JOURNAL OF NORTH KHORASAN UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:8 | Issue:4|Papers Count:16

Wilms tumor is the most common renal malignancy in childhood, whereas, it only consists 1% of adult renal tumors. It is much more difficult to diagnose in adults because of large differential diagnosis of adults renal masses. A 16 years old female with nonspecific right flank pain was referred. Computerized tomography (CT) scan revealed a large renal mass occupying the right flank area with IVC and intra-ureteral extension. Biopsy also showed a nonspecific spindle cell carcinoma. She underwent an urgent surgery because of intra ventricular extension of the tumor. Pathological assessment also approved the wilms tumor. Regarding the rarity of this lesion in adults, they are treated with the current protocols which are recommended for children. Therefore, the case was treated with adjuvant chemoradiotherapy as stage 5a and National Wilms Tumor Study (NWTS) protocols. Unfortunately, she had a recurrence in her right lung two years after the surgery which was treated with surgery and chemotherapy. She again had a recurrence four months later which ended up in patient's death due to stopping the treatment.

Background & Objectives: Menopause is a natural period of women’s life that will be experienced soon or late. Spending this period properly is directly associated with the improving quality of life.Materials & Methods: The qualitative research has been accomplished by phenomenological method using the Colazzi approach about women’s menopausal experiences. Thirty-six women at the age of over 40 who were referred to the health centers in Mashhad were enrolled in present study by target based sampling. This selection has been accomplished by the focused group discussion method to get results until saturation. Interviews details were recorded by the interviewer’s permission and immediately carried out after a few sessions by thematic analysis, according to the seven phases Colaizzi method.Results: Participants had two main ideas including satisfaction and un satisfaction about the menopause. The main thematic results were as follow: Menopause as a compulsory component of life, need of support, spirituality, education, effective compatibility, and self-efficiency. Moreover, supporting by husband and children is the most effective factor in strengthening their selfefficiency. They believed that knowledge promotion reduced morbidity and improved the quality of life and self- efficacy. Conclusion: Important aspect in the lives of women is effective adaptation with menopause as an inevitable process of life. Applying real support resources to protect and promote self-efficacy and awareness are effective to adapt them to this stage of life. These findings could be a new approach to health care practitioners to understand more realistic needs of women in this stage of life and could provide their real problems

Background & Objectives: The purpose of present study was examination of mindfulness-based cognitive therapy (MBCT) effects on depression and anxiety in female adolescents with divorced parents in Bojnurd.Materials and Methods: This quasi-experimental study was done with the design of pretest, posttest, and control groups. The study population included 19 junior high schools in which a cluster of 4 schools has been chosen. Then 50 out of 67 female adolescents with the age range of 12-14 with divorced parents in the range of 4 schools has been randomly selected based on Krejcie-Morgan’s sampling table. Then, they were randomly divided into two groups of experimental (25 people) and control group (25 people). Hamilton depression and Spielberger scale were used to collect data. Intervention procedures were performed according to the guidelines of Kabat Zinn meetings of mindfulness. Data analyzing was done via statistical approaches of Geruf Clomot test, independent t-test, Levin test, and covariance analysis using the 17 SPSS software.Results: The results showed that cognitive therapy with mindfulness approach significantly reduced depression and anxiety scores in the experimental group in comparison with the control group.Conclusion: Mindfulness-based cognitive therapy effects on depression and anxiety in female adolescents with divorced parents.

Background & Objectives: Oral health is strongly correlated with good diet. Therefore, a nutrient-rich diet with minimal cariogenic effects is crucial. The purpose of this study was to evaluate the food patterns in children who were between 3-6 years old, with early childhood caries and caries free in Mashhad kindergartens.Materials & Methods: Tooth caries status of 200 children was recorded. The parents were asked to complete the food frequency questionnaire. Food patterns were determined by factor analysis. Regression analysis, independent t-test and Mann-Whitney U test were used for data analysis. The statistical significance level was set at 0.05.Results: The study successfully identified cariogenic and non cariogenic food patterns. The chance of dental caries increased by 30 folds for every unit increase in cariogenic dietary pattern score (p=0.003), whereas there wasnt any significant correlation between non cariogenic food pattern and caries. The consumption of sweet foods and snacks as well as total carbohydrate intake was considerably higher among the cariogenic food pattern group (p<0.001). On the other hand, fat and micronutrients intake such as folate and potassium was significantly associated with caries free group (p=0.003), (p<0.001).Conclusion: Cariogenic food patterns increased the possibility of dental caries, while non cariogenic food patterns had less effect on decreasing this likelihood.

