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بررسی اثر تزریق هم زمان سلول‌های اجدادی اندوتلیال و سلول‌های بنیادی مزانشیمی در کاهش پاسخ التهابی سیستمیک ناشی از سپسیس القا شده با لیپوپلی ساکارید اشریشیاکولی در مدل موشی Effect of Co-injection of Endothelial Progenitor Cells and Mesenchymal Stem Cells in Reducing Systemic Inflammatory Response in Sepsis Induced by Escherichia coli Lipopolysaccharide in Mouse Model 1 1  سابقه و هدف: سلول‏های پیش ساز اندوتلیال (EPC) و سلول‏های بنیادی مزانشیمی (MSC) اثرات مفیدی در درمان سپسیس دارند، اما هنوز اثرات تزریق همزمان MSC و EPC در درمان سپسیس بررسی نشده است. این مطالعه با هدف بررسی اثر درمانی EPC+MSC بر کاهش پاسخ التهابی سیستمیک در مدل سپسیس القایی با لیپوپلی‏ساکارید(LPS)، انجام پذیرفت. مواد و روش‌ها: در این مطالعه تجربی، سلول‏های MSC وEPC مغز استخوان موش جداسازی و با استفاده از فلوسیتومتری، نشانگرهای سطحی آن‌ها بررسی شد. در مجموع 4 گروه موش (گروه‏های 12تایی) وارد مطالعه شدند. گروه کنترل که هیچ تیماری نداشتند، گروه دوم LPS به صورت درون صفاقی، گروه سوم پس از تلقیح LPS، بافر PBS و گروه چهارم پس از تلقیح LPS، سلول EPC و MSC دریافت کردند. سطح سرمی و بافتی IL-1β، TNF-α، IL-6 و IL-10 و سطوح سرمی CRP و آنزیم‏‏های کبدی توسط کیت‏ تعیین شد. از آنالیز واریانس یک طرفه و post hoc برای مقایسه گروه‏ها استفاده شد. یافته‌ها: شاخص‏های سطحی سلول‌های MSC و EPC توسط فلوسایتومتری تایید شد. تزریق EPC+MSC سطح سیتوکین‌‏های پیش التهابی را کاهش (0/001P<)، غلظت سیتوکین‏ ضد التهابی را افزایش (0/001P<) و میزان بقای موش‏های ناشی از LPS را افزایش داد (0/01P<). موش‏های تحت درمان با EPC+MSC، کاهش قابل توجهی در آنزیم‏های کبدی (0/05P<)، ادم ریوی (0/01P<) و سطح CRP (0/05P<) در مقایسه با گروه سپسیس القایی با LPS نشان دادند. استنتاج: تزریق همزمان EPC و MSC منجر به کاهش پاسخ التهابی می‏‏شود. این مطالعه نتایج امیدوارکننده‏ای برای درمان سپسیس ارائه می‌دهد.   2  Background and purpose: Endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) have useful effects in treatment of sepsis, but the effects of co-injection of EPC and MSC for the treatment of sepsis have not yet been investigated. This study investigated the therapeutic effect of MSC+EPC in reducing the systemic inflammatory response in lipopolysaccharide (LPS) induced sepsis in mice. Materials and methods: In this experimental study, mouse bone marrow MSCs and EPCs were isolated and their surface markers were investigated using flow cytometry. Four groups of mice (n= 12 per group) were included in the study. The control group had no treatment, group II received LPS intraperitoneally, group III received PBS buffer after LPS inoculation, and group IV received EPCs+MSCs after LPS inoculation. The serum and tissue levels of IL-1β, TNF-α, IL-6, and IL-10, and the serum levels of CRP and hepatic enzymes were determined by commercial kits. One-way ANOVA and post hoc test were used for comparison between groups. Results: The surface markers of MSCs and EPCs were confirmed by flow cytometry. The co-injection of MSC+EPC significantly decreased the levels of pro-inflammatory cytokines (P<0.001), increased the concentration of anti-inflammatory cytokines (P<0.001), and increased the survival rate (P<0.01). Mice treated with MSC+EPC represented a significant decrease in liver enzymes (P<0.05), pulmonary edema (P<0.01), and CRP level (P<0.05) compared to the mice with LPS-induced sepsis. Conclusion: Co-injection of MSC and EPC leads to a reduction of the inflammatory response. This study provides promising results for the treatment of sepsis.   1 14 2022/12/18 1401/9/27 2023/06/19 1402/3/29 صدف حسین نیا Sadaf Hoseinnia دانشجوی دکتری میکروبیولوژی، گروه میکروبیولوژی، واحد تهران شمال، دانشگاه آزاد اسلامی، تهران، ایران ایران sadafhoseinnia@gmail.com مریم قانع Maryam Ghane استادیار، گروه میکروبیولوژی، واحد تهران شمال، دانشگاه آزاد اسلامی، تهران، ایران . استادیار، گروه زیست شناسی واحد اسلامشهر، دانشگاه آزاد اسلامی، اسلامشهر، ایران ایران ghane@iiau.ac.ir جمیله نوروزی Jamile Norouzi استاد، گروه میکروبیولوژی، واحد تهران شمال، دانشگاه آزاد اسلامی، تهران، ایران ایران J_norouzi@iau-tnb.ac.ir فرزانه حسینی Farzaneh Hosseini استادیار، گروه میکروبیولوژی، واحد تهران شمال، دانشگاه آزاد اسلامی، تهران، ایران ایران hosseinimicrobiology@gmail.com lipopolysaccharide sepsis endothelial progenitor cells mesenchymal stem cells لیپوپلی ساکارید سپسیس سلول‌های پیش‌ساز اندوتلیال سلول‌های بنیادی مزانشیمی 1. Giordano NP, MB Cian, ZD Dalebroux. 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تاثیر نانوذرات طلای کانژوگه شده با اسید فولیک بر جذب و حساس‌کنندگی پرتوی سلول‌های سرطانی دهانه رحم تحت تابش فوتون‌های 6 مگاولتی Effect of Gold Nanoparticles Conjugated with Folic Acid on the Absorption and Radiosensitization of Cervical Cancer Cells Under 6 MV Photon Irradiation 1 1  سابقه و هدف: پرتودرمانی یکی از مهم‌ترین روش‌های درمان سرطان است. استفاده از نانوذرات فلزی هدفمند با افزایش اثر پرتوهای یونیزان بر سلول‌های سرطانی و کنترل اثر زیانبار پرتو بر سلول‌های سالم، عاملی موثر در کاهش عوارض جانبی پرتودرمانی است. هدف این مطالعه بررسی اثر هدفمندی نانوذرات طلای کانژوگه شده با اسید فولیک توسط لینکر آلبومین سرم گاوی در جذب و حساس‌کنندگی نانوذرات طلا در سلول‌های سرطانی HeLa در مقایسه با نانوذرت طلای غیرهدفمند است. مواد و روش‌ها: در این مطالعه، نانوذرات طلا توسط لینکر آلبومین سرم گاوی با اسید فولیک کانژوگه شد. اتصال آلبومین سرم گاوی و اسید فولیک به نانوذرات طلا با روش طیف سنجی فروسرخ بررسی شد. سنجش سمیت‌زایی با روش MTT انجام گرفت و بر اساس آن غلظت غیرسمی نانوذرات به‌دست آمد. سپس اثر نانوذرات هدفمند سنتز شده بر میزان جذب و حساس‌کنندگی آن‌ها بر روی سلول‌های HeLa ارزیابی شد. یافته‌ها: غلظت غیر سمی نانوذرات برابر µg/ml 12 به‌دست آمد. انکوباسیون سلول‌ها با این غلظت نانوذرات به‌مدت 2، 4 و 24 ساعت انجام گرفت و مشاهده شد در 4 ساعت میزان جذب نانوذرات هدفمند به چهار برابر میزان جذب نانوذرات غیرهدفمند می‌رسد. نسبت حساس‌کنندگی نانوذرات هدفمند و غیر هدفمند در سلول‌های مورد مطالعه تحت تابش فوتون‌های 6 مگاولتی به گروه کنترل (بدون نانوذرات) به‌ترتیب  0/02±32 /1  و 0/02±  19 /1  به‌دست آمد. استنتاج: استفاده از لینکر آلبومین سرم گاوی برای هدفمند سازی نانوذرات طلا در افزایش جذب نانوذرات طلا و افزایش اثر پرتوی یونیزان بر سلول‌های HeLa تحت تابش فوتون‌های 6 مگاولتی تاثیر محسوسی دارد.   2  Background and purpose: Radiation therapy is one of the most important methods in treatment of cancer. Targeted metal nanoparticles (NPs) play an effective role in reducing ionizing radiation side effects through increasing the effect of ionizing radiation on cancer cells and controlling the harmful effect of radiation on healthy cells. The purpose of this study was to investigate the effect of targeted folic acid gold NPs (GNPs) using linker bovine serum albumin in the absorption and sensitivity of gold NPs in HeLa cervical cancer cells compared to non-targeted gold NPs. Materials and methods: In this study, GNPs were conjugated with folic acid by bovine serum albumin as the linker. The binding of bovine serum albumin and folic acid to GNPs was investigated by infrared (IR) spectroscopy. Toxicity was measured by the MTT method and based on the results, the GNPs’ non-toxic concentration was determined. The effect of targeted synthesized GNPs on their absorption and sensitivity were evaluated on HeLa cells. Results: The non-toxic concentration of GNPs was 12 μg/ml. Incubation of the cells with this concentration was performed for 2, 4, and 24 hours and it was observed that in 4 hours, the absorption rate of targeted GNPs was about 4 times higher than that of non-targeted GNPs. The radiosensitization ratios of targeted and non-targeted GNPs in the studied cancer cells relative to the control group (without NPs) exposed to 6 MV photon radiation were 1.32±0.02 and 1.19±0.02, respectively. Conclusion: The use of bovine serum albumin linker to target GNPs has a significant effect on increasing the absorption of GNPs and the effect of ionizing radiation on HeLa cells under 6 MV photon beams.   15 30 2022/12/182023/02/23 1401/12/4 2023/06/192023/06/11 1402/3/21 بهاره امینی کادیجانی Bahare Amini Kadijani دکتری تخصصی فیزیک پزشکی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران ایران bahare.amini@modares.ac.ir بیژن هاشمی Bijan Hashemi دانشیار، گروه فیزیک پزشکی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران ایران bhashemi@modares.ac.ir سید ربیع مهدوی Seied Rabi Mahdavi دانشیار، گروه فیزیک پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران ایران mahdavi.r@iums.ac.ir مسعود سلیمانی Masoud Soleimani استاد، گروه هماتولوژی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران ایران Ssoleim_m@modares.ac.ir radiation therapy radiation sensitizers targeted radiotherapy gold nanoparticles (GNPs) cervical cancer پرتودرمانی حساس‌کننده‌های پرتوی درمان هدفمند نانوذرات فلزی سرطان دهانه رحم 1. 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مقایسه تأثیر دهانشویه گیاهی حاوی عصاره هیدروالکلی سعدکوفی و آویشن با کلرهگزیدین بر پاتوژن‌های شایع پریودنتال Comparing the Effect of Herbal Mouthwash Containing Hydroalcoholic Extracts of Cyperus rotundus L. and Thymus vulgaris L. and Chlorhexidine Mouthwash on Common Periodontal Pathogens 1 1 سابقه و هدف: ژنژیویت بیماری التهاب لثه است که ناشی از تجمع پلاک‌های دندانی می‌باشد. در صورتی که پلاک و جرم به زیر خط لثه گسترش پیدا کند، می‌تواند به بیماری مزمن پریودنتال تبدیل شود. شایع‌ترین میکروب‌هایی که در ایجاد بیماری پریودنتال نقش دارند، شامل Streptococcus mutans، Streptococcus pyogenes و Candida albicans است. با توجه به عوارض درمان رایج با دهانشویه کلرهگزیدین، به منظور مبارزه با این میکروب‌ها، دستیابی به درمان‌های جایگزین، امری مطلوب می‌باشد. لذا این مطالعه به مقایسه اثر ضدمیکروبی دهانشویه گیاهی حاوی عصاره هیدروالکلی سعدکوفی و آویشن با دهانشویه کلرهگزیدین بر پاتوژن‌های شایع پریودنتال پرداخت. مواد و روش‌ها: ابتدا گیاهان سعدکوفی و آویشن جمع‌آوری و خرد شدند و عصاره هیدروالکلی مخلوط دو گیاه و عصاره متانولی هرگیاه، به صورت جداگانه، گرفته شد. سپس با استفاده از اکسپیان‌های مختلف، محلول دهانشویه ترکیبی ساخته شد. برای ارزیابی اثر ضد میکروب، از میکروارگانیسم‌های S. mutans، S. pyogenes و C. albicans استفاده و پس از تعیین MIC/MBC، اثر دهانشویه بر تشکیل و تخریب بیوفیلم S. mutans بررسی شد. یافته‌ها: مقادیر MIC دهانشویه علیه S. mutans، S. pyogenes و C. albicans به ترتیب معادل 625 /0،  039 /0 و 2/5 mg/mL حاصل شد. هم‌چنین، میزان MBC دهانشویه برای هر یک از میکروارگانیسم‌ها به ترتیب 1/25، 078 /0 و ۱۰mg/mL به‌دست آمد. از سوی دیگر، تشکیل بیوفیلم توسط فرمولاسیون دهانشویه به‌طور معناداری کم‌تر از کنترل مثبت گردید(0/05>P) و هیچ تفاوت معناداری با کنترل منفی مشاهده نشد(0/05<P). اما در مورد تخریب بیوفیلم از لحاظ آماری تفاوت معناداری بین گروه دهانشویه و کنترل مثبت وجود نداشت(0/05<P). استنتاج: براساس نتایج این مطالعه، دهانشویه گیاهی مورد استفاده می‌تواند به‌صورت قابل توجهی اثرات ضدمیکروب و ضد بیوفیلم داشته باشد، به گونه‌ای که در پیشگیری از تشکیل بیوفیلم حتی نسبت به درمان استاندارد کلرهگزیدین، بسیار مؤثرتر عمل کرد.   2  Background and purpose: Gingivitis is an inflammatory disease of the gums caused by accumulation of dental plaque. It can become a chronic periodontal disease if plaque spread below the gum line. The most common pathogens that contribute to periodontal disease include Streptococcus mutans, Streptococcus pyogenes, and Candida albicans. Due to the side effects of common treatment by chlorhexidine mouthwash, novel treatments to fight such microbes are much of interest. This study aimed at comparing the antimicrobial effect of herbal mouthwash containing the extracts of nut-grass and thyme and chlorhexidine mouthwash on common periodontal pathogens. Materials and methods: First, Cyperus rotundus and Thymus vulgaris were collected, powdered, and the hydro alcoholic extract of the mixture of two plants and the methanol extract of each plant were taken. Then, a mouthwash containing combined extract of the two plants was prepared using different exipients. To evaluate the antimicrobial effect of the extracts, S. mutans, S. pyogenes, and C. albicans were used. After determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), the effect of mouthwash on S. mutans biofilm formation and degradation was investigated. Results: The MIC of the mouthwash formulation against S. mutans, S. pyogenes, and C. albicans were 0.625, 0.039, and 2.5 mg/ml, respectively. The MBC of the mouthwash for each microorganism was 1.25, 0.078, and 10 mg/ml, respectively. The herbal mouthwash significantly inhibited biofilm formation compared to the positive control (P<0.05) which showed no significant difference compared to the negative control (P>0.05). Findings showed no significant difference in biofilm destruction between the herbal mouthwash and the positive control (P>0.05). Conclusion: The prepared herbal mouthwash showed significant antimicrobial and anti-biofilm effects, and was much more effective in preventing biofilm formation than the standard treatment by chlorhexidine.   31 43 2022/12/182023/02/232022/11/26 1401/9/5 2023/06/192023/06/112023/05/22 1402/3/1 علی پزشکیان Ali Pezeshkian دستیار دکترای تخصصی اقتصاد و مدیریت دارو، دانشکده داروسازی، دانشگاه علوم پزشکی تهران، تهران، ایران ایران Apezeshkian@razi.tums.ac.ir محمدرضا عباسپور Mohammadreza Abbaspour دانشیار، گروه فارماسیوتیکس، دانشکده داروسازی، دانشگاه علوم پزشکی مشهد، مشهد، ایران ایران AbbaspourMR@mums.ac.ir سید احمد امامی Seyed Ahamad Emami استاد، گروه داروسازی سنتی، دانشکده داروسازی، دانشگاه علوم پزشکی مشهد، مشهد، ایران ایران EmamiA@mums.ac.ir وحید سهیلی Vahid Soheili استادیار، گروه کنترل دارو، دانشکده داروسازی، دانشگاه علوم پزشکی مشهد، مشهد، ایران ایران Soheiliv@mums.ac.ir Cyperus rotundus Cyperaceae Thymus vulgaris Lamiaceae gingivitis biofilm Streptococcus mutans سعد کوفی Cyperaceae آویشن Lamiaceae ژنژیویت بیوفیلم Streptococcus mutans 1. Nizami MZI, Yin IX, Lung CYK, Niu JY, Mei ML, Chu CH. In Vitro Studies of Graphene for Management of Dental Caries and Periodontal Disease: A Concise Review. Pharmaceutics 2022; 14(10): 1997.##2. Williams RC. Periodontal disease. New Engl J Med 1990; 322(6): 373-382.##3. Hoover DR, Lefkowitz W. Fluctuation in marginal gingivitis. J Periodontol 1965; 36(4): 310-314.##4. Shiva A, Sobouti F. Comparative Study of Histopathological Reports and Clinical Diagnosis of Oral Biopsies. J Mazandaran Uni Med Sci 2017; 26(144): 57-64 (Persian). ##5. Sabiha Shaheen S, ReddY P, Reddy S, Doshi D, Kulkarni S, Kumar M,et al. Antimicrobial efficacy of ten commercially available herbal dentifrices against specific oral microflora-in vitro study. J Clin Diagn Res 2015; 9(4): 42-46.##6. Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol 2023; 13: 1020995.##7. Morrison AG, Sarkar S, Umar S, Lee STM, Thomas SM. The Contribution of the Human Oral Microbiome to Oral Disease: A Review. Microorganisms 2023; 11(2): 318.##8. Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's Clinical Periodontology. 11th ed. Missouri: Elsevier Inc; 2011.##9. Abullais SS, Patel SI, Asiri EA, Jathmi AAA, Alkhayri AH, Mousa YM, et al. Comparative Evaluation of 3 Commercial Mouthwash Formulations on Clinical Parameters of Chronic Gingivitis. Med Sci Monit 2022; 28: e937111.##10. Ferrés-Amat E, Al Madhoun A, Ferrés-Amat E, Carrió N, Barajas M, Al-Madhoun AS, et al. Comparison of 0.12% Chlorhexidine and a New Bone Bioactive Liquid, BBL, in Mouthwash for Oral Wound Healing: A Randomized, Double Blind Clinical Human Trial. J Person Med 2022; 12(10): 1-10.##11. Garapati B, Ramamurthy J, Rajeshkumar S. Formulation, Development and Evaluation of Anti-Inflammatory and Anti-Microbial Effects of a Novel Polyherbal Mouthwash-an In Vitro Study. J Popul Ther Clin Pharmacol 2022; 29(3): e94-e103.##12. dos Santos Cardoso VF, Roppa RHA, Antunes C, Moraes ANS, Santi L, Konrath EL. Efficacy of medicinal plant extracts as dental and periodontal antibiofilm agents: A systematic review of randomized clinical trials. J Ethnopharmacol 202; 281: 114541.##13. González-Corrales D, Monge-Quirós T, Chavarría-Rojas M, Rojas-Campos N, Cruz-Sibaja W, Madrigal-Redondo G. Formulation and antimicrobial activity evaluation of a 0.2% chlorhexidine canine mouthwash with essential oils. Vitae 2021; 28(1): 1-14.##14. Ibn Sina H. Al-Qanun fi'l-Tibb (Canon of Medicine). Rashad MA, Mahmoud MT, (eds.). Vol. 2. Cairo Egypt University of Sciences and Technology; 2013. p. 406, 419.##15. Ernst E, März R, Sieder C. A controlled multi-centre study of herbal versus synthetic secretolytic drugs for acute bronchitis. Phytomedicine 1997; 4(4): 287-293.##16. Haraguchi H, Saito T, Ishikawa H, Date H, Kataoka S, Tamura Y, et al. Antiperoxidative components in Thymus vulgaris. Planta Med 1996; 62(03): 217-221.##17. Mossa JS, Al-yahya MA, Hassan MM. Physicochemical characteristics and spectroscopy of the volatile oil of Thymus vulgaris growing in Saudi Arabia. Int J Crude Drug Res 1987; 25(1): 26-34.##18. Van Den Broucke C, Lemli J. Pharmacological and chemical investigation of thyme liquid extracts. Planta Med 1981; 41(02): 129-135.##19. Van Den Broucke C, Lemli J. Spasmolytic activity of the flavonoids from Thymus vulgaris. Pharm Weekbl Sci 1983; 5(1): 9-14.##20. Van Den Broucke CO, Dommisse RA, Esmans EL, Lemli JA. Three methylated flavones from Thymus vulgaris. Phytochemistry 1982; 21(10): 2581-2583.##21. Badgujar SB, Bandivdekar AH. Evaluation of a lactogenic activity of an aqueous extract of Cyperus rotundus Linn. J Ethnopharmacol 2015; 163: 39-42.##22. Bown D. Encyclopaedia of Herbs and their Uses. London: Dorling Kindersley Publishing; 2002. p. 390.##23. Chandratre R, Chandarana S, Mengi S. Lipid lowering activity of alcoholic extract of Cyperus rotundus. Int J Res Pharm Chem 2011; 1(4): 1042-1045.