mahmoud haji ahmadi

Venipuncture is a common procedure in the neonatal department and causes significant pain for infants. This study aimed to compare the effect of tasting sucrose solution with those of smelling and tasting breast milk on the intensity of venipuncture pain in neonates.
This clinical trial was performed on 99 full-term neonates at Bouali Sina Hospital in Sari, Iran. The subjects were randomly divided into three groups of 24% sucrose(n:34), breast milk smell (n:31) and breast milk taste(n:34). Their venipuncture pain was measured using neonatal infant acute pain assessment scale (NIAPAS). The vital signs of neonates were monitored from two minutes before to 60 seconds after venipuncture. The data was analyzed using the Shapiro-Wilks, Chi-square, Kruskal-Wallis, at a significant level of 5%, and the Friedman tests.
The mean scores of pain during venipuncture in the breast milk smell, breast milk taste, and sucrose groups were 7.22 ± 2.41, 8.58 ± 2.25, and 7.23 ± 2.61, respectively. The mean scores of pain 30 seconds after venipuncture in the breast milk smell and taste groups and the sucrose group were 2.25 ± 2.87, 4.41±4.30, and 2.70±3.18, respectively. The mean scores of pain 60 seconds after venipuncture in the breast milk smell and taste groups and the sucrose group were 0.45 ± 0.88, 1.55 ± 2.20, and 0.47 ± 0.96, respectively. The mean score of pain was significantly different at 30 and 60 seconds after venipuncture (P = 0.017 and 0.22, respectively).
The smell and taste of maternal breast milk, in case of lack of sucrose, were effective in the relief of venipuncture pain among hospitalized neonates. It is suggested to use these non-invasive and cost-effective methods to relieve the pain of newborns during painful treatment procedures, especially when the mother is not present in the ward.

Studies on the relationship between vitamin B12 and gestational diabetes mellitus (GDM) have shown different results. Given the lack of research in this area in Iran and the inconsistent findings of studies carried out in other nations, this study was conducted in light of the significance of the problem, particularly with regard to the health of expectant mothers.

This case-control study was performed on 120 pregnant women referred to Ayatollah Rouhani hospital in Babol, private offices, and health centers to evaluate the vitamin B12 level in women with and without GDM. GDM was defined as 1) after oral ingestion of 75g glucose, fasting plasma glucose level (PGL) >92 mg/dL, 1-hour PGL >180mg/dL, or 2-hour PGL >153mg/ dL during 24-28 weeks of gestational age, or 2) in the 100-g oral glucose tolerance test (OGTT), PGL >195 mg/dL, one-hour PGL >180 mg/dL, 2-hour PGL >155, and 3-hour PGL >140, and GDM was diagnosed if there were at least 2 out of 4 mentioned cases. According to the above definition, pregnant women with GDM were placed in the case group, while those without GDM were placed in the control group. After 8 hours of fasting, intravenous blood samples were taken and sent to the laboratory for measurement, and vitamin B12 deficiency was considered <99 pg/dL after 28 gestational weeks.

Vitamin B12 deficiency was prevalent in 14.2% of 120 pregnant women studied. Vitamin B12 deficiency was more common in GDM women than in non-GDM women (58.8%-41.2%). A normal level of vitamin B12 could act as a protective factor against GDM. The vitamin B12 levels increased in the 30- to 40-year-old women with GDM. In other age groups, vitamin B12 levels were higher in non-GDM women than in GDM women. Among 17 women with vitamin B12 deficiency, 52.9% had a fasting PGL >92.

The results of the present study suggest that measuring vitamin B12 levels may aid in the early diagnosis of GDM and prevent maternal and fetal complications.

Diabetes, a currently threatening disease, has severe consequences for individuals’ health conditions. The present study aimed to investigate the factors affecting the changes in the longitudinal outcome of blood sugar using a three-level analysis with the presence of missing data in diabetic patients.

A total of 526 diabetic patients were followed longitudinally selected from the annual data collected from the rural population monitored by Tonekabon health centers in the North of Iran during 2018-2019 from the Iranian Integrated Health System (SIB) database. In analyzing this longitudinal data, the three-level model (level 1: observation (time), level 2: subject, level 3: health center) was carried out with multiple imputations of possible missing values in longitudinal data.

