Iranian Red Crescent Medical Journal
Volume:19 Issue: 6, Jun 2017

Context: Considering the stressful conditions of life and social difficulties, an important question is why are some people can show positive adaptation and avoid mental health disorders, while others cannot? The present study aimed at reviewing the national studies on the correlation between resilience and mental health.
Evidence Acquisition: In this systematic review, all national articles published in international and national databases were searched without restrictions, using the following keywords: “Resilience OR Resiliency” AND “Mental health” OR “General Health” and their combinations. The Persian equivalents of these words were also used in Persian language sites. Finally, based on PRISMA guidelines, 15 studies were selected. The results of these studies were combined using the random effects model of meta-analysis.
In the present research, 16 correlation studies were examined without time limits, and with a sample size of 3157. Overall, a positive correlation was found between resilience and mental health in the national studies (r = 0.48). The results showed that the correlation between resilience and mental health was lower in the population of school and university students than among other populations (r = 0.39, compared to r = 0.54). The analysis based on geographical division indicated that the highest correlation between resilience and mental health existed in the fifth area (r = 0.83), and the lowest correlation was found in the fourth area (r = 0.35).
By providing cognitive, behavioral and emotional responses in stressful situations, resilience can maintain and improve mental health.

Dyslipidemia is a well-known risk factor of cardiovascular disease. Few studies focused on early postpartum lipids profile, particularly in women with gestational diabetes mellitus.
This study aims at determining the levels of total cholesterol, triglycerides LDL-C, HDL-C, and VLDL-C at 6 to 12 weeks postpartum in women with gestational diabetes, comparing them to lipids profiles of controls and identifying independent risk factors of dyslipidemia in 2 studied groups.
Life after gestational diabetes, Ahvaz study (LAGAs), was started on March 2015. This was an ongoing population-based cohort study that aimed at investigating metabolic outcomes of gestational diabetes mellitus and comparing them with healthy groups. Up to February 2016, during the first 11 months sampling, 176 women with gestational diabetes and 86 healthy mothers underwent FBS, 75-g 2- hour oral glucose tolerance and fasting lipids tests (including total cholesterol, triglyceride, LDL- cholesterol, HDL -cholesterol, and VLDL-cholesterol) in 6 to 12 weeks after delivery.
Overall prevalence of dyslipidemia was 73.7%. Most common forms of dyslipidemia in 2 groups were HDL-C Dyslipidemia is highly prevalent in women with and without GDM at 6 to 12 weeks postpartum, particularly in overweight and obese women. Dyslipidemia and obesity are both modifiable risk factors for cardiovascular disease.

One of the most important non-communicable diseases (NCDs) is cardiovascular disease (CVD). CVDs caused an increase in treatment costs and sick-leave hours in employees. These diseases are originated from unhealthy behaviors. Education and training health behaviors are a necessity in the workplace. Worksites that are exclusively situated to provide interventional education would effectively reduce the risk of cardiovascular disease in employees. Petrochemical industries are regarded as the key industry and improving the working conditions leads to employees’ satisfaction and remarkable productivity levels.
The current study was aimed at investigating the impacts of the theory of planned behavior (TPB)-based nutritional education on the risk factors of CVD in the employees of petrochemical companies.
The current study was a randomized controlled field trial. The subjects were male employees aged 30 to 60 years, with at least 3 years of work experience. The employees had at least one type of blood lipid abnormalities according to their medical checkups. One hundred and four participants were randomly selected and divided into 2 groups of intervention and control. Educational program was performed in 5 educational sessions. Individuals’ data were collected before and 3 months after the intervention using demographic, TPB questionnaires and serum lipid profiles.
Totally, 92 participants were included in the study: 49 participants in the intervention group with the mean age of 42.30 ± 9.13 years, and 43 in the control group with the mean age of 43.18 ± 8.75 years. Significant differences between the scores of knowledge and other items of TPB model as well as nutritional indices were observed in the intervention group after 3 months (P value Tailored nutrition education program was effective in improving of nutritional behaviors and serum level of LDL-C in the employees of the petrochemical companies.

