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Background and purpose: Many authorities believe that university students face challenges in scientific reasoning. Metacognitive skills results in boosting and organized thinking in learning process. Students usually do not know how to use metacognitive skills, thus these skills should be strengthened in students. Material and methods: This comparative-causal study was carried out in 5096 students. Using korjesi and Morgan table, 357 students were randomly selected to participate in the study. The students were studying in undergraduate and postgraduate courses. Metacognitive skills questionnaire was used to collect the data. The student’s grade point average was used as the criterion for academic achievement. SPSS V.16 was applied to analyze the data. Results: The indices of planning, controlling, evaluating, and regulating skills were found to have significant roles in students' academic achievement (P<0.005). Metacognitive skills were found to be more effective in academic achievement in female students. These effects were similar in employed and unemployed students. Conclusion: There was a positive relationship between using metacognitive skills with increase in academic performance. Control skill was the only variable that could predict the students' academic achievement. Metacognitive skills were found to be highly influential in enhancing academic performance among university students. Hence, training programs in metacognitive skills could be of great benefit.

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Background and purpose: Alongside men addiction, the rate of women addiction is increasing. But most studies on this subject are about men. Because addiction among women is on the rise, research is needed to be done on identifying the factors influencing addiction. This research investigated the psychological factors predisposing women to addiction.

Materials and methods: This study was a qualitative study using thematic analysis. Purposive sampling of 32 women dependent on drugs was done. They were selected from those attending addiction clinics in 2015-2016. Data was collected using deep interviews. They were then coded and classified into main categories.

Results: Data analysis showed that the following psychological factors could predispose women to addiction: personality characteristics including sensation seeking, neuroticism, perfectionism; harmful coping styles including emotional and avoidant coping styles; psychological conflicts including conflict in goals, gender role conflict, self conflict; negative experiences such as loss of parents, parental neglect, violence, emotional breakdown; and individual motives including physical or mental benefits.

Conclusion: This research indicated that particular psychological factors could predispose women to addiction. Therefore, the factors causing this problem should be considered in preventing or treatment of these women.

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     Background and purpose: Maternal mental health has a major role in promoting the health of a mother and her family. Father’s involvement in pregnancy is one of the influential factors that promotes mental health in pregnant women. Therefore, this study aimed to determine the effect of paternal-fetal attachment on mothers’ mental health.
Materials and methods: A clinical trial was conducted in 60 primipara mothers and eligible spouses attending two health centers affiliated with Mashhad University of Medical Sciences. Convenient sampling and random assignment was performed. Goldberg's General Health Questionnaire was administered. The fathers in intervention group attended three 120-minute sessions of Attachment training (group discussion) once a week. Then, the effect of these trainings on the mental health of their wives was assessed at three stages: before, immediately after, and three weeks later. Data was analyzed in SPSS V22 applying descriptive and inferential statistics.
Results: Higher scores in mental health represents severity of the symptoms. In this study, the average mental health scores in intervention group at post-test (p=0.038) and follow-up (p=0.001) was significantly lower than those of the control group.
Conclusion: Paternal-fetal attachment therapy was found to be effective in increasing the mother's mental health and committed fathers were observed to have a major role in follow-up assessments.
 

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Background and purpose: Sensory processing is necessary to perform daily activities properly. The aim of this study was to investigate the frequency of sensory processing disorder in children aged 5-11 years old.
Materials and methods: This descriptive cross-sectional study included all children aged 5 to 11 years old in kindergartens and primary schools in Tehran, Iran. Children meeting the inclusion criteria were 2191, selected through multistage cluster sampling. Children parents completed the Dunn Sensory Profile. Participants’ demographic information was recorded and frequency of sensory processing disorder was analyzed in SPSS V22 based on the cut off point of the nine factors of the sensory profile.
Results: The study included 31.3% girls and 68.7% boys. Frequency of sensory processing disorder estimated based on the cut off points of the sensory profile was as follows: sensory seeking: 9.40٪, emotional reactivity: 10.81٪, low muscle tone and endurance: 18.16٪, oral sensory sensitivity: 18.34٪, inattention and distractibility: 7.85٪, poor sensory registration: 15.10٪, sensory sensitivity: 22.22٪, sedentary: 10.17%, and fine movement and perception: 3.60٪.
Conclusion: In this study, children aged 5 to 11 years were found with different patterns in sensory processing. Frequency of sensory processing disorders in all nine factors of sensory profile was higher in boys. Further studies, using the Dunn Sensory Profile, are needed in other parts of Iran, especially in children with different sensory problems.
 