Results of fitting the three-level model indicated that every unit of change in the body mass index (BMI) significantly increased the fasting blood sugar by an average of 0.5 mg/dl (p=0.024). The impact of level 1 (observations) was insignificant in the three-level model. Still, the random effect of level 3 (healthcare centers) showed a highly significant measure for health centers (14.62, p<0.001).

The BMI reduction, the healthcare centers' socioeconomic status, and the health services provided have potential effects in controlling diabetes.

Despite the self-limiting nature of bronchiolitis, its severe forms require hospitalization. Electrolyte imbalance during bronchiolitis is common, however, the relationship between bronchiolitis severity and serum sodium (Na) levels has not been well studied. The purpose of this study was to investigate the relationship between serum Na level and bronchiolitis severity.

This cross-sectional study included hospitalized children with bronchiolitis at Amirkola Children’s Hospital, Babol, Iran, from May 2020 to May 2021. Diarrhea, underlying disease, glucocorticoid intake, and intravenous fluid therapy before admission were considered exclusion criteria. The Bierman-Pierson scale was used to evaluate the severity of the disease, and hyponatremia was divided into mild, moderate, and severe groups. Variables were analyzed using Statistical Packages for Social Sciences (SPSS) 26. A value of P<0.05 was considered significant.

Sixty-one children (55.7% male) with a mean age of 5.19 ± 4.36 months were enrolled in the study, with most (50.8%) belonging to the mild form of the disease. The mean serum Na levels based on the severity of bronchiolitis were 136.22 (SD: 2.99), 133.76 (SD: 3.88), and 130.50 (SD: 11.45) in the mild, moderate, and severe groups, respectively. There was a statistically significant relationship between serum sodium level and severity of bronchiolitis (P-value = 0.013).

The results showed that higher severity of bronchiolitis was associated with an increased risk of hyponatremia. Therefore, periodic monitoring and correction of hyponatremia in children with bronchiolitis, especially at younger ages, is necessary to improve the outcome of the disease.

 One of the most common functional problems in children is functional abdominal pain (FAP), and dysmotility is one of the possible causes of FAP. Domperidone is a prokinetic drug that increases gastrointestinal motility.

 The aim of this study was to evaluate the effect of domperidone on the treatment of FAP in children.

 In this double-blind clinical trial study, FAP was diagnosed in 80 children aged 5 - 14 years, who were referred to Amirkola Children's Hospital in Babol for one year based on the criteria of the Rome IV. Then, they were randomly divided into two groups of 40 patients. Group A received domperidone tablets (0.25 mg/kg, three-time/day) for two months, and group B received a placebo. The primary outcome was at least a 50% reduction in both frequency and severity of pain, and the secondary outcome was a significant reduction in the duration, frequency, and intensity of pain according to the Wong-Baker scale compared to baseline.

 A total of 80 children completed the trial (40 with domperidone). The recovery rate was higher in the domperidone group than in the placebo group after eight weeks (71.8% vs. 28.2%; P < 0.0001), and domperidone had significant superiority over the placebo in reducing the duration (4.58 ± 7.71 vs. 24.5 ± 41.45, min/day, P < 0.001), frequency (3.35 ± 3.99 vs. 10.63 ± 10.55, episode/week, P < 0.001), and intensity (2.20 ± 2.16 vs. 5.05 ± 2.37, P < 0.001) of the pain.

 Based on the results, domperidone can be useful in the treatment of FAP in children.

