مجله دانشگاه علوم پزشکی اردبیل
پیاپی 81 (پاییز 1400)

Candida albicans is the most common cause of invasive candidiasis, but in recent years the incidence of infections caused by other species such as Candida Kruzei, Candida glabrata, Candida tropicalis, Candida parapsilosis and Candida lusitania has increased. In the last decade, the treatment methods for invasive candidiasis have changed completely, and a successful treatment depends on the timely start of treatment, the selection of an effective drug, and the lack of resistance of the fungus to that particular drug. On the other hand, the widespread use of immunosuppressive drugs as well as organ transplants has all caused widespread problems in the treatment of invasive candidiasis. Together, these observations highlight a rationale for the immediate development of new immunotherapy methods to enhance antifungal therapy in immunocompromised hosts. The past decade has seen great advances in our understanding of fungal immunobiology, leading to a number of new molecular and cellular immunotherapy methods for invasive fungal infections. Therefore, the aim of this study was to review the common and new antifungal drugs in the treatment of invasive candidiasis and to discuss the role of immunotherapy in better prevention and control of the disease.

Diabetes is a disease that requires continuous monitoring of blood glucose levels to control its complications. At present, blood glucose is measured using portable devices; most of the electrodes of these devices work using the enzyme glucose oxidase. Due to the high cost of the enzyme and its instability, non-enzymatic electrochemical sensors can significantly contribute to the emergence of new generation devices.

In this study, keywords of glucose measurement, non-enzymatic electrochemical sensors in the period 1962 -2020, were searched and studied from Elsevier, Scopus, Science Direct and PubMed databases. In this review, first, the different generations of glucose sensors and how they are made are mentioned, and the types of materials used in the preparation of enzyme-based sensors are discussed. The progress made in non-enzymatic sensors is mentioned in the following, and the advantages and challenges of these types of glucose sensors are discussed.

Materials used to prepare non-enzymatic glucose electrochemical sensors are platinum, copper, platinum alloys, gold and platinum nanomaterials, and molecular mold polymers. The main problem of these compounds is the lack of selectivity of these compounds and their weak signal due to the intervention of disturbing species. However, using molecular mold polymers seems an excellent option to solve this problem.

Non-enzymatic glucose electrochemical sensors have the advantage of high stability and low cost, and measuring the amount of glucose in biological fluids can be helpful in controlling diabetes. Advances in nanoscience and nanotechnology and molecularly formulated polymers have made it possible to produce new nanomaterials to create enzyme-free systems for glucose detection, but several studies are needed to bring these sensors to market.

Acne is a chronic inflammation of pilosebaceous units and in severe form reflects a different response to treatment in an oral regime of antibiotics. The purpose of this study is to compare the effect of the combination of erythromycin and low dose oral isotretinoin with erythromycin and low dose flutamide in women suffering from severe acne.

In a randomized controlled clinical trial, 80 women suffering from severe acne participated in the study and they were studied for 2 months. The first group received 800 mg oral erythromycin, together with 20 mg oral isotretinoin every two days and the second group received 800 mg erythromycin, together with 62.5 mg flutamide daily. The treatment efficiency was evaluated by the count of acne lesions and computing the acne severity index. The data of the study were analyzed using the version 16 of spss software.

In the present study, 40 patients participated in the research in each group. Finally, 61 people completed the study. The mean acne severity index in the flutamide group was 195.9±15 at the beginning of treatment and this index reduced to 52.8±5.8 at the end of treatment. The mean acne severity index in the isotretinoin group was 247.8±19.7 at the beginning of treatment and this index reduced to 76.3±12.5 at the end of treatment. The difference in reduction between the two groups was not statistically significant (p=0.15).

The treatment effectiveness of the above-mentioned methods in female severe acne was acceptable and this combination therapy can be presented as a better alternative compared to treatments with high dose individual treatment including oral isotretinoin and oral flutamide.

Covid's anxiety is a threat to students' mental health and it is important to identify the psychological factors that affect it .The aim of the present study was to investigate the structural relationships of Covid-19 anxiety disorder based on cognitive flexibility with the mediating role of perceived social support in students.

In this descriptive-correlational study, based on Kameri and Lee rule, 322 students of Islamic Azad University of Tehran Markaz were selected online through cluster random sampling. Coronavirus Anxiety Inventory, Psychological Flexibility Questionnaire and Perceived Social Support Questionnaire were used to collect data. Data analysis was performed using structural equation modeling by SPSS27 and AMOS24 statistical software.

The general model of the research was consistent with the experimental data (RMSEA=0.056). There was a negative and significant relationship between cognitive flexibility (p=0.001, β= -0.262) and social support (p=0.001, -0.516) with Covid-19 anxiety. Using the bootstrap method, the mediating role of social support between cognitive flexibility and covid-19 disease anxiety was confirmed (p=0.008, -0.338).

Given the inverse relationship between the level of anxiety caused by the Covid-19 epidemic and cognitive flexibility and confirmation of the mediating role of social support in students, it seems necessary to improve psychological flexibility and supportive measures by the family and others during coronavirus epidemic.

Knee osteoarthritis is an important cause of pain and disability in the community. The present study investigated the risk factors for primary osteoarthritis of the knee in patients with knee pain and their relationship with knee osteoarthritis.

