مجله دانشگاه علوم پزشکی سبزوار
سال بیستم شماره 5 (پیاپی 71، زمستان 1392)

Title: Evaluation of individual characteristics، family history and blood group in women with breast cancer in Sabzevar، 1391 Breast cancer is the most common cancer in women globally. This disease has varied Incidence and mortality rate in different communities which this variation is affected by some factors such as age، sex، race، socioeconomic and marital status، geographic location and lifestyle. this study aimed to examine individual characteristics، family history and blood group in women with breast cancer in Sabzevar. In this cross-sectional survey، 218 women with age of older than 20 years suffering from breast cancer were identified through census method by health volunteers from 1380 to 1389 in Sabzevar. Needed information was collected using an interview form whose validity and reliability were approved via face validity and content and test-retest method. Obtained data was analyzed using spss software and descriptive statistics was applied to calculate indexes and frequencies. among 218 patients، 125 (57. 3 percent) were alive. the Subjects’ average age was 52. 85± 1. 2 with a Maximum and minimum age of 86 and 28 years old، respectively. among 124 live patients، 26 patients (21 %) of them had a history of breast cancer in the family. If there is a first-degree relatives with breast cancer، chance of getting cancer would be higher than other cases (46. 1 %). The most and least frequency of blood group were O (37. 6 %) and AB + (6. 9 percent)، respectively. findings of the present study revealed that the family history and blood group of O can be considered as risk factors of developing breast cancer in Sabzevar. The mean age of onset is lower than the worldwide age. Enhance، these issues should be noticed in the planning of health services.

Background and In recent decade، the importance of exercise in offices and organizations، due to increased job stress، is increased. Everyone has some degree of nervousness and stress in his/her workplace. Therefore the aim of this study was to investigate the effect of aerobic and yoga exercises training on efficacy of female staff in Sabzevar University of Medical Sciences. Methods and materials: The method was semi experiment and the statistical sample consisted of 850 female staff in Sabzevar University of Medical Sciences in 1391 in which 57 female staff was randomly selected among them. They were divided into 3 groups (19 persons). Aerobics and yoga exercises were held at 8 weeks، 3 times a week for 60 minutes each time. The tools for gathering the data were a standardized questionnaire of self-efficacy (GSE) Schwarzer. For analyzing the data، t-test with a significant level of 0/05 was used. The results showed that between yoga and control groups، there were significant differences in the posttest (p=0/562) whereas there was no significant difference between aerobic and control groups (p =0/035) as well as between yoga group and aerobics group (p=0/002). The results showed that aerobic exercises didn''t have any significant improvement on efficacy of female staff in Sabzevar University of Medical Sciences. It also showed that yoga exercises caused increasing efficacy in female staff in Sabzevar University of Medical Sciences.

Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. Hyperuricemia is a feature of several pathologies and requires an appropriate and often early treatment، owing to the severe consequences that it may cause. A rapid and massive raise of uric acid، mainly damage the kidney.. Rasburicase، compared to allopurinol، results in more rapid reduction of uric acid and prevent its accumulation in patients with hematologic malignancy with hyperuricemia and AKI. We evaluated the efficacy of rasburicase (0. 15 mg/kg) administered as single dose in 15 patient with AKI in sheikh hospital، Mashhad University of medical Sciences. Beside conventional therapy، infusion of Rasburicase in 50cc normal saline in30 minute intravenously was done and all adverse reaction was treated. Before injection of Rasburicase and 1st، 3nd and 7rd day after it urea، creatinine، uric acid and urine output were determined and compared. Within first 24 hour، the levels of serum uric acid in all patients decreased dramatically. there was a significant improvement in estimated GFR and urine output. Urea and creatinine level decreased from Day 0 to Day 7 but there was no difference between creatinine before treatment and 1st day. Rasburicase is effective for management of hyperuricemia and uremia in AKI Patients.

