نشریه دانشگاه علوم پزشکی خراسان شمالی
سال پنجم شماره 4 (زمستان 1392)

Multiple sclerosis (MS) is a complex disease in the central nervous system (CNS) and the most common inflammatory and degenerative disease in young adults. Most studies have shown that, vitamin D may interfere with the pathophysiology of MS within the CNS. CYP27B1 gene encodes the enzyme that catalyses the formation of the biological active metabolite 1,25(OH)2D form the abundant metabolite 25(OH)D. CYP27B1 is expressed on a variety of cells including neurons, glial cells and invaded lymphocytes. In this study we reviewed some different and new articles about the role of Vitamin D in MS. Then we selected the specific and the most recent data in this field. Among the multiple recently discovered actions of vitamin D, an immunomodulatory role has been documented in experimental autoimmune and in humans system like the central nervous system, pancreas. Furthermore, some clinical findings already strongly suggest that vitamin D status influences the relapse rate in MS and cancer. Our results suggest that beside the role of vitamin D in the relapse rate and radiological lesions in Iranian patients with MS In fact, many genetic and environmental risk factors like vitamin D appear to interact and contribute to MS, especially in young woman. As well as, they can serve as biomarkers to evaluate disease progression and therapeutic efforts.

Lack of efficient wastewater management and letting out untreated sewage into the environment demonstrates the need for efficient wastewater management to prevent harmful effects for health and environment. Hence, efficient wastewater management is one of the most important environmental issues. It is not possible to evaluate efficiency of treatment system without perception of efficiency of the system. In this study performance of wastewater treatment plant of Bojnurd was evaluated and surveyed. This is a descriptive sectional study. Efficiency of activated sludge treatment system in removal of organic matter and nutrients was assessed. For this purpose samples were taken twice a month from two areas of the system during 6 months and the amount of removed organic matter and nutrients was measured by COD, BOD, Nitrate, Nitrite and total phosphorus test. Then the results were analyzed by statistical analysis. Average concentration of COD in inlet and outlet was 503 and 177.35 mg/L respectively and BOD was 58.29 and 28.82 respectively. For nutrients average amount of nitrate in inlet and outlet was 22.67 and 7.47respectively and this amount was 0.209 and 0.15, and 22.28 and 11.45 for nitrite and total phosphorous respectively. According to the results, treatment plant of Bojnurd due to the appropriate atmospheric condition and proper design rate of organic matter and nutrient reduction reduce the pollution and is suitable to meet the standards.

Multiple sclerosis (MS) is a complex disease in the central nervous system (CNS) and the most common inflammatory and degenerative disease in young adults. Most studies have shown that, vitamin D may interfere with the pathophysiology of MS within the CNS. CYP27B1 gene encodes the enzyme that catalyses the formation of the biological active metabolite 1,25(OH)2D form the abundant metabolite 25(OH)D. CYP27B1 is expressed on a variety of cells including neurons, glial cells and invaded lymphocytes. In this study we reviewed some different and new articles about the role of Vitamin D in MS. Then we selected the specific and the most recent data in this field. Among the multiple recently discovered actions of vitamin D, an immunomodulatory role has been documented in experimental autoimmune and in humans system like the central nervous system, pancreas. Furthermore, some clinical findings already strongly suggest that vitamin D status influences the relapse rate in MS and cancer. Our results suggest that beside the role of vitamin D in the relapse rate and radiological lesions in Iranian patients with MS In fact, many genetic and environmental risk factors like vitamin D appear to interact and contribute to MS, especially in young woman. As well as, they can serve as biomarkers to evaluate disease progression and therapeutic efforts.