##24. Chopra RN, Nayar SL, Chopra IC. Glossary of Indian medicinal plants. New Delhi: Publications & Information Directorate; 1956.##25. Emelugo B, Umerie S, Okonkwo I, Achufusi J. Evaluation of the tubers and oil of Cyperus rotundus Linn (CYPERACEAE). Pak J Nutr 2011; 10(2): 147-150.##26. Ghannadi A, Rabbani M, Ghaemmaghami L, Malekian N. Phytochemical screening and essential oil analysis of one of the Persian sedges; Cyperus rotundus L. Int J Pharm Sci Res 2012; 3(2): 424-427.##27. Sharma SK, Singh AP. Morphological, microscopical and physico-chemical investigations on the rhizomes of Cyperus rotundus Linn. Res J Pharm Biol Chem Sci 2011; 2(3): 798-806.##28. Sivapalan SR, Jeyadevan P. Physico-chemical and phyto-chemical study of rhizome of Cyperus rotundus Linn. Int J Pharmacol Pharm Technol 2012; 1(2): 42-46.##29. Talukdar AD, Tarafdar RG, Choudhury MD, Nath D, Choudhury S. A review on pteridophyte antioxidants and their potential role in discovery of new drugs. Assam Uni J Sci Technol 2011; 7(1): 151-155.##30. Abbas HA, Alsaade KAS, AlMAshhdan HAY, editors. Study the effect of cyperus rotundus extracted as mouthwash on the corrosion of dental amalgam. IOP Conference Series: Materials Science and Engineering; 2019: 571(1): 012074.##31. Donlan RM. Role of biofilms in antimicrobial resistance. ASAIO J 2000; 46(6): S47-S52.##32. Sawhney R, Berry V. Bacterial biofilm formation, pathogenicity, diagnostics and control: An overview. Ind J Med Sci 2009; 63(7): 313-321.##33. Prasanna S, Doble M. Medical biofilms–Its formation and prevention using organic molecules. J Indian I Sci 2008; 88(1): 27-35.##34. Zeng Z, Qian L, Cao L, Tan H, Huang Y, Xue X, et al. Virtual screening for novel quorum sensing inhibitors to eradicate biofilm formation of Pseudomonas aeruginosa. Appl Microbiol Biot 2008; 79(1): 119-126.##35. Schönknecht K, Surdacka A, Rudenko L. Effectiveness of Composed Herbal Extract in the Treatment of Gingivitis and Oral and Pharyngeal Mucosa–Review of Studies. Wiad Lek 2021; 74(7): 1737-1749.##36. de Oliveira JR, de Jesus Viegas D, Martins APR, Carvalho CAT, Soares CP, Camargo SEA, et al. Thymus vulgaris L. extract has antimicrobial and anti-inflammatory effects in the absence of cytotoxicity and genotoxicity. Arch Oral Biol 2017; 82: 271-279.##37. Yu H-H, Lee D-H, Seo S-J, You Y-O. Anticariogenic properties of the extract of Cyperus rotundus. Am J of Chinese Med 2007; 35(03): 497-505.##38. Khojaste M, Yazdanian M, Tahmasebi E, Shokri M, Houshmand B, Shahbazi R. Cell toxicity and inhibitory effects of Cyperus rotundus extract on Streptococcus mutans, Aggregatibacter actinomycetemcomitans and Candida albicans. Eur J Transl Myol 2018; 28(4): 362-369.##39. Sharma SK, Singh AP. Antimicrobial investigations on rhizomes of Cyperus rotundus Linn. Der Pharm Lett 2011; 3(3): 427-431.##40. Hammad M, Sallal AK, Darmani H. 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شناسایی عوامل مرتبط با بقای بیماران مبتلا به لوسمی با استفاده از اسپلاین های جریمه شده و مقایسه آن با مدل خطرات متناسب کاکس Factors Associated with Survival of Patients with Leukemia Using Penalized Splines and Comparing That with the Cox Proportional Hazards Model 1 1  سابقه و هدف: سرطان خون یکی از بیماری‌های شایع و کشنده است، که از جمله مهم‌ترین مشکلات بهداشتی و سلامت در جامعه می‌باشد. هدف از انجام این مطالعه بررسی بقای بیماران مبتلا به لوسمی لنفوبلاستیک حاد(ALL) و لوسمی میلوبلاستیک حاد(AML) با استفاده از مدل اسپلاین‌های جریمه شده و مقایسه آن با مدل خطرات متناسب کاکس است. مواد و روش‌ها: در این مطالعه کوهورت گذشته نگر، از اطلاعات بیماران مبتلا به لوسمی حاد مراجعه کننده به بیمارستان امام خمینی تهران استفاده شد. بیماران طی سال‌های 1390 تا 1393 وارد مطالعه شدند و تا سال 95 مورد پیگیری قرار گرفتند. اطلاعات بیماران به‌صورت سرشماری، توسط یک چک لیست محقق ساخته از پرونده‌های آن‌ها جمع‌آوری گردید و آخرین وضعیت بیماران با تماس تلفنی تکمیل شد. بررسی بقای پنج ساله بیماران با روش ناپارامتری کاپلان مایر و تعیین عوامل خطر در زیرگروه‌ها با استفاده از مدل نیمه پارامتری کاکس انجام شد. پس از آن برازش مدل رگرسیونی اسپلاین جریمه شده با نرم‌افزار R نسخه 4/2/2 انجام شد. یافته‌ها: میانگین سنی بیماران 16/01±36/29 سال بود و 36/7 درصد از بیماران مرد بودند. 50 درصد بیماران فوت شده و 12/7 درصد عود داشتند. 34/7 درصد از بیماران دارای لوسمی لنفوبلاستیک حاد و 63/3 درصد مبتلا به  لوسمی میلوبلاستیک حاد بودند. بقای پنج ساله بیماران مبتلا به ALL و AML به ترتیب 18 و 29 درصد بود. سن بیماران، تعداد گلبول‌های سفید، پلاکت و هموگلوبین خون با بقای بیماران ارتباط معنی داری داشت(0/05>P). استنتاج: سن ابتلا به لوسمی در کشور ایران پایین است و با توجه به اهمیت سن در بقای بیماران مبتلا به آن، تشخیص و اقدام به درمان زود هنگام این بیماری می‌تواند در بهبود بقای این بیماران نقش به سزایی داشته باشد.   2  Background and purpose: Leukemia is one of the most common and deadly diseases which is an important health problem. The aim of this study was to evaluate the survival of patients with acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) using the penalized splines model and comparing that with the Cox proportional hazards model. Materials and methods: This is a longitudinal survival research that used data from patients referred to Tehran Imam Khomeini Hospital between 2011 and 2014 and followed until 2016. Patients' information was collected through census, using a researcher-made checklist based on their files. Furthermore, the patients' latest status was obtained via phone calls. All medical records of the patients referred to Amir Al-Momenin hospital in Maragheh and diagnosed with prostate hyperplasia and underwent prostatectomy between 2014 and 2019 were examined taking a census. Kaplan-Meier nonparametric method was used to assess the 5-year survival rate, and Cox's semiparametric model was used to determine the risk factors in subgroups. Then, the penalized spline regression model was fitted using the R software version 4.2.2. Results: The average age of patients was 36.29±16.01 and 36.7% of the patients were men. Half of the patients died, and 12.7% experienced recurrence. Acute lymphoblastic leukemia affected 34.7% of the patients, whereas acute myeloblastic leukemia affected 63.3%. The 5-year-survival rates for patients with ALL and AML were 18% and 29%, respectively. Age, white blood cell count, platelet count, and hemoglobin levels were found to be significantly associated with patients' survival (P<0.05). Conclusion: Leukemia is seen at young ages in Iran, so, early detection and treatment of the disease can play a critical role in improving the survival of patients.   44 55 2022/12/182023/02/232022/11/262022/07/1 1401/4/10 2023/06/192023/06/112023/05/222023/05/23 1402/3/2 افسانه فندرسکی Afsaneh Fendereski استادیار، گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران afsaneh.fendereski@gmail.com جمشید یزدانی چراتی Jamshid Yazdani Charati استاد، گروه آمار زیستی، مرکز تحقیقات علوم بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران jamshid.charati@gmail.com سید رضا صفائی نودهی Sayyed Reza Safaee Nodehi استادیار، گروه داخلی، مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی تهران، تهران، ایران ایران safano1339@gmail.com رضاعلی محمدپور تهمتن Reza Ali Mohammadpour Tahamtan استاد، گروه آمار زیستی، مرکز تحقیقات علوم بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران rezaali.mohammadpour@mazums.ac.ir leukemia survival analysis acute lymphocytic leukemia acute myeloid leukemia لوسمی تحلیل بقا لوسمی میلوییدی حاد لوسمی لنفوسیتی حاد 1. 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ویژگی‌های روانسنجی پرسشنامه انگیزه‌های باروری میلر در جمعیت مردان و زنان ایران Psychometric Properties of Childbearing Questionnaire in Iranian Men and Women 1 1  سابقه و هدف: با توجه به نقش مهم شناخت انگیزه‌های باروری جهت ارائه خدمات مشاوره‌ای در زمینه رفتار باروری در ایران، هدف این پژوهش، بررسی تحلیل عاملی تاییدی پرسشنامه انگیزه‌های باروری در جمعیت مردان و زنان ایرانی بود. مواد و روش‌ها: در این مطالعه مقطعی، 398 زن متاهل غیریائسه با سن 49-15 سال و دارای قابلیت باروری و 390 مرد که از نظر باروری مشکلی نداشتند و همسران آنان نیز دارای ویژگی‌های زنان شرکت‌کننده در مطالعه بودند، از بیمارستان‌ها و مراکز بهداشت سطح شهر مشهد به روش نمونه‌گیری چند مرحله‌ای و خوشه‌ای انتخاب شدند. سپس پرسشنامه انگیزه‌های باروری میلر را تکمیل کردند. پایایی پرسشنامه با استفاده از آزمون- باز آزمون و روش همسانی درونی و روایی آن توسط تحلیل عامل تاییدی با استفاده از نرم‌افزار SPSS نسخه 19 و آموس نسخه 21 ارزیابی شد. یافته‌ها: در این مطالعه ضرایب آلفای کرونباخ و پایایی آزمون- باز آزمون بالا حاکی از پایایی مناسب مقیاس‌های انگیزه‌های مثبت و منفی باروری پرسشنامه میلر است. هم‌چنین نتایج تحلیل عاملی تاییدی نشان‌دهنده برازش ضعیف مدل در تعیین عامل‌ها به شکل اولیه بیان شده در پرسشنامه میلر بود. بعد از حذف 8 سوال با بارهای عاملی پایین و آزاد کردن خطای کواریانس بین دو سوال، مدل به برازش کافی دست یافت. استنتاج: نتایج این مطالعه حاکی از آن است که انگیزه‌های مثبت و منفی در مورد باروری، تحت تاثیر فرهنگ و ارزش‌های حاکم بر جامعه ایرانی می‌باشد و تفاوت‌هایی با جوامع غربی دارد. پرسشنامه انگیزه‌های باروری میلر به‌عنوان یک ابزار معتبر جهت استفاده در ایران تایید گردید.   2  Background and purpose: Counseling services in Iran are required to understand the motivations for childbearing to provide better services. This study was conducted to investigate the confirmatory factor analysis of the Childbearing Questionnaire (CBQ) in Iranian men and women. Materials and methods: In this cross-sectional study, 398 married women of reproductive age (15-49 years of age) and 390 men, whose wives were at similar age were recruited. They were selected from Mashhad healthcare settings using multi-stage cluster sampling. The participants completed the CBQ. The reliability of the CBQ was assessed by test-retest and Cronbach's alpha. The validity of the scale was evaluated applying confirmatory factor analysis. SPSS V19 and Amos-21 were used for data analyses. Results: Cronbach's alpha coefficient and the test-retest reliability indicated satisfactory reliability of the CBQ in terms of positive childbearing motivation and negative childbearing motivation. The original model did not show acceptable fit. After removing eight factors with low loading and two correlated error terms, the modified model was found to have adequate fitness. Conclusion: This study showed that some of the positive and negative motivations have changed due to cultural values of the Iranian society and are different compared with those of the western societies. This study supported the use of CBQ as a valid instrument in assessing childbearing motivations in Iran.   56 66 2022/12/182023/02/232022/11/262022/07/12023/01/28 1401/11/8 2023/06/192023/06/112023/05/222023/05/232023/05/27 1402/3/6 طلعت خدیو زاده Talat Khadivzadeh دانشیار، مرکز تحقیقات مراقبت پرستاری و مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران ایران khadivzadeht@mums.ac.ir معصومه غضنفرپور Masumeh Ghazanfarpour استادیار، گروه مامایی، دانشکده پرستاری و مامایی رازی، مرکز تحقیقات پرستاری، دانشگاه علوم پزشکی کرمان، کرمان، ایران ایران masumeh.ghazanfarpour@yahoo.com مسعوده باباخانیان Masoudeh Babakhanian استادیار، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، دانشگاه علوم پزشکی سمنان، سمنان، ایران ایران babakhanian.m@gmail.com صاحبه دادشاهی Sahebeh Dadshahi مربی، گروه مشاوره در مامایی، دانشکده پرستاری و مامایی رازی، مرکز تحقیقات پرستاری، دانشگاه علوم پزشکی کرمان، کرمان، ایران ایران kareshki@um.ac.ir حسین کارشکی Hossein Kareshki دانشیار، گروه روانشناسی تربیتی، دانشکده علوم تربیتی و روانشناسی، دانشگاه فردوسی مشهد، مشهد، ایران ایران sahebeh68.dadshahi@gmail.com ویکتوریا عمرانی فرد Victoria Omranifard دانشیار، مرکز تحقیقات علوم رفتاری، گروه روانپزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران ایران Vomranifard95@gmail.com childbearing questionnaire childbearing confirmatory factor analysis پرسشنامه انگیزه باروری فرزندآوری تحلیل عاملی تاییدی 1. Abbasi-Shavazi MJ, McDonald P, Hosseini-Chavoshi M. The Fertility Transition in Iran: Revolution and Reproduction. Switzerland: Springer pub; 2009.##2. Kozakowski SM, Travis A, Ashley Bentley M, Fetter Jr G. Results of the 2016 National Resident Matching Program®: 1986–2016: A Comparison of Family Medicine, E-ROADs, and Other Select Specialties Fam Med 2016; 48(10): 763-769.##3. Ghazanfarpour M, Kaviani M, Abdolahian S, Bonakchi H, Najmabadi Khadijeh M, Naghavi M, et al. The relationship between women’s attitude towards menopause and menopausal symptoms among postmenopausal women. Gynecol Endocrinol 2015; 31(11): 860-865.##4. Salehi‐Isfahani D, Abbasi‐Shavazi MJ, Hosseini‐Chavoshi M. Family planning and fertility decline in rural Iran: the impact of rural health clinics. Health Econ 2010; 19(S1): 159-180.##5. Hosseini-Chavoshi M, Abbasi-Shavazi MJ, McDonald P. Fertility, marriage, and family planning in Iran: Implications for future policy. Population Horizons 2016; 13(1): 31-40.##6. Roudsari RL, Khadivzadeh T, Bahrami M. A grounded theory approach to understand the process of decision making on fertility control methods in urban society of Mashhad, Iran. Iran J Nurs Midwifery Res 2013; 18(5): 408-415 (Persian).##7. Khadivzadeh T, Arghavani E. Relationship Between Religious Beliefs And Fertility Preferences Among Engaged Couples, Referring To Premarital Counseling Centers Of Mashhad, Iran. Journal of Midwifery & Reproductive health 2014; 2(4): 238-245 (Persian).##8. Khadivzadeh T, Arghavani E, Shakeri MT. Attitude toward governmental incentives on childbearing and its relationship with fertility preferences in couples attending premarital counseling clinic in health centers in Mashhad. J Mazandaran Univ Med Sci 2015; 24(120): 1-13 (Persian).##9. Khadivzadeh T, Roudsari RL, Bahrami M, Taghipour A, Shavazi JA. The influence of social network on couples’ intention to have the first child. Iran J Reprod Med 2013; 11(3): 209-218 (Persian).##10. Rahmati R, Khadivzadeh T, Esmaily H, Bahrami HR. Evaluation of the performance of the health care workers in giving consultation about the fertility promotion. Journal of Midwifery & Reproductive Health 2017; 5(2): 911-918 (Persian).##11. Khadivzadeh T, Latifnejad Roudsari R, Bahrami M, Taghipour A, Abbasi Shavazi J. “Caring for my family integrity”: Fertile couples’ first childbearing experience in the urban society of Mashhad, Iran. Hum Fertil 2015; 18(1): 60-69.##12. Khadivzadeh T, Rahmanian SA, Esmaily H. Young women and men's attitude towards childbearing. Journal of Midwifery & Reproductive Health 2018; 6(3): 1336-1347 (Persian).##13. Khadivzadeh T, Arghavani E, Shakeri MT. Relationship between fertility motivations and preferences in couples. IJOGI 2014; 17(114): 8-18 (Persian).##14. Miller WB. Childbearing motivation and its measurement. J Biosoc Sci 1995; 27(4): 473-487.##15. Khadivzadeh T, Hadizadeh Talasaz Z, Shakeri MT. Predicting factors affecting the delay in first childbearing among young married women using the Bandura’s social learning theory. Hayat 2017; 23(3): 226-242 (Persian).##16. Irani M, Khadivzadeh T. The relationship between childbearing motivations with fertility preferences and actual child number in reproductive-age women in Mashhad, Iran. J Educ Health Promot 2018; 7: 175 (Persian).##17. Khadivzade T, Arghavani E, Shokrollahi P, Ghazanfarpour M, Kareshki H. Factorial structure of the Persian version of Childbearing Questionnaire in first time engaged couples in Iran. J Obstet Gynaecol 2018; 38(4): 470-475 (Persian).##18. Kalantari KH. Structural equations in Social and economic research. Theran: Farhang Saba; 2013. (Persian).##19. Hyrkäs K, Appelqvist-Schmidlechner K, Oksa L. Validating an instrument for clinical supervision using an expert panel. Int J Nurs Stud 2003; 40(6): 619-625.##20. Rubio DM, Berg-Weger M, Tebb SS, Lee ES, Rauch S. Objectifying content validity: Conducting a content validity study in social work research. Soc Work Res 2003; 27(2): 94-104.##21. Dychawy‐Rosner I, Eklund M. Content validity and clinical applicability of the Irena Daily Activity assessment measuring occupational performance in adults with developmental disability. Occup Ther Int 2003; 10(2): 127-149.##22. Hooper D, Coughlan J, Mullen M, editors. Evaluating model fit: a synthesis of the structural equation modelling literature. 7th European Conference on research methodology for business and management studies; Regent’s College, London, 2008.##23. Munro BH. Statistical methods for health care research. 5th Edition. lippincott williams & wilkins; 2005. ##24. Ghazanfarpour M, Arghavani E, Khadivzadeh T, Saeidi M, Kareshki H, Irani M, et al. Childbearing Motivation in Iranian Engaged Couples: A Structural Equation Model. Int J Pediatr 2018; 6(4): 7563-7568 (Persian).##25. Ahmadi Rezamahaleh F, Khadivzadeh T, Asghari Nekah M. Comparing the Childbearing Motivations of Fertile and Infertile Women in Mashhad, Iran. Journal of Midwifery and Reproductive Health (JMRH) 2020; 8(4): 2429-2436.##26. Pezeshki MZ, Zeighami B, Miller WB. Measuring the childbearing motivation of couples referred to the Shiraz Health Center for premarital examinations. J Biosoc Sci 2005; 37(1): 37-53.##27. Shoaee F, Hafezipour F, Khoshnejad Afkham E, Mameneh M, Mohammadabadi L, Shafiei Rad B, et al. Psychometric Characteristics of Childbearing Motivation Questionnaire: A Review. Int J Pediatr 2020; 8(1): 10705-10709.## ##