Background and Objective: Mental workload is one of the affecting factors in efficiency and performance of therapist in the workplace. Neuro feedback is a new modality for improvement of healthy person's daily activity and its quality. The aim of this study is evaluation of neurofeedback effects on mental work load in occupational therapists.Materials and Methods: This study has experimental design with pre-post test, experimental- fake group and was performed on 22 occupational therapists. Subjects were divided into two real neuro feedback and mock neuro feedback (placebo) groups. Both groups were treated with neuro feedback for 12 sessions. NASA (task load index) was used to assess both groups before and after the treatment. Effect size and improvement percentage were used to analyze the collected data.Results: The results of the improvement percentage showed that mental need and hopelessness subscales in real neuro feedback have more than 15% difference in comparison with mock neuro feedback that indicate clinical significant. Effect size in the real neuro feedback on mental need subscale was great and in time need and hopelessness subscales were average. Effect size in mock neuro feedback on total subscales was low.Conclusion: The effectiveness of real neuro feedback was not due to the changes in the placebo. It can be as a complementary decreasing in the mental work load.

Background & Objectives: One of the objectives of each system is cost management to help organizations to provide high quality goods and services at a competitive environment. The present study was aimed to calculate the costs of cardiac care unit at Imam Reza hospital of Bojnurd by activity-based costing method.Material & Methods: This study is an applied study that cross-sectional and retrospective methods were carried out. Data gathered by observation, interviews, review documents and financial statements of Imam Reza hospital in Bojnurd in 2013. The hospital activity centers were identified. After costing each activity center, indirect costs of cardiac care unit were allocated to this sector by direct allocation method. Microsoft Excel 2007 software was used for the calculation.Results: The results showed that the total cost of cardiac care unite services is 19,677,265,413 Rials equivalent to 8.06% of hospital costs., that 65.1% of the costs related to personnel costs, 8.1% of the costs related to materials and supplies and expenses related to overhead costs is 26.8%.Conclusion: Majority of the costs of cardiac care unit are the employee compensation costs which are among the constant costs of hospital. It seems that we should optimize the use of staff through different processes such as ward development, proper pattern of consumption material, and increased bed occupancy index.

Background and Objective: Sore throat is a common and unpleasant complication of anesthesia which often occurs after the extubation. This study was conducted to compare the effects of two pharyngeal packing methods (wet pack with saline and wet pack with 1% of Lidocaine) on postoperative sore throat after the nasal surgery.Materials and Methods: Sixty patients aged between 18-70 years with ASA I-II-III who were candidates for elective nasal surgery and categorized in two groups were enrolled in this double-blind randomized clinical trial. In the first group dampened gauze with 10 cc/kg was used for pharyngeal packing. Patients underwent general anesthesia with a similar method and after intubation, pharyngeal pack was placed with Magill forceps and in the end of operation before extubation was removed. Amount of sore throat, coughing, odynophagia, hoarseness, laryngeal spasm, nausea, and vomiting were assessed and compared after the extubation.Results: There weren’t any significant differences between groups in term of weight, height, sex, age, duration of surgery, and type of surgery (p=0.194). Also there wasn’t significant difference in sore throat between the lidocaine and placebo group. Conclusions: There wasn’t any significant difference in sore throat between two groups of Lidocaine and placebo.

Background& objectives: Accumulation of free oxygen radicals leads to the oxidative tension. This tension will be able to change the enzyme activity, gene expression, calcium release from intracellular deposits on the membrane structure, cell growth, and death. Plants are rich in the case of antioxidant compounds which will be able to reduce the risk of some chronic diseases such as cancer, heart disease and stroke by protection of cells and increasing the plasma antioxidant power. This study aimed to evaluate the antioxidant activity and cytotoxicity of methanol extract of the Eremostachys labiosiformis (Popov) Knorring plant.Materials and Methods: Methanol extracts were obtained from E. labiosiformis plant by maceration method following the collection, drying and powdering. The antioxidant activity and cytotoxicity effect were assessed by free radical scavenging method (DPPH) and MTT (on Vero cell lines), respectively.Results: The antioxidant capacity of E. labiosiformis methanol extract was 0.392 mg/ml. Cytotoxic effect (CC50) during different times of 24, 48 and 72 hours was also 1329.16 mg/ml, 1360.25 mg/ml and 1159.71 mg/ml, respectively.Conclusion: The comparison results of E. labiosiformis antioxidant properties with ascorbic acid showed that this plant has a good free radical scavenging activity in comparison with the other similar plants. In the case of toxicity assessment, it was shown that the methanol extract of this plant can be safe for use in therapy. However, using the other cell lines as well as in vivo studies are recommended for a definitive conclusion.

