highest mean (3.22) was related to the “changing the behavior of decision-makers or achieving practical results through research results” and the lowest mean (3.05), was related to “generate evidence that can be used in decision making”. The mean of other effective factors of knowledge translation was between (3.05-3.22).

Although some of the sub-factors show a favorable situation, none of the main parameters were in the expected situation

Recently, saffron (Crocus sativus L. from the Iridaceae family) has been characterized by its antioxidant, anti-inflammatory and analgesic effects. This study aimed to evaluate the effect of saffron on disease activity in patients with rheumatoid arthritis (RA). This is a double-blind, placebo-controlled, randomized clinical trial (RCT) performed on 55 newly- diagnosed RA patients without previous treatment, who were randomly divided into intervention (included 28 cases) and control groups (consisted of 27 individuals). Standard therapy including prednisolone, oral methotrexate, folic acid, vitamin D, calcium, and alendronate, was administered similarly in both groups.  Patients received a 100 mg saffron pill/day (pure saffron powder) or placebo besides the standard protocol. The placebo had the same shape as the saffron pills. Follow up of DAS28ESR disease activity score was done on the 30th, 45th and 90th day of the study. There was no difference between the intervention and control groups regarding to the DAS28ESR at the end of the study. However, a significant decrease in DAS28-ESR was observed in each group compared to the first visit (p=0.001). The results also showed no significant difference in the incidence of side effects in both groups. In summary, patients who received pure saffron pills (100 mg/day) in addition to standard therapy did not have a significant difference in improvement of disease activity from the patients on standard therapy.

Context:

 Maxillary deficiency can lead to the reduction of airway space and increase the chances of development of obstructive airway disorders. Facemask therapy is one of the main treatment protocols in developing maxillary deficient patients.

 The purpose of this systematic review and meta-analysis was to assess the changes in the airway dimensions after face-mask therapy in both cleft lip and palate and non-cleft patients.

Data Sources: 

A systematic search in different electronic databases (EMBASE, Pubmed, Cochrance Central register of controlled trials), IADR proceedings and a hand search by October 2020 were conducted and a meta-analysis and systematic review was performed.

 In patients without cleft lip and palate, upper pharyngeal width was significantly increased by mean of 2.05mm (CI = 95%, 0.61 - 3.50) following facemask therapy in comparison to patients who did not receive the treatment.Other upper pharyngeal (nasopharyngeal) measurements also showed a statistically significant improvement after therapy: S-PNS by 4.64mm (CI = 95%, 3.34 - 5.94), AD1-PNS by 3.81 mm (CI = 95%, 2.40 - 5.21), AD2-PNS by 2.90 mm (CI = 95%, 0.13 - 5.67) and Pm’-SPL by 2.53 (CI = 95%, 0.54 - 4.51). Lower pharyngeal measurments did not show any significant changes after the treatment (P > 0.05).In the analysis of studies with 3D imaging modalities, upper pharyngeal volume was also significantly increased by 499.29mm3 (CI = 95%, 69.58-929.00) after the treatment. In addition, a review of articles that included cleft lip and palate patients also showed after the treatment, the upper pharyngeal measurements all showed a significant improvement (P < 0.05), whereas the oropharyngeal region was relatively stable.

 In maxillary deficient patients with or without an orofacial cleft, facemask therapy can improve the nasopharyngeal area dimensions; however, this treatment protocol appears not to have an effect on the oropharyngeal area of the airway tract.

Investigation of the maternal cause of death and pregnancy-related death is one of the most important responsibilities of a forensic pathologist. From the public health point of view, it may help to prevent losses during and following pregnancy and save the lives of women, especially in developing countries. We report a case of maternal death with a history of neurofibromatosis type 1 who presented asymptomatic and normotensive with normal laboratory test results. Case report: The first attack after delivery was associated with pulmonary edema, which led to death. Investigation during the medico-legal autopsy discovered a left suprarenal tumor with the diagnosis of pheochromocytoma, which was confirmed by further histopathology testing.

We believe that although the association of neurofibromatosis type 1 and normotensive pheochromocytoma during pregnancy has been reported rarely, the possibility must be considered for evaluation before elective operations to adopt proper preoperative protocols.

 It seems that the risk of developing complications associated with coronavirus disease 2019 (COVID-19) is higher among individuals with weakened immune systems.

 Therefore, this study was carried out to determine the effectiveness of intravenous immunoglobulin (IVIG) for the treatment of patients not entering the intubation phase compared to those entering the intubation phase.