Abstract Cancer prevention and treatment by medicinal plants for a long was is one of the most challenging areas of research. Among them، some plants species could suppress or kill tumor cells via apoptosis or necrosis. One of these plants is Astragalus. The purpose of this study was investigating the anti-cancer effects of this plant. The cancer cell lines obtained from Pasteur Institute of Iran. The cells were cultured in RPMI 1640. Then the cells have effected from the presence of various concentrations (0. 156، 0. 312، 0. 625، 1. 25، 2. 5، 5، 7. 5 and 10 mg/ml) of Astragalus cystosus. After 72 hours the rate of cytotoxicity was determined by using MTT test. These statistical analyses carried out with a significant level of 0. 05 and t-test with excel software. These findings indicate that the extract of Astragalus cystosus on Hela cancer cell lines had cytotoxicity in all concentrations and the highest inhibition was 7. 5 and 10 mg/ml concentrations. The rate of inhibition in higher concentrations such as 10mg/m1 was equal to 28. 98% which is the highest one. Regarding that the extract of Astragalus cystosus had cytotoxicity on hela cancer cells، further studies can be performed on animal model and clinical trial so that Astragalus used as an anticancer drug.

Abstract Nowadays، it is of utmost importance to critically appraise the research evidences presented in scientific congresses by the audiences. In addition to improvement in scientific and practical skills of critical appraisal، it is important to use a standard framework as the major tool for peer reviewing. We aimed to assess the validity and reliability of one proposed checklist for critical appraisal of the original research abstracts by student peer reviewers. Methods and Materials: This study was a part of an educational interventional project that was performed in a setting of a workshop where 40 medical students from the medical faculties of the universities in Tehran were recruited. Participants were selected using a non-probability purposive sampling method. Educational curriculum of the workshop included clarifying explanations on the 31-item checklist for peer reviewing of the abstracts as well as several tips about each item using lectures، simulations and group discussions during 10 hours. Medical students used the checklist twice، at beginning and the end of the workshop to score three sample abstracts. Data were collected and analyzed using Spearman correlation (internal consistency) and Cronbach’s’ alpha methods to calculate the reliability of different items and domains of the introduced peer reviewing checklist by SPSS software. Moreover، Delphi method was applied to confirm the validity of the instrument by experts’ opinion. A group of experts finally confirmed the validity of this checklist by means of Delphi method. Moreover، internal consistency of the main domains of the checklist consisting of “Introduction”، “Methods”، “Results” and “Conclusion” were statistically significant (P<0. 05). The coefficient of Cronbach’s alpha was calculated as excellent (0. 926) in “Methods”، and acceptable in two other domains of “Results” (0. 650) and “Conclusion” (0. 739) in pre-test data. The introduced checklist was shown to be a structured، valid and reliable tool، which could be used in research congresses to improve the quality of peer reviewing.

Abstract Visfatin is a newly discovered adipokine which increases with obesity. It is not clear whether endurance training which induces changes in adipose tissue and blood lipids might decrease the plasma level of visfatin as well. The aim of this study was to investigate the effect of 9 weeks of aerobic training on serum visfatin level and insulin resistance index in obese women. Method of research was semiexperimental. Twenty-eight obese female volunteered and were randomly divided into experimental (14 subjects with means of weight 82 ± 10. 2 kg، and BMI 34. 2 ± 4. 3 kg/m2) and control (14 subjects with means of weight 79. 9 ± 9. 5 kg، and BMI 34 ± 3. 9 kg/m2) groups. Aerobic training protocol consisted of 4 sessions per week for 9 weeks. Each training session was a slow running trial at intensity of 65 to 75 percent of maximal heart rate for a period of 15 minutes. To follow the principle of overload، half-a-minute was added to each session after the second week، so that، at the last session the running time reached to 31 minutes. Before and after the training period، blood sampling was performed. Data were analyzed using independent t test and ANCOVA. Results showed significant reduction of serum visfatin level (p < 0. 05)، and no significant difference in insulin resistance index، serum HDL، LDL، TC and TG between the control and experimental groups (p > 0. 05). In addition، aerobic training reduced significantly body mass index، body weight، waist to hip ratio، body fat percent، and increased significantly maximum oxygen uptake (p < 0. 05). It can be said that 9 weeks of aerobic training can cause significant reduction of serum visfatin and no significant change in insulin resistance index in obese women.

