alireza khalilian

Previous studies have indicated abnormalities in the immune system, such as central nervous system inflammation and high levels of activating cytokines in the cerebrospinal fluid of schizophrenic patients. Celecoxib, a modulator of proinflammatory cytokines, as an adjunctive therapy add-on risperidone (a well-established atypical antipsychotic) and amisulpiride (a benzamide antipsychotic), had improved these patients significantly.

A trial was conducted to evaluate the therapeutic effects of celecoxib add-on haloperidol, a classic antipsychotic that has been reported to have an immunomodulatory effect and mainly affects positive psychotic symptoms in schizophrenia.

In a prospective, double-blind study, after a washout period, 49 patients with schizophrenia were randomly assigned to either 15 - 30 mg/day haloperidol plus 400 mg/day of celecoxib or the same dose of haloperidol plus placebo for 5 weeks. Psychopathology was evaluated via the Positive and Negative Symptoms Scale (PANSS). The data were reported as mean ± standard deviation and frequency. An Independent t-test was carried out when comparing the data of these two groups for each week. The proportion comparison was carried out using the chi-square test. In terms of age, gender, marital and educational state, and duration or severity of disease or psychopathology and subtypes of schizophrenia, there were no significant differences.

Over 5 weeks, there was significantly greater improvement in the celecoxib group in scores on the total PANSS and on positive symptoms and general psychopathology subscales ([t = 2.89, P = 0.006], [t = 2.37, P = 0.022], and [t = 3.34, P = 0.002] respectively).

Celecoxib is an efficient adjuvant agent in the treatment of patients with schizophrenia. Significant superiority of management with a modulator of proinflammatory cytokine, which balances immune responses over haloperidol alone, reconfirms the immune dysfunction and inflammation hypothesis of schizophrenia.

The released software systems still involve some faults, for which debugging becomes necessary. On the one hand, manual software debugging remains an arduous, time-consuming, and expensive task. On the other hand, effective software debugging is organized around motivated and patient developers. In this paper, a novel approach, namely Gamifault, is provided to make debugging more attractive and enjoyable. Particularly, the objective of Gamifault is to make the developer more curious to proceed debugging, that is fault localization and program repair, enthusiastically. To achieve this objective, the concepts and potentials of gamification are adapted to the typical tasks of software debugging. In particular, Gamifault makes use of an existing fault localization technique to determine the likelihood to each statement may be faulty. Based on the likelihood, the developer then attempts to find the exact fault location and fix the fault. Next, Gamifault reacts to the developer with a gamified success rate. That is, it shows the number of test cases that have been passed on the modified program. This process is repeated until the program passes on every given test case. To evaluate Gamifault, a prototype web-based tool was implemented in Java that targets faulty software programs. Then, 16 developers were asked to employ gamified and non-gamified versions of the tool in their debugging activities on 46 subject programs taken from the Code4Bench suite of programs. Developers could successfully debug 7 and 95 faulty programs using the non-gamified and gamified tools, respectively. In addition, the gamified tool helped developers debug the faulty program in less than two minutes on average. These results suggest that Gamifault offers advantages over existing debugging systems.

Oral candidiasis has become a growing problem in hospitals worldwide, and the development of antifungal drug resistance in Candida species constitutes a serious concern. This study aimed to evaluate the in vitro efficacy of nystatin, and micafungin with chlorhexidine against fluconazole-resistant and fluconazole-sensitive Candida albicans (C. albicans) isolates.

In this experimental-laboratory study, a total of 20fluconazole-resistant (n=10) and fluconazole-susceptible (n=10) C. albicans strains were obtained from the reference culture collection of the Invasive Fungi Research Center in Mazandaran University of Medical Sciences, Sari, Iran. In vitro combination of nystatin and micafungin with chlorhexidine was performed using a microdilution checkerboar method based on the Clinical and Laboratory Standards Institute guideline.

