Iranian Red Crescent Medical Journal
Volume:19 Issue: 12, Dec 2017

Context: Hepatitis C virus (HCV) has been the main cause of post transfusion hepatitis. Long-term hepatitis can ultimately result in cirrhosis and hepatocellular carcinoma. Viral hepatitis, especially HCV infection, is a major health concern in the Middle East. The current study carried out a systematic search concerning HCV seroprevalence among blood donors in Middle Eastern countries.
Evidence Acquisition: Articles were identified through searching databases including PubMed, Scopus, and Web of Science. We reviewed systematically all studies reporting HCV seroprevalence among blood donors in Middle Eastern countries.
A total of 5662 relevant records were identified by the electronic search, of which a total of 47 studies were identified as eligible papers that were meta-analyzed for the pooled seroprevalence of HCV among blood donors. Overall, HCV seroprevalence among blood donors in Middle Eastern countries was estimated 0.88% (95%CI = 0.79% - 0.97%). The highest pooled HCV seroprevalence rate was related to Egypt (5.76% [95%CI = 3.30% - 8.22%]), Libya (1.56% [95%CI = 0.99% - 2.13%]), and Yemen (1.09% [95%CI = 0.69% - 1.50%]) while the lowest pooled seroprevalence rate was in Iran and Israel with the rates of 0.14% (95%CI = 0.12% - 0.17%) and 0.16% (95%CI = 0.06% - 0.25%), respectively. Results of annual HCV seroprevalence suggest that there is a decrease in seroprevalence rate of HCV over time among blood donors in Egypt, Iran, Oman, Lebanon, Libya, and Saudi Arabia.
Our results showed that the trend of HCV seroprevalence over time among Middle Eastern blood donors was decreasing. It suggests that recent safety measures implemented in Middle Eastern countries have been effective.

Context: Diabetic nephropathy is a common complication of diabetes mellitus with a higher incidence. Renin-angiotensin system blockers, as the main treatment for patients with diabetic kidney disease, can not only reduce albuminuria, but also lead to hyperkalaemia and creatinine. Therefore, additional protective therapeutic interventions are needed.
Evidence Acquisition: An electronic literature search was conducted in international and domestic databases including PubMed, Embase, CNKI, Scopus, Index Copernicus, DOAJ, and Wanfang database for trials up to January 2017. The search terms used were as follow: "Diabetic Nephropathies", "vitamin D3", "Cholecalciferol", "Calcitriol", "Alfacalcidol", "Paricalcitol", and "Randomized Controlled Trial". Quality assessments were evaluated with the Newcastle-Ottawa Quality Assessment Scale. Data were extracted by 2 independent reviewers (TJL and WGL). For all analysis, the standard mean difference (SMD) or odds ratio (OR) with 95% confidence intervals (CIs) were calculated, and heterogeneity of the studies was analyzed using I2 statistics.
Twenty-four studies were (1,978 patients) identified in the literature retrieve process. The assessment scores indicated that all the admitted studies were reliable with scores ranging from 6 to 9. The pooled results indicated that vitamin D3 had a significant effect in reducing albuminuria (MD = -0.23, 95% CI: -0.30, -0.15) and that the vitamin D3 group had a low ratio of urinary microalbumin to creatinine than the control group (SMD = -0.49, 95% CI: -0.90, -0.08). The results also revealed that vitamin D3 group had a lower hs-CRP than the control group (MD = -0.80, 95% CI: -1.26, -0.34).
Based on the evidence of this study, vitamin D3 could be suggested as a recommended drug for patients with diabetic nephropathy in clinical practice.

Respect to women’s autonomy in vaginal child birth is a key factor of maternity care. Engaging women in decision-making in vaginal delivery helps women have a positive experience of delivery.
In this content analysis of qualitative study we explored experiences of mothers and midwives in women’s role in normal vaginal childbirth.
This study was conducted in 2013 - 2014 in Iran. Overall 23 women and midwives were evaluated in this study. Data collected from 12 women and 11 midwives via in-depth semi structured interviews. Participants were selected from governmental and private hospitals in Mashhad and Kerman, Iran. Data analysis was performed using conventional content analysis with MAXqda software (version, 2007).
Mothers’ and midwives’ experiences about women’s role in vaginal childbirth could be organized and categorized in one theme, referred to “Empowerment of women in vaginal childbirth”. This theme consists of two subthemes: “attempts to exhibit self-assertion” and “quest for information” and four categories of compromise with the labor process, cooperation with midwife, finding delivery sources during pregnancy and seeking delivery information in labor.
Attention to women active role in vaginal child birth could improve women experience of vaginal delivery.

