Iranian Red Crescent Medical Journal
Volume:18 Issue: 11, Nov 2016

Methanol is a highly toxic substance and methanol poisoning results in severe health situations. Methanol poisoning occurs when it is consumed by various methods such as orally, by inhalation, and transdermally. Transdermal poisoning is rarely seen and causes severe health complications.
A 59-year-old male patient was admitted to the emergency room due to blurred vision and knee pain. He had wrapped alcohol soaked cotton around his knees because of pain, and left it for 10 hours at night. On physical examination the knees only exhibited redness. Upon funduscopic examination, signs of poisoning were not seen, but a high anion gap metabolic acidosis was shown by arterial blood gas analysis. Hemodialysis was performed for severe acidosis and the patient was admitted to the ICU. The patient was treated and discharged from the ICU without sequelae.
Methanol poisoning presents to the emergency department in our country with many different situations and with varying histories. In different parts of the world, transdermal intoxication cases may be more prevalent and they may be overlooked, therefore, we aimed to present this case.

Oral and dental health diseases can affect the general health of students.
The aim of this study was to identify the predictors of oral and dental health behavior using the health belief model (HBM) in female students in Teheran, Iran.
Patients and This was a cross-sectional study framed by the HBM, including 400 female students living in district 5 of Tehran, Iran. The sampling technique used in this study was multi-stage stratified random sampling. The data on the HBM constructs (perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy) and demographic characteristics were collected using a self-administered questionnaire. Descriptive statistics, bivariate correlations, and linear regression were performed to analyze the data, using the SPSS software, version 18.
The results showed that there were relationships between the knowledge, perceived barriers, cues to action, and mother’s education with oral health behaviors. A multivariate hierarchical regression analysis was conducted with the barrier entered at step one, knowledge at step two, and cues to action at step three. Finally, the three variables accounted for 17% of the total variance in the oral and dental health behavior.
The current study provided evidence for the utility of the belief-based model in the prediction of oral health behaviors. It could be suggested that oral health behavior can be promoted by reducing the perceived barriers and enhancing the students’ knowledge of oral and dental hygiene.

Family physician plans in Iran face several challenges, one of which is developing attractive and efficient contracts that motivate physicians to participate in the plan.
This study aimed to elicit GPs’ preferences for family physician contracts.
Patients and In a cross-sectional study using the conjoint analysis technique, 580 GPs selected from the family physician database in Iran in 2014. Through qualitative and quantitative methods, 18 contract scenarios were developed via orthogonal design i.e., the impact of each attribute is measured independently from changes in other attributes and a questionnaire was developed. Data were collected through this questionnaire and analyzed using the ordered logistic regression (OLR) model.
The results show that “quotas for admission to specialized courses” is the strongest preference of GPs (β = 1.123). In order of importance, the other preferences are having the right to provide services outside of the specified package (β = 0.962), increased number of covered population (β = 0.814), capitation payment 15% bonus (β = 0.644), increased catchment area to 5 km (β = 0.349), and increased length of contract to five years (β = 0.345).
The conjoint analysis results show that GPs concerned about various factors of family physician contracts. These results can be helpful for policy-makers as they complete the process of creating family physician plans, which can help increase the motivation of GPs to participate in the plan.

Post-term pregnancy is an important factor in perinatal mortality and morbidity. Generally, to reduce perinatal mortality in pregnancy, the delivery is done before adverse perinatal morbidity occurs. To prevent prolonged pregnancy, labor is induced with chemical drugs and complementary therapies. Due to the side effects and contraindications of chemical medicine, the use of herbs has been investigated in the induction of labor in post-term pregnancy.
This study was done to identify the effect of chamomile on inducing labor in women with post-term pregnancy of Shahid Akbarabadi hospital in Tehran in 2013.
Patients and This double-blind clinical trial study was performed in Iran on 80 post-term pregnant women with a gestational age of 40 weeks or more, a single pregnancy, 18 - 35 years old, cephalic presentation, an estimated fetal weight of 2500 - 4000 grams, an absence of uterine contraction, a cervical Bishop score of less than 4, the safety of the membrane, and low-risk pregnancy; they were randomly assigned to one of two groups of 40 women. Each of the participants was given a bottle containing 42 capsules (500 mg each) and took 2 capsules every 8 hours. The data were collected through the questionnaire of demographic observational, and examinal characteristics. Descriptive statistics, independent samples t-test, and Fisher’s exact test using SPSS (16/win) were used to determine and compare the effects of drugs on inducing labor in the groups.
After a week of using the first dose, the results showed that in 92.5% of the chamomile group and 62.5% in the placebo group, delivery symptoms started after taking the oral capsules, and there were significant statistical differences between the two groups for the onset of labor (P = 0.003) There was a noticeable statistical difference between the two groups regarding the mean interval time to the onset of labor pain after taking the capsules (P = 0.000).
In this study¸ chamomile stimulated labor in post-term pregnancy. With further studies, chamomile, which has no chemical side effects, can be suggested for stimulating labor in post-term pregnancy.