87 patients were included in the study and were matched in terms of age. Cases consisted of female patients less than 50 years of age with knee pain and the control group was selected from patients under 50 years of age with knee pain and no radiographic findings of osteoarthritis.

This study showed that the rate of osteoarthritis of the knee was significantly related to body mass index (p=0.001). The relationship between knee osteoarthritis and ESR was not significant, but an increase in CRP with a p-value of 0.01 was associated with a risk of approximately a 3.5-fold increase in knee osteoarthritis. With increasing education, the rate of knee osteoarthritis decreased (p=0.022). The Increased circadian outpatient activity was significantly associated with increased knee osteoarthritis (p=0.032). In performed assessments on osteoarthritis of the knee, there was no statistically significant relationship between the type of bathroom used, the use of stairs, and residential houses.

Knee osteoarthritis has a relationship with body mass index, Education level, CRP index, and circadian activity level. it is recommended to lose weight in people with abnormal body mass index, exercise, and improve their lifestyle to reduce the incidence of knee osteoarthritis and disability.

Stroke is one of the most common causes of death worldwide and has distinctive features. Moreover, the different types of strokes are characterized by different physiopathological mechanisms. In the present study, we aimed to investigate the serum levels of ATG5 and apo B-48 and their diagnostic value in patients with ischemic stroke.

We selected 100 participants, including 50 ischemic stroke patients (22 women and 28 men) as the case group and 50 healthy individuals (23 women and 27 men) as the control group. Then, we conducted a case-control study in Imam Reza Hospital (Tabriz, Iran) from March 2016 to April 2016. Serum levels of ATG 5 and Apo B-48 were measured in both groups. We also evaluated the additional diagnostic value of these factors in both groups using receptor-related power analysis (ROC).

The mean serum levels of ATG 5 and apo B-48 were significantly higher in the case group than in the control group (p<0.0001). The values under the ROC curve (AUC) for ATG5 and apo B-48 were 0.96 and 0.91, respectively. The area under the ROC curve indicates that ATG 5 and apo B 48 are appropriate biomarkers for diagnosing ischemic stroke.

Serum levels of ATG 5 and apo B -48 are significantly higher in patients with ischemic stroke than in healthy individuals and may be considered diagnostic biomarkers in patients with ischemic stroke.

Considering the importance of professional commitment in medical services, it is necessary to provide an appropriate questionnaire to measure professional commitment and behavior. Therefore, the present study was conducted with the aim of investigating the psychometric properties of the questionnaire "Patients' views regarding the observance of professional behavior by specialist doctors".

The present study is a psychometric research that was conducted in four phases. The first phase of this study was based on a professional behavior tool guide, review of texts and collection of experts' opinions. in  the second phase , determining the validity of items in the form of the face and content validity, in the third phase , the pilot study, and in the fourth phase,instrument reliability was conducted in two ways: internal consistency and instrument stability.

A pool of 50 items was formed to design the questionnaire. After interviewing the study population and removing overlapping items, the number of items was reduced to 31 items. The results of CVR calculation showed that out of the total of 31 items, 13 items had a cutoff point less than 0.42, which were removed, and 18 items with a CVR score > 0.62 remained according to the opinion of the research team. In the face validity stage, the Impact factor < 1.5 was used as the basis for exclusion, and all the items had a high impact factor, and finally, the draft of the questionnairewas approved with the same 18 items. Cronbach's alpha coefficient was 0.88 and the internal correlation coefficient of the questionnairewas 0.93, which indicated the appropriate reliability of the questionnaire.

Based on the results of the present study, the questionnaire on "Patients' views regarding the observance of professional behavior by a specialist physician" in Iranian society has the necessary content and face validity and adequate reliability. By using this questionnaire, hospital officials can check the status of professional ethics of their specialist physician from the patients' point of view and take effective measures to eliminate the shortcomings.

Covid-19 disease with widespread prevalence in 2019 worldwide has been identified as the biggest health threat, according to the definition of the World Health Organization (WHO), especially for children. In addition, sleep disorders are one of the consequences of this emerging disease; the aim of this study was to investigate the nutrition and sleep disorders of active and inactive children during the corona pandemic.

Random multistage cluster sampling was used in four geographical regions of Iran (north, south, west and east) in this research. This study was conducted in 2021 which the questionnaires were gathered from the cities and the sample size (194 people) was determined based on G-Power 3.1 software with 95% confidence and 80% statistical power (evaluation through virtual networks and web questionnaire). The Eating Attitudes Test (EAT-26) Questionnaire, the Children's Sleep Habits Questionnaire (CSHQ), and the International Physical Activity Questionnaire (IPAQ) were used. Mann-Whitney U and T-Student tests were used to compare the two groups of active and inactive children. The significance level was considered at p≤0.05.

The results showed that in the Covid-19 pandemic, the group of active children had a better level of physical activity (energy consumption) and status compared to the inactive children (p≤0.001). Also, it was shown that girls had more nutrition disorders than boys (p≤0.05), but there was no significant difference between sleep disorders between boys and girls, and there was no significant difference between nutrition disorders in active and inactive children.

In summary, during the Covid-19 pandemic, there was no difference in eating and sleeping disorders in active and inactive children, while gender is associated with nutrition disorders in children during Corona disease and was higher in girls than boys. It is suggested that parents pay more attention to physical activity and nutrition disorders in girls during home quarantine