Iranian Red Crescent Medical Journal
Volume:18 Issue: 10, Oct 2016

We describe a female patient with extreme reactive thrombocytosis (RT) in anti-neutrophil cytoplasmic autoantibodies (ANCA)-associated crescentic glomerulonephritis (CGN) with immune complex deposits, which has never been reported before.
A female adolescent with symptoms of oliguria and gross hematuresis had serious renal function impairment (crescent formation and immune complex deposits in renal pathology examination with positive serum ANCA) and extreme thrombocytosis. We made a diagnosis of CGN and RT. After treatment with Prednisone, Cyclophosphamide, and plasmapheresis, the symptoms of oliguria and gross hematuresis were relieved remarkably and the serum creatinine and platelet count declined significantly.
The diagnosis of thrombocytosis is not easy in all cases. The coexistence of ANCA and the immune complex in CGN may cause a severe inflammatory state, leading to extreme RT. The roles that the immune complex and ANCA play on the effect of the platelet count and function in CGN need further research.

Congenital tuberculosis is an infrequently encountered condition and only 300 cases were reported in the literature till 1989. There are no specific signs and symptoms pathognomonic for congenital TB, and the devastating consequences in the absence of early therapy signify the importance of early diagnosis and treatment during the neonatal period.
In this paper we report on a case of congenital TB in a newborn who was admitted to our clinic with seizures and intraventricular hemorrhage (IVH) due to TB meningitis. Her mother was diagnosed with active pulmonary TB and treated with a multi-drug anti-tuberculosis regimen. Her screening for human immunodeficiency virus (HIV) was negative. Cerebrospinal fluid was collected and showed protein levels at 300 mg/dL, glucose at 27 mg/dL (serum glucose level was 76 mg/dL), many RBC, and a positive result for acid-fast bacilli on smear microscopy, all of which were compatible with tuberculous meningitis.
It is important to consider TB meningitis in newborns with perinatal IVH and concomitant hydrocephalus particularly when the mother has a history of TB prior to or during pregnancy.

The identification of the risk factors for musculoskeletal disorders (MSDs) is the first step in designing effective preventive interventions.
To investigate the association between individual, organizational, physical, and psychological factors and upper extremity MSDs (i.e., shoulder, elbow and hand/wrist).
In this cross-sectional study, the study population was comprised of office workers from Qom Province, Iran. Of the 1630 Iranian office workers who were selected via a random multistage cluster sampling method, 1488 completed a comprehensive data collection form designed to investigate the individual, organizational, physical, and psychological factors related to MSDs (response rate: 91.3%).
The predictors of shoulder MSDs in the past 12 months were uncomfortable sitting posture (β = 0.42, P = 0.04), limited rest breaks (β=0.73, P = 0.012), and no access to adjustable desks (β = 0.43, P = 0.018). Working on a computer for more than five hours (β = 0.61, P = 0.004) and an uncomfortable sitting posture (β = 0.79, P = 0.001) predicted hand/wrist symptoms.
Various risk factors in the workplace may contribute to MSDs in different upper extremities. Preventive interventions should hence include ergonomic and office equipment modifications.