Context: Hepatitis is a term used to describe any type of hepatitis inflammation. Screening for the virus antigen during pregnancy is mandatory in some parts of the world and is recommended in others. so that, most women are aware of and understand the disease if they have it when they are pregnant. Thus, the major concerns of these women are both the virus transmission to the fetus and the effects of hepatitis B on pregnancy outcome.
Evidence Acquisition: According to a specific protocol, we searched in the Pub med, Scopus, ISI web of science from 1990 to February 2015 to find the original articles, which investigated the hepatitis B effects in pregnant women with normal singleton pregnancy who were previously diagnosed with inactive CHB or were incidentally found to be HBsAg positive in routine antenatal blood test. We included any cohort, case control and cross sectional studies if they had a healthy control group and reported one or more considered maternal or prinatal outcomes in pregnant women. Meta-analysis was performed with Review manager 5.4 and Stata 11 software. We assessed the effect size that was pooled odds ratio (OR) and 95% confidence intervals (CIs) using the random effects model. We explored statistical heterogeneity using the chi-squared (Chi2), I2 and tau-squared (Tau2) statistical tests.
From a total of 156 identified studies, 56 studies were chosen for a detailed review, and 18 studies which met the inclusion and exclusion criteria were included in the meta analysis. Among the included studies, the outcomes were small for gestational age (SGA) large for gestational age (LGA), intra uterine growth restriction (IUGR), fetal distress, fifth minutes apgar score, first minute Apgar score, low birth weight (LBW) and Fetal Macrosomia.
In this study, hepatitis B had a cause effect on LGA and fetal Macrosomia. Among the other considered adverse pregnancy outcomes; it didn’t have any significant effect.

Kaposi’s sarcoma (KS) remains the most common malignancy among HIV-infected patients. Human herpesvirus type-8 (HHV-8) is regarded as the infectious etiological agent of Kaposi’s sarcoma (KSHV). Diagnostic procedures associated with KSHV are not routinely performed in HIV-infected subjects.
The main objective of this study is to obtain information on KSHV epidemiology in Iranian HIV-infected individuals.
Patients and In the present cross-sectional study, 109 patients with established HIV infection, who visited a governmental and referral center for HIV screening in Tehran (Tehran west health center (TWHC)) between May 2014 and July 2015 were enrolled according to the convenience sample strategy. After peripheral blood collection, isolation of plasma and peripheral blood mononuclear cell (PBMC) compartments, DNA extraction was performed. KSHV DNA was analyzed by nested polymerase chain reaction (nested PCR) using primers from ORF-26 (virus minor capsid).
Among all 109 HIV-infected patients, 67 (61.5%) were male, with an age range of 2 - 64 years (mean ± standard deviation 35.8 ± 13.3). KSHV DNA was found in PBMC and plasma samples of six (5.5%) and four (3.6%) patients, respectively.
This study revealed a considerable prevalence of KSHV DNA, during latent and lytic phases, among HIV-infected patients. Risk factors for KSHV infection acquisition and concurrent. 0詷�� with HIV were also evaluated. Diagnosis of KSHV in the group could be helpful for prognosis of Kaposi’s sarcoma and clinical management.

Social anxiety is one of the most common psychological disorders that exists among children and adolescents, and it has profound effects on their psychological states and academic achievements.
The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on diminishing social anxiety disorder symptoms and improving the self-esteem of female adolescents suffering from social anxiety.
Patients and Semi-experimental research was conducted on 30 female students diagnosed with social anxiety. From the population of female students who were studying in Tehran’s high schools in the academic year of 2013 - 2014, 30 students fulfilling the DSM-5 criteria were selected using the convenience sampling method and were randomly assigned to control and experimental groups. The experimental group received eight sessions of MBCT treatment. The control group received no treatment. All participants completed the social phobia inventory (SPIN) and Rosenberg self-esteem scale (RSES) twice as pre- and post-treatment tests.
The results from the experimental group indicated a statistically reliable difference between the mean scores from SPIN (t (11) = 5.246, P = 0.000) and RSES (t (11) = -2.326, P = 0.040) pre-treatment and post-treatment. On the other hand, the results of the control group failed to reveal a statistically reliable difference between the mean scores from SPIN (t (12) = 1.089, P = 0.297) and RSES pre-treatment and post-treatment (t (12) = 1.089, P = 0.000).
The results indicate that MBCT is effective on both the improvement of self-esteem and the decrease of social anxiety. The results are in accordance with prior studies performed on adolescents.

Coronaviruses (CoVs) are large ribonucleic acid (RNA) viruses causing primarily respiratory disease in humans. A novel human coronavirus, subsequently named middle east respiratory syndrome coronavirus (MERS-CoV), was first reported in Saudi Arabia in September of 2012. With increasing numbers of infections and deaths from MERS-CoV, development of a rapid and reliable kit was crucial to prevent further spread of MERS-CoV.
In this study, we present two real-time reverse-transcription polymerase chain reaction (rRT-PCR) assays for in-house rapid and sensitive diagnostic testing of MERS-CoV, detecting the regions upstream of the envelope gene (upE) and open reading frame (ORF) 1b, respectively, for initial screening and final confirmation of MERS-CoV infection, as recommended by the world health organization (WHO).
In this experimental study, acquiring patient samples was difficult; thus, according to WHO recommendations and standard protocols, we synthesized RNA sequences of upE and ORF1b genes as the template signatures and TaqMan based-diagnostic rRT-PCR assays were carried out using these synthetic genes for detection of MERS-CoV. In this research, we also inaugurated a cell-free system to transcribe these RNA sequences using the DNA templates synthesized.
The upE and ORF1b based one-step rRT-PCR assays were optimized by testing several times via different synthetic RNAs, and validation results were highly successful. The sensitivity obtained for upE was fewer than ten copies of RNA template per reaction and for ORF1b was 50 or fewer copies per reaction.
This study showed that the developed rRT-PCR assays are rapid, reliable, reproducible, specific, sensitive, and simple tools for detection of MERS-CoV. Finally, a kit consisting of two assay signatures and controls was assembled, which can be distributed to public health laboratories in Iran to support international MERS-CoV surveillance and public health response.

