نشریه دانشگاه علوم پزشکی بیرجند
سال بیست و چهارم شماره 3 (پیاپی 72، پاییز 1396)

Family behaviors are of great importance in the case of chronic diseases that require constant self-management. Chronic diseases management often involves changes in daily procedures that occur in family settings. This study aimed to determine the effect of education provided to family caregivers on supportive and obstructive behaviors of the family of individuals with type 2 diabetes.
In this randomized controlled clinical trial) IRCT2017053017756N15(, 60 family caregivers of type 2 diabetes patients were selected based on inclusion criteria and via convenience sampling method. They were allocated to intervention and control groups through simple randomization. For the intervention group, seven educational sessions were conducted along with telephone follow-up based on nursing diagnosis. The diabetes-specific Family Support Scale by Schafer et al. was completed by the patients before and two months after intervention. Data were analyzed in SPSS software) version 18(using T-test, Chi-square, and Wilcoxon tests.
There was no significant difference between the two groups before the training. However, after the intervention, all the items of supportive behavior enhanced significantly in the intervention group compared with the control group (p Using the supportive and obstructive behavior training protocol of family caregivers, as an effective nursing intervention, promoted supportive behavior and reduced the obstructive behavior of family caregivers. Therefore, the implementation of this program can be recommended.

Resistance to trastuzumab has been a critical barrier to targeted therapy of HER 2-positive (Human Epidermal Growth Factor Receptor 2) breast cancers. MicroRNAs (miRNAs) are known as decisive core regulators of drug resistance that modulate the epithelial-to-mesenchymal transition (EMT) and cancer-related immune responses. The present study aimed at examining the expression of miR-141 in trastuzumab-resistant and trastuzumab-sensitive BT-474 breast cancer cells.
In this experimental study, trastuzumab-resistant BT-474 cells were generated by continuous in-vitro culture of BT-474 cells in the presence of trastuzumab for six months. The relative expression of miR-141 to U6 RNA was then evaluated in trastuzumab-resistant and trastuzumab-sensitive cells using Relative Real-Time PCR. Mann-Whitney test was used to compare the difference between the two groups.
There was a significant difference between the survival rates of resistant BT-474 cells and sensitive cells in the MTT test in the presence of different concentrations of trastuzumab showing that BT-474 breast cancer cells have turned resistant to this drug under long-term culture (P=0.001). Also, the expression of miR-141 in trastuzumab-resistant cells was significantly reduced by four times compared with the BT-474 parent cells (P=0.049).
Down-regulation of miR-141 in trastuzumab-resistant BT-474 cells might be one possible mechanism for resistance against trastuzumab and an indication of the role of this microRNA in controlling the metastasis pathway.

Sulforaphane is a type of isothiocyanate with anticancer effects. In the present study, the effect of sulforaphane in angiogenesis in chick's chorioallantoic membrane was investigated.
In this experimental study, a total of 56 fertilized eggs were divided into 7 groups of eight with three replications: control, control-Experimental and five treatment groups treated with sulforaphane (50,100,200,400 and 800µg/ml, respectively). On the 2nd day of incubation, a window opened on every egg. On the 8th day, treatment was done.On the 12th day, all CAMs were examined and photographed and the number and length of the vessels around the sponges, weight, and length (CR) of chick embryo were determined. Besides, every vessel hemoglobin content was measured using Drabkyn, s test. The antioxidant effect of sulforaphane was assessed by means of ABTS and DPPH assay. The obtained data were statistically analyzed using ANOVA and SPSS software (V: 16) at the significant level of 0.05.
It was found that 50 µg/ml of sulforaphane did not have any significant effect on the angiogenic process, but 100, 200, 400 and 800 µg/ml of sulforaphane; i.e in a dose-dependent manner led to a decrease in number, length, and hemoglobin content of the blood vessels. Moreover, embryo weight and CR decreased compared with the control. The results from DPPH and ABTS assay showed that Sulforaphane, dose-dependently, inhibits the activity of free radicals.
Sulforaphane has anti-angiogenic and anti-oxidant properties, and it can be a suitable candidate for the treatment of diseases associated with angiogenesis.