In recent years, much attention has been paid to occupational stress, but relatively little or no research has been conducted on the influence of knowledge, attitude, and practice of radiation protection (RP-KAP) on job stress among radiation workers.
This study aims to assess job stress among health care workers in Iran who are occupationally exposed to radiation in order to determine the effects of KAP on self-protection against radiation on their job stress.
The population in this descriptive cross-sectional study comprised 670 healthcare workers, including 428 staff with a degree in radiology and 242 other medical personnel who were working in 16 hospitals affiliated with Tehran University of Medical Sciences (TUMS) in Tehran, Iran. The census method was used to sample the workers. In total, 264 staff with a degree in radiology and 149 other medical personnel completed the job content questionnaire (JCQ) and the RP-KAP questionnaire from May to November 2014.
The prevalence rate of job stress was 22.5% based on calculation formulas and possible scores on the JCQ. Sex, RP-knowledge, attitude, practice, and in-service training predicted 41.8% of the variance in job stress. According to the results of the binary logistic regression, workers with higher scores on knowledge (OR = 0.82, 95% CI: 0.75 - 0.90), attitude (OR = 0.71, 95% CI: 0.63 - 0.82), and practice (OR = 0.78, 95% CI: 0.72 - 0.86) and those who had participated in training programs had significantly lower rates of job stress (OR = 0.51, 95% CI: 0.28 - 0.93).
The effects of RP knowledge, attitude, and practice on job stress were significant. In order to reduce job stress in radiation environments, ongoing training programs related to self-care and protection principles are recommended.

Readiness of the cervix is required for successful induction of labor, and there are a number of ways in which this can be achieved.
The aim of the present study was to assess whether taking saffron orally could have an effect on the cervical readiness (primary outcome) and some delivery and neonatal outcomes (secondary outcomes) in women in the stage of term pregnancy.
Patients and In this double-blind trial, 50 women with a gestational age of 39 to 41 weeks, no indication of cesarean section, a Bishop’s score of less than 4, who had plan to have vaginal delivery at Shohada hospital of Bonab, Iran were randomized into two groups receiving three 250mg saffron or placebo pills in 24 hours. The readiness of the cervix was assessed using the Bishop’s score. The Mann-Whitney U test was used to compare the scores between the groups.
There were no significant differences between the groups in terms of the Bishop’s score at the baseline (P = 0.792) and 10-12 hours after starting the intervention (P = 0.159). The Bishop’s score was significantly higher in the saffron group 20 - 24 hours after the intervention was started (P = 0.029) and just after onset of active uterine contractions (P = 0.003). In the saffron group, there was no cesarean section and 1 meconium staining of the fetus, but 3 and 4, respectively, in the placebo group. There was no statistically significant difference between the groups in terms of the timing of the onset of spontaneous active uterine contractions, the duration of the first and second stages of labor, the need for delivery augmentation, and the first and fifth minutes of neonatal Apgar (P > 0.05). No adverse event was reported in any of the groups.
Saffron can increase the readiness of the cervix in term pregnancies. However, the study limitations do not allow for any definite conclusions for its use in clinical practice, and more research is needed to assess its effect on delivery and neonatal outcomes.

It is rare for primary tumors to arise from the mesentery. Lymphangiomas appear as congenital malformations of the lymphatic system or benign neoplasms as a large, thin-walled, often multilocular cyst. Mesenteric infiltration is common and during surgical treatment, adjustment of structures such as the bowel and resection of the spleen may be required. Cystic mesotheliomas are rare, benign tumors that originate from the peritoneal mesothelium and are more common in women. Mesenteric cysts are mostly benign and rare intra-abdominal tumors, and can be seen as occupying a large cyst. Malignant fibrous histiocytoma is a rare pleomorphic sarcoma that is more commonly encountered in men. After the extremities, the second most common areas to be affected are the retroperitoneum and peritoneal cavity.
We encountered four cases of different primary mesenteric neoplasms that were operated at the Gazi Yasargil teaching and research hospital, department of general surgery, Diyarbakir, Turkey, between 2013 and 2014. We reviewed these primary mesenteric neoplasms and compared them with previous literature.
Primary mesenteric tumors are rare and mostly benign tumors. Complete surgical excision is necessary for all tumors and follow-up is necessary after surgery for malignant fibrous histiocytoma due to recurrence.