Micafungin had the highest antifungal activity against C. albicans susceptible and resistant strains, with a Geometric mean of (GM) =0.008µg/ml and GM=0.008µg/ml, followed by nystatin with GM=0.06µg/ml and GM=0.042µg/ml and chlorhexidine with GM=0.25µg/ml and GM=0.165µg/ml against C. albicans resistant and sensitive strains, respectively. The interaction of micafungin and nystatin withchlorhexidine showed a synergistic interaction against most C. albicans strains. Inaddition, no antagonistic interaction was observed between micafungin, nystatin, and chlorhexidine against C. albicans strains.

The synergistic interaction of micafungin with chlorhexidine against azoleresistant C. albicans suggests an alternative approach to overcome antifungal drug resistance. However, further studies are needed for in vivo evaluation. Candida albicans, Chlorhexidine, Combination, Fluconazole, Micafungin,Nystatin

Helicobacter pylori (H. pylori ) has various strains associated with human infections. H. pylori , H. heilmannii, and H. felis are the most common strains in humans. H. pylori is associated with several human diseases such as chronic gastritis, peptic ulcer, mucous membrane lymphoma, and gastric adenocarcinoma. This study aimed to determine the prevalence rates of H. felis and H. heilmannii and the effect of co-infection with H. pylori in gastric biopsy specimens of patients.

Totally, 80 gastric biopsy specimens were taken by a physician from the patients referred to Shahid Beheshti Hospital, Hamadan City, Iran. PCR test was used to confirm the presence of H. pylori in samples that had positive rapid urease tests. Moreover, the ureB gene and ureA and ureB genes were used for H. heilmannii and H. felis , respectively.

Of the study patients, 61.5% were females, and 38.5% were males with a mean age of 37.8 years. Of 80 biopsies, 50% were H. pylori -positive, 53.8% were H. heilmannii-positive, but no H. felis was identified in any sample. Results indicate that smoking, having a history of gastrointestinal diseases, and taking certain medications can be risk factors for H. pylori .

Any agent contributing to gastric mucosal damage can enhance the susceptibility to bacterial contamination. Overall, the results indicate a low probability of interactions between H. pylori , H. heilmannii, and H. felis .

Occlusal plane in edentulous patients is lost and needs to be reconstructed. The most common method for reconstructing occlusal plane is to make it parallel to the ala-tragus line. There are disagreements about the posterior reference of ala-tragus line. The aim of this study was to determine the best posterior reference of ala-tragus line (superior, middle and anterior references) for reconstructing occlusal plane.

In this descriptive-analytical study, 150 dentate patients with class I relationship enrolled. Patients were placed 1.5 meters from the camera and their head was in NHP mode and symmetrical to the line perpendicular to the horizon. Fox-plane was placed in contact with central incisors and first molars of maxilla and imaging was performed from the right side of the face. The angles required were then measured using AutoCAD 2020.

There were 75 male and 75 female patients (mean age= 23.05±1.69 years) and the mean OT1-OP angle was 8.75, which was the closest to the mean OT1-AT3 angle (8.85). This finding also was repeated in both men and women. Among all patients, OT1-AT3 angle was found to have the highest proximity to the occlusal plane (61. 33%), 53.34% in men and 69.33% in women.

Inferior point on the tragus of the ear in ala-tragus is the best reference for reconstructing the occlusal plane during construction of a removable denture for male and female edentulous patients.

Every year, 20-60% of older people experience a fall at least once. Falls account for 40% of all injury deaths at the age of 85 years and older. Medical costs and the need for traumatic ICU care in this population are three times higher than younger patients. The aim of this study was to determine the prevalence and factors associated with falls in older people living in Qaemshahr, north of Iran 2019.

In this descriptive-analytical study, five health centers were selected by simple random sampling and 450 older people (last clients) were selected via convenience sampling. Data were collected using a researcher-made questionnaire, interviewing the participants, and reviewing electronic health records. The validity of the scale was confirmed by five experts. Descriptive statistics and inferential statistics (correlation and multiple regression) were used to analyze the data.

The participants aged 60-93 years. The prevalence of falls was 44.7% (n= 198) and 12.5% (n= 58) experienced more than one fall. The incidence of falls was significantly higher in older people with lower educational backgrounds, walking aids, diabetes, myocardial infarction, and those on medication (especially aspirin, metformin, glibenclamide, gemfibrozil) (P<0.001).

