nasser behnampour

Control of hemodynamic changes and blood loss is a daily challenge in general anesthesia for patients undergoing septorhinoplasty. This study aimed to evaluate the effects of magnesium sulfate and clonidine on the control of hemodynamic factors and bleeding volume during this procedure.

This double-blind, randomized clinical trial study was conducted on 60 patients undergoing septorhinoplasty at 5th Azar Medical & Educational Centre of Gorgan in 2021-2022. Patients were divided into two intervention groups (50 mg/kg of magnesium sulfate) and control group (5 μg/kg of clonidine) with permutation random block allocation. All patients underwent induced hypotension. Before induction of anesthesia and every 5 minutes afterwards, blood pressure was recorded. Blood loss volume was calculated at the end of the surgery.

In the magnesium group, 36 individuals were evaluated, while in the clonidine group, 24 individuals were examined. There were no statistically significant differences in baseline characteristics of patients in the two groups and the duration of surgery. Both drugs were equally effective in inducing hypotension, however blood pressure changes in magnesium group were more trivial than clonidine group. The bleeding volume in the magnesium sulfate and clonidine groups was 139.44 ml and 141.25, respectively and this difference was not statistically significant (p-value=0.634).

The results of this study showed that magnesium sulfate can be effectively used as an alternative to clonidine in controlling hemodynamic changes and ultimately reducing blood loss volume during septorhinoplasty surgery. In addition, magnesium is at least as effective as clonidine in stabilizing hemodynamic changes.

Black mulberry is considered one of the most valuable fruits in complementary medicine, with its fruit, leaves, bark, and roots offering significant benefits in the food industry, cosmetics, and especially in the treatment of various diseases. In traditional medicine, black mulberry and its products have been used to treat pharyngitis, enlarged tonsils, sore throat, oral rashes, and swelling of the tongue. The purpose of this study is to review the therapeutic effects of black mulberry in both complementary medicine and modern research. This study is a review. In this review, traditional Iranian medical texts such as Makhzan Al-Aavieh, Qanun fi Tab, Alshamel, Zakhire Kharazmashahi, Riyaz Al-Adavieh, and pharmacopoeias like Qarabadin Kabir and Qarabadin Halali, along with other traditional medicine books like Summary of Al-Hakamh, Tab Akbari, and Elixir Azam, were examined regarding the habitat, appearance, actions, and therapeutic properties of black mulberry in traditional medicine. Important and effective formulations containing black mulberry were extracted from these pharmacopoeias. To explore recent studies related to the therapeutic effects of black mulberry, relevant articles were searched using Persian and English keywords in domestic and international databases from 2000 to October 2023. Keywords such as "black mulberry," "Morus nigra," "Shahtoot," "Toot siah," "traditional medicine," and "complementary medicine" were used to search databases like SID, Magiran, Irandoc, PubMed, ScienceDirect, DOAJ, and Google Scholar, and both Persian and English articles were reviewed. According to traditional Iranian medicine texts, black mulberry is used to treat mouth ulcers, rashes, plague, and swelling and inflammation of the pharynx, larynx, and tongue. It is also used to strengthen joints, lower blood pressure, treat fever, protect against liver damage, and aid urination. Furthermore, black mulberry paste is recommended for improving nocturnal snoring and dyspnea in children. In Chinese medicine, black mulberry and its various parts have been used to improve symptoms of type 2 diabetes, obesity, lipid disorders, and antimicrobial conditions. Black mulberry is a rich source of polyphenols, including anthocyanins. It has been shown to have one of the highest antioxidant capacities among fruits. In patients with type 2 diabetes, black mulberry products have been found to reduce symptoms such as frequent urination and polyphagia, as well as alleviate neurological complications. Other benefits include increasing HDL levels, reducing LDL, lowering hemoglobin A1C, and decreasing triglycerides. The findings suggest a strong concordance between traditional medicine sources and modern scientific research. Therefore, by examining historical texts and incorporating new scientific discoveries, medicinal products from black mulberry could be developed for the treatment of various diseases.

Oral cancer is the sixth most common cancer in the world and the third most common cancer in developing countries. Early detection of oral cancer can reduce mortality in several ways. The aim of the present study was to combine the quantitative results of various studies concerning serum and salivary microRNAs for early diagnosis of head and neck squamous cell carcinoma (HNSCC).

