مجله دانشگاه علوم پزشکی سبزوار
سال بیست و هشتم شماره 2 (پیاپی 115، خرداد و تیر 1400)

Clinical education is known as a central part of professional training which combines knowledge, skill, attitudes, values and professional philosophies. Clinical instructor aims to develop clinical experience and strengthen educational system. In operation room, clinical instructor roles are more different and sophisticated in comparison to other clinical department because of an interactive, dynamic and challenging atmosphere as well as teamwork, specific physical space, and less instructor control over student practice. To determine the characteristics of clinical instructor in operating room, the current study was conducted.

This was a qualitative content analysis study conducted from 2015 to 2017. Participants were stakeholders of clinical education in operating room from medical universities of Khorasan Razavi. To collect data, sampling based on purpose was performed by semi-structure interview. Of note, obtained data from participants was analyzed by MAXQDA 2007 software with continuous comparative method.

From data analysis, it was reported three themes including effective instructor with 12, neutral instructor with 7, and ineffective instructor with 11 categories as well as a general theme named as a nuclear role instructor.

The most important roles of clinical instructor are finding a right place, students' acceptance into the surgical team, providing learning opportunities in order to gain technical skills and clinical competence. Therefore, to develop quality in clinical education, it is strongly recommended that clinical instructor have some vital characteristics in operating room including clinical experience, continuous active presence, communication skills, authority, acceptance and popularity.

There has been no report on the effect of epilepsy on liver enzymes and lipoproteins and its changes following exercisetraining in epileptic rats with Pentylenetetrazole.

In this experimental study, 70 male rats were placed in 7 groups. An intact group, three groups of Kindle and three groups of non-Kindle who received PTZ or normal saline injections every 48 hours until the animals were kindled. 24 hours after Kindling, blood samples were collected in intact group and two groups of Kindle and non-Kindle. One Kindle group and one non-Kindle group from the remaining four groups performed aerobic exercise for six weeks, and the other two groups were inactive for six weeks. Blood were collected 24 hours after the 6-week period, and were compared with control groups.

After 4 weeks of Kindling period, total cholesterol, triglycerides, low-density lipoprotein, liver enzymes (P <0.001) and antigenic coefficient (P <0.01) increased significantly in the epileptic group. After six weeks of aerobic exercise in Kindle animals; Triglycerides (P <0.001), liver enzymes (P <0.01) and antigenic coefficients significantly reduced, and high-density lipoprotein significantly increased (P <0.01).

The results showed that aerobic exercise in epileptic rats with Pentylenetetrazole improved lipid profile impairement and increased liver enzymes caused by epilepsy.

In previous studies, the crosstalk between some cancer cells and platelets have been documented. The purpose of the present study was to evaluate the effects of platelet-rich plasma (PRP) on B92 glial cancer cells.

In this experimental study, 1×106 B92 cells were treated with Platelet-rich plasma (PRP) for different of 0, 5, 10 and 20 percent of cutler media for 24 h. The morphological changes of the treated cells were evaluated by inverted light microscopy. The effects of PRP on the proliferation rate of cells were measured using the tetrazolium salt reduction test (dimethyl thiazole-diphenyltetrazolium bromide, MTT). QRT-PCR technique was used to evaluate the expression level of TNFα, IL-10 and BCL-2 genes.

The results of the MTT reduction test showed that PRP promotes B92 glial cell growth in a dose-dependent manner. PRP in a dose-dependent manner also increased BCL-2 gene expression. The expression of the TNF-α cytokine gene was decreased in a non- percent -dependent manner after the treatment of B92 glial cells with PRP. Treatment of B92 glial cells with PRP promoted a significant increase in the expression level of the gene of anti-inflammatory IL-10 cytokine.

In the microenvironment of cancer, platelets promote the growth and proliferation of B92 glial cells and their escape from immune responses.