Mizaj (Temperament) is one of the fundamental concepts of Persian Medicine (PM) and identifying this concept is crucial for providing various healthcare recommendations and for the treatment of patients. In PM, various indices can indicate a person’s Mizaj, one of them is the happiness of people. From this perspective, people with warm Mizaj are happier than people with cold Mizaj.
The aim of this study was to assess the correlation between happiness and Mizaj.
In order to conduct this Cross Sectional (descriptive-correlational) study based on convenience sampling method, 610 participants completed the 29-item Oxford Happiness Questionnaire (OHQ) and the 10-item Mojahedi Mizaj questionnaire (MMQ). The study started since September, 2016 and ended in November, 2016 in Tehran, Iran. The collected data were compared by chi-squared test.
The frequency of happy individuals in warm, temperate, and cold Mizaj groups was 85.2%, 79% and 58.2%, respectively. According to the results of chi-squared test, individuals with cold Mizaj were significantly less happy than people with warm and temperate Mizaj. However, there was no significant difference between warm and temperate Mizaj groups. Moreover, the level of happiness in people with wet Mizaj was not significantly different from people with dry Mizaj.
There is a significant correlation between happiness and an individual’s Mizaj. Accordingly, one of the hypotheses regarding indices of Mizaj identification in PM is strengthened. This index can be used in researches associated with designing and validating Mizaj evaluative scales in PM to differentiate cold and warm Mizaj.

According to the Iranian Traditional Medicine (ITM) resources, myrtle (Myrtus communis L.) resolves swelling, wounds and injuries; its wound exsiccation capability and tissue enforcement properties may be helpful in the treatment of the rhinosinusitis.
The objective of the current trial was to assess the effects of Myrtus communis aqueous extract in the treatment of chronic rhinosinusitis.
A total of 38 patients referring to the Masih Daneshvari Hospital (Tehran, Iran) for the treatment of chronic rhinosinusitis during the year 2016 were recruited for a double-blinded randomized placebo-controlled trial. They were randomly allocated in 2 groups: 22 patients were in the treatment group and 16 patients in the placebo group. Recruitment was based on the European position paper on rhinosinusitis (EPOS). Patients’ data, including demographic information, SNOT22 questionnaire scores, and visual analog scale (VAS), were gathered and recorded by an otolaryngologist. Patients were investigated with a CT scan of the paranasal sinuses at the beginning of the study.
A total of 13 patients (59.1%) in the treatment group were female and 7 in the placebo group (43.7%). The median age of patients in the treatment group was 38.86 (18 - 68) and in the placebo group 39.93 (22 - 75) years. Data analysis revealed that symptoms improved in the treatment group after treatment in most parameters, according to the SNOT- 22 parameters. However, most of these improvements, such as reduced concentration (1.81 ± 2.01 vs. 0.73 ± 1.32 in control vs. treatment group, respectively; P = 0.055), frustrated/restless/irritable (1.56 ± 1.97 vs. 0.55 ± 1.1 in control and treatment groups, respectively; P = 0.113), as well as ear pain (P = 0.121), did not demonstrate a statistical significance. There was a significant improvement in symptom number 18 (reduced productivity) in the SNOT- 22 questionnaire (1.69 ± 1.92 vs. 0.77 ± 1.23 in control vs. treatment group, respectively; P = 0.041).
According to the present study findings, Myrtus communis L. syrup can be safely administered in patients with chronic rhinosinusitis and is effective in improving the outcomes of the disease.

