نشریه دانشگاه علوم پزشکی بیرجند
سال بیست و هشتم شماره 2 (پیاپی 87، تابستان 1400)

Snakebite affects around 3 or 4 million humans annually leading to more than 100,000 deaths. Coagulopathy is one of the significant causes of both morbidity and mortality in these patients. Accordingly, it is of utmost importance to diagnose and treat coagulation disorder due to bites; in addition, it is accompanied by various clinical aspects, such as pre-coagulation, fibrinogen coagulation time, fibrinolytic, platelet activation, anticoagulant, thrombotic, and bleeding. The main cause of coagulopathy caused by snakebite is the presence of compounds found in snake venom. These compounds are mostly proteins with enzymatic activity and high stability; moreover, they rapidly react with factors in the blood circulatory system and disrupt their correct functioning. Regarding the snake venom compounds, especially their proteins, it should be mentioned that different snakeschr('39') venoms have different proteins, which can have a role in coagulation or anticoagulation depending on its amount. The coagulant proteins are subclassified as clotting factor activators and thrombin-like enzymes. The anticoagulant proteins can prevent blood clotting leading to coagulopathy and include phospholipases A2, fibrinolytic, protein C activator, and L-amino acid oxidase (enzymatic anticoagulants) or C-type lectin-like proteins, three-finger toxins (TFTs), and proteinase inhibitors (nonenzymatic anticoagulants). All of these factors cause coagulopathy due to snake bites, which is a clinically important phenomenon and should be carefully examined; otherwise, it would be difficult to make the diagnosis and treatment process. If untreated, coagulopathy can develop quickly and lead to the patientchr('39')s death.

The use of methods with minimal complications and risk is of utmost importance in the promotion of oral hygiene in the care of intensive care unit (ICU) patients. The present study aimed to compare the effect of chamomile mouthwash and chlorhexidine gluconate on dental plaque and oral mucosal lesions of patients under ventilator in the intensive care unit.

This randomized controlled clinical trial was conducted on 50 eligible patients who were selected via available sampling method from among trauma patients in the ICU of Imam Reza (AS) Hospital in Birjand. They were assigned to two groups of chamomile extract 10% (n=25) and chlorhexidine gluconate 0.2% (n=25) by block randomization. In each group, the solution was used three times a day every 8 hours for 5 days. The instruments were the Backas Assessment Checklist (BOAS) and the Mucosal Plate (MPS).

In both groups, the mean total score of oral mucosal lesions and dental plaque significantly decreased 2 and 5 days after the intervention, compared to the pre-intervention (P<0.001); nonetheless, the two groups were not significantly different in this regard (P>0.05). Furthermore, there was no statistically significant difference in the mean changes in the total scores of oral mucosal lesions and dental plaque at different times in the two groups (P>0.05).

Chamomile mouthwash and chlorhexidine mouthwash have similar beneficial effects on dental plaque and oral mucosal lesions of ventilated patients admitted to the ICU.

When a neuronal axon is damaged, it returns to the neuron cell body and destroys it. Tanacetum bodjnordens as antioxidant and anti-apoptotic effects. This study aimed to determine the neuroprotective effects of ethyl acetate and n-butanol and hydroalcoholic extracts of Tanacetum bodjnordens on sciatic nerve compression in male rats.

In this experimental study, 36 male Wistar rats weighing 200-250 g were randomly divided into 6 groups )n=6). In the control group, the right thigh muscle of the rats was split after the anesthetization of the rats, while in the compression and treatment groups, the sciatic nerve was compressed for 60 seconds. The plant extract was injected intraperitoneally on the day of compression and seven days later. After 28 days, samples were taken from the lumbar spinal cord subsequent to performing the perfusion method. Afterward, 7-μm serial sections were prepared and stained using toluidine blue stain after tissue passage. Eventually, the neuronal density of rats in the six groups was compared.

Based on the results, the neuronal density in the compression group decreased significantly compared to controls and showed a significant increase in the hydroalcoholic, n-butanol, and aqueous phase treatment groups compared to that in the compression group (P<0.001).

According to the results, it seems that Tanacetum bodjnordens leaf extract has neuroprotective effects that promote the regeneration process in damaged neurons and these effects are higher in the aqueous phase fraction.

