majid zare-bidaki

The prevalence of COVID-19 disease has made virtual education more widespread and has posed daunting challenges to the quality of education and the student-teacher relationship. The present study aimed to assess the impact of the integrated method of small groups and mind mapping compared to lectures on the learning and satisfaction of pharmacy students in the Herbal Medicine course during COVID-19.

This quasi-experimental study was conducted on 33 pharmacy students of  Birjand University of Medical Sciences in the herbal medicine course in the academic year 2021-2022. The students were considered the control group (lecture) in the first semester and the experimental group (integrated) in the second semester. Data related to the final score, questionnaires of students' satisfaction, and motivation were analyzed in SPSS software (version 21) using independent T-test and descriptive statistics.

There was no significant difference between the two groups in terms of gender; nonetheless, they were heterogeneous in terms of age. The final score of the integrated group (15.19±2.69) was significantly higher than that of the lecture group (11.45±2.53) (P=0.001). However, students in the lecture group had higher motivation (48.72±4.77)  compared to the integrated group (42.81±5.59) (P=0.005). In addition, the lecture-based group reported significantly higher satisfaction scores (39.81±3.42) compared to the integrated group (31. 7±18.69) (P=0.001).

The integrated model of small groups and mind mapping in the herbal medicine course was more effective than the lectures. To increase student satisfaction and motivation in mind mapping, appropriate measures should be considered.

In this comprehensive study, the prevalence of sepsis, a potentially life-threatening condition, was investigated among 477 patients displaying sepsis symptoms.

A detailed questionnaire was used to capture the patients' demographic information and clinical treatment outcomes.The E-test method was employed to determine the susceptibility of Gram-positive bacteria to vancomycin and Gram-negative bacteria to cefepime, ceftriaxone, and imipenem.

Among the participants, 40 patients (8.6%) were diagnosed with septicemia, a condition whose prevalence significantly increased with age (p= .001). Out of 40 patients with positive blood cultures, 14 (35%) were infected by Gram-positive bacteria, while 26 (65%) were infected by Gram-negative bacteria. Acinetobacter lwoffii and Staphylococcus epidermidis were identified as the most common causes of sepsis among Gram-negative (30.7%) and Gram-positive (57.1%) bacteria, respectively Gram-negative bacteria exhibited the highest resistance to ceftriaxone (38.4%) and the highest susceptibility to imipenem (84.6%) in both laboratory and clinical settings. Gram-positive bacteria demonstrated the high susceptibility to vancomycin (78.5%), with only four patients exhibiting resistance to vancomycin in both laboratory and clinical settings. Encouragingly, there was a 77.5% concordance between laboratory and clinical antibiotic susceptibility testing results.

Based on these findings, vancomycin and imipenem are recommended as the preferred antibiotics for Gram-positive and Gram-negative bacteria, respectively. Given the high concordance (77.5%) between laboratory and clinical results, it is suggested to perform antibiogram test using E-test method on blood culture isolates in septicemia cases to guide appropriate antibiotic treatment.

Obsessive-Compulsive Disorder (OCD) is a debilitating mental health condition that can significantly impair an individual's quality of life. While traditional exposure-based therapies have shown promise, there is a growing interest in the use of virtual reality (VR) to enhance the effectiveness of OCD treatment. This study aimed to investigate the impact of a VR-based intervention on OCD symptom severity, associated mental health outcomes, and underlying neural correlates.

Thirty individuals diagnosed with OCD were recruited for this study. Participants engaged in a series of VR-based exposure therapy sessions, during which their brain activity was continuously monitored using a 32-channel EEG system. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and secondary measures included assessments of anxiety, depression, and quality of life. Data was analyzed using repeated-measures ANOVA and correlational analyses.

The VR-based intervention resulted in a significant reduction in OCD symptom severity, as measured by the Y-BOCS, from baseline to post-treatment, and these improvements were maintained at the 3-month follow-up. Participants also reported significant improvements in anxiety, depression, and quality of life. The EEG data analysis revealed increased alpha and beta power in the medial prefrontal cortex and anterior cingulate cortex, brain regions associated with cognitive control and emotional regulation, which were positively correlated with the degree of clinical improvement.

This study provides evidence for the efficacy of VR-based therapy in the treatment of OCD and suggests that this approach may lead to measurable changes in brain function that are linked to positive clinical outcomes. The involvement of bachelor's degree students in the research process highlights the value of interdisciplinary collaboration in advancing the field of mental health treatment.

This study explores the link between inflammatory markers and hospital outcomes in febrile neutropenic patients with solid cancers- a complication caused by systemic chemotherapy that can lead to hospitalization and requires timely diagnosis and treatment to reduce fatalities.