Multiple sclerosis (MS) is a complex disease in the central nervous system (CNS) and the most common inflammatory and degenerative disease in young adults. Most studies have shown that, vitamin D may interfere with the pathophysiology of MS within the CNS. CYP27B1 gene encodes the enzyme that catalyses the formation of the biological active metabolite 1,25(OH)2D form the abundant metabolite 25(OH)D. CYP27B1 is expressed on a variety of cells including neurons, glial cells and invaded lymphocytes. In this study we reviewed some different and new articles about the role of Vitamin D in MS. Then we selected the specific and the most recent data in this field. Among the multiple recently discovered actions of vitamin D, an immunomodulatory role has been documented in experimental autoimmune and in humans system like the central nervous system, pancreas. Furthermore, some clinical findings already strongly suggest that vitamin D status influences the relapse rate in MS and cancer. Our results suggest that beside the role of vitamin D in the relapse rate and radiological lesions in Iranian patients with MS In fact, many genetic and environmental risk factors like vitamin D appear to interact and contribute to MS, especially in young woman. As well as, they can serve as biomarkers to evaluate disease progression and therapeutic efforts.

Nosocomial infections have increasingly resulted in death and the patients should bear high treating costs. Members of the medical team could play an important role in prevention and control of nosocomial infections. This research has been done to determine the knowledge, attitude, and practice personnel about Nosocomial Infections Control and ways to protect against them in Teaching Hospitals of Bojnurd year 1391 In this descriptive research, 140 Members of the medical team working in three hospitals in bojnurd were selected as samples. The data collection tool was a self-made questionnaire to assess knowledge and attitude and also included a behavioral check list. Content validity was established. Reliability was examined by test-retest (for knowledge and attitude section) and split-half technique (for practice section). Findings showed that 63.6% of Members of the medical team had average knowledge and 65 % had positive attitude towards nosocomial infections control. About half of Members of the medical team (55.7%) had moderate practice to control nosocomial infections. There was not a statistically significant relationship between knowledge, attitude, and practice of samples (P>0.05). Considering the average level of knowledge and practice of most Members of the medical team, paying more attention by authorities to this specific topic is essential in order to apply the necessary actions for training of the medical team.

Muscular cramps are a familiar pain that most of dentists have experienced it at some period in their job. Situation and prolonged static positions، repetitive movements، being in a situation of long duration and age are factors causing these pains. This study aims to evaluate ergonomic risk factors for musculoskeletal disorders in dentists. This descriptive – analytical study was conducted on 60 persons working at North Khorasan dental professions by REBA method in 2013. Musculoskeletal disorders data were obtained using the Nordic questionnaire. The data were analyzed by SPSS18. results showed age and experience average were 41، 15 years respectively. The level of risk was average risk level (% 78. 3) and high level of risk (% 21. 7). The prevalence of disorders for different part of the body during the past 12 months was as followed: the neck (27%)، shoulder (40%)، elbow (20%)، hands (25%)، back (30%)، lumbar (46. 7%)، hip (23. 3%)، knee (25%) and foot (11. 7%). These disorders were higher in women than man. There were significant correlation between disorders with age، work experience and employment status (p<0. 005). It is concluded that the work conditions and postures need to be improved. Procedures such as dental education on the risks of the job، doing the job properly and work plans for the rest and appropriate exercise are essential.

stress is one of the problems that can interfere with midwifery clinical training and influence their efficiency. Continuous investigation into educational stressors and managing them is essential for quality improvement of clinical education. This study aimed to identify the stressors of clinical training in midwifery students of North Khorasan University of Medical Scieneces (2011). In this cross sectional- analytic study 51 students in the second academic year were selected. Data were collected through a questionnaire 72-item containing eight domains. Data were analyzed with SPSS (Ver. 16) software. 60.5% of students experienced average tension, and 25.6% relatively high tension. Students reported the “communication with patient” as the main source of tension while other domains were reported as causing average tension. since tension can impose adverse effects on clinical education, it is and increasing technical and professional knowledge.

