نشریه دانشگاه علوم پزشکی بیرجند
سال بیست و هفتم شماره 3 (پیاپی 84، پاییز 1399)

Cancer is one of the main causes of death worldwide. Chemotherapy is the most common method for cancer therapy which represent non-specific side effects on normal cells and tissues and drug resistance in cancer cells. There are two main mechanisms for Multi Drug Resistance (MDR) in cancer cells including: drug efflux pump and activation of anti-apoptotic pathways. Cancer chemotherapy disadvantages can be overcome by using nanoparticulate drug delivery systems like Mesoporous Silica Nanoparticles (MSNs) that have been used as drug delivery system since 2001. The present review included synthesis, targeted (active or passive) drug delivery to cancer cells, co-delivery of anticancer drugs and siRNA by MSNs and its toxicity. This review revealed that MSNs are good candidate for drug delivery to cancer cells due to its unique properties including: controllable pore and particle sizes, thermal and chemical stability, modifications of outer and inner surfaces of nanoparticles for drug and siRNA loading, attachment of ligand for targeted drug delivery, high drug loading capacity and controlled drug release, biocompatibility and biodegradation in aqueous medium.

Thrombophlebitis is considered as a major cause of peripheral intravenous catheters (PICs) failure. The flushing technique in the laboratory has been effective in clearing the catheter duct, but its effectiveness in the clinical setting is unknown, therefore, the aim of this study was to determine the effect of pulsatile flushing on phlebitis, type, and duration of PICs patency in patients.

In this double-blind clinical trial, 71 patients admitted to the inpatient and surgical wards of Imam Khomeini Esfarayen Hospital were randomly assigned to the intervention and control groups after sampling by available methods. In the intervention group, the flushing technique was performed by injecting 1 ml of the normal saline solution for one second, then interrupting less than one second and repeating the injection and interrupting until the end of 5 ml of the solution. The Consequences of this study were phlebitis, duration, and type of PICs patency, which were evaluated every 12 hours by using Jacksonchr('39')s phlebitis instrument and direct observation of the catheter.

The incidence of phlebitis in the intervention group was lower than the control group (P<0.001). In addition, two groups had a statistically significant difference in the type of PICs (P<0.001). The median duration of PICs patency in the intervention group was significantly higher than the control group (P<0.001).

Pulsatile flushing is an effective technique to increase longevity of PICs and recommended as a practical method in clinical setting.

Pregnancy due to physiological and psychological changes can affect the mental health of mothers.
This study aims to investigate the Approach of acceptance and commitment based on the fear of delivery pain.

This study was a randomized educational trial with a commitment-based treatment approach that was performed on pregnant women in Arak in 2016-2017. After obtaining written consent forms, 42 subjects were selected through the available sampling method. Subjects were grouped in the intervention group (ACT) and in the control group. Eight 90-minute sessions were held for 8 consecutive weeks of counseling Fear of delivery pain at 10 and one month after the intervention was measured in 2 groups by the Likert scale of pain (1-7) score. Data analysis was performed through repeated measure ANOVA by using SPSS (Version 18).

Results showed that the mean pain immediately after the intervention was 2.52±2.20 in the intervention group and 4.66±1.80 in the control group. Which is a month later in the intervention group compared to the control group had a significant decrease (3.52±1.81 vs. 4.52±2.30) (P=0.001).

In this study, counseling with the approach of acceptance and commitment reduction the fear of delivery pain, which is the most important reason for choosing cesarean section in women, Therefore, it seems that empowering midwives to counseling approaches can be useful to improve maternal care during pregnancy, especially in the administration of delivery preparation classes.

Heart rate variability used as a non-invasive method to investigate the effect of aerobics exercise on the cardiac autonomic system. The aim of this study was the nonlinear analysis of the effect of aerobic exercise in the water on the cardiac autonomic system in academic youngchr('39')s males.

