نشریه دانشگاه علوم پزشکی خراسان شمالی
سال سیزدهم شماره 1 (بهار 1400)

Multiple Sclerosis (MS) is an autoimmune, inflammatory and chronic disease that occurs as myelin damage and destruction in the white matter of the brain, spinal cord, and optic nerves and causes functional problems in the patient. The purpose of this study was to evaluate the effect of 8- week core stability training on some of functional indices in women with multiple sclerosis.

The study samples were 24 women with MS (25 to 40 years) in Bojourd with the EDSS level of disability of 2 to 5. Patients were randomly-purposefully divided into 2 groups: core stability training group (N = 12) and control group (N = 12) groups. Exercise group carried out an 8- week core stability exercise program for 30 to 40 min 3 times/week. During this time, the control group did not have any regular physical activity. Timed Up and Go test (TUG) was used to assessment of balance. In addition, Fatigue Severity Scale (FSS) questionnaire and One- Repetition Maximum (1RM) were used to evaluate fatigue and muscle strength of the two groups before and after training. Data were analyzed by covariance test with SPSS software at (P < 0.05).

According to the results of covariance test, performing eight week of core stability training was associated with a significant increase in balance (P = 0.000), upper body muscle strength(P = 0.000), lower body muscle strength (P = 0.014) and reduced fatigue(P = 0.000).

According to the results of this study, performing core stability training can improve functional indices (balance, muscle strength and fatigue of people with MS. Therefore, these exercises can be used as an effective exercise activity in patients with multiple sclerosis for rehabilitation.

Fever in patients with stroke causes an increase in complications and adverse prognosis in patients, which is necessary to identify the factors affecting it or predictive factors. Therefore, the aim of this study was to evaluate the frequency of fever in patients with stroke admitted to Ali ebne Abitaleb Hospital.

In this study, all patients with stroke admitted in neurology ward, Ali ebne Abitaleb Hospital, Zahedan during 2017 were assessed. According to the study criteria, 120 people were included in the project and demographic information including (age and sex) was obtained. Eligible patients were followed based on their body temperature during hospitalization, and the body temperature of those who developed fever within 48 hours were recorded. Resulted data was analyzed by using Chi-square and Mann-Whitney tests.

The results of this study showed that the prevalence of fever in patients with stroke was 32.5%, which was not related to the age and sex of the patients (P> 0.05). However, it was found that more than one third of the fever had no clear cause and in other cases of respiratory infections and urinary tract infections were highly prevalent.

Due to the effect of fever on the prognosis of patient, regular monitoring of patients vital sign and appropriate treatment measures with appropriate antibiotics in patient is necessary due to the fact that more than two thirds of the cases are of bacterial origin improved patients prognosis by reducing fewer and appropriate treatment.

Resistant and extensive resistant tuberculosis is one of the most important infectious diseases and the most important challenge in the treatment of tuberculosis. The aim of this study was to evaluate the direct treatment costs of patients with resistant and extensive resistant tuberculosis and the risk factors for developing resistance to the treatment of this disease.

This descriptive-analytical study estimated the treatment costs of resistant and extensive resistant tuberculosis in elderly patients referred to Masih Daneshvari Hospital during 2009-2010 and then the risk factors for resistance in these patients were investigated. For this purpose, 268 refractory tuberculosis patients were randomly selected. Data were analyzed using SPSS software version 17 using descriptive statistics and Pearson and Spearman tests and t-test.

The mean age and length of stay of patients were 59.96±15.45 years and 43.17± 5.8 days, respectively. 97.01% of patients had a history of tuberculosis. The average cost of medicine, diagnostic services and hospital services was estimated at 594.81, 1387.31 and 10972.28 rail millions, respectively. The relationship between direct costs of treatment and age, length of hospital stay and occupation was statistically significant (P≤0.05) but its relationship with education level and gender was not significant (P˃0.05).

Considering that hospitalization and prolongation of hospitalization costs a lot of money, so it is suggested that following the correct treatment protocols and principles of DOTs, these costs can be reduced and on the other hand follow up patients with a history of disease to prevent the spread and recurrence. Recurrence of the disease seems necessary.

The intensity of exercise is an important factor in choosing the right exercise program. The aim of current study was effect of 6-weeks of resistance training with high and low intensity on muscle growth and damage factors in active girls.