Evaluation of oral health is one of the main criteria in public health assessment. Since the time of Prevalence and incidence of oral diseases were known, their prevention has been emphasized. Planning for children health is necessary to improve the society health. Programs of providing health condition in adulthood must be continued. Mother’s role is very important in the children's dental health. So, data gathering about mothers’ awareness in this area can be useful for planning health promotion. In this cross-sectional descriptive analytical study, 100 Mothers having children less than 6 years old were selected in Shirvan by stratified random sampling method. Their Demographic and Knowledge data were collected using a valid and reliable questionnaire. Data were analyzed by SPSS-19 software and presented with descriptive (Mean and Standard deviation) and analytic statistic (t-test, Correlation analysis and Analysis of Variance) The average of Mother's Awareness was13/45±3/13. The results of analyzes showed no Significant relationship between the mother's awareness and age. There was a Significant relationship between the mother's awareness and level of education, employment, economic situation of the family, habitat and number of children. (P-Value<0/05) With respect to the oral health education of mothers, especially mothers who are less socially could have an important impress on the health of children. It is recommended to raise awareness of mothers by holding educational classes, Producing and distribution of information pamphlets and brochures on oral health in health centers.

one of the most important periods of life is adolescence and puberty because it is associated with drastic physical, sexual, psychological and social changes. Teen unfamiliarity with these issues can be the foundation of many health problems and behavioral disorders. This study aimed to determine the level of knowledge and performance of girls attending high school about menstrual hygiene in Bojnurd, Iran. Material: This was a cross-sectional study of 450 female high school students were selected by a multistage sampling method. The data collection instrument was validated through consultation with a faculty researcher and reliability was assessed using Cronbach's alpha coefficient. Awareness and performance levels were rated as poor, average and good. Data collected were analyzed using software SPSS.18. The mean age of students was 14/98±1/2 and age at menarche 11/36±1/09,346 (77/9%) of students had poor, 88 patients (19/8%) moderate and 10 (2/3%) had good knowledge. Of the 184 patients (41/4%), poor performance, 232 patients (52/3%) moderate and 28 (6/3%) had a good performance level. Between parental education, mother's occupation and source of knowledge and practice, a significant relationship (p<0.05) was observed. Based on the results drawn from the conducted research, there was a correlation between the awareness of participants about the menstrual hygiene and the level of education and the occupation of mothers. Thus, continuous training programs for teachers, educators, mothers and daughters is a priority to maintain an acceptable, healthy behavior and perspective before, during and after menstrual days, in addition to eliminating the prevalent related misconceptions.

Heavy water (high solute concentration water) has been proposed as important risk factor in areas that have reserves of heavy water. The aim of this study is to determine the main cause of stone forming in Shahrod area, which is of heavy water reserved. 100 patients with urinary stone in Shahrod city were studied. History and physical exam, stone component test, blood test of complete blood count, calcium, phosphate, urate and simple urine test accurately infection, ph, crystal, and cystine were examined in all patients. 24 hour urine test in order to determine risk factors of stone forming were performed in individuals with a history of stone their family, previous stone or multiple stone.Low water intake that defined as less than 2liters urination in 24hour observed in 81 patients (81%).Low level of citrate were found in 32 patients (32%).In 11 patients (11%)) other causes of stone forming like hypercaliuria were observed. Low water intake and low level of citrate in normal diet of Shahrod city people are the main cause of stone forming in people of this area.Heavy water and hypercalciuria had no significant role in stone forming in this area.

