مجله علوم پزشکی رازی
سال بیست و پنجم شماره 10 (پیاپی 175، دی 1397)

Nursing student's skills evaluation plays a vital role in their professional education, but unfortunately; the quality of many evaluation methods is less than optimal. Therefore, this study was conducted to determine the effect of evaluation by using Direct Observation of Clinical Skills (DOPS) and traditional methods on nursing students' clinical skills in 2016. In a quasi-experimental study, 108 senior nursing students were selected and then randomly assigned into two groups of case and control. In the case group was evaluated the skills related to dressing, intra-vein catheterization and suction by DOPS method and in the control group these skills was evaluated by traditional method. Finally, the skills in the two groups were checked by checklist and data were analyzed by using SPSS16 software, descriptive and inferential statistics, Chi-square, independent t-test, Pearson correlation and ANOVA. Independent T-test showed a significant difference in the mean score of dressing, intra-vein catheterization and suction skills between case and control groups (p<0.001). Also the results showed a significant increase in those skills in the third stage of assessment in the case group, which showed a statistically significant in ANOVA (p<0.001). Regarding the improvement of clinical skills in case group's students, it is suggested that the DOPS evaluation method as a high-performance, objective, validated method is used for assessing clinical skills and evaluating the learning of nursing students as well as accepting responsibility professionals in medical sciences.

The use of over doses of acetaminophen lead to liver and kidney necrosis. The aim of this study is to investigate the effect of Zataria multiflora extract (ZME) on male rats treated with acetaminophen. In this experimental study, 42 Wistar male rats (220-250 gr) were divided in 6 groups randomly: Control (normal saline 0.5ml, i.p), witness (acetaminophen 250mg/kg, orally), positive control (ZME, 200mg/kg, i.p), treatment groups 1, 2 and 3(acetaminophen 250mg/kg, orally and100, 200 and 400mg/kg ZME, i.p). For 10 days. After examination the animals were anesthetized by ethylene ether and blood samples were collect from heart directly and AST, ALT, ALP GGT, Total- protein, albumin and IL- 1β were analyzed. Also the liver tissue were removed and fixed by formaldehyde 10% for histopathological evaluation. The serum levels of liver enzymes reduced and albumin and total-P
Increased significantly compared with witness group (p<0.001). Histopathological studdings were showed inflammation and necrosis in hepatocytes of witness group compare with control and treated groups. Zataria multiflora extract with effective chemical compounds can protect the liver against the toxic effects of acetaminophen.

Mental well-being is one of the important constructs of mental health and identifying the factors affecting it is of paramount importance. So, the aim of this study was to discriminate between students with high and low mental well-being based on their resilient and components of the tendency to risky behaviors. It was a causal-comparative research. The research population consisted of all male and female students studying in Kurdistan University of Medical Sciences in the 2017-2018 academic year, 365 students were selected by multistage cluster sampling method. For data collection from the Warwick–Edinburgh mental well-being scale (WEMWBS), Klohnen ego-resilient scale (1996) and youth risky behaviors scale were used. Data were analyzed using software SPSS-20 and the statistical test of discriminant analysis. Discriminant analysis results showed that resilient, the tendency to drug and psychoactive and the tendency to cigarette has the highest ability in discriminating between two groups of students with high and low mental well-being were. Subsequent discriminative components included the tendency to risky sexual behavior, the tendency to drive dangerously, the tendency to violence and the tendency to alcohol, respectively. Also, the results of the discriminant analysis showed that all students with high and low mental well-being were correctly discriminated from the other students with the highest percentage of detection (100%). Resilient and components of the risky behaviors are important determinants of discrimination among students with high and low mental well-being. Therefore, in educational and research programs in order to increase the mental well-being among students, resilience and the components of the risky behaviors needs special attention.