There is growing population of older people in Iran who experience dangerous complications and high costs of fall injuries, therefore, appropriate strategies are needed to prevent falls in this population.

Social capital is one of the factors affecting the health of diabetic patients which will also affect their quality of life. The purpose of this study was to investigate the relationship between social capital, psychological well-being, and quality of life in diabetes patients.

A cross-sectional study was conducted in 275 diabetic patients attending Qaemshahr Razi Hospital in north of Iran. They were selected via convenience sampling. Data were collected using a demographic checklist, the Social Capital Questionnaire (SCQ), Diabetes Quality of Life questionnaire (DQOL), and World Health Organization Well-Being Index. Data were analyzed in SPSS V22.

The mean values for social capital, psychological well-being, and quality of life were 103.74 ± 19.56, 13.19 ± 5.47, and 43.59 ± 7.2, respectively. The study showed that social capital was positively and significantly associated with psychological well-being and quality of life (P<0.05). In this study, psychological well-being, social capital, more children, and higher educational backgrounds explained 34% of the variance in quality of life of diabetic patients.

Appropriate interventions on psychological well-being and social capital are needed to improve the quality of life of diabetes patients.

Treatment of Helicobacter pylori has various side effects like antibiotic resistance. The purpose of this study was to evaluate the effects of cinnamon extract on complications of treatment and eradication of H. pylori in infected people.

In this randomized clinical trial, a total of 98 eligible healthy and H. pylori-infected patients approved by esophageal endoscopy were selected. The cinnamon group received multidrug treatment including clarithromycin, amoxicillin and pantoprazole as well as a cinnamon extract capsule. The control group received multi-drug treatment and a 40 mg starch capsule. In order to analyze the cinnamon extract efficacy, the urea breath test (UBT) was performed 3 months after the start of treatment. Clinical symptoms were evaluated by a questionnaire at the beginning (day of 0), 7 days and 14 days after starting treatment.

The clinical symptoms such as nausea, vomiting, diarrhea, constipation, blurred vision, headache, metallic flavor, epigastric pain, burp, and appetite were significantly reduced in cinnamon group (P<0.05). The odds ratio exhibited a higher eradication rate of H. pylori in cinnamon group (73.47% in cinnamon group compared to 53.06% in the control group) (P = 0.036).

Cinnamon as assisted therapy is able to alleviate the disease and reduce the complications of H. pylori treatment

Job burnout is a kind of psychological distress that results from various occupational factors and leads to the deterioration of job performance. This condition is usually characterized by weakness, disappointment, and nonachievement of career goals. Regarding this, the present study aimed to compare the frequency of burnout syndrome between general family and non-family physicians in Mazandaran province, Iran, in 2018.

This cross-sectional study was conducted on 153 urban family physicians, 158 rural family physicians, and 295 non-family physicians (i.e., a total of 606 cases) selected using simple random sampling technique. In this study, Maslach Burnout Questionnaire was used, as the main tool for measuring the three dimensions of emotional exhaustion, depersonalization, and personal empowerment. Study participants included two groups of family general practitioners with more than two years of experience working in all shifts as a family physician, as well as non-family general practitioners working in health centers and offices affiliated to mazandaran university of medical sciences. General practitioners working in the hospital and staffing plan were excluded from the study. One-way ANOVA was used to compare the mean values and the mean differences of burnout dimensions at two levels of urban and rural family physicians and those outside the family physician plan.

Emotional exhaustion score in the non-family physicians was 14.6±10.31, while this score was obtained as 19.73±12.57 and 20.39±12.17 in the urban and rural family physicians, respectively, showing a statistically significant difference (P<0.0001). In this regard, family physicians (especially rural family physicians) had the highest occupational burnout in this dimension. However, regarding the other two dimensions, the difference between the family and non-family physicians was not statistically significant. Generally, emotional exhaustion had the highest prevalence (20.3 %), followed by depersonalization (29.4%) and personal accomplishment (24.1%). In addition, more than half of the subjects showed a high level of burnout at least in one of the three dimensions of this construct.