Backgrounds and Objectives: Eye examination for Retinopathy of Prematurity (ROP) screening is a painful procedure that causes behavioral changes in premature infants. Multisensory stimulation is a non-pharmacological analgesic method, which affects the behavior measures during painful procedures. The purpose of this study was to determine the effect of multisensory stimulation on infant behavior during an eye examination for ROP screening.Material & Methods: In this single blind randomized clinical trial, eighty premature from Khatamolanbya hospital in Mashhad at July 2014 were divided randomly into two groups. In the intervention group, multisensory stimulation was performed 15 minutes before the start of the examination and the control group received standard care. Infant behaviors were recorded at 30 seconds intervals; before, during, and after eye examination. Data were analyzed by independent t test and repeated measures ANOVA using the SPSS version 14 software.Results: 53.2% of the babies were girls and 46.8% were boys. The mean gestational age of multisensory stimulation was 30.6±1.8 weeks and the normal group was 30.6±8.1 weeks. Behavioral status was significantly different in both groups during the evaluation (p<0.001). Behavioral changes during the examination of the two groups was significant (p<0.001); however there was a greater reduction in the control in comparison with the intervention group.Conclusion: Multisensory stimulation program causes lower changes in behavioral status, and can be used as a way to reduce behavioral changes during an eye examination in infants.

Background & Objectives: Epileptic child's mothers are faced with care problems such as low levels of management of self-efficacy care. These mothers have not received the same empowerment program yet. Aim of this study was to determine the effect of an epileptic child's care giving empowerment program on management of self-efficacy care in epileptic child's mothers.Materials and Methods: This clinical trial study was conducted on 100 mothers of epileptic children who hospitalized in neurology department of Ghaem Hospital in 2013. Eligible mothers were selected via convenience sampling and randomly assigned to experimental and control group. At first, management of self-efficacy care was evaluated using standard care giving self-efficacy scale in both experimental and control groups. In experimental group empowerment care was performed and the control group received no intervention. Forty-five days after the last session of program implementation, management of self-efficacy care was evaluated in both experimental and control groups again. Data were analyzed using SPSS version 11.5.Results: The results showed that the two groups were the same considering population variables and the mean scores of management of care self-efficacy (p=0.84). Mann- Whitney tests showed significant differences in two groups after the intervention (p<0.001). Wilcoxon test also showed significant increase in the management of self-efficacy care of experimental group (p<0.001). Although, this score significantly decrease in control group (p<0.001).Conclusion: Epileptic child's care giving empowerment program can be helpful in improving management of self-efficacy care of epileptic child's mothers.

Background & Objectives: Fasting is an important decision for the diabetic patients, that should be done considering to the religious instructions and medical consultant. To decrease symptoms of diabetes, it is very important to estimate awareness of these patients in this domain. Aim of this study is knowledge of diabetic patients about fasting who were referred to the diabetic clinic at bojnurd district-2015.Material & Methods: This sectional study was performed on 376 diabetes patients who were referred to diabetic clinic at Bojnord district in 2015. Data were gathered using dual questionnaires. Statistical analysis was done by Pierson coordinate index statistical tests, freet and one way variance analysis using the SPSS 16. Results: Mean age was 54.35±15.83 years old and most of them were females (62.3%). Majority of cases (90.3%) were suffered from type two diabetes, and 48.3% of them were illiterate. Mean score for awareness was 35.31±11.36. The most correct answer was related to the feeding diabetic patients at Ramadan month (51.03+18.49), and the least correct answer was in line with consumption of medicines decreasing blood sugar (18.0+23.44). In mean score based on level of education, there was only a significant difference in total score (p=0.035).Conclusion: The results of this study showed that the diabetic patients have a low awareness of diabetes and fasting. Therefore, awareness of diabetic patients, can be important in controlling and prevention of its complications and person healthcare.

Background & Objectives: In the present study role of assertiveness training on self esteem and loneliness was examined in female students with addicted parents.Material & Methods: The method of this study was experimental and design of study was pretest-post-test with control group. The population of this study consisted of female students with addicted parents who were studying in Bojnurd middle schools between 2012-2013. Sixty cases were selected by convenience sampling and randomly divided into control and experimental groups. Self-esteem and loneliness of subjects in both pre-test and post-test were evaluated. Assertiveness skills were applied as the independent variable on the experimental group (8 sessions of 90 minutes).Results: The results showed that there were significant differences between the experimental group and the control group. This means that assertiveness skill training caused significant changes in mean scores for self-esteem and loneliness of the experimental group compared to the control group.Conclusion: Assertiveness skills can be a useful intervention for addicted parent’s students with self-esteem and loneliness problems.

