نشریه دانشگاه علوم پزشکی خراسان شمالی
سال چهاردهم شماره 3 (پاییز 1401)

The present study investigated the relationship between hematological parameters and clinical outcomes in COVID-19 patients.

This cross-sectional study was carried out on 293 adult patients with COVID-19 hospitalized in Imam Hassan Hospital (Bojnurd, Iran), and less than three days had passed since the onset of COVID-19 symptoms. Patients information, including demographic information, clinical characteristics, and clinical outcomes, were obtained from electronic medical records. The results related to the complete blood count test for each patient were also recorded.

The median age of patients was 53 years, and 147(50.17%) were female. Thirty-seven patients were admitted to the ICU, and 42 patients died. The mean of hematological parameters, except neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and erythrocyte sedimentation rate (ESR), in COVID-19 patients were within the normal range. We found that values of white blood count (WBC), NLR, and PLR in patients who died or were admitted to the ICU were significantly higher than in patients who were not admitted to ICU (P˂0.05). Moreover, our results indicated hemoglobin, hematocrit, and ESR levels were lower in patients who died than in patients who were not admitted to ICU (P˂0.05). No significant relationship was found between hematological parameters and the length of hospital stay in patients with COVID-19 (P˃0.05).

The obtained results suggest that increased values of some hematological parameters, including WBC, NLR, and PLR, at the time of admission might predict poor clinical outcomes in COVID-19 patients

Holding a post-exam feedback session may help with learning and training retention. Therefore, the present study was conducted to investigate the effectiveness of the implementation of the post-exam feedback process in the biochemistry course with an evaluation approach for learning.

This cross-sectional study was conducted on 127 students of North Khorasan University of Medical Sciences, Bojnourd, Iran. Sampling was performed by census method. Data was collected using a demographic and educational form, students' experience, satisfaction, and acceptability questionnaire from the post-exam feedback session. After completing the Biochemistry final exam at the end of the semester, the feedback session was held for two hours. Then, two weeks after this session, the aforementioned questionnaires were completed. The collected data was analyzed using SPSS (version 24), and indices of central tendency, dispersion, and frequency distribution were measured.

The mean score of satisfaction and acceptability of the post-exam feedback session was measured at 4.22 ± 0.7. The highest average score of students' experience from participating in the post-exam feedback session was related to "clarification of students' expectations," which was 4.44 ± 0.62. Moreover, the results showed that the students' experience, satisfaction, and acceptance of participating in the post-exam feedback session were higher than the expected average and optimal level.

Planning to hold a post-exam feedback process as part of the lesson plan is associated with the satisfaction and acceptance of students. It is suggested that more studies be conducted on the implementation of the post-exam feedback process after the mid-semester exams

The present study aimed to compare the effect of high-intensity interval training (HIIT), sleep regulation, and the combined method on interleukin-6 (IL-6), high-sensitivity reactive protein (hs-CRP), anaerobic capacity, and body mass index (BMI) of adolescent girls with sleep disorders.

Eighty teenage girls with sleep disorders were randomly assigned to HIIT, sleep regulation, a combination of the two (HIIT+ sleep regulation), and control groups. All girls participated in pre-test and post-test sessions for the measurements two days before and after the research process. The participants in the HIIT and combined groups underwent a HIIT training program for four weeks, three sessions per week, and the subjects in the sleep regulation and combined groups performed the sleep regulation program by extending the sleep time duration by five minutes every night.

The findings showed a significant difference between groups for the serum levels of IL-6 and hs-CRP, BMI, and anaerobic power (P<0.001). Bonferroni's post hoc test showed a significant decrease in BMI and serum levels of IL-6 and hs-CRP and a significant increase in the minimum power in the combined group compared to the other three groups (P<0.001). In addition, a significant increase in anaerobic power (peak and average power) was respectively observed in the combined and HIIT groups, compared to the sleep regulation and control groups (P<0.001).

The HIIT+ sleep regulation combined intervention can be a valuable interventional treatment to improve the care of sleep disorders in adolescent girls and, consequently, reduce the problems and costs of treatment for these individuals and their families

Diagnosis of cancer is very distressing and causes a lack of control and insecurity in the suffering person. Resilience and self-efficacy are two essential support factors that can help these people; therefore, the present study aimed to compare the effectiveness of mindfulness-based schema therapy and transdiagnostic intervention in women with breast cancer on cancer self-efficacy and resilience along with a follow-up period.

The research method was quasi-experimental with a pretest-posttest design and a follow-up period of 45 days. The statistical population included female patients with breast cancer in 2019-2022 referred to Omid and Imam Reza hospitals in Mashhad, Iran. The instruments were the Cancer Self-efficacy Questionnaire of Champion et al. (2013) and the Cancer Resilience Questionnaire of Sonaga and Futavatari (2018). In total, 41 subjects were purposefully selected from the population and randomly assigned to the experimental and control groups. For the two experimental groups, the intervention was performed for 10 weekly sessions. Data analysis was performed using the repeated measures analysis of variance (ANOVA) test and Bonferroni post hoc test using the SPSS statistical software (version 25) at the significance level of 0.05.

