Iranian Red Crescent Medical Journal
Volume:19 Issue: 1, Jan 2017

Many people are concerned with the problems and side effects caused by increased levels of fast food (FF) consumption, especially among adolescents. Several studies have assessed the problems of FF consumption particularly weight gain and obesity. However, few address the methods, strategies, and policies needed to reduce this issue..
This study aims to explore parent and stakeholder views and perspectives on the means to reduce adolescent FF consumption..
Patients and The present paper is based on original research conducted from June to December 2012. In this study, 19 participants were selected using purposive sampling. Their experiences and perspectives were explored using in-depth semi-structured interviews; a thematic content analysis with a conventional approach was conducted to analyze the data. Using this approach, the transcripts were coded openly, and subcategories and categories were chosen based on similarities. Subsequently, themes were defined at a more abstract level..
Three main themes were identified as approaches and strategies suggested by parents and stakeholders to reduce FF consumption. These included culture building, supporting healthy eating styles, and controlling and supervising healthy eating styles..
Based on the extracted themes, some interventions can be suggested to reduce FF consumption among young people. A holistic approach that incorporates a change of culture, social support, and supervision is promising. Further quantitative studies are also recommended..

Increased physical activity is associated with a reduction in the risk of breast cancer; however, the exact mechanism of the reduction is not yet completely known..
This study aimed to investigate the effect of six months of aerobic exercise on the plasma interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) levels as breast cancer risk factors in postmenopausal women..
Patients and This study was a randomized controlled trial. We randomly assigned 41 postmenopausal, sedentary women aged 50 to 74 to either an exercise or a control group. The intervention involved facility-based aerobic exercise (three days/week, at 70 - 80% of the maximum heart rate, for six months)..
Twenty-seven women completed the study. The plasma IL-6 level decreased by 21.3% in the exercisers and by 6.9% in the controls, and the intervention effect was significant (P = 0.001). The plasma TNF-α level decreased by 17.1% and 10.8% in the exercisers and controls, respectively, although the effect of exercise was not statistically significant (P = 0.28). Overall, long-term aerobic exercise may result in a decreased IL-6 concentration..
We suggest that regular aerobic exercise can favorably alter the inflammatory profile, which is a known risk factor in breast cancer development, in postmenopausal women..

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system (CNS). MS is one of the most common cause of neurological impairment at a young age with a complex etiology. The forkhead/winged helix (FOXP3) gene encodes a transcription factor that plays an important role in the working and progress of regulatory T cells. Loss of the FOXP3 function impairs the suppressor activity of regulatory T (T-reg) cells, which have been reported in MS patients..
To determine whether rs2232365 and rs3761548 polymorphisms of FOXP3 are associated with the risk of MS in an Iranian population..
Patients and In this case-control study, a total of 384 samples consisting of 190 MS patients and 194 unrelated healthy subjects from the Iranian population were recruited between December 2014 and September 2015. The patients were diagnosed by a neurologist based on McDonald’s criteria. The control group had no history or presence of autoimmune diseases. The polymorphisms were genotyped using tetra-ARMS PCR and PCR-restriction fragment length polymorphism (RFLP) techniques..
The Rs2232365 G allele was significantly associated with an increased risk of MS (P = 0.0068). In contrast, the allele and genotype frequencies of rs3761548 was not significantly different between the case and control groups (P > 0.05)..
The functional variant of the FOXP3, rs2232365 A/G, may be considered a substantial risk factor for MS..

Since injury-related mortality is preventable, identifying factors that inversely affect trauma outcome are important initial steps towards reducing injury burden..
This study aims to determine independent risk factors of early/late in-hospital mortality among adult trauma victims with equal injury characteristics and severity at Shahid Rajaee (Emtiaz) Hospital during 2013 and 2014..
Patients and A cross-sectional study of adult trauma patients (age ≥ 15 years) sustaining injury through traffic accidents, violence, and unintentional incidents was conducted. Information was retrieved from three hospital administrative databases. Data on demographics, injury mechanisms, injured body regions, injury descriptions, outcomes of hospitalization, and development of nosocomial infections were recorded. Injury severity score was calculated by cross walking from international classification of diseases (ICD-10) injury diagnosis codes to abbreviated injury scale (AIS-98) severity codes. Two multiple logistic regression models were employed to reflect the partial effect of each covariate on early (within 48 hours) and late (beyond 48 hours) deaths..
There were 47,295 hospitalized patients (male/female ratio: 2.7:1.0) with a median age of 30 years (interquartile range 23 - 44 years). A crude mortality rate of 1% (454 cases) was observed and 52% of deaths occurred within 48 hours of hospital arrival. One percent developed a nosocomial infection in the course of admission. After adjusting for covariates, sustaining a thoracic injury (OR 8.5, 95% CI [4.7 - 15.2]), ISS over 16 (OR 6.4, 95% CI [3.6 - 11.4]) and age over 65 years (OR 5.1, 95% CI [3.0 - 8.8]) were the most important independent risk factors of early trauma death. Presence of a hospital-acquired infection (OR 12.7, 95% CI [8.9 - 18.1]), age over 65 years (OR 7.4 95% CI [4.5 - 12.1]), and ISS of more than 16 (OR 14.6, 95% CI [6.2 - 34.3]) were independent predictors of late death..
Age, injury severity, injured body region, and hospital-acquired infections are important determinants of trauma outcome in our center. Timely recognition of factors affecting trauma mortality is crucial for monitoring changes of trauma quality of care. Our findings suggest the need to allocate resources for trauma prevention along with a potential focus on reducing in-hospital complications..