A decrease of naive T-cells and a concomitant increase in memory cells are the accepted consequences of aging on the adaptive immune system.
The current case-control study aimed at considering the impact of chronic hyperglycemia that leads to glycation of modified self proteins on aging via the memory cell percentages among the patients admitted to the endocrinology department of Bulent Ecevit University Hospital in Zonguldak province, Turkey, from September to October 2015.
Blood samples were collected from 81 patients with diabetes mellitus (DM) and 39 healthy volunteers with no history of autoimmune diseases or chronic inflammatory disorders, based on the purposive sampling method. The patients were divided into 2 groups based on the presence and absence of the diabetic microvascular complications. Diabetic nephropathy, neuropathy, and retinopathy were investigated according to the American Diabetes Association criteria. T-lymphocytes subpopulations were measured in peripheral blood by the flow cytometry. CD27, CD45 RO, and CD45 RA were used to discriminate naive and memory T-cells (CD4 and CD8). Data for each subpopulation were reported as a percentage of the total CD4 and CD8 cells.
The mean percentage of naive (CD45RA CD27) and memory (CD45RO CD27 central memory and CD45RO CD27- effector memory cells) CD4 T-cells in patients with type 2 DM and healthy controls were 26.73 ± 15.04, 19.21 ± 10.80, 31.35 ± 10.94, and 15.07 ± 6.97, respectively. A decrease in the naive and an increase in memory CD4 T-cell proportion were found in patients with type 2 DM, compared to the healthy controls (P values = 0.031 and 0.018, respectively).
Higher memory and lower naive CD4 T-cells probably reflect thr accelerated aging of the adaptive immune system in patients with type 2 diabetes.

Identification of the influencing factors of nursing students’ clinical judgment (CJ) facilitates the achievement of this important educational outcome. However, no tool is so far designed to assess it in the field of clinical education in Iran.
The current study aimed at designing sequential exploratory mixed method in 3 phases.
It was a mixed method study. The 1st phase included reviewing literature, analyzing the relevant studies in Iran, and a qualitative content analysis. In the 2nd phase, validity and reliability of the tool were investigated.
In the study, after assessing the face, content, and construct validity, 4 factors and 38 items obtained. Content validity ratio (CVR) ranged from 0.45 to 1.00 and content validity index (CVI) ranged from 0.6 to 1.00. Internal consistency of the total scale was good with Cronbach’s alpha coefficient 0.92, and intraclass correlation coefficient (ICC) was 0.95 that indicated good stability. In the construct validity by exploratory factor analysis, the Kaiser-Meyer-Olkin (KMO) index was higher than 0.90 and also the Bartlett test of sphericity was significant (P value The developed questionnaire in the current study was a suitable tool to assess the factors influencing the CJ of undergraduate nursing students.
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Marital satisfaction is as an important factor in family function. Considering incompatibility between couples, some approaches such as construct therapy could be effective in marital satisfaction.
This study aimed to evaluate the effectiveness of personal construct analysis model in marital satisfaction.
The present research was a quasi-experimental study with pretest-posttest and fallow up design. The population was consisted of couples referring to counseling centers in Tehran (Iran) due to marital conflict during 2011 - 2013. The participants were randomly assigned to two groups (Treatment (T) and Control (C)) of 15 pairs each. The treatment group received 10 weekly sessions of intervention. The data were collected by enrich marital satisfaction short form 47-item questionnaire and analyzed statistically using analysis of variance.
The mean differences in variables including personality issues (T = 2.96, C = -0.6, P The present study demonstrated that personal construct analysis model can be used as an alternative intervention for marital distress.