Abstract because of long communication between nurses and patients، nurses have the great opportunity to decrease anxiety level in patients and educate them. The purpose of this study was to evaluate performance of patient’s education in nurses and patients’ view. Methods and Materials: This descriptive study was conducted on 110 nurses and 110 hospitalized patients who were being discharged in the summer of 2013 in the three educational hospitals in Sabzevar. Data were collected through a questionnaire for nurses and patients and analyzed using spss software، version of 15، and descriptive tests. Nurses'' performance results showed that patients illustrated the highest level of training in time of admission was the way of using needed equipment (15%)، during the hospitalization was time of drug usage (41%) and in discharge time was follow-up and the next visit the doctor. (30%). Also، Nurses mentioned the further level of education in admission، during hospitalization and discharge time were how to use of the equipment (38%)، different methods of pain relief (66%)، subsequent follow-up and going to the doctor (41%). This study indicated that level of patients education has not been efficient in all of three times in nurses and patients ‘point of view. Therefore، health care managers should take some measure to enhance nurses’ awareness about the importance of patient education.

Congenital arhinia is a very rare anomalia which can be observed total or partial arhinia. We assessed a case which is affected to congenital arhinia، its reasons and signs in the present study. Case report: The patient is a 41w neonate who is affected to congenital arhinia، hypertelorism، cleft lip and palate. There was just a significant note in neonatal history of family which showed their first child was affected to anomalia. The neonate was transferred to a well-equip center for doing more assessments. At the present time، general condition of the neonate is good. Congenital arhinia is a very rare anomaly with an unknown etiology. This anomaly may be associated with the other medline anomalies.

Learning is regarded as one of the most important abilities of nervous system and without it the life of an individual disrupted. In fact، the learning process contributes to the organism so that it can adapt the ever – changing environment. Therefore، understanding the mechanisms involving in the learning and factors affecting on it is among the issues which have attracted the attention of many psychologists and neurologists. Motivation is one of the most important factors affecting learning and can relate evolving identity to learning. Methods and Materials: The present study is a nonexperimental design (correlation) that by using a structural model investigated the relationship between variables. Multi –stage sampling was used for selecting 1072 participants among Sabzevar and Neyshabour second grade high schools girl students. Three questionnaires were used: identity style scale (ISI)، goals achievement scale and motivational strategies for learning. (1) validity and reliability of the scales was tested by confirmatory factor analysis and composite reliability. The data has been analyzed by using path analysis method. lnformational style had both direct and indirect effect on cognitive engagement. Both effects are statistically significant (P <0/01). Indirect effect happens by mediating role mastery goals. Normative style had indirect effect on cognitive engagement.. The achieved model can anticipate %36 cognitive engagement. For improvement of Learning Cognitive engagement can be analyzed through the Cognitive and motivational variables.

Abstract Cholinergic neurons play an important role in muscle contraction، in learning and memory. Choline acetyltransferase is the enzyme that is responsible for the synthesis of acetylcholine and is a specific marker for choiinergic neurons. Computational methods investigate on Choline acetyltransferase enzyme. The aim of the present work was to describe and characterize the molecular structure vibrational properties of choline acetyltransferase crystalline-structure. In this work، the structures of a coordination compound modeling the choline acetyltransferase computationally. Thus، it is worthwhile to collect information on their structures by the means of computational chemistry as well. Monte Carlo simulations are based on pair wise additive potentials of the form. In concepts and algorithms of classical MD simulations the atoms of a biopolymer move according to the Newtonian equations of motion. These studies provided insights into the steric، electrostatic، hydrophobic، and hydrogen bonding properties and other structural features influencing the choline acetyltransferasewas Potential energies for the three force fields of MM+، AMBER and OPLS at Monte Carlo simulation were compared. Geometry of optimized variables of Bond length (B)، Bond Angle (A) and Dihedral Angle (D) investigated. The potential energy (kcal/mol) via time (ps) during Molecular Dynamic (MD) simulation at300 K in gas (R2 = 0. 7656) and water (R2 = 0. 9794) environments studied to stabilized structure of choline acetyltransferase accepted. These results also were revealed that the solvation of Choline acetyltransferase molecule is the major component for the interaction potential energy and it was clearly shown that the role of the solute-solvent interactions is more pronounced in Choline acetyltransferase molecule and it’s active site solvation.