The patient’s self-discharge from the hospital is a process in which the patient leaves the hospital voluntarily without completing the course of treatment, despite medical advice, and can indicate patient dissatisfaction and a significant challenge for health system managers. This study was conducted to investigate the causes and consequences of a patient's self-discharge from Dr. Sheikh Hospital as a referral center in the northeast of Iran.

All patients who were discharged with the personal consent from the hospital with personal consent between October 2014 and March 2015 were included in the study. A checklist was used to collect data. The patients' outcome was completed by telephone a week later. Finally, SPSS statistical software was used to evaluate the results.

Totally, 51 patients were included in this study. The leading causes of discharge with personal consent were including dissatisfaction with the physician and medical staff in 23 patients (45.1%), home care preference in 12 patients (23.5%), distance from the hospital in 5 patients (9.8%), teaching at the hospital in 3 patients (،5.9), the high cost of treatment in 3 patients (9 5.9), the overcrowding of the hospital in 3 patients (9 5.9) and the lack of specialist or diagnostic and therapeutic devices in 2 patients (3.9%). Also, in the study of patients' outcome, 21 patients (41.1%) referred to the doctor again, 18 patients (35.3%) continued treatment at home, 9 patients (17.7%) were readmitted and 2 patients (3.9%) died.

The most common cause of discharge with personal consent was dissatisfaction from the treatment team. Given that 3.9% of patients have died and a large number of patients have been re-referred to the doctor and be readmitted, it seems that justifying patients to refrain from self-discharge is in the patient's best interest.

Compliance of patients in need of liver transplantation is impaired due to many reasons, and this affects the pre and post outcomes and complications of transplantation. Therefore, the aim of this study was to evaluate the effect of a care program on the compliance of patients awaiting liver transplantation.

This quasi-experimental study was conducted in 2018 on 117 patients waiting liver transplantation in Imam Khomeini Hospital of Tehran. Based on entry criteria, the samples were selected purposefully and their compliance was evaluated. Then, a care program was implemented for them. The data collection tool was a compliance questionnaire, which was completed before and six weeks after the intervention. Data analysis was done by SPSS software.

The results showed that, the compliance of diet and medication improved after the implementation of care program in patients waiting for liver transplantation (P<0.01). But there was no significant relationship with physical activity.

The results of this study indicated a positive effect of the care program on improving the compliance of diet and medication in patients awaiting liver transplantation. Eliminating the problems of these patients requires the attention and support of planners and the cooperation of managers in order to develop care programs that can be used by healthcare professionals, especially nurses.

The most common cause of polyneuropathy is diabetes. Very few studies have investigated the effects of combined training on diabetes and diabetic-peripheral neuropathy complications. The purpose of this study was to investigate the effect of four months aerobicresistance training on glycosylated haemoglobin, total cholesterol, triglyceride and insulin resistance in postmenopausal women with diabetic-peripheral neuropathy .

For this purpose, 21 patients with diabetic neuropathy, were divided into two groups of control (n =10) and experimental (n =11). The experimental group performed resistance - aerobic training three sessions per week for four months. Subjects’ fasting serum samples were obtained before the start of the study and after the first, second, third and fourth months of training. Data were analyzed by one-way ANOVA and repeated measures ANOVA .

Total cholesterol, triglyceride, insulin resistance and glycosylated hemoglobin levels, as well as weight and fat percentage in the experimental group did not change significantly (P> 0.05) .

Stabilized glucose and glycosylated hemoglobin in diabetic-neuropathy patients and no increase in total cholesterol, insulin resistance and triglyceride levels within four months is clinically important and indicate that regular resistance - aerobic training can delay progression and complications of the disease.

Breast cancer is the second common cancer in women at worldwide. Furthermore, patients with breast cancer generally use complementary  and integrative medicine such as homeopathy. It has been shown that homeopathic remedies such as Sepia, Phosphorus and Pulsatilla have great effects in the various diseases such as some of the cancers. However, the cytotoxicity effects of these compounds have not been studied for breast cancer cell lines such asMCF-7. Hence, the aim of this study was to investigate the cytotoxic effects of these homeopathic remedies on breast cancer cell line. 