This systematic review and meta-analysis was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline. We searched all the relevant English studies in international databases of PubMed/Medline, Scopus, Web of Science, Cochrane, ProQuest, Embase, and Wiley until February 2022. A random-effects model was used to estimate the pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) for each study. A total of 672 articles were found. After screening, 93 articles were approved for systematic review. Finally, 5 completely relevant articles were examined in the meta-analysis.

Considering all studies regarding miRNAs, the combined results indicated that AUC  =  0.73, with a sensitivity of 71.68% and a specificity of 69.95%, could be used for HNSCC diagnosis. Due to the moderate sensitivity and specificity of miRNAs, they may be able to confirm or exclude suspected cases of this disease, enhancing their utility as clinical diagnostic indicators.

The available data provide evidence that miRNAs, especially MiR-31 expression in the saliva, serum, or plasma, can be used as a diagnostic biomarker for HNSCC patients. However, controlled clinical trials with large sample sizes are needed to validate different miRNAs.

 Leukemia is the most common childhood malignancy. Identifying prognostic factors of patient survival and relapse using more reliable statistical models instead of traditional variable selection methods such as stepwise regression is of great importance. The present study aimed to apply a penalized semi-parametric mixture cure model to identify the prognostic factors affecting short-term and long-term survival of childhood leukemia in the presence of competing risks. The outcome of interest in this study was time to relapse.

Study Design: 

A retrospective cohort study.

 A total of 178 patients (0‒15 years old) with leukemia participated in this study (September 1997 to September 2016, followed up to June 2021) at Golestan University of Medical Sciences, Iran. Demographic, clinical, and laboratory data were collected, and then a penalized semi-parametric mixture cure competing risk model with smoothly clipped absolute deviation (SCAD) and least absolute shrinkage and selection operator (LASSO) regularizations was used to analyze the data.

 Important prognostic factors of relapse patients selected by the SCAD regularization method were platelets (150000‒400000 vs.>400000; odds ratio=0.31) in the cure part and type of leukemia (ALL vs. AML, hazard ratio (HR)=0.08), mediastinal tumor (yes vs. no, HR=16.28), splenomegaly (yes vs. no; HR=2.94), in the latency part. In addition, significant prognostic factors of death identified by the SCAD regularization method included white blood cells (<4000 vs.>11000, HR=0.25) and rheumatoid arthritis signs (yes vs. no, HR=5.75) in the latency part.

 Several laboratory factors and clinical side effects were associated with relapse and death, which can be beneficial in treating the disease and predicting relapse and death time.

Children with Attention Deficit Hyperactivity Disorder (ADHD) exhibit a kind of negligence in performing their daily tasks and activities, which also affects the maintenance of oral health. Due to the low quality of life in these children, it is doubtful that the Oral Health-Related Quality of Life (OHRQoL) will be affected compared to healthy children. 

In this study, 106 untreated ADHD children referred to the clinic of Taleghani Hospital in Gorgan City, Iran, in 2018-2019 were selected through the convenient sampling method. Data were gathered using the Child-Oral Impacts on Daily Performance (Child-OIDP) and Clinical Examination Questionnaires. Data were analyzed through SPSS-18, descriptive statistics indexes, the Mann-Whitney test, the Shapiro-Wilk test, and the Spearman correlation test. 

The most common self-expression problem of ADHD children was decay (88.6%), followed by pain, erupting, and tooth sensitivity, respectively. The OHRQoL score of these children was 12.79, which OIDP obtained. The index and the decay score of these children were 6.62, obtained by the Decay, Missing, and Filled Teeth (DMFT) index—the correlation between total DMFT and OIDP. The index score was positive and significant (r= 0.256, P= 0.008). A significant inverse correlation existed between the total DMFT score and parents' education level (r= -0.271, P= 0.005) and (r= -0.283, P= 0.003), respectively. 

There is a significant relationship between oral health and tooth decay index. Better oral health and decay, missing, and filled teeth index are associated with a higher quality of life.

 Okra (Abelmoschus esculentus) has garnered scientific attention for its beneficial effects on various chronic disorders, including type 2 diabetes mellitus.

 The current study was designed and conducted to assess the influence of whole okra fruit powder on the serum levels of specific biochemical parameters in individuals with pre-diabetes.

 Seventy pre-diabetic patients, aged 30 - 55 years, were divided into two groups: The okra group (n = 35, fasting plasma glucose: 116.26 ± 6.02) and the placebo group (n = 35, fasting plasma glucose: 112.26 ± 5.8). The okra group received 3000 mg of okra capsules daily for eight weeks, while the placebo group received placebo capsules. Liver function, renal markers, and lipid profiles were assessed at both the baseline and the end of the experiment using a spectrophotometer. The impact of the okra intervention on biochemical parameters was determined using parametric or non-parametric analysis of covariance (ANCOVA).