Metabolic syndrome, which includes multiple metabolic disorders in an individual, has a direct relationship with incidence of various heart diseases. Satureja hortensis L. has been considered to treat this syndrome because its active compounds have valuable therapeutic effects, including anti-inflammatory, antihyperglycemic, vasodilator, and antihyperlipidemic properties as well as being antioxidants and free radical scavengers..
This double-blind randomized clinical trial assessed the effects of dried leave of S. hortensis on the serum sugar levels, lipid profiles, high-sensitivity CRP (hs-CRP), and blood pressures of 60 metabolic syndrome patients referred to the healthy heart institute in Shiraz, Iran during 2013..
First, components from the essential oil of the plant powder were identified using GC-MS instrumentation. Then, capsules of the plant were used in a double-blind randomized and controlled clinical trial involving 47 metabolic syndrome patients who were treated with either dried leaves from S. hortensis or a placebo capsule once daily for 10 weeks..
This study was registered at the Iranian Registry of Clinical Trials (No. IRCT2014012616372N1). At the end of the study, group changes (mean ± SD) in the group that received S. hortensis showed significant reductions in total cholesterol (239.4 ± 34.6 to 222.3 ± 38.0; P When used as a supplement, S. hortensis could be helpful for prevention or improvement of metabolic syndrome symptoms and primary concomitant disorders..

Patients today are required to understand more and more complex health information, and to navigate increasingly complex health systems. As a result, they need to develop skills such as finding, processing, understanding, and applying information about health issues, which has been conceptualized as health literacy (HL). Assessing HL is critical to providing meaningful health information to patients..
This study aimed to examine the cultural adaptation and the psychometric properties of the Iranian version of the functional, communicative and critical health literacy (FCCHL) scales measuring three aspects of HL among type 2 diabetic patients..
Patients and We conducted a methodological survey of 187 patients with type 2 diabetes using a cross-sectional design. The study was carried out in two phases: the first phase was designed to obtain a cross-cultural equivalent of the FCCHL scales, based on Beaton’s guidelines. In the second phase, a cross-sectional study was conducted to evaluate the psychometric properties of the questionnaire..
Exploratory factor analysis (EFA) identified three main factors with 27.07%, 22.46%, and 16.23% of extracted variance, respectively. Confirmatory factor analysis (CFA) completely supported the three-factor model of the HL scales. Internal consistency was approved for the total scale (α = 0.82) and for the functional, communicative, and critical subscales (α = 0.91, 0.80, and 0.76, respectively). Convergent validity analysis indicated a significant positive correlation (r = 0.45; P We concluded that the FCCHL scales are valid and reliable, and can be used to measure health literacy among Iranian diabetic patients. However, further research is needed to establish stronger psychometric properties for the use of this questionnaire in Iran..

Pruritus during dialysis is a common complaint among patients undergoing hemodialysis. Despite progress in medical science and technology in the field of hemodialysis, there is still no cure for pruritus..
The aim of this study was to determine the effect of cool dialysate on the severity of pruritus during hemodialysis of patients with chronic renal failure..
Patients and This study was a two-group, triple-blinded randomized clinical trial, with a parallel design. It consisted of 60 patients with chronic renal failure who were receiving hemodialysis at hemodialysis centers in Mashhad. The patients were divided into two equal groups: 30 patients in an intervention group and 30 patients in a control group. Initially, the patients in both groups underwent dialysis for one week (three sessions) with a standard dialysis solution (temperature of 37 °C). In the next phase, the control group received the standard dialysis solution, whereas the intervention group received a cool dialysis solution (35.5°C) for one week (three sessions). The severity of pruritus was recorded using a visual analogue scale (VAS), with itching scored from 0 - 10 on an hourly basis during the dialysis sessions..
Before the intervention, there was no significant between-group difference in the severity of pruritus (P Dialysis with cool dialysate is a simple and cheap nondrug method, which was readily accepted by the patients. This method could significantly reduce the severity of pruritus in patients during dialysis..

Obesity is the main cause of insulin resistance and type 2 diabetes mellitus (T2DM). Diet therapy is the cornerstone in the management of obesity and T2DM..
We evaluated the effects of calorie-restricted diet therapy on the circulating level of the serum lipid profile, glucose, insulin, and adiponectin in obese women with T2DM..
This randomized clinical controlled trial was performed for 10 weeks on 30 eligible obese T2DM women distributed to control (n = 15) and diet therapy (n = 15) groups. Demographic, nutritional, anthropometric, and laboratory data were obtained before and after the study. Data were analyzed by SPSS vs.15 and Nutritionist IV..
In addition to anthropometric measurements, diet therapy independently improved fasting blood sugar (P = 0.024, -69.37 to -5.57 mg/dL), 2-h postprandial blood sugar (P = 0.007, -123.34 to -22.3 mg/dL), serum total cholesterol (P = 0.005, -46.48 to -9.72 mg/dL), serum alanine transaminase (P = 0.001, -8.91 to -3.18 U/L), and increased circulating adiponectin (P = 0.038, 0.01 to 0.47 μg/mL)..
Improvement of biomarkers of insulin sensitivity, including adiponectin and lipid metabolism, is an important therapeutic effect of medical nutrition therapy in obese patients with T2DM..

Renal angiomyolipoma (RAML), is a rare, benign tumor arising from renal mesenchymal cells. Frequently, it is asymptomatic and found incidentally. Spontaneous rupture with consequent retroperitoneal hemorrhage is an uncommon but catastrophic complication of RAML..
Herein, we report a case of a ruptured RAML with a massive retroperitoneal hemorrhage, seen at the emergency department following a minor trauma. A computed tomography (CT) scan showed a left RAML with retroperitoneal hemorrhage. An angiography was performed and then a transarterial embolization. Cessation of bleeding and clinical stabilization occurred without deterioration of renal function..
In hemodynamically stable patients with a ruptured RAML, early detection by CT followed by selective arterial embolization may be lifesaving..