Materials & Methods

Breast cancer cells (MCF-7) were cultured in DMEM medium and treated with different potencies (30 and 200) of remedies for 24, 48 and 72 h. Cell viability was determined by MTT assay.

The findings indicate that none of the tested compounds had cytotoxicity effect on MCF-7 cancer cells.

This study shows that Sepia, Phosphorus and Pulsatilla as the three of homeopathic remedies have not in vitro cytotoxic effects on breast cancer cell line, and it seems that further studies on different cell lines and also in vivo studies are needed to confirm these findings.

Nosocomial infections are one of the most important problems in hospitals and medical centers which cause loss of economic resources increased length of stay in hospitals and mortality. Correct and appropriate use of antiseptic and disinfectants play an important role in reducing infections. In this study the efficacy of the Current Disinfectants on Bacteria Isolated from Different Wards of an Educational Hospital has been studied.

In this cross-sectional study, a total of 245 samples were taken from different wards of Allameh Behlul Hospital in Gonabad. Samples were taken before and after disinfection with disinfectants of Deconnex AF50, Peranacide M1, microzed GPH and Sarphosepte Quicks. Samples were cultured on special culture media and identified by biochemical tests and the number of colonies was determined. Data were analyzed using Wilcoxon statistical test.

In the present study, microbial contamination of different sections showed that the most gram -positive bacteria were isolated included Staphylococcus epidermidis, and the most Gram -negative bacteria were isolated included, Escherichia coli. Mean before and after disinfection in deconox and microzed disinfection was significantly different in all parts (P <0.05). For peranaside disinfection in Internal and NICU sections, and in ICU and Maternity before and after There was no significant difference in disinfection (P> 0/05).

The results of this study showed that Deconex and Microzed were among the most effective disinfectants. Peranaside disinfectant in the maternity and NICU sections, and the Sarphosepte Quicks were also less effective in the Internal and ICU sections, but had good efficacy in other sections.

Methamphetamine is a powerful stimulant of the central nervous system Methamphetamine abuse can impair cognitive function and damage the nervous system. Recent studies have shown that methamphetamine result in neuronal damage through several ways such as increased free radicals and oxidative stress, accelerated cell death, and apoptosis. In addition, there are many studies and evidence of antiinflammatory, anti-apoptotic and antioxidant effects of palmatine on various types of neurological diseases. Therefore, this study was designed to help prove the function of palmatine neurotransmitter protection against neurotoxic activity of methamphetamine.

Methamphetamine neurotoxicity was induced by 40 mg/kg of METH in four intraperitoneally (IP) injections (e.g., 4×10 mg/kg q. 2-h, IP.). Palmatine (50,100 mg/kg) was administered at 30- min, 24-h, and 48 h after the final injection of METH. Spatial memory test was evaluated by Morris water maze then the brains were removed for Nissl staining to assess necrosis neuronal death within the hippocampal CA1 area.

Behavioral tests shows that palmatine treatment could significantly improve spatial memory deficits and learning (P<0.05) versus the METH group. Moreover, palmatine could significantly reduce necrosis cell death (P<0.05) in CA1 area of hippocampus.

According to the findings, palmatine improve memory and learning function in rats by reducing cell death.

The accumulation of amyloid aggregates in the brain are associated with numerous neurodegenerative disorders. Several nanoparticles (NP) have been using for treatment of neurological disease. Metal nanoparticles can be modified through the construction of bimetallic architectures consisting of two distinct metals that their properties can be dramatically different from those of the corresponding single-component particles. At the present study, we evaluated the effect of the bimetallic Au/Ag nanoparticles on hen lysozyme amyloid aggregation as a model protein for amyloid formation .

In this experimental study, to induce amyloid formation, Acidic pH and high temperatures were used. Hen egg white lysozyme (HEWL) was dissolved at 2 mg/mL in 50mM glycine buffer (pH 2.5), and then incubated at 57 °C for the specified durations. The inhibitory effect of the nanoparticles against HEWL fibrillation using and ThT (thioflavin T), Congo red and MTT assay was investigated .