Uterine leiomyomas are the most common benign solid tumors of the female pelvis. Retroperitoneal myomas are extremely rare and usually malignant with the common location being in the pelvis.
Our case involved a woman who was suffering from dysparonia and radiculating right pelvic pain. The pelvic examination revealed a palpable tender mass of about 3-4 cm in size in the right adnexa near the pelvis bone. An orthopedic consultation was in favor of the mass being of gynecologic origin. A retroperitoneal approach on the right side revealed a 3 cm mass in the right obturator fossa.
The most common place for a myoma is in the uterus. However, other sites have also been presented as case reports. Most smooth muscle tumors originating in the retroperitoneum are malignant. Retroperitoneal sites for myomas are mostly in the pelvis (73.1%). The frequent symptoms of retroperitoneal masses, including myoma, are discomfort, fatigue, weight loss, and radiating pain. The common sonographic findings in these patients is a pelvic solid mass with heterogeneous features. Surgical excision is the main treatment of retroperitoneal smooth muscle tumors.

Gastric Helicobacter pylori is extremely common worldwide.
The aim of this study was to assess the effectiveness of combination of Nigella sativa and honey (Dosin) in eradication of gastric H. pylori infection.
Patients and Nineteen patients who had positive result for H. pylori infection by urea breath test (UBT) without a past history of peptic ulcer, gastric cancer or gastrointestinal bleeding, were suggested to receive one teaspoon of the mixture of Dosin (6 g/day of N. sativa as ground seeds and 12 g/day of honey) three times a day after meals for two weeks. The second UBT was used to detect the presence of H. pylori four weeks after completion of the test. In addition, symptoms of dyspepsia were scored before and after the study and analyzed with Wilcoxon signed-rank test
Fourteen patients completed the study. Negative UBT was observed in 57.1% (8/14) of participants after intervention. The median and interquartile range (IQR) of total dyspepsia symptoms was significantly reduced from 5.5 (5 - 12) to 1 (0 - 4) (P = 0.005). All the patients tolerated Dosin except for one who was excluded due to mild diarrhea. No serious adverse events were reported.
Dosin was concluded to be an anti H. pylori and an anti-dyspeptic agent. Further studies are recommended to investigate the effect of Dosin plus antibiotics (concurrently or following another) on gastric H. pylori infection.

Today, indexes regarding longevity and life expectancy have increased; the most important issue now is how to spend time loving or in other words quality of life.
This study was aimed to evaluate effective indexes on quality of life related to health in western Iran in 2013.
In this cross-sectional research, 918 families were selected among different counties of Ilam Province by multi-stage clustering sampling. The data collection instrument was a questionnaire used to measure the general economic and quality of life: the SF-36 health status questionnaire. Data were analyzed using multivariate regression models.
The mean age of the study participants was 32.97 ± 9.5 years, and the mean score for their quality of life was 61.74 ± 12.31. There was a significant statistical relationship between people’s quality of life and their marital status, province of residency, income, economic situation, and life satisfaction (P The mean quality of life among the individuals studied was in the middle level, however, it is important to consider the different dimensions of their living situations, such as economic protections, social cooperation, ability to present suitable behaviors to solve problems, and living situation, especially among deprived people.

There are very limited data for Iranian populations on the predisposing genetic factors for acute coronary syndrome (ACS).
The objective of the present study was to investigate the association of the angiotensin II type 1 receptor (AT1R) gene polymorphism and ACS in an Iranian population.
Patients and This cross-sectional study was conducted among 263 subjects (97 men and 166 women). Patients (n = 128) aged 30 - 80 years with chest pain were recruited from the emergency department of Ghaem Hospital (Mashhad, Iran). A 12-lead electrocardiograph plus creatine kinase MB (CK-MB) levels were used as the basis for the diagnosis of myocardial ischemia. The control group was selected from age-matched healthy subjects (n = 135). Non-enzymatic kits were used for extraction of DNA from blood samples. Polymerase chain reaction (PCR) was performed to amplify the DNA fragments. For restriction fragment length polymorphism (RFLP) determination, the DdeI enzyme was used to digest the amplified DNA fragments. Statistical analyses were performed using SPSS version 13.0.
There was no statistical difference in the genotype frequency of patients and healthy subjects with regard to age and gender (P > 0.05).
The AT1R A1166C polymorphism appeared not to be associated with the presence of ACS in the population studied.

Context: One of the most common complications of pregnancy is gestational diabetes mellitus (GDM), which is increasing worldwide. Experimental and epidemiological studies have shown that higher intake of n-3 long-chain polyunsaturated fatty acids may decrease the risk of various diseases such as diabetes. The objective of this study was to assess the effect of fish oil supplementation on the prevention and treatment of GDM.
Evidence Acquisition: This systematic review was performed by searching several databases, including PubMed, Scopus, Google Scholar, the Cochrane Library, ProQuest, Science Direct SID, Magiran and IranMedex since 1983. The researchers also searched for references in reviewed clinical trial articles in which fish oil supplementation was compared with placebo or no supplementation.
Only two published and in-press articles are included in this review. Based on these studies, docosahexaenoic acid (DHA)-enriched fish oil (800 mg/d) had no effect on prevention of GDM [0.97 (95% CI: 0.74, 1.27)]. Furthermore, omega-3 fatty acid supplementation containing 180 mg of eicosapentaenoic acid (EPA) and 120 mg DHA had beneficial effects on insulin resistance in women with GDM (change from baseline: 1.5 ± 7.5 vs þ3.5 ± 8.5 mIU/mL, P = 0.02) but did not influence fasting plasma glucose, homeostatic model assessment-Beta cell function (HOMA-B), the quantitative insulin sensitivity check index (QUICKI), or lipid profiles (P > 0.05).
There is not enough evidence to support or refute the routine use of fish oil supplements during pregnancy for the prevention or treatment of diabetes. It is suggested that further randomized controlled trials be conducted to evaluate the role of fish oil supplementation in pregnancy.

