نشریه دانشگاه علوم پزشکی خراسان شمالی
سال چهارم شماره 2 (تابستان 1391)

Nowadays diabetes is considered a risk factor of nephrolithiasis and the prevalence of uric acid stones has been reported to be higher in diabetic patients. Disorders in kidney aminogenes in diabetic patients result in reduction of urine pH that facilitates the formation of urinary tract stones. Methods & Materials: This study was performed on 210 Patients aged 30-70 with urinary tract stones referring to outpatient clinics of Ghaem hospital and medical center. These patients were evaluated for having overt diabetes. Laboratory tests was performed before hospitalization for surgery.. The removed stones had biochemical analysis. From 210 patients under study، 73 females and 137 males had a mean age of 11. 1 ± 44. 9. Patients with fasting glucose levels over 126 mg/dL were considered to have diabetes. 28 patients were identified as being diabetic (13. 3%). Stones were composed of calcium (66. 7%)، uric acid (26. 7%)، and struvite (6. 7%). prevalence of females with diabetes was more than males. However، the age and anthropometric and serum biochemistry profile in both groups were similar. The mean serum acid uric level and 24-hour urine uric acid test was higher in diabetic patients. The prevalence of acid uric stones was significantly higher in diabetic patients. Diabetes is a risk factor for urinary tract stones، especially uric acid stones.

Saleint decrease in physical activity، including problems that are frequently observed in hemodialysis patients. Inversely، the performance level of hemodialysis patients related to with major health consequences such as health care costs and mortality. This study determined the Effect of Care Plan Based on the ROY ADAPTATION MODEL on Activities of Daily Living of hemodialysis Patients This clinical trial research was performed on 54 hemodialysis patients (28 intervention and 26 control patients). The intervention group received the RAM program through a face to face process with 4 sessions at 3- week interval followed by a follow-up period of 4 weeks، while the control group received the regular services from hospital. The data collected by using of patient identification form، Inventory of Functional Status-Dialysis and Roy assessment tool. Data were analyzed with SPSS. The results indicate that the between two groups were not different on Activities of Daily Living (p=0. 060) before the intervention but they were significantly different after the intervention. Patients’ Activities of Daily Living improved in patients in the intervention group. The findings of this study indicate that the Care Plan Based on the ROY ADAPTATION MODEL is a low cost nursing intervention for Activities of Daily Living improved in Hemodialysis Patients.

Heavy metal pollution of the environment on a global scale is a problem now. heavy metals due to the chemical stability، low flexibility and power of bio-accumulate in the body organism are quickly becoming toxic pollutants. Therefore purpose of this study survey heavy metal concentration and comparing the results with national and international standards and also health risk assessment in carcinogenicity and noncarcinogenicity took in the Ali Abad Katoul region. This research was performed with temporary description method in 2009 autumn and 2010 spring. During this research have been chosen about 36 samples from 6 wells that supply drinking water to rural and heavy metal (arsenic، lead، Zinc، chromium، cadmium) was measured based on method standard 1988 with atomic absorbtion. also the human health risk assessment was measured by using the criteria of the enviromental protection Agency (EPA). Heavy metal concentrations average in autumn Zn=0. 0143، Pb=0. 0060،Cr=0. 0025، As=0. 0022، Cd=0. 00 and in spring Zn=0. 0045، Pb=0. 0066، Cr=0. 0023، As=0. 0009، Cd=0. 00 mg/l was obtanied. The results showed there is not any statistically significant differences between concentrations of heavy metals in national and international standards. Results of health risk assessment of heavy metals for residents uring the period was measured، for carcinogenicity diseases 2. 32 × 10-4 individual and for noncarcinogenicity diseases 2. 53 ×10-4 individual. Heavy metal results was measured and comparing them with standards showed that there is no treatment from sanitary in studied area. But with increasing population and pollution and disease It may be observed changes in the concentrations of heavy metals in future. Therefore it is essential to be continuously monitored for heavy metals.