 The serum levels of total cholesterol, low-density lipoprotein cholesterol, liver transaminases, and uric acid were significantly lower in the okra group compared to the placebo group. Conversely, the high-density lipoprotein cholesterol levels were significantly higher in the okra group than in the placebo group. However, there were no statistically significant differences between the two groups regarding triglycerides, creatinine, blood urea nitrogen, and alkaline phosphatase levels.

 The consumption of okra effectively improved the lipid profile and certain serum parameters (alanine transaminase, aspartate transaminase, and uric acid) related to liver and kidney health in pre-diabetic participants.

Ulcerative colitis (UC) is a long-term inflammatory bowel disease (IBD) caused by abnormal immune responses, leading to inflammation and scarring in the large intestine. The bacteria Prevotella melaninogenica, found in the intestine and mouth, may contribute to UC. This study focuses on the detection of P. melaninogenica in the saliva of UC patients and compares them with the healthy control (HC) group.

The present study was a case-control study including 40 UC patients and 40 healthy controls (HCs) with an average age of 43.0 3± 10.3. This study used a real-time PCR test to investigate the frequency and average number of P. melaninogenica from the 16S rRNA gene sequence of P. melaninogenica in both groups.

P. melaninogenica was more frequent in UC patients (77.5%) than HCs (45%) (p = 0.003). The patient group had more bacteria (339.31 ± 1082.29) than HCs (61.29 ± 154.03) (p = 0.005). Women in the UC group had more P. melaninogenica (492.35 ± 1427.61) than the control group (56.98 ± 123.50) (p = 0.0342). Similarly, men in the UC group (262.85 ± 664.97) had more bacteria than the control group (72.62 ± 222.76) (p = 0.015).

The current study showed that dysbiosis in P. melaninogenica, a bacterium in human saliva, could be important in the development of UC. Further investigation is needed to evaluate its use as a potential biomarker in the UC.

Febrile seizure is a neuroinflammatory disease involving feverinduced seizures affecting children in the early stages of life. TNFα is a pro-inflammatory cytokine reported to be elevated in FS. Specific promoter variants of TNFα could be associated with its elevated cytokine expression and susceptibility to FS. The present study analyzed the association of specific TNFα variants, including TNFα-238 G/A (a genetic variant; G: Guanine, A: Adenine) (rs361525), TNFα -308 G/A (rs1800629), and TNFα -376 G/A (rs1800750) promoter polymorphisms, with FS susceptibility, and TNFα serum levels in an Iranian population

Sixty-eight FS patients and 136 controls were enrolled. The SSPPCR method was utilized to analyze TNFα promoter genotypes. This research also confirmed the genotyping results by sequencing samples of ten patients and normal controls.

The GG (a genetic sequence; G: Guanine) genotype of -238 SNP was associated with the increased risk of FS [OR = 12.65, 95% CI (2.83-56.60), P-value = 0.0012]. The AA (a genetic sequence; A: Adenine) genotype in the-308 region was increased in patients with FS and associated with the disease [OR = 4.62, 95% CI (1.46-14.56), P-value = 0.028]. The increased occurrence of heterozygous AG in the -376 SNP among control groups has been linked to a decreased risk of FS [OR = 0.22This study revealed that AGA (a genetic sequence; G: Guanine, A: Adenine) (-238/ -308/ -376) haplotype with the highest frequency in controls was associated with a decreased risk of FS, while GAA (a  genetic sequence; G: Guanine, A: Adenine) (-238/ -308/ -376) carriers were more susceptible to FS., 95% CI (0.11-0.43), P-value = 0.0001].

The current study suggested that TNFα gene promoter variants at rs361525, rs1800629, and rs1800750 could be associated with the susceptibility to FS and altered serum levels of TNFα.

Context: 

Giving birth to one’s first child is associated with worries such as fear of fetal abnormalities, adapting to a new identity, and fear of childbirth, which can adversely affect the process of pregnancy, childbirth, and maternal and fetal/neonatal health.

 The present study was conducted to determine the effect of mindfulness‑based group counseling on pregnancy worries and stress in Nulligravida women.

