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Epidemiological trend of suicide in north of Iran from 2011 to 2018 with a focus on joinpoint regression
Full text linkBackground: Deaths due to potential suicide are preventable and this phenomenon is costly for the health care system and contradicts the values and cultural standards of an Islamic country. Methods: This study is a retrospective study. The research population includes all cases of suicide during the years 2011-2018 who were referred to the emergency department of Babol hospitals. The results were analyzed using SPSS v.23 and Joinpoint Trend Analysis software 4.9.0.0 to identify significant changes in the temporal trends of the outbreak. Results: The highest percentage of suicides occurred in summer (27.8), on Saturdays (13) and at night (53). A total of 1.9 of the cases were commit suicides (leading to death). The highest frequency of suicide was shown in 1397 (21.2) and the lowest in 1392 (5.1) and was more common in women (68.2 vs. 31.8). Suicide-related deaths was higher in the second four years (63.5), but suicide rate was significantly higher in the first four years (2011-2014) and the mortality rate due to suicide was higher in men than women. Conclusion: Suicide attempts were higher in women than men but the death rate was higher in men which means that men attempt suicide more seriously than women. The model also predicted that suicide rates would rise in the coming years. For this reason, this important issue, along with a detailed analysis of the roots of suicidal ideation and preventive measures, should be considered by health officials and social institutions.  
Learning Medical Pharmacology through Role-Playing Method
Full text linkBackground and Objective: Traditional methods of medical education, despite being easy to implement, do not have long-lasting efficiency. The main aim of this study is to use the help of the learners to teach parts of the medical pharmacology course using role-playing pedagogy. This was done for the first time in Babol University of Medical Sciences with the cooperation of medical students who entered the university in 2016.
Methods: Students were divided into 5 groups and a group leader was introduced for each group. Five topics were selected and corresponding scenarios were written. There were three to seven people in each group. The physician together with the hypothetical resident or student examined the patient's problems and prescribed medicine and gave them the necessary recommendations. All participants were given a pre-test and a post-test, and then the findings were statistically analyzed.
Findings: 101 students (49 girls and 52 boys) with a mean age of 21.43±1.14 years participated in the study. Except for the topic of poisoning, the mean difference in pre- and post-test scores of female students was lower than that of male students. For example, this difference was observed in the topic of Parkinsonism (p<0.0001). All students involved in the performance obtained better grades in the same topics compared to other students (88.15 vs. 59.71 out of 100). 74% of female students and 79% of male students expressed satisfaction with the implementation of this method.
Conclusion: According to the findings, this method has increased the motivation to learn the medical pharmacology course and stabilize the course topics. Therefore, its implementation in difficult courses with diverse and voluminous content not only helps them to learn better, but also helps them maintain their enthusiasm and increase motivation to learn more and consolidate what they have learned
Comparison of Falls and its Determinants in the Elderly with and without Knee Osteoarthritis
Full text linkBackground and Objective: The growth of aging reveals the importance of paying attention to the health needs of the elderly. According to some studies, falls and its consequences are more common in the individuals with knee osteoarthritis (KOA) than those without KOA, but due to lack of evidence, its related factors are still unknown. Thus, the aim of this study was to compare the falls and its determinants in the elderly with and without KOA.
Methods: In this case-control study, 700 older adults in two groups of elderly with and without KOA were compared in terms of falls and some variables including KOA, sex, age, body mass index, living status, quadriceps femoris muscle strength, hand muscles strength, balance, number of comorbidities, number of drugs used, walking duration, physical activity and frailty. KOA was diagnosed based on The American College of Rheumatology (ACR) criteria.
Findings: In this study, falls were 1.90 times higher in the elderly with KOA than elderly without KOA. Although all variables were significantly different in case and control groups, only female gender (p=0.035) and KOA (p=0.012) were significantly associated with falls.
Conclusion: These findings suggest that variables in combination may increase the risk of falls in the elderly with KOA, while each of them alone may not be associated with falls
Comparative evaluation of serum zinc level in head and neck cancer patients before and after radiation therapy
Full text linkBackground: Head and neck cancers (HNCs) include 5.3 of all cancers and they are the cause of the same 5.3 of cancer deaths. Oxidative stress has a crucial role in cancer progression and cancer therapy. Ionizing radiation causes cell malfunction and death by creating reactive oxygen species. Due to its antioxidant activity, immune system power enhancement and role in apoptosis, zinc is a crucial trace element in oncology including HNCs. We decided to compare serum zinc level of HNC patients before and after RT, to assess the potential effects of ionizing radiation therapy on serum zinc. Methods: Fifty-seven HNC patients, who were candidates for curative radiation therapy (RT), were enrolled and their serum zinc level just before and 2 months after completion of RT were checked in a single laboratory. RT was prescribed by linear accelerator with 60 to 70 Gy by conventional method. Data were analyzed by SPSS 20. Results: Mean serum zinc prior to RT and following RT were 77.64±13.45 mg/dl and 68.28±11.93 mg/dl, respectively, which was lower following RT (p<0.001). Patients’ sex, age and duration from diagnosis to treatment and site of disease didn’t have any impact on serum zinc difference. Conclusion: This study showed that RT of HNCs leads to serum zinc reduction, which is greater in nodal disease because of either larger field or higher dose of radiation. Taking zinc supplements while being treated by RT, may be necessary.  