عوامل موثر بر کیفیت خواب در سالمندان شهر آمل: یک مطالعه علیتی Factors Affecting Sleep Quality in Older Adults in Amol, Iran: A Causal Study 1 1  سابقه و هدف: کیفیت نامناسب خواب یکی از شایع‏ترین مشکلاتی است که سالمندان با آن روبرو هستند. اختلال خواب، اثرات نامطلوب گسترده‏ای برجنبه‏های مختلف سلامت جسمانی، روانی و اجتماعی سالمندان خواهد داشت و کیفیت زندگی ایشان را تحت تاثیر قرار خواهد داد. لذا مطالعه حاضر به‏منظور بررسی کیفیت خواب در سالمندان و شناسایی عوامل موثر بر آن انجام گرفت. مواد و روش‌ها: این مطالعه مقطعی در سال 1397 بر روی جمعیت 60 سال و بالاتر شهرستان آمل، شمال ایران، که رضایت فردی جهت شرکت در مطالعه داشتند و در مصاحبه پزشکی، آلزایمر و افسردگی شدید نداشتند و قادر به پاسخ‏گویی سوالات بودند، انجام گرفت. نمونه پژوهش به روش نمونه گیری چند مرحله ای تصادفی انتخاب شدند. برای جمع‏آوری داده‏ها از پرسشنامه کیفیت خواب پیتزبورگ، آزمون کوتاه شده شناختیAMTS، مقیاس بیمارستانی اضطراب و افسردگی HADS، کیفیت زندگی SF36و پرسشنامه فعالیت فیزیکی سالمندان PASE استفاده شد. تکمیل پرسشنامه‏ها توسط محقق آموزش دیده طرح انجام گرفت. یافته‌ها: از 401 شرکت‏کننده، 191 نفر (47/6 درصد ) زن و 276 نفر (68/8 درصد) ساکن شهر بودند. یافته‏ها نشان داد 192 نفر از سالمندان (47/9 درصد) کیفیت خواب نامطلوب داشتند. در آنالیز رگرسیون لجستیک چند متغیره، مصرف داروی خواب (14/60- 2/95)95%CI 6/57=aOR)، جنس زن (10/36- 2/81)95%CI 5/40=aOR)، افسردگی (1/00- 0/21)95%CI 0/46=aOR) و بعد جسمانی ((1/01- 0/95)95%CI 0/97=aOR) و روانی (0/99- 0/92)95%CI 0/95=aOR) کیفیت زندگی، ارتباط معنی‏دار آماری با کیفیت خواب در حضور سایر متغیرها را نشان دادند. استنتاج: یافته های این مطالعه حاکی از فراوانی بالای کیفیت نامطلوب خواب در بین سالمندان بود، که با مصرف داروی خواب‏آور، جنس زن و وضعیت افسردگی ایشان در ارتباط بود. بدین جهت، مداخلات مناسب به منظور بهبود کیفیت خواب سالمندان پیشنهاد می‏گردد. 2  Background and purpose: Poor sleep quality is one of the most common problems in older population. Sleep disorder has negative effects on physical, mental, and social aspects of their life and influences their quality of life.  This study was carried out to assess the sleep quality and its related factors in older adults. Materials and methods: This cross-sectional study was conducted in older adults aged 60 years and over living in Amol, north of Iran who were willing to participate in the study, did not have Alzheimer's disease and major depression, and could respond to questions. They were selected via multi-stage random sampling. The Pittsburgh Sleep Quality Index, Abbreviated Mental Test Score (AMTS), Hospital Anxiety and Depression Scale (HADS), SF36 Quality Of Life Questionnaire, and Physical Activity Scale For The Elderly (PASE) were used for data collection. A trained researcher filled out the research questionnaires. Results: Among 401 participants, 191 (47.6%) were women and 276 (68.8%) people were living in urban areas. Findings showed that 192 (47.9%) people had poor sleep quality. Multivariate logistic regression analysis showed significant relationships between sleep quality and taking sleeping drugs (adjusted OR: 6.57, 95% CI: 2.95-14.60, P=0.001), female gender (aOR: 5.40, 95% CI: 2.81-10.36, P=0.001), and depression (aOR: 0.46, 95% CI: 0.21-1.00, P=0.05), and also between physical (aOR: 0.97, 95% CI: 0.95-1.01, P=0.05) and mental (aOR: 0.95, 95% CI: 0.92-0.99, P=0.05) aspects of life. Conclusion: Findings revealed a high prevalence of poor sleep quality in the elderly which was associated with female gender, taking sleeping drugs, and depression. So, appropriate interventions are suggested to improve sleep quality in older adults.   67 76 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/2 1401/10/12 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/12 1402/3/22 پریسا حبیبی Parisa Habibi کارشناس ارشد سالمند شناسی، دانشکده بهداشت، دانشگاه علوم پزشکی بابل، بابل، ایران ایران habibiparisa1@gmail.com سوسن موعودی Sussan Moudi دانشیار، گروه روانپزشکی، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، پژوهشکده سلامت، دانشگاه علوم پزشکی بابل، بابل، ایران ایران sussan.mouodi@gmail.com رضا قدیمی Reza Ghadimi استاد، گروه پزشکی اجتماعی، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، پژوهشکده سلامت، دانشگاه علوم پزشکی بابل، بابل، ایران ایران rezaghadimi@yahoo.com sleep quality elderly mental health کیفیت خواب سالمند سلامت روان 1. Dogra S, Dunstan DW, Sugiyama T, Stathi A, Gardiner PA, Owen N. Active Aging and Public Health: Evidence, Implications, and Opportunities. Annu Rev Public Health 2022; 43: 439-459.##2. Ravyts SG, Dzierzewski JM. Sleep and Healthy Aging: A Systematic Review and Path Forward. Clin Gerontol 2022: 1-13.##3. Mortazavi SS, Foroughan M, Hosseini SA, Nasiri E, Shahbazi F. Negative Factors Affecting the Sleep Quality of the Elderly in Iran: A Systematic Review. JREHAB 2021; 22(2): 132-153 (Persian).##4. Cavaillès C, Berr C, Helmer C, Gabelle A, Jaussent I, Dauvilliers Y. Complaints of daytime sleepiness, insomnia, hypnotic use, and risk of dementia: a prospective cohort study in the elderly. Alzheimers Res Ther 2022; 14(1): 12.##5. Zhang C, Xiao S, Lin H, Shi L, Zheng X, Xue Y, et al. The association between sleep quality and psychological distress among older Chinese adults: a moderated mediation model. BMC Geriatr 2022; 22(1): 35.##6. Almondes KMd, Castro EdAS, Paiva T. Sleep Habits, Quality of Life and Psychosocial Aspects in the Older Age: Before and During COVID-19. Front Neurosci 2022; 16: 694894.##7. Azizoğlu Şen İ, Özsürekci C, Balcı C, Çalışkan H, Eşme M, Ünsal P, et al. Sleep quality and sleep-disturbing factors of geriatric inpatients. Eur Geriatr Med 2021; 12(1): 133-141.##8. Mc Carthy CE. Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person. Med Sci (Basel) 2021; 9(2): 31.##9. Kheirkhah F, Alishah M, Bayani MA, Hosseini SR, Ghadimi R, Bijani A, et al. Sleep Quality and Depression: Does Diabetes Mellitus Affect the Association in Older Patients? Iran J Psychiatry Behav Sci 2022; 16(2): e114899 (Persian).##10. Parveen S, George SM, Chand S. Was Sleep a Problem for the Elderly during COVID-19? Sleep Vigil 2021; 5(2): 197-203.##11. Zitser J, Allen IE, Falgàs N, Le MM, Neylan TC, Kramer JH, et al. Pittsburgh Sleep Quality Index (PSQI) responses are modulated by total sleep time and wake after sleep onset in healthy older adults. PloS One 2022; 17(6): e0270095.##12. Chehri A, Nourozi M, Eskandari S, Khazaie H, Hemati N, Jalali A. Validation of the Persian version of the Pittsburgh Sleep Quality Index in elderly population. Sleep Sci 2020; 13(2): 119-124.##13. Foroughan M, Wahlund LO, Jafari Z, Rahgozar M, Farahani IG, Rashedi V. Validity and reliability of Abbreviated Mental Test Score (AMTS) among older Iranian. Psychogeriatrics 2017; 17(6): 460-465.##14. Amini P, Maroufizadeh S, Omani Samani R. Evaluating the factor structure, item analyses, and internal consistency of hospital anxiety and depression scale in Iranian infertile patients. Int J Reprod Biomed 2017; 15(5): 287-296.##15. Doosti-Irani A, Nedjat S, Nedjat S, Cheraghi P, Cheraghi Z. Quality of life in Iranian elderly population using the SF-36 questionnaire: systematic review and meta-analysis. East Mediterr Health J 2019; 24(11): 1088-1097.##16. Hatami O, Aghabagheri M, Kahdouei S, Nasiriani K. Psychometric properties of the Persian version of the Physical Activity Scale for the Elderly (PASE). BMC Geriatr 2021; 21(1): 383.##17. Casagrande M, Forte G, Favieri F, Corbo I. Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer's Disease. Int J Environ Res Public Health 2022; 19(14): 8457.##18. Hosseini SR, Saadat P, Esmaili M, Bijani A. The Prevalence of Self-Reported Sleep Problems and Some Factors Affecting It Among the Elderly in Amirkola. Shiraz E-Med J 2018; 19(3): e59461.##19. Yue Z, Zhang Y, Cheng X, Zhang J. Sleep Quality among the Elderly in 21st Century Shandong Province, China: A Ten-Year Comparative Study. Int J Environ Res Public Health 2022; 19(21): 14296.##20. Gadie A, Shafto M, Leng Y, Kievit RA. How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults. BMJ Open 2017; 7(7): e014920.##21. Kumar S, Wong PS, Hasan SS, Kairuz T. The relationship between sleep quality, inappropriate medication use and frailty among older adults in aged care homes in Malaysia. PloS One 2019; 14(10): e0224122.##22. Fatemeh G, Sajjad M, Niloufar R, Neda S, Leila S, Khadijeh M. Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. J Neurol 2022; 269(1): 205-216.##23. Fitzgerald T, Vietri J. Residual Effects of Sleep Medications Are Commonly Reported and Associated with Impaired Patient-Reported Outcomes among Insomnia Patients in the United States. Sleep Disord 2015; 2015: 607148.##24. Should Melatonin Be Used as a Sleeping Aid for Elderly People? Can J Hosp Pharm 2019; 72(4): 327-329.##25. Paudel M, Taylor BC, Ancoli-Israel S, Blackwell T, Maglione JE, Stone K, et al. Sleep Disturbances and Risk of Depression in Older Men. Sleep 2013; 36(7): 1033-1040.##26. Kok RM, Reynolds CF, 3rd. Management of Depression in Older Adults: A Review. JAMA 2017; 317(20): 2114-2122.##27. Denison HJ, Jameson KA, Sayer AA, Patel HP, Edwards MH, Arora T, et al. Poor sleep quality and physical performance in older adults. Sleep Health 2021; 7(2): 205-211.##28. Sella E, Miola L, Toffalini E, Borella E. The relationship between sleep quality and quality of life in aging: a systematic review and meta-analysis. Health Psychol Rev 2021; 17(1): 169-191.## ##

رابطه درک از بیماری و سبک‌های مقابله ای با استرس درک شده در بیماران مبتلا به سرطان گوارشی در شهر ساری Relationship between Perceived Stress and Illness Perception and Coping Styles in Patients with Gastrointestinal Cancer, Sari 1 1  سابقه و هدف: از آن‌جا که تشخیص و درمان سرطان به مثابه یک عامل استرس‌زا می‌باشد، استرس ادراک شده و نگرانی‌های طول دوره درمان قادر است بر سیر بهبودی بیماران مبتلا به سرطان دستگاه گوارشی موثر واقع شود. از این رو هدف از مطالعه حاضر بررسی رابطه بین درک از بیماری و سبک های مقابله‌ای با استرس ادراک شده در بیماران مبتلا به سرطان گوارشی می‌باشد. مواد و روش‌ها: این مطالعه مقطعی از نوع همبستگی در سال 1401 بر روی 110 بیمار مبتلا به سرطان دستگاه گوارش در بیمارستان امام خمینی ساری، ایران انجام شد. بیماران به روش نمونه‌گیری در دسترس انتخاب شدند. از پرسشنامه اطلاعات دموگرافیک، پرسشنامه کوتاه درک بیماری، پرسشنامه سبک‌های مقابله‌ای بیلینگز و موس و پرسشنامه استرس ادراک شده کوهن برای جمع‌آوری داده‌ها استفاده شد. در نهایت داده‌ها توسط آمار توصیفی و آزمون‌های کای دو، تی مستقل، ضریب همبستگی پیرسون و ANOVA تحلیل شدند. یافته‌ها: نتایج مطالعه نشان داد، اغلب مشارکت‌کنندگان زن(50/9 درصد)، با سطح درآمد متوسط (59/1 درصد)، ساکن شهر (91/8 درصد)، مبتلا به سرطان کولون (40/9 درصد) و حین درمان (90/0 درصد) بودند. اغلب مشارکت‌کنندگان سطح استرس درک شده بالا (57/3 درصد)، درک از بیماری متوسط (71/8 درصد) و سبک‌های مقابله‌ای متوسط (71/8 درصد) گزارش نمودند. هم‌چنین ارتباط معکوس بین استرس ادراک شده و درک از بیماری (0/001>P ، 0/604-r=) وجود دارد، اما بین استرس ادراک شده و سبک‌های مقابله‌ای (0/064=P ، 0/177-=r) و هم‌چنین سایر متغیرهای دموگرافیک ارتباط معنی‌داری وجود ندارد. استنتاج: با توجه به رابطه معکوس بین درک از بیماری و استرس ادراک شده پیشنهاد می‌شود، مدیران بهداشتی و درمانی تدابیری در خصوص بهبود درک از بیماری افراد مبتلا به سرطان دستگاه گوارش اتخاذ نمایند.   2   Background and purpose: The diagnosis and treatment of cancer is stressful and perceived stress and concerns during the treatment period can add to this stress and affect the recovery of patients with gastrointestinal cancer. The aim of this study was to investigate the relationship between illness perception and coping styles, and perceived stress in patients with gastrointestinal cancer. Materials and methods: The present cross-sectional correlational study was conducted in 110 patients with gastrointestinal cancer in Sari Imam Khomeini Hospital, Iran 2022, selected by convenience sampling. Data were collected using a demographic questionnaire, The Brief Illness Perception Questionnaire (Brief IPQ), Billings and Moos Coping Styles Questionnaire, and Perceived Stress Scale (PSS). Finally, the data were analyzed applying descriptive statistics and Chi-square, independent t-test, Pearson's coefficient correlation, and ANOVA. Results: Most of the participants were females (50.9%), with a medium income level (59.1%), living in the city (91.8%), suffering from colon cancer (40.9%), and undergoing treatment (90.0%). Findings showed that most of the patients had a high level of perceived stress (57.3%), moderate levels of illness perception (71.8%), and moderate coping styles (71.8%). We observed an inverse relationship between perceived stress and illness perception (P<0.001, r=-0.604), but there were no significant relationships between perceived stress and coping styles (P=0.064, r=-0.177) and other demographic variables. Conclusion: Considering the inverse relationship between illness perception and perceived stress, healthcare managers are suggested to take measures to improve the illness perception of patients with gastrointestinal cancer.   77 87 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/25 1401/10/4 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/7 1402/3/17 مهدی یوسفی Mehdi Yousefi دانشجوکارشناسی پرستاری، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران mahdeeyousefi@gmail.com مائده صداقتی پور Maedeh Sedaghatipour دانشجوکارشناسی پرستاری، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران kamali2n@yahoo.com رضا علیزاده نوایی Reza Alizadeh-Navaei دانشیار، مرکز تحقیقات سرطان گوارش، پژوهشکده بیماری های غیر واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران reza_nava@yahoo.com مهسا کمالی Mahsa Kamali کارشناسی ارشد پرستاری، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکیی مازندران، ساری، ایران ایران kamali2n@gmail.com معصومه باقری-نسامی Masoumeh Bagheri-Nesami استاد، مرکز تحقیقات طب سنتی و مکمل، پژوهشکده اعتیاد، دانشگاه علوم پزشکی مازندران، ساری، ایران . عضو فدراسیون جهانی انجمن های طب سوزنی و موکسا درمانی (WAFS)، پکن، چین ایران anna3043@gmail.com coping style perceived stress illness perception gastrointestinal cancer سبک مقابله‌ای استرس ادراک شده درک از بیماری سرطان گوارش 1. 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Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study. BJGP Open 2018; 2(4): bjgpopen18X101621.##6. Arda Sürücü H, Büyükkaya Besen D, Duman M, Erbil EY, Ay İ. Are levels of coping with stress in pregnancy with gestational diabetes worse than in healthy pregnancy? J Psychosom Obstet Gynaecol 2019; 40(2): 114-122.##7. Hopman P, Rijken M. Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psychooncology 2015; 24(1): 11-18.##8. Hashemzadeh S, Borjali M, Hasani Abharian P. Analysis of Biological Stress Indices in Patients with Gastrointestinal Cancer Based on Perceived Stress Mediated by Rumination using Structural Equation Modeling. Razavi Int J Med 2020; 8(1234): 8-13 (Persian).##9. Kumari N, Dubey A. Coping with Cancer: What Illness Perceptions Do? Cross Current Int J Med Biosci 2020; 2(10): 165-171.##10. Malekzadeh M, Hashemi Mohammad Abad N, Vazir S. 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Broadbent E, Petrie KJ, Main J, Weinman J. The brief Illness perception questionnaire. J Psychosom Res 2006; 60(6): 631-637.##20. Masaeli N BR, Kheirabadi GH, Khedri A, Mahaki B. Psychometric properties of the persian version of the brief illness perception questionnaire in chronic diseases. Journal Of Research In Rehabilitation Sciences (JRRS) 2019; 14(6): 332-337 (Persian).##21. Khodaparast S, Soleimani MA, Bahrami N, Mafi M. Effect of Leventhal’s Self-Regulatory Model on Illness Perception in Women with Gestational Diabetes: A Randomized Controlled Clinical Trial. J Mazandaran Univ Med Sci 2019; 29(177): 111-123 (Persian).##22. Billings A, Moos R. Coping, stress, and social resources among adults with unipolar depression. J Pers Soc Psychol1984;46(4): 877-891.##23. Hosseni Ghadamgahi J, Dejkam M, bayanzadeh SA, Phaze A. The Quality of Relationship, Stress and Coping Strategy in Patients with Coronary Heart Disease IJPCP 1998; 4(1): 14-25 (Persian).##24. Sinichi F, Faridhosseini F, Hajebi Khaniki S, Chalakinia N, Saadati Z, Tara F. Psychological symptoms and coping strategies of nurses caring for patients with COVID-19 pneumonia. Journal of Fundamentals of Mental Health 2020; 22(6): 481-489 (Persian).##25. Ahmadi Z, Mehrabi HA. Relationship between social support and resilience with posttraumatic growth: the mediating role of stress coping styles. JNIP 2020; 5(9): 1-13 (Persian).##26. Einanloo M, Ghamari M. The Prediction of Academic Adjustment Based on Student Coping Strategies and Academic Ethics. Journal of Instructio and Evaluation 2021; 14(55): 13-34 (Persian).##27. Nazari S, Javid F, Negarandeh R, Farokhnezhad Afshar P. Relationship of Identity Styles and Coping Strategies With Marital Adjustment in Nurses. IJPCP 2022; 28(3): 374-385 (Persian).##28. Mamsharifi P, Akbari Bejandi N, Asadi N. Internet addiction prediction modeling based on quality of life and life satisfaction: the mediating role of stress coping strategies. Journal of Psychological Science 2020; 19(89): 541-551.##29. Aliyari M, Davati A, Fattahi F, Torkestani F, Garshasbi A. Investigating the relationship between coping styles with pregnancy stress and spiritual health of pregnant women referred to Shaheed Mostafa Khomeini hospital in Tehran. Daneshvar Medicine 2021; 29(1): 1-12 (Persian).##30. Shooshtari M, Zarafshan H, Mohamadian M, Zareee J, Keisomi I, Hooshangi H. The effect of a parental education program on the mental health of parents and behavioral problems of their children with autism spectrum disorder. Iranian Journal of Psychiatry and Clinical Psychology (IJPCP) 2020; 25(4): 356-367 (Persian).##31. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24(4): 385-396.##32. Behroozi N, Shahani Yeylagh M, Pourseyed SM. Relationship between Perfectionism, Perceived Stress and Social Support with Academic Burnout. Strategy for Culture 2013; 5(20): 83-102 (Persian).##33. Silva GdSAd, Silva GAVd, Antonietti CC, Benavente SBT, Silva RMd, Costa ALS. Stress perception among patients in pre-colonoscopy period and those undergoing chemotherapy treatment. Rev Rene 2015; 16(2): 233-241.##34. Tian X, Jin Y, Chen H, Tang L, Jiménez-Herrera MF. Relationships among social support, coping style, perceived stress, and psychological distress in Chinese lung cancer patients. Asia Pac J Oncol Nurs 2021; 8(2): 172-179.##35. Groarke A, Curtis R, Kerin M. Global stress predicts both positive and negative emotional adjustment at diagnosis and post‐surgery in women with breast cancer. Psychooncology 2013; 22(1): 177-185.##36. Geng Z, Ogbolu Y, Wang J, Hinds PS, Qian H, Yuan C. Gauging the effects of self-efficacy, social support, and coping style on self-management behaviors in Chinese cancer survivors. Cancer Nurs 2018; 41(5): E1-E10.##37. Yeung NC, Lu Q. Perceived stress as a mediator between social support and posttraumatic growth among Chinese American breast cancer survivors. Cancer Nurs 2018; 41(1): 53-61.##38. Tu H, Gong G, Zhang S, Fu Y, Wang T, Chu Q, et al. The association between illness perception and quality of life among Chinese adults with epilepsy: The mediating role of coping style. Epilepsy Behav 2022; 130: 108677.##39. Kikuchi N, Nishiyama T, Sawada T, Wang C, Lin Y, Watanabe Y, et al. Perceived stress and colorectal cancer incidence: the Japan collaborative cohort study. Sci Rep 2017; 7: 40363.##40. Martins-Klein B, Bamonti PM, Owsiany M, Naik A, Moye J. Age differences in cancer-related stress, spontaneous emotion regulation, and emotional distress. Aging Ment Health 2021; 25(2): 250-259.##41. Ruiz-Rodríguez I, Hombrados-Mendieta I, Melguizo-Garín A, Martos-Méndez MJ. The association of sources of support, types of support and satisfaction with support received on perceived stress and quality of life of cancer patients. Integr Cancer Ther 2021; 20: 1534735421994905.## ##