Emotional Intelligence theory predicts a new vision about the factors that influence success in the prevention of mental and physical disorders. Previous evidence suggest that individuals with higher emotional skills in various spheres of life are superior. Since students will be influential people in society of the future, the aim of this study was determine relationship between Emotional Intelligence and general health among them. This analytical study was conducted on 235 students from the North Khorasan University of Medical Sciences. To evaluate General health and Emotional Intelligence Goldberg and Emotional Intelligence (Bar-on i) questionnaires, were used respectively. Data were analyzed by SPSS and presented with descriptive statistics، pearson correlation coefficient and Independent t-test. The results of the Pearson correlation test showed a statistically significant positive relationship between emotional intelligence and anxiety. (p= 0. 008, r= 0. 23). Also there was a positive relationship between emotional intelligence and depression. (p=0. 000, r= 0. 43). Between semester and general health as well as their level of emotional intelligence, a meaningful negative relationship was observed. (p=0. 000, r= 0. 14) Emotional intelligence can be a predictor of general health. With respect to low general health and emotional intelligence among the studied participants, and the degree of the close relationship between these two components, using medical and psychological methods of removing barriers in the development of public health and improve emotional intelligence is recommended.

between hospital wards, operating theatres are very important because of special conditions of patients such as opening of surgical sites and increases the chance of infection at internal body tissues to bacterial contamination. Therefore the purpose of this study are to evaluate the level of microbial contamination of air in Emam Ali and Bentolhoda operating theatres using passive sampling system and decrease of nosocomial infections. Method and Materials: microbial air contamination was evaluated through passive sampling using tryptone soya agar between March and May 2013. Differential tests such as catalase, oxidize, DNASE, indole, hemolysis, gram stain and motility were performed. during surgery, the mean bacterial loads recorded were 471 and 110 cfu/m2/hr in Emam Ali and Bentolhoda hospitals, respectively. Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mitis and Bacillus Subtilis were detected in most operating theatres. While environmental health management and microbal contamination in operating theatres have been ignored, they can cause disorder in recovery, spread of sickness by infections, prolonged of hospitalization and causing Spiritual and material costs.

depression is one of the disorders that occur in health care workers due to exposure to stressors such as the death of patients and can lead to impaired job performance, social relationships and interpersonal relationships. With respect to importance of depression and efficiency of staff at the hospital, this study aimed to compare the prevalence of depression in psychiatric staff with the staff in other sections of Imam Reza in BOJNURD. The population consists of hospitals staff (N=126) other than administrative Section and specialized clinic. Staffs were asked to fill out Beck Depression Inventory. The data were analyzed by SPSS. Results showed that there is no significant differences in depression scores between different parts (P =0.2).93 of the participants had Minor depression (73.8%).18 of staffs had mild depression (3.14%), 9 had moderate depression (1.7%)and 6 staffs suffered from major depression(4.8%). the results showed that there is no significant difference in depression between staffs of different parts.

Congenital heart disease is a major cause of infant mortality and its main characteristic is deviation of heart rate than normal. Heart monitoring is the basic requirement in infants with this disease. To evaluate cardiac function and behavior, the simplest method is cardiac monitoring. The aim of this study was to design and construct a wearable system with electrocardiogram signal processing for monitoring heart activity. In this study, flexible electrodes in the external layer of baby clothes were sewed and attached to the arm. One electrode was also placed in the right abdomen. Signals were continuously recorded through a serial network communication by an external personal computer. A software interface was used to display and process the signals in the computer. To validate results, the heart rate was obtained by the designed system and spo2 system. Statistical analysis was performed by using the t test in MATLAB software. In this study, 5 babies (2/2 ± 1/16-months) participated. The results show that the signal quality and the diagnostic information by the wearable system were comparable with standard systems. The mean heart rate by designed system was 130.46±6.89 and 134.06±10.32 by spo2 system. There was no significant difference in heart rate between the two systems (p<0.05). Using the wearable system can monitor cardiac activity continuously and Based on this system present a mechanism to reduce the risk of infant mortality from cardiovascular risk.

To evaluate of corrosion products in dentin after removal of old Amalgams with and without roughness Twenty Class II cavities were prepared on extracted premolars then Randomly were divided into four groups according to how they were restored. Group 1: Lightcured packable composite to establish a microleakage baseline; Group 2: A high copper Amalgam; then stored in 37C normal saline for 6 months to create amalgam corrosion products. Group 3: Identical to Group 2, but later the amalgam was replaced with composite leaving the cavity walls intact. Group 4: Identical to Group 3 except the cavity walls were extended 0.5 mm after amalgam removal prior to insertion of the composite. There are 5 specimens in each four groups for EDX analysis.Evaluation of EDX analysis was descriptive. Corrosion products were detected in Groups 1,2,3 but were not detected in Group 4. After amalgam removal, roughing dentinal walls could remove the corrosion products penetrating it.

