نشریه دانشگاه علوم پزشکی خراسان شمالی
سال دوازدهم شماره 4 (زمستان 1399)

The aim of this study was to investigate the effectiveness of Acceptance and Commitment Therapy on depression and follow-up treatment of patients with systemic lupus.

The present study was quasi-experimental (pre-test-post-test with control group and quarterly follow-up phase). The statistical population of this study included all patients with Lupus treated in Shiraz hospitals in 1397; Using the available sampling method from a population of 750 people, 60 women were selected and then randomly assigned to two groups of 30 people included control groups and experimental group. The experimental intervention group received treatment acceptance and commitment treatment within three months in 12 session’s 90-minute, but the control group was not exposed to any activity. The questionnaires used in this study included Beckchr('39')s depression questionnaire and the follow-up and treatment questionnaire. Data were analyzed by analysis of variance with repeated measurements analysis.

The Findings of the study showed that commitment training portfolios had a significant effect on reducing depression and follow-up, treatment of women with systemic lupus (P ≤ 0.0001).

According to the findings of the present study, it is possible to use acceptance and commitment training packages to improve depression and follow-up treatment of women with lupus.

Cement factory workers exposure to airborne particles containing crystalline silica in Portland cement chemical compound can caused pulmonary diseases, including silicosis and lung cancer. The aim of this study was to assess the risk of occupational exposure to respirable cement dust and crystalline silica in a cement factory in Khorasan Razavi province.

In this cross-sectional study conducted in 1397, the method presented by the Institute of Occupational Safety and Health of Singapore was used to assess the health risk of respirable cement and silica particles. Also, the standard method MDHS101 / 2 recommended by NIOSH was used to determine the concentration of respirable cement particles in the air of the workerschr('39') respiratory area and the X-ray powder diffraction method (XRD) was used to determine the concentration of inhalable crystalline silica particles. Stata software version 14 was used for statistical analysis of data.

This study showed that most of the workers employed in various worksites of the cement factory were exposed to respirable cement dust and crystalline silica particles higher than the OEL recommended by the Iranian TCOH and the TLV recommended by ACGIH. Exposure risk assessment in different parts of cement factory showed a low risk level for respirable particles of cement in the furnace and moderate for other sections. Also a high risk level for workers’ exposure to crystalline silica was found in the cement mill and very high level for workers in other sectors.

Employees who were working in this plant were exposed to moderate risk of cement respirable particles and high risk level of exposure to crystalline silica. Thus, the engineering control methods of exposure to respirable particles is suggested.

Osteoarthritis is the most common articular disease and functional disorders is one of the symptoms. The purpose of this study was to evaluate the effect of massage on knee functional problems in elderly women with osteoarthritis.

The statistical population consisted of 58 elderly women with mild to moderate osteoarthritis referred to Rheumatology Clinic of Bojnurd city using a cross-sectional clinical trial the sampling method was purposive and the patients were divided into control group and comparative group. After the day of diagnosis, during the intervention seven phase of intervention massages was performed on the knees fifteen minutes each day for one week with effleurage method. In intervention group standard treatments (100 mg Diclofenac) were used. Statistical analysis was performed using SPSS 16 software, and paired t-test, paired and independent t-tests, central and dispersion indices were calculated.

In response to the main purpose of the study, "Determination of mean pain in older women before and after intervention" in both groups showed that knee massage reduced pain severity which revealed there was a significant difference.

Although there are many techniques which can be effective on functional disorders but performing massage techniques such as massage therapy are more effective for reduction of functional disorders due to availability, cheapness, patients interests, informality, absence of complications and efficiency.

Continued breastfeeding during the first 2 years of infant life reduces chronic illness and mortality in children and adults, but most mothers discontinue breastfeeding. Several strategies to increase the duration of breast feeding have been used. Strategy tested vary in timing (antenatal or postnatal), is lactation consultant or peer support program. Thus, the current study has been performed to investigate the effect of peer support program on the prolanged breastfeeding pattern and duration.

