نشریه دانشگاه علوم پزشکی خراسان شمالی
سال ششم شماره 3 (پاییز 1393)

Inappropriate use of antibiotics in hospitals is a major problem. This study was done with the aim of determining impact of the educational intervention on adherence to guideline for antibiotic prophylaxis before surgeries in Alejalil hospital in Aq-Qala city,2012. This quasi experimental and one blind study was done on surgeons. Proportional of performed surgical by each physician, 125 records during the month before the intervention and 125 other surgical records after the intervention were selected. Information including indication, type of antibiotic, dose, time of administration of first dose and route of antibiotic administration based on patient records were compared with Ministry of Health guideline for antibiotic prophylaxis. The intervention consisted of meeting with surgeons and sending guideline to them. Data were analyzed using PASW18 software and Chi-square and Wilcoxon test. Before the intervention, in 82.4% of surgeries and after the intervention, in 91.2% of surgeries, indication were correctly, also type of antibiotic (from 80% to 89.6%), dose (from 32% to 79.2%) and adherence to the guideline in all cases (from 32% to 79.2%) significantly had improved (P<0.05). The time and route of antibiotic administration before and after intervention was correct for all patients. Interventions based on Managed Care guidelines on the proper administration of antibiotics were effective. It is suggested that educational interventions planned in collaboration with physicians occurred to improve antibiotic prescribing.

Enterobius vermicularis-the causative agent of Enterobiasis-is one of the most ubiquitous intestinal parasites infecting children worldwide. The aim of this study was to evaluate the frequency of Oxyuris infections in preschool children among kindergartens of Khash City, Iran, 2012. In a cross-sectional study the sampling was accomplished randomly among 907 children aging from 1 to 6 years. Additional data was gathered using questionnaires which were given to parents with satisfaction forms. The samples were examined using scotch tape [Graham’s Test] by light microscopy and data was analyzed using SPSS.18 statistical software. The overall Oxyuris contamination was calculated to be 24.1% among preschool children. Considering gender, 28.7% of all girls and 19.5% of all boys were diagnosed to be infected. Considering data obtained from this study, since Enterobiasis infection rate in preschool children of Khash City was rather high it can be a serious problem to the whole population of society and should not be underestimated. To further limit its occurrence, public health measures and informative campaigns for the whole population and especially more for parents should be implemented.

Despite the multiple benefits of exercise on mental and physical health of dialysis patients, unfortunately, the level of physical activity in these patients is very limited. With this respect, it is essential to identify the barriers and motivations to exercise in these patients for care planning principles. The purpose of this study was to identify barriers and motivations to exercise and evaluate their association with activity levels in hemodialysis patients. This descriptive study was carried out on 47 hemodialysis patients selected by purposefully sampling in Imam Khomeini Hospital in Tehran. The data collection tools were demographic and Barriers and motivations to exercise questionnaire and a standard questionnaire to record physical activity GLTEQ. Data were analyzed using the software SPSS and presented with sign tests and correlation coefficient. The majority of hemodialysis patients participated in the study were inactive. Motivations such as faith in healing by exercise, sense of well-being, anxiety and depression reduction had a direct correlation with the level of activity. Barriers such as fear of falling, fatigue, shortness of breath, depression and anxiety had an inverse correlation with the level of activity(P<0/05).There was a direct correlation between the frequency and severity of barriers and an inverse relationship between activity level with intensity and frequency of barriers(P<0/05). There was a direct correlation between the frequency and severity of motivations and a direct relationship between activity level with intensity and frequency motivations (P<0/05). Activity reduces the complications of hemodialysis and increase the health and prevent situations threatening the physical and mental health

Microbial fuel cell (MFC) is a bio electrochemical system and a new method for wastewater treatment and electricity generation simultaneously. In this reactor chemical energy stored in organic materials convert to electricity through the metabolic activity of the microorganisms. In a pilot study, two chambers MFC operated in continuous mode during 720 hours at 20±4⁰C. Organic loading rate and hydraulic retention time (HRT) were effective variables for operation of reactor. Optimized HRT to achieve the maximum removal efficiency obtained 1.5 and 2.5 hours and reached to 49%. Results showed that Columbic efficiency affected by organic loading rate (OLR) and by increasing it, CE reduced from 71% to 8%. By considering, advantages such as production electricity directly and wastewater treatment simultaneously, it is recommended after further complementary studies and economical assessment, MFC could be used for wastewater treatment in industrial level.