As the findings indicated, occupational burnout was more common in family physicians, especially in rural area family physicians, which can be due to working in remote places with more duties, fewer facilities, and more difficult environmental conditions. Many demographic and environmental factors account for the incidence of burnout. Therefore, it is required to perform further studies and develop plans targeted toward reducing occupational burnout, especially in family physicians, since resolving this situation can improve the quality of patient care services.

Context: Smoking in adolescence is a worldwide health problem. Understanding the prevalence of smoking and its clinical correlates in adolescent inpatients is useful for mental health staff to plan effective programs to reduce its detrimental consequences. In this study, we investigated the prevalence and correlates of cigarette smoking and its sociodemographic and clinical correlates. We performed a narrative review of cigarette smoking prevalence among adolescents as well as a descriptive study in inpatient adolescents in Iran.  Evidence Acquisition: This was a multicentric, cross-sectional, and hospital-based survey. In total, 82 patients (male/female: 66.9% vs. 33.1%) were consecutively recruited from 5 child and adolescent inpatient psychiatric wards of Iran. The study data were collected from patients, their family members and patients’ medical records. The descriptive statistics, Pearson’s chi-squared test, and univariate logistic regression analyses were employed to analyze the obtained data. Additionally, we added a narrative review to understand the prevalence rate of smoking and its clinical correlates in adolescent inpatients. The prevalence rate of smoking was 30% in our study sample (24.5% in boys and 39.5 % in girls). There was a significant association between smoking with family size, history of suicide attempt, physical illness, drug misuse in patients, and alcohol or drug misuse in family members. The prevalence of mood disorders in the nonsmokers and smokers were 37.5% and 62.5%, respectively. Overall, 26.6% of the subjects had a history of suicide attempt of whom, 52.9% were smokers. Results of this study about the association between smoking with family size, history of suicide attempt, physical illness, drug misuse, and other related factors, call for both careful screening of smoking and specially designed integrated psychiatric/smoking treatments in these patients.

In recent decades, various efforts have been made to replace synthetic materials with natural disinfectants that have less disadvantages and lead to similar or even better results. The present study was conducted to compare the effect of Artemisia aucheri and Zataria multiflora as natural disinfectants with those of Deconex and sodium hypochlorite as two industrial disinfectants on Candida albicans. This experimental study was conducted in 128 resin acrylic dentures. After the inoculation of C. albicans on each denture, they were divided into four groups, each containing 32 dentures. Deconex, Sodium hypochlorite, Artemisia aucheri, and Zataria multiflora were administered in each group in four densities (0.1, 0.01, 0.001, and 0.0001). The data were analyzed in SPSS V19 applying t-test.  The four disinfectants were applied for 10 and 60 min. Deconex showed the highest disinfection effect on samples (P<0.05). There were no significant differences between the effect of Artemisia aucheri and Zataria multiflora after 60 min and 10 min. However, it was found that the potency of Artemisia aucheri and Zataria multiflora increased after 60 min. Current findings showed chemical disinfectants with higher potency in short-time intervals, compared to the natural ones. But, after a longer period of time, Artemisia aucheri and Zataria multiflora exerted similar effects as those of the synthetic disinfectants.

  In terms of family psychological health, emotional intelligence (EQ) and marital adjustment are issues, which should not be overlooked. However, a few studies have been conducted to experiment and evaluate the impact of EQ skill-based training on couples’ marital adjustment. The aim of this pilot study was to assess the effect of EQ components on marital adjustment among university students. The study utilized a quasi-experimental design with married couples (N = 60) from Mazandaran University aged 22 to 29 years old. The experimental group (30 married couples) participated in a training course on emotional intelligence skills and the other 30 couples did not do so. Measures of emotional intelligence and marital adjustment were completed by the participants. Pre and post training tests, Bar-On emotional intelligence test, and Har Mohan-Singh marital adjustment questionnaire were completed by both groups. The Paired t-test was used in order to evaluate the effectiveness of the training course. Participants’ data showed that the training course had an impact on EQ as well as marital adjustment. Data analysis showed that conducting the training course had significant impact on the experimental group (P < 0.001). Analysis of the data approved that training had an impact on the students’ marital adjustment in the experimental group (P < 0.001). Considering the significant positive relationship between EQ and marital adjustment, the EQ competencies can be utilized as a fundamental and effective component in improving and reinforcing satisfactory marital relationships. Therefore, interpersonal relationship and marital relationship between each couple can be improved through an emotional intelligence skill–based training course.