45 active girls with mean age of 20.7 ± 1.3 years, weight 58.5 ± 2.4 kg, and BMI 23.1 ± 0.5 kg / m2 were randomly divided to High(15 students) and low(15 students) intensity resistance training and control (15students). The experimental groups performed their special training for 6 weeks. 48 hours before and after the main protocols blood samples were taken. Within-group variations with t-test and between-group variations were analyzed by two-way ANOVA with repeated measures (time * group).

There was a significant difference in the follistatin (P = 0.002), follistatin / myostatin ratio (P = 0.001), C-reactive protein (P = 0.006), growth hormone (P = 0.021) Testosterone (P = 0.007) and testosterone / cortisol ratio (P = 0.033) were observed between the groups. The post-hoc test showed a significant difference in follistatin, follistatin/myostatin ratio, testosterone, testosterone/cortisol ratio, growth hormone and c-reactive protein in both experimental and control groups (P <0.05). However, among all the factors, only a significant increase in growth hormone was observed in the high intensity training group compared to low intensity resistance training group (P = 0.04).

Although there were significant difference in growth hormone between high and low intensity groups. However, intense resistance training seems to be as effective in terms of hormonal and metabolic changes as low-intensity resistance training.

This study aimed to investigate the effect of concept map technique for strengthening reading comprehension skill of medical studentschr('39') in general English language course for deep and permanent learning at North Khorasan University of Medical Sciences.

The current study is a quasi-experimental design with pre-test and post-test and treatment. The population of this study is 70 medical students at Bojnourd University of Medical Sciences, who were randomly selected in two groups of intervention and control. The intervention group used the concept map as a teaching a learning technique and the control group received the same training materials in the traditional way. Data were analyzed using t-test and SPSS.20 software.

As the results revealed there werenchr('39')t a significant difference at the level of (p =0.05) between the mean scores of both groups in pre-test. On the other hand, the statistical analysis revealed a significant difference at the level of (p =0.05) between the mean scores of both groups in favor of the intervention group in post-test.

According to the results of the pretest, it can be concluded that before this study reading comprehension skills of medical studentschr('39') in general English language course in both intervention and control groups were the same. The result of post-test also revealed that, the concept map is effective in improving reading comprehension skills of medical studentschr('39') in general English language course.

Research self-efficacy can be expressed as peoplechr('39')s judgments about their research abilities to organize and execute a series of tasks to achieve the specified research functions. Therefore, this study was conducted to evaluate studentschr('39') research self-efficacy of North Khorasan University of Medical Sciences.

The present study was a cross-sectional study performed on 240 students of North Khorasan University of Medical Sciences. Students were selected by stratified random sampling. The students chr('39')demographic information questionnaire and studentschr('39') research self-efficacy questionnaire were used to collecting data. Data analysis was performed by SPSS20 software using descriptive statistics (including mean, standard deviation frequency, and percentage) and inferential statistics.

According to the study results, the frequency of female students was 155 (66.8%). The mean and standard deviation of the age of students was 22.2±3.6 years. The mean and standard deviation of total self-efficacy is 151.24 ± 36.02, mean and standard deviation of statistical and analytical self-efficacy metrics 32.22 ± 10.25, self-efficacy in conceptualization 35.52 ± 8.99, self-efficacy in the method and implementation 31.41 ± 7.05, self-efficacy in qualitative research 3 12.59±4.9, reporting self-efficacy was 18.69 ± 5.76, self-efficacy in skills and proficient was 15.66 ± 3.64, and self-efficacy in ethics was 9.38 ± 2.86.

This study showed that research self-efficacy is moderate, and appropriate educational interventions are needed to promote it.

Substance use disorders are increasing in women, in contrast, withdrawal and failure in treatment have a high rate in them and it is necessary to identify the specific causes of female relapse. Therefore, the purpose of this study was to identify the factors affecting the relapse of substance use based on high-risk situations in Iranian women with opioid use disorder.

The research approach is qualitative and of the type of thematic analysis. Data were collected using purposive sampling and through semi-structured interviews and focus group discussions. Theoretical sampling continued until data saturation was reached. 25 individual interviews were conducted for 30 to 90 minutes and 2 focus groups of 15 people were conducted for 105 and 120 minutes and the data were saturated. Data analysis was performed using thematic analysis method (Sterling). Recoding and Holstie methods were used to assess the reliability and validity was calculated through content validity.

55 women with opioid use disorder with an average lapse of 4.5 participated in the study. In the results of the research, a total of 6 organizing themes including negative interpersonal emotional states, interpersonal conflicts, social and environmental factors, positive emotional states, coping and Consequences of expectations and 73 basic themes were identified and categorized.