Primary dysmenorrhea is the usual medical status in medical students that are defined as painduring the menstrual period. This study was done to evaluate the psychological problems associated with dysmenorrhea. Three hundred forty students aged 18 to 20 years participated in this cross‑sectionalstudy (194 with dysmenorrhea and 150 without dysmenorrhea). In this cross‑sectional study, data were collectedthrough the sociodemographic checklist, the verbal multidimensional scoring system (VMS), and the revisedversion of the Symptom Checklist-90 (SCL-90-R) questionnaire using the convenience sampling method. Thisquestionnaire includes 9 Subscale and a GSI index. We considered psychological distress to be equivalent tothe Global Severity İndex (GSI), which is obtained by dividing 90 questions by 90. The significance level of thetests was considered 0.05. The GSI of the SCL-90 score in the 194 students with dysmenorrhea and 150 students without dysmenorrheawas 1.02 ± 0.42 and 0.34 ± 0.15 respectively (P<0.001). In the group with dysmenorrhea, the severityof dysmenorrhea was significantly associated with a family history of dysmenorrhea and mother's education(P=0.012 and P=0.037, respectively). The strongest predictors of GSI>1 were a family history of dysmenorrheaand mother’s education [odds ratio (OR)=2.33, 95% confidence interval (CI), 1.43-4.15 and OR=0.45, 95% CI,0.24-0.87, respectively]. According to the result, dysmenorrhea is associated with psychological distress. Psychological interventionsand counseling in addition to drug treatment are suggested for treatment of primary dysmenorrhea.Therefore, it is necessary to formulate strategies and health policies to recover psychological issues of menstrualhealth.

Intraventricular hemorrhage (IVH) is an important cause of death and lifelong neurological complications in premature and very low birth weight infants. The aim of this study was to assess the frequency of IVH and its severity in infants admitted to a referral center for high-risk pregnancies and their short-term outcomes.

This retrospective cross-sectional study was conducted in an academic hospital for high-risk pregnancies over the period between Jan 2011 and Mar 2018. All premature (<34wk) and very low birth weight (<1500gr) infants diagnosed with IVH through brain ultrasound were included in the study. All infants’ information such as gestational age, birth weight, grade of IVH (I-IV) and outcome at the time of discharge was recorded and then analyzed.

Out of 2563 eligible infants admitted to the intensive care unit, 138 neonates (5.38%) were diagnosed with IVH. The mean gestational age and the birth weights were 29.97± 2.89 weeks and 1084± 327.71 grams, respectively. Male to female ratio was 2.53 to 1. The frequencies of IVH grades included: 106 (76.81%) with grade I, 23 (16.67%) with grade II, 7 (5.07%) with grade III, and 2 (1.45%) with grade IV. Four cases (2.9%) underwent ventriculoperitoneal shunt and three of them died.

In this study, the frequency of IVH was higher compared to that of developed countries; however, severe IVH (grades three and four) had a relatively low frequency.

 Urinary tract infection (UTI) is one of the most common infections in children. Arbitrary use of antibiotics has increased the resistant strains and transmits these resistant factors to other pathogens. Therefore, this study was designed to follow the resistance trend in 9-years in children with urinary tract infections referred to the Amirkola Children's hospital (Northern Iran).

 In this cross-sectional study, all children who had Urinary tract infections between 1994 to1998 and 2013 to 2018 with one month to 18 years old were included. Data (covering 9 years), such as age, sex, antibiotic resistance profile, urine culture results, and history of UTI, were collected retrospectively from patients' records. Cases were selected based on clinical and microbiological criteria. Antimicrobial susceptibility was determined by the Kirby–Bauer disk diffusion method.

 Escherichia coli was the most predominant organism isolated from urine samples. The highest drug resistance was related to cefazolin (83.3%). Resistance to nitrofurantoin was higher in children older than 5 years (P≤0.001). Moreover, the resistance pattern to gentamicin, amikacin, ceftriaxone, cephalexin, and imipenem differed in females and males (P>0.05).

 A 9-year study showed that 91.4% of the strains are still sensitive against amikacin which is a suitable treatment option in the studied strains. The establishment of antimicrobial stewardship programs and regular monitoring of antimicrobial resistance could help to reduce inappropriate prescribing for UTIs.

 Height is an important factor for medical, nutrition, and forensic sciences; nevertheless, measuring proves to be a challenging task in some cases. In this respect, an alternative immediate, accurate, and possible anthropometric evaluation is needed.

 This study was set to find a proper formula to estimate height from the lengths of the ulna and tibia in Iranian adults.

