نشریه دانشگاه علوم پزشکی بیرجند
سال هفدهم شماره 4 (پیاپی 45، زمستان 1389)

Cerebrovascular accidents can cause multiple psychiatric disorders especially depressive mood. Results of several researches have shown the effectiveness of cognitive behavioral therapy (CBT) for depression. The aim of this study was comparison of the effects of drug therapy alone and with CBT in the post-stroke depression.

In this clinical trial, 28 female patients with post-stroke depression were randomly selected and divided into case and control groups. Patients in the case group received CBT with drug therapy, and the control group received antidepressant drugs alone. Beck depression test was used to compare the recovery rate of depression in both groups after treatment interventions. Data were analyzed by means of SPSS version 15 using statistical tests of Student-t, fisher and ANOVA at the significant level of P<0.05.

Data analysis showed that although both CBT with drug therapy (P<0.001) and drug therapy alone (P<0.001) were effective on the post-stroke depression, there was a significant difference between the two groups (P<0.001).

According to the results of this study, both drug therapy alone and combined with CBT were effective on the treatment of post-stroke depression, but the combined therapy was more effective than the drug therapy alone.

Glycyrrhiza glabra has a wide variety of therapeutic effects especially on gastrointestinal (GI) tract and its anti-spasmodic and anti-inflammatory effects have also been reported. This study was preformed to determine the effects of Glycyrrhiza glabra (D-reglis tablet) on the pain and defecation of patients with irritable bowel syndrome (IBS). In a randomized double blind clinical trial, 90 patients with IBS referred to gastrointestinal clinic of Shahrekord University of Medical Sciences were randomly selected into case and control groups. Patients in the case group received nortriptyline plus D-reglis (6 tablets in three divided doses for 8 weeks) and patients in the control group received nortriptyline and placebo. During the trial, patients were evaluated for pain severity (based on VAS grade) and defecation condition (with a questionnaire). Data were analyzed by means of SPSS, using relevant statistical tests at the significant level of P<0.05. Although the pain severity showed a decreasing trend in both the case and control groups during the 8 weeks of trial (P<0.001), there was no significant difference between the groups at all times (P>0.05). Compared to the control group, patients in the case group spent less time having normal stool (P=0.02) and more time (P=0.02) having hard stool. It seems that Glycyrrhiza glabra has no significant effect on the pain of IBS patients; however, it may improve the diarrhea or exacerbate the constipation in these patients.

Septoplasty and rhinoplasty is a common surgery that requires nasal tampon usage. The aim of this study was to compare merocel and regular (mesh or ribbon gauze) tampon regarding pain, comfort, and problems of patients after surgery. This randomized controlled clinical trial study was performed on 30 septo-rhinoplasty patients in 2009. The patients were divided into case (merocel tampon) and control (regular tampon) groups according to the odd or even days of referring. Pain was measured by VAS100 mm and comfort, nose bleeding and problems of the patients was measured by a checklist and was recorded. The data were analyzed by SPSS software (version 12) using Fisher's exact, Student-t and Mann-Whitney tests at the significance level of P<0.05. The pain in the case group (64.3±13.4) was less than the control group (83.6±14) at the time of removing the tampon (P=0.001). Moreover, discomfort feeling (P=0.01), respiratory problems and nausea (P=0.02) in the case group, was significantly less than control. No significant differences in the incidence of bleeding and other complications and problems between the two groups were observed. Although merocel tampon in comparison with regular tampon may not cause a significant decrease in the nasal bleeding, its consumption in the nasal surgery associated with less pain and more convenience for the patients.

Treatment with antibiotics is accompanied by difficulties, such as unwanted side effects and drug resistance. Medicinal plants can be considered as suitable alternative, because they may have fewer side effects. Pomegranate and bottle gourd are fruits that are easily available in many areas of the world. The current study was aimed to determine the antibacterial effect of these nutrients. In this experimental study, the antibacterial activity of whole fruit powder extract of skinless pomegranate and bottle gourd and their fruit juices, were determined by the disc plate method against six different bacterial species, including salmonella typhi, Escherichia coli, Klebsiella pneumonia, Bacillus cereus, Bacillus Subtilis and Shigella dysentery. The diameter of zone of inhibition was measured by adding the samples and tetracycline (as reference) in the culture medium containing each bacterium (at least 3 times for each sample). To compare the groups, ANOVA and Tukey's tests were used at the significant level of P<0.05. Powder extract of pomegranate (250 µg/disc) could stop the growth of the studied bacteria (except Bacillus Subtilis) mildly, whereas the fruit juices of pomegranate and bottle gourd and the powder extract of bottle gourd did not show antibacterial activity. The mild antibacterial activity of powder extract of pomegranate may be related to its more polyphenolic compounds compared to bottle gourd