Dysrhythmia is one of the most common causes of sudden cardiac death worldwide. An implantable cardioverter defibrillator is the most effective method of treatment for dysrhythmias causing cardiac arrest. However, living with an implantable cardioverter defibrillator is associated with challenges such as fear, anxiety, and depression.
The purpose of this study was to identify the challenges of living with an implantable cardioverter defibrillator.
Patients and In this qualitative study, an interpretive phenomenological approach was used, with thirteen participants (seven men and six women) between the ages of 21 and 70 years old (mean = 58.15, SD = 14.4). The duration of having an implantable cardioverter defibrillator was 1 - 120 months (mean = 23.15, SD = 33.31). Maximum variation sampling was used to purposefully select the participants from the governmental Imam Khomeini hospital in Tehran, Iran, between May and October of 2013. Semi-structured interviews were conducted for 30 to 45 minutes, and Van Manen’s six-step method was used in this study.
The challenges of living with an implantable cardioverter defibrillator include: living with fear, concerns about the future, concerns about device malfunction, fearing death during the shock, pain due to the shock, loss of control, the cost of the device, and the lifestyle limitations.
Patients who live with implantable cardioverter defibrillators face many concerns and challenges. Therefore, the role of nurses in teaching patients before and after implementation is very important.

Building materials and the ventilation rate of a building are two main factors influencing indoor radon and thoron levels (two radioactive gases which have the most important role in human natural radiation exposure within dwellings).
This analytical descriptive study was intended to determine the relationship between indoor radon and thoron concentrations and the building materials used in interior surfaces, as well as between those concentrations and the type of ventilation system (natural or artificial).
102 measurements of radon and thoron levels were taken from different parts of three hospital buildings in the city of Kermanshah in the west of Iran, using an RTM-1688-2 radon meter. Information on the type of building material and ventilation system in the measurement location was collected and then analyzed using Stata 8 software and multivariate linear regression.
In terms of radon and thoron emissions, travertine and plaster were found to be the most appropriate and inappropriate covering for walls, respectively. Furthermore, granite and travertine were discovered to be inappropriate materials for flooring, while plastic floor covering was found suitable. Natural ventilation performed better for radon, while artificial ventilation worked better for thoron.
Internal building materials and ventilation type affect indoor radon and thoron concentrations. Therefore, the use of proper materials and adequate ventilation can reduce the potential human exposure to radon and thoron. This is of utmost importance, particularly in buildings with a high density of residents, including hospitals.

Essential primary health care is delivered through the public health center PHC network by public health workers (Behvarzs). Health workers are exposed to different types of stresses while working.
The aim of this study is to determine the prevalence of burnout and associated factors among rural health workers in the health centers of Birjand University of Medical Sciences.
Patients and All rural health workers of health centers under the coverage of the Birjand University of Medical Sciences selected through census sampling participated in this cross-sectional study. The Maslach Burnout Inventory, GHQ-12 questionnaire, and demographic questionnaire were completed by the participants. Data were analyzed by SPSS 15 using descriptive statistics, chi-square (χ2), t-test, and ANOVA test.
A total of 423 health workers participated in this study, and their mean age was 39 ± 8.4 years. Among the participants, 34.5% had moderate to severe levels of burnout. About 31.4% of the subjects had abnormal scores in emotional exhaustion, 16.8% in depersonalization, and 47% in the personal accomplishment subscales. The rate of abnormal mental health among the participants was 36.68%. The prevalence of mental disorders was 24.5% in subjects with low burnout or without burnout against 60.4% of subjects with moderate or severe burnout (P = 0.001). Age, education level, number of children, and years of employment were found to have a significant association with the burnout level of the participants (P Burnout was prevalent among health workers. Based on the high level of burnout among health workers, reducing job ambiguity/conflict, participating in planning new programs, and improving interaction with health authorities may help them to overcome their job-related pressure and to give a more desirable performance.