 A total of 500 healthy males and females aged 20-40 years were randomly selected from the volunteers’ pool for this cross-sectional study. Ulna and tibia lengths and standing heights were measured according to standard protocols. Ulna and tibia lengths were applied to find a reliable equation to predict stature accurately. Data were statistically analyzed by SPSS version 17 using regression, curve estimation, and linear model.

 The mean (SD) heights of male and female participants were 176.45 (11.98) cm and 161.29 (10.11) cm, respectively, while the right and left ulna and the right and left tibia were 29.05 (1.63) cm, 29.03 (1.44) cm, 38.86 (1.33) cm, and 38.88 (1.25) cm, respectively. The correlation coefficients of r2 = 0.80 and r2 = 0.69 for males and females participants’ right ulna, respectively, showed a significant correlation with height. Hence, the new formula provided reliable results for stature estimation for northern Iran subgroups.

 Equations based based on right ulna length are more reliable and accurate for height prediction in both genders. It should be considered that these equations could be different among ethnically diverse populations, even in the northern Iranian population.

Decreased physical functioning and increased risk of fall are among the most common age-related problems among elderly people. This study aimed at assessing the effects of tai chi exercise on gait speed (GS) and fall rate among a group of elderly women in Iran.

This randomized controlled trial was conducted in 2018. Participants were sixty elderly women purposefully selected from comprehensive healthcare centers in Lahijan, Iran, and randomly assigned to an intervention and a control group. Study intervention was Yang-style tai chi exercise implemented in two group sessions per week for twelve consecutive weeks. GS was assessed before and after the intervention using the short physical performance battery and fall rate was assessed using a researcher-made self-report fall assessment checklist. The SPSS program for Windows (v. 18.0) was employed for data analysis at a significance level of less than 0.05.

Between-group differences respecting the pretest and the posttest GS were not statistically significant (P > 0.05). Moreover, posttest fall rate in the intervention group was less than the control group.

Tai chi exercise is effective in increasing GS and reducing fall rate among elderly women and is recommended for elderly people.

There is some evidence of a relationship between attention-deficit/hyperactivity disorder (ADHD) and functional defecation disorders (FDDs), both of which are common in childhood. The aim of the study was to investigate the frequency of ADHD in children with fecal incontinence (FI) and functional constipation (FC).

This cross-sectional study was conducted on 99 children aged 4-14 years who met the Rome IV criteria to diagnose pediatric chronic FC with FI from January to May 2020. The ADHD was then assessed by the child and adolescent psychiatrist via clinical visits, DSM-5 and Conners Rating Scale (CRS). Pearson’s Chi-Square test and Mann-Whitney’s test were used to compare children with and without ADHD. A P value <0.05 was considered statistically significant.

According to DM-V and clinical visits, about 24 (24.2%) children with FC and FI were diagnosed with ADHD. Moreover, six and one of their relatives had anxiety/depression and schizophrenia, respectively. Children with ADHD were significantly male (83%, p= 0.009), older (p= 0.003), heavier (p= 0.005), first born (79%, P < 0.001) and premature (37%, P=0.01) with older mothers (p=0.01).

This study showed that there was a high prevalence of ADHD in children with FC and FI. Therefore, screening of suspected children is recommended.

Hypomagnesemia can lead to bronchial smooth muscle contraction and is associated with wheezeing, airway hyperactivity and impairment of lung function. The aim of this study was to compare serum magnesium levels between asthmatic and healthy children.

This case-control study was performed from September 2018 to February 2019. Totally, 125 children (78 asthmatic and 47 healthy non-asthmatic children) aged 3-14 years referred to Amirkola Childrenchr('39')s Hospital in Iran were entered to the study. Sampling was done using the available method based on inclusion criteria. Serum magnesium levels were measured in all children in the laboratory of Amirkola Childrenchr('39')s Hospital. P<0.05 was considered a significant level.

The mean age of children was 81.21±35.45 months, among them, 77 (61.6%) and 48 (38.4%) were male and female, respectively. The mean serum magnesium level of children was 2.08 and 2.04 mg/dl in the control and asthma groups, respectively and there was no statistically significant difference between the two groups (p=0.49).