The relationship between ovulation induction and ovarian cancer is an important issue in gynecology..
The studied patient was a 32-year-old G1P1 woman with abdominal pain who was diagnosed with a large ovarian cyst during ovulation induction, which could possibly raise the risk of ovarian torsion. She had a 2-year secondary infertility and had received three cycles of ovulation induction with letrozole 6 months earlier. An emergency laparoscopy showed large complex ovarian cysts without torsion. We then performed a cystectomy. Based on the pathology report revealing a primary ovarian cystadenocarcinoma, the patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and retroperitoneal lymphadenectomy..
The emergence of a suspected ovarian cyst during letrozole-induced ovulation is of great importance and needs to be investigated..

Type 2 diabetes is a chronic disease that is spreading very quickly worldwide and is second in priority for investigation of chronic diseases. According to research, self-efficacy is low in diabetic patients..
This study analyzes the effect of empowerment programs on self-efficacy in type 2 diabetes patients..
Patients and In this clinical trial, 100 patients with type 2 diabetes who had inclusion criteria were chosen randomly and divided into control and experimental groups by a randomized block method. Intervention was accomplished through educational sessions scheduled twice a week for four weeks. Diabetes self-efficacy questionnaires were completed before and two months after the intervention for each group. Data were analyzed using the SPSS 16 and the Mann Whitney U, chi-square, exact Fisher’s, and t-test statistical tests..
Before intervention, the mean score of self-efficacy was 45 ± 14.49 and 39.61 ± 17.01 for the experimental and control groups, respectively, and the difference was not significant (P = 0.1). Two months after the intervention, the mean of self-efficacy was 55.71 ± 13.25 and 40.24 ± 17.55 for experimental and control groups, respectively; and the difference was significant (P Using an empowerment program had positive effects on self-efficacy in patients with type 2 diabetes..

Skp2 (S-phase kinase-associated protein 2 is overexpressed in many kinds of cancers, and is related to the occurrence and development of tumors. The molecular mechanism of Skp2 in the regulation of bladder cancer cell biological behavior after Skp2 expression knockdown, however, has remained unknown..
In our present studies (experimental cytobiological studies, we used an RNAi approach to knock down Skp2 expression, and studied its impact on cell proliferation and invasion of T24 cells..
The expression of the Skp2 gene was knocked down by RNA interference (RNAi) in T24 cells. The transcription level of Skp2 was detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis. The expression of Skp2, caspase-3, caspase-8, caspase-9, and p27 (p27Kip1) were measured by western blot assay. Cell proliferation and apoptosis were detected by MTT and flow cytometry. Cell invasion analysis was performed by a matrigel transwell assay. We also detected the level of MMP2 (metalloproteinase-2) and MMP9 (metalloproteinase-9) in cell culture medium by ELISA..
The levels of Skp2 mRNA in the negative control group (0.911 ± 0.073) and the blank control group (0.940 ± 0.046) was significantly higher than Skp2 RNAi group (0.185 ± 0.033) (P The proliferation and invasion of human bladder cancer cells can be inhibited by RNAi-targeting Skp2. As a result, Skp2 may be a potential target for gene therapy in cases of human bladder cancer..

Saddle nose deformities mostly result from trauma. Most reports of saddle nose correction after trauma relate to isolated fractures, but in this article the experience of the authors is presented in relation to bone grafting for the correction of the saddle nose in multiple facial fracture patients..
The current study aimed to report the results of a protocol for choosing the source of bone graft for dorsal nasal bone grafting in acute trauma patients with multiple facial fractures..
Patients and In a retrospective study, archived files of maxillofacial trauma patients who were treated between 2005 and 2012 at Mashhad Emdad hospital (a level one trauma center) were reviewed. Cases were selected in which a traumatic saddle nose deformity concomitant with other facial fractures had been corrected with dorsal nasal bone grafting. The donor site, type of fixation, access to the dorsum of the nose, associated facial fractures, shape of the graft (cantilever or L-shaped), and plane of dissection in the dorsum of the nose (subperiosteal or subcutaneous) were assessed..
There were 11 patients treated using this method. The male-to-female ratio was 7:5. One miniscrew with the lag technique was the preferred method for the fixation of the dorsal nasal bone graft. Splitcalvarial bone graft was the most commonly used type of bone graft. An open rhinoplasty approach and maxillary degloving were two commonly used incisions, and the most commonly associated fractures were maxillary Lefort fractures. The cantilever design was used in eight patients for the correction of the saddle nose deformity, and in four patients the bone graft was inserted into the nose in the subcutaneous plane..
Saddle nose reconstruction with bone graft in multiple facial fracture patients is a predictable method if surgical accesses to the region are carefully designed, considering the accompanying fractures..

Sufficient evidence is lacking about patient safety culture in Iran. It is only by focusing on the culture of safety within healthcare and treatment institutes that improvements may be made in patient care services..
The present study aimed to examine patient safety culture and factors that affect that culture in two hospitals in Tehran city..
Patients and A cross-sectional study was conducted in two government teaching hospitals (135- and 650-bed hospitals) in Tehran city in February of 2013 using a proportional stratified sampling method. The participants completed questionnaires with questions concerning their demographics and patient safety culture..
Overall, the study participants rated patient safety culture within their healthcare institutions at 64.7%. The highest and lowest patient safety culture subscales were 73.8% and 50.1% for “teamwork within units” and “staffing,” respectively. According to the findings, hospital size (P Given that “Staffing” was the lowest rated element in patient safety culture, improving this element could help to increase patient safety culture in hospitals in Tehran..

