نشریه دانشگاه علوم پزشکی بیرجند
سال سی و یکم شماره 4 (پیاپی 101، زمستان 1403)

Branched-chain amino acid (BCAA) supplementation is used as a nutritional strategy to reduce muscle soreness in athletes. The present study aimed to investigate the effect of BCAA supplementation on muscle soreness and muscle damage factors after exercise in healthy adults.

A systematic search of articles published in English and Persian databases until November 2023 (without limiting the year of publication) was conducted to the effect of BCAA supplementation on muscle soreness and markers of muscle damage, including creatine kinase (CK), lactate dehydrogenase (LDH) and myoglobin (MB) was investigated in healthy adults.

A total of 28 studies, including 528 subjects, were included in the present meta-analysis. The results showed that BCAA supplementation significantly reduced muscle soreness at 24, 48, and 72 h after exercise compared with the control group (P<0.05); however, it was not significant immediately after exercise. This supplementation caused a significant decrease in CK and LDH immediately, 48 hours after exercise, compared with the control group (P<0.05). In addition, BCAA supplementation caused a significant decrease in circulating myoglobin after exercise in athletes and non-athletes compared with the control group (P<0.05).

Using BCAA supplementation can be considered a useful and effective strategy for athletes to reduce muscle soreness (24-72 hours after exercise) and muscle damage markers, including CK (48-72 hours after exercise) and LDH (48 hours after exercise).

Epilepsy is the most common chronic neurological disorder, with approximately 80% of people suffering from epilepsy in developing countries. Due to the importance of drug interactions among antiepileptic drugs, this study aimed to determine the prevalence of drug interactions between antiepileptic drugs and other drugs, as well as associated factors.

In this descriptive-analytical study, 300 patients with epilepsy referring to Razi Hospital in Birjand in 2020 were studied. The patients receiving at least two drugs were included in the study. Drug interactions were evaluated in Lexicomp® software. The data was entered into SPSS19 software. The Chi-square, Fisher's tests, and logistic regression were used for data analysis.

The results showed that 154 patients (51%) were women in this study. The mean age of the patients was 45.12±16.20 years. 220 (73.3%) had drug interactions, and 111 (50.5%) had polypharmacy. The number of 1,147 drugs were prescribed, and 939 drug interactions were reported, of which 680 (72.4%) were moderate type C, 94 (10%) were major type D, 97 (10.3%) were major type C, 45 (4.8%) were moderate type D, and 23 (2.4%) were mild type B. The variables of occupation, type of epilepsy, medical history, education level, and age were effective in drug interactions of the patient.

This study showed the importance of awareness of drug interactions in patients with epilepsy. The presence of a clinical pharmacist can be effective in preventing such interactions in hospitalized patients.

Incorrect and excessive use of antibiotics has led to a significant rise in drug resistance. Nowadays, irrational antibiotic use is a major contributor to increased illness, death, and healthcare costs. Therefore, the present study aimed to investigate the pattern of Teicoplanin use in hospitalized patients at teaching hospitals in Birjand, Iran, from 2022 to 2023.

This descriptive cross-sectional study based on hospital data was conducted on all patients hospitalized in the wards of Vali-Asr, Imam Reza, and Razi teaching hospitals in 2022 and 2023 who were prescribed Teicoplanin. In this study, all the information required by the patients was recorded in Excel based on the study objectives, as well as the global protocols of the Infectious Diseases Society of America (IDSA(, and American Society of Health-System Pharmacists )ASHP(. Finally, the results were analyzed using the SPSS (version 26) software.

The study included 73 patients with a mean age of 64.26±17.90 years; 37 (51%) were women. The most common clinical conditions leading to Teicoplanin administration were pneumonia (73%) and sepsis (32.9%). According to the results, 87.7% of Teicoplanin treatments were based on antibiogram test results, while only nine patients (12.3%) received empirical Teicoplanin treatment. In 11% of cases, the loading dose of Teicoplanin was correctly administered. Additionally, the maintenance dose was correctly administered in 54 patients (74%). In addition, adverse drug reactions to Teicoplanin were observed in 12 patients (16.4%). The results revealed that 67 patients (91.8%) were admitted to the Intensive Care Unit (ICU). According to the researcher-developed checklist, only four patients (5.4%) adhered to all protocol guidelines.

According to the findings, the patterns of rational Teicoplanin prescription in the studied hospitals do not sufficiently align with existing guidelines and standards.

A significant part of infertility has been related to environmental conditions as well as acquired risk factors. Different environmental conditions emphasize the necessity of studying different etiologies of infertility in each region. The present study aimed to determine the etiologies of infertility in infertile couples.

In this cross-sectional study, 583 infertile men and women referred to the infertility clinic from 2021 to 2022 were examined. In addition, sampling was performed using the census method. Information about patients was obtained from medical tests and laboratory findings. It is noteworthy that descriptive statistics, such as frequency and mean, were used to analyze the data.

According to the results, oligospermia was the most common cause of male infertility (44.72%), and ovulation disorder was the most prevalent reason for female infertility (66.17%). In general, ovulation disorder and sperm motility were the most common causes of infertility (36.73%). There was no significant relationship between women's underlying diseases and the causes of infertility (P>0.05).

The etiology pattern of infertility is closely similar to that of many other regions reported by the World Health Organization (WHO). Despite this, the rate of ovarian disorders is higher than that in many other studies, which needs further studies.