Based on the findings of this study, there is no significant difference between serum magnesium levels in asthmatic patients and the control group and it is not necessary to routinely measure magnesium levels in these patients.

Verse 37 in Baqare Sura is the most comprehensive and most beautiful section of the Qur'an about human repentance. Exegetes and theologians investigated this verse from different directions. The main question in this verse is what "acceptance of words" means? And what place does this acceptance have in the process of repentance of humans and God? Research on this issue explains the meaning and stages of "repentance" in the position of religious teaching with moral, theological, and mystical aspects. Based on research in Arabic vocabulary, other verses of the Qur'an, and the words of commentators and theologians, it is found that "The Words" in the context of this verse are truths that appear in the form of saying. These truths are rooted in the divine Lordship, human accepts these facts. This acceptance is a kind of mutual visit and assent. Before and after human's repentance, God's repentance is on humans. Previous repentance is allowing repentance: Putting "words" at the disposal of sinful man. And the latter repentance means accepting the servant's repentance and means influencing his repentance. Therefore, God is always repentant and returns to man after man's repentance. The final sentence of the verse contains two names of God: Repentance and Mercy. God's repentance is the good news to all human beings that if they forsake sin, God will accept their repentance. God's mercy is both good news and warning; Gospel to the repentant who have accepted God's mercy and warn the sinners have not repented who have departed from the scope of God's eternal mercy.

Lifestyle modification and self‑care have potential effects on hypertension management among older women.

The aim of this study was to assess the effects of using Orem’s Self‑Care Deficit (OSCD) theory on self‑care behaviors among older women with hypertension.

This clinical trial was conducted in 2018–2019. A Seventy old women with hypertension were conveniently recruited from healthcare centers in Ramsar, Iran, and randomly allocated to a control and an intervention group. Participants in the intervention group received self‑care education based on the OSCD theory. The control group received no intervention. Data were collected using a personal characteristics questionnaire, a researcher‑made self‑care need assessment checklist, and the Hypertension Self‑Care Activity Level Effects questionnaire. The Wilcoxon and the Mann–Whitney U‑tests were used to analyze the data.

There were no significant differences between the groups respecting the pretest mean scores of medication adherence, weight control, physical activity, and nutrition‑related self‑care behaviors (P > 0.05). However, after the intervention, the between‑group difference respecting the mean scores of these behaviors were statistically significant (P < 0.001).

The OSCD theory is effective in promoting self‑care behaviors among women with hypertension. Therefore, its use is recommended to improve hypertension management and quality of life and reduce treatment‑related costs in these patients

Elective cesarean section (ECS) increases neonatal respiratory complications like transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS). This pilot study examined the effect of antenatal steroids on the prevention of respiratory problems in full-term neonates born via ECS.

This experimental study was carried out on full-term neonates (39-42 weeks) born by ECS to the mothers admitted to Babol Clinic Hospital, northern, Iran in 2016. The intervention group received betamethasone (12 mg, intramuscular, once a day) for 2 days before ECS plus conventional care, but the control group received only conventional care. The rate of respiratory complication and the admission rate of the newborn ward and neonatal intensive care unit (NICU) were compared between two groups.

Overall, 200 full-term neonates (100 neonates in the experimental group and 100 neonates in the control group) were enrolled. Nine neonates (9%) in the experimental group and 8 neonates (8%) in the control group had TTN (P=0. 64), and one (1%) neonate in the experimental group and one neonate (1%) in the control group had RDS (P=1).

Antenatal corticosteroid administration to the mothers before ECS with gestational ages of 39-42 weeks does not reduce the incidence of respiratory complications.  Thus, further studies are needed to determined its effects in gestational age group more than 39 weeks.

The prognosis of early neonatal sepsis is significantly associated with rapid diagnosis and appropriate antibiotic therapy. Since blood culture has been reported positive in less than 16% of neonatal sepsis cases, various biochemical markers have been evaluated. This study was performed to evaluate the umbilical cord blood procalcitonin (PCT) as an early diagnostic marker of early neonatal sepsis.