This study was conducted in 2017 at Vali-e-Asr Hospital in Birjand with 22 participants. Blood samples were collected to measure inflammatory indexes. The study documented various hospital outcomes, including duration of neutropenia and fever correction, length of hospital stays, ICU admission or mechanical ventilation, and mortality. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each marker.

According to the findings, there was no significant difference in the mean duration of neutropenia, the duration of fever, or the length of hospital stay comparing procalcitonin (PCT; P = 0.96, P = 0.36, P = 0.66, respectively), polymorphonuclears (PMNs; P = 0.11, P = 0.94, P = 0.52, respectively), and erythrocyte sedimentation rate (ESR; P = 0.41, P = 0.24, P = 0.17, respectively). Further, the performance metrics calculated for PCT, ESR, and PMNs were an accuracy of 50%, 50%, and 40.90%, sensitivity of 88.8%, 100%, and 88.8%, specificity of 23.07%, 15.38%, and 7.6%, PPV of 44.4%, 45%, and 40%, and NPV of 75%, 100%, and 50%, respectively.

Our findings suggested that there was no significant relationship between inflammatory factors and hospital outcomes. However, further research is needed to explore the prognostic value of these markers in a larger and more diverse patient population.

During the corona days, the body's activities are very reduced due to the quarantine, and after that, many people still have little activity. Nearly two billion people in the world are overweight. In other words, more than 30% of the world's population is obese or overweight. In this study, a solution for fitness and weight loss at home has been proposed. 2 groups participated in this study, the first group consisted of 20 people in a traditional way and the second group included 20 people under virtual reality, all of whom were undergraduate students, for 4 weeks and 3 sessions per week participated in this study and none of them had experience using virtual reality. The results show that fitness parameters include waist circumference, weight, BMI and the distance traveled in the Cooper test have improved. The motivation of people to continue this study was more in the virtual reality group than in the normal group.

 Vulvovaginal candidiasis (VVC) is a common fungal infection caused by Candida species in the female genital tract.

 This study attempts to predict predisposition to VVC related to risk factors and clinical symptoms among vaginitis cases using the artificial neural network (ANN) model.

 This cross-sectional study was performed on 250 women referred to gynecology clinics in Birjand, Iran. A questionnaire was used to record participants' demographic information. Swabs were used for wet mounts and culture. Candida species were identified by morphological and physiological methods. The performance of the optimal neural network model was assessed by the sensitivity, specificity, and accuracy area under the ROC curve (AUC). Descriptive statistics were used for the statistical description of data, and chi-square test, t-test, and ANN analysis using SPSS application tools (Statistical Product and Service Solutions) version 22 software at 0.05 significant level.

 The prevalence of vulvovaginal candidiasis was 41.0%, and Candida albicans was the most frequently identified species (55.9%). The descriptive statistics (chi-square test and t-test) revealed no significant difference between the frequencies of Candida infection with demographic factors and clinical presentations. However, factors such as abortion history, number of sexual intercourse, dyspareunia, education, natural vaginal delivery (NVD), and lower abdominal pain included in our ANN model had significant differences (P < 0.05).

 The result of the ANN model revealed that using demographic factors and clinical symptoms can predict VVC infection. Therefore, this model can identify the effect of the clinical presentations and symptoms of infection.

Amniotic fluid in the uterus is beneficial for the fetus growth and protection due to its nutritional elements as well as its antibacterial and anti-inflammatory properties. Today, body membranes are increasingly being used in multiple fields. The purpose of the current study was evaluation of the antibacterial effects of amniotic fluid and comparison of its effects on pathogenic and probiotic bacteria.

This experimental study was conducted on amniotic fluid obtained from 43 healthy mothers who gave birth by selective cesarean section. Then, antibacterial effects of amniotic fluids were investigated on 8 standard bacterial strains, including Bacillus cereus, Escherichia coli, Staphylococcus aureus, Shigella flexneri, Pseudomonas aeruginosa, Klebsiella pneumoniae, Bacillus cereus, and Lactobacillus plantarum by agar well-diffusion method. Data analysis was performed by SPSS software, vs. 22 (IBM, US).

Amniotic fluid revealed an inhibitory effect on the growth of bacterial strains. Staphylococcus aureus and Streptococcus pyogenes strains showed growth inhibition in 39% and 17% of samples, respectively. In other bacterial strains, there was growth inhibition in less than 5% of the samples. Also, the zone of growth inhibition for Staphylococcus aureus and Streptococcus pyogenes was significantly higher than the other strains. Amniotic fluid samples had an antibacterial effect on all pathogen strains in general, but not on the Lactobacillus plantarum probiotic strain.