Non-alcoholic fatty liver disease (NAFLD) is the most common form of liver disease in many parts of the world.
The aim of the present study was to identify the most important factors influencing NAFLD using a classification tree (CT) to predict the probability of NAFLD.
Patients and This cross-sectional study was conducted in Kavar, a town in the south of Fars province, Iran. A total of 1,600 individuals were selected for the study via the stratified method and multiple-stage cluster random sampling. A total of 30 demographic and clinical variables were measured for each individual. Participants were divided into two datasets: testing and training. We used the training dataset (1,120 individuals) to build the CT and the testing dataset (480 individuals) to assess the CT. The CT was also used to estimate class and to predict fatty liver occurrence.
NAFLD was diagnosed in 22% of the individuals in the sample. Our findings revealed that the following variables, based on univariate analysis, had a significant association with NAFLD: marital status, history of hepatitis B vaccine, history of surgery, body mass index (BMI), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), triglycerides (TG), alanine aminotransferase (ALT), cholesterol (CHO0, aspartate aminotransferase (AST), glucose (GLU), albumin (AL), and age (P The CT is a suitable and easy-to-interpret approach for decision-making and predicting NAFLD.

Breast cancer is the most common cancer in women, and the second leading cause of cancer deaths. The detection and treatment of this cancer may create mental pressure and lower mood levels, causing anxiety, depression, stress, and pain for the patients.
The aim of this study was to determine the effects of Swedish massage on mood disorders in breast cancer patients undergoing radiotherapy at the cancer institute of the Imam Khomeini hospital at the Tehran University of Medical Sciences.
Patients and This study consisted of a clinical trial including 100 patients with breast cancer. The participants were chosen randomly, with their consent, by the use of polling, to be included in the intervention group (which received a Swedish massage three times a week, for 30 minutes, over five weeks) and control group (which received routine care). At the beginning of the intervention and after 5 weeks, the mood disorders of the patients, including anger, anxiety, depression, and any positive affect, were assessed using the affective control scale (ACS) questionnaire.
Before the intervention, there was no significant difference in the average of the overall scale between the intervention and control groups in the subscales of anger, anxiety, depression, and positive affect (P = 0.469). The average of the overall scale in the Swedish massage group decreased from 3.52 ± 0.65 to 2.42 ± 0.76 when compared to the pre-intervention conditions, and to (P When compared to the control group, the Swedish massage showed an improvement in the mood disorders of women with breast cancer.

Dressler Syndrome should be considered in the differential diagnosis of chest pain, especially in patients who are in a late stage of the evolution of the ischemic process.
A 46-year-old male was admitted to the emergency department due to pleuritic chest pain. Two weeks before this admission, he presented with a typical angina episode, likely an ST segment elevation myocardial infarction (STEMI), and did not receive reperfusion therapy or any medical care. The patient’s electrocardiogram showed diffuse ST segment elevation and PR segment depression, and his blood tests showed positive myocardial necrosis markers. A coronary angiography showed a proximal occlusion (not recanalized) of the circumflex artery. There was a late gadolinium enhancement area seen through cardiac magnetic resonance imaging (CMR), suggestive of recent transmural infarction, pericardial injury, and pleural effusion (inflammatory).
These findings strongly suggest the diagnosis of delayed post-infarction pericarditis, or Dressler Syndrome, a rare disease in the age of reperfusion therapy. Although rare, it is a syndrome that must be considered in the differential diagnosis of chest pain.

A combination of the oils of sesame, hemp, wild pistachio, and walnut has been used for treatment of skin disorders, including wound burns, in some parts of Kerman, Iran. Evaluation of this remedy in the form of a pharmaceutical formulation in animal models can pave the way for its future application in wound burn healing in humans.
This experimental study investigated the healing potential of a new formula (NF) based on folk medicine from Iran for the treatment of third degree burns in mice. The formula was a combination of the oils of four plants: sesame (Sesamum indicum L.), wild pistachio (Pistacia atlantica Desf.), hemp (Cannabis sativa L.), and walnut (Juglans regia L.)
Twenty-four mice were selected based on simple random sampling. Twenty-five percent of the total body surface area was burned by exposure to boiling water, according to the Walker-Mason method. NF and silver sulfadiazine (the positive control) were applied topically twice a day for 21 days. The burned area in the negative control group was left untreated. Epithelialization time and the percent of wound contraction were measured during the treatment period. The process of wound repairing was evaluated using histological (H and E and trichrome staining) and immunohistological (anti-pancytokeratin) methods.
When compared to the controls, NF significantly improved wound contraction after day 10. Epithelialization time in the NF group was significantly faster than in the other groups (20 vs. 25.5 days) (P A new therapeutic remedy was introduced for the treatment of burn wounds. Further clinical and molecular studies are suggested to determine the exact mechanism(s) involved in the burn wound healing effect of NF.