ThT assay showed that the particles are able to inhibit HEWL aggregation in a pattern of inverse dose-dependent inhibition and with the best inhibitory concentration 0.01 µg/ml. Kinetic study of showed that the particles caused lag phase do not change but stationary phase decreased and also cytotoxic activity of HEWL aggregates in presence of Au/Ag nanoparticleswas significantly diminished (P˂0.05) .

We anticipate that based on obtained insights in design of new bimetallic nanoparticles, rationally design of effective NP-based therapeutics for neurodegenerative diseases may be a feasible perspective .

Brain-derived neurotrophic factor (BDNF) is one of the factors affecting nervous system efficiency and enhancing mental processes, which is significantly increased by environmental enrichment. Therefore, the purpose of this study was to investigate the effect of a SPARK program on BDNF in children with Down’s Syndrome (DS) and those with intellectual disability (ID).

Twenty male students with DS and twenty male students with ID, aged 7 to 9 years, in Shiraz voluntarily participated in this quasi-experimental study. The participants in each group were randomly divided into two experimental and control subgroups. Experimental subgroups performed a selected SPARK program 3 sessions of 45 minutes per week for 12 weeks. Control subgroups did not participate in this intervention program.  Blood sample were taken from all groups before and after SPARK program. After separation of serum from plasma by ELISA, BDNF levels were measured with a precision of 0.01 ng / ml using a Chinese Eastbiopharm Kit for human samples .

Analysis of variance (NOVA) with repeated measures showed a significant phase * group interaction. Further analysis showed no significant differences in BDNF level between the four groups in pretest. However, in post-test, both experimental subgroups (DS & ID) had significantly higher BDNF than control subgroups.

According to the results, it can be argued that the selected SPARK program increases the level of BDNF in children with developmental disorders. However, the program has equally affected children with Down’s Syndrome and those with intellectual disabilities.

The aim of this study was to stereological evaluate of the protective effect of pancreatin on morphological changes in mice kidney after treatment with L-arginine .

To conduct research, 50 adult male rats weighing 30±2 gr were divided into 5 groups (equal). In the control group, no administration was made. The pancreatitis induction groups received 2 doses of 300 and 400 mg/100 g body weight of L-arginine. To the induction groups with two different doses, therapeutic drug was prescribed 3.5 pp. of lipase-pancreatin. All treatments were received for 3 consecutive days once a day from L-arginine solution and 72 hours later, a lipase-pancreatin solution was administered to groups of pancreatitis for 20 days .

The results showed that due to experimental pancreatitis, except for medulla volume, decreasing volume of renal cortex, proximal and distal convoluted tubules, and glomeruli was observed in the treated groups compared to the control group. By the administration of pancreatin lipase along with L-arginine, mean volume values of factors such as mean volume of renal cortex, proximal convoluted tubules and glomeruli, have gotten closed to the control group .

According to a final review of the findings, lipasepancreatin solution may be partially effective in mitigating the effects of pancreatitis induced by high doses of L-arginine

Mesenchymal stem cells (MSCs) have been identified as an attractive source for cell therapy of damaged tissues. The multipotential differentiation capability, easy accessibility, low immunogenicity and significant role in wound healing physiology have led to the widespread use of these cells for wound healing. In this review study, the role of mesenchymal stem cells in repair of skin wounds is discussed .

This review was written based on findings from a search of the PubMed and Google Scholar databases between 1990 and 2020.

Mesenchymal stem cells have important roles at all stages of wound healing. These cells migrate to the site of skin damage and not only differentiate into the skin cells but also through paracrine signalling inhibit the immune and inflammatory responses, induce proliferation and differentiation of resident progenitor cells and result in angiogenesis, epithelialization and granule tissue formation. In the regeneration and maturation phase, the MSCs reduce scar formation and wound contraction and increase collagen expression and wound tensile strength. These cells alter their function based on the biomolecular properties of the lesion site, and create a wound-healing rather than fibrotic microenvironment .