Despite advances in postoperative pain control, it is still a big challenge with high-prevalence for practitioners. Inadequate control of postoperative acute pain is common which can lead to serious complications for patient.
This study aimed to compare massage therapy and music therapy in the control of postoperative pain and amount of received opioid drug after abdominal surgery.
In this randomized 3-group trial, 102 patients in the surgical wards of 3 military hospitals, Ahvaz, Iran, were randomly allocated to music group, massage group, and usual-care group. Participants in the massage and music groups received 10-minutes sessions of slow-stroke back massage and without lyrics music, respectively, 1, 6, and 12 hours after surgery. The pain intensity was measured by numeric rating scale 10 minutes after each intervention session. Also, the mean of received opioid drug during 12 hours was measured in each group.
The results indicated a decreasing trend of pain intensity in all the groups. However, the trend of pain intensity had a significantly more decrease in the massage group compared to the both music group (P = 0.001) and usual-care group (P = 0.001). Pain intensity at the baseline had no significant difference between the massage group and the music group (Mean ± SD: 7.13 ± 1.2 vs. 6.97 ± 1.3, P = 0.6); whereas, pain intensity 12 hours after surgery had a significant difference between the massage group and the music group (Mean ± SD: 2.26 ± 1.03 vs. 3.30 ± 1.5, P = 0.002). Also, the mean of received opioid drug was significantly lower in the massage group than both the music and the usual-care groups (P = 0.013 and P = 0.001, respectively). Also, the mean of received opioid drug was significantly lower in the music group than the usual-care group (P = 0.047).
Massage therapy was more effective than music therapy in controlling postoperative acute pain after abdominal surgery. Hence, the use of non-drug methods (especially massage therapy) as safe, inexpensive, effective, and available methods are very helpful for controlling postoperative acute pain.

Colorectal cancer (CRC) is one of the most common neoplasms of the digestive system with high morbidity and mortality. Treatment of CRC in advanced metastatic stages is problematic. Thus, early diagnosis in primary stages using sensitive molecular markers seems to be necessary.
This study aimed at investigating the immunohistochemical expression of P16ink4a in CRC compared to adenomatous and normal colorectal tissue samples of a population from the southeast of Iran.
This case-control study was conducted on 137 colorectal formalin fixed paraffin-embedded tissue blocks for P16ink4a a protein using Immunohistochemistry (IHC). The tissue blocks were categorized in 3 groups, including adenocarcinoma (n = 63), adenomatous (n = 38), and normal (n = 36). All tissue blocks were collected from the pathology department of Ali-Ebne-Abitaleb central and referral Hospital, Zahedan, Iran from 2010 to 2015. The sections were evaluated using semi-quantitative scoring. The P16ink4a expression was reported as negative and positive. Clinicopathological characteristics were also assessed. The data were analyzed by Kruskal-Wallis and Fisher exact tests. The significance level was considered as P The expression of P16ink4a in adenocarcinoma, adenomatous, and normal colorectal tissues was 25.40%, 50.00%, and 69.50%, respectively. The P16ink4a expression was significantly higher in non-neoplastic tissues compared to the adenomatous and colorectal tissues (P Considering the significant expression of P16ink4a in normal compared to adenomatous and cancerous samples, it seems that this biomarker could be used as a potential useful predictor for screening and diagnosis of CRC patients in early stages. Further researches should be conducted on this matter.

Cyclic mastalgia (breast pain) is one of the most common reasons for referral of women of childbearing age to physicians. Due to the increasing popularity of herbal medicines among women, this study investigates the effect of cinnamon on cyclical breast pain.
The aim of this study is to determine the effect of cinnamon on cyclical breast pain.
This was a randomized clinical trial in which 74 women with cyclical breast pain and who met the eligibility criteria were randomly divided into intervention and control groups, based on the four and six random block sampling method. Cinnamon was given to the intervention group and a placebo was given to the control group. The collected data was analyzed by SPSS (statistical package for social science) statistical software (version 14). Chi-square, repeated measures ANOVA (analysis of variance), and independent and paired-t tests were performed.
The mean (SD) values of the patients in the intervention group and the control group were 9.08 (3.56) and 9.45 (2.55), respectively. There was a statistically significant difference between the two groups in the mean scores of pain at the end of the first and second months (P Cinnamon can be effective in reducing the intensity of cyclical breast pain in women.