In this randomized clinical study, 240primiparous women were participated. Control group included the routine trainings and intervention group program included the routine trainings plus the support from the 30 peer support during the 6 months after delivery. Feeding pattern and duration were evaluated by the end of The1, 2, 3, 6, 12 and 24 months after birth. Data were collected by questionnaire and were analyzed with chi- square, fisher and t-test tests.

Exclusive breast feeding rates was significantly higher in intervention group than control in the first, second, third and six months postpartum (P = 0.001). significantly more mothers in the intervention group than The control group continued to breast feed at 12 and 24 months after birth (% 89.9, 82 v 52.3 , 27% P = 0.001).

The results of this study indicated the peer support intervention was succeed in improving exclusive breastfeeding rate and duration.

Macrosomia is a common complication in obstetrics and gynecology and its complications usually expose mother and fetus at risk. The aim of the present study was to evaluate the prevalence rate of macrosomia and related risk factors in pregnant women in Bojnourd.

This descriptive analytic study was performed on 7908 pregnant women referred to Bentolhoda Hospital. Mothers with macrosomic infant were selected as case and the same number of women with term and normal delivery were selected as control groups. Data was analyzed by SPSS 24 software.

Maternal mean age, weight gain and duration of pregnancy were significantly increased among macrosomia group. Previous history of macrosomic infant and maternal hyperglycemia was directly related to increased risk of macrosomia. We did not find correlation between macrosomia and increased risk of neonatal malformations, shoulder dystocia, clavicle fractures, brachial plexus damage and maternal complication after delivery and increased cesarean section.

Due to 2.41% macrosomia frequency in Bojnourd city and its significant relationship with risk factors such as maternal age, mean pregnancy weight gain and pregnancy duration, maternal diabetes and macrosomic birth history, appropriate planning for pregnancy and Entering a well-weighted pregnancy and enjoying a varied and healthy diet will help maintain and promote maternal and neonatal health in the normal weight range.

The high prevalence of childhood dental caries is one of the most common dental problems and mother’s participation in oral health programs can decrease the caries rate. Undoubtedly, one of the applicable strategies is health education and one of the most effective training models is the Planned Behavior Theory. Therefore, this study was conducted to identify influential factors that predict motherchr('39')s health behaviors about their children’s oral health based on the Planned Behavior Theory in Khaf city in 2019.

This cross-sectional study was performed by 200 mothers with children under three who were randomly selected from the mothers referred to Khaf Health Centers. Data collection was conducted through a researcher-made questionnaire whose validity and reliability were confirmed. The questionnaire included demographic information, knowledge questions and Planned Behavior Theory structures. Data were analyzed by SPSS20 using descriptive statistics, regression and Pearson correlation coefficient at a significant level of 0.05.

Our results showed that motherschr('39') average score for knowledge was 17.55 ± 5.75, for attitude, perceived behavioral control, behavioral intention was 42.49 ± 4.61and 17.40 ± 2.89 and 47.3 ± 9.43 respectively. The motherschr('39') average score of subjective norms was 32.66±4.80 and average score of behavior was 24.86± 8.76. Based on the results of the linear regression test, predictors of health behavior include behavioral intent (β = 0.198, P = 0.002), and subjective norms (Β = 0.432, P < 0.001), and predicted 28.8% of behavior variance. Structures of attitude (Β = 0.199, P = 0.003) and subjective norms (Β = 0.287, P < 0.001) explained 13.8% of behavioral
intention variance.

Planned Behavior Theory can predict a part of oral health behaviors. The results of this study showed the application of this theory with emphasis on promoting abstract norms and the intention to perform behavior in educational interventions have effective results.

Studies have shown that CTRP3, as an insulin-independent anti-inflammatory adipokine, affects metabolism and regulates glucose metabolism. The aim of this study was to investigate the effect of combined aerobic- resistance training on serum concentrations of CTRP3 and interleukin-6 in men with type 2 diabetes.

In this quasi-experimental study, 24 male patients with type 2 diabetes were randomly divided into two groups of combined resistance aerobic exercise (n = 12) and control (n = 12). The subjects of the training group performed combined aerobic- resistance exercises 3 sessions per week for 12 weeks. Before and after 12 weeks of exercise program, blood samples were taken to measure the concentration of CTRP3 and interleukin-6 and anthropometric measurements of the subjects. Analysis of covariance was used to analyze the data.