Improper diet can cause to the increased risk of overweight or obesity in students. Considering that the pattern of change stages is a known comprehensive model in the diet, this study aimed to evaluate change stages of diet and attitude toward nutrition in students of school of Nursing and Midwifery, North Khorasan University of Medical Sciences in 2012. Methods and materials: This cross-sectional study was carried out on 300students from first to fourth year in school of Nursing and Midwifery in Bojnurd. Feeding behaviors of students were evaluated using the questionnaire of model of change stages in six areas, and interviews by trained interviewers. Data analysis was performed using SPSS software package (version19). findings showed that 27% of students were in the prethinking stage, 42% of them were in the active stage(thinking, decision making, performance, maintaining), and 17% of participants were in the return stage. A significant association was seen between change stages and sex (p=0.045), marital status (p<0.001), body mass index (p<0.001), and the field of study (p=0.033.)The mean score of attitude toward nutrition was (3.7±1.43). The results showed that change stages of nutritional behaviors were desirable in these students, and positive attitude toward nutrition was observed in them. Demographic characteristics and other factors that cause progression to a higher stage of change can be effective to plan correcting the dietary pattern and maintaining it.

Hepatitis B is a viral disease with high prevalence. Vaccination of at risk persons like medical students will preven of infection. Unfortunately immunologic response to the vaccines is not perfect sometimes and it is necessary to examine the immune response. In a cross-sectional study of 210 female students that have been vaccinated against hepatitis B at the dormitories of North Khorasan University of Medical Sciences, Bojnurd in 2013. After collecting demographic data, samplingof blood was done and antibody titer HBV was assessed by ELISA. Data were analyzed by SPSS software and presented with chi-square test. Among 210 participants, 198 completed the 3 stages of vaccination against HBV and 91.9 % of participating in the study had adequate response against hepatitis. Also, there were no significant correlation between the immunity response, diabetes, family history, living in urban or rural and marriage condition. In this study immunity against hepatitis was in acceptable level. Health education and evaluation of immune responses against hepatitis in medical staff and students is very effective. Also revaccination for persons with low titers of antibody is essential.

Qualifying the given services to the old people is affected by several factors and one of them is nurses’ attitudes toward the old people and aging phenomena. The aim of this study was to determine the nurses’ attitude to older people and aging phenomenon This study started searching wildly in databases such as Pub Med, Google Scholar, Science Direct and Iran Doc by older people, nursing and attitude key words to find related articles and studies about nurses’ attitudes toward the old people and aging phenomena. Then among all the articles, the ones were chosen which were more related to the research subject by the research group members. 30 articles were chosen based on the input criteria and no time limit was included. Nurses are the effective members of the health care team who are responsible to take care of the old people. So it is important for the nurses to become more familiar with the old people characteristics to be able to take care and meet their needs better. In order to give the better services to seniors, it seems necessary to have got positive attitude about them. The nurses’ attitudes to the old people and the aging phenomena is affected by their personal and religious beliefs, their personal experiences, social culture and the latter one is how much the nurses know about the old people.It is hoped to change the nurses’ attitudes about the seniors by offering them the proper lessons and courses.