Our findings suggest that the antibacterial effect of amniotic fluid on pathogenic bacteria is significantly higher than the Lactobacillus plantarum as a probiotic one. Overall, the findings support the use of natural substances as alternative therapeutic agents to combat antibiotic resistance.

In this research, an attempt was made to identify Candida isolates collected from women with suspected vulvovaginal candidiasis using single Multiplex PCR reaction as a swift and valid method. Beside, this method was compared with phenotypic methods.

In this study, 250 vaginal swabs were collected from patients referring to obstetrics and gynecology specialists. In addition to phenotypic methods, multiplex PCR designed by species-specific primers was performed to identify Candida isolates in a single reaction. Descriptive statistics were analyzed by t-test and Chi-square test in SPSS software (Ver. 22) (p< .05).

According to the results, 92 positive samples were diagnosed using the culture method. Four species were identified by culturing the specimens on CHROM agar. The most common Candida species isolated was C. albicans (54.3%), followed by C. parapsilosis (28.2%), C. glabrata (17.4%), and C. krusei (1.0%). The most common Candida spp. identified by Multiplex PCR method were C. albicans (50.0%), C. glabrata (33.7%), and C. parapsilosis (6.2%). Also, three mixed infections with C. albicans and C. glabrata as well as C. albicans and C. parapsilosis were identified

In comparison to phenotypic methods, considering the cost-effectiveness of PCR methods, the single multiplex PCR reaction was shown to be efficient in epidemiological studies on pathogenic species.

Echinococcus granulosus (sensu lato) is the main cause of cystic hydatid in human and livestock in the world and is considered a neglected tropical disease. Hydatid cysts often form in the liver (50–70%) and less frequently the lung, spleen, kidney, bone, brain and genital system. Ovarian hydatid cyst is one of the rarest cases with nonspecific clinical presentation. Here in a case report study we report a primary unilateral ovarian hydatid cyst in a 45-years-old woman. This patient was presented with a large pelvic mass. A pelvic multiloculated mass in abdominal ultrasound and a solid-cystic lesion of the left adnexa in CT scan was reported. All other laboratory tests and chest X-ray showed typical results. Molecular method was performed to confirm radiography and staining methods. A cystic mass on the left fallopian tube and ovary was found in the patient's laparotomy and all were resected with the appearance of a tubo-ovarian abscess. Postoperative pathological and molecular diagnosis confirmed a hydatid cyst disease. Five years follow-up revealed no recurrence of the disease. Hydatid cyst can cause cystic masses anywhere in the all anatomic of body, especially in endemic locations.

Pistacia atlantica is one of the medicinal plants native to Iran and known for its antimicrobial properties. Therefore, the present study aimed to investigate the antibacterial and antifungal effects of the aqueous extract of P. atlantica leaves on clinical isolates of Escherichia coli and Candida albicans in vivo.

In this descriptive-cross-sectional study, the minimum inhibitory concentration (MIC) and minimum bactericidal/ fungicidal concentration (MBC/MFC) of aqueous extract of pistachio leaf were determined on 60 isolates of E. coli and 60 isolates of C. albicans, according to CLSI protocol at concentrations of 0.125-100 mg/ml. The obtained results were analyzed using R software at a significance level of 0.05.

The mean minimum inhibitory concentrations of coriander extract for E. coli and C. albicans clinical isolates were obtained at 45.3±1.0 and 43.7±1.1 mg/ml, respectively. The comparison of the minimum concentration of growth inhibitor and lethality of clinical isolates with standard E. coli strain was not significantly different (P=0.65); nonetheless, the standard strains of C. albicans were significantly different from the clinical isolates of this fungus (P<0.001).

As evidenced by the results of the present study, the aqueous extract of P. atlantica leaves has inhibitory effects on the clinical isolates of E. coli and C. albicans. Therefore, it is possible to use the aqueous extract of this plant in isolation or in combination with other drugs to treat urinary tract and vaginal infections.

With the onset of the coronavirus disease 2019 (COVID-19) pandemic in December 2019, healthcare systems faced an unprecedented challenge. Medical and paramedical students are the front-line warriors in this combat.

This study aimed to assess COVID-19 knowledge, attitudes, and practice among the students of Birjand University of Medical Sciences, Iran, in 2020.

This cross-sectional analytical study was carried out on 329 students who passed the microbiology course from October 2020 to March 2021. The data collection tool was a researcher-made questionnaire consisting of four sections: demographic data, COVID-19-related knowledge, attitudes towards COVID-19, and participants’ practice. Finally, statistical analysis was performed in SPSS software version 19, and a significance level of 0.05 was considered in all tests.