Background & Objectives: Drug substitution treatments are important due to their social pathology decreasing role. The effectiveness of these treatments is depended on several factors including patients’ treatment attitudes, which is critical in their treatment acceptance and persistence. Regarding a valid instrument necessity in study of the patient’s attitudes, a survey was conducted to validate the Persian version of the questionnaire on attitudes toward methadone maintenance treatment.Material and Methods: It was a cross-sectional study in 2015. The questionnaire was translated into the Persian language through an open translation procedure and was revised and modified by the related professionals. Seven hundred and fifty patients with substance use disorder filled out the questionnaires. The same questionnaire was filled out again by 100 out of the 750 participants. Data was statistically analyzed through SPSS16 based on statistical tests including Cronbach’s Alpha, intraclass correlation coefficient, and factor analysis correlation.Results: The mean age of participants was 40.92+13.12 years old and 628 participants were male (83.7%). The Cronbach’s Alpha coefficient for Methadone scale treatment of the addiction treatment attitudes in this study was 0.81 and The Intraclass correlation coefficients were 0.75.Conclusion: The Persian version of the 32-item questionnaire of the addiction treatment attitudes toward methadone maintenance treatment was found as an appropriate instrument for addiction treatment attitude study.

Background and Objectives: The University of Medical Sciences is one of the most important organizational justices of the giving service to the citizens and the main purpose of that is giving service and supplying citizens’ needs. The study of the ethical behavior of nurses of this organization and its affecting of organizational justices leads to offer better services.Materials and Methods: This descriptive and correlation analysis was performed to assess the role of job stress as a mediator between organizational justices and the job ethics of nurses. According to statistics offered in 2015, the number of total nurses of Taleghani hospital Mashhad was about 400 persons, from which 200 person were selected using the sampling formula. The survey method and questionnaire were used to collect the information. Then the data were analyzed using AMOS statistical software.Results: The organizational justice improved the job ethic. Moreover, stress can be as a mediator in this relationship between organizational justice and the job improvement ethic.Conclusion: The study showed that there was a relationship between organizational justice and job ethic of nurses. Therefore, organizational justice could lead to their job ethic. Beside the positive role of organizational justice in job ethic improvement, the job stress act as a mediator in this relationship in which the effect of organizational justice on the job ethics is more among the nurses with low stress.

Background & Objectives: Life satisfaction among the elderly people can be affected due to different variables such as social participation. This study aimed to determine the relationship between social participation and life satisfaction among elderly in Kerman.Materials & Methods: This was a cross-sectional study in which 200 elderly people were questioned in Kerman. Social participation and life satisfaction were measured using the social participation questionnaires (Canadian Community Health Survey) and Life Satisfaction Index (LSI-Z). To analyze the data we used descriptive statistics and to study the relationship among variables, statistical tests such as Pearson correlation, Chisquare, T test and one-way ANOVA were used. Data were analyzed using the SPSS. 17 software.Results: The highest and lowest rates of social participation were related to participation in religious ceremonies and social communities such as neighborhood council, respectively. Diseases and health (67.5%) were the most important barriers to social participation. However, more than half of the elderly people had medium life satisfaction (52.1%). There was a significant correlation between social participation and life satisfaction (p=0.003).Conclusion: The results of this study indicated that the social participation has an important role in life satisfaction among the elderly people. Therefore, it is necessary to consider barriers of social participation such as geriatric disease.

Background & Objectives: The gallbladder and bileduct epithelium lining of bacteria that are able to create a powerful source for gallbladder disease. Since Helicobacterpylori infection plays an important role in the development of chronic inflammation of the gastric mucosa and provides conditions for the development of gastric adenocarcinoma and peptic ulcer disease, recent reviews showed probability relationship between this bacterium and gallbladder cancer. To determine the frequency of H. pylori in gallbladder samples of patients with cholecystitis and determine pathologic changes.Material & Methods: 100 patients with cholecystitis were investigated randomized. In the operating room after cholecystectomy, urease test was performed on gallbladder samples; then samples in formalin solution transferred to a Afzalipoor hospital laboratory and the samples were assessed for H. pylori by Giemsa staining. The pathological changes such as hyperplasia, metaplasia/dysplasia and lymphocytic infilteration were reported by the Department of Pathology.Results: 23% of samples was positive for H. pylori that 39.1% was male and 66.9% was female and 95.7% was chronic cholecystitis and 4.3% was acute. In positive Hpylori cases there was 21.7% cases with pathological change that lymphocytic infilteration and mononuclear cells were seen commonly. Conclusion: In this study, the prevalence of H. pylori and urease test results were significantly associated with pathologic changesbut had no correlation with age, sex and status.