High-risk situations can lead to lapse, relapse, and failure in treatment, but the good news is that these situations can be prevented. Identifying high-risk situations in women with opioid use disorders, in addition to increasing knowledge in this field, can be basis of the way for specific preventive therapeutic interventions in this group.

Pharmacological studies revealed anti-inflammatory and analgesic properties of chamomile and its main components. The aim of the present study is preparing and characterizing a niosomal gel containing chamomile extract.

Nisomes containing 2% and 5% of the extract were prepared using film hydration method. Non-ionic surfactants including sorbitan esters (spans) and ethoxylated sorbitan esters (tweens) as well as cholesterol were used. Physicochemical evaluations of the niosomes including microscopic characteristics, stability studies, and encapsulation efficacy and in-vitro release test were performed. The rheological behavior of the niosomal gel was also evaluated.

Morphology studies indicated the formation of MLV and LUV niosomic vesicles. The stability test results show span 60/tween 60 formulations in both 2% and 5% of the extract met the stability criteria. HPLC analysis revealed that encapsulation efficacy of the formulation containing 60% Span 60/Tween 60, 40% cholesterol and 5% extract was 64%. The release test results show a 30% release of apigenin (standard) from the formulation. Rheological study on the niosomal gel revealed a pseudo-elastic behavior.

Niosomes containing span 60/tween 60, 40% cholesterol and 5% chamomile extract showed the most acceptable physiochemical characteristics and is recommended to be used in further pharmacological and clinical investigations.

Probiotics are living microorganisms that have beneficial effects on host health. They are mainly residents of the gastrointestinal tract. This study aimed to introduce the effects of probiotics in diseases such as obesity, diabetes, infertility, gastrointestinal diseases, and the effect on vaccination efficacy.

Herein, the newest relevant data that evaluated the effects of probiotics in the treatment of the aforementioned diseases were collected from Scopus and PubMed.

The results showed that probiotics have a significant effect on controlling obesity and diabetes by regulating the balance of energy in the body. They modulate the level and type of autoantibodies, beta-cell autoimmunity and appetite-regulating hormones. Furthermore, these organisms reduce the absorption of dietary free fatty acids in the small intestine and increase the resistance of the intestinal barrier. Based on the gathered data, they are effective in improving bowel inflammatory disease, infertility, and depression by increasing the amount of pepsinogen and decreasing mucosal disorders and stress. They have a fantastic role in regulating the immune system, increasing sex hormones, and reducing inflammation. These microorganisms are also effective in improving the vaccination efficacy by regulating the production of antibodies and the cellular immune response.

Based on the results of this study, special species of probiotics could be considered a good candidate in adjuvant therapy of diseases that are related to human immunity dysfunction.

Respiratory distress syndrome is one of the most common diseases in premature infants and one of the leading causes of death in premature infants. Treatment is the administration of exogenous surfactant, which is administered intramuscularly, which is an invasive and painful procedure. The aim of this study was to compare the effect of concomitant administration of surfactant and fentanyl with the administration of surfactant in reducing the administration of repeated doses of surfactant in infants with respiratory distress syndrome.

This study was performed by a step-by-step clinical trial with a blind historical comparison on 30 infants with respiratory distress syndrome hospitalized in Bent Al-Huda Hospital with a mean and standard deviation of 32/8 ± 2/24 years. Patients were divided into intervention and control groups. In the control group, surfactant patients received only and in the intervention group surfactant and fentanyl. Data analysis was performed by SPSS software, version 19, using statistical tests. A significant level of 0/05 was considered.

In this study, there was no significant relationship between fentanyl administration and surfactant compared with surfactant administration only in reducing the frequency of repeated doses of surfactant, however, the number of infants requiring repeated dose of surfactant in infants receiving fentanyl was lower. Significant correlation was found between fentanyl administration and neonatal pain.

It is recommended that fentanyl be used for pain relief when administering surfactant by intra-chip tubing in infants with respiratory distress syndrome.

Having cognitive flexibility enables people to not only cope better with stressful situations, but also have less stress and have more ability to cope with problems. The aim of this study was to determine the effectiveness of treatment of acceptance and commitment and existentialism therapy on increasing psychological flexibility in the elderly.