Using time effectively has become increasingly important in terms of the successful performance of healthcare managers.
In this study, the time management behaviors of healthcare managers and the effects of demographic variables on these behaviors are determined.
This cross-sectional and descriptive research was carried out on managers from five hospitals in Tekirdag, Turkey. The data was collected with the survey method. The research population of 175 managers were targeted with an initial invitation to participate in the study. However, only 163 managers accepted the invitation to complete a questionnaire. SPSS for Windows 15.0 package software was used to analyze the data.
For managers, general planning, meeting management, determining priorities, substitution, table and file folder set up, procrastination, and answering unnecessary phone calls were found to occur frequently; general time management was also found to consume a significant amount of time, whereas saying “no” to visitors was determined to be of only an average level of time consumption. With respect to the scores of women, determining priorities, saying “no” to visitors, table and file folder set up, and procrastination took up more time than they did for men.
It was determined that demographic variables do affect the time management behaviors of healthcare managers.

Striae Gravidarum is a physiological skin change that many females experience during pregnancy and causes stress and concerns about their beauty, self-esteem and other psychological problems, by irritation and even ulcers in the affected areas.
This study was performed to evaluate the effect of sesame, sweet almond, and sesame and sweet almond oil on prevention of striae (primary outcome) in primiparous females.
This triple-blind randomized controlled clinical trial was done on 200 18 to 35-year-old primiparous females at five governmental health clinics affiliated to Arak University of Medical Sciences, Iran. The subjects were allocated to three intervention groups and one control group by four and eight block randomization and allocation ratio of 1:1:1:1. The strategy used for analyzing data was intention to treat analysis. The intervention groups and control group received 1cc sesame, 1cc sweet almond and sesame oil, 1cc sweet almond oil, and 1cc Placebo, respectively, two times (1 mL twice daily without massaging the abdomen) for 20 weeks. One-way analysis of variance (ANOVA), chi-square, Kruskal-Wallis and binary logistic regression were used to analyze data.
Striae at 35 to 38 weeks of pregnancy were observed in 59.2%, 16.7%, 14% and 82% of participants in sweet almond, sesame, sesame & sweet almond oil and control groups, respectively (P The sesame oil, sweet almond oil and their combination was effective in reducing the occurrence of abdominal steriae and its itching.

Since insulin receptor substrate-1 (IRS-1) is the main substrate of the insulin receptor tyrosine kinase and has been detected to activate phosphatidylinositol (PI) 3-kinase and promote GLUT4 translocation, the IRS-1 gene is a possible candidate for development of type2 diabetes, insulin resistance, and obesity. Preilipin (PLIN) coats intracellular lipid droplets and modulates adipocyte lipolysis.
In this study, we investigated whether insulin receptor substrate-1 (IRS-1) and Perilipin (PLIN) genes polymorphism were associated with Type 2 diabetes (T2D), obesity, and lipid profiles in a sample of the Iranian population (Southeast of Iran).
In this randomized case-control study (Feb, 2016 to Sep, 2016), we genotyped 200 patients with T2D and the same number (200) of controls by using the combined nested-polymerase chain reaction (PCR) as well as the amplification refractory mutation system (ARMS)-PCR for IRS-1 variant and Tetra-ARMS-PCR for PLIN variant in southeast Iran (Zahedan).
The polymorphism of 4578621 in the PLIN gene was associated with T2D. GG genotype and G allele at rs4578621of PLIN gene were significantly higher in patients than in controls (for the G allele: OR = 2.31, 95%CI = 1.55 - 3.46, P The rs2943641 polymorphism of the IRS-1 gene is a major genetic determinant of obesity but not Type 2 diabetes and lipid profiles. The rs4578621 polymorphism of the PLIN gene related with T2D and TG but not obesity.