There was a significant difference between the mean scores of the first and second experimental groups and the control group in the post-test and follow-up concerning resilience (P<0.007) and self-efficacy (P<0.01). On the other hand, there was no significant difference between transdiagnostic effectiveness and mindfulness-based schema therapy in the post-test and follow-up (P>0.05).

Based on the present findings, it is suggested to reduce the psychological problems of women with breast cancer through mindfulness-based schema therapy and transdiagnostic treatment

Methamphetamine is a stimulant of the central nervous system that is usually misused. This study aimed to determine the effects of methamphetamine on the diameter and thickness of seminiferous tubules of adult male rats’ main gonad.

Twenty adult male rats weighted 200 to 220 gr were used in the current study. They were divided into study and control groups, each consisting of 10 rats. The study group received 2 mg per body weight of methamphetamine in the first three days and 5 mg in the next four days in peritoneum. The control group, on the other hand, received 0.5 ml per rat of physiologic serum in the the peritoneum. Twenty-four hours after the last injection, the rats were killed, and the main gonad was taken out of the scrotum. After tissue passage and dying with hematoxylin and eosin, the main gonad was observed with an optic microscope, and the results were analyzed using an independent t-test. A value of P<0.05 was considered to determine the level of significance between the two groups.

The findings showed that using methamphetamine significantly decreases the average diameter and thickness of the epithelium of seminiferous tubules of rats. It was also found that the weight of rats and gonads decreased, but it was not statistically significant.

The results of this study show that methamphetamine is a poisonous compound for the main gonad of male rats due to the degeneration and atrophy of seminiferous tubules

The positive effects of exercise training in modulating cardiovascular risk factors in individuals with hypertension have been reported. The present study aimed to investigate the effects of 8 weeks of combined training and L-arginine supplementation on the serum levels of intercellular and vascular adhesion molecules (ICAM-1 and VCAM-1) and nitric oxide (NO) in postmenopausal hypertensive women.

The postmenopausal women with hypertension were assigned into four groups consisting of 12 individuals, including placebo (P), L-arginine (L), training (T), and training+Larginine (TL) groups. The combined training program (resistance-endurance) was conducted 3 sessions per week for 8 weeks. The L-arginine ingestion was 6 g daily. Blood sampling was performed at the beginning and the end of 8 weeks of intervention, and the levels of ICAM-1, VCAM-1, and NO were measured. The collected data were analyzed in SPPSS software (version 24), one-way ANOVA, and Tukey post hoc test.

The levels of ICAM-1 and VCAM-1 in the T and TL groups compared to the P and L groups significantly decreased (P<0.05). Significant increases of NO levels in the L (P=0.003), T (P<0.001), and TL (P<0.001) groups compared to the P group, and also a significant decrease in systolic and diastolic blood pressure were observed in all intervention groups in comparison to the P group (P<0.05).

Based on the findings of the present study, L-arginine ingestion and combined training alone or combined together are effective in the reduction of blood pressure in hypertensive patients. Moreover, L-arginine was associated with amplifying combined training effectiveness in decreasing systolic blood pressure. Blood pressure reduction in the above-mentioned groups is probably exerted partly by the upregulation of NO levels

Trust is among the social determinants of health in the elderly. Considering the importance of trust, this study was conducted to investigate demographic, economic, social, and health factors affecting trust in the elderly over 60 years old.

This cross-sectional study was based on the data of the second phase of the Urban Health Equity and Response Tool (Urban HERAT-2) on 5,760 elderly people. The economic status of the household was measured by principal component analysis and based on the variables of living supplies and facilities. Then, demographic and socio-economic variables such as the economic score of the household, ethnicity, occupation, education, and self-reported physical and mental health were presented in the linear regression of the explanatory model of trust using STATA software.

Based on the findings of this study, The living supplies and facilities explained 0.58 of the variances of the economic score of the household. Furthermore, it was observed that being married, having seasonal and permanent labor jobs, and being relatively poor was associated with a decrease in trust in the elderly and the ability to read and write, good self-reported physical health, and unchanged with an increase in trust in the elderly. The variables of age, gender, retirement, ethnicity, and mental health were not related to trust in the elderly.

The variables such as labor jobs, low education, and poor economic status affected trust in the elderly. The findings of this study showed the lack of institutional and intergroup trust in the elderly, and it requires the attention of policymakers

Diabetes is currently the sixth cause of death and has no definitive cure. Therefore, it is essential to focus on patients’ awareness and education. This study aimed to determine the effectiveness of a specifically designed integrated web-based self-care protocol on health-related quality of life, mental well-being, and blood sugar in type 2 diabetic patients.

The present study followed a pretest-posttest design with a control group. Of patients with type 2 diabetes referred to the Diabetes Society of Tehran (Tehran, Iran), 64 were selected and randomly assigned to the two groups. The experimental group attended five one-hour treatment sessions on the Internet. Data were collected by administering the Self-Care Summary Questionnaire, Diabetes Dependent Quality of Life Scale, and Psychological Welfare Questionnaire before and after the treatment. Collected data were analyzed using Multivariate Analysis of Covariance (MANCOVA).