Using various models of behavior change, a number of studies in the area of nutrition education have confirmed that nutrition habits and behaviors can be improved.
This study sought to determine the effects of education on patterns of dietary consumption among medical students at the military university of Tehran, with a view to correcting those patterns.
In this quasi-experimental study, 242 medical students from the Military University of Tehran were chosen by convenience sampling and then divided into control (n = 107) and intervention groups (n = 135) by block randomization. The self-administered questionnaire involving six categories of item (knowledge, perceived benefits, perceived barriers, perceived threats, self-efficacy and behavior) has been validated (Cronbach alpha > 0.7 for each).
Following the educational intervention, the mean score of knowledge, health belief model (HBM) structure, and behavior of students in relation to healthy patterns of food intake increased significantly (P The significant improvement in the experimental group’s mean knowledge, HBM structures , and behavior scores indicates the positive effect of the intervention.

It seems that there is a relationship between consanguinity and profound hearing loss but there is little data about the association of consanguinity and hearing loss in Iran.
The aim of this study is to demonstrate the causes of profound bilateral sensorineural hearing loss among Iranian samples who are candidates for cochlear implantation.
This study was retrospective, analytical, and designed to collect information about profound hearing impaired cases referred to the Baqiyatallah Cochlear implantation center using enumeration. A total of 310 children with profound hearing impairments participated in this study. They were aged from 6 months to 4 years old. The study was done between January 2007 and April 2009. Chi-square tests were used to show whether there was any statistical difference between the incidence of marital consanguinity of their parents and the normal population.
Sixty-five percent of those 310 children had parents who had married with their relatives. Of the 203 (65%) parents that had consanguineous marriages, 132 were first cousins, which includes the children of two brothers (37 [11.8%] patrilateral parallel cousins), the children of two sisters (38 [12.2%] multi-lateral parallel cousins), or the children of a brother and a sister (57 [18.3%] cross cousins). Fifty-four (17.4%) of the parents were second cousins and 17 (5.2%) were beyond second cousins. Also, hearing loss etiology was obvious in 237 (76.3%) of the patients with profound hearing loss but was unknown in 73 (23.7%). Hereditary was identified as the most common cause in 33% of the cases.
Our data demonstrated a 65% occurrence of consanguineous marriage among the parents of deaf children, which is statistically different from the percentage of consanguineous marriage among Iranian population (38%). This indicates an obvious relationship between severe hearing loss and consanguineous marriage.

Context: The incidences of both gastroesophageal reflux disease (GERD) and metabolic syndrome (MetS) have increased in recent years, and it has been suggested that there is a probable association between the two. The aim of this review is to clarify whether or not MetS is a risk factor for the incidence of GERD.
Evidence Aquisition: We searched the PubMed, ProQuest, Ovid, Science Direct, and Google Scholar databases up to February 2015 regarding the relationship between GERD and MetS as found in observational studies. Any studies that evaluated the association between the components of MetS and GERD, as well as any studies examining the association of MetS with Barrett’s esophagus or esophageal carcinoma, were excluded.
Thirteen studies met the eligibility criteria. The results of nine studies suggested that there was a higher prevalence of MetS among patients with GERD (P It can be concluded that MetS may increase the risk of GERD. Consequently, there might be potential benefits to treating the metabolic abnormalities in these patients.

The outcomes of hospitalization anxiety are mental health disorders. One of the methods of anxiety reduction is massage, which can cause reduction of pain and changes in physiological parameters.
This study aimed to investigate the effects of slow-stroke back massage (SSBM) on hospitalization anxiety and physiological parameters in school-age children.
This clinical trial study included 80 school-aged children from Ali Ebne Abi Taleb hospital, located in Zahedan, who were selected using sequential sampling and randomly divided into two groups: a massage group (40) and a control group (40). Data were collected using a demographic questionnaire and the state-trait anxiety inventory for children (STAIC). Subjects in the massage group received SSBM, using sesame oil, for 3 days. Massage was given three times a day, and each massage session lasted for 15 - 20 minutes. Physiological parameters and hospitalization anxiety were determined from the second to fifth days. T-test and Chi-square were used for analysis data.
There was a statistically significant difference (P The results suggest that massage reduced hospitalization anxiety, PR, and BP. Therefore, we propose that nurses can use massage to reduce anxiety in school-age children in hospital. This method has no side-effects and is easily applicable.

Probiotics can alter the colonic microbiota and might improve bowel function.
The aim of this study was to evaluate the effect of the consumption of yogurt, enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 (CFU) on the symptoms of constipated pregnant women.
This triple-blind randomized controlled trial was conducted on 60 constipated pregnant women who were diagnosed by the ROME III criteria in Tabriz, Iran from December 2014 to July 2015. Participants were randomly put into two groups including the treatment and the control group through block randomization. The treatment group received 300 g of yogurt enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 colony forming units (CFU) (n = 30) while the control group received conventional yogurt (n = 30) for 4 weeks. The defecation frequency, stool consistency, straining during defecation, sensation of anorectal obstruction, sensation of incomplete evacuation and manual manoeuvres to facilitate defecation were primary outcomes while the amount of defecation, stool colure, and quality of life were secondary outcomes.
The frequency of defecation was increased from 2.1 (0.8) at baseline to 8.3 (4.4) in the probiotic yogurt group vs. 2.3 (0.7) at baseline to 8.1 (4.3) in the conventional yogurt group at the end of 4th week. These results were based on the repeated measure ANOVA test and there was no statistically significant difference between the two groups (mean difference: 0.1; Confidence Interval 95%: -1.4 to 1.7; P = 0.872). Constipation symptoms including straining, anorectal obstruction, manipulation to facilitate defecation, consistency of stool and color of stool were improved significantly (P Consumption of 300 g/day probiotic and conventional yogurt can play a role in improving the symptoms of constipation during pregnancy.