Malware writers leverage several techniques for thwarting the detection method of antimalware software. An effective technique is applying obfuscation techniques to make metamorphic malware. Metamorphism modifies the code structure in a way that while retaining the behavior, the pattern and structure of the code is changed. Recently, researchers have proposed a new method for metamorphic malware detection that works based on static analysis of malware code. However, some obfuscation techniques exist that when applied, the efficacy of static analyzes is adversely affected. To overcome this issue, in this paper, we apply a dynamic analysis in addition to static analysis. The new method elicits some information from both static and dynamic analyzes, combines them, and uses the resultant information to learn a classifier. The obtained classifier is then used to detect a new instance of an existing family of metamorphic malwares. In fact, the combination of both static and dynamic information is intended to address the weaknesses of each individual analysis and leads to an overall better effectiveness. In order to evaluate the proposed method, experiments on 450 files including benign files and 5 families of metamorphic malwares, namely MPCGEN, G2, VLC, NGVCK, and MWOR, have been conducted. The experiments were performed in three cases: static analysis, dynamic analysis, and the combination of both. The results of comparison among three cases show that metamorphic malware detection is not reached to 100 percent precision via either static or dynamic analysis individually. However, using the combination of both static and dynamic information could have consistently led to detection with 100 percent precision, which have been measured using ROC metric.

Diabetes caused by insulin production disturbance is considered as the most common metabolic disorder all over the world. Diabetes may outbreak because of low insulin secretion by Islets of Langerhans β-cells, insulin resistance or both of them. In this way, using stem cells, which have the capability to differentiate into Pancreatic β-cells, is one of novel methods in this field. MSCs are the most important candidates for cellular therapy.
Insulin level was examined using ELIZA method. In order to examine the morphology of differentiated cells, they were stained by Dithizone. Insulin-producer cells are cells which turn into red as a result of staining. Specific gene involving insulin-producing cells was evaluated by Real Time-PCR method.
The ELISA results showed that the treated cells secreted more insulin than the control group. Moreover, we found differentiation of MSCs toward insulin-secreting cells. In order to evaluate insulin production in clusters on day 21 of differentiation, we used dithizone (DTZ) staining. PDX-1 gene was confirmed by RT- PCR analysis.
In this study, we differentiated MSCs into insulin-producing cells in vitro. It is concluded that MSCs may be considered as an excellent candidate in β-cell therapy in diabetes patients.

Aseprugo procumbens is used as antianxety and depression in Iranian traditional medicine; however no clinical trial has been performed about these properties. The aim of this study was to evaluate the antidepressant efficacy and safety of hydroalcoholic extract of A. procumbens.

In this double blind study, 30 outpatients with mild to moderate depressive disorder (according to DMS-IV-TR criteria who had a score of 18-25 on the Hamilton Depression Rating Scale (HDRS) were randomly divided in two group, 1) received 10 mg fluoxetine capsule, 2) received 1.2 g dried extract of A. procumbens capsule (6 mg flavonoid,) orally per day. Patients were followed up for 6 weeks; the recovery process was assessed by the HDRS in weeks 0, 2, 4 and 6.

A significant decrease in HDRS was observed in both groups after the fourth week. After the sixth week, fluoxetine had a greater anti-depressant activity than A. procumbens (p value =0.03). There were no significant differences in terms of adverse effects in both groups.

The hydroalcoholic extract of A. procumbens can be considered as an effective and safe remedy for mild to moderate depressive disorder.