A total of 28 young men were purposefully selected and randomly assigned to two groups of control and aerobic exercise in water. In the pre-test period and after the training intervention, all parameters of heart rate variability were measured by examining heart rate sequences, In the pre-test period and after the training intervention, all parameters of heart rate variability were measured by examining heart rate sequences, and then the standard deviation of the recorded sequences was interpreted by using the Poincare plot method. Independent t-test and paired t-test were used to compare the differences in the research stages.

Regular participation in aerobic exercise in water caused a significant (45.1±9.2 vs. 34.1±12.3)  and standard deviation of time intervals of heart rate sequences compared to their adjacent sequence compared to the control group (P=0.03). The longitudinal standard deviation of time intervals of heart rate sequences compared to the pre-test (P = 0.04) had a significant increase (79.5±12.5 vs. 56.9±15.8 After transferring the absolute results to normal, the normal state of the standard deviation of time intervals of heart rate sequences compared to its adjacent sequence compared to the control group (P=0.03) had a significant increase (44.7±12.05 vs. 36.5±13.52). Also, the normal state of the longitudinal standard deviation of time intervals of heart rate sequences compared to the pre-test (P=0.02) increased significantly (76.4±15.29 vs. 61.3±9.32).

Performing aerobic exercise in an aqueous environment can be used as a useful training method to improve the responsiveness of the cardiac autonomic system.

Crocus sativus (C. sativus) petals attenuates smooth muscle tension and blood pressure in control animals. However the antihypertensive effect and its mechanisms haven’t been recognized. This study investigates the antihypertensive effects of C. sativus petals’ aqueous extract in hypertensive rats and also responses of the rat isolated perfused mesenteric bed.

The interventional experimental study was performed on 20 male rats (divided to 5 and 15 rats for in vivo and in vitro studies respectively). Hypertension was induced by DOCA-salt injection (20 mg/kg, twice weekly, for 5 weeks, S.C) and water was replaced by NaCl (1%). Five weeks later, animals were anaesthetized with sodium thiopental (30 mg intraperitoneal). Then systemic arterial blood pressure was measured by cannulation of carotid artery following administration of different doses of aqueous extract of C. sativus. Isolated mesenteric beds precontracted with KCl (40 mM), and the tension was measured in presence of different concentrations of the aqueous extract. Finally, various doses of C. sativus extract were applied after incubation by L-NAME or indomethacin. The mesentry was perfused with pump and the recordings were done by physiograph.

Mean arterial blood pressure in hypertensive rats was 231±6 mmHg. Administration of aqueous extracts of C. sativus reduced the blood pressure in a dose–dependent manner. In mesenteric beds preparation, addition of C. sativus reduced the contractile effects of KCl. Incubation with L-NAME but not indomethacin abolished hypotension effect of the extract.

It was proposed that the antihypertensive effects of C. sativus petals’ extract are through the reduction in total peripheral resistance following nitric oxide production.

Thymus kotschyanus is one of the most famous medicinal plants in Iran from the mint family and it has many applications in traditional medicine, such as relieving the symptoms of colds and coughs and relieving some gastrointestinal diseases. It also has antibacterial and antifungal effects. This study was performed to investigate the diversity of antibiotic effects of this plant.

Essential oils of fourteen different ecotypes of Thymus kotschyanus were extracted by using the Clevenger apparatus. After oil analyses with GC-MS device, the minimum inhibitory concentration of growth and also the minimum lethal concentration of 7 types of bacteria and 2 types of fungi were measured by microdilution method in the range of 0.01 to 5.12 mg/ml.

Oxygenated monoterpenes were the major fraction (64.60–90.60%) of the oils, and thymol and carvacrol were considered as the most abundant constituents (27.23–75.55%). The amount and concentration of these two phenolic substances in thyme essential oil are directly related to antibacterial and antifungal effects. The antibacterial and antifungal activity of the essential oils ranged from 0.24 to 5.12 and 0.08 to 0.96 mg/ml, respectively. The most active antimicrobial activity is related to the essential oil of Salmas and Nodoshan ecotypes and the least activity was seen in Rudbar ecotype.