Hypertension is one of the major risk factors for cardiovascular morbidities, including coronary artery disease (CAD).
With interest on the important role of hypertension in the progression of CAD, this study was designed to estimate the effect of garlic powder tablets on the blood pressure (BP) in patients with severe CAD.
A randomized, placebo-controlled, clinical trial was conducted on 56 CAD patients, aged 25 - 75 years old. The patients were randomly divided into two groups: Galois groups (n = 27), receiving garlic powder tablet (400 mg garlic) twice daily and the placebo groups (n = 29), receiving placebo for 3 months. The BP was assessed at baseline and at the end of the study.
During the 3 months study, in the placebo group, systolic BP (SBP) increased with 6.3 mmHg and diastolic BP (DBP) increased with 4.6 mmHg, changes which were significant. After the 3 months, the effect of garlic on SBP, after adjusting for baseline value, was significant, and this effect was more significant in hypertensive patients. Plasma lipids and lipoproteins did not change significantly in either the garlic or placebo groups, during the study. Tolerability, compliance and acceptability were high in all patients.
These results demonstrate that treatment with garlic-based drugs can be an effective treatment for controlling BP in CAD patients and has no interaction with other drugs that CAD patients take. Therefore, it may be considered as a safe adjunct treatment for this group of patients.

Weaning patients from mechanical ventilation is a complex and highly challenging process. It requires continuity of care, the overall assessment of patients, and a focus on all aspects of patients’ needs by critical care nurses.
The aim of the present study was to explore holistic care while patients are being weaned from mechanical ventilation from the perspective of the critical care nurses.
The study was carried out in the intensive care units (ICUs) of six hospitals in Ahvaz, Iran, from 2014 to 2015. In this qualitative study, 25 ICU staff including nurses, nurse managers, and nurse educators were selected by means of purposive sampling. Semi-structured interviews were used for data collection. The interview transcripts were then analyzed using qualitative content analysis.
The four main themes that emerged to explain nurses’ experiences of holistic care when weaning patients from mechanical ventilation include continuous care, a holistic overview of the patient, promoting human dignity, and the overall development of well-being.
It was found that avoiding routine pivotal expertise, increasing consciousness of the nonphysical aspects of patients while providing treatment and presenting exclusive care, utilizing experienced ICU nurses, and placing more emphasis on effective communication with patients in order to honor them as human beings can all enhance the holistic quality of care.

Rapid dose assessment using biological dosimetry methods is essential to increase the chance of survival of exposed individuals in radiation accidents.
We compared the expression levels of the FDXR and RAD51 genes at 6 and 18 MV beam energies in human peripheral blood lymphocytes. The results of our study can be used to analyze radiation energy in biological dosimetry.
For this in vitro experimental study, from 36 students in the medical physics and virology departments, seven voluntary, healthy, non-smoking male blood donors of Khuzestan ethnicity with no history of exposure to ionization radiation were selected using simple randomized sampling. Sixty-three peripheral blood samples were collected from the seven healthy donors. Human peripheral blood was then exposed to doses of 0, 0.2, 0.5, 2, and 4 Gy with 6 and 18 MV beam energies in a Linac Varian 2100C/D (Varian, USA) at Golestan hospital in Ahvaz, Iran. After RNA extraction and cDNA synthesis, the expression levels of FDXR and RAD51 were determined 24 hours post-irradiation using the gel-purified reverse transcription polymerase chain reaction (RT-PCR) technique and TaqMan strategy (by real-time PCR).
The expression level of FDXR gene was significantly increased at doses of 2 Gy and 4 Gy in the 6 - 18 MV energy range (P The data suggest that the expression analysis of the FDXR gene, contrary to that of the RAD51 gene, may be suitable for assessment of high-energy X-ray. In addition, RAD51 is not a suitable gene for dose assessment in biological dosimetry.

Intramedullary cavernous angioma (ICA) is a rare lesion of the spinal cord, representing only 3% - 5% of central nervous system lesions. The coexistence of trigeminal neuralgia and refractory itch is very rarely encountered in clinical practice. To our knowledge, a report of an ICA with trigeminal neuralgia and local neuropathic itch has never been published to date. Thus, we present a very interesting case of a C2 ICA.
A 61-year-old female presented with right facial pain for three years, which was exacerbated by accompanying cervical pain and itch for one month. The patient’s symptoms were relieved after surgery, and there was no recurrence of lesions one year later.
ICA with trigeminal neuralgia and local neuropathic itch is very rarely encountered in clinical practice. As it is not always diagnosed at first, some patients miss the best treatment period. Therefore, we call for emphasis to be placed on early diagnosis and timely surgical treatment.