After 12 weeks in the exercise group, fasting glucose (P = 0.014), HbA1c (P = 0.001), body weight (P = 0.048), body mass index (P = 0.037), body fat percentage (P = 0.001), fat mass (P = 0.001) were significantly decreased compared to the control group, but there was a significant difference in insulin (P = 0.054), lean mass (P = 0.987) and WHR (P = 0.291) between the two groups. After 12 weeks, the concentration of CTRP3 (P = 0.040) in the training group increased and IL-6 (P = 0.028) concentration decreased significantly compared to the control group.

12 weeks of combined aerobic- resistance training in men with type 2 diabetes in addition to glycemic control leads to a significant increase in CTRP3 and a significant decrease in interleukin-6.

Anemia in critically ill patients is common and affects their outcome. Treatment of anemia in ICUʾs patients have some challenges. Red blood cells transfusion is associated with some serious adverse effects which further affects patient’s outcome. In this article, the etiology of the anemia in critically ill and its management strategies is reviewed.

This study was done to summarize findings from earlier evidence on the prevalence and effect of anemia in critically ill patients on their outcome. We searched in medical data sources of PubMed, Scopus and Google Scholar using the following keywords: anemia OR erythropoietin, OR red blood cell, OR transfusion, AND critical illness, OR intensive care. After reviewing title and abstracts, all clinical studies conducted on this group of patients were included.

In most studies, the evidence supports restrictive protocol of RBC transfusion (transfusion at Hb < 7 g/dL) preferably over a liberal transfusion strategy (transfusion at Hb < 10 g/dL), in ICU patients. Only those with acute cardiovascular disease or early stages of severe sepsis may benefit from higher threshold of 9-10g/dL for blood preparation transfusion.

The occurrence of anemia is common in critically ill patients. Considering its multifactorial etiology, it has a negative effect on patients’ outcome. Blood transfusions are associated with some serious adverse effects, such as Acute respiratory distress syndrome and infections. The potential risk benefit must be carefully evaluated in every patient for whom a blood transfusion is being considered.

Malocclusion causes patientchr('39')s physical or emotional problems, tooth decay, gingivitis, etc. Risk of Malocclusion Assessment index determines the early orthodontic treatment need. The purpose of this study was to determine the prevalence of malocclusion required early orthodontic treatment in children 7-11 years old in Bojnurd in 2018.

A total of 616 students aged 7 to 11 years (271 boys and 345 girls) during mixed dentition in elementary schools in Bojnurd, who were selected by cluster sampling, were examined by two orthodontists. Those who were grade one or two were considered as no or low treatment need and those who were grade three, four and five were considered as treatment need by Risk of Malocclusion Assessment index. Collected Data were analyzed by Mann-Whitney, Kruskal-Wallis, Chi-square and Fisher tests in SPSS version 23, and the prevalence of malocclusion, required early orthodontic treatment, was determined. P-value <0.05 was considered as significant.

The prevalence of grade 1 and 2 of Risk of Malocclusion Assessment index was announced 14%. The prevalence of grade 3, 4, and 5 of Risk Of Malocclusion Assessment index were 77.7%, 8% and 0.3% respectively.

In this study, the prevalence of early orthodontic treatment need was 86.2%. According to the results, it can be concluded that the risk of malocclusion in children in Bojnurd is very high and planning to take preventive measures to reduce malocclusion in Bojnurd seems to be necessary.

The high rate of relapse after addiction withdrawal indicates inadequacy of detoxification courses and ignoring the role of psychosocial variables as critical component of successful treatment protocols. The aim of the present study was to apply the theory of planned behavior (TPB) to determine the effective factor related to the substance abuse treatment continuity in the in-treatment clients referring to drug-stop clinics of Masal city.

With a simple random sampling method, 195 in-treatment clients referring to drug-stop clinics of Masal city participated in a cross-sectional study. Data were collected by demographic information questionnaire, TPB-related scales, substance abuse screening questionnaire (TCU) and treatment continuity questionnaire. Chi-Squared test, independent t-test, one-way analysis of variance (ANOVA), Pearson correlation coefficient and path analysis were used to analyze the data.