Hemocytometer parameters can be important biomarkers for some types of cancers and diseases. There is a need to evaluate their biomarker potential in thyroid diseases.
The current study aimed at contributing to potential biomarker researches to diagnose papillary thyroid carcinoma (PTC) and benign multinodular goiter (BMG), evaluate the role of these markers to determine the PTC characteristics and contribute to clarification of controversial issues.
The study was designed as a retrospective observational study. The study included 389 patients who underwent total thyroidectomy at private Sani Konukoglu hospital (Sanko University, School of Medicine, Gaziantep, Turkey) due to BMG or PTC diagnosis from November 2011 to May 2017. The study subjects were divided into 3 groups. Groups 1, 2, and 3 were subjects with BMG, PTC, and the control, respectively. The comparisons were made among the groups in terms of hemocytometer parameters. In the group with the thyroid papillary carcinoma diagnosis, the relationship between the hemocytometer parameters and the bilateral tumor presence, single-sided multicentrite, and tumor diameter (size) were investigated.
Red cell distribution width (RDW) levels were 15.50 ± 2.39, 15.68 ± 2.16, and 12.5 ± 1.51 in the BMG, PTC, and control groups, respectively. Mean platelet volumes (MPV) were 7.97 ± 1.19, 8.05 ± 1.20, and 7.23 ± 1.39 in the BMG, PTC, and control groups, respectively. MPV and RDW values were significantly lower in group 3 compared with the groups 1 and 2 (P RDW, MPV, haemoglobin content, and PCT were significantly higher in the BMG and PTC groups. This increase was not specific for either of the 2 groups. No significant difference was found between any of the hemocytometer parameters and the multicentricity and bilaterality of PTC. But, a possible correlation was observed between activated partial thromboplastin time (aPTT), hemoglobin content, and tumor size.

Theory-oriented interventions play a key role in promoting people’s QOL and preventing the risk of immobility. Given this key role and due to the critical nature of nurses’ professional duties, this study was performed.
The study aimed to determine the effect of a TTM-based intervention on level of physical activity in ICU nurses working at hospitals affiliated to Guilan University of Medical Sciences.
This randomized controlled trial first selected 82 nurses through the census method in order to determine their SOC, then assigned 68 nurses who were in the first three stages to case and control groups. Valid and reliable data collection tools were used, including a demographic questionnaire and TTM constructs (SOC, GPAQ, SE, DB, and POC). Path analysis of data was performed by Lisrel-8.80. The inter-correlation matrix was determined within the model’s constructs and between the constructs and the level of physical activity in order to design and implement the intervention. Two-stage assessment was performed, once immediately after the intervention and again six months later. The data obtained were analyzed using appropriate statistical tests and Pearson correlation coefficient.
82.9% of the participants were in the first three stages of TTM. Immediately after the intervention, 55.9% were in the preparation stage, 44.1% in the pre-contemplation stage, and 76.5% in the contemplation stage. Before the intervention, only 26.5% were in the preparation and 44.1% in pre-contemplation stages. There was a statistically significant difference (P = 0.0001) between the control and case groups immediately and six months after the intervention.
TTM-based intervention led to the subjects’ placement in higher levels of SOC.

Recently, HVBP has been a tool for improving the quality of healthcare services and managing costs. This study was conducted to identify and propose an appropriate model of HVBP in the general selected teaching hospitals in Isfahan, Iran.
The purpose of this study was to propose an Iranian model of HVBP in the selected teaching hospitals in Isfahan, Iran, 2015 - 16.
This study was a theoretical and qualitative study. It was cross-sectional and prospective in terms of time, direction, and trend. The sample was determined purposefully in Delphi methods. Three types of Delphi methods were conducted including: theory, policy, and implementation Delphi. The sample size in Delphi methods respectively included 9, 13, and 21 that were selected in type of experts sampling and cascading in 2015 - 16. Inclusion and exclusion criteria were designated to select sample in all three types of Delphi methods.
According to the results of the study, the proposed Iranian model of HVBP had seven dimensions including structure, process, outcome, patient experience, quality of clinical care, sensitivity of care team, and efficiency with the weight percentages of 5, 5, 25, 20, 15, 15, and 15, respectively. Each of the dimensions had 5, 6, 5, 7, 5, 4, and 1 components/component, respectively.
This study identified and proposed a model of HVBP in the Isfahan selected general teaching hospitals. The practical application of the findings was to determine the dimensions and components of HVBP in Isfahan general teaching hospitals. According to the findings of this study, it is suggested that a series of related research be conducted to complete the identification process of HVBP in Iran in other types of hospital settings.