A total of 329 medical, dentistry, pharmacy, and laboratory sciences students participated in this study. The mean score of COVID-19 knowledge was 10.26 ± 1.21 (out of 12). Among the participants, 103 (31.3%) individuals expressed being in crowded places in recent days, and 324 (98.5%) of them confirmed wearing masks. More than half of the students had positive attitudes towards COVID-19 control. The average knowledge was higher in females and medical and laboratory sciences students (P = 0.008). Also, the students’ knowledge was inversely related to their practice of wearing a mask (P = 0.015).

While students had a high level of COVID-19 knowledge, they had some misconceptions that should be included in educational programs. Students of medical sciences should be responsible for preventive behaviors and strive to be good role models for others.

Currently medical education in Iran consists of basic sciences, physiopathology and clinical stages. Medical students learn them separately and often are confused that how basic sciences materials would be helpful for the patient’s diagnosis and treatment. Integration of various related subjects during medical education is one the proposed strategy to overcome this problem.

The present study was conducted to assess the effect of an integrated teaching approach on medical students’ attitudes and knowledge about infection diseases.

This quasi-experimental study was conducted in the infectious disease ward of Valia-e-asr Hospital affiliated to Birjand University of Medical of Sciences, Birjand, Iran. A total of 60 medical students (stagers) were randomly selected and assigned to the control and intervention groups. The two groups were matched based on their grade point average (GPA), age, and gender. An integrated teaching approach was adopted in the intervention group by four epidemiology, microbiology, infectious diseases, and pharmacology professors. The students’ knowledge was assessed by a written exam, and their attitude was evaluated using a questionnaire. Data was analyzed by SPSS version 16 and using paired and independent samples t-test.

The analyses showed that 52% of the participants were male. The mean scores in the cognitive and emotional domains (the students’ points of view) were not correlated with students’ gender, and they were not significantly different before (p= 0.12) and after (p= 0.25) the intervention. The students’ final learning scores were significantly higher in the intervention group than that of the control group (16.16±1.17 vs 14.12±1.73; p=0.001).

The integration of basic and clinical subjects helps students to better understand the physiopathology of diseases and enhances their satisfaction.

Student-centered educational models, such as Flipped classrooms, seem to provide more educational opportunities for learners, especially when combined with web technology. This study aimed to evaluate the effectiveness and satisfaction of medical students with the web-based Flipped classroom method in comparison with the lecture-based teaching method.

This is a quasi-experimental case-control study that evaluates 51 people in each of the two intervention and control groups. In the intervention group, pulmonary physiopathology e-contents were delivered to the students one week before the presence-based class in the form of digital files such as video, text, image, audio and interactive applications through Navid learning management system. Students were required to read the content before the class. Then the face-to-face classroom time was completed with group discussion, question and answer and problem-based learning. In the control group, teaching was carried out by the traditional lecture method in the classroom. Data were analyzed using SPSS, 18.

In terms of age, sex and, mean pre-test scores, there were no significant differences between the groups. The mean scores in the final exam turned out to be 14.66 (10.16-66) in the intervention group but 12 (9.14-3.66) in the controls (P < 0.001) to make a significant difference. In addition to gaining higher final exam scores as for the flipped classroom group, they were also more satisfied with the procedure (P < 0.001).

The flipped classroom approach not only improves learning but also leads to greater students’ satisfaction.

Improper use of antibiotics has led to the development of antibiotic resistance. On the other hand, due to the uncertainty of the stability and safety of artificial antioxidants, their use is not recommended. Plants can be used as a reliable and natural source of antioxidants. The Mastic (Baneh) plant with the scientific name of Pistacia atlantica is remarkable due to its various compounds and antibacterial properties. This stud aimed to investigate the antibacterial effects of aqueous extract of mastic tree leaf on six oral and gastrointestinal bacteria.

In this study, the values of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of aqueous extract of mastic leaf against 6 bacterial species were determined by the microdilution broth method. Each experiment was repeated three times. The results were analyzed using SPSS22 software by One-Way ANOVA and the least significant difference (LSD) statistical tests.

All studied bacteria were sensitive to different concentrations of aqueous extract of mastic leaves. The mean MIC ofaqueous extract of mastic was significantly different between the studied bacteria (P<0.05); So that the sensitivity of gram-positive bacteria to the extract was significantly higher than gram-negative bacteria (P<0.05). The mean MBC of aqueous extract ofmastic did not show a significant difference between tested bacteria (P=0.253).

This study showed that the aqueous extract of mastic leaves has antibacterial properties that can be used in the food and pharmaceutical industries.