Schizophrenia is considered as one of the most extreme mental illnesses in the area of psychiatry which is characterized by social and occupational incompetence. Support and care of these patients has always been on the part of families. The imposed burden includes physical، mental، social and economic problems being experienced by caregiver of the family. The present study aimed at investigating the burden experienced by schizophrenic patients at Imam Reza Hospital in the city of Bojnurd. This is a descriptive-analytical study conducted on 75 family caregivers visiting Imam Reza Hospital. Data collection methods included demographic questionnaire، and Zarit Questionnaire which measured degree of experienced burden by caregivers. Reliability and validity of both questionnaires had already been established. Then، data were fed into SPSS 14 for analysis. 12. 2% of caregivers experienced low burden، 36. 4% average burden، and 51. 5% high burden. The perceived burden among women was significantly higher (P=0. 003) than that of men. There was significant relationship (p=0. 03) between the obtained score of caregiving and age of caregivers while the relationship between caregiving score and age of patients was not significant (p>0. 05) but was negative. Younger patients imposed higher burden on the caregivers. Taking care of schizophrenic patients put immense pressure on family especially on caregivers. Therefore، it can be said that the mental pressure imposed by such patients threatens caregivers'' mental health، hence reduction in quality of care and support. Consequently، family centered programs are recommended for decreasing the burden incurred by schizophrenic patients.

Gestational diabetes mellitus (GDM) is a state of glucose intolerance that is diagnosed during pregnancy. Maternal GDM increases the risk of some complications in children، which includes macrosomia and the risk of cardiovascular and renal disorders. The purpose of the present study was to investigate the outcomes of gestational diabetes on progenies in an experimental rat model. Female pregnant rats were randomly divided into 4 groups: intact control، sham، diabetics treated with streptozotocin (STZ، 50 mg/kg)، and gestational diabetics treated with hypertonic glucose (2g/kg) and medroxyprogesterone (3mg/kg) (GM). On postnatal day 1، the weights of several organs such as، kidney and heart، as well as body weight of progenies were measured. Furtheremore، some histological studies were performed on the heart and kidney tissues، and several parameters such as total heart volume، cardiac ventricle volume، wall thickness of aorta، renal cortical volume and total number of glomeruli in each kidney were determined. The average body weight of progenies in STZ group was significantly higher than control (P<0. 001)، sham (P<0. 05) and GM (P<0. 001) groups. The body weight of progenies in GM group was lower than sham group (P<0. 01). A significant decrease was observed in the kidney weight of progenies in GM group in comparison to sham (P<0. 05). Histological analysis on the tissues showed no significant difference between groups. Our findings suggest that the hyperglycemic pregnant rat model is a reliable model for gestational diabetes in human. In addition، induction of STZ diabetes or hyperglycemia in pregnant rats lead to some changes in body or organ weights of progenies، however، it does not induce structural changes in various tissues.

Because of the main effects of stress on human communication، having a spouse with PTSD disorder can increase marital conflicts. So، this study done with the purpose of survey of effectiveness of coping with stress strategies training on decreasing marital conflicts among combat-related PTSD patient’s wives. In this study 30 persons among wives of combat veterans with PTSD diagnosis are chosen with random selection، and they placed in two groups in random; experimental group and control group. Experimental group had received coping with stress strategies training in 12 sessions، and they filled marital conflict’s questionnaire before and after the intervention. Data analyzed with analysis of covariance test and by the SPSS 17، the significance level considered 0. 01. The result shows there is a significant difference between experimental and control groups. Training coping with stress strategies to combat veterans with PTSD’s wives is effective in decreasing their marital conflicts.