Context: After about 40 years from the discovery of bone marrow stem cells, the adipose stem cells (ASCs) were identify and the applications of these cells in different fields including the medical and biomedical fields have always attracted the attention of the scientists. The great quantity of stem cells obtained from adipose tissue allows the scientists to rapidly apply these primary cells without culture expansion..
Evidence Acquisition: Human has different types of fat tissues and each has its own applications, which means that the ASCs are harvested from different niches and each could be applied for different purposes. There are also specific biomarkers on the surface of the stem cells which is specific for every kind of these cells and the ASCs have also their own surface markers which help to easily detect..
Already the ASCs are clinically applied in many other purposes but the first clinical application of ASCs was reported in 2004 for the treatment of traumatic calvarial deficiency in a 7-year-old girl. However in the last decade a huge number of studies has been done on ASCs and the ASCs are used for different reasons and in different medical fields including the treatment of cardiovascular and immune diseases, for healing the wound scars and also is applied for skin rejuvenate, radiation injury, scar remodeling, and skin engineering..
This review was to focus on the roles of ASCs in different applications and also provide the researcher general information about the history and current applications of ASCs. We found that the ASCs have a potential role to be used for the treatment of different sorts of disorders, with the less side effects and is also a new approach toward new remedies..

MicroRNAs have recently been introduced as epigenetic regulators of glucose and lipid metabolic pathways, which are impaired in obesity and diabetes..
We evaluated the effects of calorie-restricted diet therapy on the circulating levels of miR-33b and miR-29a in relationship to glucose and lipid metabolic parameters in obese patients with type 2 diabetes mellitus (T2DM)..
This randomized clinical controlled trial was performed on 30 eligible obese women with T2DM, randomly divided into two groups (control group, n = 15; diet therapy group, n = 15) for 10 weeks. Ten healthy women with normal weight were enrolled at the baseline of the study as controls. Demographic information, dietary intake, and anthropometric and biochemical indices were obtained before and after the study. Circulating miR-33b and miR-29a were assessed for all subjects using quantitative RT-PCR, and the fold change of each circulating miRNA was compared between groups..
The circulating levels of miR-29a and miR-33b in the diabetic women were higher (0.40-fold) and lower (1.43-fold), respectively, than normal levels. Diet therapy significantly increased the circulating level of miR-33b (P = 0.023, 0.97-fold upregulation) to normal levels. This increase was independently correlated with caloric restriction (95%CI: -0.004 to -0.0001, P = 0.022) and 2hPPBS (95%CI: -0.009 to -0.001, P = 0.035). No remarkable change was observed in circulating levels of miR-29a..
Our findings introduced a novel therapeutic effect of diet therapy on circulating miRNAs in obese patients with T2DM. MiR-33b is an important therapeutic target in the treatment and prevention of T2DM and its complications..

It is especially true that prevalence of overweight and obesity is increasing worldwide and it is probably because of changes in diet and physical behavior pattern..
The current study aimed to test the effect of weight loss program on overweight and obese females based on protection motivation theory..
A randomized clinical trial (RCT) was implemented in the form of single blind. In total, 150 females with overweight and obesity were randomly divided into three groups including: 1, standard program group; 2, motivation interviewing (MI) group and; 3, motivation interviewing (MI) and intention intervention (II) condition (50 subjects in each group). They participated in a randomized clinical trial, also attended a private nutrition clinic in Gorgan city (Golestan province, North of Iran) for the first time. A researcher-made questionnaire and participant’s sheets (including three days food recall and anthropometric traits) were used to collect data. Data were analyzed using SPSS (ver.11) and statistical tests including Kruskal-Wallis, One-way ANOVA, Friedman test, Tukey test, Paired T-test and linear regression model were employed..
The mean age of females was 38.45 ± 9.49 years, most of them had academic degree 46.7% (n = 70), 78.7% (n = 118) were married and 60.7% (n = 91) were housewives. ANOVA repeated measure test showed that daily energy intake decreased two (P = 0.001) and six months (P = 0.001), weight (P = 0.007) and body mass index (BMI) (0.005) after intervention. Threat appraisal statistically differed six months after intervention (P = 0.001)..
Motivational interviewing resulted in decreased daily energy intake, anthropometric characteristics as well as augmented scores of coping and threat appraisal..

The benefits of the addition of L-carnitine to the diet of cats to control weight gain after the removal of their ovaries have been highlighted recently. It is also used in women after menopause. Whether its supplementation alters the sexual hormones is a concern..
The objective of this study was to evaluate the effect of dietary supplementation of L-carnitine on estrogen, progesterone and testosterone in cats following ovariohysterectomy..
Conventional midline ovariohysterectomy was performed in 14 DSH adult and healthy female cats. 10 days after the surgery, the cats were divided into two groups randomly. In group 2, a single dose of 100 mg/kg/day L-carnitine was added to the regular diet for 50 days. The cats in group 1 received no L-carnitine in their diet. Blood samples were taken from all cats prior to surgery, and then again 10 and 60 days post-operatively. Serum levels of estrogen, progesterone and testosterone were measured using a commercially available AMH enzyme-linked immunosorbent assay (ELISA)..
Serum levels of estrogen and progesterone significantly decreased at 10 days after the surgery in all cats (P 0.05)..
It is concluded that dietary supplementation of L-carnitine has no effect on serum levels of estrogen, progesterone and testosterone in cats following ovariohysterectomy. Long-term study is recommended..