Emerging infectious diseases are contagious, made of a newfound lineage of a microorganism. The aim of this survey was to evaluate knowledge, attitude, and practice of Health sciences students regarding emerging and re-emerging infectious diseases.

This cross-sectional survey was conducted on 462 randomly selected students from several constituent colleges of Birjand University of Medical Sciences, including the Colleges of Nursing, Medicine, Dentistry, and Paramedical (from October to March 2019). For data collection, a structured Knowledge, Attitude, and Practice (KAP) questionnaire was used, which its validity was checked by professionals. At the end, the collected data were analyzed by SPSSV19 using independent t-test and ANOVA.

A number of 230 (49.8%) participants were female. According to the collected data, the mean knowledge, attitude, and practice were at a medium level, which are not ideal and show that, there are several weaknesses in the curriculum. The mean knowledge scores for medicine, dentistry, laboratory science, and nursery students were 42.53±15.78, 46.24±20.99, 39.63±15.35, 40±19.43. The mean attitude scores were 60.25±6.13, 59.68±5.86, 58.60±5.06, 57.77±6.59, and their practice mean scores were 58.99±25.11, 67.80±25.72, 62.46±24.48, and 62.29±21.08.

According to the collected data, paying more attention to the microbiology course plan is recommended in all medical and paramedical disciplines. Moreover, Further education should be given to prepare students for having proper practices preventing from the spread of infection.

This research was a retrospective study on the prevalence of nosocomial infections (NIs) and the associated risk factors among the patients admitted to the surgery and internal Intensive Care Units (ICU).

This cross-sectional descriptive study was conducted on patients admitted to ICUs over one year. Clinical data of patients, including demographic information, length of stay, underlining disease, the rate of patients with NIs and distribution of NIs sites and pathogens were collected. Univariate and multivariate logistic regression were run to determine the factors associated with NIs.

Collectively, 1018 patients were studied, including patients admitted to surgical ICU (n = 665) and internal ICU (n = 353). The incidence rate of NI in the surgical and internal ICUs was 67 (10.1%) and 96 (27.2%), respectively. The most NIs in the internal ICU were respiratory tract infections (RTI, 46.9%) and urinary tract infections (UTI, 37.5%), while the common infections in the surgical ICU were respiratory tract infections (RTI, 38.3%) and surgical-site infections (SSI, 22.0%), respectively. The major risk factors, length of stay and use of nasogastric intubation (NG tubes), were associated with NIs in both ICUs.

Our results indicated that the incidence of infections in the internal ICU was more than the surgical ICU. Age, underlying diseases, the long stay, and use of ventilator and NG tube were of factors associated with NIs rate in internal ICU.

 Chlamydia trachomatis is one of the most common sexually transmitted infections in the world. However, there is no detailed information on its incidence, especially in developing countries where routine laboratory diagnosis is unavailable.

 This study aimed to investigate the prevalence of endocervical C. trachomatis infection and related risk factors among women attending the University Gynecology Clinic of Birjand, East of Iran.

 This cross-sectional study was conducted on 195 women attending the University Gynecology Clinic in South Khorasan, Birjand. Endocervical sampling was performed in a lithotomy position using a sterile brush. Identification of C. trachomatis was performed by real-time PCR method using GeneProof C. trachomatis PCR kit. Data on socio-demography and potential risk factors for genital infection were analyzed using SPSS software (version 21).

 In the study, the prevalence rate of C. trachomatis among women was reported 4.1% (8/195 subjects). Statistical analysis showed that the rate of C. trachomatis infection in women was only statistically related to the history of vaginal infection (P = 0.001). Although there was no statistically significant association between chlamydial infection and age, the highest infection rate was in women less than 30 years old.

 Given the relatively significant incidence of C. trachomatis infection among women, our findings highlight the importance of routine screening and early diagnosis of C. trachomatis to control the infection.

Urinary incontinence (UI) is a common disease that affects millions of people throughout their lives. It is reported that UI has a considerable economic burden on patients and communities. The aim of this study was to find out the prevalence of urinary incontinence (UI) and its related factors among women living in Birjand city, Iran.

 A cross-sectional study from September 2020 to December 2020 was conducted on women 15 to 70 years living in nine areas of Birjand city. Data were gathered by researcher-made questionnaire and in-person interviews about demographic, obstetrics, and UI (stress, urge, and overflow UI) characteristics. Chi-square test was applied to analyze differences between women with and without UI about risk factors.

Of 3028 women (mean age 32.70±11.49 years), 828 (27.3%) reported to have UI. The rate of stress, urge, and mixed UI was 18.1%, 3.4%, and 5.9%, respectively. All types of UI were associated with age, education, BMI, chronic cough / dyspnea, constipation, diabetes mellitus, and smoking.