Since the intensity and duration of exercise and recovery time are one of the influencing factors on injuries and adaptations, the current study examined changes in muscle damage active in overweight male students after exhaustive aerobic and anaerobic exercises.
In this semi-experimental study, 22 overweight male students were randomly divided into experimental (n = 12) and control (n = 10) groups.The subjects first tested the aerobic test of astrand (including running on a treadmill at the rates of 5 to 8 mph with a gradient of 0, for 3 minutes, and after 3 minutes every 2 minutes, a steep gradient of 2.5%, and the rate was constant and the activity continued until the time of exhaustion, and one week after an anaerobic Rast test (including 6 repetitions of two fast running 35 meters and with a maximum intensity performed after the rest interval of 10 seconds in each repetition) The control group continued to their daily activities without any interruption. Finally, the obtained data were analyzed through covariance and T-dependent analyses at the significant level of 0.05.
It was found that in the pre-test, post-test LDH(17.16±0.9), AST(140±5.61) and CPK(147.5±7.65) levels in the experimental group, compared to the control, due to aerobic and anaerobic exercise, showed a significant increase. The level of CPK and LDH between the experimental and control groups was significant in aerobic exercise (P≤ 0.05), (P≤ 0.01); respectively, and in anaerobic exercise (P = 0.004), (P = 0.006) ; respectively, but the AST values between the two groups increased except for the aerobic exercise sessions (P = 0.7), (P = 0.1); respectively.
In general, the study showed that the muscle damage in exhausted aerobic exercise is less than that in anaerobic exercise. Thus, it is recommended that performing aerobic and anaerobic activities should be done at appropriate resting intervals.

Congenital hypothyroidism is one of the most important preventatives and curative causes of the growth and developmental disorder, which results in the implementation of a screening program for prevention of retardation. The purpose of this study was to compare the developmental indices of children with congenital hypothyroidism treated with healthy children in South Khorasan.
In this case-control study, 30 children aged 18-24 months with hypothyroidism were diagnosed with screening Selected as a case group. Also, 30 healthy children were matched with the case group, From health centers that children with hypothyroidism were covered by those centers, They were randomly selected as control group. These children were examined for evolutionary indicators. The data collection tool was a questionnaire for ages and stages of Ages & Stages Questionnaire(ASQ). Data were analyzed by SPSS software (version 15) and analyzed by means of Kolmogorov-Smirnov statistical tests and t-test. Independent samples were analyzed at the significant level of P=0.05.
It was found that mean somatic developmental indicators in congenital hypothyroid children, compared with those in the healthy group were significantly lower. However, the score for all children was above a standard deviation one unit.
Although the mean developmental indices in hypothyroid children under treatment, based on Ages & Stages Questionnaires were lower than those in the control group, it was acceptable

Iron deficiency anemia is the most common hematic disorder in infants and children, and is regarded as a major health problem. The easiest way to prevent this disorder is to take iron supplements on a daily basis (i.e., iron supplementation). The current study aimed to determine the effect of education to mothers based on the theory of planned behavior (TPB) on iron drop intake of infants and children aged 6 to 24 months.
This is a randomized, controlled field clinical trial incorporating 100 mothers with 6-20 month infants from Ferdows city. Two healthcare centers were selected as case and control groups by simple randomization method. Eligible participants were then selected from each center by systematic sampling method. A researcher-made questionnaire was used to collect data based on demographics and TPB constructs. Reliability and validity of the questionnaire was validated according to expert view. The data were analyzed in IBM SPSS software using Chi-Square, Independent T, Fisher’s exact T, Paired T, and Cochran tests.
Before the educational intervention, control and case groups were not significantly different in terms of TPB constructs’ mean scores. However, after intervention, mean scores of attitude increased from 34.69±3.391 to 39.82±4.260; abstract norms increased from 23.58±2.532 to 26.60±2.942; perceived behavioral control from 14.20±2.109 to 17.56±2.082; and behavioral intention from 19.26±2.293 to 22.32±2.691. While these differences were significant in the case group, the differences were not significant in the control group.
TPB-based education provided to mothers can be contributory to the prevention of behaviors leading to iron deficiency anemia in children.

