نشریه دانشگاه علوم پزشکی خراسان شمالی
سال دوازدهم شماره 1 (بهار 1399)

Diabetes through sex hormone deficiency can cause erectile dysfunction in type 2 diabetic men, however, resistance training can improve diabetes by reducing complications of this disorder.

The purpose of this study was to investigate the effect of resistance training on serum levels of dihydropyronestrone, estradiol and erectile dysfunction in type 2 diabetic men.

In this quasi-experimental study, 24 men with type 2 diabetes with a mean weight of 77.1±3.5 kg and BMI of 26.13±3.3 kg/m2 were randomly selected. They were randomly divided into two groups Diabetics were divided into control exercises and diabetic control. The diabetic group performed 8 weeks of resistance training with resistance training. Serum levels of dihydroepiandrosterone, estradiol, erectile dysfunction and other dependent variables were measured 48 h before and after the training period. Data were analyzed using covariance analysis (ANCOVA) (P = 0.05).

Resistance training in diabetic group resistance training significantly decreased insulin resistance index (HOMA-IR) compared to diabetic control group (P = 0.010). Resistance training also significantly decreased serum estradiol levels (P = 0.040) and significantly increased serum levels of dihydroepiandrosterone (P = 0.030) in diabetic group resistance training compared to diabetic control group. Resistance training also increased erectile function in the areas of erectile function (P = 0.019), marital satisfaction (P = 0.012) and total scores (P = 0.002) in diabetic group resistance training compared to diabetic control group.

Overall, based on our findings, it seems that resistance training reduces serum estradiol levels and increases serum levels of dihydropyronestrone in improving erectile function in type 2 diabetic patients. Keywords: Type 2 diabetes, Resistance training, Dihydroepiandrosterone, Estradiol, Erectile function.

Domestic violence is the cause of most physical and psychological damages in women. The purpose of this study is to predict domestic violence against women based on Alexithymia and family performance by mediating differentiation in women visiting to comprehensive urban health services centers in Bojnourd.

The present study is a structural type and the statistical population of all women visiting in 1335 number of people. The sample size was estimated to be 250 by Cochran formula. The sampling method was a single stage cluster method. In order to measure the research variables, domestic violence, Alexithymia, family performance, and family data were analyzed using Amos software, Self-assessment mediation test method, structural equation method, path analysis.

The findings showed that family performance with Alexithymia of women's differentiation is significant at a confidence level of 0.99.

The results of this study showed that differentiation can play the mediation role in the prediction of domestic violence.

Due to the continued urbanization and industrialization in most parts of the world, metals are constantly being introduced into the soil environment and posing a major threat to human health. The purpose of this study was to investigate the contamination of Esfarayen surface soils with heavy metals and its hazards to human health.

Surface soil samples were collected from 5 areas with different land uses in Esfarayen. The concentration of heavy metals in the soil was measured by ICP-OES. Contamination factors (Geoaccumulation Index and Pollution Load Index) and health hazards (carcinogenic and non-carcinogenic) of heavy metals in surface soils were evaluated.

The results showed that the mean concentrations of cadmium (Ca), chromium (Cr), copper (Cu), nickel (Ni), lead (Pb) and zinc (Zn) in Esfarayen soil were 0.21, 33.27, 39.91, 32.25, 25.17 and 25.52 mg/kg, respectively. It was much higher than the natural background values. The highest and the least carcinogenic risk were related to chromium and lead, respectively. Soil health risk assessment for the pediatric group showed that the soil did not pose a risk to children and adults.

The contamination factor (Cf) values showed that the heavy metal contamination levels were Zn> Cr> Ca> Cu> Ni> Pb, respectively. These results are important in developing appropriate management strategies to reduce pollutant resources in Esfarayen.

In present study, we evaluated the effect of plasma collected from packed red blood cells (PRBCs) at various weeks after donation on peripheral blood mononuclear cells (PBMCs).