Renal cell carcinoma (RCC) is a common malignancy of the urinary system with high rates of morbidity and mortality.
This study aimed to investigate and analyze the clinical efficacy of retroperitoneal laparoscopic partial nephrectomy and laparoscopic radical nephrectomy for the treatment of small RCC.
In this retrospective study of 45 patients with small RCC, the patients were divided into two treatment groups: Group A (retroperitoneal laparoscopic partial nephrectomy, 25 cases) and Group B (retroperitoneal laparoscopic radical nephrectomy, 20 cases).
There were no statistically significant differences in the operative time, amount of intraoperative blood loss, length of hospital stay, preoperative creatinine level, postoperative creatinine level after 24 hours, and survival rate after 1, 2, and 3 years between the two groups (P > 0.05).
There were no significant differences in the survival rates and short-term postoperative complications between the laparoscopic partial nephrectomy group and the laparoscopic radical nephrectomy group for small RCC, but the former was slightly more effective.

Herpes simplex virus 1 (HSV-1) is normally associated with orofacial (orolabial) infections and encephalitis, whereas HSV-2 usually causes genital infections and can be transmitted from infected mothers to neonates. The evidence suggesting that HSV is facilitating the spread of the global human immunodeficiency virus (HIV) epidemic and the risk posed by these synergies to neonates in developing countries informed this study.
To determine the seroprevalence and co-infection of HIV and HSV, as well as their associated risk factors, in Lokoja, Nigeria.
This was a hospital-based cross-sectional, prospective study, which was carried out among pregnant women attending the antenatal clinic at the federal medical centre in Lokoja, Nigeria. sociodemographic characteristics and HIV-HSV status were determined by the use of a structured questionnaire and immunoassay kits, respectively. All data were analyzed using Stata statistical software (version 12), and the level of significance was determined to be P Of the 250 pregnant women screened for HIV and HSV, 154 (61.6%) were in the 2nd trimester of gestation, and all of the co-infected respondents were in their 2nd trimester. Only six (2.4%) of the respondents tested positive for HIV, with all six (100%) showing positivity for HSV so the co-infection rate was six (2.4%). Co-infection was found to occur between the ages of 15 and 35 years, while higher age groups did not show any co-infection. Parity, level of education, and history of painful genital ulcers had no significant association with co-infection.
Advocacy and publicity to raise awareness of the potential public health impact of HSV and HIV co-infection in Nigeria, where anti-HSV testing is not generally performed in all populations, is therefore recommended.

Intermittent theta burst stimulation (iTBS) is a repetitive transcranial magnetic stimulation (rTMS) protocol that influences cortical excitability and motor function recovery.
This study aimed to investigate the effects of iTBS on manual dexterity and hand motor imagery in multiple sclerosis (MS) patients.
Thirty-six MS patients were non-randomly assigned into sham (control) or iTBS groups. Then, iTBS was delivered to the primary motor cortex for ten days over two consecutive weeks. The patients’ manual dexterity was assessed using the nine-hole peg test (9HPT) and the Box and Block Test (BBT), while the hand motor imagery was assessed with the hand mental rotation task (HMRT).
iTBS group showed a reduction in the time required to complete the 9HPT (mean difference = -3.05, P = 0.002), and an increase in the number of blocks transferred in one minute in the BBT (mean difference = 8.9, P = 0.001) when compared to the control group. Furthermore, there was no significant difference between the two groups in terms of the reaction time (P = 0.761) and response accuracy rate (P = 0.482) in the HMRT.
When iTBS was applied over the primary motor cortex, it significantly improved manual dexterity, but had no significant effect on the hand motor imagery ability in MS patients.

There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor.
Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the second stage of labor on maternal and fetal outcomes.
Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparous mothers, live fetus with vertex presentation, gestational age of 37 - 40 weeks, spontaneous labor, and no complications. The intervention group pushed spontaneously while they were in the lateral position, whereas the control group pushed using Valsalva method while in the supine position at the onset of the second stage of labor. Maternal outcomes such as pain and fatigue severity and fetal outcomes such as pH and pO2 of the umbilical cord blood were measured.
Data pertaining to 69 patients, divided into the intervention group (35 subjects) and control group (34 subjects), were analyzed statistically. The mean pain (7.80 ± 1.21 versus 9.05 ± 1.11) and fatigue scores (46.59 ± 21 versus 123.36 ± 43.20) of the two groups showed a statistically significant difference (P Spontaneous pushing in the lateral position reduced fatigue and pain severity of the mothers. Also, it did not worsen fetal outcomes. Thus, it can be used as an alternative method for the Valsalva maneuver.