This cross-sectional study included 100 neonates in two groups of case and control. The PCT level of umbilical cord blood was measured by immunoluminoassay method and PCT=2-10 ng/ml,./5-2ng/ml and >10ng/ml were considered positive, weak positive and strong positive respectively. Sepsis screening tests and culture from blood or other sterile fluids were studied in the case group.

The PCT mean was 1.39±1.52 in the case group (sepsis) and 0.17±0.05ng/ml in the control group and finally, the PCT level was significantly higher in all cases in the proven sepsis group so that it was between 2-10 ng/ml in most cases.

The result of our study showed that the mean value of PCT level in umbilical cord blood was higher in the sepsis group, and it was higher than the other two groups of sepsis in the group with proven sepsis (positive culture).

Aspiration or ingestion of foreign bodies (FBs) is a common health problem leading to hospitalization of children around the world. The purpose of this study was to detect the FBS of aspirated or swallowed in children.

The present cross-sectional descriptive-analytical study was conducted on 77 hospitalized children due to FBs aspirated or swallowed from 2008 to 2013 at Amirkola Childrenchr('39')s Hospital. Information including demographic profile, type of FBs and their location, clinical manifestations, treatment used and possible complications were extracted from their medical records, and the data were analyzed.

Out of 76 cases, 51 (67.1%) were boys; 47.4% of children were 1-2 years old (mean age 2.6±2.2 years), and 67.1% of the bodies were in the gastrointestinal tract. The most common FBs were foodstuff (42.1%), metallic bodies (39.5%) and non-metallic bodies (18.4%), respectively. The most common symptoms were cough (84%) in respiratory FBs and vomiting (57%) in gastrointestinal FBs. The mean duration of hospitalization was 74.8±57.1 hours in gastrointestinal FBs and 126.7±56 hours in respiratory FBs. There was a significant statistical relationship between location of FBs (p=0.000) and type of swallowed or aspirated bodies (p=0.041) with the duration of hospitalization. No mortality was observed.

Findings show that foodstuffs are the most abundant FBs aspirated or swallowed in children aged 1-2 years. Obviously, educating parents and caregivers to take required care of children, especially while eating in this particular age group, is a key element in reducing such injuries.

Older adults who receive hemodialysis face different physiological and psychosocial stressors. Management of physiological and psychosocial stressors is among their basic needs for a desirable life.

This study aimed to evaluate the effects of telephone‑based telenursing on perceived stressors among older adults receiving hemodialysis.

This quasi‑experimental study was conducted in 2018 on sixty older adults who were receiving hemodialysis. Participants were conveniently recruited from the hemodialysis centers of Shahid Beheshti and Imam Khomeini hospitals, Babol and Behshahr, Iran, and were randomly allocated to a control and an intervention group. A 3‑month telephone‑based telenursing program was implemented for participants in the intervention group. Physiological and psychosocial stressors were assessed before and after the study intervention. Data were analyzed using the Chi‑square, paired‑samples t, and independent‑samples t‑tests.

The mean score of physiological stressors in the intervention group statistically significantly reduced from 17.33 ± 1.74 at pretest to 11.96 ± 3.16 at posttest (P < 0.001), whereas it statistically insignificantly changed in the control group from 17.30 ± 1.66 to 17.16 ± 3.03 (P = 0.747). Moreover, the mean score of psychosocial stressors in the intervention group statistically significantly reduced from 57.80 ± 8.17 at pretest to 32.53 ± 5.84 at posttest (P = 0.001), but statistically insignificantly changed in the control group from 61.2 ± 9.03 to 62.53 ± 6.04 (P = 0.416). Although the between‑group differences respecting the pretest mean scores of physiological and psychosocial stressors were not statistically significant (P > 0.05), there were significant between‑group differences respecting the posttest mean scores and the pretest‑posttest mean differences of both physiological and psychosocial stressors (P < 0.05).

Telenursing is effective in significantly reducing perceived stressors among older adults receiving hemodialysis. Nurses can use telenursing to reduce stressors among this patient population.