the present research aims at predicting employees’ mental health based on life-work quality in the Sport and Youth offices of North Khorasan Province. the present study is a cross-sectional correlational study، which was conducted on the Sport and Youth offices of North Khorasan Province in 2013. The data for 70 cases were collected by statistical methods. The data gathering tools were the word-life quality questionnaire and the Goldberg mental health questionnaire (GHQ-28). The research data were investigated and analyzed using Pearson correlation coefficient and stepwise multiple regression test by SPSS14 software. the findings of this study showed there is a negative and significant relationship between work-life quality and its aspects، and mental discrepancies (P = 0. 001، r = -0. 463). Among the aspects of work-life quality، safe and hygienic work environment and work-life، social interdependence and the highest affectivity or predictive value for mental health، respectively. the results of this study indicated that just payments، not necessarily higher financial payments، safe and healthy environment as well as work relationship between employees are affective on their mental health.

Due to repeated environmental disparities nursery children are at risk for developmental delay. This study aimed to determine the effect of an evidence-based care package on infant fine motor development. In this clinical trial at the Ali Asghar (AS) nursery of Mashhad, an evidence-based care package was utilized. Fifty babies with the age of 1-12 month eligible for inclusion criterion were randomly divided in to the intervention (25 infant) and control (25 infant) groups. Then the care package was administered for the intervention group, three times a week for 8 weeks (24 sessions of two hours). Fine motor developmental age of the children was assessed by Denver-II, before the intervention, 6 and 8 weeks after the intervention, and the resulting data were analyzed using independent t-test, Mann- Whitney U and repeated measures. The mean age of the sample was 20.64±14.62 week,consisting of 32% female and 68% male. The mean of the fine motor age respectively were 23.5±14.2 and 21.1±17.7 in the intervention group and control group (P>0.05). After 6 weeks implementing the care package, the mean of the fine motor age in the intervention group (33.3±14.9) and control group (23.3±14.4) showed a statistically significant difference (p- 0.008). Two weeks later (8th weeks) this value in the intervention group (35.8±13.4) and control group (24.9±13.4) showed a statistically significant difference (p<0.001). Six weeks intervention by this evidence-based care package is effective on the infant's fine motor development. This effect was approved 2 weeks later.

One of the ways to control nosocomial infection is to identify the disease transmission tool, and to determine the infection transmitted through the tool. The aim of this study was to determine the prevalence, type and severity laryngoscope pollution blades for 4 months in treatment wards of Musabne Jafar (AS) hospital Quchan in 2000. This was a descriptive study in which 104 laryngoscope blades were randomly selected from all the blades disinfected during the four months. Sampling was done with sterile swab samples. In case of bacterial growth and production of colonies, slide preparation and the type of bacteria and bacterial growth was studied. Statistical data were analyzed by SPSS 17 software and used descriptive statistical tests. The results show that the 52.9% (n=55) was infected. Most types of microbial contamination associated with coagulase negative staphylococcus strains with 36.4% (n=20) and the least polluting type associated with enterococci 9.1% (n=5). Comparing the intensity of the treatment units showed the most is relevant to the operating room and the lowest in pediatrics and surgery in men. General principles and methods are common in washing and disinfecting the laryngoscope blades that are acceptable. But the observance of detail and fastidious cleaning and disinfection procedures by the people in different sectors are not approved and not verifiable, that requires more training and the committee of infection control must strict.

Dermatophytosis is the infection of skin, hair and nail that is caused by various keratinophilic dermatophytes. It is a common infection wide spreading in the world and a public problem common endemic disease in Iran. As a short study we assessed the frequency of dermatophytic cutaneus infections in west Azarbayejan, Iran.Methods & Material: A total of 246 specimens were collected from clinically suspected. All patients were referred to medical mycology lab for the laboratorial identifications. Among 246 clinical samples examined, 28 positive patterns of dermatophytes were identified and five dermatophyte species including Trichophyton mentagrophytes (42.8%) Trichophyton rubrum (7.1%), Microsporum canis (32.1%), Microsporum gypseum (14.2%) and Trichophyton schoenleini (3.5%) were identified. Our results showed that the frequency and prevalence of dermatophytic infections have an increasing mode in Urmia, Iran.