Women should be continuously educated by health care providers on the risk factors and activities which can reduce their risk for UI. Further studies on women across the country may help decision makers to measure the regional burden of disease and to plan population-level interventions.

Academic motivation of students in universities is one of the highly important issues in the higher education and university system of any country and is one of the significant indicators in evaluating the quality of the higher education system. One of the important and influential factors on studentschr('39') academic motivation is the teaching method of faculties in the classroom. Therefore, this study aimed to compare the effectiveness of lecture and mixed training methods for the diagnosis and treatment of dyslipidemia topic on the academic motivation of medical clerks and interns.

This is a quasi-experimental study (pre-test, post-test, and a control group), which was performed with 100 clerks and interns in the cardiology department of Birjand University of Medical Sciences. The study samples were randomly assigned into two groups (n = 50 cases; n = 50 controls). The subject matter of diagnosis and treatment of dyslipidemia was taught for 4 hours (2 h per week) using the lecture (traditional) method in the control group and mixed method in the case group. A 20-item researcher-made motivation questionnaire was used to collect data. The data were analyzed in SPSS software version 22 using the independent and paired t-test. The significance level was set at P < 0.05.

The results showed that the mean and standard deviation values of academic motivation at baseline were 65.6 ± 4.47 in the case group and 64.68 ± 6.75 in the control group. In the post-intervention phase, these were 68.42 ± 4.64 in the cases and. 64.4 ± 4.13 in the controls. Therefore, mixed education has a significant effect on the academic motivation of clerks and interns at the significant level of P < 0.05.

The academic motivation of students who were taught using the mixed method was higher than that of the lecture method. Therefore, it is recommended that teachers use mixed teaching methods in the classroom.

Fear of dental procedures is one of the main reasons why patients tend to avoid dental clinics. The present study aimed to investigate the effect of using Virtual Reality (VR) videos during dental treatments on anxiety levels of the adolescents receiving treatment in dental clinics.

A total of 66 patients aged 12-15 years were referred to the dental clinic at the Orthodontic Department of Birjand University of Medical Sciences. The participants were randomly assigned to two groups (n=33). The patients in the experimental group were engaged in watching a VR clip using a headset, while the control group directly observed the treatment procedure. Beck Anxiety Inventory (BAI) was administered to measure the participants’ anxiety levels before and after the treatment. SPSS (Version 22) was used to analyze the data.

The results of Mann-Whitney U test revealed a statistically significant difference between the anxiety levels of the participants in experimental and control groups (P=0.014). However, the results of Spearman Correlation test did not suggest any significant direct correlation between the participants’ age and anxiety scores after the intervention in control (r=0.002, P=0.992) and experimental (r=0.2755, P=0.122) groups. Additionally, the results of the Mann- Whitney U test indicated that there was no statistically significant difference between gender and anxiety scores after the intervention in the control (P=0.203) and experimental (P=0.207) groups.

The results of the present study showed that the patients receiving VR distraction experienced lower anxiety caused by orthodontic procedures. This finding implies the effectiveness of the VR-based techniques to reduce anxiety during dental treatments.

Dental caries is one of the most common chronic diseases around the world. Inhibitory effects of Magnolia Grandiflora bark extract has been proved on tooth decay both in vitro and by using free sugar chewing gum. This research aimed to examine the effect of Magnolia Grandiflora bark mouth-wash on the prevalence of Streptococcus mutans in dental plaque.

This crossover, placebo-controlled, clinical trial study, was performed on a total of twenty participants (aged 18 to 35 years) in both control and intervention groups and four phases. The prevalence of S. mutans was measured in a certain volume of volunteer’s dental plaque at the beginning of the project (phase 1), after the first prescription (phase 2), following the washout period (phase 3) and finally after the second prescription (phase 4) by culture on bacteriology medium. Plaque index and saliva sampling were carried out in follow-up visits by a dentist. The data were analyzed using T-Test (paired and independent) quantitatively.

There was a significant difference in S. mutans frequency in dental plaque between when the participants used Magnolia mouthwash and when they washed out or used a placebo (p<0.005). Results also showed a significant difference between Magnolia and Placebo groups in the mean count of saliva bacterial colony counts after oral administration in the first and second time (P<0.001 and P<0.004, respectively).