Investigating the effect of nifedipine mucosal adhesive on the wound healing process in the palate: A clinical trial study
Full text linkIntroduction: Nifedipine (NF) is a calcium channel blocker that accelerates wound healing and subsequently relieves pain and discomfort. The aim of the present study was to investigate the local effect of this drug on the wound-healing process of the palate.
Materials & Methods: In this triple-blind clinical trial study, 31 patients who were referred to the Periodontology Department of Babol Dental School (14 in the experimental group and 17 in the control group) were examined. They were candidates for gingival surgery and needed a palate transplant. Mucotom was used to create identical wounds in the palate (transplant donor). After a free gingival grafting, the active ingredient of 0.3% NF was applied as a mucosal adhesive (made of chitosan) in the area of the graft (palate). Patients were examined and recorded on days 2, 4, 7, 14, and 30 after surgery for wound closure and healing criteria (Landry & Manchester scar scale) and pain (VAS). Sutures were removed on day 7 of the study. Data were analyzed with SPSS 20 and chi-square, Kruskal-Wallis and Mann-Whitney tests. The significance level was set at 0.05.
Results: Based on Landry and Manchester criteria, the wound healing process in the two groups was not significant (p=0.125). There was no significant difference between mean wound size reduction and VAS in both treatment and control groups (p=0.253).
Conclusion: Topical NF has no effect on the natural process of healing oral mucosal ulcers and reducing pain
The State of Food Insecurity and Its Relationship with the Physical and Mental Health of the Elderly (Sanandaj, 2019)
Full text linkBackground and Objective: Food insecurity is defined as limited or uncertain access to adequate and healthy food in terms of nutrition or limited ability to obtain food in socially acceptable ways, which can affect the health of the elderly. The aim of this research is to investigate the state of food insecurity and the factors affecting it and its role in physical and mental health in the elderly.
Methods: This cross-sectional study was conducted on 550 elderly people aged 60 years and older who referred to 10 health centers in Sanandaj, and were selected via random cluster sampling. Demographic information questionnaire, HFIAS food security questionnaire (8 questions with a score range of 0 to 24) and Goldberg General Health Questionnaire (28 questions with 4 subscales) were completed and reviewed.
Findings: In this study, 324 elderly women and 224 men were evaluated, 75.6% were married and 73.6% were illiterate. The findings showed that 59.1% (325 people) of the elderly had some degree of food insecurity and severe insecurity was observed in 62 people (11.3%). Food insecurity in people with moderate to severe physical symptoms (OR=7.33), anxiety and sleep disorder (OR=8.63), functional disorder (OR=6.78), depression (OR=21.12) and in general, moderate to severe general health disorder (OR=11.85) was seen more. In addition, food insecurity, not being married, being illiterate, living alone, and low income were observed to a greater extent in women.
Conclusion: The results of the study showed that the prevalence of food insecurity among the elderly in Sanandaj is significant and is related to factors such as general, physical and mental health disorders
The Effectiveness of Well-Being Therapy on Coping Strategies and Self-Efficacy of Patients with Chronic Neuropathic Pain
Full text linkBackground and Objective: Neuropathic diseases are neurodegenerative conditions and a wide and difficult group of peripheral nerve diseases in humans. Since well-being therapy emphasizes the high levels of six domains of psychological well-being, this study was conducted to investigate the effectiveness of well-being therapy on pain coping strategies and self-efficacy of patients with chronic neuropathic pain.
Methods: This clinical trial was conducted on 30 chronic neuropathic patients referred to Ayatollah Rouhani hospital in Babol and a neurologist's private office in two groups of experimental and control (n=15). Well-being therapy was performed in 8 sessions of 120 minutes, once a week for the experimental group, while the control group received the routine treatment. After the follow-up period, the control group also underwent psychotherapy. Both groups completed questionnaires of pain coping strategies (Rosenstiel and Keefe, 1985) and pain self-efficacy (Nicholas, 1989) in the pre-test, post-test and follow-up (two months after the post-test) and were compared.