In this experimental study, plasma prepared from twenty PRBCs in the first, second, fourth, and fifth weeks after donation. PBMCs were also isolated from healthy donors and treated with different concentrations of prepared plasma in vitro. NO and MDA levels were measured in culture supernatant using Griess reaction and thiobarbituric acid method, respectively and cell activity was evaluated using MTT assay. GraphPad Prism (version 5) software was used for statistical analysis (repeated measure) of the data. P values less than 0.05 were considered statistically significant.

Our results indicated that plasma prepared from PRBCs during the early weeks increases the activity of PBMCs and enhance NO production. We also found that these plasmas have various effects on concentration of MDA released from PBMCs depending on time and concentration.

We concluded that plasma of PRBCs can have immunostimulatory or immunosuppressive effects on PBMCs, depending on the concentration and duration of blood bag storage.

Musculoskeletal disorders are one of the prevalent factors that lead to absenteeism at work. The purpose of this study was to evaluate the physical posture and methods to improve workstations in the petrochemical industry.

This interventional study was carried out at the Petrochemical Company and according to the type of work and posture evaluation using two methods QEC and LUBA. Ergonomic chair design was done by examining the anthropometric dimensions of the staff and then Posture re-evaluated and data were on paired t-test statistical tests analyzed by SPSS19.

In the QEC method 100% observations of fourth level loading workers in the loading section were in the fourth level and all workers in the bag sewing sector were in the third level. Posture evaluation by LUBA showed that 50% of workers' postures were in Area 3 of the Corrective Action Schedule and 37.5% of Postures in Area 4 of Corrective Action Table 3. Also, after intervention 28% frequency was in third level and 72% in QEC method. The LUBA showed that 20 percent of workers' postures were in Area 3 of the Corrective Action Table and 80 percent of Posters in Area 2 of the Corrective Action Table.

These two methods have shown similar results for postural evaluation. Therefore, it can be concluded that proper application of optimized design will result in improved postures in the workplace. And prevented musculoskeletal disorders.

With increasing resistance to overuse of synthetic chemical antibiotics, it is necessary to find alternative drugs that have both antibacterial and minimal side effects. The aim of this research is the effect of different types of solvents on the extraction of effective antibacterial agents of the plant and the identification of chemical compounds of Arenaria hispanica essential oil in North Khorasan province.

Arenaria hispanica with locally name ‘Marjaneh’, after collection and drying, was extracted using various solvents by maceration method. Essential oil distillation was performed by Clevenger apparatus and the compounds were analyzed by gas chromatography-coupled mass spectrometry (GC/MS). Disk and well diffusion method, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were used to determine the antibacterial activity.

The extracts had effect only on gram positive bacteria and the inhibitory effects of methanolic extract was more than others. Escherichia coli was the most resistant and Bacillus cereus was the most susceptible bacterium, which showed no statistically significant differences between groups (P > 0.05). The MIC / MBC results showed that none of the extracts were able to inhibit or remove the bacteria and higher concentrations are required. Nonadecane was the main compound identified in the essential oil.

Different extracts had less antibacterial effects than commercial antibiotics and small numbers of compounds were identified by the GC/MS analysis.

The aim of this study was to investigate the mediating role of perception of illness in relation to psychosocial factors with self-care in type II diabetes patients.

The present study was a descriptive-analytic one. The statistical population of this study included diabetic patients referring to type II diabetes in Milad Clinic of Mashhad. The sample consisted of 392 subjects who were selected by convenience sampling method. To measure the research variables, Short illness perception Questionnaire of Birdbent et al., Stress Coping Styles of Lazarus and Folkman (1984), Tangeny Self-Control Short Form (2004), Zement et al. Social Support (1988), Physician-Patient Relationship of Wendreflets et al. (2004) and the Tobert and Klasgow Self-Care Scale (2004) were used. Statistical analysis of the data was done by structural equation modeling using path analysis with Amos-23 and SPSS-23 software.

There was a significant relationship between coping styles, self-control, social support, and physician-patient relationship with self-care in type II diabetic patients (P < 0.05). The results also showed that perception of illness has a mediating role in relation to psychosocial factors with self-care.