Myonectin is one of the well-known myokines and similar to insulin-like growth factor-1 (IGF-1) involves in cellular signaling pathways. The aim of this study was to survey the effect of resistance training length on serum levels of myonectin and IGF-1 and their relationship in sedentary young men. Fourteen volunteer non-physical education students (age 26.50±0.94, BMI 23.70±2.34) were randomly selected to participate in this semi-experimental study. For 6 weeks, the participants performed resistance training. The protocol consisted of 3 sessions per week and included 6 exercises (bench press, barbell curl, leg press, leg extension, leg curl, wide grip lat pull down), with 3 sets of 8-10-12 repetitions in each exercise and the intensity of 60 -70- 80 percent of one repetition maximum (respectively for first, second and third two weeks). Rest time between sets and exercises were determined two and three minutes, respectively. Blood samples were collected 24 hours before and 48 hours after four and six weeks of resistance training. The data were analyzed at significance level of p≤ 0.05, using 23th version of SPSS software. According to the results, there were no significant difference in serum levels of myonectin and IGF-1 after four weeks of resistance training (p=0.202, p=0.337 respectively). However, serum levels of myonectin and IGF-1 increased significantly after six weeks of resistance training (p=0.001, p=0.029 respectively). It should be noted that Pearson correlation coefficient did not show any significant relationship between myonectin and IGF-1 (p= 0.74: fourth week, p= 0.71: sixth week). The results showed four weeks of resistance training could not significantly change serum levels of myonectin and IGF-1 in sedentary young men, and to do that, at least 6 weeks of resistance training is required.

Miswak is the product of Salvadora persica L. that has antibacterial, antifungal, antiplasmudium, anticonvulsant, and gastroprotective properties. In this study, the anti-inflammatory effect of aqueous extract of miswak sticks (Salvadora persica L.) was investigated in carrageenan-induced rat paw edema. Adult male rats were divided into five groups, receiving normal saline, indomethacin (5 mg/kg), extract of Salvadora persica L. (50, 75, and 100 mg/kg), intraperitoneally. Then, carrageenan was injected into plantar surface of paw, and edema was measured using a micrometer in different times. Salvadora persica L. extract at dose of 50 mg/kg reduced inflammation at 4 and 5 hours after carrageenan injection (p<0.05). Doses of 75 mg/kg (p<0.01) and 100 mg/kg (p<0.001) of this extract exerted anti-inflammatory effects at 4, 5, and 6 hours after carrageenan injection. Indomethacin also decreased edema, significantly compared to saline-injected group (p<0.0001). Our data revealed that Salvadora persica L. extract possesses anti-inflammatory properties. However, further experiments on the possible use of this plant in inflammatory disorders are required.

Diagnosis and early intervention of chronic kidney disease is essential to prevent loss of a large amount of financial resources. For this reason, the researcher is seeking to design a fuzzy logic based expert system for diagnosis of chronic kidney disease. At first, a strategic search was conducted in the Pubmed database for initial identification of the parameters. A questionnaire was distributed to all nephrologists in Iran University of Medical Sciences (18 physicians). Data analysis was performed using SPSS v.22, which was calculated by taking the average of the scores given to each parameter. Depending on the features selected, a set of general rules for the diagnosis of chronic kidney disease was determined by reviewing the literature, guidelines and consulting with a nephrologist. Fuzzy Expert System was designed using MATLAB software and Mamdani Inference System. Finally, the fuzzy expert system was evaluated using medical records of 216 patients with and without chronic kidney disease. The main parameters for diagnosis of chronic kidney disease were 16. The accuracy, sensitivity and specificity of the system were respectively 90.74%, 87.03% and 94.44%. The surface under the roc curve was 0.90 and the kappa coefficient was 0.81, indicating a very high correlation between the system diagnosis and the final recorded diagnosis in the patient medical records. Considering the desirable outcomes resulting from the implementation and evaluation of the proposed expert system, The system can be useful in diagnosis of chronic kidney disease.