awareness of prenatal care and observing them is the most important factor for maintaining mother and fetus healthiness. Health literacy is an important and improvable factor in accessing health information, the mode of communication with health services providers and approaching to health care system. Hence the present study was carried out to determine health literacy in relation to prenatal care among pregnant women referring to health centers of Kerman, Iran. This descriptive- analytical study was carried out cross sectional in 2010. Research population, consisted of all pregnant women referring to health centers of Kerman, 220 pregnant womenwere selected according to a stratified sampling basis. A questionnaire developed by researchers after reliability and validity confirmation was applied for data collection. Data were analyzed using descriptive statistics and Chi square test through SPSS. the results of the study indicate that 24 percent of studied women had good health literacy, 45% moderate health literacy and 31% weak health literacy. There was a significant relationship between health literacy and age, educational level, history of abortion and number of children (p≤0.05).Discussion and This study indicated that the health literacy regarding prenatal care was at a moderate level among most of studied women. However thirty percent of studied subjects had weak prenatal care health literacy. Because of the importance of health literacy, it is necessary for national health authorities to develop more plans to improve health literacy and empowerment of this group.

nowadays usage of internet has been growing explosively in homes, schools, colledges, libraries. Its excessive use may lead to a phenomenon called "Internet addiction". The use of internet and the internet addiction increased among students and university students. This study was done with the purpose of determining the knowledge condition, attitude and addiction to internet among students of North Khorasan University of Medical Sciences(NKUMS). In this descriptive, cross-sectional study, 87 students of NKUMS were randomly selected. Data were collected through Young's questionnaire. The questionnaire included demographic information, reasons of using the internet, and addiction evaluation test. After receiving informed consents, the students completed the questionnaires. Then, data were analyzed by SPSS and presented with Pearson's correlation, t-test, and Spearman tests. The students were scored as normal (20-49), slightly addicted (50-79), or severely addicted (80-100). 87 students participated in the study, 33 male students and 54 female students, the mean time the students were using the internet to 3/9 ± 3/2 hours a day. The incidence of Internet addiction was established to be 20.7% among university students in this present study. Of those with Internet addiction, 8.6% were females and 12.1% were males. Based on our findings, the knowledge and attitude of the studied students are inadequate and the internet addiction behavior exists among them.Therefore, actions such as proper education using the Internet and gain information on the Internet is essential for parents and students.

Correlation between stress and coronary artery disease has been documented in many studies. Schemas develop in childhood and make cognitions and believe in future. Purpose of this study was investigation into the relationship between emotional schemas and anxiety, depression and coping stress styles in patients with coronary artery disease. 100 patients with coronary artery disease who admitted in Bojnourd Imam Reza Hospital selected and evaluated by Leahy Emotional Schemas scale (LESS), shortened version of the coping inventory for stressful situations(CISS)and hospital anxiety and depression scale(HADS). In order to analyze data, multi variables regression test has been used. Results showed a significant positive correlation between task- focused coping style and intellectual emotional schemas (R2=0/215,p<0.05) and a significant negative correlation between task- focused coping style and blame emotional schemas(R2=0/219,p<0.05). task- focused coping style was not predicted by any dimension of emotional schemas (R2=0/159)., Assessment of all dimensions of emotional schemas showed that higher values predicted negatively emotion- focused coping (R2=0/271), rationality negatively predicted avoidance - focused coping style (R2=0/291), Blame predicted anxiety (R2=0/47) and numbness was negative predictor of depression (R2=0/484). Result of this study showed that emotional schemas have important role in coronary artery patients and needs to special concern in treatment and rehabilitations of these patients

Toxoplasma gondii is an obligate intracellular protozoan parasite which can infect human and animals. Acquired toxoplasmosis can lead to fetal infection, which may ultimately result in loss of fetus or lesion in brain and eyes in woman with no immunity. This study was performed to evaluate the seroepidemiological status of toxoplasmosis among pregnant women referring to health center Laboratories of Bojnurd in 2013. Methods& Materials: In this cross-sectional study, 211 blood samples were collected from pregnant women. Sera were separated and were tested for IgG & IgM antibody by ELISA test. Data were analyzed by using SPSS software and presented with chi-square test. Out of the 211 samples, 65(30.8%) were positive for T. gondii IgG antibodies and with 3(1.4%) woman positive for IgM. The results show that exposure or keeping cat, increases risk of infection. Also, no significant correlation between the consumption of raw or undercooked meat, the way of washing, unclean vegetables and level of antibodies were seen. The rate of IgG positive was low and it seems that, before pregnancy and marital status, education and control for toxoplasmosis is important

