مجله دانشکده علوم پزشکی نیشابور
پیاپی 18 (بهار 1397)

Introduction and Aims: The choice of the patient to leave the hospital before the physician discharges him is called discharge against medical advice (DAMA). The purpose of this study was to identify the characteristics of patients with DAMA and compare them with non-DAMA patients.
This cross-sectional study was performed on all the patients discharged from the emergency department of Imam Reza Hospital in Mashhad in 2015. The patient's data were retrieved from their electronic medical records. After pre-processing, the data were finally analyzed using a frequency table and a chi-square test. All analyzes were performed using SPSS Statistics Version 22 software.
The total number of the eligible patients in the study was 19,313, of whom 6,993 were discharged against medical advice. The mean age of DAMA patients was 38.1 ± 19.34 years. 57% of DAMA patients were male; and being young, married, and lack of insurance were three major factors associated with DAMA. Other related factors were: Iranian nationality, rurality, residence in Mashhad, length of stay, admission- shift/ day/ month/ season.
Consultation: Although the DAMA rate is low in this study (3.49%), it is very important to pay attention to this issue; because the risk of death and re-admission in DAMA patients is high. Therefore, identifying the general characteristics of these patients and determining the factors associated with DAMA can help decide on the selection of effective interventions to reduce DAMA rate.

Introduction and Aim: Topiramate is a new generation of antiepileptic drugs, that there is incomplete information about the role of this drug in creating teratogenic effects on the fetus. This study was designed in order to determine teratogenic effects of topiramate on the development of neural tube and skeletal during the period of organogenesis of mouse fetus.
In this experimental study forty pregnant female mouse (NMRI type) were divided in to three experimental groups (Ι¡ Π ‚ III) and one control group. Three experimental groups Ι, Π and Ш received 50, 100 and 200 Milligrams per kilogram of body weight in day of topiramate with 0.2 milliliter injection volume intraperitoneally from the day 6 (GD6) to day 14 (GD14) of pregnancy and the control group received the same volume of normal saline instead. The mices were sacrifieed on the eighteen day of pregnancy and fetuses were studied in view point of skeletal malformations. Then fetuses were stained with Alizarin Rea S/ Alcian blue 8GX and fetuses were studied in view point of neural tube defects. Then data were analyzd by using SPSS statistical software and LSD test.
In all three experimental groups Ι, Π and Ш were observed abnormalities for neural tube defects and skeletal malformations that showed a significant increase from the statistical point in comparison with the control group (P This study showed that the utilization of topiramate drug during organogenesis in mouse fetus can induce neural tube defects and skeletal malformations.

Introduction and Aims: The difference in exercise are of the most important factors that affect cardiovascular risk factors. The aim of this study was to examine the effects of concurrent endurance and Pilates training on body composition, CRP, fibrinogen, and blood cell count in normal weight and the obese female.
Material and This study was a semi-experimental research. 30 obese and normal weight students (BMI; 28.7, 1.2 kg/m2 were purposefully selected and divided into two groups. The exercise program was performed for 6 weeks and 90 minutes in every session with both exercise groups. The blood sampling was accompanied with 12 fasting before and after the training. Anthropometric measures, inflammatory, and hematological markers were measured before and after the intervention. The data were analyzed using the independent and paired t-test at α ≤ 0.05 significance level.
Results showed that significantly decreased C-reactive protein (order in obesity group and normal weight P = 0.04, P = 0.02), fibrinogen (P = 0.03, P = 0.01) and body composition. Our data also showed a significant increase in Red Blood Cells and White Blood Cells. In addition, a significant difference was observed in body composition between two groups (P The concurrent endurance and Pilates exercises can affect the CRP, fibrinogen and blood cell count. Therefore, they can be considered as a suitable and non-medication approach to prevent the incidence of obesity-related disorders in obese female adolescents.

Toxicity of heavy metals and their accumulation in food chain is one of the major environmental and health problem in modern societies. Heavy metals are as inevitable contamination of industries regions. This study is carried out with the aim to investigate the accumulation of heavy metals such as, lead, nickel, chromium and cadmium in two species of Eucalyptus and Borhan in Iran National Steel Industrial Group in 1395.
Substance and for sampling 5 stations within the area of the company were considered and from tree like lead of Eucalyptus and Borhan and its soil was sampled in three iterations. Plant samples digesting by Jackson (1958) method and for soil samples was conducted by 3050EPA of and heavy metals concentrations in the samples was read by ICP.
The concentration of heavy metals process in the five stations for all samples were equal to Cr> Ni> Pb> Cds. Most of heavy metals absorption was for chromium metal in species of Eucalyptus with 3753.45±0.39 mg/kg. Bioaccumulation amounts of lead, nickel and chromium was less than 1. But in relation to cadmium, bio-accumulate levels was greater than one that indicates the ability of this species in purification of infected soils.to heavy metal cadmium.
it can be concluded that the contamination amount of studied plants in the region were affected by the production processes in the company. It is recommended to use Eucalyptus species in the industrial areas of in order to attract and reduce pollution in the environment.