Geographical characteristics of the place where plants grow have a significant role in the type and amount of compounds in the essential oil of the plant. In this regard, different biological effects and antibacterial and antifungal properties can occur from each ecotype.

The third molar tooth lies with symptoms such as periodontal problems, caries, crowding, root resorption, cyst and tumor formation of the adjacent second molar. The purpose of this study was performed to evaluation of the position of mandibular third molar teeth and its effect on second adjacent molar teeth.

Panoramic radiography were obtained from 264 patients with mandibular third molar hidden teeth referred to the Birjand School of Dentistry in 2018. The material and direction of their placement and the vertical position of the third molar tooth (based on the PELL & Gregory classification) and its placement angle (based on Winter classification) were determined. Also, the prevalence of distal caries, external root resorption, the amount of displacement, and the amount of inflammatory lesions and the cystic was examined in the adjacent second molar tooth. Data were analyzed using SPSS software (Version 19), and chi-square statistical test, p-values less than 0.05 were considered statistically significant.

 The data from this study showed that most of the wisdom hidden teeth were in Class B and III of Pell and Gregory classification, had Mesial angle based on Winter classification. In 20.8% of patients with caries, there was 3% root canal resorption and 1.1% displacement of the second molar tooth, while no cases of inflammatory and cystic lesions in the second molar tooth were found due to the hidden third molar tooth. The Mesial and horizontal angles of impacted wisdom teeth were associated with increased risk of caries and root resorption of the second molar. Also, Class Bchr('39')s third molar teeth increased caries in second molar teeth.

Most pathological problems were observed in Mesial, horizontal, and class B impaction. According to the observed relationship, it seems that the angle and depth of the hidden third molar should be taken into account considered when deciding whether or not to extract it.

Spiritual intelligence is a set of abilities to take advantage of religious resources that can predict a personchr('39')s quality of life and adjustment. The aim of this study was to investigate the relationship between spiritual intelligence and quality of life in nurses of Birjand teaching hospitals in a descriptive-analytical and cross-sectional study. Data were collected by using the Spiritual Intelligence Questionnaires (SISRI-24) and Quality of Life (SF36) and analyzed using the correlation t-test. In this study, 187 subjects were included in the study, of which 42.2% were male and 58.8% were female. The average score of spiritual intelligence of the subjects was 48, which is lower than average. Based on the results of correlation coefficient test, there was a significant relationship between spiritual intelligence and emotional health (r=0.77) and the individualchr('39')s general health score (r=0.20).Based on the results, the spiritual intelligence score of the subjects was moderate and low. On the other hand, spiritual intelligence predicted some areas of quality of life in nurses, Therefore, the implementation of programs aimed at increasing the spiritual intelligence of individuals can increase the quality of life of nurses.

Brucellosis is an endemic disease in Iran that is transmitted from animal to human. The clinical manifestations of brucellosis are nonspecific and its complications involve bones and joints. Brucellosis osteomyelitis can mimic the manifestations of neoplasms; therefore, it cannot readily be diagnosed in some cases. Under such circumstances, high incidence can be a helpful factor. We reported a 49-year-old man patient who presented with chronic musculoskeletal pain in the lower back. Initially, he was treated for osteoarthritis due to several negative serological tests for brucellosis. He was referred to a specialized clinic with no recovery achievement after 5 months treatment. The musculoskeletal pain together with the patient’s occupation (animal husbandry), was resulted in a high clinical suspicion of brucellosis. Consequently, the patient underwent another serological test and Magnetic resonance imaging (MRI). He was diagnosed with brucellosis-induced spondylodiscitis by positive serology result and bone involvement on MRI. Regular treatment was then started, which led to clinical and radiological improvement at the end. With regard to chronic symptoms of the disease and despite the negative results of serological tests, it is recommended that radiological diagnostic methods such as MRI should be adopted in cases where there is a clinical suspicion of brucellosis.