Many pharmacological agents may lead to kidney damage. Preventing nephrotoxicity reduces the risk of morbidity and mortality, as well as decreasing hospitalization costs..
In this study, we investigated the comparative nephroprotective effects of silymarin, N-acetylcysteine (NAC), and thymoquinone (TQ) in animal models (rats) in which we induced nephrotoxicity using carbon tetrachloride (CCl4)..
This animal experimental study was conducted at the experimental animals center of Yuzuncu Yil University, Turkey, in 2015. Thirty-eight adult male Wistar rats were used in this study. We defined five experimental groups and treated them for four weeks. The first group (n = 8) was given no medicine. The second group (n = 8) was given only CCl4 (1.5 ml/kg, intraperitoneally (IP), in olive oil, twice a week). The third group (n = 6) was given TQ (10 mg/kg, IP, in dimethyl sulfoxide (DMSO), daily) and CCl4 (1.5 mL/kg). The fourth group (n = 8) was given silymarin (100 mg/kg, IP, in DMSO, daily) and CCl4 (1.5 mL/kg), while the fifth group (n = 8) was given NAC (10 mg/kg, IP, daily) and CCl4 (1.5 mL/kg). The kidneys of all the rats in every group were evaluated histologically using light microscopic methods at the end of the fourth week. A grading scheme was used to score the histological alterations related to tubular injury: absent (−), mild (), moderate (), severe (), and quite severe (ﯯ)..
In terms of the mean values of tubular damage, the first group had a mean of 0.0, the second group had 3.88 ± 0.35, the third group had 1.00 ± 0.89, the fourth group had 2.13 ± 1.13, and the fifth group had 2.75 ± 1.04. The results showed that, histopathologically, CCl4 had quite a severe toxic effect on the tubules when compared to the control group, although the glomeruli were intact. Silymarin, TQ, and NAC all showed statistically significant nephroprotective effects (P In conclusion, we suggest that TQ may be used as a prophylactic agent against nephrotoxicity, especially in instances of tubular injury. However, human-based studies are still needed..

Castor bean seed is used to control some medical conditions including diabetes mellitus due to popular belief in its effectiveness. However it may cause severe poisoning in humans and animals and its components (ricin) might be used as a biological weapon. In the present case, a rare intra-ventricular hemorrhage followed by unconsciousness had occurred after poisoning with caster bean. Because there is no direct antidote or reversal agent for this condition, fresh frozen plasma (FFP) was prescribed to control the hemorrhage and good results were achieved..
A 63-year-old female taking castor bean seed as a treatment for her diabetes was admitted to the emergency ward for a comatose state. A computed tomography image of her head demonstrated an intraventricular hemorrhage. Symptomatic and supporting care was prescribed. After two weeks without significant improvement, the patient was administered five units of FFP. However, the patient’s neurological status dramatically improved and remained stable..
Intraventricular hemorrhage followed by comatose state is a rare finding of the castor bean seed ingestion. The patient’s condition improved dramatically after FFP transfusion..

The empowerment of heart failure (HF) patients to improve self-care behaviors through appropriate training programs is necessary. Evidence has indicated a lack of theory-based trials in hospitals and healthcare centers, both of which represent important health promotion settings..
This study aimed to examine the effect of a hospital-based educational program based on the constructs of the health belief model (HBM) on self-care behaviors of patients with HF..
This controlled quasi-experimental study consisted of 84 patients with HF (42 patients in an intervention group and 42 in a control group) who were admitted to two large, specialized, referral hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from April to August 2015. The patients were selected using purposive sampling. Data on self-care according to the constructs of the HBM were collected using a European HF self-care behavior questionnaire and a researcher-made questionnaire..
Before the intervention, the mean score for self-care behaviors was 30.69 ± 5.13 in the intervention group and 31.23 ± 5.48 in the control group. In the first and second post-tests of the intervention group, the mean scores for self-care behaviors were 39.47 ± 3.40 and 40.09 ± 2.91, respectively (P This study showed that implementation of the HBM-based educational intervention positively influenced the self-care behaviors of patients with HF. Thus, implementing long-term educational interventions, including continuous follow-ups, in inpatient treatment centers may result in improved and sustained self-care behaviors. We strongly suggest that novel trials of educational interventions that use other health behavior theories and training strategies are needed to expand training knowledge in hospitals..

Saccharomyces cerevisiae, a common probiotic, can induce in vitro apoptosis in human cancer cells, which could explain its antitumor activity..
The present study was conducted to investigate the in vitro effects of a cytoplasmic extract from S. cerevisiae on the proliferation and viability of a K562 (chronic myeloid leukemia) cell line..
S. cerevisiae was cultured and then disrupted by sonication. After centrifugation, the harvested supernatant was considered to be a cytoplasmic extract. The protein concentration was determined by the Biuret method and the extract was diluted to concentrations of 500, 1000, and 2000 µg protein/ml. The frequencies of apoptosis and necrosis were assessed in extract-treated K562 cells by electrophoresis to show DNA segmentation and by flow cytometry..
The cytoplasmic extract exhibited a time-dependent antitumor activity. DNA electrophoresis did not reveal apoptosis and necrosis in the treated cells, but the DNA bands were weak. The flow cytometry results indicated the induction of apoptosis as well as necrosis in the K562 cell line and the intensity of apoptosis increased with time..
The cytoplasmic extract of S. cerevisiae investigated here may inhibit cell growth and induce apoptosis of chronic myeloid leukemia cells..