The aim of this study was to determine the growth status of very low birth infant at corrected age of two years.

This cross-sectional study was performed on all babies with birth weight ≤1500 gr without any congenital anomalies, genetic disturbance and chronic disease (e.g. cardiopulmonary insufficiency, cholestasis, malabsorption). They were called at corrected age 2 years, namely the calendar age by month + (40-gestational age by week). Their height, weight and head circumference were recorded and a nutritional check list was prepared. The values were entered into the WHO Standard Growth Curve Chart for male and female genders (CDC, November 2009) in the <10th, 10-49th, 50-89th and ≥90th percentiles.

Forty-three children with mean gestational age of 30.08±3.23 weeks and mean birth weight of 1163.95±240.77 g were studied. Thirteen cases (30.2%) in length, 10 cases (23.3%) in weight, 6 cases (14%) in head circumference and 17 cases (39.5%) in weight-for-height were below the 10th percentile. There was no significant difference between the sex, gestation age and the birth weight of these children below and above the 10th percentile (P<0.05).

According to the findings of this study, about one-third of infants born ≤1500 grams were below 10th percentile for height, and nearly a quarter of them were under10th percentile for weight at corrected 2 years old. Therefore, their growth should be more accurately controlled by health care centers based on the growth curve in the first year and any problem case should be referred to specialized centers.

Pediatric poisoning is a common and predictable cause of morbidity worldwide. It is necessary to determine the pattern of this problem in order to take preventive measures. The aim of this study was to determine the epidemiological and clinical pattern of children poisoning.

This cross-sectional, descriptive-analytical study was carried out on 408 children hospitalized due to poisoning in Amirkola Children’s Hospital from 2008 to 2013. The hospital information system was used to recognize children with a definite diagnosis of poisoning. Individual and epidemiological information of the participants was extracted from their medical records and analyzed.

Out of 408 poisoning cases, 97% of cases were unintentional, 55.4% of subjects were male, and the mean age of the children was 36.27±2.8 months. Totally, 56.6% of the children were residing in urban areas (P=0.004), and most cases (56.12%) suffered from medication poisoning. Moreover, 30.4% of them had no abnormal clinical manifestations, and the most common manifestation was loss of consciousness (29%). Besides, 61% of medical measures taken included the prevention of gastrointestinal absorption of the poison. The mean hospital stay duration was 2.7±2.1 days, and the consequence of poisoning was treatment and discharge in 68.3% of the cases and 1 death (0.2%).

The most common cause of pediatric poisoning was medications. In order to prevent poisoning in children, it is necessary to inform parents and other carers about the proper storage and use of medications, and in case of poisoning, urgent referral of the child to the centers.

Nowadays, uncontrolled use of chemical fertilizers in agriculture is one of the reasons for the entry of heavy metals into the environment. In this study, the heavy metals contamination of the soils enriched with compost and chemical fertilizers in the North of Iran and its ecological risk assessment
were evaluated.

In this study, 108 soil samples were collected from agricultural soils of some places of Babol in Mazandaran province. An atomic absorption spectrophotometer (PG-990) was used to determine the concentrations of lead, cadmium, and zinc in the soil samples. The assessment of soil contamination was performed by the contamination factor, degree of contamination indices, and the potential ecological risk of the heavy metals. Data were analyzed using SPSS version 22. Descriptive and chi-square tests were used to compare the mean with existing standards. Significant level was considered at P < 0.05.

The highest lead concentration (35.7 ± 9.5 mg/kg) was observed at 5-cm depth, and the maximum cadmium (1.1 ± 0.2 mg/kg) and zinc (88 ± 22.6 mg/kg) concentrations were observed at 15-cm depth. The results showed that lead, cadmium, and zinc concentrations in the agricultural soils enriched with compost fertilizers were acceptable, but agricultural soils enriched with chemical fertilizers indicated higher content than those enriched with compost fertilizers and higher than the maximum allowable concentration. The maximum contamination degree, pollution index, and potential ecological risk in the agricultural soils enriched with the chemical fertilizers were 15.77, 1.97, and 293.48, respectively, and these soils had low potential pollution and moderate ecological risks.