Wharton`s jelly-derived mesenchymal stem cells (WJ-MSCs), have a high proliferation valency and they do not produce teratogen or carcinogen after subsequent transplantation. They are known as regenerative medicine. Thus more research is needed on the isolation and characterization of mesenchymal stem cells. In this experimental study, we obtained Wharton's jelly tissues from mothers during normal vaginal delivery, after obtaining their informed consent. Mesenchymal stem cells were isolated from cultured Wharton`s jelly, cultured, and were then examined for their proliferation, immunophenotypes, and differentiation capacities. The immunophenotypes of WJ-MSCs were analyzed by flow cytometry. Differentiation was performed resulting in osteogenic, chondrogenic and adipogenic cells. WJ-MSCs formed a homogenous monolayer of adherent spindle-shaped cells. Our results showed the high capacity of the proliferation of WJ-MSCs. Immunophenotyping further confirmed the purity of the isolated cells; their surface antigen expression showed the phenotypical properties like those of WJ-MSCs. The expanded cells were positive for CD 90, CD105, and CD44; they were negative for CD34 and HLA-DR surface markers. The cells had the adipocytic, osteocytic and chondrogenic differentiation capacity. The isolation and characterization of WJ-MSCs with high purity had been conducted, and the results were obtained in a short span. The present study has revealed the feasibility of the culture medium with high glucose and 15% FBS in isolation and proliferation of WJ-MSCs. When Wharton`s jelly pieces were put in the dry bottom of the flask, very effective separation of the MSCs was achieved.

Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures.

This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology.

108 patients with the mean age of 44.6 § 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively.

The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures.

Background and Today, increased rate of demand for insulin is predictable due to increasing cases of diabetics in the world. Therefore, it is necessary to develop economic approaches and increasing the production of insulin for the future and medicinal plants could be regarded as a promising prospect for insulin production.
The Allium ursinum and Silybum marianum were collected. Each herbarium was identified in School of Pharmacy affiliated with Mazandaran University of Medical Sciences and the extract was used by percolation with 70% ethanol extraction, after the solvent was evaporated by using the rotary. After the successful isolation of mesenchymal stem cells (MSCs), Wharton's jelly was derived and approved. Then, the mesenchymal stem cells were differentiated to pancreatic beta cells with two herbal extracts.
Compared with the control group, there was a significant difference between the levels of insulin in the culture medium obtained from the two plants (P= 0.0001). In addition, via specific dithizone staining, the insulin producing cells (IPCs) were proven.
The extracts of Allium ursinum and Silybum marianum were found capable in inducing differentiation of the mesenchymal stem cells derived from Wharton's jelly into IPCs. Allium ursinum was seen with the highest rate of insulin production, while Silybum marianum had the lowest rate of insulin production, therefore, Allium ursinum could be more effective in treatment of diabetes.

Background and Gastric cancer is the third leading cause of mortality in Iran after cardiovascular diseases and accidents. The aim of the present study was to assess survival and it’s affecting factors in gastric cancer patients through using Cox and parametric models along with frailty.
In this study, the medical records of gastric cancer patients treated from 2008 to late 2010 were collected in Afzalipour and Bahonar Hospitals in Kerman and Imam Khomeini Hospital in Sari. 383 patients entered the study and were followed up for at least five years. The survival of patients was assessed by using Cox proportional hazard, log-normal and log-logistic models under gamma and inverse-Gaussian distributions, as two special models for frailty. Models efficiency comparison criteria were Akaike information criterion and Cox-Snell residuals.
Out of 196 patients in Kerman, 132(67.3%) were males and 64(32.7%) were females. The average age of the patient was 61yr and 59 yr for the males and females, respectively. Also, the survival rates after 1, 3, and 5 years of the diagnosis were 62%, 50%, and 45%, respectively. In the city of Sari, 69% (129 people) of the patients were male and 31% were female. The mean ages of male and female were 66 and 62 yr, respectively. At the same time, 1, 3, and 5 year survival rates of patients were 58%, 36%, and 30%, respectively. Based on Akaike information criterion, Cox-Snell residuals, and non-monotonic failure rate, log-logistic model along with gamma frailty was more fitted in comparison with other models. Using this model, radiotherapy, heartburn, and tumor grade were found as significant predictors.
Radiotherapy, heartburn, and tumor grade could be considered as more affected factors. According to rejection of the proportional hazard assumption, assessments of residual figures, and according to non-significant frailty effect by log-normal model, log-logistic model along with gamma frailty was found to be the best fitted model.