In competing risks data, when a person experiences more than one event in the study, usually the probability of experiencing the event of interest is altered. Therefore, it is necessary to analyze the competing risk data.
The current study aimed at analyzing the colorectal cancer (CRC) risk factors based on competing risks model. The log-logistic model was also fitted with 2-parameter to evaluate the prognostic factors that affect the survival of patients with CRC, and comparisons were made to find the best model.
The current retrospective study was conducted on 1054 patients with CRC registered in the Research Institute of gastroenterology and liver disease center (from 2004 to 2015), Taleghani hospital, Tehran, Iran. The demographic and clinical features including age at diagnosis, gender, family history of CRC, body mass index (BMI), tumor size, and tumor site were extracted from the hospital documents. Analysis was performed using competing risks model and was based on the 4-parameter log-logistic distribution and log-logistic distribution. The analysis was carried out using R software version 3.0.3. P value less than 0.05 was considered as significant.
Overall, 1054 patients with CRC and complete data were included in the analysis. The mean ± standard deviation (SD) of survival time was 92 ± 6.62 months. Out of the 1054 patients, 379 (36%) subjects died of CRC and 49 (4.6%) subjects died of other causes such as myocardial infarction, stomach cancer, liver cancer, etc. Four-parameter log-logistic model and log-logistic model with competing risk analysis indicated age at diagnosis and BMI as the prognosis.
The current study indicated age and BMI as prognosis of CRC, using a 4-parameter log-logistic model with competing risk analysis. Although the odds ratio (OR) in 4-parameter log-logistic model and log-logistic model ones were approximately similar, according to Akaike information criterion, the 4-parameter log-logistic model was more appropriate for survival analysis.

Despite progress in the control and treatment of gestational diabetes mellitus (GDM) in pregnant females, these patients remain at risk of disease complications.
The present study aimed at investigating the effect of probiotic supplements on Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) in pregnant females diagnosed with GDM.
This randomized double-blind, placebo-controlled trial randomly assigned 64 pregnant females with GDM, recruited through convenience sampling, to either a group receiving a probiotic capsule (n = 32) or a group receiving a placebo (n = 32) for 8 weeks in Tabriz, Iran, during the spring and summer months of 2014. Their blood pressure was measured at baseline and at 2-week intervals, up to 8 weeks.
A total of 56 subjects completed the study. There was no significant difference in SBP in the probiotic group at any time compared with that at onset, yet, SBP increased significantly in the placebo group. The declining trend of DBP was evident in the probiotic group at 2 weeks and continued to the end of the study; however, DBP had increased slightly by week 6 in the placebo group. There were significant differences between the probiotic and placebo groups at 6 and 8 weeks, respectively, for SBP (104.828 (2.051) mmHg vs. 112.963 (2.126) mmHg; P = 0.008) and (106.552 (1.845) mmHg vs. 115.185 (1.912) mmHg; P = 0.002) and for DBP (62.414 (1.353) mmHg vs. 70.741 (1.402) mmHg; P The results demonstrated that consumption of probiotic supplements for 8 weeks prevented an increase in SBP and decreased DBP in pregnant females diagnosed with GDM.

