Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 Large Multiple Sialoliths of Bilateral Submandibular Glands: A Case Report 4504 4511 FA Mohsen Barzegar Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohsen.barzegar90@gmail.com N 0000-0002-5039-4488 Adele Pouyafard Department of Oral and Maxillofacial Diseases, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. a.pouyafard@gmail.com N 0000-0003-1324-1252 Hamidreza Ajami Department of Oral and Maxillofacial Surgery, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran. hamidrezaajami@yahoo.com N 0000-0001-5445-8226 Sahar Pakzad Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. dr.sahar_pakzad@yahoo.com Y 0000-0002-3646-9711 10.18502/ssu.v30i2.9273  Introduction: Sialolithiasis is a most common disease of salivary glands most commonly occurs in submandibular gland system. Simultaneous sialolithiasis in more than one salivary gland and multiple stone formations have been reported in only 5% and 3% of cases, respectively. In this article, a rare case of bilateral presence of various stones in different sizes and shapes in the submandibular glands and its duct in a 68-year-old man has been investigated.  Stones on left side were removed through an intraoral incision and on the right side; the entire salivary gland was removed with extraoral access. Conclusion: After precise diagnosis of sialolithiasis through various diagnostic modalities, treatment plan should be tailored based on existing condition and the decision was made to remove a salivary gland with extraoral access on one side and remove the stones by intraoral incision on the other side while preserving the salivary gland. Sialoliths, Submandibular gland, Salivary glands, Sialadenitis. http://jssu.ssu.ac.ir/article-1-5586-en.html http://jssu.ssu.ac.ir/article-1-5586-en.pdf

Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 Angiotensin-Converting Enzymes, the Key Components in the Pathogenesis of COVID-19 Infection and their Role in the Interaction of SARS-Cov-2 with Human Host Cells 4512 4534 FA Seyed Mehdi Hoseini Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran sm_Hoseini@outlook.com N 0000-0001-8759-2712 Mohammad Hasan Sheikhha Department of Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Sheikhha@yahoo.com N 0000-0002-3734-8970 Mohammad Samet Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Samet_mo@ssu.ac.ir N 0000-0002-4124-1009 Elham Sadat Hoseini Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. elhamhoseini1990@gmail.com N 0000-0003-2461-806X Fateme Montazeri Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. f_montazeri@Outlook.com Y 0000-0002-1984-951X 10.18502/ssu.v30i2.9275 Introduction: Over the past 20 years, seven coronaviruses have caused more or less severe respiratory diseases in humans. Among these, the most important ones are SARS-CoV and the coronavirus, a similar virus that has created a pandemic called Covid-19 since 2019, belonging to the b-category of beta-coronaviruses called Sarbecovirus. This virus is due to a kind of spike-like structure to the ACE2 receptor (angiotensin converting enzyme 2) bind to the surface of host cells. Often, dysfunction of ACE2 protease after viral infection leads to dysfunction of the RAAS (renin-angiotensin-aldosterone) pathway and, as a result, by affecting blood pressure, it upsets the balance of fluids and electrolytes in the body, a process that results in increased inflammation and permeability of arteries in the airways. Furthermore, the widespread release of cytokines by the immune cells in response to viral and/or secondary infections can lead to cytokine storms along with symptoms of sepsis. In these cases, uncontrolled inflammation causes multiple organ damage that leads to organ failure, particularly in cardiovascular, hepatic, and renal systems. Conclusion: Despite the findings of the pathogenic mechanism of SARS-CoV-2, there is still no specific drug to treat COVID-19. Therefore, achieving proper therapeutic strategies against COVID-19 requires a comprehensive understanding of its pathogenesis in the host for developing new drugs and/or using approved drugs. Angiotensin-converting enzyme, Coronavirus, COVID-19 infection, Severe acute respiratory syndrome, SARS-CoV-2. http://jssu.ssu.ac.ir/article-1-5382-en.html http://jssu.ssu.ac.ir/article-1-5382-en.pdf

Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 Effect of Particulate Properties of Inhaled Dry Powder Formulation on Bioavailability, Dissolution Rate of Drug Particles and Rate of Drug Removal from the Body 4535 4552 FA Ali Akbar Alizadeh Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. alizadehaa@tbzmed.ac.ir N 0000-0001-7781-4019 Hamed Hamishehkar Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. hamishehkar.hamed@gmail.com N 0000-0001-9905-0662 Shadi Yaqoubi Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. Shadi.yaqoubi@gmail.com Y 0000-0001-6107-8141 10.18502/ssu.v30i2.9276 Introduction: The use of pulmonary drug delivery as a non-invasive drug delivery system for the systemic treatment of diseases as well as the topical treatment of respiratory diseases is increasing. Among the various inhaled formulations, inhaled dry powders show advantages over the other forms of inhaled medicines due to high stability, bioavailability and ease of use. The effect of particle properties on the rate of drug delivery to the lungs in inhaled dry powders has been investigated in previous papers. Conclusion: Since the physicochemical properties of particles of dry powder inhalation formulations such as particle size, surface and particle shape, as well as the electrical charge of the particles play a decisive role in drug pharmacokinetics, in the present review article we intended to discuss the effect of these parameters of inhaled dry powder formulations on bioavailability, dissolution rate of drug particles and the rate of drug clearance from the body. Dry powder inhalation, Pulmonary drug delivery, Bioavailability, Drug formulation. http://jssu.ssu.ac.ir/article-1-5625-en.html http://jssu.ssu.ac.ir/article-1-5625-en.pdf

Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 Frequency of Latent Tuberculosis Infection in Patients with Type 2 Diabetes referred to Shahid Rahimi Hospital in Khorramabad City with Tuberculin Skin Test in 2018-2020 4553 4564 FA Mahshad Mousavi Student Research Committee, School of Medicine, Lorestan University of Medical Science, Khorramabad, Iran. mahshad.mosavi.94@gmail.com N 0000-0002-9158-4069 Nazanin Mousavi Student Research Committee, School of Medicine, Lorestan University of Medical Science, Khorramabad, Iran. nazanin.mosavi.74@gmail.com N 0000-0003-0186-6052 Majid Abdollahian Department of Internal Medicine, School of Medicine, Lorestan University of Medical Science, Khorramabad, Iran. kavianim29@yahoo.com N 0000-0002-5336-7522 Mozhgan Kaviani Department of Internal Medicine, School of Medicine, Lorestan University of Medical Science, Khorramabad, Iran. kavianim29@yahoo.com Y 0000-0003-2774-6091 10.18502/ssu.v30i2.9277 Introduction: Tuberculosis is the leading cause of death from infectious diseases worldwide. Diabetes has been suggested as an important risk factor for tuberculosis. To date, few studies have examined the association between diabetes and tuberculosis. In this study, the prevalence of latent tuberculosis in diabetic patients was investigated. Methods: In this study, 195 patients with type 2 diabetes were studied in a cross-sectional study to diagnose latent tuberculosis infection with a tuberculin skin test. Individuals with symptoms of active tuberculosis were excluded from the study, and individuals with a positive tuberculin test were evaluated for active tuberculosis by chest x-ray. For analyzing the data, SPSS software version 16 was run, a t-test was used to analyze quantitative variables, and for qualitative variables, Chi-square was applied.  The significance level of 0.05 was considered for all the results. Results: Out of 195 diabetic patients, 115 patients were referred for tuberculin test results. 43 out of 115 patients (37.39%) had an induration diameter greater than or equal to 5 mm, 29 patients (25.21%) had an induration diameter greater than or equal to 8 mm, and 3 patients (2.61%) had an induration diameter greater than or equal to 10 mm (Positive tuberculin test) (p>0.05). Conclusion: False tuberculin skin test results can hide the true prevalence of latent tuberculosis infection. The sensitivity of the tuberculin test decreases in immunocompromised patients and leads to limitations in assessing the prevalence of latent tuberculosis infection. Although not enough information was available in this study to establish a significant association between diabetes and latent tuberculosis infection, further studies will help to investigate this association Tuberculosis, Latent Tuberculosis, Type 2 Diabetes Mellitus, Tuberculin Skin Test. http://jssu.ssu.ac.ir/article-1-5552-en.html http://jssu.ssu.ac.ir/article-1-5552-en.pdf

Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 Study of Lifestyle during Covid-19 Epidemic in Nursing Students of Yazd Shahid Sadoughi University of Medical Sciences in 2020 4565 4575 FA Naiire Salmani Meybod School of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. n.salmani@ssu.ac.ir Y 0000-0001-8193-6246 Mojgan Baraty Kahrizsangi Meybod School of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. mojganb78@gmail.com N 0000-0002-2576-3093 Fatemeh Kafi Meybod School of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. f.kafi78@gmail.com N 0000-0002-6697-3767 10.18502/ssu.v30i2.9278 Introduction: The spread of COVID-19 rapidly affected the daily lives of individuals, including students. It has led to changes in students' usual curricula and nursing students' lifestyles. It has affected not only on the personal life and health of nursing students but also the lifestyle and health of other people in the community. Therefore, this study aimed to determine the lifestyle of nursing students of Shahid Sadoughi University of Medical Sciences and Health Services during the COVID-19 epidemic in 2020. Methods: This was a cross sectional  study in 2020 on 171 nursing students of Shahid Sadoughi University of Medical Sciences and Health Services using the convenience sampling method. To collect the required data, demographic information form and lifestyle questionnaire during the COVID-19 epidemic were used. The collected data were then analyzed by SPSS software version 16 using descriptive and inferential statistics methods (independent t-test and ANOVA). Results: The mean and deviation score of students' general lifestyle was at a moderate level, 38.08 ± 16.8. Mean and deviation scores of both happy and healthy lifestyles were at a low level, 21.66 ± 9.4 and 16.42 ± 8.5, respectively. There was no significant relationship between demographic characteristics and mean lifestyle score (P≥0.05). Conclusion: Due to the fact that students' lifestyle are at a moderate level and the score of lifestyle components (both happy and healthy) was at a poor level, and given that the end of the COVID-19 pandemic is uncertain, therefore, it is necessary for managers and officials of universities and the Ministry of Health to plan timely and effective interventions to improve the lifestyle of nursing students. Lifestyle, Nursing students, COVID-19 http://jssu.ssu.ac.ir/article-1-5419-en.html http://jssu.ssu.ac.ir/article-1-5419-en.pdf

Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 Evaluation of Attitudes and Practices of mothers on Antibiotic Use in Children under five years old Referred to Shahid Sadoughi Hospital in Yazd, 2019-2020 4576 4582 FA Zahra Nafei Department of Pediatrics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. nafeiy@yahoo.com N 0000-0001-8714-2201 Mehran Karimi Department of Pediatrics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. drmehrankarimi@yahoo.com N 0000-0001-7987-6694 Zahra Najafi School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. dr.najafi2021@gmail.com Y 0000-0002-9147-568X 10.18502/ssu.v30i2.9279 Introduction: Microbial resistance due to antibiotics overuse can endanger the general health of society. Various factors play a role in mothers' overuse of antibiotics for their children. This study aimed to investigate mothers' attitude and behavior about the use of antibiotics in children under five years old in Yazd City. Methods: In this cross-sectional descriptive study, 302 mothers with children under five years old were included in 2019-2020; a questionnaire of mothers' attitudes and practices regarding antibiotic use was completed. Then, the obtained data were analyzed by SPSS software version 16 and P-value less than 0.05 was considered statistically significant. Results: The mothers' attitude level was poor, moderate, and good in 60 (20%), 180 (59.5%), and 62 patients (20.5%), respectively. Furthermore, mothers' practice level was poor in 55 (18.2%), moderate in 210 (69.5%) and good in 37 (12.3%). The level of attitude (P = 0.000) and practice (P = 0.007) in mothers with a higher level of education was significantly higher. With increasing the number of children, mothers' attitude (P = 0.03) and practice (P = 0.02) were significantly lower. Conclusion: The study results showed that most mothers have a moderate level of attitude and practice in using antibiotics in their children. A significant number of them also mentioned antibiotic use without a prescription. Therefore, to reduce the improper use of antibiotics, it is recommended to pay attention to educational programs with proper planning by the public media. It makes sense to train physicians, monitor their performance and closely monitor the sale of antibiotics in pharmacies to reduce their use without a doctor's prescription. Attitude, Practice, Antibiotics, Children. http://jssu.ssu.ac.ir/article-1-5568-en.html http://jssu.ssu.ac.ir/article-1-5568-en.pdf

Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 Relationship between Sleep Disorders and Diabetes Mellitus in Adults: Results of the First Phase of Shahedieh Cohort Study 2015-2017 4583 4592 FA Mahdieh Momayyezi Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. mahdieh_momayyezi@yahoo.com N 0000-0002-8205-3231 Hossein Fallahzadeh Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. hofaab@yahoo.com N 0000-0001-6518-366x Leila Fakhravari Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. leila74fakhravari@gmail.com Y 0000-0001-7703-6616 Masoud Mirzaei Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. masoud_mirzaei@hotmail.com N 0000-0001-6455-0747 10.18502/ssu.v30i2.9280 Introduction: Disruption of the sleep cycle can disrupt the activity of the hormonal rhythms. Given that diabetes mellitus (DM) is the most common endocrine disease, and few studies have been conducted to investigate its relationship with sleep quality, the present study aimed to investigate the relationship between sleep disorders and diabetes mellitus. Methods: The present study was a descriptive, cross-sectional study. In this study, all adults aged 35-70 years from Shahedieh, Ashkezar, and Zarch Cities were investigated. The data used in this study included demographics, sleep variables, and fasting blood sugar level. Data were analyzed using SPSS V. 16 and Chi-square, T-test, ANOVA and regression. Results: The results showed that the prevalence of sleep less than 6 hours was significantly higher in people with diabetes type2, and also, the sleep latency increased with increasing blood sugar level (R=0.06, P=0.001). The results of regression analysis indicated that the chance of diabetes in people with a sleep duration of less than 6 hours was 12%, in people with a sleep latency of more than 15 minutes was 11%, in people who used sleep medications continuously was 15% and in people who nap during the day was 27% higher than other people. Conclusion: According to the findings of this study, the prevalence of sleep disorders was higher in people with diabetes and sleep was a strong predictor for diabetes type2. Sleep duration, Sleep disorder, Blood sugar levels, Diabetes. http://jssu.ssu.ac.ir/article-1-5454-en.html http://jssu.ssu.ac.ir/article-1-5454-en.pdf

Shahid Sadoughi University of Medical Sciences SSU_Journals 2228-5741 2228-5733 30 2 2022 5 1 NLRP-3 Expression in Pancreatic Tissue Following Moderate and High Intensity Interval Training with Liposomal Alpha-Lipoic Acid Supplement in Diabetic Rats 4593 4606 FA Seyed Abdollah Fatemi Department of Exercise Physiology, Faculty of Humanities, Sari Branch, Islamic Azad University, Sari, Iran. aminak101@yahoo.com N 0000-0003-9459-3067 Amin Frzaneh Hesari Department of Exercise Physiology, Faculty of Humanities, Sari Branch, Islamic Azad University, Sari, Iran. af.hessari@gmail.com Y 0000-0003-3477-8286 Minoo Dadban shahamat Department of Exercise Physiology, Faculty of Humanities, Azadshahr Branch, Islamic Azad University, Azadshahr, Iran. m_dadban@yahoo.com N 0000-0003-2811-9874 10.18502/ssu.v30i2.9281 Introduction: Activation of NLRP-3 Inflammasome is considered an indicator of chronic inflammation in type 2 diabetes. Regular exercise training along with antioxidants supplements can control inflammation. The aim of the present study was to investigate the effect of training with different intensity and alpha lipoic acid supplement on pancreatic NLRP-3 expression in diabetic rats. Methods: In this experimental study, 35 Wistar rats were randomly divided into seven groups: control, diabetic, diabetic+ supplement (S), diabetic+ high intensity training (HIT), diabetic+ moderate intensity training (MIT), diabetic+ high intensity training + supplementation (HIT+S), diabetic+ moderate intensity training + supplementation (MIT+S). The HIT and MIT protocols were performed five days a week for six weeks. HIIT included 10 bouts of four minutes running (at 85–90% of VO2max) and MIT, 13 bouts of four minutes running (at 65–70% of VO2max). Alpha lipoic acid was administered orally at a dose of 20 mg/kg was given to rats once a day by gavage. Blood and tissue sample was taken 24 h after last exercise session. Real-time PCR method for the relative expression of NLRP-3 gene expression was used. Results: Expression of LRP-3 gene in pancreatic tissue was increased significantly in the diabetic group compared to control group (p=0.0001). In addition, S (P = 0.021), MIT (P = 0.009), HIT (P = 0.001), MIT+S (P = 0.003) and HIT+S (P = 0.0001), significantly reduced the NLRP-3 levels in pancreatic tissue compared to the diabetic group. Conclusion: Type 2 diabetes is associated with increased mRNA NLRP-3 in pancreatic tissue. MIT and HIT plus alpha lipoic acid can be considered as an effective intervention in decreasing pancreatic mRNA NLRP-3 in diabetic rats. Interval training, Alpha lipoic acid, NLRP-3, Diabetes. http://jssu.ssu.ac.ir/article-1-5517-en.html http://jssu.ssu.ac.ir/article-1-5517-en.pdf