Background and Temporomandibular disorders (TMD) are manifested as a group of signs and symptoms diagnosed by pain, and malfunction of temporomandibular joint (TMJ) and masticatory muscles. The role of etiologic factors such as stress and occlusal interferences has gained much attraction. In this study, we assessed the incidence of TMD and its relationship with stress and occlusal interferences in individuals attending Sari Dental School Clinic, 2014-2015.
In this descriptive-analytical study 68 people (41 females and 27 males) were selected. Occlusal interferences were assessed by clinical examinations and the stress levels of the participants were determined by The Taylor Manifest Anxiety Scale (TMAS). The relation between TMD and other variables were analyzed by Chi-square and exact fisher tests. Data was analyzed in SPSS V. 22.
Of the total population studied 51 (75.0%) had TMD. Among TMD patients one (1.9%) had low-level stress, 30 (58.8%) had moderate-level, and 20 (39.2%) were found to have high-level stress. No significant relationship was found between TMD and stress. In TMD group, 13.7% did not have centric interferences; 70.6% showed interferences up to arch of closure, and 15.7% had interferences up to line of closure. Significant relationships were found between TMD and interferences of working side (P Temporomandibular disorders were found to be more prevalent among the population studied. No relations were found between TMD and stress while TMD incidence was related to some occlusal interferences.

Background and Type A acute aortic dissection is a serious life-threatening condition that requires emergency surgery. Development of complications and operative management may be affected by various factors. The aim of this study was to evaluate the risk factors and outcomes after surgical treatment of acute type A dissection.
A Cross-sectional descriptive study was done in two phases during March 2010 and June 2015, in Fatemeh Zahra Hospital, Sari, Iran. The research population included the patients who had surgery for treatment of type A acute aortic dissection. In phase I a checklist was completed (using the patients records, n=25) that consisted of demographic, clinical and imaging data, and the information that was recorded during the operation. In next phase, laboratory analysis and postoperative echocardiography were conducted for seven patients.
Phase I showed that none of the patients had Marfan syndrome, history of hyperlipidemia and diabetes. Frequency of other risk factors (history of hypertension, history of smoking, chronic pulmonary disease, renal failure, cardiac surgery, aortic arch involvement, bicuspid aortic valve, and cardiac tamponade) were found to be different in patients. In phase II, we observed death in three cases after being discharged from the hospital and prediction of morbidity rate was not possible due to low number of samples.
In this study, Gender and functional class were found as the risk factors in patients who had syrgery for acute aortic dissection.

Anterior cruciate ligament (ACL) rupture is the biggest concern for orthopedic surgeons who are involved in sports injuries, so most of ACL reconstruction surgeries are sports related. ACL injuries in female athletes are 2 - 8 times more common than male athletes in similar sport injuries..
The aim of this study was to compare knee laxity changes in the menstrual cycle in female athletes referred to the orthopedic clinic of Imam Khomeini hospital in the north of Iran, Sari, 2013..
Patients and The present descriptive study was conducted on 40 female athletes that were referred to the orthopedic clinic. Hormone levels, such as estrogen and progesterone were assessed by one laboratory in 3 phases of the menstrual cycle. We used Lachman test and anterior drawer test for knee laxity rate. The descriptive statistics were calculated as indices of central distribution of bonds (x ± SD) and relative frequency distribution was used for qualitative variables..
The results of the current study showed that there is no significant difference in ACL laxity in female athletes in three phases of menstrual cycle; namely menstruation time, ovulation time and mid-luteal phase..
Despite numerous studies and research in the field of knee laxity and effects of female hormones, many researchers do not agree about the effect of female hormones on knee laxity. The current study also reported no relationship between female hormones and knee laxity, while statistics show fundamental difference between male and female athletes..