Valproic acid (VPA) and carbamazepine (CBZ), two widely used antiepileptic drugs, have recently been found to inhibit histone deacetylases (HDAC). HDAC inhibitors (HDACIs) have various effects on cancer cells.
The aim of this study was to compare the anticancer activity of these drugs on SW480 colon cancer cell lines.
In the present experimental study, implemented during 2014 - 2015 in Iran, after incubation of cells into 96-well plates with 5,500 cells/well, the tested drugs were added, and cytotoxic effects were assessed by MTT. Moreover, after incubation of 8×106 cells in 75 cm² flasks to obtain β-catenin levels and 106 cells in a six-well plate to obtain vascular endothelial growth factor (VEGF) levels , these levels were estimated using enzyme-linked immunosorbent assay (ELISA) analysis.
Through MTT assay, we found that the inhibitory concentration of 50% (IC50) values for VPA and CBZ were 2.5 mM and 5 μM, respectively in comparison to controls in terms of total concentration and times evaluated (P VPA and CBZ treatments caused a decrease in β-Catenin and VEGF levels in SW480 colon cancer cell lines. These results suggest that CBZ can be considered a potential antitumor drug with potencies different from VPA.

Context: Women’s attitudes towards menopause have an important impact on menopausal experiences, including the perceived severity of symptoms and women’s general lifestyles during menopause. Therefore, such attitudes should be considered when developing management and counseling programs for women in menopausal transition. This systematic review and meta-analysis was conducted to examine Iranian women’s attitudes towards menopause.
Evidence Acquisition: In this study, searches for English articles were conducted using PubMed, Scopus, Science Direct, and Google Scholar databases, and searches for Persian articles were conducted using Magiran, SID, and Google Scholar. All articles published until April 30, 2015 were considered, using the keywords “Menopause,” “Attitude,” “Iran,” and “Iranian women.” Out of 1160 potentially relevant publications, 21 documents met the inclusion criteria. Then, the quality of the studies was examined by two reviewers independently using additional pre-specified criteria. Measures of the effects were pooled, and random effect meta-analysis was conducted using Stata software version 11.
Out of the 21 selected documents, 11 studies were eligible for inclusion in the meta-analysis. The results of the meta-analysis on 3453 participants showed that 25% of Iranian women had positive attitudes, 58% had neutral attitudes, and 17% had negative attitudes towards menopause.
The majority of Iranian women had neutral attitudes towards menopause, which may be evidence of poor knowledge about menopause. Therefore, it is suggested that appropriate educational programs be developed and implemented by policymakers in order to increase knowledge and raise awareness among women about menopause.

Monosodium glutamate (MSG) is a widely-used flavor enhancer and stabilizer in ready-made or packaged foods. The excessive use of MSG has been shown to increase oxidative stress in different organ systems and causes glucose metabolism disorders, obesity, and coronary diseases.
In this study, the antioxidant activity of tannic acid was investigated experimentally with respect to its protective effects against overdosed MSG-induced oxidative stress in rats. The study took place in Turkey in August 2013.
Four groups (n = 7) of three- to four-month-old Sprague-Dawley female rats were used in this study. The first group was the control, who were administered saline. The second group received tannic acid (50 mg/kg, 3 days) intraperitoneally (i.p.). The third group received MSG (2 g/kg, 7 days) i.p., and the fourth group received both tannic acid (50 mg/kg, 3 days, pretreatment) and MSG (2 g/kg, 7 days) i.p. The animals were euthanized ten days later. Blood was collected for determining the hematological values and blood glucose levels. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels were determined in the brain, liver, and kidney homogenates, and in the erythrocyte hemolysate. Histopathological examination of the brain, liver, and kidneys was conducted through hematoxylin-eosin staining.
The data showed that the tannic acid treatment statistically decreased the MDA levels in the brain tissues of the group administered MSG and tannic acid (P In the literature, it was observed that short-term MSG exposure does not cause significant histological changes in the kidneys, liver, or brain cortex. These findings should be re-evaluated in additional long-term studies.