The sedentary lifestyle in individuals with metabolic syndrome is a main threatening risk for their health. This study aimed to investigate the effects of aerobic exercise with 65% of maximal oxygen consumption on heart rate variability and vascular nitric oxide levels in middle-aged males with metabolic syndrome.

In total, 30 middle-aged men with metabolic syndrome were randomly divided into control and aerobic training groups. At the pretest and posttest, the values ​​of metabolic risk indices, heart rate variability, and nitric oxide were measured in both groups. The aerobic training group performed aerobic exercise for eight weeks at 65% of maximal oxygen consumption. The data were analyzed using the independent and paired t-tests.

According to the results, after comparing the values obtained from the posttest and pretest, there was a significant difference between the training and control groups regarding the fasting blood glucose, triglyceride, metabolic Z score, Standard deviation of NN intervals (SDNN), Square root of the mean squared differences of successive NN intervals (rMSSD), very-low-frequency (VLF), High frequency (HF), and vascular nitric oxide levels. Total cholesterol and low-density lipoprotein levels were significantly different in the aerobic training group, compared to those of the control group and LF as well as LF/HF at the pretest (P=0.01). However, despite slight changes in high lipoprotein and blood pressure levels, there was no significant difference in the aerobic training group, compared to the control group and pre-test.

Regular moderate-intensity aerobic exercise can be used as an appropriate exercise protocol to improve cardiovascular function for males with metabolic syndrome.

Bromelain is a substance derived from pineapple and has antioxidant, anti-inflammatory, and analgesic effects. This study aimed to investigate the effect of bromelain on the healing of tooth extraction sockets in an animal model.

This experimental study was performed on 24 male rats. After anesthesia, the first maxillary molar tooth was extracted with minimal damage using a hemostat. The rats were randomly divided into two groups, namely control and bromelain. In the bromelain group, the rats were orally administered by gavage with a 500 mg dose of bromelain that was dissolved in water twice a day for 2 days, while the control group received no medications. On the 3rd and 10th days after the surgery, 6 rats were killed per group each day. Afterward, the maxillae of rats were removed and slides were prepared from their dental sockets. The slides were examined by light microscope for histopathological variables (mean of macrophages, fibroblasts, lymphocytes, neutrophils; granulation tissue extent and angiogenesis and bone cells).

The results showed that the angiogenesis and granulation tissue extent increased significantly in the bromelain group, compared to the control group, on the 3rd day (P<0.05). Also, bromelain administration significantly increase the the number of fibroblasts (P<0.01), granulation tissue extent (P<0.05) and angiogenesis (P<0.05) in 3rd day of the experiment in comparison with the 10th day.

The results of the present study showed that bromelain accelerates the process of wound healing after tooth extraction.

Physical health is an important aspect of the health of any society and one of the most basic needs of human life. The present study aimed to investigate the effect of body mass index and level of physical activity on motor competence in women within the age range of 8-85 years in Tehran, Iran.

The present cross-sectional study was performed on 323 women aged 8-85 years who were divided into five groups, namely children, adolescents, young women, adults, and the elderly. The participants were selected using the convenience sampling method, and the required data were collected using a weight gauge, a height gauge, the short form of the International Physical Activity Questionnaire, and a motor competence test. The collected data were analyzed using multivariate one-factor analysis of variance and Bonferroni test.

The results of multivariate one-factor analysis of variance showed that the body mass index had no significant effect on motor competence (P<0.05). The main effect level of physical activity and age group on motor competence variable was significant (P=0.001). Performance of the children group was significantly weaker than that of young women regarding motor competence (P<0.05). Moreover, the performance of female children was better than that of the elderly group in terms of the motor fitness variable. In addition, the elderly group had lower motor competence, compared to children and adolescents. Besides, people with a moderate level of physical activity performed significantly better in the motor competence test than those with low and intense levels of physical activity (P<0.05).

The level of physical activity should appropriately increase to enhance motor competence and physical health. Furthermore, the downward trend of motor competence can be delayed by the adoption of proper plans.

This study aimed to evaluate the effects of education of proper oral hygiene via virtual reality simulation on the dental plaque in high school students.

This study was carried out on 90 high school students who were selected randomly and then divided into three groups. Group one was the first intervention group (VR) that was introduced to oral hygiene through virtual reality training in one session (n=30). Group two was the second intervention group (Verbal) that was introduced to oral hygiene through verbal training in one session (n=30). Group three was the control group that received no training (n=30). Plaque index (PI) was recorded both before and after the intervention (after one month) using Quigley–Hein plaque index. Data were collected and then analyzed in SPSS software (version 18) at a significance level of 0.05.