مقایسه دقت تشخیصی پرسشنامه‌های گلسگو-بلچفورد اسکور و روکال اسکور کامل و بالینی دربیماران با خونریزی گوارشی فوقانی حاد Comparison of Diagnostic Accuracy of the Glasgow Blatchford Score, Clinical and Full Rockall Scoring Systems in Patients with Acute Upper Gastrointestinal Bleeding 1 1 سابقه و هدف: خونریزی گوارشی فوقانی یکی از علل شایع مراجعه بیماران به اورژانس‏ها می‏باشد. در اکثر این بیماران خونریزی خود به خود متوقف می‌شود ولی تعدادی از بیماران high risk می‏باشند که ممکن است دچار عوارض متعددی شوند و افتراق آن‏ها از بیماران low risk در بخش‏های اورژانس از اهمیت ویژه‌ای برخوردار است. پرسشنامه‏های Glasgow Blatchford Score، Clinical Rocall Score و Full Rocall Score از رایج‌ترین پرسشنامه‏های بالینی برای ارزیابی بیماران مراجعه‌کننده با خونریزی گوارشی فوقانی می‌باشد. مواد و روش‌ها: در این مطالعه توصیفی آینده‌نگر برای ۲۴۹ بیمار با خونریزی گوارشی فوقانی مراجعه‌کننده به اورژانس، پرسشنامه‌های GBS و CRS در بدو مراجعه و بعد از انجام آندوسکوپی، پرسشنامه FRS کامل شد. سپس دو هفته بعد از ترخیص، چک لیستی شامل وضعیت مرگ و میر، خونریزی مجدد، نیاز بیماران به اقدامات جراحی وترانسفوزیون خون برای تعیین پروگنوز تکمیل شد. یافته‌ها: درسیستم امتیازدهی GBS ۲۳۸ نفر (95/6درصد) high risk محسوب می‏شدند و ۱۱ نفر (4/4درصد) low risk بودند. درسیستم امتیازدهی CRS ۱۶۵ بیمار (66/3 درصد) high risk و ۸۴ بیمار (33/7درصد) low risk بودند و در سیستم امتیازدهی FRS ۱۹۳ بیمار (77/5درصد) high risk محسوب می‌شدند و ۵۶ نفر (22/5درصد) low risk بودند. استنتاج: سیستم امتیازدهی FRS معیاری قابل قبول برای شناسایی بیماران high risk و یک روش امتیازدهی بعد از آندوسکوپیک دقیق، برای شناسایی بیماران با پیش‌آگهی بد می‌باشد. در بین روش‏های امتیازدهی قبل آندوسکوپیک CRS در شناسایی بیماران low risk ارزشمند می‌باشد و برای یافتن بیماران low risk و پیگیری و آندوسکوپی آن‌ها به‌صورت سرپایی ارزش بیش‌تری دارد و GBS در شناسایی بیماران high risk ارزشمندتر می‌باشد.   2  Background and purpose: Upper gastrointestinal (GI) bleeding is one of the most common reasons for emergency admission. In majority of patients, bleeding stops spontaneously, but some high-risk patients may suffer from many complications secondary to upper GI bleeding, so differentiation of low-risk and high-risk patients in emergency departments is of particular importance. Glasgow Blatchford Score (GBS), Clinical Rockall Score (CRS) and Full Rockall Score (FRC) are the most common assessment tools for evaluating patients with upper GI bleeding. Materials and methods: In a prospective descriptive study, for 249 patients with upper GI bleeding who referred to an emergency department, GBS and CRS were used at first visit, and after endoscopy the FRC was used. Two weeks after discharge, a checklist was completed to determine the disease prognosis that included items about mortality, re-bleeding, the need for surgery, and blood transfusion. Results: In Glasgow Blatchford Scoring system, 238 (95.6%) people were considered high risk and 11 (4.4%) patients were low risk. CRS showed 165 (66.3%) high-risk patients and 84 (33.7%) low-risk patients. According to FRC, 193 (77.5%) patients were high risk and 56 (22.5%) were low risk. Conclusion: The Full Rockall scoring system is an acceptable criterion for identifying high-risk patients and a very accurate post-endoscopic scoring tool that helps in identifying patients with a poor prognosis. Among the pre-endoscopic scoring systems, CRS is valuable in identifying low-risk patients, and their follow-up and endoscopy as an outpatient procedure. GBS is more valuable in identifying high risk patients.   88 97 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/9 1401/8/18 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/31 1402/3/10 سیدمحمد ولیزاده طوسی Seyed Mohammad Valizadeh Toosi استادیار، گروه داخلی، مرکز تحقیقات گوارش و کبد، پژوهشکده بیماری‌های غیر واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران seyedmohammadv@yahoo.com ایرج ملکی Iraj Maleki دانشیار، گروه داخلی، مرکز تحقیقات گوارش و کبد، پژوهشکده بیماری‌های غیر واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران iradj2001@yahoo.com ساناز گنودی Sanaz Gonoodi فلو فوق تخصصی گوارش، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران acute upper GI bleeding Glasgow Blatchford Score Clinical Rocall Score Full Rockall Score خونریزی گوارشی فوقانی حاد گلسگو- بلچفورد اسکور روکال اسکور بالینی روکال اسکور کامل 1. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for uppergastrointestinal haemorrhage. Lancet 2000; 356(9238): 1318-1321.##2. Longstreth GF, Feitelberg SP. Successful outpatient management of acute upper gastrointestinal hemorrhage: use of practice guidelines in a large patient series. Gastrointest Endosc 1998; 47(3): 219-222.##3. Pithawa A. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: pathophysiology, diagnosis, management. Med J Armed Forces India 2007; 63(2): 205.##4. Atkinson RJ, Hurlstone DP. Usefulness of prognostic indices in upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 2008; 22(2): 233-242.##5. Alio H, Lang E, Barkan A. Emergency department risk stratification in upper gastrointestinal bleeding. CJEM 2012; 14(1): 45-49.##6. Farrell RJ, Alsahli M, LaMont JT. Is successful triage of patients with upper-gastrointestinal bleeding possible without endoscopy? Lancet 2000; 356(9238): 1289-1290.##7. Das A, Wong RC. Prediction of outcome of acute GI hemorrhage: a review of risk scores and predictive models. Gastrointest Endosc 2004; 60(1): 85-93.##8. Laursen SB, Hansen JM, De Muckadell OBS. The Glasgow Blatchford score is the most accurate assessment of patients with upper gastrointestinal hemorrhage. Clin Gastroenterol Hepatol 2012; 10(10): 1130-1135. e1.##9. Gralnek IM, Dulai GS. Incremental value of upper endoscopy for triage of patients with acute non-variceal upper-GI hemorrhage. Gastrointest Endosc 2004; 60(1): 9-14.##10. Chen I-C, Hung M-S, Chiu T-F, Chen J-C, Hsiao C-T. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med 2007; 25(7): 774-779.##11. Srygley FD, Gerardo CJ, Tran T, Fisher DA. Does this patient have a severe upper gastrointestinal bleed? JAMA 2012; 307(10): 1072-1079.##12. Cipolletta L, Bianco MA, Rotondano G, Marmo R, Piscopo R. Outpatient management for low-risk nonvariceal upper GI bleeding: a randomized controlled trial. Gastrointest Endosc 2002; 55(1): 1-5.##13. Church NI, Dallal HJ, Masson J, Mowat NAG, Johnston DA, Radin E, et al. Validity of the Rockall scoring system after endoscopic therapy for bleeding peptic ulcer: a prospective cohort study. Gastrointest Endosc 2006; 63(4): 606-612.##14. Pang SH, Ching JY, Lau JY, Sung JJ, Graham DY, Chan FK. Comparing the Blatchford and pre-endoscopic Rockall score in predicting the need for endoscopic therapy in patients with upper GI hemorrhage. Gastrointest Endosc 2010; 71(7): 1134-1140.##15. Stanley A, Ashley D, Dalton H, Mowat C, Gaya D, Thompson E, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet 2009; 373(9657): 42-47.##16. Struckmann V, Panteli D, Legido-Quigley H, Risso-Gill I, McKee M, Busse R. Deciding when physicians are unfit to practise: an analysis of responsibilities, policy and practice in 11 European Union member states. Clin Med 2015; 15(4): 319-324.##17. Custovic N, Husic-Selimovic A, Srsen N, Prohic D. Comparison of Glasgow-Blatchford score and Rockall score in patients with upper gastrointestinal bleeding. Med Arch 2020; 74(4): 270-274.##18. Maia S, Falcão D, Silva J, Pedroto I. The clinical impact of Rockall and Glasgow-Blatchford scores in nonvariceal upper gastrointestinal bleeding. GE Port J Gastroenterol 2021; 28(4): 243-252.## ##

مقایسه آموزش درس جنین شناسی به روش ترکیبی و سنتی بر میزان یادگیری، یادداری و رضایتمندی دانشجویان رشته پزشکی Comparing the Effects of Blended Teaching and Traditional Teaching on Learning, Memorability and Satisfaction of Medical Students in an Embryology Module 1 1  سابقه و هدف: علوم تشریح برای دانشجویان پزشکی به جهت ارزش آن در پاراکلینیک و طبابت اهمیت خاصی دارد. ارائه این دروس و استفاده از روش‌های ساده و در عین حال در دسترس آموزشی از دیرباز مورد توجه مدرسان این رشته بوده است. لذا مطالعه حاضر با هدف مقایسه آموزش درس جنین‌شناسی به روش ترکیبی و سنتی بر میزان یادگیری، یادداری و رضایتمندی دانشجویان پردیس پزشکی آمل انجام شد. مواد و روش‌ها: در مطالعه ترکیبی حاضر، تعداد 50 دانشجوی پزشکی در دو گروه فیلم آموزشی و شاهد به‌صورت تصادفی تقسیم شدند. ارزشیابی از دانشجویان در دو سطح کمی و کیفی انجام شد. در سطح کمی، نمرات آزمون‌های میان‌ترم و پایان‌ترم ملاحظه شدند و هم‌چنین با استفاده از چک لیست استاندارد به بررسی متغیرهای رضایتمندی و ... پرداخته شد. در سطح کیفی اطلاعات مربوط به دیدگاه دانشجویان از فیلم‌های آموزشی با انجام مصاحبه با 20 دانشجو جمع‌آوری و نتایج به روش تحلیل محتوای کیفی آنالیز گردید. یافته‌ها: یافته‌های بخش کمی نشان داد که وضعیت نمرات گروه فیلم در مقایسه با گروه شاهد به‌طور معناداری در میان‌ترم و پایان‌ترم بهتر بود (0/05P<). هم‌چنین نتایج حاصل از چک لیست حاکی از آن بود که در گروه فیلم در هر سوال، نمرات بالاتر از میانگین بوده و ارزیابی دانشجویان به‌صورت کلی از این روش بالا بود. در بخش کیفی مطالعه، طبقه اصلی استخراج شده یادگیری اثربخش بود که شامل سه زیر طبقه ارتقاء یادگیری، افزایش انگیزه و توانایی‌های شناختی بودند. استنتاج: با توجه به این که روش فیلم‌های آموزشی خللی در روند آموزش ایجاد نمی‌کند و می‌تواند عامل تاثیرگذار در یادگیری دروس تجسمی مانند جنین‌شناسی باشد، به‌نظر می‌رسد پیشنهاد این روش در کلاس‌های درس به دانشجویان کمک‌کننده و مفید باشد.   2  Background and purpose: Anatomical sciences are highly important in education of medical students due to their role in practice. Delivery of simple educational materials that are easily available to students have always been an interest of lecturers in this field. The present study aimed to compare the effect of blended teaching and traditional teaching on learning, memorization, and satisfaction of medical students in an embryology course in Amol medical Students, Iran. Materials and methods: In the present mixed method study, 50 medical students were randomly divided into two groups: educational film and control. Quantitative and qualitative evaluations were carried out. At quantitative level, midterm and final term exam results were studied and a standard checklist was used to measure satisfaction, etc. At qualitative level, information about students' views on educational videos was collected through interviews with 20 students and data were analyzed using qualitative content analysis. Results: According to quantitative data, the students in the intervention group showed significantly better results at both midterm and final exam compared to the control group (P<0.05). Also, the checklist analysis indicated the blended teaching was superior to traditional teaching and the scores of responses in intervention group were higher than the average. At qualitative analysis, effective learning was the main class extracted, which included three sub-classes of learning promotion, increasing motivation, and cognitive abilities. Conclusion: Considering that this method does not cause disruption in education and can be effective in visualization courses such as embryology, it seems to be beneficial to students.   98 109 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/5 1402/1/16 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/23 1402/3/2 نوشین موسی زاده Noushin Mousazadeh استادیار، گروه پرستاری، دانشکده پرستاری آمل، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران somaye87@gmail.com علیرضا خلعتبری Alireza Khalatbary استاد، گروه علوم تشریح، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران khalat90@yahoo.com داود نصیری Davood Nasiry استادیار، گروه پیراپزشکی، دانشکده پیراپزشکی آمل، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران davood1990nasiry@gmail.com medical education learning memorability satisfaction medical students embryology آموزش پزشکی یادگیری یادداری رضایتمندی دانشجویان پزشکی جنین‌شناسی 1. Zargaran A, Turki MA, Bhaskar J, Spiers HVM, Zargaran D. The role of technology in anatomy teaching: striking the right balance. Adv Med Educ Pract 2020: 259-266.##2. Karbasi Z, Kalhori SRN. Application and evaluation of virtual technologies for anatomy education to medical students: A review. Med J Islam Repub Iran 2020; 34: 163.##3. Riederer BM. Plastination and its importance in teaching anatomy. Critical points for long‐ term preservation of human tissue. J Anat 2014; 224(3): 309-315.##4. Nasiri M, Nasiri M. Comparing the Effect of Teaching Anatomy through Lecture and Compound Methods on Medicine Students’ Learning and Knowledge Retention at Busheher University of Medical Sciences. Educational Development of Judishapur 2014; 5(3): 183-190 (Persian).##5. Singh K, Gaur U, Hall K, Mascoll K, Cohall D, Majumder MAA. Teaching anatomy and dissection in an era of social distancing and remote learning. Advances in Human Biology 2020; 10(3): 90-94.##6. Alizadeh S, Pourhosseini S, Vakili A, Ghorbani R, Zolfaghary S. Factors Affecting Learning of Anatomy: Students' Viewpoints. Iranian Journal of Medical Education 2019; 13(1): 49-57 (Persian).##7. Mayer R. Research-based principles for designing multimedia instruction. E-Learn: World Conference on E-Learning. Santa Barbara: APA; 2014.##8. Bloomfield JG, Jones A. Using e-learning to support clinical skills acquisition: Exploring the experiences and perceptions of graduate first-year pre-registration nursing students—A mixed method study. Nurse Educ Today 2013; 33(12): 1605-1611.##9. Lee N-J, Chae S-M, Kim H, Lee J-H, Min HJ, Park D-E. Mobile-based video learning outcomes in clinical nursing skill education: a randomized controlled trial. Comput Inform Nurs 2016; 34(1): 8-16.##10. Mohammadi F, Momennasab M, Rostambeygi P, Ghaderi S, Mousazadeh S. The effect of education through conceptual mapping on critical thinking of nursing students. J Pak Med Assoc 2019; 69(8): 1094-1098.##11. El-Sayed R, El-Hoseiny S, El-Sayed E. Video-based lectures: An emerging paradigm for teaching human anatomy and physiology to student nurses. Alexandria J Med 2018; 49(1): 215-222.##12. Nadeak B, Naibaho L. Video-based learning on improving students’learning output. PalArch's J Archaeol 2020; 17(2): 44-54.##13. Ballouk R, Mansour V, Dalziel B, McDonald J, Hegazi I. Medical students’ self-regulation of learning in a blended learning environment: a systematic scoping review. Med Educ Online 2022; 27(1): 2029336.##14. Joos U, Klümper C, Wegmann U. Blended learning in postgraduate oral medical and surgical training-An overall concept and way forward for teaching in LMICs. J Oral Biol Craniofac Res 2022; 12(1): 13-21.##15. Vaske JJ, Beaman J, Sponarski CC. Rethinking internal consistency in Cronbach's alpha. Leis Sci 2017; 39(2): 163-173.##16. Bagherian S, Sharif F, Zarshenas L, Torabizadeh C, Abbaszadeh A, Izadpanahi P. Cancer patients’ perspectives on dignity in care. Nurs Ethics 2020; 27(1): 127-140.##17. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24(2): 105-112.##18. Dharamsi MS, Bastian DA, Balsiger HA, Cramer JT, Belmares R. Efficacy of Video-Based Forearm Anatomy Model Instruction for a Virtual Education Environment. J med educ curric dev 2022; 9: 23821205211063287.##19. Babazadeh Kamangar M, Jahanian I, Gholinai H. A Preliminary Study Of The Effect Of Mobile-Based Education On Dental Students'learning In Practical Course Of Oral Pathology. JMED 2016; 9(22): 21-26 (Persian).##20. Mousazadeh N, Momennasab M, Sharif Nia H, Nazari R, Hajihosseini F. Effective Factors in Critical Thinking Disposition in Nursing Students. Education Research International 2021; 2021: 1-6.##21. Dikmen Y, Ak B, Yildirim Usta Y, Ünver V, Akin Korhan E, Cerit B, et al. Effect of peer teaching used in nursing education on the performance and competence of students in practical skills training. Int J Edu Sci 2017; 16(1-3): 14-20.##22. Zarifnejad G, Mirhaghi A, Rajabpoor M. Learning experience through peer education: a qualitative study. Iranian Journal of Medical Education 2015; 15: 27-40 (Persian).##23. Viebig C. Blended learning in entrepreneurship education: a systematic literature review. Education & Training 2022; 64(4): 533-558.##24. Buckley S, Zamora J. Effects of participation in a cross year peer tutoring programme in clinical examination skills on volunteer tutors' skills and attitudes towards teachers and teaching. BMC Med Educ 2007; 7: 1-9.##25. Dakhi O, Jama J, Irfan D. Blended learning: a 21st century learning model at college. International Journal Of Multi Science 2020; 1(8): 50-65.## ##

