مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و نهم شماره 2 (پیاپی 145، خرداد و تیر 1395)

Staphylococcus aureus is an opportunistic pathogen and often causes asymptomatic diseases. Methicillin resistance staphylococcus aureus (MRSA) strains are dangerous pathogens that are resistant to most common antibiotics and can challenge specific treatment of a disease. The aim of this study was to determine the frequency and pattern of antibiotic resistance strains in Imam Reza Hospital Mashhad.
This cross-sectional (descriptive-analytical) study was conducted from April 2013 to September 2015. A phenotypic method was performed to identify MRSA strains. Studying the antibiotic resistance pattern of MRSA strains was done using disc diffusion method against eight antibiotics based on CLSI protocol. Data were analyzed by SPSS software.
In this study, From a total of 7335 strains isolated from patients hospitalized in Imam Reza, 925 strains of S.aureus (6/12%) were detected. The frequency of MRSA was 382 cases (7/41%). Most MRSA were isolated from cultured blood sampling and wound. Most cases of MRSA were reported from Edalatian emergency department, internal, burn and cardiology wards.
The prevalence of MRSA can result from long-term hospitalization of patients and overdosing of antibiotics to more effectively treat infections. As a result, monitoring and developing safe and effective infection control practices in these sectors are of great importance.

Cancer is a disease of the body's cells And The most common symptom is pain in cancer. This study aimed to investigate the effect of hypnosis to manage pain in patients with acute myeloid leukemia were treated with chemotherapy.
The research method was quasi-experimental with pre-test and post-test in experimental and control group. Statistical population consisted of 86 patients with (AML) , under chemotherapy , 26 patients randomly selected and divided in two group.( 13 patients in control and 13 patients inexperimental groups.That number was 86 And The sample size of 26 patients were selected and randomly sampling in two to groups exprimental group (n = 13) and control group (13 case). A questionnaire to collect information were considered included the McGill Pain Management (MPQ) in six therapeutic hypnosis sessions were conducted for the experimental group And For statistical analysis of data from analysis of covariance was used to help software SPSS22.
The results showed that hypnotherapy resulted in significantly reduced, pain perception, Emotional perception of pain, pain Assessment, Various pains And pain Management By Which was statistically significant (p

Type 2 diabetes is the most common metabolic disorder with progressive incidence .Metformin is the first choice treatment in type 2 diabetes. There are evidences that chronic of metformin consumption results in vitamin B12 deficiency, therefore we aimed to evaluate vitamin B12 levels in diabetic patients with and without metformin usage.
Overall,90 type 2 diabetic patients were selected. A questionnaire containing personal information and duration of diabetes and drug information was completed.Laboratory tests including CBC, FBS, HbA1C and vitamin B12 levels were measured. Serum vitamin B 12 below 200 pg / ml was considered as low. Patients divided into two groups with and without metformin taking and all variables compared between these two groups.
Mean age of patients was 52.5 ± 5.72 years .76, patients were consumed metformin and 14 patients didn’t take it. The mean duration of metformin using was 4.95 ± 4.57 years. The prevalence of vitamin B12 deficiency in all patients was 73.3%. Vitamin B12 level in metformin users was 159.7±132.5 pg/ml and in non - metformin users was125.4±116.2 (p=0.79). There was no significant difference between two groups regarding to B12 level and MCV. There was not any significant difference in dosage (p=0.80) and duration (p=0.63) of metformin treatment between patients with and without B12 deficiency.
Also there was no statistically significant difference in other parameters in B12 deficient patients and others.
Vitamin B12 deficiency was common in our diabetic patients but there was no relation between metformin consumption and serum vitamin B12 concentration.

The studies about the effect of shift work on cardiovascular diseases (CVD) have inconsistent results. This study was conducted to assess the relationship between shift work and the CVD risk factors.
A cross-sectional study was carried out during 1393-94. The participants were divided into two groups: shift workers (work shift between 3 pm and 7 am) and day workers. The shift workers were selected from among the Healthcare workers of 4 teaching hospitals of Mashhad and the day workers also were selected among the office workers by simple sampling. Demographic data, smoking, regular exercise, medical and occupational history were collected through a check list and interviews. Physical examination was done by a physician. Blood cholesterol, triglyceride and glucose were measured in a blood sample after standard fasting time.
A total of 439 subjects including 218 women and 221 men with a mean age of 34.6 years old participated in this study. In terms of work schedule, 229 participants (52%) were day workers and 210 subjects (48%) were shift workers. The effect of covariates such as age, employment duration and regular exercise was controlled statistically. Of all factors studied, diastolic blood pressure ≥ 90 mmhg and blood triglyceride level ≥ 150 mg/dl were associated with shift working.(p≤ 0.001).
shift work is associated with high levels of diastolic blood pressure and triglyceride. This association could be attributable to altered life style like diet or health behaviors or due to an independent effect.