In the VR group, there was a statistically significant decrease in the mean values of PI (P<0.001) after the intervention (1.92±0.77) in comparison to the baseline (2.69±0.62). Moreover, in the verbal training group, there was a statistically significant decrease in the mean values of PI (P=0.014) after the intervention (2.16±0.95), compared to the baseline (2.45±0.91). This difference was significant in the virtual reality and oral education group compared to the control group (P<0.001).

Based on the findings, oral health education in general and virtual reality education, in particular, are effective in the removal of dental plaque and improvement of oral health.

Happiness and vitality are among the most important and effective components in the process of human life, without which activity, creativity, initiative, invention, and healthy life cannot be created. Happiness is a valuable tool for improving the personality and job performance of employees; meaning that happy people are more successful in the workplace. The creation of social vitality is the priority for comprehensive intervention in South Khorasan Province, Iran, for comprehensive intervention. Therefore, this study aimed to investigate the individual and organizational factors related to the social vitality of women working at the Birjand University of Medical Sciences, Birjand, Iran.

This descriptive-analytical cross-sectional study was performed on 214 females working at Birjand University of Medical Sciences selected using a systematic random sampling method in 2019. The 29-item Oxford Happiness Standard was used to collect data to measure social vitality.

The mean score of the femaleschr('39') happiness was estimated at 73.55±12.32 and the majority of the subjects had moderate happiness (60.3%). Moreover, most of the cases had not participated in happiness courses before (85.6%). The results also showed that happiness had no significant relationship with age, educational level, marital status, education level of the spouse, and occupation of spouse among the women (P>0.05); however, happiness showed a significant relationship with income and place of residence (P<0.05).

It seems that the social vitality of working women was moderate; in this respect, it is recommended to officials and planners implement educational interventions to improve the vitality of employees.

Given the high prevalence of Helicobacter pylori infection in Iran, eradicating it with an effective, low-cost, and easy diet is one of the challenges ahead The aim of this study was designed to compare the effect of "levofloxacin-based regimen “with” clarithromycin-based regimen” in the treatment of Helicobacter pylori. This quasi-experimental study was performed on 161 patients with Helicobacter pylori infection referred to the gastrointestinal clinic of Vali-asr Hospital in Birjand. Patients were randomly divided into two groups A (levofloxacin, pantoprazole and amoxicillin) and B (amoxicillin, pantoprazole, clarithromycin and bismuth sub citrate) and were treated for 14 days. 4 weeks after the end of treatment, the urease breath test was performed to check for eradication In levofloxacin group, 67 patients (91.8%) and in clarithromycin group 55 patients (70.5%), eradication was performed which was statistically significant. (p=0.001). Also, there was no statistically significant difference between the two groups in terms of complications (p=0.3).  The results showed that the levofloxacin-based regimen could be used as an alternative to four clarithromycin-based therapies due to its greater efficacy in eradicating Helicobacter pylori despite the lower number of drugs and similar side effects.

Identification of hard tick species and their hosts are essential for the development of control and prevention programs for tick-borne diseases. In this descriptive cross-sectional study, ticks were collected from the sheep, goat, and camel in different regions of South Khorasan province, Iran in 2018 through cluster sampling method. Fauna and frequency of ticks were recorded and analyzed in SPSS software (version?). In total, 977 ticks were collected, such as: Hyalomma spp, including Hy. dromedarii (40.5%), Hy. anatulicum (30.7%), Hy. marginatum (12.5%), Hy. asciaticum (6.8%), Hy. schulzei (4.4%), Hy. detritum (3.2%), and Hy. scupense (1.1%); Rhipicephalus spp, including Rh. bursa (0.3%), Rh. sanguineus (0.2%);  and Haemaphysalis spp, including Ha. concina (0.2%), and Ha. punctate (0.1%). The ticks have a high frequency in the region and the identified species in this study were vectors of Crimean Congo Hemorrhagic Fever (CCHF). Moreover, the Hyalomma species is dominant and prevalent throughout the studied region in spring and summer. Therefore the health system of the province has to put into consideration the essential care, education and informing about the CCHF disease.