---

Background and Objective: Normal psychological behaviour is one of the general concept of health. This study was carried out to evalute psychological disorders among inhabint residing in poor social district of Gorgan, Iran. Materials and Methods: This cross-sectional study was done on 376 subjects (188 males and 188 females) with simple random sampling method. Data were gathered using the general health questionnaire (GHQ-28). Data was analyzed by SPSS-16, Kruskal–Wallis and Pearson tests. Results: The prevalence of psychological disorders was 37% (33.5% in men, 40.4% in women), depression was 24.45% (22.5% in men and 26.4% in women) and anxiety was 31.6% (31.2% in men, 32% in women). Social affairs disorder 21% (19.2% in men, 22.7% in women) and psychosomatic disorders in 28.5% (22% of men, 35% of women). The relationship between psychological disorder with economic level and family size was significant (P<0.05). Conclusion: This study showed that 37% of inhabint residing in poor social district of Gorgan, Northern Iran had psychological disorders.

---

Background and Objective: Continuous antigenic variation of Influenza a viruses causes a major concern to develop Influenza vaccine. Conserved antigens are suitable candidates for vaccine production due to its non-requirement to match the designed strains with circulating strains. The M2 gene is conserved among Influenza a viruses and has potential to be considered as a universal vaccine. This study was designed to evaluate the effects of aqueous Echinacea purpurea extract on immunogenicity of DNA vaccine encoding M2 gene of Influenza virus. Materials and Methods: This interventional study was carried out on female BALB/c mice with 3-4 week age (250-300 gr). Plasmid DNA encoding M2 gene (pcDNA-M2) of Influenza virus A/New Caledonia/20/99 (H1N1) was transformed into E.coli top10 f' and cultured in LB broth media. Large scale plasmid preparation was done and the concentration was measured by spectrophotometric method. Mice were divided into eight groups and immunized three times with fifteen days apart. Vaccine groups received inactivated Influenza virus or pcDNA-M2, alone or in combination with Echinacea extract. Control groups were injected pcDNA, Echinacea extract, and phosphate buffer. All animals were left to bleed before immunization and at 21 days after the last vaccination and specific anti-M2 antibodies were measured by indirect ELISA. Then the mice were intranasally challenged under an aesthesia with mouse-adapted PR8 Influenza virus and monitored for 3 weeks to evaluate the vaccine regimen efficacy in reduction of mortality rate compared to control groups. Data were analyzed using SPSS-16, One-way ANOVA and Kaplan–Meier tests. Results: The highest specific immune response was obtained in mice received inactivated virus plus extract (P<0.05). Immune responses in mice inoculated with pcDNA-M2 were significantly higher compared to all control groups mice (P<0.05). In addition the specific immune responses in group inoculated with pcDNA-M2 and aqueous extract was higher compared to the group receiving only pcDNA-M2 (P<0.001). The highest survival rate was observed in mice injected with inactivated virus or pcDNA-M2 plus extract. Conclusion: This study showed that pcDNA-M2 induced specific immunity and protected mice against lethal challenge with PR8 Influenza virus. Furthermore, application of Echinacea extract with M2 gene vaccine increased vaccine efficacy.

---

Background and Objective: A high percentage of patients with multiple traumas sustained at least from an orthopedic problem. One of the high frequent lesions was femoral shaft fracture. The aim of this study was to determine the amount of bleeding and the need for blood transfusion in femoral shaft fractures and risk factors.

Methods: This descriptive, retrospective study was done on 84 patients with femoral shaft fractures whom were operated in Imam Khomeini Hospital in, Sari, in northern Iran during 2012-15. Age, sex, comorbidities, type of fracture, hospitalization period, pre and post-operative hemoglobin and blood unit's loss were recorded for each patient.

Results: In 43 patients (51.19%) plate and in 41 patients (48.80%) intramedullary naling were used for treatment of fractures.13 (15.47%), 33 (39.28%) and 37(44.04%) of patients were received one, two and three blood units, respectively. There was no significant relationship between energy intensity and age. There was significant relationship between the intensity and the type of fracture (P<0.05). A significant correlation existed between blood unit transfusion with sex, fracture type, hemoglobin before surgery and fracture energy intensity (P<0.05).

Conclusion: Based on the results of this study, it is recommended for hip fracture at least 3 units of blood should be reserved.

---

Background and Objective: Due to the spread of the new coronavirus disease 2019 (COVID-19), the amount of physical activity and exercise in people’s lifestyles was greatly reduced to reduce interpersonal contact to control the infection. The current study aimed to investigate students’ physical fitness levels during the quarantine period of COVID-19, and the study examined its changes after four months of training at home.
Methods: This quasi-experimental study was done on thirty-two students (16 males and 16 females) in Shahrekord University, Iran during 2019-21. Physical fitness (swimming, Sit-ups, jumping rope, and flexibility) was measured and compared three times before the start of the Coronavirus, one year after the beginning of the Coronavirus, and after four months of exercise at home.
Results: COVID-19 leads to a decrease in the level of physical fitness in the post-exam phase compared to the pre-exam phase. Due to the restrictions related to the quarantine period, students’ physical fitness levels showed a significant reduction in the post-corona period compared to the pre-corona period. In addition, four months of training at home showed a significant effect on physical fitness indicators, compared to the time of quarantine, in such a way that the average of physical fitness factors increased significantly (P<0.05). Therefore, growing measures are needed to motivate and support students to maintain a conscious level of physical fitness to avoid any threat to the population’s health, especially in quarantine conditions.
Conclusion: The quarantine period during the outbreak of COVID-19 caused a decrease in the physical fitness of the studied students, and performing four-month exercises at home increased their physical fitness.

---

Background and Objective: Tuberculosis (TB), caused by a bacterium called Mycobacterium TB, is the most prevalent infectious disease leading to mortality worldwide. Weight loss is frequently observed in TB patients at the time of diagnosis. Body weight changes have been identified as a potential predictive marker for TB treatment outcomes, particularly in drug-susceptible cases. This study was conducted to evaluate weight changes during TB treatment and associated factors in Golestan Province, Iran.
Methods: This historical cohort study was conducted on 348 patients (178 males and 170 females) with TB referring to health centers in Golestan Province, Iran, in 2020. Data including age, gender, type of TB, pre- and post-treatment weight, place of residence (urban or rural), and treatment outcomes were extracted from patients’ medical records in the TB Register System. Weight changes were then compared before and after treatment across three groups: Smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB.
Results: Patients’ post-treatment weight showed a statistically significant mean increase of 1.98 kg (P<0.05). Based on the grade of sputum smear positivity, post-treatment weight gain was higher in pulmonary TB patients (both smear-positive and smear-negative) compared to extra-pulmonary cases. Overall, weight gain in all three groups (smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB) was statistically significant (P<0.05). Furthermore, weight gain was significant across all groups of sputum smear positivity (+ to +++) (P<0.05), with the most substantial weight changes occurring in patients with a ++ sputum smear. Mean weight gain was also significant in both smear-negative patients and other categories (P<0.05), with smear-negative individuals showing higher weight gain than other states. Although weight gain was slightly higher in men than in women, it was statistically significant in both genders (P<0.05). Weight gain was significant in both urban and rural residents (P<0.05), with rural patients exhibiting more pronounced weight gain. Significant weight gain was observed across individuals under 15, 15–65, and over 65 years of age (P<0.05). The least weight changes were observed in the over 65 age group, while the most significant changes occurred in those under 15.
Conclusion: The type of TB (pulmonary versus extra-pulmonary), the grade of sputum smear positivity, treatment outcomes, gender, place of residence, and age were identified as factors associated with weight changes in patients with TB.