In recent decades, the possibility of vitamin D deficiency in type 2 diabetes and serum levels of 25-hydroxyvitamin D values has been considered as a predictor for long-term complications of diabetes such as cardiovascular disease. This study was done for Comparison of vitamin D level in diabetic patients and healthy subjects.
In this case-control study, 90 patients with type 2 diabetes as a case group and 90 healthy subjects matched for age and sex , as a control group were studied. After recording demographic data, height, weight, BMI and blood pressure for all patients, serum levels of fasting blood glucose, creatinine, calcium, phosphorus, Alkaline phosphatase and 25 (OH) D were measured in both groups. Data were analyzed using Stata 12 software, χ 2, t-test and Mann-whitney. Linear Regression used to measure the effect of different variables on the levels of vitamin D.
The average age of subjects was 56.47±9.37 years, 72.8% of them were females. In diabetic patients, 82.2% have vitamin D deficiency as compared with 61.1% in healthy subjects. The means of 25 (OH) D level in patients with diabetes and the control group were 20.7±18 and 12.4±6.1 ng per ml, respectively and cosiderd as a significant difference between the two groups (P0.05). Based on multivariate linear regression, vitamin D level increased more by an average of 7.06 ng per ml in diabetic patients than in healthy people and more in overweight people than those with a normal BMI, the average vitamin D level reduced to 5.4 ng /ml.
According to the results, mean levels of 25 (OH) D were significantly lower in diabetic patients than in healthy subjects, hence, check of vitamin D levels and supplementation with this vitamin is recommended in patients with diabetes.

In the workplace, there are different sources of energy.that are associated with the physical condition of the workplace.if standard conditions are not respected in the work place they will be converted to the risk factors of health. One of the implications is increased blood pressure that Could be caused by factors such as noise. This study aimed to investigate the effect of noise on workers blood pressure.
This cross-sectional study was conducted on 604 workers of the steel company. Demographic and occupational information and risk factors for high blood pressure, and the mean blood pressure of twice measurements were recorded in questionnaires. There was an audiometer in each workstation, the workers were divided in to two proups based on the level of expoesure to noise And in each of the two groups: less or more than 85 dB noise level was applied.
In the totall population the prevalence of hypertension was 11.6% ,The prevalence of smoking was 15/3% and 56/4% of workers exposed to noise 85 db A and more. There were statistically significant differences in the Comparison of the mean systolic and diastolic blood pressures in 2 groups.The Workers exposed to noise of ≥ 85db were 3.2 times more at risk of developing systolic hypertension and 2.5 times more at risk of developing diastolic high blood pressure
In this study there was a significant difference between more than the limit exposure to noise and the prevalence of high blood pressure and the risk of high blood pressure infection..Therefore, we suggest continuous monitoring of blood pressure of the workers exposed to noise, to prevent complications well timed.

Catechin compounds in green tea can prevent lipid peroxidation by chemical materials in the liver and kidneys. The aim of this study was to evaluated the effects of eight weeks aerobic training and green tea supplementation and combination of them on serum liver enzymes and apolipoproteins in inactive overweight women.
In this quasi experimental study, 40 subjects with age range 35-50 years and BMI 25-27 kg/m2 were selected by convenience sampling. They were divided randomly into 4 equal groups: aerobic training, green tea, aerobic training green tea and control groups. Aerobic training program included aerobic exercises 45-60 minutes at 65-75% maximum reserve heart rate, three sessions per week which lasted for 8 weeks. Green tea group 2 hours after each meal brewed 2 g green tea in 100 mil liter water and consumed. To make intra and between group’s comparison, paired sample t-test and one-way analysis of variance (ANOVA) along with the follow-up test of LSD were used to examine the mean differences between the groups. The significance level for the study was less than 0.05.
The amounts of weight and BMI in each of three group’s aerobic training, green tea, aerobic training green tea were reduced significantly. The levels of APOA and APOB only in aerobic training groups were statistically significant. The amount of ALT in aerobic training and the combination group, and AST levels in green tea and aerobic training group had a significant variation. The average difference in weight, BMI, APOB and AST were statistically significant.
Eight weeks of aerobic training, consumption of green tea and combination of them through the reduction of liver enzymes and some cardiovascular risk factors can reduce the inflammation and improve cardiovascular health.

Regarding the importance of positive parenting and mother-child relationship in future social and academic life and prevention of behavioral disorders among children, this research aimed to assess the effect of group hurturing of positive child training with respect to Iranian culture on academic achievement and child-mother relationship.
This clinical trial conducted in academic year of 2014-2015 and the participants included 30 mothers who had daughters studying in the 3rd grade of elementary school of the 6th region of Mashhad city. These participants selected through available method then they were divided into two groups randomly (interventional and control groups). The interventional group was trained with the positive parenting program for 4 weeks (two 90 minutes sessions weekly) and control group did not received any intervention. Data gathered by child-mother relationship evaluation and educational mark list. Data analyzed by descriptive statistics and ANCOVA.
There were significant differences between two groups in the average of acceptance and overprotection subscales (p=0.0001, p=0.006) but the differences in other subscales including radical irresponsiblelity and rejection and academic improvement were not significant (p=0.407, p=0.875 and p=0.08).
It seems that the positive parenting program approach based on Iranian culture can improve mother-child relationship.