Context: Many psycho-socioeconomic and other types factors associated with cancer, the treatment process, and changes in patients’ physical appearance and sexual function influence the body image of women with breast cancer. The purpose of this study was to determine which factors influence the body image of women with breast cancer.
Data Collection: A narrative literature review was conducted. Electronic databases, including Google Scholar, SID, Magiran, IranDoc, Barekat, Web of Science, Science Direct, Cochrane Library, ProQuest, Scopus, and PubMed, including Medline, were searched to retrieve articles published from 1993 to 2016 using the keywords breast cancer, treatment, body image, and related factors. The quality of selected studies was appraised using a checklist adapted from Samadaee-Gelehkolaee (2016).
Of 690 articles retrieved in the search, 190 articles were selected for full text appraisal. Finally, 44 articles were selected for data analysis. The results were classified under three headings: bio-psycho-socioeconomic factors, factors associated with the disease and treatment processes, and physical appearance and sexual function.
The findings of this review showed that many factors can influence the body image of women suffering from breast cancer. These factors were predictors of patients’ inter-personal and intra-personal relationships with their partners and others who influenced various other aspects of their lives, possibly leading to many life’s issues. These factors must be identified and considered to make the most appropriate decisions for patients. The strength of this study lies in the exploration of factors influencing the body image of women with breast cancer which earlier studies did not consider. Moreover, the authors believe that this research has addressed nearly all the factors that are real concerns in the body image of women with breast cancer.

A lack of neurotrophic support is believed to contribute to the development of diabetic neuropathy. On the other hand, neurotrophins have consistently been shown to increase in the central and peripheral nervous system following exercise, but the effects of exercise intervention on brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in diabetic neuropathy are not understood.
This experimental study was designed and carried out at the Tarbiat Modares university (TMU) in Tehran, Iran, to investigate the hypothesis that increased activity as endurance training can help to increase the endogenous expression of neurotrophins in diabetic rats.
This was an experimental study with 2 × 2 factorial plans performed at TMU in Iran. Sampling was accidental and 28 adult male Wistar rats in the body mass range of 326.3 ± 8.4 g comprised the sample, with each rat randomly assigned to four groups: diabetic control (DC), diabetic training (DT), healthy control (HC), and healthy training (HT). To induce diabetic neuropathy, after 12 hours of food deprivation, an intraperitoneal injection of streptozotocin (STZ) solution (45 mg/Kg) method was used. Two weeks after STZ injection, the endurance training protocol was performed for 6 weeks; 24 hours after the last training session, the rats were sacrificed. Real-time PCR was used for BDNF and NGF expression.
The data indicate that diabetes decreases BDNF and NGF expression in sensory (92%, P = 0.01; 90%, P = 0.038, respectively) and motor (93%, P = 0.05; 60%, P = 0.029, respectively) roots. However, NGF mRNA levels in the DT group were significantly higher than in the HC group ((7.1-fold), P = 0.01; (2.2-fold), P = 0.001, respectively, for sensory and motor roots), but this was not shown for BDNF. In addition, endurance training can increase NGF expression in healthy rats ((7.4-fold), P = 0.01; (3.8-fold), P = 0.001, respectively, for sensory and motor roots).
This study shows that BDNF and NGF expression decreases in diabetic neuropathy. However, this decrease can be reversed through endurance training. These results also indicate that endurance training may have a potential role in compensating for neurotrophin deficiency following diabetic neuropathy.