 This descriptive case-control study was performed on 26 patients with COVID-19 referring to Imam Reza hospital in Mashhad, Iran, in March 2020. For subjects with COVID-19 not responding to the standard three-drug protocol (i.e., ribavirin, hydroxychloroquine, and lopinavir/ritonavir), three doses of IVIG (0.4 g/kg/day) were added to the protocol. The patients were divided into two groups of subjects not entering the intubation phase and those entering the intubation phase and compared in terms of different variables.

 The comparison of laboratory findings showed a significant difference before and after receiving IVIG regarding oxygen saturation (P < 0.005), white blood cell (P = 0.001), hemoglobin level (P = 0.0002), lymphocyte count (P = 0.03), and C-reactive protein (P = 0.001). In general, 53.8% and 46.2% of the patients were discharged and expired, respectively. All the subjects not entering the intubation phase were recovered; nevertheless, only one case entering the intubation phase was recovered, and 92.3% of the patients expired. A significant difference was observed between the patients not entering the intubation phase and those entering the intubation phase in terms of mortality (χ2 = 22.28; P < 0.005).

 In summary, the obtained results of the current study confirmed the therapeutic effects of IVIG on patients with COVID-19. Moreover, better treatment results, shorter hospital stay, and lower mortality rates were observed among COVID-19 patients who did not enter the intubation phase in comparison with those entering the intubation phase.
 

Prostate cancer is the most common visceral cancer recognized in men. Considering the incidence of prostatic cancer in our country, evaluation of anatomical location of prostatic cancer and frequency of extraprostatic extension (EPE) and seminal vesicle invasion (SVI) as important prognostic factors, could be of great importance.

Patients suspected of prostatic cancer were subjected to transrectal systemic needle biopsy. 12 to 14 samples from different prostate anatomical regions were prepared.In pathology lab Based on morphology or if necessary with the help of immunohistochemical methods, 68 Patients with prostate cancer as well as extra-prostatic involvement in the sample ,received the criteria for entering the study. Pathologist  determined the anatomical location of prostate conflict. Data and statistical analysis were used to find out the relation between anatomical location of prostate cancer and EPE and SVI.

Patient’s mean age was 73.82 year. 29 patients (42.6%) had seminal vesicle invasion. In 41 patients (60.3%) all 12 biopsies were involved. In 90% cases involvement of the base region were seen. Also, the average rate of involvement of various margins was 10.97 out of 12 biopsies.In 97.05%    of patients half and more than half of biopsies were involved. The mean serum PSA level before surgery in patients was 53.64 ng/dL.

There was no significant relationship between anatomic region of prostate cancer and extraprostatic extension(EPE) or seminal vesicle invasion(SVI).Also as our study showed more biopsies involved with cancer ,more EPE and SVI were seen. Patients with EPE and SVI had higher mean age.

The study was investigated the basic and transmission information of medical students towards HIV/AIDS in clinical and preclinical courses, their informational needs and the source of information they usually use for getting information.

This descriptive analytical study was carried out on 220 medical students in preclinical and clinical course, using a stratified random sampling method in 2015-2016. The study instrument was extracted from a WHO questionnaire.

The mean age of the subjects was 22.31+2.97 years. Most of them were female 130 (65.7%) and 154 (77.4%) were single. There is no statistically significant difference in basic and transmission information between preclinical and clinical students (22.11+1.66 vs 22.08+1.70, p value=0.91). The most of the students reported that books (85.85%) were their main source of getting information about HIV/AIDS, followed by friendship organizations (32.82%) and then television (29.29%). Most students reported they need more treatment information (59.59%), as well as information on prevention (42.42%) and modes of transmission (39.89%).

The present study showed that medical students are knowledgeable about HIV/AIDS but there are some considerable misconception in their basic and transmission knowledge that require more attention and revising in the HIV educational curricula.

Supracondylar humeral fractures constitute about 60% and 13% of all pediatric elbow and pediatric skeletal fractures, respectively, with a peak incidence in the 5-7 years age group. The aim of this study was to evaluate and compare closed reduction with open reduction and pin fixation in type III supracondylar humeral fractures in children younger than 12 years.

In this retrospective study, all children under 12 years of age with type III supracondylar humeral fractures who referred to two teaching hospitals in Mashhad, Iran, between March 2017 and March 2019 were included. Patients were divided into two groups:  open reduction and fixation with pin (OR) (n= 30), and closed reduction and percutaneous pinning (CR) (n=15). The method of surgery for each individual patient was chosen based on the surgeon’s preference. For patients who had a follow-up of at least 6 months, subsequent elbow radiographs were requested.