Diazinon is an organophosphorus poison and insecticide that has negative effects on the environment and human health. Lemon balm (Melissa officinalis) is one of the plants that is consumed and has antioxidant compounds. The aim of this study is to investigate the protective effect of lemon balm in diazinon treated rats.

The aerial parts extract of Melissa officinalis was prepared by maceration method. 56 male Wistar rats were divided to control, sham, diazinon-received(30mg/kg), lemon balm-received (50 and 100 mg/kg) and both diazinon and lemon balm-received groups. All injection was done intraperitoneally for 30 days. The level of alanine aminotransferase and alkaline phosphatase was measured by ELISA. After killing the animals, liver tissue was also stained with hematoxylin-eosin and observed by light microscope.

Diazinon caused a significant increase of alkaline phosphatase and alanine aminotransferase and the number of Kupffer cells compared to the control group (P<0.05). In diazinon and Melissa officinalis extract receiving group, the level of these enzymes and Kupffer cells decreased compared to diazinon group(P<0.05). Diazinon decreased the number of hepatocytes compared to the control group(P<0.05). In diazinon and Melissa officinalis extract receiving group, the number of hepatocytes increased compared to the diazinon group(P<0.05).

Lemon balm extract improved the effects of diazinon on the liver of mice receiving diazinon.

Adhesive capsulitis is a painful shoulder disease associated with fibrotic and inflammatory contracture of the rotator cuff, capsule, and ligaments. The present study aimed to investigate the epidemiological factors predisposing patients to frozen shoulders during the COVID-19 and post-COVID-19 eras. It also evaluated the role of COVID-19 infection or vaccination in adhesive capsulitis among patients referred to the Physical Medicine and Rehabilitation Clinic of Birjand University of Medical Sciences, Iran.

In this descriptive study, the participants were 83 patients with adhesive capsulitis referred to the Physical Medicine and Rehabilitation Clinic of Imam Reza Hospital in Birjand City in Iran from September 23, 2022, to March 20, 2023. A checklist was completed according to the study's objectives, which included demographic information, such as age, gender, and anthropometric measurements of height and weight. Additionally, it recorded details about the dominant hand, affected hand, history of COVID-19 infection, history of vaccination against COVID-19 (including type and number of doses received), and any underlying diseases.

The mean age of the patients was 58.45±10.2 years. In addition, 59% of patients were female, 90.4% had the right dominant hand, and 59.1% of patients showed the occurrence of disease in the non-dominant shoulder. Moreover, 51.8% had a history of COVID-19 infection. All the examined patients had a history of the COVID-19 vaccination.

In conclusion, old age, female gender, and diabetes were among the risk factors of adhesive capsulitis. According to this study and similar works from pre-COVID situations, with comparable risk factors and occurrences of frozen shoulder, it is likely that COVID-19 cannot be recognized as an independent risk factor. However, further studies in this field are recommended.

Electronic prescription services can enhance patient safety and the quality of healthcare services by reducing medical mistakes. Therefore, this study aimed to examine the perspectives of physicians and pharmacists in Birjand regarding electronic prescriptions. This descriptive-applied study was conducted cross-sectionally during 2023-2024 in public and private hospitals, clinics (including charity, private, government-affiliated, and social security), as well as medical offices and pharmacies in Birjand County. Based on a standard deviation of 0.9, an acceptable margin of error of 0.2, and a 20% anticipated dropout rate, a sample size of 100 physicians and pharmacists was determined and recruited using convenience sampling. Data were collected using a two-part questionnaire. The first part included demographic information, such as gender, age, occupation, workplace, work experience, and electronic prescription experience. The second part consisted of 31 specific items across nine fields. The researcher personally distributed the questionnaire to the participants. The collected data were then analyzed using descriptive-analytical tests in SPSS software version 22. The average scores in the evaluated fields, from highest to lowest according to users' perspectives, were as follows: social influence (4.01), actual use (3.71), habit (3.66), intention to use (3.39), trust (3.15), expected performance (3.07), expected effort (2.78), price value (2.73), and facilitating conditions (2.32). A significant inverse correlation was observed between age and factors such as expected effort (r=-0.615), expected performance (r=-0.44), trust (r=-0.305), price value (r=-0.397), and facilitating conditions (r=-0.584) (P<0.05). Female pharmacists and physicians generally held more favorable views across most dimensions, except for social influences. Notably, expected effort and performance differed significantly between male and female participants (P<0.05). In conclusion, physicians and pharmacists held a moderate perspective on the use of electronic prescription services.

Considering the sexual problems in hemodialysis patients and the need for intervention in this regard, this study aimed to investigate the effect of sexual counseling based on the Permission, Limited Information, Specific Suggestions, and Intensive Care (PLISSIT) model on the quality of sexual life and emotional divorce of hemodialysis patients. This semi-experimental randomized controlled study was conducted on 60 hemodialysis patients who met the inclusion criteria of the study. The intervention group received sexual counseling based on the PLISSIT model, and the control group received only routine care. The standard questionnaire on sexual life quality and emotional divorce by Gottmann was completed before and one month after the intervention. The average score of the quality of sexual life and emotional divorce in the intervention group showed a significant increase after the intervention compared to before the intervention (P<0.001); however, the difference before and after in the control group was not significant. According to the results of this study, sexual counseling based on the PLISSIT model had a positive effect on the quality of sexual life of hemodialysis patients and also emotional divorce. Therefore, this training can be useful and effective in solving the sexual problems of dialysis patients.