The current trial showed that Magnolia Grandiflora %0.3 mouthwash tends to decrease the number of S. mutans in dental plaque significantly. Therefore, its mass production and release to the oral health community are suggested. However, further studies with larger sample sizes and varying treatment are required to substantiate the findings of this study.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new virus from the coronavirus family (1) regarded as enveloped, positive-sense, single-stranded ribonucleic acid (RNA) viruses with helical symmetric nucleocapsid (2). According to the whole genome sequencing and phylogenetic analysis of coronavirus strains, a distinct clade of betacoronavirus is shown to be associated with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (3). This novel clade is called the 2019 novel coronavirus (2019-nCoV) and due to more similarity to the SARS virus is also called severe acute respiratory syndrome coronavirus 2. The disease is known as COVID-19.

Infectious diseases such as tooth decay are a challenge to oral health in humans.Mouthwashes arean auxiliary tool and in addition to this, mechanical dental plaque control i.e. brushing and flossing, play an important role in controlling plaque. In the past three decades, the pharmaceutical industry has produced a significant number of antibiotics, but the resistance of microorganisms to these drugs has increased. Thus, the increasing spread of microbial resistance has made the treatment of infectious diseases difficult and costly. Much research has been done on chlorhexidine-containing solutions, which is a gold standard. Chlorhexidine belongs to the group of medicines called antiseptic antibacterial agentsand its only side effect is a change in tooth color. Therefore, now days it is sought to replace the products with herbal antimicrobial properties due to their availability and low side effects, instead of antibiotics. Ephedraguardianais an herbal medicine that has been used in the treatment of asthma, nasal congestion and disorders of the central nervous system. Almost all species of this plant are adapted to the environmental and climatic conditions of Iran and have significant antimicrobial effects. The aim of this study was to investigate the effect of aqueous and alcoholic extracts of Ephedra gerardiana with chlorhexidine on normal flora of oral bacteria and Candida albicans in vitro.

In this experimental study, the conical section of Ephedra gerardianawascollected and then approved by anexpert of medicinal plants of the Faculty of Agriculture department in Birjand University. Extraction was performed by soaking the conical parts of the plant after drying and grinding.To prepare hydroalcoholicextracts, the plant powder was boiled for one hourand then condensed in a rotary evaporator at a temperature of 60 degrees to reach a volume of 20 ml. The antimicrobial effect of the extracts was determined by broth microdilution method on Enterococcusfaecalis(ATCC29212), Streptococcus mutans (ATCC35668), Lactobacilli casei (ATCC39392) and Candida albicans (ATCC 10231).Thus, the concentrations of chlorhexidine 1%(0.03-10 mg/ml) and hydroalcoholic extractof Ephedra gerardiana(0.01-20 mg/ml)were prepared in 96-well plate wells, respectively.Bacterial cell suspensionwas adjusted to the turbidity of 0.5 McFarland standard and for Candida albicans and 5 × 103 cells mL−1was prepared by spectrophotometry and confirmed byhemocytometric counting.The extract-free wells were considered as positive control and extract control were considered as negative control.  A well microtiter platewas incubated in a 96- for 24 h at37 °C. At the end of this incubation,minimum inhibitory concentration (MIC) andminimum bactericidal concentration (MBC) and minimum fungicidal concentration (MFC) was determined by using colony count on blood agar medium.

The results showed that E. gerardiana aqueous extract did not affect the growth of Enterococcus faecalis and Streptococcus mutans. Enterococcusfaecalis and Streptococcus mutans were resistant to aqueous extractswhile aqueous extract showed an inhibitory effect on Lactobacilli casei and Candida albicans.Lactobacilli casei and Candida albicans had MIC 2.5 and 0.31 mg / ml, MBC/ MFC 0.62 and 5.0 mg / ml, respectively. Enterococcusfaecaliswas also resistant to alcoholic extracts.The results of the alcoholic extract showed that different concentrations of extract did not affect the growth of Enterococcusfaecalis. However, Streptococcus mutans and Lactobacilli casei and Candida albicans were susceptible to alcoholic extracts.Lactobacilli casei, Streptococcus mutans, and Candida albicanshad MICs at 0.07, 1.25, 2.5, mg / ml and MBC/ MFC at0.3, 2.5, 5.0 mg / ml, respectively. Also,chlorhexidine 1% showed an inhibitory effect on all bacterial strains and Candida albicans. All three bacterial strains (Enterococcusfaecalis, Streptococcus mutans and Lactobacillus casei) had MIC at 1.25 and0.07 mg / ml and MBC 2.5 and0.3 mg / ml to chlorhexidine 1%respectively. Furthermore, Candida albicans demonstrated MIC at 0.3 mg / ml and MFC at 0.62 mg / ml to chlorhexidine.