Kidney stones are the third most common problems in the urinary tract. According to the economic burden and its rising trend, it seems, knowing the associated factors can prevent the spread and cost of it. Therefore, this study was conducted to determine the risk factors of kidney stones.
This study was a retrospective case-control study that the case group consisted of 124 persons over the age of 18 which referred to lithotripsy centers and Yazd Khatamolanbiya clinic who for the first time they had been diagnosed with stones and the control group consisted of 186 persons over the age of 18 who had no symptoms or history of kidney stones. They were at the same time attended in the hospital with case group. The data collected through a questionnaire and interviews face to face. The data analyzed using SPSS19 software by chi-square and t logistic regression.
In this study, education level(OR=0.63, CI 95%=(.51,.77)) and family history (OR=2.1, CI 95%=(1.3,3.3)) were the only factors that were influential in the development of kidney stones.The results also showed that drinking water, low-fat dairy, consumption of fruits, and vegetables reduce the risk of stones, but drinking tea has the direct relationship with the risk of kidney stones.
Although family history and genetic expression are unchangeable, but we can greatly decrease the percentage of patients with raising awareness and changing of their diet.

Because of impotance of anesthesia in surgery and also high usage of ketamine for keeping anesthesia, this study was done for investigating on effects of short- and long- term anesthesia by ketamine in cerebellum in rats.
Thirty rats were chosen in both sex with weight about 190 g and age about 8-12 weeks divided into 6 groups. Firstly, balance test was done for each of the groups and anesthesia induced for a month. The two control groups (male and female) that they were not anesthetized. Another the two groups (male and female) were anesthetized by ketamine (25 mg/kg) three times in the week (short term anesthesia), and final the other 2 groups were anesthezed by ketamin (75 mg/kg) once a week (long- term anesthesia).
The balance test was done for the whole groups after a month. The rats’s cerebellum were removed and their histological slides were examined
The histological examination showed the mild to moderate changes in some layers of the cerebellum. However, in terms of balance, the studies did not show significant differences among the groups.
Our result showed that ketamine has a mild effect on the cerebellum. There was no significant difference between the short-term anesthetic groups with a dose of 25 mg/kg and the long-term groups with a dose of 75 mg/kg.

The main purpose of this study was to investigate the effects of aerobic training with coriander seed extract on serum paraoxonase-1, TNF-α, and CRP in diabetic rats.
40 Diabetic male Wistar rats (8 weeks old; weight: 130 ± 10 g) were randomly divided into four groups: control, extract, training, and training-Extract. Diabetes was induced by using Streptozotocin. Rats were selected as diabetic, with fasting blood glucose 126-400 mg/dl. The extract was administered orally (150 mg/kg/day). The exercise program was six weeks, 5 times a week with 50-55% of maximal oxygen consumption. The data were analyzed using of one-way ANOVA and Tukey test at α Aerobic training with coriander seed extract increased serum paraoxonase-1 (P = 0.000) and HDL (P = 0.000). It also decreased TNF-α (P = 0.017), CRP (P = 0.014), TG (P = 0.007), TC (P = 0.029) and LDL (P = 0.012) in diabetic male rats. We, then applied, post hoc test, it showed that a significant difference between the groups at the level of this profile.
Six weeks of regular aerobic training with coriander seed extract have been shown to increase paraoxonase-1 and decrease levels of TNF-α and CRP in diabetic rats, and possibly moderates the risk of atherosclerosis in type 2 diabetes.

Introduction and Aims: Pharmaceutical pollutants in aqueous can cause a number of health problems for people and other creatures. In this study, a survey of Dexamethasone removal from synthetic aqueous solutions was investigated by using UV/S2O8 and UV/H2O2 methods.
This experimental study carried out at lab scale at a reactor with the batch flow. In this study, the parameters of time (5- 60 min), pH (3, 7 and 11), dose of S2O8 (0.1-7.5 mM), dose of H2O2 (0.1- 7.5 mM), and Dexamethasone concentration (5- 20 mg/L) were studied to specify their effects on Dexamethasone removal. Furthermore, the remaining concentration of dexamethasone was determined by spectrophotometer DR (model 5000) in the 241 nm wavelength.
Results showed that with the increasing amount of parameters of pH, retention time, and a dose of H2O2 and S2O8 and with decreasing parameter of dexamethasone concentration, removal efficiency raised. Removal efficiencies of dexamethasone in the optimum condition of time=40, pH=3 and dexamethasone concentration = 5 mM was obtained 47, 59, 82, 91, and 98 percent for UV/S2O8 concentrations of 0.1, 0.5, 1.5, 5, and 7.5 mM, and 19, 49, 61, 65, and 72 percent for UV/H2O2, respectively.
According to higher removal efficiencies of UV/S2O8 method than UV/H2O2, easier storage and moderate stability of S2O8 and also more oxidation ability of SO4- than OH°, it is better to apply UV/S2O8 method to degradation of dexamethasone.