Regular body mass index (BMI) screenings in schools is important to ensure that 3- to 6-year-old children are not negatively affected by obesity in terms of their current and future health.
The aim of this study was to determine the overweight and obesity results of 3- to 6-year-old children and to guide children and their family in making healthier dietary choices by informing them.
This analytical-descriptive study was conducted in Corum, Turkey, in the year 2011. The study’s sample consisted of all available 3- to 6-year-old children entering nursery school (specifically, the Buharaevler, Karsıyaka, Nasrettin Hoca, Ulukavak, Mimar Sinan, and Sevgi nursery schools). Findings from the study were statistically analyzed using the SPSS 15.0 program. The Chi-square test and analysis of variance (ANOVA) program were used in the comparison of study data. A p-value of less than 0.05 was considered significant.
It was determined that 9.5% of the participating female children and 5.2% of the male children were underweight and that the boys were more obese than the girls in general. The correlation between the child’s gender and their BMI was not found to be statistically significant (P-value > 0.05). The overweight frequency of the children was 12.1%, and the obesity frequency was 14.3%. Furthermore, it was determined that the obesity rates of the children increased with their age. Accordingly, the correlation between the child’s age and BMI was found to be statistically significant (P-value An approach to preventing obesity must not be enacted only in health centers. Schools should also offer information and resources for families in order to prevent obesity in children.

Vaginitis is one of the most common diseases in reproductive-aged women (15 - 49 years of age). Side effects of vaginitis can affect other aspects of health, which could be prevented by promoting a healthy lifestyle related to vaginal health.
This study aimed at determining the impact of health-promoting educational intervention on lifestyle (nutrition behaviors, physical activities, and mental health) related to vaginal health among reproductive-aged women with vaginitis.
The data set was collected as part of an experimental study conducted on 350 reproductive-aged women with vaginitis. Participants were selected through a stratified two-stage clustered sampling and simple randomization from 10 attending health centers affiliated with Kermanshah University of Medical Sciences in five regions (North, South, East, West, and Center) of Kermanshah (a city in western Iran) in 2015. Two clinics in each region were selected; patients from the first center were chosen as the intervention group and patients from the second center made up the control group. To collect data, a questionnaire including socio-demographic and lifestyle questions was used. The questionnaire was designed and validated via the psychometric process. Educational intervention was performed over twenty sessions of 25 to 35 minutes. The intervention group was followed up with face-to-face education, a pamphlet, phone contact, and by social media. The control group continued the routine treatment without contacting the intervention group. Data were collected from both groups before the intervention and six months after the intervention. Data were analyzed using the SPSS-20 package, using the independent t-test, paired t-test, chi-square test, and analysis of covariance (ANCOVA) test. The confidence interval was 95% and P ANCOVA showed that after adjusting for effects of pretest scores, the difference between mean scores on the scale of lifestyle related to vaginal health in the intervention group (28.48 ± 0.38) and control group (23.65 ± 1.23) was significant (P 0.05). The independent t-test did not show significant statistical differences between the two groups in terms of demographic characteristics (P > 0.05).
According to the findings, educational intervention is beneficial in promoting three aspects of women's lifestyle related to vaginal health. Therefore, a health-promoting lifestyle seems essential for having a healthy vagina and for preventing vaginitis.