Musculoskeletal disorders are of the most prevalent damages caused especially in smaller industries. This study aimed to determine the prevalence of musculoskeletal disorders and also assess the risk of these disorders has been in workers in brick factories in the city of Yazd This study was a cross-sectional study on 220 workers in the city of Yazd has been brick ovens that were randomly selected. The prevalence of the musculoskeletal disorders were studied via the Nordic questionnaire, and also the QEC method was used to analyze the risk of musculoskeletal disorders, which for the means a film was taken from each worker at his working post, and eventually were statistically analyzed via the SPSS-13 software. Based on the data analysis, the average age and experience of the studied people were respectively 30.02 ± 10.56 and 6.57 ± 5.94 years. Also based on the results acquired from the Nordic questionnaire, 61.8% of the studied people had at least one physical injury or disorder over the past year, and there was a significant statistical difference between the threat level achieved from the QEC method, and the prevalence of musculoskeletal disorder signs (P < 0.001). It was determined in this study that the prevalence of musculoskeletal disorders is high among the workers in the brick workshops; Therefore, it is necessary that appropriate control measures are taken as soon as the conditions are corrected.

The high prevalence of obesity، especially among adolescence، is one of the most important problems of societies. In addition to genetic factors، dietary habits and lifestyle (physical and leisure time activity) are the factors that could influence the prevalence of obesity. This study aimed to determine the pattern of food consumption and physical activity among high school students in the North Khorasan Province This cross-sectional study was conducted among 450 high school students in North Khorasan. A multistage sampling was done. Data were collected for each subject using a questionnaire consist of anthropometric، demographic، dietary habits and lifestyle (physical and leisure time activity) information. Statistical paired t-test، chi-square، ANOVA، and Pearson correlation were used to analyze data using SPSSversion16 From the 450 study population، 228 were females (50. 7%). The prevalence of obesity was higher in girls in comparison with boys. Up to 60. 2% and 64. 5% of boys and 38. 6% and 47. 4% of girls in the morning and evening shift of the school eat breakfast during the weekdays، respectively. The boys were doing more Physical activity compare with girls. Up to 35% of students during weekdays were watching television for two hours، while on holidays 39. 8% were watching about 4 hours. Statistically significant association was found between BMI and eating snacks while watching TV، working with computer، eating dinner، eating snacks in the morning and afternoon، rice consumption for meals، using bread with the meals، consumption of raw vegetables and fruit during the week، cooking methods of rice،and attending in the sports class during summer. (P <0. 005) high prevalence of obesity، receiving high calorie in diet and poor dietary habits،and physical inactivity in adolescence need careful educational and cultural planning by the authorities and health policy makers.

Amblyopia is a visual disorder that occurs in childhood and due to some complication such as visual acuity (visual error)، strabismus and psychosocial disturbances on time diagnosis and treatment is of great importance. For this issue، this study was performed to determining prevalence of amblyopia in 3-6 years old children in Bojnurd. This study was a cross sectional in 14061 children in Bojnurd. Screening instruments in this study was Snellen chart and standard questionnaire of state program of amblyopia. Children who were abnormal in visual screening، referred to ophthalmologist. The best reform visual was or less in any eyes، defined as amblyopia. Of all participants، 12935 children (92%) healthy and 1126 (8%) was suspicious and referred to ophthalmologist. Of all referred participants، 69 children (11. 8%) has amblyopia، 133 (22. 8%) children had reflective errors، 11 (1. 8%) was strabismus and other (1. 03%) given other visual disease. Reflective errors with 78. 2% was the most prevalent cause of amblyopia and so strabismus and other disease. The results of this study are in line with other studies in Iran، underlining high prevalence of ambylopia in childhood ages، and capability of prevention and effective treatment، according to removable reasons، provided on time diagnosis.