Todays, significant advances have been made in the delivery of MSCs into healing wounds. These cells are delivered via intravenous or intradermal injection, or delivered with scaffolds, as a fibrin polymer spray or with hydrogels. In addition, the extracellular vesicles and conditioned medium of MSCs alone are effective. Future studies could lead to more effective strategies for the use of mesenchymal stem cells in wound healing . Received

Paneer-boot, with its antifungal and antibacterial effects, blood sugar and cholesterol-lowering, immune system, and antioxidant activity, has recently received pharmacologists' attention due to its high compatibility. Due to difficult ecological conditions, it can grow in the country's tropical regions such as Sistan and Baluchestan Province .

This study was designed in a completely randomized design with four replications under laboratory conditions at Khorasan Razavi Agricultural and Natural Resources Research and Education Center. Concentrations of 0, 2, 4, 6, 8, and 10 bar PEG were used to induce the effect of drought stress on MS medium containing BAP on secondary traits of cheese .

The results showed that the drought stress significantly increased antioxidant enzymes such as catalase, peroxidase, ascorbate peroxidase, proline, phenol, and flavonoid content membrane leakage. On the other hand, it resulted in a significant decrease in the relative humidity content, potassium ion content and potassium to sodium ratio. Also, most of the studied traits had a significant correlation.

The results showed that the Paneer-boot plant had acceptable tolerance to induction of drought stress with polyethylene glycol. Enzymatic and non-enzymatic mechanisms had a significant role in reducing the adverse effects of drought stress. On the other hand, drought stress increased some metabolites, such as phenol and flavonoids, which have medicinal uses .

Educational well-being and educational fascination are important variables in the field of education and learning that need to be recognized for their underlying factors. Therefore, the aim of this study was to determine the relationship between learning approaches and educational well-being and educational fascination.

In this descriptive correlational cross-sectional study, a sample of 244 Zanjan medical sciences students was selected by convenience sampling and proportional sex sampling from five fields of study in 1397.Data were collected through the Learning approaches Questionnaire from the approaches and Study Skills Questionnaire for Tait and Partners, the Salmela-Aro & Upadya educational Well-being Questionnaire, and the Martin and Jackson educational fascination Questionnaire (2008). Data were analyzed using Pearson correlation coefficient.

The results showed that the correlation coefficient between academic well-being and deep approach was 0.56, with surface approach -0.31 and and with strategic approach was 0.16. Also the correlation coefficient of academic fascination with deep approach was 0.61, with surface approach -0.25 and with strategic approach 0.22. All these coefficients are significant at the error level of less than 0.05.

It seems to increase educational well-being and Facilitate students' fascination experience Promoting their learning approach from surface to deep can be a useful and effective solution.so, it is necessary to promote studying and learning approaches through educational interventions.

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders in women of infertility. Women with PCOS are at high risk for early cardiovascular disease. The aim of this study was to evaluate the oxidative stress, inflammatory factors and other cardiovascular risk factors in patients with PCOS.

In this case-control study, 50 women with PCOS and 50 healthy women referred to Zahedan Infertility Clinic who were matched for age and BMI were selected by convenient  sampling method. Anthropometric parameters, biochemical tests, C3 and C4 complements, TAC and MDA levels were measured in all subjects. Data were analyzed using independent t-test and analysis of variance at the significant level P

Results showed that mean waist circumference (P = 0.048), systolic blood pressure (P <0.01) and diastolic (P = 0.048), serum LDLC levels (P = 0.05) and MDA (P <0.0001) were significantly higher in women with PCOS and serum HDL-C levels (P = 0.03) and TAC (P = 0.05) were significantly lower than   control group. Mean serum levels of C3 and C4 were higher in the PCOS group than in the control group, but this difference was only significant for C3 (P = 0.03) .

The findings showed that levels of dyslipidemia, oxidative stress and inflammatory factors were higher in PCOS women with abdominal obesity. Thus, screening of these factors and weight management, especially in obese women with polycystic ovary syndrome, is recommended in treatment strategy.