The reason behind patients’ overcrowding in emergency departments (ED) may be due to several factors such as great number of referring patients or inaccessibility of facilities or hospital beds.
The present study aimed at evaluating the overcrowding of ED in Tabriz Imam Reza hospital in 2015 using 2 scales: National Emergency Overcrowding Scale (NEDOCS), and Emergency Department Work Index (EDWIN).
This was a cross-sectional descriptive study conducted in the ED of Imam Reza hospital affiliated to Tabriz University of Medical Sciences, Iran, in a one-year period (Jan- Dec 2015). Convenience sampling method was used for data collection. During the study, the researchers randomly selected 10 days out of every month and started to collect index variables 4 times a day at 6 AM, 12 noon, 6 PM, and 12 midnight. In total, 488 samples were gathered and both NEDOCS and EDWIN were implemented for each sample. Then, the frequency of overcrowding in the emergency department was reported based on the obtained results.
Based on NEDOCS, ED was extremely busy, but not overcrowded in 51 cases (10.5%), it was overcrowded in 298 (61.1%) cases, severely overcrowded in 138 cases (28.3%), and it was busy only in one case (0.2%). However, based on the EDWIN scale, the ED was active but manageable in 91 cases (18.6%), very busy in 36 cases (7.4%), and extremely busy in the remaining 361 cases (74%).
EDWIN scale depicted August, July, December, June, and April to be, respectively, the most overcrowded months. This finding revealed EDWIN scale to perform better when trying to have an overall assessment of ED during the whole year, which helps us have clear- cut results for analysis and policy making in managing EDs.

Pneumocystis carinii pneumonia remains a crucial cause of morbidity and mortality in organ transplant recipients. Pneumocystis carinii pneumonia occurs most frequently within the first 6 months post-transplant. Onset is generally fulminant, and typical symptoms include fever and productive cough accompanied with respiratory distress.
Here, we present a case of a patient who developed P. carinii pneumonia 18 years after renal transplantation and referred to Taichung Veteran General hospital in Taiwan in September 2015. The disease course was indolent without hypoxemia and dyspnea, mimicking walking pneumonia. The risk factors in our case contributing to P. carinii pneumonia included increased doses of immunosuppressants due to recent rejection, treatment with tacrolimus rather than cyclosporine, lymphopenia, and possibly the occurrence of urothelial carcinoma, implying an immune-deficient state. The inflammatory response of P. carinii pneumonia was not intense and gave rise to an indolent disease course.
This case should remind clinicians that P. carinii pneumonia could present atypically in an indolent form many years following organ transplantation, especially when predisposing factors are present. Longer duration of P. carinii pneumonia prophylaxis, especially for high-risk patients such as those with potent immunosuppressive regimen, or those who received recent treatment for acute cellular or humeral rejection may be considered.

Splenic artery aneurysms are the most common visceral arterial aneurysm formations, as well as the 3rd frequent abdominal aneurysm. Most of them are asymptomatic until rupture and are ascertained unintentionally, usually after an imaging study. Open surgery is the elective therapy for splenic artery aneurysm, but has the disadvantages of severe surgical injuries including high rates of mortality and high risk complications.
In this case report, we present a 44-year-old woman with right upper quadrant abdominal pain diagnosed as Splenic artery aneurysms. This pain was first vague and gradually caused more discomfort and, occasionally, caused a sharp pain with radiation to the back that had no relation with food or position aneurysms.
Selection of a suitable super-stiff guide wire during the procedure to provide sufficient support and decrease the difficulties related to stent graft delivery and release seems to be necessary. Nowadays endovascular modality for the treatment of splenic artery aneurysm is recognized and in selected patients can be done with fewer complications and good results.

Severe presentation of concomitant carotid, coronary, and peripheral arteriosclerosis is not a common finding. However, some studies have reported surgical and noninvasive interventions for this condition.
Herein, we present a patient with concomitant carotid, coronary, and peripheral arteriosclerosis, who underwent angioplasty in Tehran, Iran in November 2015. Some studies have been carried out on surgical and percutaneous coronary, carotid and peripheral intervention for concomitant lesions; however, reports about percutaneous coronary, carotid and peripheral intervention, similar to the present case, are not available.
Due to lack of evidence on the prevalence and management of concomitant multifocal coronary, carotid, and limb arteriosclerosis, it is necessary to perform well-designed studies on such groups of patients to define proper management (surgical versus endovascular interventions), periprocedural complications, as well as short- and long-term outcomes. 