Depression disorder as one of the most common psychiatric disorders involves a wide range of symptoms, and behavioral brain systems and emotion regulation strategies can serve as an effective framework for predicting these symptoms. The aim of this study was to examination of association between behavioral inhibition/activation systems and positive and negative cognitive emotion regulation strategies with depression symptoms in patients with major depression disorder. The statistical population included all male patients with depression disorder in Razi hospital. The sample consisted of 60 depressed patients that were sampled by criterion sampling. For collecting the data, Carver and White’s behavioral inhibition/activation questionnaire (BIS/BAS), Garnefski’s cognitive emotion regulation questionnaire (CERQ) and Beck depression inventory (BDI-II). The data were analyzed using Pearson correlation test and multiple regression analysis. The results showed that thebehavioral inhibition systems and negative cognitive emotion regulation strategies had a positive relationship with the all of affective, cognitive, somatic and total score of depression symptoms (p<0.01), but behavioral activation systems and positive cognitive emotion regulation strategies had a negative relationship with them (p<0.01). Also, the result of multiple regression showed that the behavioral inhibition/activationsystems and cognitive emotion regulation strategies had a significant role in predict of depression symptoms (p<0.01). This findings showed that brain/behavioral systems and emotion regulation strategies have an important role in the psychopathology of depression disorders symptoms and can be an important therapeutic target for treatment of patients with depression disorder.

Breast cancer is one of the most common recurrence cancers among women. There are several factors that can affect the multiple recurrence of this disease, which have been studied and recognized in various studies, however, with the fact that these factors are known, cannot always accurately predict the incidence of metastasis. On the other hand, simultaneous examination of the types of relapses will make the results more accurate. One of the types of models used to analyze recurrent events with heterogeneity among patients is a frailty model. The purpose of this study was to use a joint frailty model to model multiple recurrences in breast cancer patients data. In this retrospective study, 342 breast cancer patients whose records were registered at the Shohada Tajrish Hospital Cancer Research Center were investigated. Patients were monitored for at least 6 months after diagnosis, and their last condition was recorded. For data analysis, the joint frailty survival model was used. Data modeling and data analysis were done in R software. The three-year and five-year survival rates for patients were respectively 0.79 and 0.68 respectively. According to the results of the fitted joint frailty model, it can be said that the risk of multiple recurrence (local and metastasis) is increased for patients with tumor grade greater than I. We also found that if we did not consider the relationship between multiple recurrence in patients with breast cancer, we would lose significant correlation. Considering the significant variance of the frailty component of the metastasis event, it can be concluded that patients with the same predictor variables also have a different metastasis risk and, on the other hand, given the low frequency of types of recurrences in this study, the results should be considered with caution.

The aim of this study was to determine the relationship between decisiveness and trait-state anxiety in students at Kurdistan University of Medical Sciences during 2017-18. In this cross-sectional study, 385 students (173 males & 212 females) were recruited using a stratified random multi-stage sampling methods. Data were collected using a "Trait Spilberger Anxiety", and "Assertion Inventory" (AI) of Gambrill & Richey. In order to investigate the relationship between two questionnaires, linear regression analysis was used. The significance level in this study was considered to be below 0.05. The results of study showed that with increasing trait anxiety in students, the mean score of the decisiveness questionnaire was increased, which indicates a reduction of decisiveness in students. In this study, age has a significant positive correlation with the degree of determination in students (p= 0.0001). Considering the relationship between decisiveness and anxiety and their impact on mental health, academic performance and occupation of students, the special attention of educators and planners towards determining the inhibitors and facilitators of incisive behavior; increasing the efficiency of counseling systems to increase decisiveness and anxiety reduction is essential.

Oral and dental diseases such as dental caries and gingivitis are common problems in human societies. The formation of biofilms is considered as a very important mechanism of disease by these bacteria. The present study is an overview of these infectious diseases and their bacterial etiology, the mechanism of formation and role of dental plaque biofilm in the development of these infections and vaccination against dental caries is a new research field for dealing with these oral-dental diseases. In the current review paper, relevant articles were collected at Science Direct, Google Scholar, and PubMed databases from 1995 to 2017 and reviewed over a period of 2 months. Articles related to the role of bacterial biofilms in oral and dental diseases were used to write this research. As a result of the review of articles, it was seen that bacteria are one of the main causes of oral and etiology infections. Although the formation of bacterial biofilm at the different dental and oral surfaces is not necessarily related to the disease, but the formation of biofilms is considered as a very important mechanism of disease by these bacteria. The dental plaque biofilm in health condition often consists of non-pathogenic bacteria and humans. However, the in pathogenic biofilms, the levels of acidogenic and aciduric bacteria have increased dramatically and, by creating a stable acidic environment, demineralization occurs more rapidly.