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Managing overweight and obesity is associated with lower risks of chronic diseases like diabetes. Digital health, particularly smartphones or m-health, effectively manages body weight. Technologies such as telemedicine services, mobile health (mHealth) or the use of mobile phones or portable digital devices in healthcare services and wearable devices can be used in this field. Therefore, this study was conducted to understand the impact of digital health technologies on weight management in diabetic patients. Methods: The present study is a systematic review study that was initially searched using a systematic review of published studies in the field of digital health for weight management in diabetic patients from October 1401 to October 1402. Our study was conducted in two rigorous steps. Firstly, we performed a systematic review by searching for publications on Digital Health Solutions for Body Weight Management in Diabetic Patients until 12 October 2022. We meticulously combed through two comprehensive databases, PubMed and Web of Science, using a set of specific and relevant keywords. After a thorough screening and full-text assessment, we handpicked eight documents for this study. We cross-referenced with the companies' websites producing the identified applications to enrich our findings further. Results: In the initial search, 223 documents were identified and after screening and qualitative evaluation, eight documents were selected for this study. Our research uncovered a range of mHealth apps that have shown promise in weight management for diabetic patients. These apps have demonstrated potential efficacy, high acceptability, and favorable user experiences. Importantly, they have also improved diabetes management and quality of life for the users. Conclusion: Our review of digital health solutions has not only illuminated their potential in weight management for diabetic patients but also opened up new avenues for a more personalized, engaging, and practical approach to this issue. As technology continues to advance, these interventions hold the potential to revolutionize diabetes self-management, significantly enhance the quality of life, and contribute to better health outcomes for individuals living with diabetes.

Background: While the beneficial effects of PA on the mental and physical well-being of elderly individuals are recognized, there has been little focus on its effects on older adults with mild cognitive impairment (MCI). Therefore, the objective of this investigation was to examine the correlations between physical activity (PA) and depression, perceived health, physical function, and quality of life (QoL) among older women with Mild Cognitive Impairment (MCI).Methods: This study employed a descriptive-correlation design. The statistical population comprised women with MCI (scoring 21 to 24 on the Mini–Mental State Examination) over 65 years residing in nursing homes in Tehran, Iran in 2023. The sample of this study consisted of 334 women (mean age=69.12±3.68) with MCI who were selected using a purposive sampling method. Standard tools were utilized for measuring PA, depression, balance, muscle strength, and QoL, respectively. Perceived health status was assessed using one item. Pearson correlation test and independent t-test were employed for data analysis.Results: The results showed that 66% of the entire sample suffered from depression. The participants engaged, on average, in 14.69 minutes of moderate physical activity (MPA) per day. Only 22% of the participants met the WHO’s guidelines of 30 minutes of MPA daily. It was found that higher MPA was significantly correlated with lower depression (P

Background: The effects of the coronavirus outbreak on the psychological and physical wellbeing of teenage girls is not well understood. Herein, one of the important mental health-related variables is introduced to be psychosocial distress (PSD). The current research aimed to explore the status of PSD in teenage girls during the coronavirus outbreak considering the impact of physical activity (PA) and sedentary time (ST).Methods: This research utilized a descriptive-correlation method. We selected 384 teenage girls (mean age 16.93±0.72 years) in Iran, in 2020, using a convenience sampling procedure. The participants were healthy and without any physical or mental disabilities. They completed the standard questionnaires including the COVID-19-Related Psychological Distress Scale, Physical Activity Behavior in Leisure-Time Scale, and Adolescent Sedentary Activity Questionnaire. Spearman correlation test and structural equation modelling were utilized for data analysis.Results: Our findings revealed that the psychosocial status of adolescent girls during the coronavirus outbreak was 41.50 out of 70. The subjects who were more physically active had lower levels of PSD (r=-0.627, P

Abstract Recently, mesenchymal stromal cells (MSCs) and their derivative exosome have become a promising approach in the context of liver diseases therapy, in particular, acute liver failure (ALF). In addition to their differentiation into hepatocytes in vivo, which is partially involved in liver regeneration, MSCs support liver regeneration as a result of their appreciated competencies, such as antiapoptotic, immunomodulatory, antifibrotic, and also antioxidant attributes. Further, MSCs-secreted molecules inspire hepatocyte proliferation in vivo, facilitating damaged tissue recovery in ALF. Given these properties, various MSCs-based approaches have evolved and resulted in encouraging outcomes in ALF animal models and also displayed safety and also modest efficacy in human studies, providing a new avenue for ALF therapy. Irrespective of MSCs-derived exosome, MSCs-based strategies in ALF include administration of native MSCs, genetically modified MSCs, pretreated MSCs, MSCs delivery using biomaterials, and also MSCs in combination with and other therapeutic molecules or modalities. Herein, we will deliver an overview regarding the therapeutic effects of the MSCs and their exosomes in ALF. As well, we will discuss recent progress in preclinical and clinical studies and current challenges in MSCs-based therapies in ALF, with a special focus on in vivo reports.