Physical activity in the elderly is influenced by aspects of aging that cause personal, mental, environmental, and social changes. Increases in factors that are barriers to activity cause physical energy expenditure to decrease.
The aim of the present study was to survey the relationship between energy expenditure in metabolic equivalent units (MET) and factors that are barriers to physical activity in elderly people in Kashan, Iran
This is a descriptive analysis done in 2014. The study population was 400 people above 60 years old in medical facilities in Kashan. Multistage sampling was used in 10 clinics in 5 areas of Kashan. The sample size was varied according to gender and elderly population. Contributors were given questionnaires concerning energy expenditure levels in physical activity and factors that are barriers to being active.
The average age among the study population was 67.6 ± 6.8 years median, and the interquartile range (IQR) of barriers to physical activity among Kashan’s elderly was (8.75) ± 33. Average energy expenditure was 326.21 ± 364.84 based on metabolic equivalent units (MET). In fact, 340 persons (85%) were practically without any active energy expenditure. The most common barrier was the lack of an appropriate place for doing physical activity; 298 (74%) of the participants cited this barrier. The results show the Spearman rank-order correlation is significant (P = 0.038, r = 0.104) between barriers to physical activity and activity energy expenditure in Kashan’s elderly.
Decreasing barriers to physical activity among the elderly causes physical activities to increase; therefore, energy expenditure is increased. Decreasing social and environmental problems for the elderly is effective in increasing physical activity and energy expenditure.

Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily. Reduced OPG levels are related to obesity, insulin resistance, and non-alcoholic fatty liver disease (NAFLD).
The aim of this study was to evaluate the relationship between OPG levels, obesity, insulin resistance, and NAFLD in pediatric patients.
This was a prospective, cross-sectional, controlled study that was conducted in the department of pediatrics at Bagcilar training and research hospital in Istanbul, Turkey, between April and August 2015. The study was performed on 107 children with obesity and 37 controls aged 5 - 17 years. In the obese subset, 62 patients had NAFLD. Homeostatic model assessment-insulin resistance (HOMA-IR) was used to calculate insulin resistance. Insulin resistance was defined as a HOMA-IR value greater than 2.5. Plasma OPG levels were measured using enzyme-linked immunosorbent assays. NAFLD was diagnosed by hepatic ultrasound.
The mean age was 11.25 ± 3.38 years in the patient group and 10.41 ± 3.15 years in the control group. The OPG level in the obese group with the mean of 55.20 ± 24.55 pg/mL (median = 48.81 pg/mL) was significantly lower than that in the control group with the mean of 70.78 ± 33.41 pg/mL (median = 64.57 pg/mL) (P = 0.0001). The optimal cut-off point (sensitivity, specificity) of the OPG level for the diagnosis of obesity was ≤ 46, 19 pg/mL. According to logistic regression analysis, fasting insulin (P = 0.036) and OPG (P = 0.01) levels were most affected by obesity. In the obese patients, who had HOMA-IR We confirmed that serum OPG concentrations reduce in obese children. However, no correlation was identified between OPG and insulin resistance. OPG levels are not meaningful in the diagnosis of NAFLD in children with obesity.

Rates of drug-resistant tuberculosis (TB) and TB associated with human immunodeficiency virus (HIV) infection have increased dramatically, intensifying challenges in TB control. New formulations of TB treatment drugs that control drug release and increase local drug concentrations will have a significant impact on mitigating the toxic side effects and increasing the clinical efficacy of anti-TB drugs.
The aim was to observe the sustained release characteristics of rifapentine polylactic acid sustained-release microspheres in vivo and the accumulation of rifapentine in other tissues following paravertebral implantation.
This study is a basic animal experimental study that began on July 17, 2014 in the Fifth Affiliated hospital of Xinjiang Medical University. One hundred and eight New Zealand white rabbits (weighing 2.8 - 3.0 kg, male and female, China) were randomly divided into three groups of 36 rabbits each. Blood and tissue samples from the liver, lungs, kidneys, vertebrae, and paravertebral muscle were collected at different time points post-surgery. High performance liquid chromatography (HPLC) analysis with a biological internal standard was used to determine the drug concentrations in samples.
In group A, no significant differences in rifapentine concentrations in the liver were detected between any two time points (P > 0.05). However, the differences in rifapentine concentrations between day 10 and day 21 were statistically significant (P 0.05). In group B, the differences in rifapentine concentration between days 3 and 10 in vertebral bone and in paravertebral muscles were statistically significant (P After paravertebral implantation of rifapentine polylactic acid sustained-release microspheres, the concentration of rifapentine in local vertebral bone tissues was maintained above the TB minimum inhibitory concentration for up to 60 days with no apparent accumulation of the drug in other tissues.

Despite the introduction of new drug regimens with high effectiveness for the hepatitis C virus (HCV) patients, especially in HCV genotype 1, no cost-effectiveness study on the selection of the superior drug strategy in Iran has been conducted yet.
This study is aimed to assess the cost-effectiveness of the three drug regimens of pegylated interferon and ribavirin (PR), sofosbuvir (SOF) PR and ledipasvir and sofosbuvir (LDV/SOF) in patients with HCV genotype 1 in Iran in the year 2014.
A Markov micro-simulation model was used to evaluate the cost-effectiveness of the three drug strategies for a cohort of 10000 patients. Quality-adjusted life-years (QALYs) were extracted from published studies. Cost data was estimated through the review of medical records and obtaining experts opinion.
The results showed that the SOF PR drug compared with PR had a lower cost and was more effective, but compared with the LDV/SOF, in spite of its lower cost, it was less efficient. The QALY values obtained for PR, SOF PR and LDV/SOF, respectively, were 10.98, 12.08 and 12.28 and their costs were $ 41,741, $ 7,676 and $ 46,993. Moreover, the results obtained from acceptability curves showed that SOF PR were the most cost-effective treatment for thresholds below $ 45,270 PPP.
The use of SOF PR regimen or LDV/SOF can significantly reduce the incidence of complications associated with the disease. For example, short and long-term outcomes are better than the current drug regimens for HCV genotype 1 patients in all stages of the disease.