Job stress including physical، social and psychological factors، impact on personnel’s health. This problem is more observed in health workers that have continuous communication with patients. Continual and severe stressors are integral part of health worker that exposed at risk of burnout. This study aimed to determine the association between burnout and workplace physical condition in health department staff of Sabzevar University of Medical Sciences. This cross - sectional study was conducted among 220 staff of health Department of Sabzevar University of Medical Sciences. Maslach standardized inventory and workplace physical condition questionnaire contain ten question verified by Faculty members of Sabzevar school of health were completed by employee. The collected data were analyzed by spss 16 software. The highest average of age was in caretaker and administrative staff (41. 3±7. 08). There was a significant relationship between lack of personal accomplishment and depersonalization with workhouse and also significant relationship between lacks of personal accomplishment، depersonalization، and emotional exhaustion whit field of activity was observed.. Physical condition of the workplace was associated with lack of personal accomplishment. The work environment in healthcare system is always associated with job stresses and its personnel that are susceptible to job burnout. It is proposed by encouraging informal relations within the organization، motivating employee، training، improving of physical conditions of work and meritocracy can implement effective interventions to reduce vulnerability and staff burnout.

Nursing and midwifery profession has been faced with many challenges due to inability to express oneself and justice. Nonetheless، little research has been performed about them. Because of impact of decisiveness on the mental health، this study performed to determine factors that weakened or facilitate decisiveness among nursing and midwifery students of Sabzevar University of Medical Sciences. A cross-sectional study was performed among nursing and midwifery students of Sabzevar University of Medical Sciences، in 2013. Data collection tool was a three parts questionnaire containing demography questions، Rathus Assertiveness Schedule and the Spielberger Anger Expression Scale. Data were analyzed in SPSS software version 19. The results indicated that 20% (n = 17) of midwifery students and 22% (n = 35) of nursing students had high decisiveness. Most of midwifery (60%، n = 50) and nursing (60%، n= 98) located in the category of medium decisiveness. Also، 20% (16 patients) of midwifery and 18% of nursing students (n = 33) had low decisiveness. Factors affecting decisiveness among midwifery students were semester (p = 0. 04)، interesting to his/her field (p = 0. 04)، marital status (p = 0. 04) and age (p = 0. 03). Among nursing students، these factors were semester (p = 0. 04)، interesting to his/her field (p = 0. 03) and age (p = 0. 03). Regard to decisiveness rate among study students and its effect on the mental health and academic performance and career، special attention must be paid to factors affecting decisiveness and reinforcement of them.

Many patients who are undergoing anesthesia and surgical have untreated stress and anxiety in day of surgery that will effect on the psychological and physiological levels. Reduction anxiety accepted as part of pre-operative nursing care. The present study investigated the effects of Guided Imagery on Anxiety level of the patients undergoing appendectomy. In this randomized clinical trial، 60 patients undergoing appendectomy، admitted Beheshti hospital،Sabzevar in 2013، were randomly allocated into two intervention and control groups. Intervention was performed in 18 minutes Audio CD Guided Imagery for an hour before the operation. Data were analyzed bySPSS software version 20، using Chi-square،paired t test and analysis of covariance. 95% confidence level was considered. The average of state and trait anxiety level in Guided Image regroup before of intervention were 51/90 ± 7/88 and 42/76 ± 8/34 respectively which decreased to 38/53 ± 6/48 and 40/70 ± 7/88 after intervention. On the other side the average of state and trait anxiety level incontrol group were 52/03 ± 6/49 and 43/86 ± 8/29 respectively that increased to 60 ± 7/97 44/36 ± 8/18 in the end of the study. Statistically، the paired t test showed significant difference between the levels of anxiety before and afterof study in two groups (p<0/001). A Guided Imagery session pre-operative can reduce state and trait anxiety. Therefore using this method to reduce anxiety is recommended.