Setting and Design:

 The present randomized field trial study was conducted on 114 Nulligravida women at 12–20 weeks of gestation covered by comprehensive health centers of Gorgan.

 The data were collected using a demographic form and the Farsi version of the 25‑item Pregnancy Worries and Stresses Questionnaire. In the intervention group (n = 53), 6 to 12 pregnant women participated in 8 weekly 120–150‑min sessions of mindfulness‑based group counseling. The mothers in the control group(n=61) received no intervention. At the end of the eighth session, the posttest was completed by both groups.

Statistical Analysis Used: 

Data were analyzed in SPSS‑16 at a confidence level of 95% using the parametric independent and paired t‑tests and nonparametric Chi‑squared, Mann‑Whitney, and Wilcoxon tests.

 The mean scores of pregnancy stress and worries before and after mindfulness‑based group counseling increased by 11 units from 23.46 ± 13.03 to 34.96 ± 15.88 in the intervention group (P < 0.001), but these scores showed no significant changes in the control group in the pretest and posttest (P > 0.05).

 The results showed that mindfulness‑based group counseling can abate the worries and stresses of Nulligravida women.

Background and Objective Human papillomavirus (HPV) is one of the most common sexually transmitted infections and the main cause of cervical cancer, which increases and persists under various factors. This review study aims to investigate the relationship between psychological disorders and the persistence of HPV infection.
Materials & Methods This scoping review study was conducted in 2023 by searching for the related articles in SID, PubMed, MagIran, IranDoc, Science Direct, Scopus and Google scholar databases. Finally, 8 eligible articles were selected. Their quality was examined by the Appraisal tool for cross-sectional studies (AXIS) and the critical appraisal skills program (CASP) checklists.
Results Seven studies showed that stress caused by psychological, social and physical issues can cause the persistence or risk of HPV infection, change in cervical cells, and increase in the risk of cervical cancer. One study showed that depression and associated disorders such as sleep disorder can be related to the persistence or risk of HPV infection, change in cervical cells, and the risk of cervical cancer.
Conclusion The persistence of HPV infection can be related to psychological disorders. The findings of this study can be used to design clinical trials to examine this relationship.

Periodontal clinical parameters are highly sensitive for the assessment of bone resorption, while radiographic images are highly specific. Two-dimensional parallel periapical (PA) and bitewing (BW) intraoral radiographs are used as adjuvant methods to assess bone resorption in periodontal diseases. The present study aimed to compare the efficacy of PA and BW radiographs in assessing marginal bone level.

This cross-sectional study was conducted on 77 (52 females and 25 males) subjects with a mean age of 40.12±14.9 years with chronic periodontitis. Parallel PA and BW radiographs of patients, who required periodontal flap surgery or crown lengthening, were acquired, and evaluated. The distance between the alveolar bone crest (ABC) and the cemento-enamel junction (CEJ) was determined during surgery using the Williams probe. The same distance was measured in proximal areas on intraoral radiographs using Romexis Version 11.4. To evaluate intra-observer agreement, three observers re-evaluated the radiographs after a minimum of 1 week. Intra-class correlation coefficient (ICC) was applied to evaluate the inter- and intra-observer agreement. Data were analyzed using the Shapiro-Wilk test and paired t-test.

According to the results, the mean distance between the CEJ and ABC was 4.61±1.22 mm, and the mean distance on the PA and BW radiographs was 4.20±1.23 (P<0.001) and 4.02±1.06 mm (P<0.001), respectively. PA radiography was more accurate than BW radiography, although the difference was insignificant (P=0.182). The mean ICC value of the inter-observer agreement was 0.88 for BW and 0.87 for PA radiographs. The mean intra-observer agreement was 0.97 and 0.95 for BW and PA radiographs, respectively.

The accuracy of PA radiography was higher than BW radiography. However, there was no significant difference regarding the accuracy of these two techniques in determining the level of ABC in the posterior area of the jaws.

 Fear of childbirth can affect the health of the mother and the baby, which can be associated with unfavorable consequences. This study was conducted to determine effects of an emotion regulation training based on the Gross model on the fear of childbirth in primigravida women.

 This randomized field trial was conducted on 62 primigravida women with a gestational age of 28-32 weeks, who were referred to comprehensive healthcare centers in Gorgan (Iran) from April to November 2019. Subjects were selected using simple random sampling. The subjects were randomly divided into a control group (n=31) and an intervention group (n=29) based on their mean score of fear of childbirth at pretest. The Gross model-based emotion regulation training was held in 8 sessions of 120 minutes, twice a week, for women in the intervention group in three groups. The control group received routine training programs. Data were collected using the Persian version of the 14-item fear of childbirth questionnaire, at baseline and one month after the intervention. Statistical analysis of data was carried out in SPSS software (version 16) and at significance level of 0.05.

