نشریه دانشگاه علوم پزشکی بیرجند
سال بیست و هفتم شماره 1 (پیاپی 82، بهار 1399)

Old World cutaneous leishmaniasis (OWCL) is a relatively common parasitic infection that is among endemic diseases in many regions worldwide, particularly in Iran. Leishmania major and Leishmania tropica species with over 500,000 and 400,000 annual cases are considered the two main causes of OWCL, respectively. Diagnosis and treatment of cutaneous leishmaniasis (CL) can be difficult due to alterations in clinical manifestations and resistance to treatment.There is currently no vaccine available for (CL). Its systemic treatment also has serious and severe side effects.
The uncomplicated cases of (CL) in a person with healthy immunity can be managed alone by topical treatment as an effective and less complicated treatment and may not require other systemic therapies.This study aims to describe topical treatment methods for OWCL.

Asthma disease, it's the first reason for absence from school and the third cause of hospitalization for children less than 15 years. This disease is the main cause of impaired ability and activity in childhood and cause to psychological and emotional complications, reduction of self steam and communication disruptions with friends and family. Lack of control of it can lead to frequent hospitalization of affected children. It seems information in an easy way and in an attractive way about their illness will improve their self-efficacy. Therefore, the present study aims to investigate the effect of the discharge program based on animation and pamphlets on the self-efficacy of children with asthma were designed

This randomized clinical trial, with the participation of 90 children with asthma was randomly divided into that is three groups of 30 people: animation, pamphlet, and control. This was done in Akbar hospital in Mashhad in 2018..Animation group received a training CD and the pamphlet group received a training pamphlet and both groups were asked to study educational content twice a week for two months. In the control group, information was presented according to the usual method of section. Before and after intervention, children's self-efficacy was measured. Data were analyzed using SPSS software (Version 16) and one-way ANOVA, Kruskal-Wallis, Kolmogorov-Smirnov, t-test, Chi-square and Tukey post hoc tests.

Mean score of self-efficacy after two months in children in the animation group was 55.2±8.8,  in the pamphlet group 34.0±7.1 and in  the control group was 27.1±5.9 (P = 0.001). The research findings showed, after the intervention, the self-efficacy score of the animation group was significantly higher than the pamphlet and control group (P <0.001). In comparison, intra-group self-efficacy was significantly increased in all three groups after two months compared to baseline (p <0.001).

The discharge program based on animation compared to pamphlet and the usual way, it promotes self-efficacy in children with asthma and it is recommended to pay more attention to it in nursing care.

 Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory disease that affects synovial tissue in multiple joints. The potential side effects of current treatments have limited their use. As a result, interest in using complementary and alternative medicine(CAM) has reappeared. According to studies, Ferula assa-foetida L. resin it has many pharmacological effects such as anti-inflammatory property.The purpose of this study was to evaluate the effect of extract of  Ferula assa-foetida L. resin on the severity of rheumatoid arthritis symptoms which is caused by collagen.

 In this experimental study, 30 female Wistar rats were randomly divided into 6 groups: healthy control, sham, Dexamethasone receiving group to amount 1 mg/kg, receiving group to 100 mg/kg concentration of extract of asafoetida resin, receiving group to 300 mg/kg concentration of extract of asafoetida resin and receiving group to 100 mg/kg extract and dexamethasone (mixed group). Rheumatoid arthritis was induced by the administration of collagen type 2 and adjuvant and the intervention was performed for 24 days. The clinical evaluation started and the severity of the symptoms of rheumatoid arthritis, by examination and standard scoring was performed.

 From the thirteenth day, Symptoms of the disease appeared and from the fourteenth day, there was a significant difference between the control and sham groups in the clinical symptom score of arthritis. Among intervention groups, receiving group to 100 mg/kg concentration of extract earlier and more cause to decreased severity of symptoms. So on the 28th day, disease severity in the control group was 13.4 and in the treatment group with a concentration of 100 mg/kg extracts of Ferula assa-foetida L. resin was 9.6.

Hydroalcoholic extract of asafoetida resin, its could reduce the severity of symptoms of ankle RA and in the dose of 100 mg/kg cause to mitigate the symptoms of apparent swelling and inflammation.

 Researches have shown that promoter methylation of the CADM1 gene is one of the main mechanisms is to silence its expression in cancer cells. The objective of this study was to determine the methylation pattern of the CADM1 gene promoter and to quantify the human papillomavirus.