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Recently, there is an increasing trend in the diversity of pathogenic yeasts isolated from clinical samples. However, Candida albicans is even now the major cause of yeast infections. Candida albicans is one of the members of the mucosal microbiota which can cause cutaneous, mucosal, and disseminated invasive infections in susceptible individuals. For persistence in the host, the yeast must have the ability to adhere to both biotic and abiotic surfaces following host tissue invasion, and obtain iron. One of the important properties of this pathogenic yeast is dimorphism which is its ability to switch from a unicellular to a hyphal mode of growth. Dimorphism is triggered in response to certain environmental conditions, such as pH alternation, temperature, or serum availability. These changes which allow the yeast to invade are associated with the expression of several genes involving in its pathogenesis, including SAP genes family encoding the secreted aspartic proteinases (Saps), the agglutinin-like sequence (ALS) family encoding the adhessive proteins, and phenotypic and morphologic switching systems. This review aimed at summarizing recent data on the regulation and relevant signal transduction of some important essential genes associated with virulence factors in Candid albicans. Surely, understanding the genetic of the virulence factors would be of great benefit in effective combating the yeast and also in designing new antifungal agents.
 

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Background and purpose: It is estimated that 70–75% of women experience one episode of vulvovaginal candidiasis (VVC) during childbearing age and 40-50% suffer from recurrent VVC. Because of the resistance of Candida species to certain drugs, such as azoles, physicians tend to use complementary or alternative medicine such as vinegar in treatment of VVC. The current study aimed to determine the therapeutic effects of acetic acid vaginal gel on VVC.
Materials and methods: A double-blind randomized clinical trial was done in women (n=41) with VVC in Sari, Iran. The patients were allocated into two treatment groups to receive either 2% acetic acid vaginal gel + 2% acetic acid intravaginal wash + clotrimazole vaginal cream (n=20) or 2% acetic acid intravaginal wash + clotrimazole vaginal cream (n=21) for 10 days. After treatment, clinical symptoms and mycological cure rate were assessed by culture of vaginal secretions. All yeast isolates were identified by molecular method.
Results: Before the intervention, there were no significant differences in signs and symptoms
(P= 0.703), fungal burden rate (low, medium, heavy) (P= 0.092), and causative Candida species (P= 0.188) between the two groups. After treatment, an improvement in symptoms was seen in case group but the difference was not significant (P =0.3512). A significant difference was found between the two groups in mycological cure rate (P= 0.0377). Candida albicans were the most common species causing the disease.
Conclusion: The study showed that acetic acid vaginal gel could have a significant effect on the definitive cure of VVC.
 
(Clinical Trials Registry Number: IRCT20190309042978N3)

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Background and purpose: Clinical epidemiology of deceased COVID-19 patients is of great importance in identifying the risk factors for mortality and controlling the pandemic. In this study, we studied the demographic and clinical characteristics of deceased COVID-19 patients in Sari Fatemeh Zahra Hospital, Iran, between March 2020 and February 2021.
Materials and methods: This retrospective cross-sectional study was performed by reviewing hospital records of deceased patients diagnosed with COVID-19 (n=214). Diagnosis of COVID-19 was confirmed on the basis of positive RT-PCR test and lung CT scan findings. Information about demographic and imaging characteristics, underlying diseases, and risk factors were collected. Data were analyzed in SPSS V25.
Results: The mean age of deceased patients was 68.37 ± 14.1. The most common underlying diseases were hypertension(47.2%), cardiovascular disease (45.8%), and diabetes (40.7%). Abnormalities in lung imaging included peripheral lesions of ground glass in 149 (69.6%), ground glass with consolidation in 46 (21.4%), and crazy paving in 19 (9%) patients, respectively. There was no difference in mean age, sex, underlying diseases, and type of supportive care in patients who died during the epidemic waves of one to three.
Conclusion: Underlying diseases were the most critical risk factors for the death of patients with COVID-19 and should be given special attention in assessing the need for hospitalization and treatment of these patients. It is also recommended to conduct a comprehensive study of deceased patients before and after vaccination to evaluate the final effects of general immunization.