 The demographic characteristics of the subjects did not differ significantly between the two groups. After the training intervention, the mean score of fear of childbirth in the intervention group (26.55±5.44) was significantly lower than that in the control group (34.48±7.32) (P=0.0001).

Based on the results, we suggest providing the Gross model-based emotion regulation training in health care centers in order to reduce the fear of childbirth in primigravida women.

Chronic periodontitis is caused by the interaction between plaque biofilm microorganisms and host immune cells. The serum level of some vitamins may play a role in the prevention and control of the disease. This study aimed to determine the relationship between serum vitamin D levels and chronic periodontitis in patients referring to Dental School, Golestan University of Medical Sciences, Gorgan, Iran.

A total of 49 individuals with healthy periodontium (control group) and 49 patients with chronic periodontitis (case group) participated in this case-control study. Blood samples were taken from the participants, and serum vitamin D levels were measured using an enzyme-linked immunosorbent assay. Serum vitamin D levels were compared between the two groups using the Mann-Whitney test. Data were analyzed in SPSS 22 software at a 0.05% confidence level.

A total of 37 (37.8%) males and 61 (62.2%) females were included in the study. Serum vitamin D levels in the control and case groups were 35.61±16.12 ng/ml and 24.98±10.54 ng/ml, respectively (P˂0.001). The odds ratio of periodontitis per unit change in vitamin D level with the removal of confounders was 0.94 (95% confidence interval: 0.90-0.97) (P˂0.001).

Serum vitamin D levels were lower in patients with chronic periodontitis than in healthy individuals. It seems that decreased serum vitamin D levels may increase the chances of developing chronic periodontitis.

Periodontitis is one of the most common periodontal diseases, characterized by destruction of connective tissue and supporting structure of the tooth. Osteoporosis is a systemic disease of skeletal tissue characterized by a decrease in bone mass and leads to the destruction of bone structure. The aim of this study was to evaluate the correlation between systemic osteoporosis and periodontal status in menopausal women referred to the bone density measurement center in Gorgan.

In this case-control study, 56 menopausal women aged 45-65 years participated. Among the participants, 28 individuals had osteoporosis and 28 women were healthy. Periodontal pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and gingivitis index (GI) were measured for each patient. Finally, the data were analyzed using 95% confidence level.

A total of 56 menopausal women were included in the study. The mean GI in the osteoporotic group was 0.74 ± 1.43 and in the non-osteoporotic group was 0.77 ± 1.32 (p value = 0.280). The mean periodontal pocket depth in the osteoporotic group (0.63 ± 3.73) was more than the non- osteoporotic group 0.57 ± 3.66 (p value = 0.363). PI mean in the osteoporotic and non-osteoporotic groups were 37.11 ± 15 and 37.39 ± 15, respectively (p value = 0.363).

The mean clinical attachment level in menopausal women with osteoporosis was significantly higher than normal menopausal women. On the other hand, there was no significant difference in other indices of periodontal disease such as PPD, PI, GI.

Vaginal atrophy is one of the most common complaints in postmenopausal women. Symptoms of vaginal atrophy include dryness, itching, bleeding, and dyspareunia. According to Traditional Persian Medicine (TPM), the using of moisturizing plants can treat dry mucous membranes. TPM suggests the use of marshmallow (Alcea angulata) to moisturize dry cells with its mucilage. The aim of this study was to evaluate the effect of Alcea on the treatment of vaginal atrophy. This double-blind, clinical trial was conducted on 60 postmenopausal women with vaginal atrophy (40 – 65 years of age). The patients were randomly assigned into two groups of treatment and control (n = 30). The treatment group received Alcea vaginal suppository 5% (125 mg), and the control group received placebo. Both groups used suppositories every night for two weeks and every other night for six weeks. Vaginal Maturation Value (VMV), symptoms of vaginal atrophy, and pH were compared before and after the intervention. Data were analyzed using SPSS 16. VMV was increased in the treatment group, from 40.30  ±13.27 to 46.40 ± 11.27, (p ˂ 0.0001) compared to the control group, in which the change of VMV was not significant (p = 0.122). The vaginal pH was significantly decreased in the treatment group, from 6.45 ± 0.92 to 5.52 ± 0.62, (p ˂ 0.0001) compared to the control group, in which the change of pH was not significant (p ˂ 0.257). The symptoms were significantly reduced in the treatment group. It seems that Alcea vaginal suppository can be useful as a natural product to relieve the symptoms of vaginal atrophy.