The level of fatty acids in human diets, affecting the atherogenic and thrombogenic indices, which has an important role in the function and healthiness of cardiovascular system. Due to high level of cholesterol, eggs are risky regimen for cardiovascular patients. This study was conducted to modify the composition of layer ration for reducing the risk of cardiovascular disease resulting form consumption of eggs.

In this experimental study. 288 Leghorn hens were selected to 12 groups, receiving different level of linseed, safflower seed, palm olein oil and fish oil in the rations and control group. After three 28-day periods, level of blood cholesterol of hens and also level of cholesterol and fatty acids of egg yolks were evaluated.

The cholesterol and saturated fatty acid concentrations of yolks did not significantly change (P>0.05). Omega-9 and omega-6 fatty acids increased in the groups that were fed with palm olein oil and safflower see, respectively. Linolenic acid and long chain omega-3 fatty acids were higher in linseed and fish oil groups, respectively (P<0.05). The atherogenic (AI) and thrombogenic indices (TI) decreased significantly in higher level of these rations compare to control group. The highest amount of TI was observed with high level of safflower seed rations. The lowest amount of AI and TI were obtained in the fish oil and linseed rations (P<0.05).

Modifying the level of fatty acids in the rations of hens, may introduce the egg as a good and safe source of protein for the cardiovascular patients.

Controlled ovarian stimulation (COS) using gonadotropin is an important technique in the infertility and genetics research. The effect of hCG on development of ovarian follicles of Balb/c race mouse was studied in this investigation. In this experimental study, 30 virgin female Balb/c mice (21 days) were selected and divided into three groups of control, sham exposed (0.1ccNormal saline) and experimental group (0.1cc hCG 5IU/ml). The Mice were scarified 18 hours later by chloroform injection, and their ovaries were removed for morphometric and histological studies and the weight and size were recorded. The number of primary, secondary, growing and early antral follicles were determined and compared for each sample by light microscopy. The data were analyzed by means of SPSS software using ANOVA and Kolmogorov-Smirnov tests at the significant level of P<0.05. There was no significant difference in the size of ovary, the average number of primary and secondary follicle among the 3 groups of mice (P>0.05). The administration of hCG caused a significant increase in ovarian weight and the average number of growing and early antral follicles compared with control and sham exposed groups (P=0.001). The results of this study indicate that the effect of hCG hormone on ovarian follicles growth rate, is higher in end-stages of development.

Febrile convulsion (FC) is the most common seizure disorder in childhood and a common cause of admission in pediatric hospitals. The present study was conducted to determine the characteristics of febrile convulsion in children. In this cross-sectional study, all children (9 months to 6 years old) that were admitted with the diagnosis of seizure in pediatric department of Valiasr hospital of Birjand, during one year (March 2007 to 2008) were studied. The obtained data was analyzed by means of SPSS software (version 11) applying chi-square at the significant level of α=0.05. Out of 145 children with seizure, 102 cases (70.3%) had FC and 43(19.7%) had other causes. Mean age of children with FC was 25.5±18.6 months. FC was more prevalent in the boys than girls (58.8% vs. 41.2%). The most common types of seizure were simple FC (61.8%) and complex FC (38.2%). Generalized tonic-clonic seizure was the most common form (90.2%). The most common underlying causes were respiratory infections (45.1%), followed by gastroenteritis (21.6%). There was no significant correlation between age, sex and the type of seizure. Simple FC was more prevalent in children with the positive family history of this type of seizure. Majority (74.5%) of children were referred with the first attack of FC. The epidemiological and clinical characteristics of FC in our study were similar to other studies in other places, although the incidence of complex FC was considerable that require a more serious approach.