In this research, 75 tumor tissues and 75 tumor marginal tissue samples taken from patients with definitive diagnosis of cervical cancer were examined. After extraction of DNA and ensuring the quality and quantity of DNA extracted by spectrophotometry and the Agarose gel electrophoresis method, the methylation pattern of the CADM1was performed by the HRM method. Determining the methylation pattern of the CADM1 gene, without considering the type of involved variants was performed by using the Eva Green method and comparing the high-resolution melting point and HPV quantities were determined after isolation from the block.

Methylation of CADM1 gene in cervical tumor cells increased significantly (P< 0.0001) in comparison with the tumor margin before and after radiotherapy. But the change in the level of methylation of tumor cells before and after radiotherapy was not significant. This means that radiotherapy does not affect the level of methylation of the CADM1 gene. Moreover, the level of methylation of CADM1 gene in patients with HPV titer higher than 500 ml / IU was significantly more than that of patients with HPV titer lower than 500 ml / IU.

Use of DNA methylated of the cancer cells as a prognosis for cervical cancer in HPV positive women it’s appropriate, also the CADM1 gene can be used as a marker of cervical cancer.

Zinc oxide nanoparticle (ZnO NPs), Due to its unique properties, such as its anti-cancer and antioxidant properties, it has attracted researchers attention. In the present study, the cytotoxic and anti-angiogenic properties of zinc oxide nanoparticles prepared with the green method from extract Origanum Majorana were investigated.

Cytotoxic effects of zinc oxide nanoparticles, By MTT assay on cells of HUVEC، MDA-MB-231 and Hep-G2 was examined. In order to evaluate the anti-angiogenic effects in an in vivo model, 48 fertile eggs with Ross breed randomly divided into 6 groups Consist of: 4 treatment groups with different concentrations of (125, 250, 500 and 1000 µg / ml) , control and sham groups. After 12 days of incubation, the number and the length of the vessels of the chorioallantoic membrane of chick embryos were assessed. Eventually, data were analyzed using Image J and SPSS software (version 16) and one-way ANOVA and LSD statistical tests at the significant level (P <0.05).

The results showed that ZnO nanoparticles made the concentration-dependent cytotoxic effects with the amount IC50 values ​​of 60, 15 and 80 μg / ml. The number and length of chorioallantoic membrane vessels and by chick embryos weight and height in treated groups with different concentrations of nanoparticles significantly decreased compared to the control group (p<0.05).

The Zinc oxide nanoparticles produced by the green method from the extract of Marjoram probably with more severe cytotoxic properties for cancerous cells compared to healthy cells and it can also have anti-angiogenic potential.

Metronidazole is one of the antibiotics that are widely used and resistant to biodegradation, it is one of the most important pollutants in the environment. The purpose of the study was to examine the efficacy of the Electro-Fenton process for removing metronidazole from synthetic wastewater using iron electrode under operating different conditions.

 The present study was an experimental, laboratory-scale study that was done discontinuously. The effect of soluble pH variables (11, 9, 7, 5, 3), initial concentration of metronidazole (10, 15, 20, 25 and 30 mg/ L), electrode spacing (0.5, 1, 2 and 3 cm), hydrogen peroxide concentration (50, 100, 150 and 200 mg/L) and current intensity (1, 0.5, 0.3, 0.2 and 0.05 A) with the mixing rate of 100 RPM at ambient temperature was investigated. The reaction kinetics was also studied. The antibiotic concentration was read by UV / Vis T80 + spectrophotometer at 320 nm wavelength.

 The results showed that at optimum conditions (pH 7, 120 minutes, antibiotic concentration 20 mg / L, the hydrogen peroxide concentration 150 mg / L, inlet current intensity of 0.05 A and electrode spacing of 1 cm), The removal efficiency of metronidazole by Electro-Fenton process was 96.37%.

According to the results, it was found that Electro-Fenton with iron electrodes can be used as an effective method in the removal of metronidazole from aqueous solutions.

 Exercise reduction of respiratory symptoms of asthma and Vitamin D by adjusting the immune system can have a significant effect on the health of asthmatic patients. The purpose of this study was to investigate the effect of short-term vitamin D supplementation following a session of increased activity on respiratory parameters and activity tolerance in women with mild asthma.

  This study was quasi-experimental based on pre-post test That Following the announcement of the call, on thirty asthma women volunteered in Ahwaz performed. Balk test for cardiopulmonary patients was used for increasing aerobic exercise. Supplementation with vitamin D tablets at a dose of 1000 units daily for six weeks. About evaluation of pulmonary function we used Vital Capacity (VC) and Maximum Voluntary Ventilation (MVV) indicators by Spirometry devises. In order to determine normality of the data was used Shapiro-Wilk's test, T-test was used to analyze the data.