Background and Cardiac catheterization is one of the most common diagnostic and therapeutic methods of cardiovascular diseases. The present study was conducted to determine the effect of guided imagery on patients’ anxiety awaiting cardiac catheterization. This interventional study (randomized trial) was carried out on 62 patients undergoing coronary angiography for the first time in vasey hospital of Sabzevar in 2013.. In the case group، guided Imagery method (a method of relaxation) was performed Information was collected via a State-Trait Anxiety Inventory (STAI)، and an anxiety standard questionnaire. Data analysis was done using SAS 9. 1 and SPSS 16 statistical softwares. The average age of participants in this study was 57. 06 ±8. 9 years. 25 participants (40. 32%) were female and 37 (59. 67%) were male. in the case group، mean score of State-Trait Anxiety decreased significantly in comparison to the control one after the intervention. (p<0. 001). The average score of anxiety in the control group before angiography had increased. Moreover، there was no significant correlation between anxiety and demographic variables like age and sex. Guided imagery and relaxation impress patients’ anxiety undergoing first-time coronary angiography. Therefore، there is recommended to use this method before cardiac catheterization performance.

Background and Appendicitis is the most common cause of acute abdomen in the world، and like other surgical procedures، the postoperative pain is one of the most common problems. Nowadays people tend to use non-drug methods and alternative medicine for reducing the effects of drug side effects. Reflexology is one of these treatments which can reduce pain and stress by applying pressure on a specialized area of the hands، feet and ears. The aim of this study was to determine the effect of Reflexology massage on pain relief after appendectomy surgery. This critical trial study has performed in the emergency department of the Imam Reza Hospital، in Mashhad in 1392. Pain level and analgesic intake of 105 patients were compared in three groups before، immediately، one، six and 24 hours after treatment. In intervention group a specific area in the right leg and Shenman part of the ear was pressed for ten and one minute respectively. In the control group the pressure was applied on the back of left foot and right earlobe. Patients in the control group received only routine care. The results were evaluated at 95% confidence level. Data analysis was performed with SPSS 21 software. The The difference of mean pain level at baseline was not statistically significant in the different groups (P=0/430)، but after the reflexology message there was a significant difference between the amount of pain in intervention group compared with two other groups (P≤0/001). Reflexology is an effective method for pain relief of patients after appendectomy surgery and it is recommended nurses to apply this method for reducing pain of these patients.

Due to the high production rate and the manual nature of the manufacturing of Arc opal dishes the probability of the musculoskeletal disorder onset is high. The aim of present study was to detect and assess the risk of musculoskeletal disorders and its relation to the work pace among the staffs in one of the dishes manufacturing companies. This cross-sectional descriptive-analytical study was carried out on the 100 staffs employed on the decoration section of the company that had job experience equal to one year. They was selected randomly.. To detect the disorders in different parts of the body and to assess the risk of MSDs were used Nordic questionnaireand QEC method respectively. Using SPSS15 software، we analyzed data that used one way ANOVA and Independent Sample t- test. The results from Nordic questionnaire revealed that the most prevalent disorders in past year related to back (93%)، neck (89%)، and shoulder (82%) regions respectively. The QEC showed that level of worker exposure with risk factors in back (53%)، shoulder (58%)، Wrist – Hand (71%) and neck (58%) regions is high. Also 71 percent of worker employees have inappropriate posture during work. A significant relation was found between the MSDs and the work pace. Considering the high prevalence of MSD and analyzing the related risk factors which signifying the risky condition of work environment، it proposed to apply the ergonomic intervention for reduction of work pace.

Colored wastewaters are major source of aquatic pollution which will cause considerable impacts to the environment if discharge without treatment. In recent years، Electrocoagulation (EC) process has been attracted a great attention for treatment of industrial wastewaters as an appropriate method. In this study، the efficiency of electrocoagulation process on color removal of natural dyeing wastewater was investigated. This study experimentally was run in a batch electrochemical reactor consisting of a 0. 6 L glass beaker، two anodes and two cathodes. The anodesand the cathodeswere made of aluminumand iron or copper respectively which installed in parallel. In each of test، 400mLof wastewater add into the reactor، then effect of three parameters including the current (50-500mA)، reaction time (5-40 min) and the pH of wastewater (pH=4-8) on process performance were investigated. Theresults showed that optimal conditions for Al/Cu and Al/Fe systems was in 400 mA applied current، pH of 4 and 40 minutes. In these conditions، EC with Al/Cu electrodes were capableto remove of almost complete color (98%) and efficiency of COD removal was 28 %، whereas EC with Al/Fe resulted in 97% color removal and 21% COD reduction. Electrical energy consumption and current efficiency of EC process for optimal condition werefound 2. 9kWhm-3 and 110% respectively. According to our finding،it proposed that EC process is very efficient and economic process for color removalfrom wastewater.