As one of the major causes of hospital and community acquired infections, Methicillin-resistant Staphylococcus aureus (MRSA) requires accurate and timely diagnosis. This study aimed to investigate the prevalence and antibiotic resistance patterns of MRSA in patients hospitalized in the Birjand-based Imam Reza hospital.
In this cross-sectional study, a total of 102 clinical Staphylococcus aureus isolates were evaluated. Staphylococcus aureus isolates were confirmed via conventional microbiological and PCR methods (coa gene). The antimicrobial resistance patterns of the isolates were determined using the Kirby-Bauer disk-diffusion based on CLSI guidelines. Resistance to methicillin in the isolates was confirmed by means of PCR method (mceA gene). Finally, the obtained data was analyzed using SPSS software (version 16).
In this study, 50.9% and 58.8% of Staphylococcus aureus isolates were reported as methicillin-resistant using the Kirby-Bauer disk-diffusion and PCR methods, respectively. The highest antibiotic resistance in MRSA strains was found to penicillin (96.6%), to erythromycin (45%), and to ciprofloxacin (36.6%). In present study, resistance to azithromycin, erythromycin, ciprofloxacin, gentamicin, minocycline, and rifampin in MRSA isolates was significantly greater than Methicillin-sensitive Staphylococcus aureus (P A significant percentage of MRSA isolates in the hospitalized patients was resistant to methicillin, which is confirmed even with a wider range in their genotype.

Many causes of blindness or vision impairment are treatable, and their irreversible complications can be prevented by early diagnosis and proper treatment. Thus, the current study aimed at investigating the epidemiology of various eye diseases in patients (i.e.760 cases) referring to the ophthalmic clinic of Vali-e-Asr hospital in Birjand (Dec.22, 2014-Jun 20, 2015).
In this cross-sectional study, all patients referring to the ophthalmic clinic of Vali-e- Asr hospital between Dec.22, 2014 and Jun 20, 2015 (including 760 subjects) were enrolled through census method. The respective demographic form was completed for every patient. The patients were examined by an ophthalmologist, and results were recorded in the check-list form. Finally, the obtained data was fed into SPSS (V: 18), using statistical tests descriptive statistics and logistic regression at the significant level of P≤0.50.
The prevalence of eye diseases including cataract, nerve and retinal disease, trauma, retinopathy and glaucoma were 31.4%, 13.7%, 13.4%, 11.3%, and 6.2%, respectively. A significant relationship was found between age and habitation, cataract and retinal nerve disease, age and glaucoma, location and history of diabetes; and thyroidism and trauma (P According to the results, planning for the prevention of diseases such as thyroidism and diabetes, and advocating a healthy lifestyle can be effective in reducing eye diseases.

Hexavalent chromium is a heavy metal with harmful effects on surface and ground water. Its removal from contaminated water and waste water has received great interest in recent years. This study aimed to evaluate the absorption of hexavalent chromium from aquatic environments using functionalized carbon produced from rice husk as an inexpensive and biological adsorbent.
This experimental study investigated the effects of pH (2-10), adsorbent dose (5-20 g/l), initial chromium concentration (5-20 mg/l), contact time (5-60 min), temperature (1-40 °C), and mixing rate (100-500 rpm) on removal of hexavalent chromium from aqueous solutions using functionalized carbon made from rice husk. The results of absorption in equilibrium conditions were analyzed by Langmuir isotherm model. UV/V Spectrophotometer T80 was employed to assess the obtained samples of hexavalent chromium at a wavelength of 540. The diagrams were drawn using the Excel software.
The most efficient removal of hexavalent chromium occurred at pH=2 and optimal dose of 10 g/l. As the initial hexavalent chromium concentration increased from 5 to 20 mg/lit, the removal percentage from reduced from 97.3 to 85.7%. Additionally, along with increased contact time and mixing speed, the removal efficiency improved.
Functionalized carbon derived from rice husk with a maximum efficiency of 97% is very effective in the removal of hexavalent chromium from aqueous solutions.