Congenital abnormalities are essential causes of morbidity and mortality in neonates. Congenital disorders are diseases which develop during egg fertilization or during embryo development. The prevalence of affected infants that are born alive is estimated about 3-5%.. This study has been performed on revealed malformations of the infants born in Sistan region. This descriptive cross-sectional analysis was performed on all infants born alive and the congenital anomalies were detected from 1800 infants in three months. Sex، gestational age، type of abnormality، and neonate’s status at discharge were recorded in a questionnaire. The data was analyzed by the spss 19 and chi-square test software. The prevalence of abnormalities was 1/8%. There was a significant difference between maternal age and the incidence of congenital anomalies (P≤0. 05). According to our findings، the prevalence of congenital malformation especially abnormalcy of the ear، eye and face was 29. 5%. The prevalence of congenital anomalies in year 1391 was higher than 1383 in Sistan region. Thus، more medical attention should be paid to their diagnosis and treatment at early stage. Also educational programs on congenital malformations and the consequences of consanguineous marriages should be performed.

The most common disposal method in the most countries of the world is in municipal landfills. Contamination from landfill leachate can pose irreparable risks to the environment، particularly to the groundwater. Today، the use of coagulants in water and wastewater treatment is common and use of this material is increasing. The aim of this study was to determine poly aluminium chloride efficiency in removal of COD، TSS، color and turbidity of wastes landfill leachate of Qazvin city. in this study leachate were taken from landfill of Qazvin. Samples were taken during 6 months and the sampling interval was every 2 weeks. The Samples were transported to the laboratory and stored at 4 °C until testing. Experiments were performed according to standard methods for water and wastewater testes. The results showed that the optimum pH and poly aluminium Chloride amount was 7. 5 and 2. 5 gr / L، respectively. The removal efficiency in the optimum conditions for COD، TSS، turbidity and color was 48. 5%، 82. 5%، 73. 5% and 70. 5%، respectively. Qazvin has a high production rate of landfill leachate. Besides، cost effectiveness and high removal efficacy of poly aluminium chloride makes this method a convenient، no high tech technique for treatment of landfill leachate.

Test anxiety is one of the common problems in children and adolescents that reduces their efficiency. Too much anxiety may firstly disrupt studying and memorizing، and finally disturb the performance of individual during the test. The purpose of this study was to investigate the effectiveness of metacognitive therapy (MCT) on reducing test anxietyand changing the metacognitive beliefs of the eleventh and twelfth grade students. This empirical research uses pretest، posttest and follow-up design for the experimental and control groups. For this purpose، 32 students who visited Razicounseling center in Alborz Province and gained high scores (higher than 12) in Questionnaire Sarason Test Anxiety were selected as sample group and were divided to experimental and control groups through random assignment. For the experimental group metacognitive therapy (Wells -1995 to 1997) was conducted in 10 sessions lasting 45 Minutes. Metacognition Questionnaire-Short Form (MCQ30) Wells and SarasonTest Anxiety questionnaire were used to measure their metacognitive beliefs. Finally data were analyzed via spss software version 16 by use of ANCOVA analysis test. The outcomes showed that test anxiety in the experimental group has declined significantly (P <0/05) after treatment. Also in this group metacognitive beliefs (positive and negative metacognitive beliefs regarding worry، cognitive confidence، need to control thoughts،cognitive selfconsciousness) hassignificantlydeclinedfollowingmetacognitive therapy (P <0/05). After 6 months follow-up were the results significantly (05/0P <) has decreased compared to the pre-test. cognitive therapy led to improved metacognitive beliefs of students، as well as reducing the test anxiety in them.

in the recent decades، clinical governance have been used for reducing a deep division between the qualities and the potential to provide the desired and high quality services en. This study aimed to assess the readiness to deploy clinical governance in hospitals of Shiraz University of Medical Sciences. This study is a cross-sectional study was conducted in the summer of 2013. The target population for all categories of staff in five hospital affiliated to Shiraz University of Medical Sciences. The sample size was set equal to 150. Standardized questionnaire to collect information on clinical governance climate Freeman (26) was used. Content validity of the questionnaire was approved by the therapists and reliability using Cronbach''s alpha، was estimated at 79%. For data analysis، descriptive statistics and ANOVA، t-test and Pearson correlation were used SPSS21 software. The findings of this study indicate that all six components of clinical governance are higher than the baseline average. Between the age and experience of clinical governance there is no statistically significant relationship (P> 0. 05). T test results also showed that there is a statistically significant relationship between gender and clinical governance (P = 0. 041) so that the mean clinical governance was higher in women than in women. the hospitals in this study have a good readiness for implementation of clinical governance and to develop and enhance this، it suggested that focus on educational staff needs and managers’s perspective.