The results of the effect of hydroalcoholic extractof Ephedra gerardianashowed that it has antibacterial effects on some gram-positive bacteria of normal oral flora, including Streptococcus mutans,Lactobacillus casei and Candida albicans. Compared to the effect of different concentrations of chlorhexidine 1% and hydroalcoholic extractitdid not have a significant effect on the growth of Enterococcus faecalis. According to the study, with the exception ofEnterococcus faecalis, which was resistant to all aqueous and alcoholic extracts, Ephedra gerardiana extract has antibacterial and antifungal properties and therefore can be an effective antimicrobial agent compared with chlorhexidine 1% as a commercial mouthwash solution that has side effects of tooth discoloration;Ephedra gerardianaextract can be used alone or in combination with other antimicrobial agents as mouthwashes.To better identify the performance and antimicrobial properties of Ephedra, it is recommended that different species of Ephedra be collected from different areas and examined phytochemically.

Raising antibiotic resistance has led the human community to more frequent application of herbal medicines. The tomato fruit, scientifically called Lycopersicon esculentum mill, is an important source of vitamins, minerals, and antioxidants, all with beneficial effects on human health. The present study aimed to evaluate the antibacterial effects of tomato aqueous extract on four species of common bacteria associated with gastrointestinal infections.

After preparing the aqueous extract of native tomato, its minimum inhibitory concentration (MIC) was determined against Staphylococcus aureus (S. aureus) (TCC116538), Klebsiella pneumonia (K. pneumonia) (ATCC700603), Shigella flexneri (S. flexneri) (ATCC12022), and Proteus vulgaris (ATCC6380) species using micro dilution broth method based on the Clinical and Laboratory Standards Institute guidelines. Each of the experiments was repeated three times. The results were subdivided into normal and abnormal variables by one-sample Kolmogorov-Smirnov test. One-way Analysis of Variance (ANOVA) was used for examining normal variables.

The results of this study showed that the most significant effect of the tomato extract is on S. aureus. The MIC of tomato extract for S. aureus was 31.25 mg/ml, while for Proteus vulgaris, K. pneumoniae, and S. flexneri was 62.5 mg/ml. The mean MIC of the extract was significantly different between the studied bacteria (P < 0.05). The LSD post hoc test showed that the MIC for S. aureus (0.0599 ± 0.001) was significantly higher than that of Shigella flexinari (S. flexneri) (0.351 ± 0.009) (P < 0.001), K. pneumoniae (0.469 ± 0.062) (P = 0.001), and Proteus vulgaris (0.492 ± 0.005) (P = 0.003). Moreover, the MIC for S. flexneri was significantly lower than that of K. pneumoniae (P = 0.002) and Proteus vulgaris (P = 0.001). The mean MIC values for K. pneumoniae and Proteus vulgaris (P = 0.394) were not significantly different.

The current study revealed a significant antibacterial effect of tomato extract against different bacterial species. Therefore, the extract can be used as an antiseptic agent in pharmaceutical and food industries.

 Infections acquired in ICU wards is a major part of nosocomial infections in each hospital. Controlling this type of infections can reduce mortality and hospitalization time. An important and high-risk target group for these infections involves older adults. This study aimed to investigate the infections acquired in ICU among older adults as well as contributors to and complications of these infections. 

 In this descriptive, analytic study, all the elderly patients (>60 y) hospitalized in two ICUs wards of teaching hospitals of Birjand University of Medical Sciences during 2015 were included. The patients who were being treated by antibiotics or were unwilling to participate or had preliminary positive cultures were excluded. After 72 hours of hospitalization in ICU, a set of participants’ samples including blood, urine, wounds, lung discharges, and sputum were cultured. In the positive samples, factors associated with the infection, such as age, sex, initial disease, catheterization, and the complications were examined.

 In this study, 417 older adults (>60 y) hospitalized in Imam Reza and Vali-e-Asr Hospitals of Birjand with Mean±SD age of 74.04±8.9 years were entered in the study. Among them, 255 (61.2%) patients were in Imam Reza Hospital and the remaining were in Vali-e-Asr Hospital. Men were accounted for 45.8% (n=191) of participants. The infection had a frequency of 18.7% (n=78). Men showed a higher rate of infection than women (24.1% vs 14.2%; P=0.01). Infections increased significantly as hospitalization time increased (i.e., 2.7% in patients with <5 days, 30.2% in patients with 5-10 days; 67.2% in patients with >10 days of hospitalization; P>0.001). The most common infection was respiratory infection observed in 42 (53.8%) of cases followed by urinary infections. There was no significant correlation between age and infection occurrence. Correlation was found neither between infection and mortality, nor between age and mortality. Infection rates was significantly greater in the internal diseases ICU (35.8%) than in the surgery ICU (7.8%) (P<0.001). 

 Elderly adults hospitalized in the ICU are prone to infections. Thus, the hospitalization time and the intubation times should be reduced as far as possible.