water treatment systems by reverse osmosis are treatment systems in consumer point. According to water quality in Bojnurd city and Consumers tend to use water treatment systems. This study was carried out for the evaluation of water treatment systems’ performance and compared with national standards.Method and Materials: This cross-sectional descriptive study was carried out using samples taken from the inlet and outlet water of plants during a seven-month period in winter until summer seasons of the year 2013. A total number of 66 samples taken from 6 plants were analyzed for water physical, chemical and microbial quality. Data were analyzed with SPPS 18 and presented with Kolmogorov–Smirnov and T-Test. According to the results the percentage of physical and chemical parameters in treated water for hardness, Alkalinity, Fluoride, TDS, Turbidity, EC, chloride, Na, K, Nitrate, Sulfate and Phosphate were all in acceptable level except for Fluoride and Mg. The average concentration of residual chlorine= 0.64 mg/l and pH range = 7.68. T-Test for total parameters except Phosphate were P<0.05. 5.41% of samples were contaminated by Total Coliforms and all samples by Clostridium perfringens but no fecal coliforms. Heterotrophic bacteria were lower than standards. Continuous control and monitoring of the quality of inlet and outlet water in desalination plants is necessary.

It is generally believed that medical sciences students face tremendous stress in the course of their study, these stresses affects their quality of life. Regarding the importance of this feature, we decided to determine quality of life in North khorasan University of medical Sciences in 2011. A descriptive analytical (cross-sectional) study was conducted on students of North khorasan University of medical Sciences (n=300) in 2011. The research tools included the questionnaires of demographic information and SF-36, a validated instrument for mental and physical health assessment. The data were analyzed by SPSS-16 software and presented with nonparametric tests such as Kruscal -Wallis and man-witney. The results showed that 115(38.3%) of students were male and 185 (61.7%) were female. 15.2% of students experienced very weak level of quality of life, 26.4% weak level, 32.9% good level and 25.5% very well level of quality of life. There was significant relationship between the obtained score of quality of life and level of interest in field of education, satisfy of facilities and field of education The results showed that more than of students experienced good level of quality of life. The results suggest paying more attention to HRQOL and planning for promotion student's HRQOL.

self-medication as a health and social concerns can cause serious problem for individual and society. Therefore this study aimed to determine the prevalence of self-medication and its related factors among the students of Bojnurd universities in 2012. This is a cross-sectional and descriptive study. For the purpose of this study, stratified random sampling was applied to select 600 subjects from 3 Universities namely,Medical university, Islamic Azad university and Payam Noor university. Data were collected via a self-made questionnaire which consisted of demographic and self medication questions. A typical 3- points linker rating scale used for the questions. Subject rank from 1- 3 was measured as low, medium and high. There were 590 subjects who answered the questionnaires, the mean age was (4.19 ± 22.84) and 60.50% of subjects were female and others male. Average rate of self-medication in this study was (41.9%) and the results showed that the prevalence was higher in female. Students get medical information through reading books (43.6%). The results also showed that there is a significant relationship between self-medication, uncertainty of medical practice, lack of time to call a doctor and easy medication. Payam Noor university students had the highest self-medication. in this study the prevalence of self – medication was high. According to the findings (results) of this study, teaching students to increase their medication knowledge and monitoring sales of pharmacies is necessary.