   Results indicated that there was a significant difference between VC and MVV levels and Activity tolerance to pre-test, supplement and exercise levels after the intervention (P ≤ 0/05.(

 Taking vitamin D supplementation with aerobic exercise can improve respiratory function in asthmatic patients and increase tolerance to activity.

Metabolic thyroid disease is one of the most common diseases in adults. On the other hand, environmental pollutants, including heavy metals, can interfere with hormonal function. So, the aim of this study was to evaluate the serum level of magnesium, manganese, and selenium in patients with hypothyroidism, hyperthyroidism and thyroid cancer in South Khorasan in 2018.

In this study, 77 patients were evaluated in three groups: hypothyroidism (n=33), hyperthyroidism (n=33) and cancer (n=11). After receiving the consent of the patients, their demographic information were collected. Sampling was convenient sampling method. Then, 10 ml of venous blood after 12 hours of fasting were taken. After the serum preparation, the levels of trace elements were assayed by ICP-MS.

The mean level of the studied metals (except for manganese) were not significantly different in the three groups (p> 0.05). The level of magnesium, manganese, and selenium in the hypothyroidismwere 1.74±0.55, 6.30±4.88, and 1.38±0.80; in the hyperthyroidism were 1.77±0.41, 5.55±4.55, and 1.47±0.70; and in the thyroid cancer group were 2.07±0.81, 6.02±2.22 and 1.84±1.03 respectively (p< 0.05).

According to the findings of this study, the changes in the trace element status can lead to a type of thyroid disorder, or even these disorders may alter the serum levels of these metals. But this difference, except for manganese metal, was not significant in other cases, however, further studies with other metals and elsewhere are recommended.

 One of the most important components of medical student education, it is clinical education that should always be observed because of its importance. Accordingly, the present study aimed to investigate barriers to quality of clinical education from the viewpoints of medical students of Birjand University of Medical Sciences in the academic year 2018-2019.

This descriptive cross-sectional study was performed on medical students. A total of 133 students who had completed their basic sciences courses were selected by the available sampling method. The data collecting tool was researcher made questionnaire that its validity and reliability were confirmed. Data were analyzed by SPSS software (Version 16).

The mean score of professor’s domain was 15.06±5.69, educational environment and staff 6.1±2.38, personal characteristics of students 6.64 ± 2.43 and curriculum 7.66 ±3.05. The lack of emphasis on important points of the educational materials while presenting the lesson, master's disregard for communication between theoretical knowledge and clinical skills, inadequate knowledge and theoretical information of students, and the student’s lack of confidence in the patient's bedside they were identified as the most important barriers to clinical education. There was also no agreement between the existing and the desired conditions in the areas of interest from the viewpoint of the students and the clinical environment and staff had the highest inconsistency.

According to the present study, Students of among master's fields, Student individual characteristics, curriculum, staff and clinical environment, the most important barriers to education knew staff and clinical environments, which could be remedied by providing equipment and facilities and creating the necessary coordination between students and staff.

Tooth decay is the most common childhood disease that unlike other infectious diseases, this disease cannot be stopped by antibiotics. The purpose of this study was to determine the evaluation of knowledge, attitude, and performance of elementary school students about oral health in the year 2016 that was designed and implemented in Birjand.

This is a descriptive-analytical cross-sectional study, was performed on 390 primary school students in Birjand city in 2016. The subjects were selected by multistage cluster sampling. Data collection tools were a questionnaire with 4 sections: demographic information, knowledge (7 questions), attitude (10 questions) and performance (8 questions). Data were analyzed by SPSS software (Version 18) using independent t-test and ANOVA at the significant level P≤0.05.

Most of the subjects (40.5%) had moderate knowledge. Overall, 2.6% had low attitude, 25.6% had moderate attitude and 71.8% had good attitude. The mean score of the student's performance was 5.48±1.71. Most of the subjects (40.3%) had moderate performance, 31.5% had good performance and 28.2% had low performance. There was a significant statistical relationship between knowledge and attitude, knowledge and performance as well as between attitude and performance (P = 0.001).

Student's attitude towards oral health was good, but their knowledge and performance were at a moderate level, this highlights the need for expanding educational programs to improve the awareness and performance of students and their parents about oral health.