"Caring behavior" are actions that are performed for the well-being of the patient. Nurses and patients' perceptions of caring behavior may differ. The aim of this study was comparison of nurses’ and patients' perspective on caring behaviors in intensive care units of educational and medical hospitals affiliated Golestan University of Medical Sciences.

This descriptive- analytical, cross-sectional study was performed in 2021 in intensive care units (ICU, CCU, hemodialysis) in educational and medical centers of Golestan University of Medical Sciences. Cluster and census random sampling were used to select hospitals and nurses, respectively. The patients entered into the study by convenience sampling. Data collected using Caring Behavior Inventory (CBI) questionnaire consisting of 42 questions and five domains (respect for others, ensuring human presence, communication and positive attitude, knowledge and professional skills and attention to other experiences) with six-point Likert responses. Data were analyzed using Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient tests.

149 nurses and 145 patients were studied. The mean of nurses’ caring behaviors from the nurses and patients’ perspectives were 229.07±14.65 and 208.79±19.92 respectively. The CBI’ scores in each of five domains were significantly higher in nurses than patients (P-value <0.001).

The difference between patients' and nurses' perception about caring behaviors confirms that although nurses' perspective is that they perform care well, but from patients' point of view, nurses have not been able to meet their expectations.

Growth of Mycoplasma in genital tract can cause problems such as infertility, pelvic inflammatory disease (PID), and preterm labor. This study was designed to evaluate the role of these bacteria in preterm labor among individuals in Gorgan city which is located in north of Iran.

The study included 100 women with complaints of pain in preterm labor before 37 weeks of pregnancy (case group) and 100 women with term labor (control group) who were referred to Shahid Sayyad Shirazi Teaching Hospital in Gorgan city, north of Iran. Vaginal swabs, collected from all of these women, were evaluated for genital Mycoplasma sp. by molecular method using specific primers with polymerization chain reaction (PCR). The comparison of results was done by conducting X2 and p<0.05 was considered significant.

Genital Mycoplasma was detected in 78 cases (39%) of 200 vaginal samples. Genital Mycoplasma colonization rates in the preterm and term samples were 60% and 18%, respectively, with relative risk of 2.05 (1.78-2.37) (p=0.001). The proportion of Ureaplasma parvum (44% and 15%), Ureaplasma urealyticum (11%, 3%), and Mycoplasma homins (5%, 0%) was significantly higher in women with preterm birth (PTB) than term labor. No cases of Mycoplasma genitalum were detected in this study.

There is a significant relationship between presence of genital Mycoplasma in vaginal secretion and the risk of preterm labor.

An effective interview can strengthen the clinician‑patient relationship and improve treatment outcomes. We aimed to assess the effect of communication skills training using the Calgary‑Cambridge model on interviewing skills among midwifery students.

In this randomized controlled trial, 30 midwifery students of Golestan University of Medical Sciences were selected using the convenience sampling method and randomly assigned through minimization into the intervention (n </em>= 15) and control (n </em>= 15) groups in 2018. The routine interventions were administered for the control group, and four sessions of communication skills training based on the Calgary‑Cambridge model was performed in small groups for the intervention group. Evan and colleague’s History‑taking Rating Scale was used before and four weeks after the intervention. Data were analyzed using paired and independent‑sample t and Mann‑Whitney U tests at the significance level of less than 0.05.

The mean (SD) scores of interviewing skill before and after the intervention was 33.71 (7.34) and 54.50 (8.16), respectively, in the intervention group (t13 = 9.26, p </em>< 0.001) and 33.64 (6.02) and 33.93 (5.39) in the control group, respectively (p </em>= 0.85). The difference between the two groups was significant (t26 = 7.86, p </em>< 0.001).

Communication skills training based on the Calgary‑Cambridge model can be used as an effective method to improve interviewing skills among midwifery students.

 Tuberculosis is appraised to cause the deaths of more than a billion people in the last decades.

 The current study compares the performance of microplate Alamar blue assay for clinical isolates of Mycobacterium tuberculosis and multidrug-resistant tuberculosis. Microplate Alamar blue assay was performed in a central tuberculosis laboratory at Golestan University of Medical Sciences in Gorgan, Iran.