Probiotics are beneficial and non-pathogenic microorganisms. Isolation of probiotic bacteria from traditional dairy products can not only lead to the isolation of probiotic bacteria with special characteristics، but it can offer a good approach for the mass production of traditional dairy products containing natural probiotic bacteria. After collection of dairy products samples from different regions of Sabzevar، they were continuously cultured on the specific media of MRS and MRS Broth. Initial identification of isolates was performed by gram stain، motility test، nitrate reduction test، growth at 15 and 45 °C، growth at pH: 9/6 and fermentation capability of 11 different sugars. To identify desired strains more precisely، the 16S rDNA gene was amplified by PCR with specific primers and then sequenced and BLASTed. Acidic and bile salts conditions tolerance tests were performed for the final confirmation of desired strains. After continuous culture on specific agar media، 16 strains for further analysis were selected. In early identification of isolates by phenotypic methods، 14 strains were positive. To identify these strains more precisely، the 16S rDNA gene was amplified. Following molecular identification and sequencing of 16S rDNA gene، the BLAST sequence similarities were found with Lactobacillus planetarium. In addition، acidic and bile salts conditions tolerance tests showed that these bacteria had the best growth pattern at PH: 4 and they were able to grow in the presence of bile salts. Biochemical results showed that the most common strains in the tested dairy products are Lactobacillus. These results also confirmed by the molecular tests. Acidic and bile salts conditions tolerance test، as a main characteristic of probiotic bacteria، showed that the strain was able to withstand these conditions.

Backgound: Neonatal respiratory distress is a main cause of preterm neonatal mortality. Surfactant is one of its standard treatments. The current study was conducted to compare clinical effects of different kinds of surfactant in the treatment of respiratory distress of preterm neonates admitted to NICU of Sabzevar. This cross-sectional study was conducted on the preterm neonates admitted to NICU of Shahid Mobini Hospital of Sabzevar University of Medical Sciences، in 2009-2010. Sample size was 115 neonates at 95% confidence interval. Inclusion criteria were neonates with respiratory distress and 26-37 weeks gestional age who had been treated with surfactant. Exclusion criteria were neonates with 5-min Apgar score less than 7، neonates with major congenital anomalies، or neonates whose mothers received steroids before giving birth. The data were gathered by questionnaire to assess clinical effects of different kinds of surfactant in the treatment of preterm neonatal respiratory distress. The questionnaire was confirmed by content validity and inter-rater reliability (r=0. 9). The data were analysed in SPSS software version 20 using descriptive statistics and non-parametric tests including ANOVA and multiple comparisons، kruskalwalis and chi-square. 41 neonates were allocated in a group with birth weight less than 1500 g and 74 neonates in a group equal or grater than 1500 g. According to the statistical tests، intubation duration in neonates less than 1500 g who received Newfactan was significantly more than the two other drugs (P=0. 01). Duration of CPAP in Curosurf group was more than Survanta and Newfactan groups with a significant difference. Time of starting feeding was lesser in neonates who had recieved Survanta than Newfactan. In neonates less than 1500 g، none of the variables had a significant difference after surfactant therapy. This study showed that Survanta has a better efficacy than Newfactan and Curosurf. But in regard to the importance of applying this drug، and the controversy of results obtained from studies، it is recommended to perform further studies about this issue.

Oral health care in patients with an endotracheal tube is one of the most important aspects of nursing care and nursing tasks in intensive care units. Mouth cleaning can reduce the amount of dental gingival، gum disease and the incidence of pneumonia associated with mechanical ventilation. The purpose of this study is the comparison between the effect of chlorhexidine solution and toothbrush in the prevention of oral lesions in patients hospitalized in intensive care unit in Shaheed Beheshti Hospital of Sabzevar. This study is a clinical trial. The Research Society in this study is patients hospitalized with endotracheal tube from the arrival time in intensive care unit in 1392. In this study، 30 patients were selected with target-based approach. They were divided into two groups by permutation blocking method for oral care toothbrush and chlorhexidine. There were 15 patients in each group. Beck Oral Assessment Scale (BOAS) modified and MPS are used in order to collect information on demographics List of information from the checklist of oral health. Data are analyzed by R software، Kolmogorov–Smirnov test، Chi square test، and Fisher and multiple logistic regression at 95% confidence level. Patients toothbrush and chlorhexidine groups of characteristics like age، sex، and drugs were similar (p>0. 05). The results show that the toothbrush and chlorhexidine are effective in preventing oral lesions، but in some cases، when the toothbrush was used، the oral health status of the patient was better (OR=1. 52، p=0. 0046). Discussion and The results indicated the use of toothbrushes and toothpaste is a significant effect in reducing oral lesions in comparison with chlorhexidine.