Candida albicans is the most common pathogen in patients with vulvovaginitis. Secretory aspartyl proteinases (SAPs) are potential factors in the virulence of C. albicans. Antimicrobial peptides (AMPs) are recognized as a promising antimicrobial group of drugs with a membrane degradation mechanism. Occurrence of resistance to these drugs is quite rare. The impact of rapid membrane degradation on AMPs is relative to the prevention or delay in drug resistance mechanisms in different microbes.
The purpose of this study was to compare the inhibitory effects of the designed NK95 peptide and caspofungin on expression of SAP4-SAP6 genes from clinical vaginal isolates of C. albicans .
In this experimental study, samples were collected from 350 women, who were suspected of vulvovaginal candidiasis and were referred to Zahedan gynecology clinics during 6 months. The clinical specimens were cultured in Sabouraud glucose agar (SGA). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to identify the vaginal isolates of C. albicans. Afterwards, the NK95 peptide was designed and synthesized. Drug susceptibility test was carried out at different concentrations of NK95 peptide and caspofungin. RNA extraction, cDNA synthesis, and quantitative Real-time PCR were performed on the clinical isolates before and after treatment with the designed peptide and caspofungin.
Based on the findings of this study, the minimum inhibitory concentration (MIC90), MIC50, and minimum fungicidal concentration (MFC) of C. albicans isolates were 62.5, 31.25, and 125 μg/mL for the designed peptide, respectively. The SAP4 (45%), SAP5 (85%), and SAP6 (73%) genes expressions significantly reduced at 48 hours after treatment with the designed peptide (P Our findings showed that the designed NK95 peptide has antifungal effects on the clinical vaginal isolates of C. albicans. Moreover, it has potential down-regulating on expression of SAP4, SAP5 and SAP6 genes.

It is important to check the skin of neonates on a daily basis so that abnormal conditions and skin problems are identified.
This study aimed at testing the validity and reliability of a revised Northampton Neonatal skin assessment tool in Turkish; a review to determine whether it is valid and reliable in the care of neonates.
The research had a cross-sectional and methodological design. The data for the study was collected between 1st of January 2015, and 20th of June 2015, at the neonatal intensive care unit (NICU) of a major training and research hospital in Istanbul/Turkey; 362 neonatal skin assessments were executed. The revised tool's language, face, content, construct validity, and reliability were evaluated.
The intra-class correlation coefficient, which indicates interrater reliability, was 1.00 in the study, representing 100% agreement. The Cronbach alpha internal consistency coefficient revealed that the tool’s general reliability was at an acceptable level (Cα = 0.71). Although the model was not found to be significant (Chi-square = 46.22, df = 17, and P 1.96).
The Turkish version of the revised northampton neonatal skin assessment tool is an appropriate, valid, and reliable instrument to be used in the assessment of neonatal skin, especially of infants at the NICU. The tool may be recommended for use in the care of neonates.

Contovir is a mixture of herbal extracts (Tanacetum vulgare, Rossa canina, Urtica dioica) that is supplemented with selenium.
This study aimed to add Contovir to the classic treatment of recurrent respiratory papillomatosis (RRP) in order to decrease the severity and extent of the disease, elongate the surgical intervals and improve the sense of patient well-being. Furthermore, we had to adjust the prescribed drug dosage, since there were no previous findings available.
Patients and This is a case study of RRP patients treated with Contovir as an adjuvant to the classic treatment, from March 2011 to February 2013, at an academic tertiary hospital (Rasoul-e-Akram hospital). All patients underwent surgical removal of papilloma and then were prescribed Contovir. Disease severity was quantified based on Derkay’s staging system.
Eight patients were enrolled in this study. The extent and severity of the disease improved in six cases. One had no response, and the severity of disease increased in one patient. Patients with supraglottic lesions had better responses to Contovir adjuvant therapy. No immediate or long-term side effects were reported.
Although Contovir has been found to be an advantageous adjuvant for RRP treatment, further studies are called for to verify these findings.