Given the importance of psychosocial factors, the results of this study showed that a rational understanding of the disease, on the one hand, reduces the emotional disturbance of dealing with unpredicted illness-related issues, and on the other hand, improves self-care by adjusting patterns of drug use and meeting with the physician.

Cleft lip/palate is the most prevalent congenital anomaly of the head and neck area. This problem has a multifactorial nature and the causing factors have not yet been fully known. 60 percent of cleft lip is accompanied with cleft palate. The prevalence rate of this anomaly is estimated 1 in 700 people due to several studies.

In this cross-sectional study data of the neonates born with cleft lip/palate during 2016-2017 in hospitals of North Khorasan province was collected. To extract the data, in every hospital which has a Maternity ward the birth registration book and the patients file were checked. Data of neonates was collected. The data was analyzed in SPSS version 23.

Out of 31724 neonates checked in this study 22 had cleft lip and/or palate. Seven cases were boys and 15 were girls in which there was not significant differences P = 0.58. Maternal use of drugs was not different among affected babies. Parity and maternal age was not associated with prevalence rate of cleft palate and/or lip.

Prevalence of this malformation in North Khorasan province during 2016 and 2017 was 0.69 per 1000 births. There was no significant relation between cleft lip and/or palate and gender.

The purpose of this study was to determine the effectiveness of Mindfulness-Based Cognitive Therapy and metacognitive therapy on psychological well-being, mental agility and resilience of mothers of children with cerebral palsy. The statistical population of this study included all mothers of children with cerebral palsy in North Khorasan Province in 2017 and 2018.

Samples were selected by simple random sampling method (39 people) Then, they were randomly divided into two experimental groups (13 in the Mindfulness-Based Cognitive Therapy group and 13 in the metacognitive therapy group) and one in the control group (13 people).The pre-test was used from Reef Psychological Well-Being Questionnaire, Conner-Davidson Resilience Scale, Ryan's and Friedrich's mental regression scales. In the next step, the Mindfulness-Based Cognitive Therapy and Metacognition Therapy in 8 sessions and once a week For two hours was performed on examination Group and control group didn’t received any intervention. Then, the post-test was completed for all three groups. Eventually, after two months, all three groups were evaluated And the necessary data were collected And analyzed by repeated measures of variance analysis.

The results showed a significant difference between the two groups of meta-cognitive therapy and mindfulness-based cognitive therapy whit control group on the Variables of subjective well-being and Mental vitality. However, this difference was not significant in the resilient variable. Also, comparing Between the two treatments of mindfulness and metacognition on the present research variables, showed no significant difference between the two groups.

According to the findings, in order to increase the level of psychological well-being and mental vitality of mothers of children with cerebral palsy, meta-cognitive and mindfulness training should be paid more attention.

According to EAU 2018 guidelines, TURBT is the gold standard method for diagnosis and treatment of non-muscle invasive bladder tumor. It has been reported that in 50% of cases no detrusor was found in the specimen. The aim of this study is to compare presence of detrusor in specimens taken by conventional and en-bloc method.

From September 2017 to September 2018, 60 patients with solitary papillary tumor sized less than 3 cm, and no prior history of bladder cancer, randomly divided into two groups: Conventional TURBT and en-bloc TURBT with monopolar hook. Mean operation time, perforation rate, and presence of detrusor muscle were compared between two groups.

Mean operation time in en-bloc TURBT was 15.46 ± 3.52 minutes and in conventional TURBT was 20.6 ± 5.04 minutes. The mean operation time was significantly different between the two groups. No clinical bladder perforation was seen in the two groups. In 28 cases (93.3%) of en-bloc group the detrusor was seen in pathologic reports while presence of detrusor in pathology report was positive in 25 cases (83.3%) of the conventional group, this difference was not statistically significant.

En-bloc TURBT with monopolar hook was as effective as conventional method with no increase in bladder perforation, and due to lower operation time it is a better option than conventional TURBT.

Various studies indicate that generalized anxiety disorder has a high comorbidity with major depression disorder. Emotion dysregulation plays an important role in onset and maintenance of generalized anxiety disorder and major depressive disorder. The purpose of this study was to examine the efficacy of emotion regulation therapy in control of attention, mindfulness and reappraisal of generalized anxiety disorder comorbid with major depression.