The current research method is semi-experimental and its design is preexperimental-
post-experimental with control group. The statistical population of the present study included all members of the Bojnourd Retirement Association in 2020, who were at least 60 years old. The sample size in this study included 45 people, first by targeted sampling and random substitution in three experimental groups 1
[15]. Individual], experimental group 2 [15 people] and control group [15 people] were included. The research instrument was the Dennis and Vanderwall Cognitive Flexibility Questionnaire [2010]. Acceptance and commitment therapy packages were administered in 8 sessions of 90-minute and existential therapy in 10 sessions of 90-minute for intervention groups. Data using descriptive statistics [mean and standard deviation] and inferential statistics [analysis of covariance And follow-up
test] were analyzed. Data analysis was performed using SPSS statistical analysis software version 22.

Acceptance and commitment-based and existential therapeutic package were effective in increasing participantschr('39') cognitive flexibility. Also, in terms of comparison between the two treatments, there was a slight difference in the cognitive flexibility variable, but this amount of difference between the two treatment approaches was not statistically significant.

Acceptance and commitment-based therapy package and existential therapy in 8 and 10 sessions of 90 minutes, respectively, were able to increase cognitive flexibility in the elderly. Therefore, it seems that performing such interventions in turn can provide the basis for improving performance in the elderly in most issues and areas of social and psychological life.

Coronavirus 2019 is an epidemic caused by a group of viruses with symptoms such as respiratory symptoms, fever, sore throat, and fatigue. This article is presented with the aim of practical recommendations in the field of effective nutrients against coronavirus.

In this review article, articles focusing on nutrition, the immune system, viral infections, and coronaviruses were published by searching databases for both articles and manuscripts accepted from 1990 to 2020, and articles without English abstracts were excluded from the review system.

Some nutrients are actively involved in the proper functioning and strengthening of the human immune system against viral infections including dietary protein, omega-3 fatty acids, vitamin A, vitamin D, vitamin E, vitamin B1, vitamin B6, vitamin B12, Vitamin C, iron, zinc and selenium. There have been few studies on the effect of dietary factors on the prevention of COVID-19, but supplementation with these nutrients may be effective in improving the health status of patients with viral infections.

Following a balanced diet and supplementation with appropriate nutrients may play an important role in the prevention, treatment, and management of COVID-19. However, more clinical trials are needed to confirm these findings and provide strong recommendations against the epidemic.

This study was performed to investigate the effect of cholestasis on memory and the role of sex difference in this effect.

This experimental study performed at Gonabad University of Medical Sciences, male rats were divided into 4 groups of 8 (sham and 3 cholestatic groups) to investigate the effect of cholestasis (7, 14 and 21 days) on lateral memory. To evaluate the effect of sex difference on the memory of cholestatic mice, rats were divided into 6 groups of 8 (male and female sham, male and female gonadectomy, male and female cholestatic-gonadectomy). In the gonadectomy groups, the testicles and ovaries were surgically removed, in the cholestatic groups, the bile duct was closed, and in the sham groups, only surgical stress was received. A shuttle box was used to evaluate the passive avoidance memory. Data were evaluated by PRISM software and ANOVA test.

In the study of memory in male cholestatic groups during days 7, 14 and 21, after cholestasis, the mean latency of dark room entry in all three groups were significantly reduced (P <0.05) compared to the sham group. Also, in the male gonadectomy group, the mean delay time in entering the dark room compared to the sham group showed a significant decrease (P < 0.05). In male and female cholestatic-gonadectomy groups, this time was significantly reduced compared to male and female sham groups as well as male and female clastatic (P < 0.05, P < 0.001).

Based on these findings, it can be concluded that due to the sex difference in the effect of cholestasis on memory and learning, sex hormones may have some protective effect on memory impairment due to cholestasis.

Maintaining and promoting childrenchr('39')s health is one of the most fundamental goals of many international organizations. The purpose of this research was to study of effectiveness health visitors in environmental health and safety of primary schools.

The research method was descriptive-survey. The statistical population was all governmental female primary schools across the country (8775 primary schools) in academic year 2016-2018. According to Chocran formula, 400 primary schools (200 schools with health visitor and 200 schools without health visitor) were selected multistage random cluster. The data ghatered by a researcher-made checklist based on hygienic environmental regulations that included 11 major components and 37 specific components. Its validity was confirmed based on school health experts and its reliability was calculated by Cronbachchr('39')s alpha (0.78). Data were analyzed by using descriptive statistics (frequency and percentage) and inferential statistics (using factor analysis, multiple regression and z Fisher).

The findings showed that there was a significant difference between status of environmental health and safety in schools with & without health visitor (P ≤ .01).

Status of environmental health and safety in schools with health visitor is more desirable than schools without health visitor.