The results showed a significant difference between the two groups in the level of blood sugar (F=4.35), well-being (F=14.24), quality of life (F=52.63), and self-care (F=68.54) at the significance level of 0.001.

Considering the importance of self-care education and mobile (virtual) health, it is recommended that web-based self-care treatments are utilized for controlling diabetes

Medicinal plants have played a major role in the treatment of multiple diseases for centuries. Ziziphora clinopodioides is one of these plants with well-known antibacterial properties. The present study aimed to investigate the antibacterial effects of Z. Clinopodioides essential oil and nanoemulsion.

After preparing and collecting the plant in spring, the samples were dried in the shade and transferred to the laboratory. Thereafter, the essential oil was extracted by Clevenger. Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus were used to determine antibacterial properties.

Pulegone had the highest composition (44.49%) of essential oil. Particle size in 5% nanoemulsion of Z. Clinopodioides essential oil was 13.0 nm. The results demonstrated that considering the diameter zone of the no-growth, there was no significant difference between 5% nanoemulsion and 5% Z. Clinopodioides essential oil in both gram-positive and gram-negative bacteria.

Nanoemulsion containing essential oil showed no significant difference in antibacterial activity compared to essential oils

Research efforts for early prediction of COVID-19 are still ongoing. This study aimed to introduce an index for predicting lung involvement in hypertensive patients with COVID-19.

All hypertensive patients with COVID-19 who were hospitalized in the intensive care unit of Imam Sajjad Hospital in Tabriz, Iran, from February 1400 to May 1401 comprised the statistical population of this study, who were selected as the statistical sample by the census. The vitamin D concentration, C-reactive protein, and L-cysteine levels in serum were determined by the ELISA technique. An independent t-test was used to analyze the differences between groups. In addition, the C-reactive protein to L-cysteine ratio was calculated in both groups. A P-value of less than 0.05 was considered statistically significant.

All hypertensive patients with COVID-19 admitted to the intensive care unit had lung involvement of > 50% and vitamin D deficiency of < 20 ng/ml. The Vitamin D concentration was > 26 ng/ml in healthy individuals. The findings showed hypertensive patients with COVID-19 had significantly higher levels of C-reactive protein, L-cysteine, and C-reactive protein to L-cysteine ratio than healthy individuals (P≤0.005).

The ratio of C-reactive protein to L-cysteine and vitamin D deficiency could better predict lung involvement in hypertensive patients with COVID-19

The reduction of inequality in the utilization of resources and facilities of society is considered one of the most important criteria of development. The present study aimed to investigate equality in the distribution of human resources in the health sector in North Khorasan province (by the Gini coefficient and Lorenz curve) in 2020.

This study was conducted based on a descriptive-analytical design. The study population included human resources in the health sector. Data were collected from the national portal of the Statistical Center of Iran and the population yearbook of the province using a researcher-made form. Data were analyzed in STATA (version 12) and DASP (version 2.2) software packages.

For every 10,000 people, 55.3 human resources were working in the health sector of North Khorasan province. Human health resources are distributed equally in this province. The Gini coefficient for all human health resources, except nurses and specialists, was less than 0.2, indicating complete equality in the distribution of resources. The lowest coefficient value was related to general practitioners (0.052), and the highest Gini coefficient pertained to specialized physicians (0.422), pointing to a relative inequality in the distribution of specialized physicians.

The removal of inequalities in human resources in the health sector in different regions can result in the promotion of equality in health outcomes. Therefore, it is suggested that policymakers and senior health system managers take effective measures to improve justice in access to human resources

Semaphorin 3C (Sema3C) is a relatively new and lesser-known adipokine. Recent studies have demonstrated that the class 3 semaphorin subfamilies have the most significant role in metabolic disorders. Therefore, the present study aimed to investigate the effect of obesity on skeletal muscle Sema3C levels in male and female Wistar rats.

In this experimental study, 12 male and female 8-week-old Wistar rats with a mean weight of 138 ± 13.60 gr were randomly assigned to two groups of six: non-obese (three males and three females) and Obese (three males and three females). The rats were dissected after eight weeks of induction of obesity and 18-20 hours of fasting, and their skeletal muscle tissue was rapidly removed and frozen. The sema3C level of skeletal muscle was measured by ELISA. Data were analyzed in SPSS software (version 21) using a two-way ANOVA test at a significance level of P≤0.0. In addition, the effect of obesity intervention was investigated in male and female rats separately.

Based on the results of the present study, the level of Sema3C in male and female rats in the obese group increased; nonetheless, it was not significant (P≥0.05). Moreover, Lee's index did not change significantly in male and female rats in the obese group (P≥0.05).

It seems that a high-fat diet increases the level of Sema3C in skeletal muscle which can have negative effects on the whole body system considering the role of this adipokine in the spread of metabolic diseases