Candidiasis, the infection caused by Candida albicans, is one of the most common infections of the oral cavity in humans. Candidiasis causes irritation and is known for its carcinogenic effects. Thus, it is important to recognize the predisposing factors for this opportunistic infection. Several previous studies have demonstrated an increased frequency of vaginal candidiasis in relation to oral contraceptive consumption.
Only a few studies on the relation between oral contraceptives and oral candidiasis have been previously conducted. This study aims to evaluate the possible relation between oral contraceptive pills and oral candidiasis.
This analytic, case-control study included 40 non-pregnant women divided into two groups: 20 who used oral contraceptive pills and 20 who did not. The groups were matched according to age, oral health, and past and present medical history. Samples were collected from the tongue’s dorsum using a cotton swab and inoculated on CHROMagar culture plates. The frequency of positive cultures and the number of Candida colonies were compared between the two groups using independent t-tests and Mann-Whitney statistical tests with SPSS18 software.
The frequency of positive cultures of Candida albicans was higher (P value = 0.03) for the case group. Also, the number of C. albicans and C. krusei was significantly higher for the case group compared to the control group (P value = 0.04, P value = 0.03).
The results of the present study demonstrate that oral contraceptives containing estradiol can lead to Candida colonization in the oral cavity. It is recommended that further studies comparing the influence of oral contraceptives on Candida’s adherence to the epithelium is highly recommended.

Context: Migraine is a major dilemma and problem which affects public health and results to reduced quality of life. This study aimed to determine the prevalence of migraine in Iran.
Evidence Acquisition: A systematic search was conducted using Pub Med, Web of Science, Embase, Scopus, Ovid, Google Scholar, as well as Iranian databases including: MagIran, IranMedex and Scientific Information Databank, from 2000 to November, 2015. The Der-Simonian/Laird’s random-effects model, with a 95% confidence interval was employed to estimate the overall pooled prevalence. Heterogeneity was investigated using subgroup analysis based on sample size and time of study.
Thirty studies comprising 33,873 participants met the inclusion criteria for the analysis. The overall prevalence of migraine in Iran was 14% (95% CI, 12% to 17%), respectively. The overall prevalence was (8%; 95% CI 6% to 11%) according to the international classification of headache disorders (ICHD-1), (17%; 95% CI 13% to 21%) according to ICHD-2, and (18%; 95% CI 7% to 30%) according to the other questionnaire for migraine screener (ID Migraine), respectively. Meta-regression demonstrated that the prevalence of migraine increased by year of publication and decreased by sample size.
The prevalence of migraine in Iran, which was estimated as 14%, was similar or even higher than that reported world-wide. Migraine can have impact on the economic productivity of any country; therefore it is necessary to educate people on the early detection and the discovery of an effective treatment of migraine. More thorough review of further studies in this field is recommended.

Vancomycin is a first-line therapy for infections due to Methicillin-Resistant Staphylococcus aureus (MRSA). Nephrotoxicity subsequent to vancomycin administration has been discussed in many previous researches.
The present study aimed to determine the nephrotoxic potential of vancomycin among ventilator-associated pneumonia (VAP) poisoned patients after restricting the effect of risk factors such as rhabdomyolysis and other nephrotoxicants.
This two-year cross-sectional retrospective study was conducted among VAP patients, who received vancomycin at the toxicological intensive care unit of Loghman Hakim hospital of Iran from 2013 to 2015. Baseline and laboratory data of eligible patients were extracted from medical records. Nephrotoxicity was defined based on the risk, injury, failure, loss, and end state (RIFLE) criteria.
One hundred and fifty-four VAP patients’ profiles were reviewed, of whom 110 were eligible. The median age was 33.50 (12 to 94) years and 73.6% were male. The median time interval between poisoning and admission was four (0 to 48) hours. The most common cause of poisoning was opioids (33%). Ten patients developed new-onset nephrotoxic event, including four in risk, four in injury and two in failure class. Median vancomycin treatment time until a nephrotoxic event was three days. There was no significant difference between those who developed nephrotoxicity compared to those who did not except median vancomycin trough level (14.5 in nephrotoxic versus 13.7 in non-nephrotoxic, P = 0.007).
The result of this study indicated that nephrotoxicity rate among patients treated with vancomycin is under the influence of the poisoning by nephrotoxicants. Higher vancomycin trough level was associated with increasing nephrotoxicity rate..