No significant differences were observed between the two groups in terms of range of motion of the fractured limb and radiographic angles at follow-up (p > 0.05). However, operation time was significantly shorter in the CR group compared with the OR group (p < 0.001). Three patients (6%) had cubitus valgus (all of whom were in the OR group [10%]), and two patients (4%) had cubitus varus (one patient in the OR group [3.33%] and the other in the CR group [5%]). Wound dehiscence was only seen in one patient in the OR group (3.33%).

Based on the results, there was no significant difference between the open and closed reduction methods in type III supracondylar humeral fractures with respect to elbow function and union of the fracture.

Sexual transmission of human T-lymphotropic virus 1 (HTLV-1) has been widely reported in different populations, including Khurasan in the northeast of Iran.

The present study compared the frequency of psychiatric symptoms and disorders in patients with HTLV-1 associated myelopathy, asymptomatic carriers of the virus, and healthy control group. Patients and

This cross-sectional study had three groups, including HTLV-1 infected patients who visited HTLV-1 Clinic of Qhaem Hospital of Mashhad, Iran (30 individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis [HAM/TSP] and 45 in the asymptomatic group) and 41 HTLV-1 seronegative individuals in the control group. All subjects were screened by SCL90 for psychiatric symptoms, as well as motor disability levels according to Osame’s motor disability score (OMDS). Subjects who scored higher than the cut-off point in each screening evaluation attended structured clinical interviews (SCID) based on the fourth edition of the diagnostic and statistical manual of mental disorders (DSM-IV-TR). The data were analyzed by using one-way analysis of variance (ANOVA), the spearman correlation test and chi-square test, and SPSS19 was used for statistical analysis (P < 0.05).

In general, 116 subjects were studied. The carrier and healthy groups were not significantly different in terms of psychiatric disorders. However, the frequencies of major depression (P = 0.011) and dysthymic disorders (P = 0.028) were higher in patients with myelopathy than healthy individuals. In addition, the frequency of the major depressive disorder was higher among patients with HAM/TSP than the HTLV-1 seronegative group (P = 0.002). The frequency distribution of major depression (P < 0.001) and generalized anxiety (P = 0.018) was observed with an increase in OMDS.

Regarding the high frequency of psychiatric symptoms, especially in patients with myelopathy, designing suitable psychiatric interventions seems essential in such patients.

The aim of this study was to perform a systematic review and meta-analysis to compare the effect of bone-borne expansion (BBE) and tooth-borne expansion (TBE) in patients with maxillary constriction.

Electronic databases, including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, were searched up to February 2019. Eligible clinical trials and cohort studies that studied the effects of bone-borne and tooth-borne expansion appliances on patients with constricted maxilla were selected. The study selection, data extraction, and risk of bias assessment were independently performed by two authors. Then, the random-effects meta-analysis and post-hoc heterogeneity tests were performed.  

In the end, four studies were included in the present meta-analysis (i.e., a randomized clinical trial, two prospective controlled clinical trials, and a cohort study) that collected data from 117 patients. The mean differences between TBE and BBE were 0.38 mm and -0.28 mm for premolar and molar apices, 0.67 mm and 1.18 mm for premolar and molar crowns, 0.19 mm and 0.17 mm for alveolar bone in premolar and molar areas, and -0.61 mm and 0.02 mm for nasal and maxillary bones, respectively. Moreover, the differences between TBE and BBE for dental angulation were 3.84◦ and 1.52◦ for left and right molars, as well as 4.85◦ and 3.46◦ for left and right premolars, respectively.

The BBE appliances do not have any advantages over tooth-borne devices with regard to the amount of skeletal or dental expansion; however, it seems to produce less tipping in posterior teeth.

Bipolar disorder (BD) is one of the most important psychiatric disorders in the world. There is evidence suggesting the role of inflammatory mediators such as chemokines in the etiology of BD. The objective of the current study was to evaluate the gene expression of CCL2, CCL3, and CXCL8 in patients with BD and compare them to healthy controls. A total of 48 patients with confirmed BD and 48 healthy controls enrolled in this study. All patients were recruited from April to August 2016 at Ibn‑Sina Psychiatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. RNA was extracted from the whole blood samples and then cDNA was synthesized. Gene expression of CCL2, CCL3, and CXCL8 was measured using SYBR® Green real‑time polymerase chain reaction. The difference of delta‑CT values between patients and healthy controls was compared with the independent samples t‑tests. CCL2 and CXCL8 genes expressed at higher levels in patients with BD as compared to healthy controls, but not significant. On the contrary, we found lower expression levels for CCL3 gene in our patients compared to healthy controls, but the difference was not statistically significant. Our findings do not show an association between the gene expression of CCL2, CCL3 and CXCL8 and BD. Increasing the sample size and evaluation on the gene expression of other chemokines in depression and mania phases of BD might be helpful to get a better conclusion.