Despite improving therapeutic methods of lumbosacral disc herniation, open surgery is still the conventional method. This study was aimed to investigate the recurrence rate and risk factors of lumbar disc herniation after open surgery and comparison of clinical outcomes of second surgery with the first surgery. This prospective descriptive study was performed on patients with disc herniation surgery during 5 years (March 2003 to 2008). The questionnaires including personal information, clinical findings and neurological examination were completed for all patients before and after surgery. Pain intensity and function of patient were evaluated by visual analogue scale (VAS) and MODQ respectively. Data were analyzed by mean of SPSS software (version 12) and appropriate statistical test at the significant level of P<0.05. In this study, 844 patients with mean follow-up period of 38±8 month were studied. The most common complaints and signs of the patients were Low back pain, sciatalgia and positive SLR respectively. Recurrence of symptoms was confirmed by MRI in 16 patients (1.89%). Relapse risk factors were sex, age, smoking and spine trauma. Comparison of pain severity and function rate in group with primary hernia (86.7% and 21.2 respectively) with recurrent group (85.7% and 21.1 respectively) showed no significant difference (P>0.05). While this study, determined the incidence of recurrent disk herniation, it showed that the results of the second surgery were satisfactory and the complications is not more than the first surgery.

Early diagnosis of cancer warning signs and the necessary actions can be an effective step in prevention of cancer and its progression toward advanced stages of disease. The present study, as the first comprehensive research, investigated the knowledge level of the warning signs of cancer and its correlated determinants in Tehran inhabitants. This cross-sectional study was conducted in 2007 on people aged above 18 years living in Tehran and Suburbs. Data were collected by means of questionnaires from 2500 persons who were selected through multi-stage cluster sampling. In this study, knowledge, considered as a latent response variable based on the knowledge of persons about each of the nine warning signs of cancer, which was evaluated by generalized latent class regression model. Moreover the factors affecting the level of knowledge were assessed. The analysis was done be means of Latent Gold software. A small portion of respondents (18.82%) had high knowledge about warning signs of cancer and more respondents had moderate (54.49%) or low (26.69%) knowledge level. The most important determinants of level of knowledge were education level, gender and marital status. This study showed that the overall level of knowledge and recognition of warning signs of cancer is low in the studied population. The obtained data about level of knowledge and its effective factors are useful in developing programs of cancer prevention, especially in the field of health education.

Assertiveness is considered as one of the important factors of success in inter-personal relationships. Weakness in this ability causes to increase stress and results in impaired mental health. On the other hand, previous studies show the effect of assertiveness on educational and career success. The purpose of this study was to investigate the effect of assertiveness training on self-esteem and depression in students of Isfahan University of medical sciences. This experimental study, as pre- and post-test with a control group, was conducted in the academic year of 2009-2010. Forty students were selected through randomized cluster sampling into case and control groups (10 female and 10 men for each group). The assertiveness training program was used in case group for 8 sessions. The Ellis Pop esteem test and Beck depression questionnaire were used to evaluate the variables before and after training. The collected data were analyzed by means of SPSS (version 16) using MANCOVA and t tests, at the significant level of P<0.05. The assertiveness training caused a significant increase in the self-esteem level and decrease in the depression rate in case group (P=0.001 for both); but this effect was not seen in control group (P>0/05). Training the assertiveness skills can be used as a method to improve the mental health of students of medical sciences.

Respecting the clients is an important element for every successful information system. This study was done to determine the user's satisfaction rate with the services offered by the Central Library of Birjand University of Medical Sciences. In this descriptive analytical study, 400 students, through systematic sampling, and other members, by means of census, were studied. A self-made questionnaire was designed based on the study goals and its content validity was approved by a number of professionals. The obtained data were analyzed by means of SPSS software using statistical tests, at the significant level of P<0. 05. Out of 696 cases studied, 53% were students, 27% were employees, 16% were faculty members and 4% were ordinary members of the library. Satisfaction rate of the users were in the order of: educational workshops (88.6%), personnel treatment (85.2%), book loaning services (84.8%), Physical and welfare facilities (82.2%), information services (65.5%), quality of sources (54.7%), quantity of sources (53.4%) and references and journals (51.6%). Faculty members had the highest mean satisfaction scores regarding book loaning services, references and journals, physical and welfare facilities, educational workshops, and personnel treatment. The working period of the library was appropriate for %76.7 of the library users. Student's satisfaction was significantly lower than other users in most of the fields (P<0.01). The average satisfaction rate of Central Library's members in most of the aspects was high. In order to improve the quantity and quality of the library services, it is suggested that the library activity hours, number and period of the source's loaning, number of the computers and period of using the Internet be increased.