Many patients with chronic renal failure are fatigue due to disease process and long-term treatment with hemodialysis. Because of very different side effects of medication، using complementary methods seems to be reasonable way to reduce fatigue in hemodialysis patients. This study aimed to effect of Benson relaxation on fatigue in hemodialysis patients. The present research is an experimental controlled trial study conducted on 65 hemodialysis patients selected from Vasei Sabzevar Educational hospital in 2013. Patients were selected using convenience sampling method according to inclusion and exclusion criteria and then were divided randomly into two groups (33 patients) in experimental and (32 patients) in control group. The experimental group received Benson relaxation for 15 minute، twice a day during one month. control group received no intervention. Data-collecting instruments included demographic information form and Brief Fatigue Inventory (BFI) questionnaire were completed before، 2 and 4 weeks after intervention. Data were analyzed by means of SPSS-11/5 and SAS 9. 1 statistical software using descriptive statistics، T test، Chi-square، Mann-Whitney Test and generalized estimation equations. Mean score of fatigue in the experimental group was 6/97± 0/84، 5/25± 1/07and 3/92 ± 1/11 before intervention، after two weeks and four weeks later، respectively. Analysis of the data revealed a significant difference between the mean score of fatigue of before and after intervention in the experimental group (P<0/01). Benson relaxation can be considered as a cost-effective، simple and secure way to decrease the fatigue in the Hemodialysis patients.

Now a days، musculoskeletal disorders are of a great concern in job health issues and their prevalence are relatively high among various occupations. On the other hand، agriculture is one of the most important production sections which have great roles in creating new jobs، and if these sections pay well attention، it can help in renewing economic growth، independency، and self-efficiency in our country. In the agricultural sections the workers do hard physical jobs، so these persons encounter musculoskeletal disorders more than the others. This descriptive-analytical study was a cross-sectional one which performed among 400 farmers in Sabzevar. The data were gathered through Nordic Standard Questionnaire in which a group of trained persons completed it by interviewing. Gathered data were analyzed through statistical tests by the use of SPSS، v. 16. The prevalence rate of musculoskeletal disorders in one or both knees، the waist and one or both feet and finally the ankle during one year was 52%، 46. 5 and 27%، respectively. The result showed that during the last year، there was a significant relation between pain in waist and individuals’ weight (p = 0. 033)، pain in one or both knees and their age (p= 0. 0001)، pain in one or both knees and the height (0. 036) and pain in shoulders and age (p=0. 028). The results showed that there is a significant relation between the musculoskeletal disorders in farmers and their demographic characteristics like weight، age and the height.

People can direct their lives and activities into deeper، richer and more meaningful way using spiritual intelligence. Utilization of spiritual patterns in everyday life leads to an enhanced compatibility and evolution of well-being. The purpose of this study is to determine if spiritual intelligence can predict happiness. This cross-sectional analytical study was carried out among students of North Khorasan University of Medical Sciences in the year 1391. 129 individuals were selected via Stratified sampling method. Individuals were assessed by spiritual intelligence questionnaire and Oxford Happiness Inventory (OHI) whereas statistical data was analyzed by Pearson correlation coefficient، t-student test and linear multiple regression (stepwise)، by SPSS 20 software. The p-value was considered 0. 05. Correlation coefficient between spiritual intelligence and happiness was r=0. 505 (p-value<0. 001)، which was statistically significant. In predicting happiness by spiritual intelligence and adjusting other variables effect such as gender، age، habitat، university grade point average by multiple regression test (stepwise)، the results determine that spiritual intelligence and gender can significantly predict happiness score. And also the two main components of spiritual intelligence that were able to predict happiness were critical existential thinking and personal meaning production. The conclusion of the study is that spiritual intelligence and gender are prolific in predicting happiness. And since spiritual intelligence is a set of capabilities، promoting these skills can help to enhance happiness.