Caregivers’ self-assessments of the care they provide are the main vehicles that help explore their experiences and are thought to have a major role in care outcomes. The rising number of people with dementia and their need for care provided within the family makes family caregiving a major topic for study and evaluation..
The present study was conducted to assess the psychometric characteristics of the Persian version of the revised caregiving appraisal scale (RCAS) in family caregivers of older adults with dementia..
In this cross-sectional methodological study, 236 family caregivers were recruited through convenience sampling. The revised caregiving appraisal scale (RCAS) was translated using the international quality of life assessment (IQOLA) protocol, and then a panel of experts examined its face and content validities. To ensure construct validity, the translated revised caregiving appraisal scale (RCAS) was completed by 236 family caregivers, and the factor construct of the scale was assessed using five initial factors for confirmatory factor analysis. Internal consistency was confirmed using Cronbach’s alpha, and test-retest using the intraclass correlation coefficient (ICC). The confirmatory factor analysis was performed with LISREL-8.8 software for Windows®..
The mean age of the participating caregivers was 53.5 ± 13.13 years. The content and face validities of the scale were confirmed using the feedback of the family caregivers and panel of experts. The confirmatory factor analysis results reported appropriate values for all the fit indices (RMSEA = 0.046, df / χ2 = 2.428, CFI = 0.98, AGFI = 0.84, and GFI = 0.9), and the 5-factor model was confirmed with 27 items. The scale-level Cronbach’s alpha was reported as 0.894 and the scale-level ICC as 0.94. The scale met the minimum reliability standards (Cronbach’s alpha and intraclass correlation coefficient > 0.7)..
This study has provided some preliminary evidence of the reliability and validity of the Persian version of RCAS when used with family caregivers of older adults with dementia..

Tracheal stenosis is one of the worst complications of endotracheal intubation, but timely diagnosis can change its natural history. Management of these patients places a great burden on the health care system and the well-being of the patients and their families. Therefore, discharged intensive-care-unit (ICU) patients who underwent more than 24 hours of intubation should be actively followed-up 3 months after extubation and screened for post-intubation tracheal stenosis. The present study was aimed at assessing the impact of post-discharge follow-up call interviews on increasing successful screening for post-intubation tracheal stenosis..
To determine the effect of post-discharge call interviews on improving screening of post-intubation tracheal stenosis..
This experimental study was conducted in Iran in September 2014. Using the simple randomization method, 140 patients who had undergone than 24 hours of endotracheal intubation and had received oral and written educational materials upon discharge from the ICU were equally assigned to an intervention and a control groups (received a call interview before or after the follow-up due date, respectively). The needed sample size was calculated to be 70 participants in each group (considering α = 5%, the statistical power of 90%, and effect size = 0.4)..
There was a significant difference in follow-up rates at the due date between the intervention group (50.7%, 34of 67 participants) and the control group (17.5%, 11 of 63 participants) (OR = 4.871, 95% CI = 2.172 to 10.924, P We highly recommend making call interviews, along with distributing the oral and written educational materials, to increase the follow-up rate among discharged ICU patients..

Myosin heavy chain 9 (MYH9) gene polymorphisms have been implicated in different types of renal disease, as well as in nephropathy attributed to type 2 diabetes mellitus..
This study sought to analyze the association of MYH9 gene polymorphism (rs4821481) with diabetic nephropathy (DN), urine albumin excretion value, and glomerular filtration rate (GFR) in an Iranian diabetic population..
This case-control study included 201 diabetic patients with and without DN, who were referred to the diabetes and metabolic center, Tehran, Iran. The allele and genotype frequencies of rs4821481 were determined using ARMS-polymerase chain reaction (ARMS-PCR). In both groups, blood levels of fasting glucose, HbA1c, urea, creatinine, uric acid, and lipids, as well as urine albumin and creatinine, were measured and GFR was calculated..
Patients who carried the rs4821481 polymorphism had significantly higher urinary excretion of albumin (P Although we found an association between MYH9 gene polymorphism and urinary albumin excretion, the results did not show a significant association between MYH9 polymorphism (rs4821481) and risk of DN in Iranian diabetic patients..

The aim of this study was to evaluate the effect of fish oil supplementation on antenatal and postpartum depression score..
This was a randomized, triple-blind, placebo-controlled trial. We enrolled 150 eligible pregnant women with Edinburgh postnatal depression scale (EPDS) score of less than 20, aged 18 to 35 from Feburary 2014 to April 2015 in Tabriz, Iran. Participants were randomly assigned to receive either 1000 mg of fish oil supplements or placebo from 16 - 20 weeks of gestation to one month after giving birth. Participants completed the EPDS at baseline, 26 - 30 weeks, 35 - 37 weeks, and 30 - 45 days after birth. Primary outcome measures were the mean depression score at 26 - 30 weeks, 35-37 weeks, and postpartum period. The statistical analysis was intent-to-treat..
A total of 150 females were included, and no one was lost to follow up. There were significant differences between the two groups in the mean score of depression only at 35 - 37 (adjusted mean difference = -1.4; [95% CI -2.6 to -0.25]). The mean score of depression during pregnancy and postpartum period significantly decreased within the fish oil group (P Fish oil supplements significantly decreased the mean score of EPDS at weeks 35 to 37. It seems that females may benefit from daily fish oil supplements during pregnancy especially in countries with low intake of fish yet further studies are needed to confirm these results..