مقایسه اثربخشی روان درمانی تحلیلی معطوف به انتقال و مبتنی بر پذیرش و تعهد بر روان رنجوری و تکانشگری بیماران مبتلا به اختلال شخصیت مرزی Comparing the Effectiveness of Transference-Focused Psychotherapy and Acceptance and Commitment Therapy on Neuroticism and Impulsivity in Patients with Borderline Personality Disorder 1 1  سابقه و هدف: اختلال شخصیت مرزی یکی از شایع‏ترین اختلالات در روانپزشکی است. مطالعه حاضر با هدف مقایسه اثربخشی روان درمانی تحلیلی معطوف به انتقال و درمان مبتنی بر پذیرش و تعهد بر روان رنجوری و تکانشگری افراد مبتلا به شخصیت مرزی انجام پذیرفت. مواد و روش‏ها: این مطالعه از نوع تجربی، کاربردی، طرح نیمه آزمایشـی بود. روش پژوهش از نوع طرح تک آزمودنی A-B-A بودجامعه آماری شامل تمامی افراد مبتلا به اختلال شخصیت مرزی که به بیمارستان روانپزشکی زارع و کلینیک خانه معنا ساری در اردیبهشت الی خرداد 1399 (32 نفر) مراجعه نمودند، بود. با روش نمونه‏گیری در دسترس (11 نفر) انتخاب و برای روان درمانی تحلیلی معطوف به انتقال (4 نفر)، درمان مبتنی بر پذیرش و تعهد (4 نفر)، گروه کنترل (3 نفر)، به روش تصادفی قرعه‏کشی جایگزین شدند. داده‌ها در پنج مرحله به صورت خط پایه، مرحله میانی، مرحله پیشرفت، مرحله خاتمه درمان و پیگیری، در طول یک سال (در طی صد جلسه)، با استفاده از پرسشنامه پنج عامل شخصیت NEO، پرسشنامه تکانشگری بارات، جمع‏آوری شد. برای تحلیل آماری از روش اندازه‏گیری مکرر و آزمون کروسکال والیس استفاده شد. یافته‌ها: درآزمون اندازه‏گیری مکرر تفاوت معناداری بین دو گروه نسبت به گروع کنترل در تکانشگری شناختی دیده شد (0/025=P). درمان معطوف به انتقال در آزمون کروسکال والیس اولاتر شد. استنتاج: با درنظر گرفتن این مهم که هدف هر دو درمان کاهش علائم نمی‏باشد، نتایج نهایی مطلوبیت درمان معطوف به انتقال را نشان می‏دهد، به علاوه برای تعمیم نتایج به پژوهش‏های بیش‏تر نیازمندیم. 2  Background and purpose: Borderline personality disorder is one of the most common disorders of mental health conditions. The aim of this study was to evaluate the effectiveness of transference-focused psychotherapy and acceptance and commitment treatment on neuroticism and impulsivity in individuals with borderline personality disorder. Materials and methods: In an applied quasi experimental study, we used single subject design involving ABA design in which a behavior is studied at baseline (A), during treatment (B), and after treatment (A). The statistical population included all patients with borderline personality disorder attending Sari Zare Psychiatric Hospital and Sari Mana Clinic in May to June 2020 (n=32). Eleven patients were selected using convenience sampling and were randomly allocated to transference-focused psychoanalysis (n=4), acceptance and commitment-based therapy (n=4) or control group (n=3). Data were collected in five stages: baseline, mid-stage, progress stage, treatment termination stage, and follow-up for one year (100 sessions) using the NEO five-factor personality questionnaire and Barat impulsivity questionnaire. Data analysis was performed applying repeated measures and Kruskal-Wallis test. Results: In the repeated measurement test, a significant difference was seen in cognitive impulsivity between the two groups compared to the control group (P=0.025). According to Kruskal-Wallis test, transference-focused psychoanalysis was prioritized. Conclusion: Considering that these two treatment methods do not aim to reduce symptoms, our final results showed that transference-focused psychoanalysis was more effective. But, further studies are need to generalize current findings.   109 123 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/27 1401/4/6 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/13 1402/3/23 فاطمه فتحی Fatemeh Fathi دکترای روانشناسی بالینی، گروه روانشناسی، دانشکده پزشکی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران ایران fatemeh_fathi67@yahoo.com شهرام وزیری Shahram Vaziri دانشیار، گروه روانشناسی، دانشکده پزشکی، واحد رودهن، دانشگاه آزاد اسلامی، رودهن، ایران ایران shahram.vaziri@gmail.com مهدی پوراصغر Mehdi Pourasghar دانشیار، گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران me_pourasghar@yahoo.com مریم نصری Maryam Nasri استادیار، گروه روانشناسی، دانشکده پزشکی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران ایران maryam_nasri_58@yahoo.com transference-focused psychotherapy acceptance and commitment therapy neuroticism impulsivity borderline personality disorder روان درمانی معطوف به انتقال درمان مبتنی بر پذیرش و تعهد نوروتیزم تکانشگری اختلال شخصیت مرزی 1. American Psychiatric Association. Diagnostic and Statistical manual of Mental Disorders (DSM-5-tr). 5th ed: American Psychiatric Publishing, Inc; 2013.##2. Lubke G, Laurin C, Amin N, Hottenga JJ, Willemsen G,van Grootheest G, et al. Genome- wide analyses of borderline personality features. Mol Psychiatry 2014; 19(8): 923-929.##3. Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, et al. Prevalence, correlates, disability, and comorbidity of DSM–IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008; 69: 533–545.##4. McCrae RR, John OP. An Introduction to the Five-Factor Model and its application. Journal of Personality 1992; 2: 175-215.##5. Haren EG,Mitchell CW. Relationships between the Five-Factor Personality Model and coping styles. Psychology and Education: An Interdisciplinary Journal 2003; 40(1): 38-49.##6. Fang L, Heisel MJ, Duberstein PR, Zhang J. Combined effects of neuroticism and extraversion: findings from a matched case control study of suicide in rural China. Journal of Nervous and Mental Disease 2012; 200(7): 598-602.##7. Shah AJ, Veledar E, Hong Y, Bremner JD, Vaccarino V. Depression and history of attempted suicide as risk factors for heart disease mortality in young individuals. Arch Gen Psychiatry 2011; 68(11): 1135-1142.##8. Sadock BJ, Sadock VA. Ruiz P. Kaplan and Sadock's Synopsis of Psychiatry behavior sciences. 11th ed. new york: Wolters Kluwer Health; 2015.##9. Segal ZV, Teasdale JD, Williams JMG. Mindfulness-Based Cognitive Therapy: Theoretical Rationale and Empirical Status. 2004.##10. Bagherian-Afrakoti N, Alipour A, Pourasghar M, Ahmad Shirvani M. Assessment of the efficacy of group counselling using cognitive approach on knowledge, attitude, and decision making of pregnant women about modes of delivery. Health Care for Women Int 2018; 39(6): 684-696.##11. Stern BL, Yeomans F. The Psychodynamic Treatment of Borderline Personality Disorder: An Introduction to Transference-Focused Psychotherapy. Psychiatr Clin North Am 2018; 41(2): 207-223.##12. Adler G. The psychotherapy of core borderline psychopathology. Am J Psychother 1993; 47(2): 194-205.##13. Khodabakhsh R. Comparison of the prevalence of personality disorder in men and women by adjusted raw scores of III million. Cultural and Educational Quarterly of Women and Family 2016; 7(22): 103-125 (Persian).##14. Sperry L. Handbook of diagnosis and treatment of DSM-IV-TR. Personality disorders. 2th ed. New York: Brunner-Routledge; 2003.##15. Kring A, Johnson S, Davison GC, Neale JM. Abnormal Psychology. 11th ed. New York: Wiley; 2009.##16. Westen D, Bradley R. Empirically supported complexity: Rethinking evidence-based practice in psychotherapy. Current Directions in Psychological Science 2005; 14(5): 266-271.##17. Kernberg OF, Burstein ED, Coyne L, Appelbaum A, Horwitz L, Voth H. Psychotherapy and psychoanalysis: Final report of the Menninger Foundation's psychotherapy research project. Bull Menninger Clin 1972; 36(1): 1-277.##18. Clarkin JF, Kernberg OF. Transference-focused psychotherapy for borderline personality disorder: A clinical guide: American Psychiatric Pub; 2015.##19. Yeomans FE, Clarkin JF, Kernberg OF. Transference-focused psychotherapy for borderline personality disorder: A clinical guide: American Psychiatric Pub; 2015.##20. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behavior Resrch Therapy. 2006; Acceptance and commitment therapy: model, processes and outcomes”. Behav Res Ther 2006; 44(1): 1-25.##21. Reyes‐Ortega MA, Miranda EM, Fresán A, Vargas AN, Barragán SC, Robles García R, et al. Clinical efficacy of a combined acceptance and commitment therapy, dialectical behavioural therapy, and functional analytic psychotherapy intervention in patients with borderline personality disorder. Psychol Psychother 2020; 93(3): 474-489.##22. Berking M, Neacsiu A, Comtois KA, Linehan MM. The impact of experiential avoidance on the reduction of depression in treatment for borderline personality disorder. Behav Res Ther 2009; 47(8): 663-670.##23. Fischer-Kern M, Doering S, Taubner S, Hörz S, Zimmermann J, Rentrop M, et al. Transference-focused psychotherapy for borderline personality disorder: Change in reflective function. Br J Psychiatry 2015; 207(2): 173-174.##24. Hayes SC, Smith S. Get out of your mind and into your life: the new acceptance and commitment therapy. New York: Springer; 2005.##25. Bach PA, Moran DJ. ACT in practice the conceptualization of the case in the treatment of acceptance and commitment. Tehran: Arjmand Publishing; 2017.##26. Hayes SC, Strosahi K, Wilson KG. Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press; 1999.##27. Twohig MP. Acceptance and commitment therapy—Introduction. Cognitive and Behavioral Practice 2012; 19(4): 499-507.##28. Gall MD, Gall JP, Borg WR. Applying educational research: How to read, do, and use research to solve problems of practice, Loose-Leaf Version. 7TH ed:‎ Pearson; 2014.##29. Harris R. ACT in simple language. Tehran: Arjmand Publications; 2009.##30. Morton J, Snowdon S, Gopold M, Guymer E. Acceptance and commitment therapy group treatment for symptoms of borderline personality disorder: A public sector pilot study. Cognitive and Behavioral Practice 2012; 19(4): 527-544.##31. Barratt ES, Stanford MS, Kent TA, Felthous A. Neuropsychological and cognitive psychophysiological substrates of impulsive aggression. Biol Psychiatry 1997; 41(10): 1045-1061.##32. McCrae RR, Costa Jr PT. Rotation to maximize the construct validity of factors in the NEO Personality Inventory. Multivariate Behav Res 1989; 24(1): 107-124.##33. McCrae RR, Costa Jr PT. A contemplated revision of the NEO Five-Factor Inventory. Personality and Individual Differences 2004; 36(3): 587-596.##34. Clarkin JF, Cain NM, Lenzenweger MF. Advances in transference-focused psychotherapy derived from the study of borderline personality disorder: Clinical insights with a focus on mechanism. Curr Opin Psychol 2018; 21: 80-85.##35. Gabbard GO, Horowitz MJ. Insight, transference interpretation, and therapeutic change in the dynamic psychotherapy of borderline personality disorder. Am J Psychiatry 2009; 166(5): 517-521.##36. Karami J, Soliemani B, Ghorbani H, Dastbaz A. The effectiveness of acceptance and commitment-based therapy on cognitive Fusion, perceived stress, and autobiographical memory in people with borderline personality disorder. Clinical Psychology Studies 2020; 10(40): 1-26 (Persian).##37. 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تبیین تجارب پرستاران بخش مراقبت ویژه از دیسترس اخلاقی در همه‌گیری کوید-19 Intensive Care Nurses' Experiences of Moral Distress in the COVID-19 Pandemic 1 1  سابقه و هدف: پرستاران به‌عنوان ارائه‌دهنده مستقیم و مداوم خدمت به  بیمار، بیش از سایر گروه‌ها در محیط کاری با انواع گوناگونی از تنش‌های روانی رو به رو هستند. در این بین حضور دیسترس اخلاقی در بخش‌های مراقبت ویژه بسیار چشمگیرتر است. لذا این مطالعه با هدف تبیین تجارب دیسترس اخلاقی پرستارانی که در مراکز مراقبت ویژه از بیماران کوید-19 مراقبت می‌کردند، طراحی شد. مواد و روش‌ها: پژوهش حاضر یک پژوهش کیفی و از نوع تحلیل محتوا قراردادی است که در سال 1400-1399 انجام شد. جامعه پژوهش، پرستاران بخش‌های مراقبت‌های ویژه کرونا بودند که ﺑﻪ‌ﺻﻮﺭﺕ ﻣﺒﺘﻨﻲ ﺑﺮ ﻫﺪﻑ از بیمارستان‌های آموزشی استان مازندران انتخاب شدند. ابزار جمع‌آوری ﺩﺍﺩﻩ‌ﻫﺎ، ﻣﺼﺎﺣﺒﻪ‌ ﻋﻤﻴﻖ با سوالات نیمه ساختاریافته بود. جهت تحلیل داده‌ها از رویکرد کیفی گرانهیم و لوندمن استفاده شد. صحت و استحکام مطالعه توسط معیارهای پیشنهادی گوبا و لینکلن بررسی شد. یافته‌ها: در این مطالعه با 14 پرستار(4 مرد و 10 زن) با محدوده سنی 25 تا 48 سال مصاحبه شد. یافته‌های مطالعه شامل سه ﻃﺒﻘﻪ اﺻﻠﯽ و هشت زیﺮ ﻃﺒﻘﻪ شامل آزردگی متعدد (تنش‌های روانی جسمی پرستار، اثرات منفی بر روابط خانوادگی و دوستان، اثرات منفی بر کار حرفه‌ای)، فشارکاری پرستاری (شرایط سخت بیمار و همراه، سختی و تنش‌کاری، ضعف مدیریت در اداره شرایط) و ماندگاری و انطباق (خودحفاظتی پرستار، کنارآمدن پرستار با شرایط سخت) بود. استنتاج: براساس یافته‌های مطالعه پرستاران باید تشویق به بیان احساسات خود شوند، تا از طریق آن بتوانند بین دشواری تصمیمات اخلاقی و برآوردن نیاز بیمار و مدیریت احساسات خود تعادلی برقرار کنند. 2  Background and purpose: As direct and continuous care providers to patients, nurses face various types of psychological stress in the work environment more than other groups. Meanwhile, moral distress in special care units is much more impressive. This study aimed to explain the moral distress experienced by nurses that provided care to patients with COVID-19 patients in special care units. Materials and methods: We performed a conventional qualitative content analysis in 2020-2021. The study population included nurses caring for COVID-19 patients in special care units selected by purposive sampling in educational hospitals affiliated with Mazandaran University of Medical Sciences. In-depth, semi-structured interviews were carried out for data collection. Graneheim and Lundman qualitative approach was used to analyze the data. The trustworthiness of the study was assessed by Guba and Lincoln's stringent criteria. Results: In this study, 14 nurses (25-48 yeas of age) were interviewed. We found three main layers and eight sub-layers, including multiple annoyances (mental and physical stress, negative effects on family and friends relationships, negative effects on professional work), work pressure (hard conditions of the patient and companion, difficulty and work stress, weak management), and persistence and adaptation (self-protection, coping with difficult conditions). Conclusion: Based on this study, nurses should be encouraged to express their feelings so that they can establish a balance between the difficulty of ethical decisions and meeting the patient's needs and managing their emotions.   124 134 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/21 1401/9/30 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/12 1402/3/22 فرشته عراقیان مجرد Fereshteh Araghian Mojarad استادیار، مرکز تحقیقات طب سنتی و مکمل ، انستیتوی اعتیاد ، دانشگاه علوم پزشکی مازندران ، ساری ، ایران ایران fereshteharaghian@yahoo.com ویدا شفیع پور Vida Shafipour دانشیار، گروه پرستاری، دانشکده پرستاری و مامایی نسیبه، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران vidashafipour@yahoo.com nurse intensive care moral distress COVID-19 پرستار مراقبت ویژه دیسترس اخلاقی کوید-19 1. Cacchione P-Z. Moral Distress in the Midst of the COVID-19 Pandemic. Clin Nurs Res 2020; 29(4): 215-216.##2. Abu-El-Noor N-I, Abu-El-Noor M-K. Ethical issues in caring for COVID-patients: A view from Gaza. Nurs Ethics 2020; 27(8): 1605-1606.##3. Morley G, Grady C, McCarthy J, Ulrich CM. Covid-19: Ethical Challenges for Nurses. Hastings Cent Rep 2020; 50(3): 35-39.##4. Abidemi Mary A, Rene L. Type 2 diabetes and depression in the African American population. J Am Assoc Nurse Pract 2020; 32(2): 120-127.##5. Jameton A. What Moral Distress In Nursing History Could Suggest About The Future Of Health Care. AMA J Ethics 2017; 19(6): 617-628. ##6. Hamric AB, Borchers CT, Epstein EG. Development And Testing Of An Instrument To Measure Moral Distress In Healthcare Professionals. AJOB Prim Res 2012; 3(2): 1-9.##7. Mccarthy J, Gastmans C. Moral Distress: A Review of the Argument-Based Nursing Ethics Literature. Nurs Ethics 2015; 22(1): 131-152.##8. Oh Y, Gastmans C. Moral Distress Experienced By Nurses: A Quantitative Literature Review. Nurs Ethics 2015; 22(1): 15-31.##9. Papathanassoglou ED, Karanikola MN, Kalafati M, Giannakopoulou M, Lemonidou C, Albarran JW. Professional Autonomy, Collaboration With Physicians, And Moral Distress Among European Intensive Care Nurses. Am J Crit Care 2012; 21(2): E41-E52.##10. Azadian M, Rahimi A, Mohebbi M, Iloonkashkooli R, Maleki M, Mardani A. The barriers to observing professional ethics in the practice of nursing care from nurses’ viewpoints. Clinical Ethics 2020;16(2): 114-121 (Persian).