Findings: The results showed that there was a statistically significant difference between the two experimental and control groups in the score of the subscales of pain coping strategies in distraction from pain (23.13±3.88 versus 11.47±7.34) (p<0.001), reinterpretation of pain (17.33±5.56 versus 13.0±8.65) (p=0.114), catastrophizing (10.0±6.24 versus 16.33±5.4) (p<0.001), ignoring pain (24.4±6.67 versus 12.6±5.11) (p<0.001), hoping/praying (29.13±9.97 versus 22.4±5.7) (p=0.031), self-talk (25±4.03 versus 21.2±4.79) (p=0.026), behavioral activation (20.47±4.43 versus 11.20±4.94) (p<0.001) and pain self-efficacy (43.2±9.45 versus 33.33±13.34) (p=0.027). These results were maintained in the follow-up period.
Conclusion: The present study showed that wellness therapy can be an effective intervention in improving pain coping strategies and increasing pain self-efficacy in chronic neuropathic patients
Evaluation of morphine, methadone, digoxin, and dronabinol poisoning during the years 2017 to 2019 in Ilam, Iran
Full text linkBackground: Every year, drug poisoning is the most prevalent reason for referring patients to medical centers. This study aimed to evaluation of morphine, methadone, digoxin, and dronabinol poisoning in Shahid Mostafa Khomeini Hospital in Ilam. Methods: In this In this Cross-sectional study, patient samples suspected of morphine, methadone, digoxin, and dronabinol poisoning referred to the toxicology laboratory of Ilam University of Medical Sciences were analyzed using the HPLC method, and the results were analysed using SPSS software. Results: Results showed that the percentage of drug use is greater in men than in women. The highest percentage of morphine and methadone poisonings were detected in those under the age of 40, whereas the highest percentage of digoxin poisonings were recorded in those over the age of 80. As a result, the average age of digoxin users was substantially greater in men than in women. Methadone consumers showed significantly greater blood levels than others. In addition, there was a significant difference (P<0.01) in blood levels between men and women who used morphine. Conclusion: In general, it is important to understand the status of drug poisoning with drugs such as morphine, methadone, digoxin, and dronabinol, as well as the prognosis associated with the treatment process of such poisoning.  
The weight of Mizaj (temperament) indices in Persian Medicine: A Delphi study
Full text linkBackground: Mizaj is an individualized viewpoint in Persian Medicine (PM) that is used for the prevetion of diseases and also treatment. Evaluating Mizaj in the two domains of hotness-coldness, and wetness-dryness, 10 criteria have been introduced, most of them are qualitative. To achieve valid and reliable questionnaires, the weight of these criteria must be determined in assessing the Mizaj. Methods: In a cross-sectional study with Delphi method, 10 indices were extracted from PM references and sent to PM experts via e-mail. They were asked to score the weight of each index in determining the Mizaj from 0 to 10. The scores ranked and comparing previous preliminary studies, criteria of major and minor were proposed. Results: Out of 147 invited PM experts, 122 completed the tables. Based on scores, physical functions, physique, and responsiveness of organs obtained the highest scores in the field of hotness-coldness. In wetness-dryness muscle/fat mass and sleep/wakefulness received the highest scores from the viewpoint of experts. Conclusion: Physical functions, physique (Anthropometry), responsiveness of organs and psychic function can be used as major criteria in Mizaj assessment methods in the hotness-coldness field. In the field of wetness-dryness, muscle/fat mass, sleep/wakefulness, tactile condition and physique (anthropometry) can be considered as major criteria
Genotoxicity and cytotoxicity effects of X-rays on the oral mucosa epithelium at different fields of view: a cone beam computed tomography technique
Full text linkBackground: Cone beam computed tomography (CBCT) is considered a common examination for dentistry problems. Cellular biology can be affected by exposure to ionizing radiations procedures. In this study, we aimed to assess the genotoxicity and cytotoxicity effects of CBCT dental examinations at two different fields of view (FOVs) in exfoliated buccal epithelial cells. Methods: Sixty healthy adults participated in the current study. They were divided into two identical groups; CBCT with FOV of 6*6 cm2 and 8*11 cm2. Exfoliated oral mucosa cells were prepared immediately before and after 10-12 days of CBCT exposure. The cytological smears were stained with the Papanicolaou technique. The amounts of micronuclei and other cytotoxicity cellular changes (Pyknosis, Karyolysis, and Karyorrhexis) were evaluated. The variables of the parameters before and after CBCT examination in the two investigated FOVs were performed using Wilcoxon test and paired-samples t-test in SPSS software. Results: The micronuclei and other cytotoxic changes parameters before and after CBCT exposure for both FOVs (6*6 and 8*11 cm2) increased significantly (p<0.001). Furthermore, a significant difference (p<0.05) was observed between the investigated parameters at the two FOVs. Notably, the FOV of 8*11 cm2 had more side effects than that of 6*6 cm2. There were no statistically significant among males and females for both FOVs. Conclusion: CBCT examinations of dental disorders would increase the risks of inducing genetic damage. The cytotoxicity and chromosomal damage were considered in males and females in both investigated FOVs (6*6 and 8*11 cm2). In this regard, the use of CBCT must be following the ALARA principle