Osteoarthritis (OA) is a degenerative joint disease with several pathological mechanisms. The intervention that provides for reduced pain and disability with fewer side effects may help improve OA. Pomegranate peel is known to have powerful antioxidant and anti-inflammatory properties due to its great amount of polyphenols..
The objective of this study was to evaluate the effects of the pomegranate peel extract on clinical signs and symptoms of knee OA..
This randomized, doubleblind placebo-controlled clinical trial was conducted amongst 60 women in the age range of 38 - 60 years who were referred to the physical medicine and rehabilitation department of the Tabriz University of Medical Sciences in Tabriz, Iran (Sep 2014 - Feb 2015). The participants were allocated using the block randomization method in one of two study arms. The intervention and control groups received 500 mg of pomegranate peel, hydro alcoholic extract (n = 30) and placebo (n = 30), twice daily for 8 weeks, along with standard drug therapy. The primary outcome measure was the change in mean, Knee injury and osteoarthritis outcome score (KOOS) and the secondary outcome measure was the visual analog scale score..
There were no significant differences between the two groups in the mean of age, body mass index (BMI), disease duration and parity before intervention (P > 0.05). The mean of KOOS increased from 46.15 ± 16.82 to 57.57 ± 15.61 after 12 weeks (P This study presented some effects of the pomegranate peel extract in reducing pain and improving clinical signs and symptoms in women with knee OA and might be considered as a complementary medicine in treating OA..

Road traffic injuries (RTIs) are the leading cause of injuries and the second cause of mortality in Iran..
The aim of this study was to investigate the epidemiological pattern of RTIs in Iran based on the data from disaster management information system (DMIS) of the Iranian Red Crescent..
In this cross-sectional study, the pattern of RTIs in Iran was studied based on the data from DMIS in the period from 20 March 2012 to 19 February 2016 (35 months). All of the 78775 RTIs recorded were selected through census. Data analysis was done using the SPSS.16 software package. P value less than 0.05 was considered statistically significant..
Among the 19 types of accidents whose data are recorded, road traffic accidents with a 78775 number of occurrence (136.1 ± 86.5 per 100000 people), 186860 injuries (332.1 ± 220 per 100000 people) and 12596 deaths (22.6 ± 11.1 per 100000 people) were the highest in ranking. The most common annunciator of the accidents was the emergency. Receiving the first report of the rescue operation was most done by telephone. The mean number of the operational forces involved in RTIs per 100000 people was 529.2 ± 407. The results showed that there was a significant difference between high, moderate and low population rate provinces in the mean number of injuries cases, the mortality of RTIs and the total number of Red Crescent operational forces (P Considering the high occurrence of the mortality and the injuries of the RTIs compared to that of the other types of accidents, more attention to RTIs in planning and interventions seems necessary..

Context: Infections caused by the hepatitis B virus (HBV) pose a major challenge to the public health and also results in high mortality and morbidity rates in different parts of the world, especially in children. This study performed a systematic review and a meta-analysis of cross-sectional studies conducted during the years 2000-16 to clarify the prevalence of hepatitis B surface antigen (HBsAg) in children and adolescents younger than 16 years of age in EMRO and Middle Eastern (E and M) countries..
Evidence Acquisition: Scientific databases including PubMed, Ovid, Scopus, Google Scholar, and Persian databases were searched for relevant articles published from January 1, 2000 to October 31, 2016. Based on the results of homogeneity tests (a significant homogeneity test and a large I2 value) a random effects model was used to aggregate the collected data and calculate the pooled prevalence estimates..
We included 20 articles in our meta-analysis. The pooled HBsAg prevalence in children of E and M countries was 2.73% (95% CI: %1.73% - 3.72%). The prevalence rates in the EMRO and Middle Eastern countries were 1.85% (95% CI: 1.27% - 2.43%) and 2.66% (95% CI: 1.31% - 4.01%), respectively. The prevalence rates amongst children in nations considered in more than one study were 0.81% (95% CI: 0% - 1.74%) in Iran, 2.64% (95% CI: 1.63% - 3.64%) in Pakistan, and 5.83% (95% CI: 2.99% - 8.67%) in Turkey..
Based on the world health organization classification of HBV prevalence, intermediate HBsAg prevalence rates were detected in children of E and M countries during 2000 - 2016. Nevertheless, the prevalence rates were low in several included countries in mentioned regions..

Lactate level is known to increase among the majority of patients with toxicity. This study aimed to determine whether lactate level upon admission is higher among patients with ventilator-associated pneumonia (VAP)..
We aimed to determine whether serum lactate level is associated with the increased risk of VAP in intensive care unit (ICU)-admitted patients with toxicity..
This retrospective study was conducted in a training medical poisoning center in Iran, using convenience sampling. A total of 157 poisoned patients, aged ≥ 13 years, who were admitted to the ICU over the past seven months, were included in the study. Subjects were categorized into two groups, based on their VAP diagnosis (VAP-positive and non-VAP) and the outcomes (surviving or non-surviving). The VAP-positive patients were compared with others with regard to the mean level of serum lactate level upon admission. Additionally, non-surviving patients were compared with their surviving counterparts..
Overall, 71 (45.2 %) VAS-positive cases were reported, in addition to 36 cases of mortality. Alkaline phosphatase (ALP) was the most common toxic agent (36%), followed by methanol. Significant differences were noted between the groups in terms of Simplified Acute Physiology Score-II (SAPS-II), Glasgow Coma Scale (GCS) score, length of ICU stay, and percentage of ventilation process. The mean levels of lactate at admission were 3.71 ± 3.35 and 4.19 ± 4.09 among VAP-positive and non-VAP patients, respectively; the difference was not statistically significant. Also, non-surviving patients had a longer ICU stay (12.20 days), compared to surviving patients (5.39) (P = 0.008). Moreover, admission lactate level was 7.06 ± 5.29 mmol/L among non-surviving patients and 3.01 ± 2.53 among surviving cases (P Based on the findings, the mortality rate was 22.9% among poisoned patients with an elevated serum lactate level. We can conclude that mortality is associated with toxicants, but not the occurrence of VAP; in fact, VAP scenarios do not elevate serum lactate level..