neonatal Sepsis is one of the most important and common disease in infancy which caused by bacterial infection، in this study clinical and laboratory findings of neonatal sepsis in pediatric ward at Ghaem hospital in Mashhad. It was a descriptive-analytical study which performed on 186 neonate who suspected to sepsis in pediatric ward at Ghaem hospital in Mashhad from 1385 to 1388. Data was collected from records of patients and was analyzed with Excels and SPSS 16. in this study Male to female ratio was 2:1. Mean age of admission was 8. 1 days. Poor feeding and fever were most common complains. Other common findings were hyporeflexia، respiratory distress، hypothermia and convulsion. Klebssiela pneumonia was the most common organism of sepsis. Information Strong suspicion to sepsis especially in a neonate who suffers from fever or poor feeding can lead to early diagnosis and treatment of neonatal sepsis and result decrement in neonatal mortality rate

European Foundation for Quality Management has designed the EFQM Model to determine the rate of organization development and excellence and construct ways to achieve organizational excellence. Self-assessment based on EFQM model provides the opportunity for managers to move on the path to excellence Status of their organization and the findings resulting take action to improve its This cross-sectional study was conducted in 2011 in Bujnord.. The research population are comprised from 28 employees Quality improvement committee in Imam Ali and Imam Reza Hospital. Data was collected by self- assessment Standard and valid questionnaire of EFQM. Date analyzed using chi – square and descriptive tests by Spss16 software. In the enabling criteria this hospital has obtained a score of 360 (of 500): [71/2 % of the desired level]. In terms of the results criteria it has gained a score of 335/5 (of 500) [65/5 % of the desired level]. As a whole، this hospital has obtained 695/5 point [of a total of score 1000]. Although the EFQM scores rated by hospital employees seems unrealistic to some extent، but considering the results can improved the hospital managers’ view، confirm that the people results and key performance results criteria need pay more attention to improved

Depression associate with increase severity of illness، length of hospitalization and mortality in heart failure patient''s. The aim of this study was to investigate the frequency and related factors of depression in male systolic heart failure patients. This is a cross sectional study that was conducted on 100 male patients with systolic heart failure in Alborz of Karaj and Shahriar Social Security Hospitals in 2010. Sampling method in this study was Convenience sampling. Data collected by demographic data form، MLHFQ (Minnesota Living with Heart Failure Questionnaire)، (CES-D) Center for Epidemiologic Studies Depression Scale. Data was analyzed by SPSS software version 18 and using descriptive statistics، t-test، ANOVA and coefficient Pearson correlation. The findings indicated that mean score of depression was 20. 3±12. 47% had severe and 16% had mild to moderate depression. Depression significant associated with age (p=0. 002)، education (p<0. 001)، economic status (p=0. 002)، smoking (p=0. 034)، hemoglobin level (p=0. 004)، left ventricular ejection fraction (p=0. 012)، use of digoxin (p=0. 019)، angiotensin receptor blocker (ARB) (p=0. 005)، aldacton (p=0. 005) and quality of life (p<0. 001). Depression was common among men with systolic heart failure and had negative impact on quality of life. Nurses by screening and assessment symptoms of depression and refer patients for counseling and treatment can help to improve quality of life in heart failure patient.

Sleepiness is not only as a sign of sleep disorders، But as a normal physiological experienced by most people in any period of 24 hours. This study investigated the relationship between sleepiness and general health of shift workers have been working in the automotive industry. In this study، a descriptive - analytic study was done A total of 120 workers employed in the automobile industry in Tehran were studied. The number 60 in the morning and the rest to be rotated constantly working the night shift. Number of samples were selected by simple sampling. Data in this study، the 28-item General Health Questionnaire (GHQ) and the Stanford sleepiness scale to assess the degree of Sleepiness. The mean age of the constant shifts in the morning (5/55 31/16 ± years) and for night shift (7/29 31/83 ± years). Also، 80% of the study population were married، and 5/77% of them were smokers. Pearson test showed that between shift work and Sleepiness at 4 am، there is a direct relationship (P-value=0. 02). T - test showed (P-value =0. 03) Sleepiness rates at 12 o''clock at night، In married ones is higher than singles Shifts and Sleepiness has negative effect on public health workers In automobile industry And can be used In administrative planning And married people to apply for jobs and dropout prevention will eventually lead to keeping health staffs.