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Background and purpose: The term nosocomial infection refers to any type of infection that does not exist at the time of hospital admission and occurs within 48-72 hours after admission or up to 3 days to 6 weeks after discharge, or 30 days after surgery. Nosocomial infections can cause side effects, mortality and reduce quality of life in patients. So, so we decided to study the clinical, laboratory, and microbiological characteristics of patients with heart disease and nosocomial infections in Sari Fatemeh Zahra Hospital.
Materials and methods: In this descriptive study, 22811 people were studied. Information were recorded, signs of infection in patients were reviewed and in case of symptoms, patients were further examined. Data analysis was performed in SPSS ver.18.
Results: In this study, 1.4% of patients developed nosocomial infections. The mean age of patients was 64.5±12.5 years and the majority of patients were males (53.3%). The most common underlying diseases were hypertension, diabetes, and hyperlipidemia. The most common type of nosocomial infection was respiratory infection (47.8%) and the most common bacteria found in culture medium was Escherichia coli. Acinetobacter was resistant to all antibiotics tested except colistin which was susceptible in 80% of cases and resistant in 20%.
Conclusion: Control and prevention of nosocomial infections is of particular importance, especially in patients admitted to intensive care units after heart surgery.

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Background and purpose: Ventilator-associated pneumonia (VAP) is one of the major factors of mortality and morbidity in Intensive care units (ICUS), especially in open-heart surgery patients. The purpose of this study was to investigate VAP in open-heart surgery patients admitted to the ICU in Sari Fatemeh Zahra Hospital, 2017-2019.
Materials and methods: In this retrospective descriptive cross-sectional study, demographic, clinical, laboratory, and therapeutic information of patients with VAP were examined. Data were analyzed using SPSS V25.
Results: A total of 52 patients with VAP were elevated after open heart surgery. The mean age of patients was 64.41±10.85 years and 55.8% were men. Half of the patients (51.9%) underwent intubation for less than five days and the mean duration of occurrence of VAP after initiation of ventilation was about six hours. The most common microorganisms causing pneumonia were Acinetobacter baumannii (23.63%) and Citrobacter freundii (16.36%). In general, the highest resistance of isolated microorganisms was toward third-generation cephalosporins and their highest sensitivity was to aminoglycosides.
Conclusion: Control and prevention of ventilator-associated pneumonia is of particular importance, especially in patients after open-heart surgery admitted to intensive care units.

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Background and purpose: The northern regions of Iran have a high incidence of esophageal cancer. This study was conducted with the aim of epidemiological investigation of esophageal cancer patients in the population covered by Mazandaran University of Medical Sciences.
Materials and methods: In this cross-sectional descriptive study, the records of 170 patients over 18 years of age who were referred to Tuba Oncology Clinic (affiliated with Mazandaran University of Medical Sciences) between 2014 and 2016 were reviewed. All relevant information, including age, sex, occupation, marital status, level of education, clinical and pathological findings of patients were collected and analyzed in SPSS V22 using Chi-square and Fisher’s exact test.
Results: The mean age of patients with esophageal cancer was 68.2±12 years. The disease was more frequent in patients aged 70-79 years old. There were 53.5% male patients and 94.1% of patients had dysphagia. The frequency of squamous cell carcinoma (SCC) was found to increase by aging. The most and least metastatic segments were middle and upper parts of the esophagus, respectively.
Conclusion: Esophageal cancer is common in old age and age is probably the most important factor in developing the disease.

 

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Background and purpose: The prevalence of bacterial infections and the type of bacteria involved in causing endocarditis and knowing their antibiotic resistance pattern are very important for the correct selection of antibiotics to treat these infections and the proper control of infection in the hospital. In this retrospective cross-sectional descriptive study, we investigated the antibiotic resistance pattern of bacterial agents isolated from blood cultures of patients with infective endocarditis.
Materials and methods: This retrospective study was conducted on patients with infective endocarditis admitted to Razi and Fatemeh Zahra teaching hospitals over the four years from 2019 to 2023. After collecting the data, it was entered into Excel software and then analyzed using SPSS version 19 software.
Results: Among 28 patients included in the study, 57.1% were men and 42.9% were women; the median age of patients was 56.79±13.41 years. The most common isolated microorganism was Staphylococcus aureus with 11 positive samples (39.2%). Ninety-three percent of the studied microorganisms were resistant to at least two drugs. The result of the treatment was not significantly related to any of the gender, type of valve, and type of isolated microorganism (P=0.624, P=1.000 and P=0.398, respectively).
Conclusion: In this study, gram-positive bacteria were the most common group of microorganisms causing infective endocarditis. A high percentage of resistance was observed against some antibiotics including penicillin, ceftazidime, and ceftriaxone, which should be considered in initial empiric antibiotic therapy among hospitalized patients with infective endocarditis