Discharge of colored sewages، resulting from domestic and industrial wastewaters، results in eutrophication، coloring and hypoxia of waters. Furthermore، colors have mutagenic and carcinogenic effects. This study aimed to investigate the removal rate of acid black 1 dye from aqueous solution using nano-iron particles. This study was done experimentally and discontinuously in lab scale. The effect of variables such as contact duration (30، 60، 90، 120، 150 and 180 min)، pH (3، 7 and 11)، adsorbent dose (0. 4، 0. 8، 1. 2 and 1. 6 g/200ml) and dye concentration (50، 150 and 200 mg/l) were evaluated on the removal rate of dye from aqueous solution. The data were analyzed using Excel software. The results showed that with increase in contact duration، the removal efficiency of dye also increased from 92. 85 percent to 99. 17 percent. Also، the increase in adsorbent concentration resulted in increase in removal efficiency of dye from 62. 11 percent to 99. 1 percent. A decrease in pH and dye concentration also increased removal efficiency of dye from 53. 71 percent to 99 percent، and from 99. 97 to 100 percent، respectively. The results of isothermal study showed that the removal of acid black 1 dye from aqueous solution follows from the Langmuir equation (0. 999)

Implementation of internal assessment provides Opportunity to identify strengths، challenges، and encourages the authorities to resolve problems and provide appropriate raining to improve or upgrade the quality of education، research and management. Therefore، Nursing Department of Sabzevar University of Medical Sciences، conducted internal evaluations. This study was descriptive and analytical cross- sectional research. The study population included all members of the internal evaluation committee، faculty، administrator groups، students، graduates، interns، and nursing supervisor at University Medical Sabzevar comprised 87-88 school year. Students and interns were selected by simple random sampling method. evaluation committee members، faculty، administrator group and supervisors were selected through census sampling method. The ten factor that were evaluated included mission and objectives، management and organizational structure، faculty، students، teaching and learning process، training and curriculum، teaching and research facilities، graduates and interns. Data were collected by questionnaire، interview and questionnaire. After the completion and collection of information، all data were analyzed using SPSS version 15 and descriptive and analytical statistics methods. values were interpreted، lower than %50 undesirable، between %50-%74. 9 partially desirable and higher than %75 desirable. The results showed that from the 10 factors examined، Department of Nursing achieved a total score of 80/55 (79/2 percent). According to the ranking criteria، the internal evaluation is relatively favorable within the Department of Nursing. Although the result of internal assessment nurse was desirable، But it still appeals more and Necessary changes and Implementation of the strategy for improving the quality of internal evaluation in the Department is required.

Delirium as a syndrome which is recognized by consciousness disorder and changing in cognition. Delirium patients after by-pass are a common neurological complication, which is a component of the cognitive disorder. A high percentage of these kinds of patients suffer from after surgery. Evaluation of risk factors (blood transfusions and the use of more than one unit CPB) after surgery can be a valuable step in order to highlight the importance of prevention and early detection of delirium. This study aimed to recognize some risk factors related to delirium in patient who had a by- pass operation. This study is a cross - sectional. The number of participants was 370 patients who had a by-pass operation were studied by the continuous sampling method. Researcher referred to the selected clinical centers in Tehran to identify related patients to our study and then informed consents were obtained from all patients. Using the Delirium Screening Scale, we analyzed psychological condition of patients until they were discharged from the critical care unit daily. The personal information questioner was completed on the first day of analyzing the psychological condition. Then the gathered data was analyzed by the SPSS 16 statistical package. Our findings showed that there was no meaningful statistical relationship between the incidences of delirium with risk factors despite its being common among participants. According to these factors it is not possible to predict incidence of delirium in patients after a by- pass operation. In other words, there is an equal chance of delirium incidences among all patients’ regardless of having or not having these factors; therefore the analyzed factors of this study cannot be used to predict the delirium incidence.