##11. Daubman BR, Black L, Goodman A. Recognizing Moral Distress in the COVID-19 Pandemic: Lessons From Global Disaster Response. J Hosp Med 2020; 5(11): 696-698. ##12. Lusignani M, Giann ML, Giuseppe RE L, Buffon ML. Moral distress among nurses in medical, surgical and intensive-care units. J Nurs Manag 2016; 25(6): 477-485.##13. Soleimani MA, Pahlevan Sharif A, Yaghoobzadeh A, Sheikhi MR, Panarello B, Thin Mar Win M. Spiritual well-being and moral distress among Iranian nurses. Nurs Ethics 2019; 26(4): 1101-1113.##14. Christodoulou-Fella M, Middleton N, Papathanassoglou E-DE, Karanikola MNK. Exploration of the Association between Nurses' Moral Distress and Secondary Traumatic Stress Syndrome: Implications for Patient Safety in Mental Health Services. Biomed Res Int 2017; 2017: 1908712.##15. Asgari S, Shafipour V, Taraghi Z, Yazdani-Charati J. Relationship between moral distress and ethical climate with job satisfaction in nurses. Nurs Ethics 2019; 26(2): 346-356.##16. Ohnishi K, Kitaoka K, Nakahara J, Välimäki M, Kontio R, Anttila M. Impact Of Moral Sensitivity On Moral Distress Among Psychiatric Nurses. Nurs Ethics 2018; 26(5): 1473-1483.##17. O'Connell CB. Gender and the experience of moral distress in critical care nurses. Nurs Ethics 2015; 22(1): 32-42.##18. Beikmoradi A, Rabiee S, Khatiban M, Cheraghi MA. Nurses distress in intensive care unit: a survey in teaching hospitals. IJMEHM 2012; 5(2): 58-69 (Persian).##19. Joolaee S, Jalili HR, Rafii F, Hajibabaee F, Haghani H. Relationship between moral distress and job satisfaction among nurses of Tehran University of Medical Sciences Hospitals. Hayat 2012; 18(1): 42-51 (Persian).##20. Graneheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24(2): 105-112.##21. Strubert Speziale H, Carpenter D. Qualitative Research in Nursing: Advancing the Humanistic Imperative. 3thed. Philadelphia: Williams & Wilkings; 2003.##22. Schaefer R, Zoboli Elma Lourdes Campos P, Vieira M. Moral Distress In Nurses: A Description Of The Risks For Professionals. Texto Contexto Enferm 2018; 27(4): e4020017.##23. Sheppard KN, Runk BG, Maduro RS, Fancher M, Mayo AN, Wilmoth DD, Morgan MK, Zimbro KS. Nursing Moral Distress and Intent to Leave Employment During the COVID-19 Pandemic. J Nurs Care Qual 2022; 37(1): 28-34.##24. Forozeiya D,Vanderspank-Wright B, Bourbonnais FF, Moreau D, Wright DK. Coping with moral distress-The experiences of intensive care nurses: An interpretive descriptive study. Intensive Crit Care Nurs 2019; 53: 23-29.##25. Rezapour M, Zarghami M, Sheikhmoonesi F. Psychological Experience and Needs of Front-line Nurses during COVID-19 Outbreak in Iran: A Qualitative Study. J Mazandaran Univ Med Sci 2021; 31(196): 125-135 (Persian).##26. Shali M, Ghorbani A, Matourypour P, Salehi Morkani E, Salehpoor Emran M, Nikbakht Nasr Aadi A. Exploring Nurses' Experiences of Coping Mechanisms Used in COVID-19 Pandemic: A Qualitative Study. IRJE 2021; 17(2): 204-214 (Persian).## ##

تحلیلی بر مفهوم رطوبت غریزی در طب ایرانی An Analysis of the Concept of Innate Moisture in Persian Medicine 1 1  سابقه و هدف: در طب ایرانی اعتقاد بر این است که ایجاد حیات و ادامه آن به رطوبت غریزی وابسته است و مرگ طبیعی انسان زمانی رخ می‌دهد که این رطوبت به پایان می‌رسد. علی‌رغم کاربرد این واژه در متون طبی، درک واحدی از مفهوم رطوبت غریزی وجود ندارد. هدف ما در این پژوهش ارائه یک جمع‌‎بندی منظم از داده‌‌های مرتبط با مفهوم رطوبت غریزی از دیدگاه اطبای کهن در قرون مختلف است، تا ضمن تبیین مفهوم رطوبت غریزی، استفاده‌های بالینی بیش‌تری از این مفهوم را مقدور سازد. مواد و روش‌ها: برای استخراج اولیه داده‌ها کلیدواژه‌های رطوبت غریزی، رطوبت اصلی، رطوبت، الرطوبه‌الغریزیه، الرطوبه الاصلیه، Innate Moisture، Innate Humidity و Natural Moisture متناسب با محیط جستجو، مورد استفاده قرار گرفت. در این مطالعه از روش تحلیل مفهوم راجرز استفاده شده ‌است. این روش شامل یک دسته از مراحل هم پوشاننده است که هدف اساسی آن، شفاف کردن مفهوم می‌باشد. یافته‌ها: در کتب، رطوبت از دو منظر مورد توجه قرار گرفته‌است: رطوبت به‌عنوان عَرَض (کیفیت) و رطوبت به عنوان جوهر (ماده رطب). رطوبت غریزی به‌عنوان یک ماده رطب در بدن انسان وجود دارد. اگرچه در منابع، ماهیت رطوبت غریزی کم‌تر مورد بحث قرار گرفته است ولی نقش آن به‌عنوان یک پایه اصلی برای تداوم حیات انسان مورد اتفاق نظر اطبا می‌باشد. استنتاج: رطوبت غریزی به دو دسته اصلی (ناشی از نطفه) و غیراصلی (ناشی از تغذیه) قابل تقسیم است. انواع رطوبات غریزی غیراصلی، جایگزین رطوبات غریزی اصلی می‌شوند، تا رطوبت غریزی اصلی در حد امکان دچار کم‌ترین تحلیل شده و تا زمانی که عمر طبیعی فرد اقتضا می‌کند، باقی ‌بماند.   2  Background and purpose: In Persian medicine, it is believed that the creation of life and its continuation depends on Innate Moisture, and natural human death occurs when this moisture ends. Despite the use of this term in medical texts, there is no acceptable understanding of this concept. The purpose of this research was to provide a systematic summary of data about Innate Moisture from the perspective of traditional physicians in different centuries, to explain that and enable more use of this concept in clinical setting. Materials and methods: The keywords in this study were as follows: Innate Moisture, Original Moisture, Moisture, al-Rotuba al-Ghrizia, al-Rotuba al-Asliyyah, Innate Humidity, and Natural Moisture in both Persian and English. We used Rodgers' evolutionary concept analysis which consists of a series of overlapping steps whose main goal is to clarify the concept. Results: In medical books, Moisture is considered from two perspectives: Moisture as an accident (quality) and Moisture as a substance (moist substance). Innate Moisture is present as a moist substance in the human body. The nature of Innate Moisture is less discussed in sources, but physicians are in agreement about its role as a main basis for the continuation of human life. Conclusion: Innate Moisture can be divided into two types; original (originated from zygote) and non-original (originated from nutrition). Non-original Innate Moistures are considered as alternative for original Innate Moisture so that the original Innate Moisture is reduced less and remains as long as the natural life of the person continues.   135 145 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/12 1401/10/22 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/12 1402/3/22 طاهره امیریان Tahereh Amirian دکترای تخصصی طب ایرانی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران Dramirian7@gmail.com امیرسعید حسینی Amirsaeed Hosseini استادیار، مرکز تحقیقات طب سنتی و مکمل، پؤوهشکده اعتیاد، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران Sadr128@yahoo.com محمد یوسف پور Mohammad Yousofpour استادیار، گروه طب ایرانی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران m.yousofpoor@yahoo.com محمد کمالی نژاد Mohammad Kamalinejad محقق، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، ایران ایران Innate Moisture Avecina Traditional Persian Medicine Natural Moisture moisture رطوبت غریزی ابن سینا طب سنتی ایرانی رطوبت اصلی رطوبت 1. Heravi MY. Ain al-Hayat. Tehran: Iran Univ Med Sci , Medical History Studies; 2007.##2. Ibn Sina HA. al-Qanun fi al-tibb. Lebanon: Alamy Le-Al-Matbooat Institute; 2005.##3. Hakimi F, Mokaberi Nejad R, Nazem E, Mojahedi M, Tansaz M, Choopani R, et al. The concept of wetness and its kinds in Persian medicine. JIITM 2019; 9(4):321-332.##4. Rodgers BL, Knafl KA. Concept development in nursing: foundation, techniques and application. 2nd ed. Philadelphia: Saunders; 2000.##5. Sadr al-Din Shirazi ME.Al-Hikma al-muta'aliya fi l-asfar al-'aqliyya al-arba'a. Beyrut: Muktaba Al-Mustafawi; 1989.##6. Ahwazi AA.Kamel-al-Sanaeh. Qom: Jalaoddin; 2008.##7. Aghili khorasani MH. Moalejat-e Aghili. Tehran: Institute of Meical History, Islamic Medicine and Complementary Medicine; 2008.##8. Ibn Sina HA. Al-Shifa (Al-Tabiyat). Qom: Public Library of Hazrat Ayatollah Marashi Najafi; 1984.##9. Aghili khorasani MH. Kholasat al-Hikma. Qom: Ismaeelian; 2005.##10. Aqsarai J. Sharh-e aqsarai. Tehran: Iran Univ Med Sci, Institute of Medical History Studies; 2008. ##11. Shaharzani MA. Mofarreh-al gholoob. Tehran: Alma’ee; 2012.##12. Jorjani E. Zakhireye Kharazm Shahi. Tehran: Iranian Medical Academy; 2001.##13. Qutbuddin Razi MM. Sharh-o al-Esharat-o al-tanbihat (maa al-Mohakat). Qom: Book Publishing Office; 1982.##14. Razi Baha-doleh, Kholasato al-taterob, Tehran: Iran Univ Med Sci, Institute of Medical History, Islamic and Complementary Medicine; 2013.##15. Ibn Nafis. Sharh-e fosol-e aboghrat. Tehran: Iran Univ Med Sci, Institute of Medical History Studies, Islamic and complementary medicine; 2005.##16. Sadr al-Din Shirazi ME. Al-Mabad and Al-Maad. Tehran: Iranian Wisdom and Philosophy Association; 1975.##17. Hopwood N, Flemming R, Kassell L. Reproduction: antiquity to the present day. Cambridge: Cambridge University Press; 2018. p. 195-208.##18. Moreau E. Innate Heat. In Sgarbi M, (ed). Encyclopedia of Renaissance Philosophy. Switzerland: Springer International Pub; 2022. p. 1690-1691.##19. Sethi S, Rivera O, Oliveros R, Chilton R. Aortic stiffness: pathophysiology, clinical implications, and approach to treatment. Integr Blood Press Control 2014; 7: 29-34.##20. Angoff R, Mosarla RC, Tsao CW. Aortic stiffness: epidemiology, risk factors, and relevant biomarkers. Front Cardiovasc Med 2021; 8: 709396.## ##

اثر پماد عصاره شنبلیله Trigonella foenum-graceum L. و پیچک صحرایی Convolvulus arvencis L در زخم ناشی از سوختگی در رت Healing Effect of Trigonella foenum-graceum L. and Convolvulus arvensis L. Ointments on Rat Model of Burn Wounds 1 1  سابقه و هدف: زخم عارضه‌ای با شیوع بالاست که جامعه را تحت تاثیر قرار داده است. در این مطالعه اثرات عصاره شنبلیله (Trigonella foenum-graceum L.) و پیچک صحرایی (Convolvulus arvencis L.) بر زخم ناشی از سوختگی در موش‌های صحرایی نر نژاد ویستار مورد بررسی قرار گرفت. مواد و روش‌ها: سوختگی با صفحه داغ تحت بی‌هوشی در رت‌ها ایجاد شد و رت‌ها به 5 گروه نرمال سالین، اوسرین، سولفادیازین نقره و گروه‌های درمان شده با پماد حاوی 5/2 درصد عصاره شنبلیله و پیچک صحرایی تقسیم شدند. مساحت زخم در روزهای 7، 14، 21 و 28 اندازه‌گیری شد و 28 روز پس از ایجاد زخم، از نمونه بافت ترمیم یافته ارزیابی هیستوپاتولوژی انجام شد. هم‌چنین میزان فلاونوئید تام دو عصاره پیچک صحرایی و شنبلیله تعیین شد. بهبود ماکروسکوپی زخم و هم‌چنین نتایج پاتولوژیک از نظر آماری مورد ارزیابی قرار گرفت. یافته‌ها: نتایج اندازه‌گیری سایز زخم، کاهش چشم‌گیری را در گروه پماد پیچک صحرایی در مقایسه با گروه اوسرین و نرمال سالین نشان داد. هم‌چنین گروه پماد شنبلیله اثر بخشی بهتری را نسبت به گروه اوسرین نشان داد. نتایج پاتولوژی نشان داد که بیش‌ترین بهبود به ترتیب در گروه  شنبلیله و پیچک صحرایی بود. استنتاج: مصرف موضعی پماد شنبلیله و پیچک صحرایی با محتوای غنی از فلاونوئیدها در درمان زخم سوختگی‌ها موثر است.   2  Background and purpose: Wound is a complication with high prevalence that negatively affects many people. The aim of this study was to evaluate the effects of Trigonella foenum-graceum L. and Convolvulus arvensis L. extracts on induced burn wounds in male Wistar rats. Materials and methods: Burn wounds were induced by hot plates burns under anesthesia. Twenty five rats were divided into five groups: normal saline, Eucerin, silver sulfadiazine, treatment groups treated with ointments containing 2.5% of Trigonella foenum-graceum L. or Convolvulus arvensis L. extracts. The wound area was measured at days 7, 14, 21, and 28, and 28 days after wound formation. Histopathological evaluation of the recovered tissue samples was done. Total flavonoids of the two extracts were determined. Microscopic analysis of wound healing was carried out and pathologic data were statistically evaluated. Results: In this study, wound size significantly decreased in rats treated with Convolvulus arvensis L. compared to Eucerin and normal saline groups. Furthermore, Trigonella foenum-graceum L. showed better efficacy than Eucerin. Pathological examination showed the highest improvements in the Trigonella foenum-graceum L. group and then in the Convolvulus arvensis L. group. Conclusion: Topical administration of Trigonella foenum-graceum L. and the Convolvulus arvensis L, with rich flavonoid contents can be beneficial in treatment of burn wound healing.   146 153 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/3 1400/8/12 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/20 1402/2/30 شهره مرادی کریم آباد Shohre Moradi Karimabad دانشجوی دکتری داروسازی، دانشکده داروسازی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران moradi333333@gmail.com محمد آزادبخت Mohammad Azadbakht استاد، گروه فارماکوگنوزی و بیوتکنولوژی، دانشکده داروسازی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران azadbakhtm@hotmail.com حسین عسگری راد Hossein Asgarirad استاد، گروه فارماسیوتیکس، دانشکده داروسازی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران asgariwww@outlook.com لاله واحدی Lale Vahedi استاد، گروه پاتولوژی، دانشکده ی پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران lalevahedi@gmail.com علی داوودی Ali Davoudi استادیار، گروه فارماکوگنوزی و بیوتکنولوژی، دانشکده داروسازی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران davoodi@gmaiol.com صبا غلامی Saba Gholami دانشجوی کارشناسی پرستاری، دانشکده پرستاری، دانشگاه آزاد اسلامی علی آباد کتول، گلستان، ایران ایران sabagholami@gmail.com فاطمه اکبری Fatemeh Akbari استادیار، گروه فارماکوگنوزی، دانشکده داروسازی، دانشگاه علوم پزشکی سمنان، سمنان، ایران ایران akbariftm@yahoo.com burn wound healing traditional medicine Trigonella foenum-graceum L. convolvulus arvensis L. بهبود زخم سوختگی طب سنتی شنبلیله پیچک صحرایی 1. Nasiri E, Hosseinimehr SJ, Azadbakht M, Akbari J, Enayati-Fard R, Azizi S, et al. The healing effect of Arnebia euchroma ointment versus silver sulfadiazine on burn wounds in rat. World J Plast Surg 2015; 4(2): 134-144.##2. Hoogewerf CJ, Hop MJ, Nieuwenhuis MK, Oen IM, Middelkoop E, Van Baar ME. Topical treatment for facial burns. Cochrane Database Syst Rev 2020; 7(7): CD008058.##3. Wang Y, Beekman J, Hew J, Jackson S, Issler-Fisher AC, Parungao R, et al. Burn injury: challenges and advances in burn wound healing, infection, pain and scarring. Adv Drug Deliv Rev 2018; 123: 3-17.##4. Bahramsoltani R, Farzaei MH, Abdolghaffari AH, Rahimi R, Samadi N, Heidari M, et al. Evaluation of phytochemicals, antioxidant and burn wound healing activities of Cucurbita moschata Duchesne fruit peel. Iran J Basic Med Sci 2017; 20(7): 798-805 (Persian).##5. Murlidhar M, Goswami T. A review on the functional properties, nutritional content, medicinal utilization and potential application of fenugreek. J Food Process Technol 2012; 3(9).##6. Nagulapalli Venkata KC, Swaroop A, Bagchi D, Bishayee A. A small plant with big benefits: Fenugreek (Trigonella foenum‐graecum Linn.) for disease prevention and health promotion. Mol Nutr Food Res 2017; 61(6): 1600950.##7. Azman NAM, Gallego MG, Juliá L, Fajari L, Almajano M. The effect of Convolvulus arvensis dried extract as a potential antioxidant in food models. Antioxidants 2015; 4(1): 170-184.##8. Al-Rifai A, Aqel A, Al-Warhi T, Wabaidur SM, Al-Othman ZA, Badjah-Hadj-Ahmed AY. Antibacterial, antioxidant activity of ethanolic plant extracts of some Convolvulus species and their DART-ToF-MS profiling. Evid Based Complement Alternat Med 2017; 2017: 5694305.##9. Sowemimo B, Farnsworth N. Phytochemical investigation of Convolvulus arvensis (Convolvulaceae). J Pharm Sci 1973; 62(4): 678-679.##10. Molyneux RJ, Pan Y, Goldmann A, Tepfer DA, Elbein A. Calystegins, a novel class of alkaloid glycosidase inhibitors. Arch Biochem Biophys 1993; 304(1): 81-88.##11. Naidu MM, Shyamala B, Naik JP, Sulochanamma G, Srinivas P. Chemical composition and antioxidant activity of the husk and endosperm of fenugreek seeds. LWT-Food Sci Technol 2011; 44(2): 451-456.##12. Akbari F, Azadbakht M, Bagheri A, Vahedi L. In Vitro and In Vivo Wound Healing Activity of Astragalus floccosus Boiss. (Fabaceae). Adv Pharmacol Sci 2022; 2022: 7865015.##13. Pękal A, Pyrzynska K. Evaluation of aluminium complexation reaction for flavonoid content assay. Food Anal Methods 2014; 7(9): 1776-1782.##14. Sharififar F, Khazaeli P, Alli N. In vivo evaluation of anti-inflammatory activity of topical preparations from Fenugreek (Trigonella foenum-graecum L.) seeds in a cream base. Iranian Journal of Pharmaceutical Sciences 2009; 5(3): 157-162 (Persian).##15. Al-Snafi AE. The pharmacology of Equisetum arvense-A review. IOSR Journal of Pharmacy (IOSRPHR) 2017; 7(2): 31-42.##16. Panche AN, Diwan AD, Chandra SR. Flavonoids: an overview. J Nutr Sci 2016; 5.##17. Nasiri E, Hosseinimehr SJ, Azadbakht M, Akbari J, Enayati-Fard R, Azizi S. Effect of Malva sylvestris cream on burn injury and wounds in rats. Avicenna Phytomed J 2015; 5(4): 341-354 (Persian).##18. Yuniarti WM, Lukiswanto BS. Effects of herbal ointment containing the leaf extracts of Madeira vine (Anredera cordifolia (Ten.) Steenis) for burn wound healing process on albino rats. Vet World 2017; 10(7): 808-813.##19. Nascimento EGd, Sampaio TBM, Medeiros AC, Azevedo EPd. Evaluation of chitosan gel with 1% silver sulfadiazine as an alternative for burn wound treatment in rats. Acta Cir Bras 2009; 24(6): 460-465.##20. Akbari F, Azadbakht M, Bagheri A, Vahedi L. In Silico, In Vitro, and In Vivo Wound Healing Activity of Astragalus microcephalus Willd. Adv Pharmacol Pharm Sci 2022; 2022: 2156629.##21. Sayar H, Gergerlioglu N, Seringec N, Ozturk P, Bulbuloglu E, Karabay G. Comparison of efficacy of topical phenytoin with hypericin in second-degree burn wound healing: an experimental study in rats. Med Sci Monit Basic Res 2014; 20: 36-46.## ##