Arbitrary drug use is considered as one of the major problems in all countries. Several studies indicate that self-medication is more prevalent in women. In addition to the side-effects of drugs on women’s health, their health behavior can affect their families, as well. Qualitative research provides insight into participants’ internal world as well as the chance to specify and interpret the data and their experience at a deeper level..
The present qualitative study aimed to explore women’s perception of OTC drugs..
The present study is a conventional qualitative content analysis conducted on women’s community in the Guilan province, the North of Iran. The study population was selected through purposive sampling, and the data were gathered through semi-structured interviews, which continued up to data saturation point. Data analysis was performed as per the stages recommended by Graneheim and Lundman. Research strength and its scientific accuracy were evaluated as per the criteria proposed by Guba and Lincoln..
Data analysis identified three main themes and 9 subthemes as follows: “fragmented interaction in health system (poor relationship between patients and therapists, government’s poor economic support, inadequate supervision); “false self-confidence” (belief in the non-riskiness/efficiency of self-medication, self-esteem in understanding one’s health status, good memories of healing); “perceived personal stonewalling” (limitations in time, huge costs of treatment, and poor understanding of nuisances)..
Participants’ experience highlighted the necessity of awareness about adverse side effects of OTC drug use; such awareness can be achieved through various methods such as information dissemination and proper culture of drug use promoted by healthcare professionals to resolve the mentioned issues and improve, consolidate, and promote society’s level of knowledge and health..

Amyloid precursor protein (APP), which is involved in cell proliferation, is observed to be over expressed in human cancer. Thus, it is crucial to investigate its role in cancer and suggest treatment strategies to alter its effects on cell growth..
The main purpose of this study was to determine APP concentrations in colon cancer SW480 cell line after treatment with histone deacetylase inhibitors (HDACIs), namely valproic acid (VPA) and carbamazepine (CBZ)..
In the present experimental study, carried out during the period 2014 - 2016 in Iran, 1000000 cells were seeded and incubated in a six-well plate for each sample preparation. The cells were then treated with drugs and APP was evaluated. The concentration of this protein was detected using the enzyme-linked immunosorbent assay (ELISA) method..
We found that treatment with CBZ (P The results of this study suggest that APP reduction by HDACIs can apparently play an important role in the treatment of colon cancer..

Wound healing is a process that occurs following skin lesions. Shortening healing time is of critical importance as it reduces the risk of infection, complications, and costs..
In this experimental study, 36 male Wistar rats each weighting approximately 200 - 220 g were studied in six groups, each with 6 animals for 21 days. Hydroalcoholic extract of Burdock root was prepared through the maceration method. The animals underwent a 2 × 2 cm diameter resection of cutaneous fragment on the dorsum. The first group was kept without treatment as the control group, the second group (negative control) was treated with Eucerin, and the third group (positive control) was treated with ointment of phenytoin (1%). Eucerin based-ointments from hydroalcoholic extracts of Burdock root with concentrations of 20%, 40% and 60% of weight/weight were administered to the animals in the other three groups twice a day. The lesion diameter and programmed euthanasia were analyzed through a surgical specimen resected for histopathology..
The healing process was completed in 21 days in both no treatment and Eucerin groups. In the phenytoin 1% group, the healing time was 16 days and in hydroalcoholic extracts of Burdock root groups of 20%, 40% and 60%, complete wound closure was observed in 16, 16 and 14 days, respectively. All the treated groups and the control group showed significant differences when compared with the negative control and control group (P The crude hydroalcoholic extract of Burdock root was found to cause better outcomes in the healing process, acute inflammation, and fibrosis on the 7th, 14th, and 21st day postoperatively..

This was a report of uterocutaneous fistula as a rare complication of expectant management of placenta increta, and a review of the literature..
A 38- year- old pregnant woman in her third term of pregnancy was operated on in a secondary hospital in Arak (a city located in the center of Iran) in April 2015. As a result of placenta incereta, the attached placenta was left in the uterus. On the 38th day, she was referred to our tertiary care hospital due to intermittent fever and bleeding. More examinations by MRI and hystrosalpingography revealed uterocutaneous fistula. She was operated on again, and surgical findings indicated coexistent uterine necrosis and uterocutaneous fistula..
This case was the first reported morbidity of fistula in the uterocutaneous pathway..

The prevalence of Hypertension (HTN) in developing countries might have a different pattern in different countries..
This study aimed at investigating the current pattern of HTN and evaluating its relationship with health complaints in elderly Iranian individuals in 2012..
This cross sectional study used multistage sampling to investigate 1 350 Iranian elderly subjects (≥ 60 years) living in the community. Those elderly, who had a systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg and/or those who used antihypertensive drugs during the previous two weeks, were considered as HTN. A face-to-face interview was performed using a structured questionnaire, including demographic factors, awareness, treatment and control of HTN, and health complaints for each individual. Chi-square test and multiple logistic regression analyses were applied to detect the most important variables related to HTN..
Hypertension was seen in 48.5% of individuals. Awareness, treatment, and control of HTN were seen in 40.7%, 82.5%, and 30% of individuals, respectively. Elderly individuals with HTN had significantly more experienced visual disturbances (P = 0.03), fecal or urinary incontinence (P = 0.006), nocturia (P = 0.002), attacks of shortness of breath (P = 0.004), and hyperlipidaemia (P The prevalence of HTN was lower in elderly community-living Iranians than developed countries, yet, was still considerable. Nocturia and hyperlipidemia were the most common health complaints in Iranian elderly with HTN..