Background and Temporomandibular disorders (TMD) are manifested as a group of signs and symptoms diagnosed by pain, malfunction of temporomandibular joint (TMJ) and masticatory muscles. The need to determine the prevalence and factors associated with their communities is emphasized in studies. The present study investigated the incidence of TMD and its symptoms in individuals attending Sari Dental School Clinic, 2014-2015.
A descriptive-analytical study was conducted in 68 individuals (41 females; 27 males) who were selected by random sampling. Demographic and clinical data were obtained by asking questions and examining the patient. The relation between TMD and other variables were analyzed by Chi-square and exact fisher tests. Data was analyzed in SPSS V.22.
A total of 68 patients was investigated of whom 51 (75%) had TMD. Among these five people had headache (P A high incidence of TDM was detected in the population attending Sari Dental School Clinic. Significant relation was found between symptoms and TMD.

Background and The survival rate of gastric cancer patients has significantly increased during the last decades because of the advances in this type of cancer treatment. The purpose of the current study was to examine the survival levels of gastric cancer through Weibull regression and its affective causes.
In this research, the records and personal information of 643 patients who were evolved by gastric cancer and referred to Imam Khomeini hospital of Sari (2007- 2013) were studied in order to determine their levels of survival. During the study, 74 cases of patients were exempted from the study due to their defective data, and the data collected from 569 cases were analyzed to obtain the results. In the current study, the impact of factors affecting Survival time was determined using the Weibull regression model. The analysis of data was performed using Stata statistical Software in 0.05 significance level.
The findings of the study showed that these patients were estimated to experience 5 years of survival probability equal to 0.75, 0.68, 0.54, 0.41, 0.3 during the time period November – December, 2013, the 1, 2, 3, 4 with a median survival time equal to 19 months, resulting in a survival mean equal to 24.49 months. Based on the Univariate and Multivariate analyses methods, some variables like: stage and metastasis were determined as the affective factors on the survival probability. (p-value In this study, it was then concluded that the life span of examined patients is very low in comparison with developed countries, which might be because of late reference or delayed diagnosis and the lack of facilities for treatment. Thus, the factors such as earlier diagnosis of the problem and screen methods could certainly influence and increase the patient's survival rate.

Hospitalization and surgery are crucial adverse life events that lead to considerable anxiety in patients..
The present study aimed to investigate stressors after coronary artery bypass graft surgery and identify stressors that predict anxiety..
Patients and This is a descriptive-analytical study that uses a non-random convenience sampling method on patients undergoing coronary artery bypass graft surgery at the cardiac surgery intensive care unit of Fatemeh Zahra Cardiac center in Sari, Iran. A total of 186 patients completed the post-surgical stressors questionnaire and the Spielberger State-Trait Anxiety Inventory on postoperative days 2 or 3 in the cardiac surgery intensive care unit. Data were analyzed using descriptive statistics including frequencies, means, and standard deviations. The Mann–Whitney U test was used to determine the relationship between the observed variables, and the logistic regression model was used to identify the relationship between stressors and anxiety after-surgery..
Post-surgical anxiety predictors included insufficient sleep during hospitalization (Odds ratio [OR]: 5.42; 95% confidence interval [CI]: 1.46 - 20.00; P = 0.010), treatment not explained to the patient by the nurse (OR: 4.83; 95% CI: 1.82 - 12.84; P = 0.002), being away from family members (OR: 3.88; 95% CI: 1.46 - 10.26; P = 0.006), presence of a chest tube (OR: 3.27; 95% CI: 1.83 - 5.84; P = 0.000), and pain in any part of the body (OR: 1.95; 95% CI: 1.06 - 3.58; P = 0.031)..
Physical or physiological and psychological stressors impose greater stress and are predictors of anxiety. When preparing their nursing care plan, nurses should consider these stressors that affect anxiety levels in patients undergoing CABG surgery and those hospitalized in intensive care units..