No doubt، in one hand، organizational intelligence as a capability of an organization to create mental power and in the other hand nurturing creativity، finding creative minds and making use of employee’s creativity must be regarded important by managers of an organization. The purpose of the present study is to investigate the relationship between organizational intelligence and employee’s creativity for the staff of the medical training center in hospitals affiliated to North Khorasan University. The present study is descriptive – analytical. The statistical population includes the whole staff of the medical training centers in hospitals affiliated to North Khorasan University (n=1050) in 2012-2013. The sample group (n=286) was selected by the stratified proportionate method using Morgan Table. The data was collected using two questionnaires: 1. Albericht Standard Organizational Intelligence Questionnaire (reliability rate= 95%) 2. Rendsip Standard Creativity Questionnaire (reliability rate= 88%). The collected data was analyzed using SPSS and LISREL software. On the whole، there was no significant statistical relationship between organizational intelligence and creativity (p=0. 061). Some dimensions of organizational intelligence (strategic vision، knowledge and performance) showed significant relationship with creativity. Knowledge was more influential in employee’s creativity (p=0. 024) than strategic vision Since organizational intelligence and its parameters play an important role in capacity building and promotion of organizational knowledge، and on the other hand since it is very important to create a creative climate in organization، managers of organization must provide a suitable climate for creativity in the organization based on effective parameters of organizational intelligence

Dracocephalum kotschyi is one of the medicinal plants in Lamiaceae family and native to Iran، In traditional medicine، this plant is used for treatment fever، joint pain، rheumatism and is used as an anti-inflammatory and contains essential oils، flavonoids، Rosmarinic acid and monoterpene but it is endangered due to indiscriminate harvesting. After preparation of different extracts such as Hexane، Dichloromethane، Ethyl acetate and Methanol of kotschyi، their antioxidant properties were measured by two methods، DPPH and FRAP. BHT and vitamin C were used as positive control for comparison. In this study، the amount of phenols، flavonoids and anthocyanins were also measured. The results showed that the antioxidant activity was dependent on concentration and the highest antioxidant activity was observed in Methanolic extract and the lowest activity in the hexane extract. Total phenol and flavonoid content of the Methanolic extract was higher than other extracts. However، It was a direct relationship between flavonoid and phenolic content and antioxidant activity (R2=0. 917، 0. 885). The more antioxidant activity of extracts was obtained in the higher concentration، Furthermore the results showed that flavonoids and phenolic compounds had a major role in the antioxidant activity and more studies are needed for the isolation and purification of specific active components of this plant.

Hospitals are significant provider arm of health care services. Performance indices are one of the importance factors in hospital efficiency and productivity. This study aimed to compare the performance indices for hospitals in North Khorasan University of Medical Sciences by Ministry of Public Health standard. this was a cross-sectional study that investigates the performance indices for hospitals in the North Khorasan University of medical sciences in 2013-2014. Data collection was performed standard Questionnaire of the Health Ministry. To analyze the data we used SPSS 16 software and descriptive statistical were applied. Performance indicators of hospitals in North Khorasan University of Medical Sciences have good condition. the bed occupancy rate، the average turnover rate and the average length were %74. 6، %75. 81 and 2. 23 days in 2013 respectively. the bed occupancy rate، the average turnover rate and the average length were %71. 2، %76. 41 2. 5 days in 2014 respectively. Between 2013 and 2014، the indicators of hospitals showed no significant change. in according to the state of the studied hospitals by standards have in good condition. In order to improve and to develop، new goals select for the Hospital and It is recommended that hospital administrators use experiences of others.