سطوح پایین سلنیوم در بیماران مبتلا به سارکوئیدوز مراجعه کننده به بیمارستان‌های آموزشی دانشگاه علوم پزشکی مازندران Low Selenium Levels in Patients with Sarcoidosis in Teaching Hospitals at Mazandaran University of Medical Sciences 1 1  سابقه و هدف: اخیرا مطالعات بسیاری بر روی نقش سلنیوم در بیماری‌های خودایمنی انجام شده است. کمبود عناصر کم  مقدار هم‌چون سلنیوم یک یافته شایع در بیماری‌های خودایمنی است. این کمبود ممکن است نتیجه بیماری‌های التهابی و یا علت آن‌ها باشد. هدف از این مطالعه بررسی سطح سلنیوم در بیماران مبتلا به سارکوییدوز و مقایسه آن با افراد سالم در بیمارستان‌های آموزشی دانشگاه علوم پزشکی مازندران بود. مواد و روش‌ها: در این مطالعه مورد- شاهدی، سطح سرمی سلنیوم در 42 بیمار مبتلا به سارکوئیدوز اندازه‌گیری شد و با 42 فرد سالم که از لحاظ سنی و جنسی با گروه بیمار همسان‌سازی شده بودند، مقایسه شد. بدین صورت که، 2 سی‌سی خون از نمونه‌های مورد مطالعه (بدون ناشتایی) گرفته شد و به آزمایشگاه ارسال شد. سپس میزان سلنیوم سرم به روش AAS (Atomic absorption spectrometry) اندازه‌گیری شد. سطح نرمال سلینوم نیز بین 46 تا 143 میکروگرم/لیتر می‌باشد. یافته‌ها: میانگین سنی افراد مورد مطالعه در گروه شاهد 23 /7 ±24 /47 سال و در گروه مورد 6 /7± 45 /47 سال بود، که تفاوت معناداری بین دو گروه وجود نداشت ( 898/0=P). سطح سرمی سلنیوم در بیماران به طور معناداری پایین‌تر از گروه کنترل بود (11/ 24± 82/42  در مقابل 27/01 ±79 /94 میکروگرم/لیتر،  0/03=P). در گروه بیماران، اختلاف آماری معناداری بین سطح سرمی سلنیوم با جنسیت وجود نداشت (0/165=P). ارتباطی بین سن( 0/258=P)، مدت زمان ابتلا به بیماری(0/121=P)، مدت زمان درمان(0/837=P)، تاخیر در شروع درمان(0/316=P) و نوع داروی مصرفی(0/859=P) با سطح سرمی سلنیوم وجود نداشت. استنتاج: سطح سرمی سلنیوم در بیماران مبتلا به سارکوئیدوز به‌طور معناداری پایین‌تر از گروه کنترل بود، که با توجه به آن ممکن است تجویز مکمل‌های سلنیوم در این بیماران، کمکی در جهت درمان باشد 2  Background and purpose: Recently, many studies have been conducted on the role of selenium in autoimmune diseases. Trace element deficiency is not an uncommon finding in autoimmune diseases. This deficiency may be a consequence of autoimmune diseases or may contribute to their aetiology. The aim of this study was to investigate the level of selenium in patients with sarcoidosis compared to healthy controls in teaching hospitals affiliated with Mazandaran University of Medical Sciences. Materials and methods: In this case-control study, serum selenium levels were measured in 42 patients with sarcoidosis and compared with 42 healthy, age- and sex-matched controls. Two cc non-fasting blood samples were collected. The serum selenium level was measured using Atomic Absorption Spectrometry (AAS). The normal range for serum selenium is between 46 to 143 micrograms per liter. Results: The mean ages in the case group and controls were 47.45±7.6 and 47.24±7.23 years, respectively (P=0.898). Serum selenium levels were significantly lower than the controls (82.42±24.11 vs. 94.79±27.01 µg/ml, P=0.03). In case group, there was no significant difference between serum selenium levels and sex (P=0.165). The study showed no relationship between serum selenium levels and age (P=0.258), duration of disease (P=0.121), duration of treatment (P=0.837), delay in initiation of treatment (P=0.316), and type of treatment (P=0.859). Conclusion: Serum selenium levels were significantly lower in patients with sarcoidosis than the healthy controls, so, these patients may benefit from selenium supplements.   154 159 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/32022/09/7 1401/6/16 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/202023/05/20 1402/2/30 ارمغان کاظمی نژاد Armaghan Kazeminejad استادیار، دپارتمان پوست، بیمارستان بوعلی سینا، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران armaghanjgh@yahoo.com لیلا پاکدل Leila Pakdel گروه داخلی، بیمارستان امام خمینی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران leyla.pakdel@gmail.com لطف اله داوودی Lotfollah Davoodi دانشیار، گروه عفونی، مرکز تحقیقات مقاومت‌های میکروبی، پژوهشکده بیماری‌های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران lotfdavoodi@yahoo.com جمشید یزدانی چراتی Jamshid Yazdani Cherati استاد، گروه آمار زیستی، مرکز تحقیقات علوم بهداشتی، پژوهشکده ترک اعتیاد، دانشکده بهداشت، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران jamshid.charati@gmail.com سحر خسروی Sahar Khosravi پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران sahar.khosravi@gmail.com عرفان قدیرزاده Erfan Ghadirzadeh دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران er.ghadirzadeh@gmail.com امیرمسعود طاهری Amirmasoud Taheri پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران t.amirmasoud@yahoo.com sarcoidosis selenium autoimmune inflammation immunity سارکوئیدوز سلنیوم خودایمنی التهاب ایمنی 1. Rybicki BA, Iannuzzi MC, Frederick MM, Thompson BW, Rossman MD, Bresnitz EA, et al. Familial aggregation of sarcoidosis. A case-control etiologic study of sarcoidosis (ACCESS). Am J Respir Crit Care Med 2001; 164(11): 2085-2091.##2. Salah S, Abad S, Brézin AP, Monnet D. Sarcoïdose. J Fr Ophtalmol 2019; 42(3): 303-321.##3. Huang Z, Rose AH, Hoffmann PR. The role of selenium in inflammation and immunity: from molecular mechanisms to therapeutic opportunities. Antioxid Redox Signal 2012; 16(7): 705-743.##4. Hadjibabaie M, Iravani M, Shamshiri AR, Zaker Z, Mousavi A, Alimoghaddam K, et al. The prevalence of low selenium levels in adult patients undergoing bone marrow transplantation: a brief communication. Nutr Cancer 2008; 60(6): 837-839.##5. Javanbakht M, Daneshpazhooh M, Chams-Davatchi C, Eshraghian M, Zarei M, Chamari M, et al. Serum selenium, zinc, and copper in early diagnosed patients with pemphigus vulgaris. Iran J Public Health 2012; 41(5): 105-109.##6. Yu N, Han F, Lin X, Tang C, Ye J, Cai X. The Association Between Serum Selenium Levels with Rheumatoid Arthritis. Biol Trace Elem Res 2016; 172(1): 46-52.##7. El-Tahlawi SM, El-Ramly AZ, El-Nabarawy E, Abd El-Ghaffar N, Emam H, Hussein MM. Serum selenium levels in alopecia areata. J Egypt Women's Dermatol Soc 2012; 9(3): 174-177.##8. Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol 2017; 2017: 1297658.##9. Akinboro AO, Mejiuni DA, Onayemi O, Ayodele OE, Atiba AS, Bamimore GM. Serum selenium and skin diseases among Nigerians with human immunodeficiency virus/acquired immune deficiency syndrome. HIV/AIDS (Auckl) 2013; 5: 215-221.##10. Toossi P, Sadat Amini SH, Sadat Amini MS, Partovi Kia M, Enamzade R, Kazeminejad A, et al. Assessment of serum levels of osteopontin, selenium and prolactin in patients with psoriasis compared with healthy controls, and their association with psoriasis severity. Clin Exp Dermatol 2015; 40(7): 741-746.##11. Önal S, Nazıroğlu M, Çolak M, Bulut V, Flores-Arce MF. Effects of different medical treatments on serum copper, selenium and zinc levels in patients with rheumatoid arthritis. Biol Trace Elem Res 2011; 142(3): 447-455.##12. Moraes MLd, Ramalho DMdP, Delogo KN, Miranda PFC, Mesquita EDD, Oliveira HMdMGd, et al. Association between serum selenium level and conversion of bacteriological tests during antituberculosis treatment. J Bras Pneumol 2014; 40: 269-278.## ##

بررسی میزان آنتی اکسیدان‌های بزاق در بیماران مبتلا به آبسه حاد اپیکال، قبل و بعد از درمان ریشه Salivary Antioxidants in Patients with Acute Apical Abscess before and after Root Canal Treatment 1 1  سابقه و هدف: آنتی‌اکسیدان‌‌ها می‌توانند از آسیب اکسیداتیو ناشی از افزایش تولید رادیکال‌های آزاد در بیماری‌های دهان و دندان جلوگیری کنند. در این مطالعه به بررسی میزان ظرفیت کلی آنتی‌اکسیدان (TAC) بزاق در بیماران مبتلا به آبسه‌ حاد اپیکال، قبل و بعد از درمان ریشه و مقایسه‌ آن با گروه کنترل پرداخته شده است. مواد و روش‌ها: در این مطالعه‌ مورد- شاهدی، نمونه ‌برداری از میزان آنتی‌‌اکسیدان بزاق 20 نفر از بیماران مبتلا به آبسه‌ حاد اپیکال، قبل و سه هفته بعد از درمان ریشه انجام شد. علاوه بر این 20 فرد سالم (فاقد پوسیدگی و آبسه دندانی و بدون داشتن بیماری‌های سیستمیک)، به‌عنوان گروه کنترل در نظر گرفته شد. برای اندازه‌گیری میزان آنتی‌اکسیدان نمونه‌های بزاق از روش توانایی پلاسما در احیای یون‌های فریک(FRAP) استفاده و TAC نمونه‌ها ارزیابی شد. سپس تمامی داده‌ها جمع‌آوری و آنالیز آماری با استفاده از آزمون آماری T-test و نرم‌افزار SPSS نسخه 16 انجام شد. یافته‌ها: میزان TAC بزاق افراد در گروه‌ مورد قبل از درمان برابر µmol/L 174/9±298/8 و بعد از درمان برابر µmol/L 145/2±450/9 حاصل شد، که این افزایش از نظر آماری معنی‌دار بود(0/009=P). اما TAC گروه مورد پس از درمان ریشه و گروه کنترل اختلاف آماری معنی‌داری نداشت(0/056=P). استنتاج: نتایج این مطالعه نشان داد، درمان مؤثر آبسه حاد اپیکال می‌تواند باعث افزایش ظرفیت کلی آنتی‌‌اکسیدانی و کاهش استرس اکسیداتیو شده و نقش مؤثری در ترمیم صدمات ناشی از فعالیت رادیکال‌های آزاد داشته باشد.   2  Background and purpose: Antioxidants can prevent oxidative damage caused by increased production of free radicals in oral and dental diseases. In this research, the total antioxidant capacity (TAC) of saliva in patients with acute apical abscess before and after root canal treatment was investigated and compared with a control group. Materials and methods: In this case-control study, salivary antioxidant levels of 20 patients with acute apical abscess were collected before and three weeks after root canal treatment. Also, 20 healthy people (without tooth decay and abscess and without any systemic diseases) were considered as the control group. The ferric reducing ability of plasma (FRAP) was used to measure total antioxidant in the saliva samples and the TAC was evaluated. Then, all data were analyzed in SPSS V16. Results: The mean salivary TAC in the case group was 298.8±174.9 µmol/L before treatment and 450.9±145.2 µmol/L after treatment (P=0.009). However, there was no significant difference in the TAC between the case group after root canal treatment and the control group (P=0.056). Conclusion: This study showed that effective treatment of acute apical abscess can increase the overall antioxidant capacity, reduce oxidative stress, and have an effective role in repairing the damage caused by the activity of free radicals.   160 165 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/32022/09/72023/04/18 1402/1/29 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/202023/05/202023/06/28 1402/4/7 صدیقه ابراهیمی پور Sediqe Ebrahimipour دانشیار، گروه اندودانتیکس، دانشکده دندانپزشکی، دانشگاه علوم پزشکی بیرجند، بیرجند، ایران ایران sdent22@gmail.com کوثر خسروی Kowsar Khosravi دندانپزشک عمومی، دانشکده دندانپزشکی، دانشگاه علوم پزشکی بیرجند، بیرجند، ایران ایران km.Khosravi77@gmail.com محدثه بنی‌اسدی Mohadese Baniasadi دستیار تخصصی درمان ریشه، دانشکده دندانپزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران ایران BaniasadiM991@mums.ac.ir total antioxidant capacity saliva acute apical abscess ferric reducing ability of plasma ظرفیت کلی آنتی‌اکسیدان بزاق آبسه حاد اپیکال توانایی پلاسما در احیای یون‌های فریک 1. Siqueira Jr JF, Rôças IN. Microbiology and treatment of acute apical abscesses. Clin Microbiol Rev 2013; 26(2): 255-273. ##2. Cope A, Francis N, Wood F, Mann MK, Chestnutt IG. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. Cochrane Database Syst Rev 2014; 6(1): Art. No. CD010136. DOI: 10.1002/14651858.CD010136.pub2.##3. Dezerega A, Madrid S, Mundi V, Valenzuela MA, Garrido M, Paredes R, et al. Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response. J Inflamm 2012 ;9(1):8.##4. Inchingolo F, Marrelli M, Annibali S, Cristalli MP, Dipalma G, Inchingolo AD, et al. Influence of endodontic treatment on systemic oxidative stress. Int J Med Sci 2013; 11(1): 1-6.##5. Chapple IL, Matthews JB. The role of reactive oxygen and antioxidant species in periodontal tissue destruction. Periodontology 2007; 43(1): 160-232.##6. Tartaglia GM, Gagliano N, Zarbin L, Tolomeo G, Sforza C. Antioxidant capacity of human saliva and periodontal screening assessment in healthy adults. Archives of Oral Biology 2017; 78: 34-38 (Persian).##7. D’aiuto F, Nibali L, Parkar M, Patel K, Suvan J, Donos N. Oxidative stress, systemic inflammation, and severe periodontitis. J Dent Res 2010; 89(11): 1241-1246.##8. Baser U, Gamsiz-Isik H, Cifcibasi E, Ademoglu E, Yalcin F. Plasma and salivary total antioxidant capacity in healthy controls compared with aggressive and chronic periodontitis patients. Saudi Med J 2015; 36(7): 856-861.##9. Vengerfeldt V, Mändar R, Saag M, Piir A, Kullisaar T. Oxidative stress in patients with endodontic pathologies. J Pain Res 2017; 10: 2031-2040.##10. Alvarez M, De Jesús RM, Morales G, Magali M, Quen G, Margarita P, et al. Hypolipidemic activity of Phaseolus vulgaris (Fabaceae) in mice. ECORFAN Journal-Bolivia 2022; 9(17): 1-9.##11. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. Missouri.WB Saunders. Elsevier; 2016. p. 604-605.##12. Ranganath A, Magesh M. Evaluation of oxidative stress levels in patients undergoing endodontic treatment-an in vivo study. Int J Endod Rehabil 2022; 18(6): 1-5.##13. Aksoy U, Savtekin G, Şehirli AÖ, Kermeoğlu F, Kalender A, Özkayalar H, et al. Effects of alpha‐lipoic acid therapy on experimentally induced apical periodontitis: a biochemical, histopathological and micro‐CT analysis. Int Endod J 2019; 52(9): 1317-1326.##14. Szczeklik K, Krzyściak W, Cibor D, Domagała-Rodacka R, Pytko-Polończyk J, Mach T, et al. Markers of lipid peroxidation and antioxidant status in the serum and saliva of patients with active Crohn disease. Pol Arch Intern Med 2018; 128(6): 362-370.##15. Hasan NA, mohammed SA, Saeed AY. Evaluation and comparison of total antioxidant capacity of saliva in patients with and without chronic periodontitis patient. Duhok Med J 2022; 16(2): 1-10.##16. Darczuk D, Krzysciak W, Vyhouskaya P, Kesek B, Galecka-Wanatowicz D, Lipska W, et al. Salivary oxidative status in patients with oral lichen planus. J Physiol Pharmacol 2016; 67(6): 885-894.##17. Ahmadi-Motamayel F, Goodarzi MT, Mahdavinezhad A, Jamshidi Z, Darvishi M. Salivary and serum antioxidant and oxidative stress markers in dental caries. Caries Res 2018; 52(6): 565-569.##18. Zovari F, Parsian H, Bijani A, Moslemnezhad A, Shirzad A. Evaluation of salivary and serum total antioxidant capacity and lipid peroxidation in postmenopausal women. Int J Dent 2020 ;2020: 8860467.## ##

بررسی ویژگی‌های کلینکی مبتلایان به زونا بر حسب سن در شهرستان ساری Clinical Features of Patients with Herpes zoster According to Age, in Sari, Iran 1 1  سابقه و هدف: بیماری زونا در افراد مسن‌تر، بیش‌تر بروز پیدا می‌کند که شناخته شده‌ترین علل آن کاهش عملکرد سیستم ایمنی بدن و وجود بیماری‌های زمینه‌ای در این افراد می‌باشد. این مطالعه با هدف بررسی ویژگی‌های کلینیکی مبتلایان به زونا بر حسب سن در شهرستان ساری، انجام پذیرفت. مواد و روش‌ها: در این مطالعه توصیفی- تحلیلی گذشته‌نگر، افراد مورد مطالعه شامل کلیه بیماران بستری یا تحت درمان سرپایی، با تشخیص زونا در سال‌های ۹۷-۹۵ در بیمارستان‌های ساری که اطلاعات پرونده‌ای آن‌ها کامل بوده است، می‌باشد. اطلاعات به صورت سرشماری و با بهره‌گیری از اطلاعات موجود پرونده‌های بایگانی، جمع‌آوری گردید. یافته‌ها: تعداد بیماران وارد شده به مطالعه 180 نفر بودند که گروه‌بندی افراد براساس سن آن‌ها صورت گرفت. در افراد زیر ۵0 سال ۹۷ نفر بیماری زمینه‌ای خاصی نداشتند، 6 نفر مبتلا به دیابت بودند 4 نفر مبتلا به فشارخون، 3 نفر به بدخیمی و 12 نفر به بیماری قلبی عروقی مبتلا بودند. در افراد بالای ۵0 سال نیز 21 نفر فاقد بیماری زمینه‌ای، 15 نفر مبتلا به دیابت، 2 نفر مبتلا به فشارخون، 11 نفر مبتلا به بدخیمی و ۹ نفر مبتلا به بیماری قلبی عروقی بودند. وجود بیماری زمینه‌ای در بیماران مبتلا به بدخیمی و دیابت بالای پنجاه سال مبتلا به زونا به‌طور معناداری از افراد زیر 50 سال بالاتر بوده است(0/042P= و 0/05P=). استنتاج: با توجه به ریسک فاکتورهای مطرح شده در این مطالعه و مخصوصا در افراد مسن، در افراد مبتلا به بیماری زمینه‌ای یا افرادی که داروهای سرکوب‌کننده سیستم ایمنی مصرف می‌کنند، باید با دقت بیش‌تری تحت نظر گرفته شوند و به محض ابتلا به بیماری درمان به سرعت آغاز شود تا از بروز عوارض شدید آن در این افراد جلوگیری شود.   2  Background and purpose: Reduced function of immune system and underlying diseases make older people more susceptible to Shingles (herpes zoster). The present study aimed to compare the clinical findings and underlying conditions between patients with herpes zoster under 50 years and over 50 years of age. Materials and methods: This cross-sectional descriptive study included all patients who were admitted or hospitalized in Sari hospitals due to herpes zoster in 2016-2018 with complete medical records. Information was collected by census. Results: There were 180 cases who were investigated according to their age. In patients under 50 years of age, 97 had no underlying diseases, while diabetes, hypertension, malignancy, and cardiovascular diseases were seen in 6, 4, 3, and 12 patients, respectively.  In patients over 50 years of age, 21 were found with no underlying diseases, but 15, 2, 11, and 9 cases had diabetes, hypertension, different types of malignancies, and cardiovascular diseases, respectively. The frequency of underlying diseases in patients with cancer and diabetes in patients with herpes zoster were significantly higher in people over 50 years of age (P= 0.042 and P= 0.05). Conclusion: Given the risk factors presented in this study, patients with underlying diseases or those on immunosuppressive drugs are required to be closely monitored and receive early treatments as soon as developing herpes zoster to avoid severe complications.   