 In the first step, the microplate Alamar blue assay was used for the detection of 78 clinical isolates in the Golestan Regional Tuberculosis Reference Laboratory, and the results were compared with those of the proportion assay. In the second step, the microplate Alamar blue assay and the proportion assay were used for the drug-susceptibility of 35 isolates.

 In the microplate Alamar blue assay, the sensitivity was 100 (90.97 - 100), with a specificity of 74.36 (57.87 - 86.96), positive predictive value of 79.59 (65.66 - 89.76), and negative predictive value of 100 (88.06 - 100). For the microplate Alamar blue assay with rifampin, the sensitivity was 100 (89.11 - 100), specificity was 100 (29.24 - 100), positive predictive value was 100 (89.11 - 100), and negative predictive value was 100 (29.24 - 100). For the microplate Alamar blue assay with isoniazid, the sensitivity was 84.38 (67.21 - 94.72), specificity was 66.67 (9.43 - 99.16), positive predictive value was 96.43 (81.65 - 99.91), and negative predictive value was 28.57 (3.67 - 70.96).

 We found high accuracy between the microplate Alamar blue assay with rifampin and the proportion assay. The rapid and low-cost microplate Alamar blue assay is an inexpensive and appropriate assay for the detection of rifampin-resistant tuberculosis in low-income countries.

Survival tree model is a nonparametric method which can be used to identify the affecting factors from a specific time to the onset of an event. In this method, the categories are selected according to the most important factors. The purpose of this study was to determine the factors affecting the duration of breastfeeding in mothers and introduce the homogeneous subgroups using a survival tree model.

 It was a historical cohort study analyzing the survival data of mothers with healthy single childbirths referring to the rural and urban health centers of Agh-Ghala County since 2011 until 2014. Data analyses and groupings of breastfeeding survival were performed using survival tree model with conditional inference algorithm in R Software. A separation criterion (SEP) confirmed the relevance of the model.

Survival tree model results revealed that the type of consumed milk with the complementary nutrition, ethnicity and the time interval between current childbirth and the previous delivery were the most important factors affecting the duration of breastfeeding. The SEPchr('39')s criterion was 2.082. Thus, due to the significant difference between the subgroups and the value of more than 1 for SEP criterion, the efficiency of the model was confirmed.

Survival tree model could be introduced as a suitable and powerful method for ranking the duration of breastfeeding rate which presents four homogeneous subgroups for analysis in addition to identifying the predictive variables.

Frailty is accompanied by serious health complications in the elderly, especially during hospitalization. Visual scales have been designed for quick and easy evaluation of frailty in different cultures and settings. Therefore, this study aimed to define the accuracy of the Pictorial Fit Frail Scale (PFFS) for frailty screening in the hospitalized elderly in Iran.

This cross-sectional study was conducted on 304 hospitalized participants, aged 65-85 years old admitted at Ziaeian Hospital (Tehran) were enrolled through the inclusion criteria from August to December 2019. All participants were evaluated based on the Minimum Data Set-Home Care, the Pictorial Fit Frail Scale, and the Quality-of-Life instrument, through face-to-face interviews by a trained nurse at the admission time. Spearman’s correlation coefficient, and ROC analysis were performed using SPSS at p<0.05.

The highest correlation was obtained by Frailty Index (FI) and PFFS (0.770). FI had a negative correlation with QoL (-0.48). The optimal cut-points for PFFS according to FI ≤ 0.08 (robust vs. pre-frail) was obtained 0.10 with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00% and the best cut-point for PFFS based on FI ≥ 0.25 (pre-frail vs. frail) was obtained 0.29 with sensitivity and specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00%.

It seems the Pictorial Fit-Frail Scale (PFFS) is a reliable scale with a high level of accuracy, and excellent sensitivity and specificity to measure the frailty level in hospitalized elderlies.

Time management skill learning and identification are very effective in the study process, and can reduce the adolescentschr('39') waste of time and help them increase the academic achievement. The present study aimed to determine the effect of time management skill on the academic achievement of female students.

This interventional study was a randomized controlled field trial. The statistical population consisted of all 2785 female second-grade high school students in 2017-2018 covered by health centers of Gorgan, Iran. Forty eligible students were selected and allocated into intervention and control groups. In the intervention group, a group counseling session of time management training was held for 6 hours in two days. A month after intervention, all students completed the questionnaire, and the studentschr('39') grade point average (GPA) of the first and second semesters were extracted in 2017-2018. To compare the academic achievement we used the Mann-Witny U test, paired t-test, and Wilcoxon test in SPSS-16.