According to the results, it is necessary to use compost fertilizers for the agricultural soils enrichment.

Continuing care of an elderly patient with Alzheimer’s disease may result in psychosocial and physical disorders in family caregivers, as well as limitations to providing complete care.

The aim of the present study was to determine the effectiveness of resilience education in the mental health of family caregivers of elderly patients with Alzheimer’s disease.

This study followed a randomized, clinical trial design. The study population consisted of family caregivers of elderly patients with Alzheimer’s disease who referred to hospitals and neurologists’ offices located in the western cities of Mazandaran province, Iran. Data were collected between 2016 and 2017. Fifty-four family caregivers were recruited through convenience sampling and randomized into control and intervention groups (27 in each group). Demographic characteristics, Connor-Davidson Resilience Scale, and General Health Questionnaire were used for data collection. Resilience education was provided in eight sessions (45 min each) using PowerPoint presentations and educational pamphlets. The mental health scores were calculated using the indices including normality tests and analyzed using the independent and paired t-tests, analysis of variance (ANOVA), and Bonferroni test.

An independent t-test showed improvements in the mental health status of those who received the educational intervention (mean difference: 23.8 ± 6.4; P < 0.001). The independent t-test also indicated statistically significant differences between the groups’ anxiety/insomnia (8.8±2.3 versus -0.12±2.5), somatic symptoms (7.2±2.2 versus -0.9±1.03), social dysfunction (4.5±2.9 versus 0.2 ± 1.3), and depression (3.2 ± 2.2 versus -0.08 ± 0.6; P < 0.001).

Resilience education successfully improved the mental health of family caregivers. Therefore, it is suggested that healthcare providers, Alzheimer’s associations, and NGOs provide educational interventions to help promote the caregivers’ mental health.

The Holy Qur'an is a comprehensive and eternal book that has presented its educational programs in the form of verses and various methods tailored to the needs, desires and characteristics of man. Adopting different methods from the Holy Quran to cultivate virtues and avoid vices and providing proper educational solutions is of one the necessities for the Islamic society. One of these methods is warning and glad tiding (Inzar and Besharat) in which by warning and causing fear about the consequences of bad deeds, and giving glad tidings and encouragement by reminding the favorable outcomes of good deeds, the motivation required for avoiding illegal (Haram) and disapproved (Makruh) actions and doing obligatory and recommended (Mostahab) deeds is created. The study of the relationship between the Qur'anic glad tidings of Heaven and the anthropological aspects of behavior are the subject of this research. The research results show that the All Wise God has presented such glad tidings with regard to the inter- individual and intra-individual grounds and factors that affect behavioral motivations in man, so that human beings benefit from the glad tidings to obtain a suitable educational model and pass the stages of development and happiness.

T-lineage acute lymphoblastic leukemia (T-ALL) is a malignant hyperplastic disease of the hematopoietic system. This tumor is the most common tumor in children and adolescents. Myeloid cell leukemia-1 (Mcl-1) is described as a prosurvival protein from the Bcl2 family. It is an important factor in routine cancer treatments. In fact, in different types of cancers, Mcl-1 downregulation can be a potential target. The present study aims to evaluate the cytotoxic effect of MCL-1 siRNA in T-ALL cells. The present study evaluated the effects of Mcl-1 small interfering RNAs (siRNAs) on survival in Jurkat cells. Specific Mcl-1 siRNA was transfected and using quantitative real-time PCR, the relative expression of Mcl-1 mRNA was determined. Moreover, cell survival was determined using the colorimetric MTT assay. The expression of mRNA reduced effectively in a dose-dependent manner at 48 hours after transfection with Mcl-1 siRNA. In addition, Mcl-1 siRNA treatment could significantly reduce tumor cell survival. Based on the results, downregulation of Mcl-1 by specific siRNAs in T-ALL cells can effectively reduce cell survival. Therefore, Mcl-1 siRNA may be a complementary agent along with standard methods in the treatment of T-ALL.