166 170 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/32022/09/72023/04/182023/02/1 1401/11/12 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/202023/05/202023/06/282023/06/12 1402/3/22 لطف اله داودی Lotfollah Davoodi دانشیار، مرکز تحقیقات مقاومت‌های میکروبی، گروه عفونی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران lotfdavoodi@yahoo.com طهورا موسوی Tahoora Mousavi استادیار، مرکز تحقیقات سلولی مولکولی، پژوهشکده هموگلوبینوپاتی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران stm.jmums@gmail.com مهسا حسن آبادی Mahsa Hasanabadi دانشجوی پزشکی، مرکز تحقیقات مقاومت های میکروبی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران Mahsa.hassanabadi@gmail.com حسین جلالی Hossein Jalali استادیار، مرکز تحقیقات تالاسمی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران Hossein.jalaliakerdi@gmail.com Varicella zoster virus herpes zoster underlying diseases واریسلا زوستر زونا بیماری زمینه‌ای 1. Liesegang TJ. Herpes zoster virus infection. Curr Opin Ophthalmol 2004; 15(6): 531-536.##2. Veronika M, František G. A Possible Role of Human Herpes Viruses Belonging to the Subfamily Alphaherpesvirinae in the Development of Some Cancers. Klin Onkol 2018; 31(3): 178-183.##3. Vrcek I, Choudhury E, Durairaj V. Herpes zoster ophthalmicus: A review for the internist. Am J Med 2017; 130(1): 21-26.##4. Arvin AM. Varicella-zoster virus. Clin Microbiol Rev 1996; 9(3): 361-381.##5. Dolin R, Bennett JE, Blaser JM. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Amsterdam: Elsevier Inc; 2005.##6. Kimberlin DW, Whitley RJ. Varicella–zoster vaccine for the prevention of herpes zoster. N Engl J Med 2007; 356(13): 1338-1343.##7. Cohen JI, Brunell PA, Straus SE, Krause PR. Recent advances in varicella-zoster virus infection. Ann Intern Med 1999; 130(11): 922-932.##8. Yamamoto M, Mine H, Akazawa K, Maehara Y, Sugimachi K. Gastrointestinal cancer and herpes zoster in adults. Hepato-gastroenterology 2003; 50(52): 1043-1046.##9. Mostafavi SN, Ghaffari Hoseini S, Kelishadi R, Ataei B, Safari O, Yaran M, et al. Seroprevalence of varicella zoster infection at provincial level in Iranian adolescents: The CASPIAN-III study. Arch Pediatr Infect Dis 2017; 5(4): e61647.##10. Babamahmoodi F, Alikhani A, Ahangarkani F, Delavarian L, Barani H, Babamahmoodi A. Clinical manifestations of herpes zoster, its comorbidities, and its complications in north of Iran from 2007 to 2013. Neurology Research International, 2015; 2015: 896098.##11. Zamanian A, Pilehvar M, Farshchian M. The Study of Herpes Zoster in Patients who Referred to the Dermatology Ward of Sina Hospital of Hamadan between 1994-98. Avicenna J Clin Med 2002; 8(4): 0-0 (Persian).##12. Khorvash F, Zare far S, Salehi H. Manifestations, Complications and Underlying Disease Associated with Zona in Al_Zahra Hospital, Isfahan (1375-1385). Pars Journal of Medical Sciences 2007; 5(5): 30-37 (Persian).## ##

درمان علائم افسردگی با رویکرد نوین درمان شناختی رفتاری مذهب محور: مطالعه مرور نظام مند Treatment of Depressive Symptoms Using the New Approach of Religion-Based Cognitive Behavioral Therapy: A Systematic Review 1 1  سابقه و هدف: افسردگی یک بیماری روان‌پزشکی با ایجاد ناتوانی‌های عمده و اثرات منفی بر کیفیت زندگی افراد در سراسر جهان است. در سال‌های اخیر استفاده از روش‌های درمانی جدید و غیردارویی برای بهبود افسردگی بسیار مورد توجه قرار گرفته است. هدف از این پژوهش، مرور نظام‌مند مطالعات اولیه تجربی با موضوع اثربخشی درمان‌شناختی رفتاری مذهب محور در درمان علائم افسردگی می‌باشد. مواد و روش‌ها: این مطالعه مرور نظام‌مند مطابق با راهنمای PRISMA (موارد ترجیحی در گزارش مقالات مروری منظم و فرا تحلیل) اجرا شد. واژه‌های کلیدی افسردگی، درمان شناختی-رفتاری، مذهب محور در پایگاه‌های اطلاعاتی Cochrane library، PubMed، Web of Science، Embase، Magiran SID، International Clinical Trials Registry Platform(ICTRP) و Clinicaltrials.gov و محدود به مقاله‌های فارسی و انگلیسی زبان منتشر شده تا سال 2022 جستجو شد. مطالعاتی در نظر گرفته شد که اثربخشی مداخله درمان‌شناختی-رفتاری مذهب محور در مقایسه با حالت بدون مداخله و یا درمان‌شناختی-رفتاری مرسوم در بهبود علائم افسردگی در بیماران افسرده را بررسی نمودند. سوگرایی مطالعات تجربی و نیمه‌تجربی به‌ترتیب به‌وسیله مقیاس‌های ROB 2 و ROBINS-I ارزیابی شد. یافته‌ها: در جستجوی اولیه، 1037 مقاله یافت شد. بعد از بررسی مطالعات از نظر معیارهای ورود و و خروج و ارزیابی کیفی مقالات، در نهایت 20 مقاله با مجموع 1682 نمونه برای مرور نظام‌مند انتخاب شدند. بیش‌ترین نمونه‌ها از بین جمعیت زنان بود و بیش‌ترین فراوانی مربوط به انواع اختلال افسردگی ماژور و افسرده خویی بود. تمامی نتایج مطالعات منتخب حاکی از اثر بخشی درمان شناختی-رفتاری مبتنی بر مذهب در کاهش علائم افسردگی بود. استنتاج: اجرای مطالعات تجربی با حجم نمونه بزرگ‌تر جهت بررسی نقش متغیر جنسیت و انواع اختلالات افسردگی در زمینه کارایی مداخله CBT مذهب محور بر کاهش شدت افسردگی پیشنهاد می‌شود.   2  Background and purpose: Depression is a psychiatric disorder that causes major disabilities and has negative effects on the quality of life of people all over the world. In recent years, non-pharmacological treatments that may improve depression have received much attention. The purpose of this research was to systematically review primary experimental studies on the effectiveness of religion-based cognitive behavioral therapy (CBT) in treatment of depression symptoms. Materials and methods: This systematic review was carried out using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The search was performed in Cochrane library, PubMed, Web of Science, EMbase, Magiran SID, International Clinical Trials Registry Platform (ICTRP), and Clinicaltrials.gov using the following keywords:  depression, cognitive-behavioral therapy, and religion-based. The search was limited to articles published in Farsi and English until 2022. We studied articles that investigated the effectiveness of religion-based cognitive-behavioral therapy compared to no intervention or conventional cognitive-behavioral therapy in improving depressive symptoms. Bias assessment of experimental and semi-experimental studies was done by RoB 2 and ROBINS-I scales, respectively. Results: In the initial search, 1037 articles were found. Considering inclusion criteria and qualitative evaluation of the articles, finally 20 studies were selected. A total of 1682 samples were studied in these articles. The majority of samples were female patients, and major depressive disorder and depressive mood were the most common disorders. All studies indicated the effectiveness of religion-based CBT in reducing depressive symptoms. Conclusion: Further experimental studies with larger sample size are needed to investigate the role of gender and different types of depression on the effectiveness of religion-based CBT in reducing the severity of depression.   171 184 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/32022/09/72023/04/182023/02/12022/08/12 1401/5/21 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/202023/05/202023/06/282023/06/122023/06/11 1402/3/21 محمدامین جندقیان بیدگلی Mohammadamin Jandaghian-Bidgoli دانشجوی کارشناسی ارشد پرستاری روان پرستاری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران ایران mohammadaminjandaghian@sbmu.ac.ir نگین شاطریان Negin Shaterian دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی کاشان، کاشان، ایران ایران negin_shaterian@yahoo.com فرشته قربانی Fereshteh Qorbani کارشناسی ارشد مدیریت، دانشگاه علوم پزشکی البرز، کرج، ایران ایران qfereshteh@yahoo.com سید هادی پژوم Seyed Hadi Pazhoom کارشناسی ارشد مدیریت، دانشگاه علوم پزشکی البرز، کرج، ایران ایران الهام کاظمیان Elham Kazemian دکترای تخصصی علوم تغذیه، گروه پزشکی، موسسه جامع سرطان ساموئل اوشین، مرکز پزشکی سدار سینای، لس آنجلس، کالیفرنیا، ایالات متحده آمریکا امریکا kazemianelham@yahoo.com فاطمه عبدی Fatemeh Abdi استادیار، مرکز تحقیقات بیماری های غیرواگیر، دانشگاه علوم پزشکی البرز، کرج، ایران ایران abdi@sbmu.ac.ir depression religion-based cognitive behavioral therapy systematic review افسردگی درمان شناختی رفتاری مذهب محور مرور نظام‌مند 1. 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توسعه داربست‌های مهندسی بافت به منظور کشت سلول‌های سرطانی Development of Tissue Engineering Scaffolds for Cancer Cell Cultures 1 1  تکنیک کشت سلول یکی از ابزارهایی است که در مطالعات زیست سلولی و مولکولی مانند کشت سلول‌های سرطانی، پزشکی بازساختی و طراحی دارو مورد استفاده قرار می‌گیرد. در سال‌های اخیر، کشت سلول سه بعدی در تحقیقات سرطان مورد توجه قرار گرفته است. داربست‌ها، ساختارهای متخلخلی هستند که در کشت سلول سه‌ بعدی استفاده شده و توانایی شبیه‌سازی محیط سه بعدی بافت‌های سرطانی را دارند و اطلاعات دقیق تری از برهمکنش سلول‌های توموری، سلول با ماتریکس خارج سلولی و هم‌چنین ویژگی‌های توموری می‌دهند. این داربست‌ها بر پایه پلیمرهای سنتزی و یا اجزای ماتریکس خارج سلولی هستند و می‌توانند مسیرهای پیام رسانی، بقا و تکثیر سلول‌های سرطانی را تقویت کنند. پلیمرهای طبیعی و سنتزی، هیدروژل‌ها، میکروسفرها می‌توانند برای ساخت داربست‌های سه بعدی مورد استفاده قرار گیرند. تکنولوژی کشت سلول های سه بعدی سرطان می‌تواند باعث پیشرفت در مسیر درمان سرطان شود. این مقاله مروری به پیشرفت‌های اخیر در حوزه مدل‌های سه بعدی مبتنی بر داربست در بافت‌های سرطانی اشاره می‌کند.   2  The cell culture technique is one of the tools used in cellular and molecular biology such as cancer cell culture, regenerative medicine, and drug discovery. In recent years, three-dimensional (3D) cell culture has gained attention in cancer research. Scaffolds are porous structures that are used in 3D cell culture to mimic the 3D architecture of tissues and provide more accurate information about tumor cells, extracellular matrix (ECM), and tumor characteristics. These scaffolds are based on synthetic polymers or ECM components and can promote the signaling pathways, survival, and proliferation of cancer cells. Natural and synthetic polymers, hydrogels and microspheres can be used to make 3D scaffolds. 3D cancer cell culture technology can improve cancer treatment. This review article discusses recent advances in the field of scaffold-based 3D models in cancer tissues.   185 213 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/32022/09/72023/04/182023/02/12022/08/122023/02/11 1401/11/22 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/202023/05/202023/06/282023/06/122023/06/112023/06/12 1402/3/22 سیده مریم ولی زاده اطاقسرا Seyede Maryam Valizadeh Otaghsara دکتری تخصصی بیوتکنولوژی پزشکی، دانشکده فناوری های نوین، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران ایران maryamvallizade@gmail.com حسن داریوش نژاد Hassan Dariushnejad استادیار، گروه آموزشی زیست فناوری پزشکی، دانشکده علوم پزشکی، دانشگاه علوم پزشکی لرستان، لرستان، ایران ایران dariushnejad@gmail.com امیر ملتی Amir Mellati استادیار، گروه آموزشی مهندسی بافت و سلول‌های کاربردی، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران amirmellati@gmail.com الهام حسن زاده Elham Hasanzadeh استادیار، گروه آموزشی مهندسی بافت و سلول‌های کاربردی، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران hasanzadeh.elham88@gmail.com مژگان عباسی Mozhgan Abasi استادیار، گروه آموزشی مهندسی بافت و سلول‌های کاربردی، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران mozhgan.abasi@yahoo.com پدرام ابراهیم نژاد Pedram Ebrahimnejad دانشیار، گروه فارماسیوتیکس، دانشکده داروسازی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران pedram.ebrahimnejad@gmail.com three-dimensional cell culture scaffold cancer hydrogel extracellular matrix tissue engineering microfluidic systems 3D printing microspheres organoid کشت سه بعدی داربست سرطان هیدروژل ماتریکس خارج سلولی مهندسی بافت سیستم‌های میکروسیالی چاپگرهای 3 بعدی میکروسفر ارگانوئید 1. 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تکنیک‌های پیشرفته کمیت سنجی نیتروزو دی اتانول آمین در فرآورده های آرایشی Advanced Techniques for Quantification of N-nitrosodiethanolamine in Cosmetic Products 1 1  لوازم آرایشی و بهداشتی، محصولات صنعتی شیمیایی هستند که روزانه به منظور پاکسازی و مراقبت از سلامت و زیبایی استفاده می‌شوند. در این فرآورده‌ها احتمال حضور آلودگی‌هایی از جمله فلزات سنگین، مواد شیمیایی ناخواسته و سایر مواد خطرزا وجود دارد، که می‌توانند منجر به آلودگی‌های محیطی و ایجاد انواع بیماری‌ها و عوارض جانبی فیزیولوژیکی در انسان شوند. از جمله آلودگی‌های ناخواسته ایجاد شده در حین تولید محصولات، ترکیبات نیتروزآمینی می‌باشند. در سال‌های اخیر، انواع روش‌های آنالیز برای تشخیص کیفی و کمّی انواع ترکیبات نیتروزآمینی در محصولات متعدد به‌کار رفته است و تکنیک‌های مختلفی جهت ساماندهی و حل محدودیت‌های روش‌های پیشین طراحی شده است. لذا مطالعه حاضر با هدف مروری بر روش‌های نوین توسعه یافته برای تشخیص این عامل، از جمله تکنیک‌های میکرو استخراج و کاربرد فناوری نانو جهت طراحی روش‌های آنالیز دقیق و نانو حسگرهای با حساسیت بالا جهت غلبه بر محدودیت‌های روش‌های موجود و طراحی سامانه‌های کاربردی و مقرون به صرفه، انجام شده است.   2  Cosmetics are daily chemical industrial products used for cleaning, health care, and beauty purposes. Sometimes these products are contaminated by heavy metals, unwanted chemicals, and other dangerous substances that can lead to environmental pollution and cause various diseases and physiological side effects in humans. N-nitrosodiethanolamine compounds are among the unwanted contaminants created during the production of cosmetic products. In recent years, various qualitative and quantitative analytical methods have been used for detection of nitrosamine compounds in many products, and various techniques were developed to address the limitations of previous methods. This study reviewed approaches developed to detect N-nitrosodiethanolamine compounds, including microextraction techniques and application of nanotechnology in order to design accurate analytical methods and high sensitivity nanosensors to overcome the limitations of current methods and designing practical and cost-effective systems.   214 225 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/32022/09/72023/04/182023/02/12022/08/122023/02/112023/01/3 1401/10/13 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/202023/05/202023/06/282023/06/122023/06/112023/06/122023/06/12 1402/3/22 زهرا ولی پناه Zahra Valipanah دانشجوی کارشناسی ارشد نانوفناوری پزشکی، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران zahravph@yahoo.com ابوالقاسم رحمانی Abolghasem Rahmani دانشجوی کارشناسی ارشد نانوفناوری پزشکی، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران rahmani.mar@yahoo.com پوریا گیل Pooria Gill استاد گروه نانوفناوری پزشکی، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران . مرکز تحقیقات سلامت محصولات گیاهی و دامی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران pooriagill@yahoo.com عادله رافتی Adele Rafati استاد گروه نانوفناوری پزشکی، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران. مرکز تحقیقات سلامت محصولات گیاهی و دامی، دانشگاه علوم پزشکی مازندران، ساری، ایران ایران rafati.adele@gmail.com nitrosamines microextraction nanosensor cosmetics نیتروزآمین میکرو استخراج نانوحسگر محصولات آرایشی 1. 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اصلاحیه : ارتباط بین اختلالات شخصیت والدین با اختلالات روانپزشکی در کودکان و نوجوانان شهرستان ایلام Correction to: Relationship between Personality Disorders in Parents and Psychiatric Disorders in Children and Adolescents in Ilam, Iran 1 1 اصلاحیه : ارتباط بین اختلالات شخصیت والدین با اختلالات روانپزشکی در کودکان و نوجوانان شهرستان ایلام عباس ناصری1      نورالله یادگاری2      یوسف ویسانی2      خیرالله اسدالهی3 مولف مسئول: خیرالله اسداللهی- ایلام: دانشگاه علوم پزشکی ایلام، دانشکده بهداشت                                                     E-mail: masoud_1241@yahoo.co.uk 1. دانشجوی کارشناسی ارشد اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران 2. دانشیار، مرکز تحقیقات آسیب‌های روانی- اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران 3. استاد، گروه اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران در مقاله فوق که در شماره 220 اردیبهشت سال 1402 در دوره 33 این نشریه منتشر شده بود، نام آقای دکتر یوسف ویسانی (در چکیده انگلیسی) و مرتبه علمی ایشان اشتباه چاپ شده بود، اصلاح گردید.   2 Correction to: Relationship between Personality Disorders in Parents and Psychiatric Disorders in Children and Adolescents in Ilam, Iran Abbas Naseri1, Noorollah Yadegari2, Yousef Veisani2, Khairollah Asadollahi3 1 MSc Student in Epidemiology, Faculty of Public Health, Ilam University of Medical Sciences, Ilam, Iran 2 Associate Professor, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran 3 Professor, Department of Epidemiology, School of Health, Ilam University of Medical Sciences, Ilam, Iran In the article published in volume 33, issue 220, 2023, the third author’s surname was incorrect. It should have been Yousef Veisani, also his affiliation was incorrect, which both are now corrected.   226 227 2022/12/182023/02/232022/11/262022/07/12023/01/282023/01/22022/12/252022/11/92023/04/52022/06/272022/12/212023/01/122021/11/32022/09/72023/04/182023/02/12022/08/122023/02/112023/01/32023/07/5 1402/4/14 2023/06/192023/06/112023/05/222023/05/232023/05/272023/06/122023/06/72023/05/312023/05/232023/06/132023/06/122023/06/122023/05/202023/05/202023/06/282023/06/122023/06/112023/06/122023/06/122023/07/1 1402/4/10 عباس ناصری Abbas Naseri دانشجوی کارشناسی ارشد اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران نورالله یادگاری Noorollah Yadegari دانشیار، مرکز تحقیقات آسیب‌های روانی- اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران یوسف ویسانی Yousef Veisani دانشیار، مرکز تحقیقات آسیب‌های روانی- اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران خیرالله اسدالهی Khairollah Asadollahi استاد، گروه اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران masoud_1241@yahoo.co.uk erratum erratum اصلاحیه اصلاحیه 1. 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