The presence of certain chemical compounds in dialysis water which enter patients’ bodies through hemodialysis can cause various problems such as acute poisoning, brain damage, osteoarthritis. Therefore, applying the standards for dialysis water is indispensible. This study was carried out to determine the chemical quality of water entrance to dialysis machines and its comparison with AAMI and EPH standards in the hospital22 Bahman’s Gonabad. This cross-sectional study was performed on 66 samples including water systems used in dialysis units in the 22 Bahman hospital Gonabad. Samples were analyzed by Atomic Absorption, DR4000 and Flame photometer. Data were analyzed by SPSS software and presented independent t-test (p<0.5). The results of this study showed the measured values were less than standard reference values. In all samples Measured, elements and compounds such a sodium, potassium, fluoride and nitrate less than standard, but only a temporary calcium concentrations expressing as difficulty were higher than standard level. This result showed that the averages of all measured compounds are less than standard, representing high quality water hospital for dialysis. This is while high calcium concentration in some samples needs to be further assessed.

Lapse is a taking drug again after a period of time after stopping the drug. And due to the high incidence of lapse in drug addicts, this study surveys the affecting factors of lapse among the patients referring voluntarily to addiction-abandoning centers. This case-control study was conducted on 200 drug addicts that referred voluntarily to addiction-abandoning centers in Esfarayen-1391 and selected by cluster random sampling. Data were collected by researcher made questionnaire by interview and documents. Data were analyzed by SPSS18 statistical software presented with t-tests and chi-square. Of 200 participants in the study, 77/5% were male, and mean of age was 45/9 years. Results showed that relationship between age (p=0/01), daily consumption (p=0/04), existing of chronic pain (p=0/02) and being with addicted friends (p=0/04) with lapse. But there was not relationship between smoking (p=0/32), type of treatment (p=0/18), marital status, education, employment and gender with lapse. According to the findings, education and intervention can change the affecting patterns of lapse and also strengthen coping skills in drug addicts for reduction of lapse.

Due to recent changes such as increasing the number of higher education institutions -public, Azad, and non-profit universities- student demographic change and gradual decrease in the number of applicants to enter universities, all these education institutions have to compete recruiting students more than each other using the marketing principles and strategic planning and development to be adopted with the current and future conditions. The nursing school is aimed to recruit students and upgrade nursing courses. The purpose of this review article is to attract nursing students focusing on marketing principle and its applications. To access the articles and studies related to marketing and relevant Keywords during the years 2000 and 2013, an investigation was done by searching in international web sites such as: Scopus, pub med, science direct, Iran doc and Iran medex. Then among all the articles, those were chosen which were more related to the research topic by the expert members of the research group. In this study, 20 articles and 4 books were selected according to the inclusion criteria. The overall picture of university in the minds of people depends on various factors: School is known as a center for teaching and education and focusing on clinical, social and cultural issues. This is one of the factors which encourage the students to join nursing courses. To achieve the strategic goals of the university and attract more students who are the system customers, it is essential to get familiar more than before with the marketing principles especially in higher education and medical sciences. In general, marketing increases the efficiency, responsibility, satisfaction and also the allocated resources to the higher education.

Fall is one of the common problems among olds that increases disabilities and mortality in this age group. So it is necessary to review and identify the different fall reasons in elderly in order to decrease the risks of fall and prevent it. This study is aimed to review the literatures related to the fall reasons in elderly. In this study, 40 articles with the words elderly, falling, falls, and aging databases PubMed; IranDoc; Science Direct; Google Scholar; Iranian geriatric journals from 2000 to the present was reviewed comprehensively and in depth. More than 30 percent of the people over the age of 65 falls at least once a year, 37 percent of them were women and the other 25.2 percent were men. Fall reasons which have been known till now were: loss of consciousness, seizures, strokes and sudden environmental problems. In 10 percent of falls the problems as serious injuries to head, hip fractures and subdural bleeding were reported. Fall decreases aged people activities and changes their life style. It is important to take care of them much more and try to provide a safe environment for them to have a healthy elderly population. So, initial standard assessments play a key role in recognizing and identifying the seniors at risk of the fall and supporting them.