one of the most common problems in metal ceramic restorations is the loss of porcelain- metal bond that causes the treatment to fail. The aim of this study was to evaluate fracture mode of Ceramco and Noritake porcelains bonded to Commend base metal alloy after various surface treatments. In this laboratory study، 64 wax papers in size of 1 x 8 x 25 mm were cut with a surgical blade and after investing، burning out، casting with base metal alloy and surface treatment، were divided randomly into two groups. Porcelain application was done by Cermco porcelain in one group and by Noritake porcelain in the other. Surface treatment in each group was randomly accomplished by one of four different methods to improve metal-porcelain bonding. Porcelain fracture of the samples was evaluated by 3- point bending test by Universal Testing Machine with the speed of 1 mm per minute. Photos were taken from the samples. In the Ceramco porcelain group، the highest percent of cohesive failure was in the sandblast، grinding، sandblast، oxidation subgroup (22%) and in the Noritake porcelain group، it was in the sandblast، grinding، sandblast، steam cleaning، oxidation subgroup (96. 97%) (P value<0. 001). Performance of oxidation stage increases the percent of cohesive failures. Type of applied porcelain is effective on percent of cohesive failure without considering type of surface treatment and Noritake porcelain showed more failure.

Congenital adrenal hyperplasia is a common autosomal recessive disorder، resulting from lack of activity in one of the five enzymes which produce cortisol from cholesterol. Treatment of these patients is very difficult and overtreatment or under treatment of them both influence on their growth pattern. Accordingly، we evaluated the growth pattern of these patients during one year. Methods and Materials: We studied 50 patients whom visited in endocrinology department of Imam Reza hospitial، Mashhad، Iran، during one year. We measured height rate، weight rate، and upper segment to lower segment index، body mass index and 17-Hydroxyprogesterone (17-OHP) levels regularly. The results showed that with increasing levels of 17- hydroxyprogesterone، the height growth rate of the patients also increases (P<0. 05). In patients with salt-wasting group، there was a potential of height reduction and height standard deviation with advancing of age comparing with other groups (P<0. 05). The average age of the 11-Hydroxilase deficiency patients was higher than the other groups. There was a significant difference between the age at diagnosis and the age that patients were visited regularly. Therefore the specific etiology and appropriate treatment are the main predictors of growth pattern at these patients، and it also requires using all necessary facilities for regular care of these patients، in order to optimally control the disease is felt.

Discourse analysts have employed genre analysis to discover textual structures of medical texts as well as to compare and contrast differences within and across genres due to variables such as language and cultural background. However، a lack of research is felt in analyzing the research article genre in the field of nursing and midwifery in the Iranian context. It seems that few studies have focused on finding the textual differences between abstracts published locally in Iran and those published internationally. In this study، 30 abstracts from two Iranian journals and 30 abstracts from two international journals were chosen and compared based on Swale''s and Nwogu''s model. Chi-square test was utilized to detect the possible differences. The results showed that Iranian and international abstracts were significantly different in providing «indicating a gap» and «indicating non-consistent results». No other significant differences were observed in the analysis. The findings can be incorporated in teaching materials for writing courses and encourage Iranian ESP teachers toward more research-based teaching. It also seems that further studies are needed for other aspects of writing.

The dentists evaluate dental development according to radiographic records and developmental tables. if a tooth is not visible in radiograph, while expected to be traced in, mostly is diagnosed as congenital tooth missing. although more than 99% of teeth develop in expected range of time presented in developmental tables, sometimes this process takes long more than normal and if the dentist hesitate in treating the problem by closing the space a catastrophic situation might happen because the tooth may develop so later than normal and if the dentist try to close the space as treatment plan, impacted tooth may resorb the adjacent roots. This report has presented a 12 years old girl with several years delay in eruption of lower left second mandibular premolar.

There are few reports on unilateral renal agenesis with unilateral dilated ectopic ipsilateral ureter entering a massive seminal vesicle cyst. Naturally such rare case makes the diagnosis difficult. Here we are presenting a 36 years old man with hematospermia. The diagnosis was confirmed by imaging and under laparoscopic surgery the ectopic ureter and seminal vesicle cyst were removed.