The mean of the GPA of students in control group before and after intervention were 17.95±1.47 and 17.86±1.67, respectively (P=0.43). The GPA in the intervention group was 17.61±0.84 before intervention and showed an increase to 17.75±1.08 after the time management skill training; but the increase was not statistically significant (P=0.43). The results indicated a statistical significant difference in mean scores of 2 subscales; short-term planning and time attitude in the intervention group in comparison with the control group.

Despite the fact that time management skill training did not lead to the academic achievement in students, it could improve the short-term planning. Since the follow-up of the present study was short-term, it needs time to improve planning and affecting the academic achievement. It is suggested to examine this assumption in longitudinal and long-term studies.

Understanding of the risk factors for cardiovascular artery disease, which is the leading cause of death worldwide, can lead to essential changes in its etiology, prevalence, and treatment. The aim of this study was to compare the results of logistic regression model and Classification and Regression Tree Analysis (CART) in determining the prognostic factors for coronary artery disease in people living in Mashhad, Iran.

The present case-control study used the cohort data of Mashhad stroke and heart atherosclerotic disorder (MASHAD STUDY), 2009. The prognostic factors for coronary artery disease were determined by CART and Logistic regression models using R and Stata 14. Then, the efficiency of the models was compared by computing the area under the performance characteristic curve (AUC). All patients with coronary artery disease were considered as the case and for each case, three controls were selected.

According to Logistic model, prognostic factors for coronary artery disease included age, history of myocardial infarction, diabetes, history of hyperlipidemia, and family history of heart disease (father and brother). The CART algorithm showed age, history of myocardial infarction, history of hypertension, depression, physical activity level, and body mass index as prognostic factors for coronary artery disease in people in Mashhad.

Myocardial infarction and age were common prognostic factors for coronary artery disease according to the models applied. According to the efficiency of logistics model, binary multiple logistic regression model is suggested to be used in identifying the factors affecting coronary artery disease, if there is no interaction between the predictors.

Head and neck cancers (HNC) and their treatment can cause short-term and long-term impairment in patient’s quality of life (QOL). The aim of this study was to evaluate QOL in HNC patients suffering from xerostomia due to radiotherapy.

This Descriptive analytical study was performed on 44 HNC patients suffering from xerostomia experiencing radiotherapy for more than one week at the Azar 5th educational center during 1397-1398 In Gorgan. WHOQOL-BREF questionnaire was used for data collection. Data analysis was performed by calculating central indices and dispersion, and calculating Pearson linear correlation coefficient and using independent t-test. Significance level was 0.05 and SPSS-18 software were used for data analysis.

The participants include 26 (59.09%) male and 18 (40.91%) female. The mean quality of life and general health, social relations, mental health, physical health and environmental health on a scale of 100 were 54.82, 57.95, 53.78, 48.86 and 48.22, respectively. The highest score for QOL was for men and intermediate educated and the least for the illiterate people. Aging caused all components of the quality of life to decrease which was reported to be significant (p-value<0.05) expect in social relations component.

Xerostomia due to radiotherapy reduces patientchr('39')s quality of life. Various factors such as aging, female gender and low education can be effective on the reduction of QOL.

Coronary disease is the most common life-threatening among chronic diseases. Coronary angiography is one of the most important diagnostic procedures that have complications similar to other invasive procedures. This study was performed to determine the effect of changing sandbag weight on complications of femoral artery catheterization and patient comfort.

This single-blind clinical trial was performed on 140 patients who were referred to Amir Al-Mochr('39')menin Kordkoy hospital in northern Iran. Patients were randomly assigned into four groups consisting 35 patients. After angiography, sandbags with different weights (control group, first intervention, and second intervention, third intervention with weights of 4, 3.5, 3 and 2.3 kg) were placed on the angiography site for 6 hours. Bleeding, hematoma, pain and comfort of patients were recorded and compared immediately, 2, 4, 6, 8 and 24 hours after angiography.

Bleeding and hematoma were not observed in any of the patients. There was a significant difference in pain and patients comfort between groups (P<0.05). The third intervention group had the lowest pain and highest comfort at 6 and 8 hours after angiography. Also, the control group had the highest pain and the lowest comfort.

Reducing sandbag weight leads to decrease back pain and improves patient comfort without increasing vascular complications.