The finding of the two models revealed that the strongest correlation coefficients were found between intention with constructs such as attitude, perceived behavioral control (PBC), and treatment continuity, as well as between treatment continuity and attitude (P < 0.05). Also, attitudes (β = 0.51, P < 0.05) and PBC (β = 0.33, P<0.05) had the greatest effect on intention to treatment continuation. Moreover, attitudes and subjective norms significantly mediated the relationship between the history of substance abuse and the intention to treatment continuation (P < 0.05). Finally, TPB constructs described 52% and 31% variance of intention and treatment continuity, respectively (P < 0.05).

The findings confirmed the usefulness of TPB to determine the factors influencing the substance abuse treatment continuity. So, design of TPB-based behavioral-cognitive interventions is recommended to improve substance abuse treatment continuity.

Test anxiety is one of the most critical concerns of the education system. Spiritual intelligence is a collection of individual capacities about spiritual resources. Due to the importance of spiritual intelligence on test anxiety and studentschr('39') mutual success and academic achievement, this study aimed to determine the relationship between spiritual intelligence and test anxiety in North Khorasan University of Medical Sciences students.

The present study is a cross-sectional analytical study investigating the relationship between spiritual intelligence and test anxiety in 435 students of North Khorasan University of Medical Sciences in 2017-18. The subjects were selected by multistage sampling (stratified and systematic random sampling). Data were collected by Kingchr('39')s standardized questionnaire of spiritual intelligence and Sarason test anxiety. Data were analyzed by SPSS 20software using t-test, Analysis of variance, and Pearson correlation test.

The subjectschr('39') mean age was 21.57 ± 3.57 years, and 308 (70.8%) of the issues were female. The mean score of studentschr('39') spiritual intelligence was ± 45.82 13.9, and the mean score of exam anxiety was 15.7± 6.07. The results showed a significant and inverse relationship between test anxiety and total spiritual intelligence score. There was a substantial and inverse relationship between spiritual intelligence dimensions, the dimension of critical existential thinking, and personal meaning production with exam anxiety (P-value < 0.001).

According to the results of this study, recognizing the inverse relationship between spiritual intelligence and students chr('39')test anxiety can provide a basis for promoting spiritual intelligence and reducing studentschr('39') stress.

Tyrosinemia is a congenital metabolic disease in which the breakdown of the amino acid tyrosine is reduced and its amount is increased in the body. Tyrosine metabolites can involve specific organs that according to the clinical manifestations there are three types of this disease.

Case:

 This article reports type 1 tyrosinemia in a 2-year-old child who complained of urinary problem and restlessness. Despite the absence of pathological findings in fetal ultrasound screening, imaging findings indicate involvement of both kidneys.

It is a rare, inherited and metabolic disease that despite the challenges of diagnosis has simple cure.

Aging is associated with muscle atrophy or sarcopenia. Autophagy is a process that reduces muscle atrophy; however, the efficiency of this process decreases with age. Exercise improves sarcopenia and the process of autophagy by activating signaling pathways. Therefore, the aim of the present study was to investigate the effect of moderate-intensity continuous training (MICT) on protein levels of ULK1, beclin1, Sestrins2, and AMPK phosphorylation in skeletal muscle of elderly male rats.

Twenty elderly male Wistar rats (18 months years old) were randomly divided into two groups of 1) MCIT 2) control (10 ones in each). MICT protocol included eight weeks of running on treadmill at intensity of 65-70 percentage of Vo2max with speed of 18-29 meter per minute for 25-40 minutes per sessions and five sessions per week. Muscle tissue samples were taken from gastrocnemius muscle at 48 hours after the last training session. Independent t-test was used to analyze the data and P value <0.05 considered significant.

Beclin1 protein levels were significantly increased in the MICT group compared to the control group (P = 0.001). However, the protein levels of ULK1, Sestrins2 and p-AMPK in the MICT group did not change significantly compared to the control group (P > 0.05).

It seems that MICT is not a suitable training method to activate autophagic pathways and subsequently improve the effects of aging in the skeletal muscles of elderly rats.