Using single subject experimental designs with multiple baselines and according to participant tendency, structured diagnostic interview and inclusion criteria, 2 GAD patients comorbid with major depression were selected. Participants received emotion regulation therapy according in sixteen sessions. Patients were examined by Attention Control Scale, Kentucky Mindfulness Skills Questionnaire and Emotional Regulation Questionnaire. To analyze the data, indexes of process changes, slope and interpretation of ups & downs in charts were employed.

The results showed that emotion regulation therapy dramatically increased reappraisal, mindfulness and attention control strategies in patients with generalized anxiety disorder comorbid with major.

Findings generally showed that emotion regulation therapy via targeting reappraisal, mindfulness and attention control components can be appreciate choice for treatment of generalized anxiety disorder comorbid with major depression.

Binding of mature brain derived neurotrophic factor (BDNF) to tyrosine kinase B (TrkB) receptor leads to cell survival, while proBDNF binding to p75 receptor leads to cell death. Thus the aim of the present study was to investigate the effects of eight weeks pre-conditioning endurance training on BDNF, TrkB, proBDNF and p75 levels in the hippocampus male rats following ischemic reperfusion.

40 male wistar rats (12 weeks old and 236.56 ± 16.98g) were divided into four groups, including: ischemic control, ischemic training, healthy control, healthy training. Training groups (healthy and ischemic), trained with 30m/min (70% VO2max), 30min/day, and 5 days/week for 8 weeks on the treadmill. To induce ischemia (in ischemic groups), carotid artery is clamped with microsurgery clamp for 45 minutes. For data analysis, one-way ANOVA and post hoc Tukey tests were performed at a significance level of P ˂ 0.05.

The results showed that BDNF levels in hippocampus of ischemic control group were significantly lower than healthy control group (P = 0.001). Also BDNF levels in hippocampus of ischemic training group were higher than ischemic control group (P = 0.002). TrkB levels in control group were significantly lower than healthy control group (P = 0.026). But despite increasing in TrkB levels of ischemic training group than ischemic control group wasn’t significant (P = 0.556). proBDNF levels in ischemic control group were significantly higher than healthy control group (P = 0.001). No significant difference were found in proBDNF levels of ischemic training group than ischemic control (P = 0.418). No significant difference were found in p75 levels in difference were found in different group (P = 0.071).

Based on these results, it seems that pre-conditioning endurance training can have neuroprotective effect through improving BDNF, TrkB and proBDNF levels in hippocampus and can prevent apoptosis and neuronal death following ischemic reperfusion and can be studied as a complementary therapy in ischemic disease.

Spinal anesthesia is the most common anesthesia in cesarean section that creates a strong sensory and motor block. Fentanyl and sufentanil are among the intrathecal opiate medication that each have different side effects, and this has led to a lack of consensus on the most appropriate or dosage medication. In this study, sufentanil and fentanyl were compared with placebo.

In this clinical trial study, 120 pregnant women who were candidates for elective cesarean section and the ages between 18 and 30 years were selected. After obtaining informed consent, they were randomly divided into three groups of 40 each. The groups included bupivacaine plus 20 μg fentanyl, or 2.5 μg sufentanil, or 0.5 cc normal saline. The duration and quality of analgesia, heart rate, blood pressure, and side effects including vomiting, itching, and chills were recorded.

The mean age of patients was 29.1 ± 5.1 (P = 0.75). The mean duration of analgesia in the fentanyl and sufentanil groups was more than the placebo group (P = 0.008). There was no significant difference in analgesic quality between the three groups (P = 0.68). Postoperative nausea was significantly higher in the fentanyl group than in the other groups (P = 0.021). The itching rate in the bupivacaine group was also significantly lower than the other two groups (P = 0.018).

According to the results of this study, the use of sufentanil increases the duration of analgesia and its side effects are less than fentanyl, so in cases such as elective cesarean section it can be used to increase the duration of nerve block.