Cheating rate is rising and engages newer methods. This study performed to estimate the rate of research misconduct in the thesis of undergraduate and postgraduate medical students in 2015.
In this cross sectional study, all undergraduate and postgraduate medical students graduated during the study period in 2015, from the School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran were asked to fill a small checklist anonymously. It consisted of two demographic questions and two other ones for estimation of research misconduct. All three major types of research misconduct were explained in the checklist. We used the Randomized Response Technique for sensitive question in this survey. We asked the respondent to choose one question randomly and answer to it. The probability of selection of each question was equal.
There were 149 filled questionnaires out of which 44 (31%) were graduated for General Practitioner, 63 (44%) for Residency, 31(21%) for Master Degree and 6 (4%) for Ph.D. Fifty-two percent (75) were male. More than half of participants were graduated between 2011 and 2012. The majority of participants were native (104, 81%). Undergraduate students had an estimation of 19% research misconduct in performing the thesis while this was 26% of postgraduate students. Males were nearly two times comparing to females in this issue (30% vs. 16%).
This high estimation must be considered in future policy making about observing strictly on researches.

Despite its proven efficacy, the hepatitis B vaccine requires improvements in immune enhancement and durability, especially in the elderly. Levamisole, an immune modulator, has been tested as an adjuvant to hepatitis B vaccine in several studies in immune-compromised populations. However, we aimed to evaluate the effect of levamisole on the immune response to hepatitis B vaccine in healthy subjects. In this randomized clinical trial, healthy family members of chronic hepatitis B patients were given twenty-microgram intramuscular injections of hepatitis B vaccine at 0, 1, and 6 months and 50 miligrams of oral levamisole twice a day for two weeks with every vaccination dose. Serum hepatitis B surface antibody (HBsAb) levels of ultimately 98 individuals were measured one month after the final vaccination dose and compared to those of 119 subjects that received placebo and vaccine with an identical regimen. HBsAb levels >10 mIU/mL were considered protective. The Student’s t-test, Mann-Whitney test, Kruskal–Wallis analysis (quantitative comparison in age groups), Chi-square test, and the Pearson correlation were used to analyze data. p

Hypertension (HTN) is an important public health challenge worldwide. The prevalence of HTN varies across countries. It is necessary to obtain valid information about the prevalence of chronic condition like HTN and its predictors in different societies. Hence, this study was conducted to assess the prevalence of HTN and associated factors in Mashhad, Iran, 2015.
This cross-sectional study was performed on 2974 adults residing in Mashhad in 2015. Multistage random sampling was used. A checklist was fulfilled for each subject, and a blood sample was taken for measuring fasting blood sugar, total cholesterol, triglycerides, hemoglobin, serum creatinine, high-density lipoproteins, and low-density lipoproteins. The height and weight of participants and their blood pressure were measured according to protocols.
The prevalence of HTN in this population was 22% (25.9% in male and 20% in female). Most interestingly, smoking and drug abuse were more prevalent in men (14.9% and 3.8%), but the sedentary behavior was more prevalent in women (51%). Interestingly, by increasing the age, the frequency of optimum, normal and high normal type was decreased and the frequency of HTN, specially sever form were increased. In binary logistic regression model, age [odds ratio (OR): 1.07, 95% confidence interval (CI): 1.06-1.09], gender (Ref:Female) (OR: 1.39, 95% CI: 1.05-1.83), and obesity (OR: 1.09, 95% CI: 1.06-1.12) were the predictors of HTN.
The prevalence of HTN among this population was found to be high; which indicates the need for HTN-screening programs, especially for the elderly, male and obese population. Given the close relationship between obesity and various diseases, including HTN, practical solutions, including lifestyle interventions, need to be developed.

Despite the importance of the journal club in eduction, but problems threaten the quality of journal clubs. This study aimed to evaluate the quality of journal clubs in clinical groups in Mashhad University of Medical Sciences from the perspective of residents and faculty members.
Subjects& This cross-sectional study was conducted in 2016 in the Medical School. The sapmle was all the third and fourth year residents and faculty members with more than two years experience
A total of 372 subjects were enrolled which 201 were faculty members (45%) and 163 were assistants (55 %)
The average score given to the conduct of the Journal club in Mashhad University of Medical Sciences was15.3±3.20.The highest score from the perspective of faculty members belonged to the Department of Nuclear Medicine (19) and from the perspective of residents belonged to the Department of Occupational Medicine (18). Average scores in residents and faculties was not significantly different in most groups. However, in orthopedic, ENT, pediatrics, pathology, dermatology and anesthesia, assistants rated the Journal club significantly less than faculty members.
It is suggested that with reforming the journal club, make this training tool more productive.