In short memory، hippocampus has an important role. Hippocampus is one of the regions of brain which neurogenesis has been shown in adults. In the present study، effect of ethanol on histological structure of dentate gyrus (DG) in epileptic mice was investigated. in this experimental study، mice (25-30g) during chemical kindling (pentylentetrazol; 40 mg/kg) received ethanol (0. 5، 1 and 2 g/kg body weight) intraperitoneally. After treatment period، hippocampus and DG was dissected out. Histological passage and coronal cross-section was carried out in final. After Hematoxyline-stained slides forty fields random systematic (counting of normal neurons in DG) from each group by photomicroscope (Motic، X400) and Advanced motic plus2 software were studied. The mean number of normal neurons in DG of hypocampus were analyzes by ANOVA، Dunnett and Duncan. Immunohistochemical method used caspase 3 for program cell death in hypocampal neurons. Dunnett test showed the number of normal neurons in ethanol receiving groups (0. 5 g/kg، 7 or 21 days injection) has not been decreased significantly different in comparison with control group (p=0. 41 and p=0. 07 respectively). The number of normal neurons in groups which received ethanol 1g/kg (7 or 21 days injection) has been decreased significantly different in comparison with control group (p=0. 014 and p=0. 007 respectively). This parameter is also different between ethanol 2g/kg group and control group (p<0. 001). The apoptosis of hypocampal neurons in groups which received high dose of ethanol 2 g/kg greater. decreasing of the number of normal neurons in DG hippocampus has right relationship with increasing dosage and duration of ethanol usage in epileptic mice

Amygdal is a subcortical nucleus of limbic system that has a pivotal role in behavioral، vegetative and endocrine activities. Sexual dimporphism in some amygdale nuclei have been investigated. The aim of this study was to answer this query: does the total volume of amygdale nucleus differ in two sex morphometrically? This study was conducted on Adult wistar rats (male and female N=10 per group، 8weeks old، weight 240-260 gr). Brains were removed and fixed in formalin 10% and in 10 µm sections were prepared by microtome. After staining with cresyl violet 1% the boundary of amygdal was defined and its volume calculated with cavalieri method The volume of amygdala nucleus was estimated 2. 07 ± 0. 12mm3 in male rats and 1. 57± 0. 11 mm3 in female rats (P<0. 05). Based on our finding the total volume of amygdala nucleus in male rats is larger than those of female rats that suggest the sexual dimorphism of amygdala nucleus between tow genders. These findings may have implications for developmental studies dimorphisms in human amygdala.

The purpose of the present study was to examine the effects of three treating methods (behavioral mother training، Verbal self-instruction to the children، and pharmacotherapy) in children with attention deficit-hyperactivity disorder on maternal mental health changes. In this semi-experimental study، 95 of mothers with ADHD children were selected by multi-stage sampling and accessible sampling and divided to four groups; Mother Behavioral training group، Verbal Self-instruction، pharmacotherapy and Control group. Data collection tool was General Health Questionnaire (GHQ). All of the groups were evaluated after the intervention in post-test and also 2 months later in follow up. Finally، data were analyzed using SPSS (ver15) and General linear models and Bonferroni post hoc test. Significant declines were observed in behavioral mother training group and pharmacotherapy in post test (respectively P=0. 04، P=0. 007)، and follow up (P=0. 002). In the verbal self-instruction and control groups، there were no significant differences in scores of maternal mental health among the pre test، post test and follow up. The behavioral mother training and pharmacotherapy treatment for ADHD can improve the maternal mental health.