Profound metabolic alkalosis is an uncommon consideration for the anesthetic management of kidney transplantation. Serum total carbon dioxide content and complex electrolyte abnormalities might be important diagnostic clues for the presence of metabolic alkalosis in the absence of arterial blood gas analysis.
A 34-year-old female visited Gachon University Gil Medical Center, Incheon, South Korea during year 2015. She experienced aggravated renal function due to chronic hypokalemia and severe hypochloremic metabolic alkalosis, induced by laxative abuse, and underwent ABO incompatible kidney transplantation. Serum total carbon dioxide content remained high (about 60 mEq/L) over eight months of monthly follow-up prior to kidney transplantation.
The authors described their anesthetic experience of profound metabolic alkalosis with complex electrolyte abnormalities and provided a review of relevant literature.

Diarrhea is one of the most common disorders in infancy and childhood and recurrent vomiting is a main reason for hospitalization for these patients. This study was to assess the effect of injective ondansetron on decreasing the hospitalization rate in children with diarrhea and recurrent vomiting.
In this clinical trial study, patients between six months and six years, with acute viral diarrhea and recurrent vomiting, were assessed for the possibility of being treated as outpatients, based on their response to ondansetron, compared to a control group who did not receive ondansetron. The sample size was 100 for each group. Cases for the ondansetron group were under observation for at least two hours in the emergency ward and were followed until 72 hours to find out if there was any need for them to return to the hospital due to vomiting. Otherwise, all cases in the control group were hospitalized. Data of both groups, including the rate and duration of hospitalization, was analyzed.
Of the 100 individuals who received ondansetron (n = 91) 91% did not need to be hospitalized and 9 patients needed to be admitted in the next 72 hours, while (n = 100) 100% of control group were hospitalized (P value = 0.003). Vomiting in the control group continued in 35% of patients after 72 hours of admission. The duration of hospitalization for the patients of the control group was 2.94 ± 1.40 (mean ± SD) days.
Interpretation: Ondansetron can be considered as an effective agent to decrease the hospitalization rate in infants and children with diarrhea as well as vomiting. Injective forms of ondansetron seem to be more achieved than oral forms.

Urinary tract infection is a common disease in the general population. However, in patients with frequent urinary tract infection, it is important to determine any treatable cause to avoid recurrence.
Herlyn-Werner-Wunderlich syndrome or OHVIRA syndrome is a very rare congenital anomaly with uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. The earliest presentation of this syndrome is hematocolpos that develops during menstruation and results in dysmenorrhea and a pelvic mass shortly after menarche. Herein, we report a patient with Herlyn-Werner-Wunderlich syndrome manifested with unusual symptoms, delayed onset and without surgery. The unique point of this patient is the partial obstruction of cervico-vaginal junction.
Early diagnosis and timely treatment of OHVIRA syndrome can prevent long-term complications, such as recurrent urinary tract infection and infertility. A high index of suspicion is required, even though OHVIRA syndrome is extremely rare and may have an atypical presentation.

The recent investigations have rendered microRNAs (miRs) as a novel biomarker in cancer research. In fact, alteration in miR expression may be associated with tumor suppression, tumorigenesis, metastasis, and poor prognosis in human breast cancer (BC).
The aim of this clinical experimental study was to measure the miR-328 expression level in breast cancer tissues, at first. Then, we tried to find out any possible correlation between miR-328 and prognostic and predictive biomarkers in BC. Both of these two objectives were investigated for the first time; and we did not find any similar survey measuring the expression level of miR-328 in both tumor and non-tumor breast tissues. This research was conducted in Iran (Ahvaz, Khuzestan), between December 2013 and April 2014. Furthermore, we did not find any previous document investigating the correlation between miR-328 expression level and prognostic factors in BC. Due to the lack of similar studies intending to measure the expression level of miR-328 in tumor and adjacent non-tumor tissues, we decided to carry out a pilot study.
We measured the expression level of miR-328 by Poly (A) real-time PCR based on SYBR Green-I in 28 fresh samples of BC tissues and 28 samples of normal adjacent tissues, including invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and ductal carcinoma in situ (DCIS). We tried to attribute the results to clinicopathologic features such as status of estrogen and progesterone receptors (ER/PR), HER2/neu (HER2), P53 and also Ki67 labeling (Ki67-LI).
The results showed that the miR-328 median level of expression was 0.88 (2-ΔΔCt) (25th-75th percentile, 0.07 - 2.34). It means that the expression level increased in tumor tissues compared to normal adjacent tissues (NATs). However, a statistically significant correlation between the miR-328 median expression level and prognostic factors, including pathologic diagnosis, age, and also the status of ER, PR, HER2, and Ki67-LI was not observed (P > 0.05).
Therefore, it might be possible to consider miR-328 as an oncogene; but not necessarily an oncomiR, in human BC.

Domestic and industrial swallowing of caustic substances can cause acute and chronic injuries. In the acute phase of care, focus is on the immediate control of tissue damage and perforation, and in the chronic phase, the focus is on the treatment of pharyngeal narrowing and impaired swallowing.
The patients of this report were an 18-year-old man and a 20-year-old woman, who had esophageal burns after ingesting chemicals, and for solving their nutritional problems, such as difficulty in swallowing, they had underwent surgery. Patients had continued follow-up after surgery.
Treatment of esophageal burn lesions is by immediate and delayed removing of damage outcomes.