Since the incidence rate of colon carcinoma is growing significantly and natural products and medicinal plants are widely used in cancer treatment، the cytotoxic effects of two unstudied medicinal plants have been studied.

Different concentration of the hexane، chloroform and ethanol fractions of Uvaria grandiflora Roxb. (leaves and stem barks) and Diospyros wallichii King&Gamble. (fruits and stem barks) were subjected to cytotoxic investigation against HTC-116 cell line by using MTT technique. In this study، quercetin was used as a positive control.

The chloroform fraction of Uvaria grandiflora Roxb. stem barks and the chloroform fraction of Diospyros wallichii King&Gamble. Fruits exhibit the highest growth inhibiting activities among all the tested samples with the GI50 value of 3. 85 µg/ml and 4. 58 µg/ml، respectively.

From the obtained results، it was concluded that the Naphthoquinones derivatives from Diospyros wallichii and Flavonoids from Uvaria grandiflora are responsible for pharmacological and biological activities. Therefore، more investigations and isolations are recommended.

The aim of the study was first to translate the Kidney Disease Quality of Life Short Form KDQOL-SF (version 1. 3 (Questionnaire into Iranian and then to assess it in terms of validity and reliability on Iranian patients. The questionnaire was first translated into Farsi by two independent translators، and then subsequently translated back into English. An initial test-retest reliability evaluation was performed on a sample of 20 patients from the total group (212 patients with end stage renal disease)، over a ten day interval. Afterwards، reliability was estimated by internal consistency and validity was assessed using known group comparison and construct validity on the patient group as a whole. Finally، the factor structure of the questionnaire was extracted by performing exploratory factor analysis (EFA (. All of the scales in the questionnaire showed good test–retest reliability(all above 0. 7(. All of the items met the minimal criteria (i. e. 0. 7 (for internal consistency and Cronbach''s α ranged from 0. 73 to 0. 93. To test construct validity، we examined correlations of the kidney disease targeted scales and overall health rating scale. The majority of items correlated significantly with the overall health rating. Furthermore، results from a discriminate validity evaluation showed that the questionnaire could be used to discriminate between subgroups of the patients. Finally، a principal component analysis of the disease specific scales indicated that this part of the questionnaire could be summarized into a two-factor structure (disease burden and patient satisfaction (that jointly accounted for 63 % of the variance. The Iranian version of the KDQOL-SF questionnaire is both highly reliable and valid for use with Iranian ESRD patients.

Considering the high application of diagnostic tests in medical practice، understanding the concept of diagnostic test evaluation indices is highly important. Ability of test in distinguishing healthy subjects from patients is evaluated by sensitivity، specificity، positive predictive value (PPV)، negative predictive value (NPV). Although their understanding is relatively straightforward، they are often used mistakenly or interchangeably. We have tried to present these concepts utilizing the diagrams to make it easier to understand and remember. we used diagrams to illustrate the concept of diagnostic indexes. Then we showed the effect of change of prevalence of disease in these indexes. Sensitivity and specificity are not sensitive to the prevalence of disease in the population. On the other hand positive predicted value increase when the prevalence of disease increase and negative predictive value increase when the prevalence of disease decreases. Although it has been shown that sensitivity and specificity are essential in evaluation of accuracy in diagnostic tests، their ability to discover the degree of confidence is limited، so the predictive values is used to indicate the posterior probability of disease after observing the test results. It should be considered that predictive values are dependent upon the prevalence of disease in population and should not be generalized for different populations with different prevalence of diseases.

Primary neoplastic lesions presenting with a mucocele of the Appendix are very rare and can be divided in to benign variant of mucinous adenomas or cyst adenomas، mucinous tumours of uncertain malignant potential or mucinous cyst adenocarcinomas. Most of these tumors are asymptomatic and are found incidentally or by symptoms of simple appendicitis. We describe an unusual presentation of pseudomyxoma peritonei (the major complication of neoplastic mucinous appendiceal tumor) with urologic symptoms.