Background and Objectives: Diabetes is one of the diseases in which the patient plays a major role in its treatment. The comprehensive support of the treatment team, family and peers in various fields including nutritional management and physical activity is very important for this disease. Considering the importance of a healthy lifestyle, this study aims to determine the effect of a health promotion support program on nutritional status and physical activity of patients with type 2 diabetes. Methods: This is a quasi-experimental study that was conducted in 2020 on patients with type 2 diabetes in two intervention groups (n=30) and control (n=30) who were selected by a convenience sampling method from among those referred to the endocrinology clinic of Bank Melli Hospital, Tehran, Iran. The health promotion support program based on Orem’s theory was implemented in three stages of analyzing/identification, planning, and evaluation. Data were collected using a demographic form, a three-day food-reminder form, and a physical activity reminder form before and two months after the intervention in two groups, and were then analyzed using Chi-square test, Mann-Whitney U test, and Wilcoxon test in SPSS software, version 24. Results: Results showed that the mean score of eating “dairy products”, “vegetables”, “fruits”, “meat, eggs, and legumes”, “bread, cereals, starches” in the intervention group were significantly different after intervention, but this difference was not significant in the control group. The physical activity score in the intervention group also showed a significant difference (P

Background: Assessing students' mental health status and related factors is one of the important ways to achieve academic development. In this regard, the present study was conducted to determine the relationship between mental health with self-control and life satisfaction in students of Isfahan University of Medical Sciences, Isfahan, Iran. Methods: This descriptive-analytical study was conducted on 230 undergraduate and doctoral students of Isfahan University of Medical Sciences. The research instruments were demographic information Questionnaire, General Health Questionnaire (GHQ-28), Tanji Self-Control Questionnaire, and Diener Life Satisfaction Questionnaire. Data were analyzed using SPSS software with 95% confidence level. Findings: 49% of students had mental health and mental health status was better in men and married people. There was also a significant correlation between mental health, self-control, and life satisfaction. Conclusion: Mental health has an effect on students' life satisfaction and self-control. Therefore, it is recommended to hold one-on-one counseling sessions with students, and in their educational program, the issue of life satisfaction should be addressed. In order to maintain high self-control in students and prevent the occurrence of abnormal behaviors in universities, this issue should be considered.

Aims: Fatigue is a state in which a person's energy is completely depleted due to excessive physical or mental work. In addition to the importance of women workers and the effects of fatigue on them, limited studies have been conducted in this field in the world, especially in Iran. The present study was conducted to investigate the prevalence of fatigue and related factors among women workers in one of the cities of Iran. Materials and Methods: A cross-sectional study was performed among women workers in Kashan in 2018. The sample size was 265 participants from 300 workers. The data collection tool was the multidimensional fatigue inventory questionnaire. Data were analyzed via SPSS version 16. Results: The lowest and highest total score was 38 and 78, respectively. The mean score of activity decrease was 11.78, which was the highest score among questionnaire. Factors such as overtime, number of children, and work experience showed a statistically significant relationship with the total fatigue score (P < 0.05). Conclusion: According to the results, a large percentage of participants had a high score of fatigue. Managements should identify and modify the factors affecting fatigue to reduce the worker's fatigue. It seems that further studies are needed to reveal the relationship between fatigue and other variables to provide a deeper understanding of the causes of fatigue.

Background and Objectives: Diabetics need to improve their lifestyle. They should control and prevent the complications of diabetes to improve their quality of life. This study aimed to investigate the effect of health promotion support programs on the quality of life in patients with type 2 diabetes. Methods: The present study was a quasi-clinical trial. A total of 60 people were selected by convenience sampling method and then divided purposefully into intervention (n= 30) and control (n= 30) groups. The health promotion support program was implemented in three stages: review and recognition, support planning, and evaluation. The study data were collected by Demographic and Quality of Life Questionnaire of diabetic patients (DQOL-BCI) before and two months after the intervention in the experimental and control groups. Results: The difference between the two groups regarding gender, age, marriage, education, and the job was not significant. The Mean±SD score of quality of life in the intervention group before the intervention was 46.8±8.06 and increased after the intervention to 56.8±6.06 (P

Patient engagement (PE) is a well-known strategy introduced and implemented by pharmaceutical and medical device companies for patient compliance and adherence to treatment protocols during clinical trials and care processes. This can affect a wider range of outcomes such as the quality of treatment decisions and quality of care outcomes. Few studies have paid attention to it. The involvement of patient is one of the crucial stakeholders of health care in their treatment that makes controversial opinions about the potential outcomes of their engagement in various aspects of healthcare. This scoping review was conducted in 2022 to collect the results of PE. The search was performed in the MEDLINE and Web of Sciences databases. The selected documents were categorized and reported by the direct content analysis method. Out of 3974 published documents, 17 articles were selected. Findings are categorized into 4 groups: (1) Health outcome, (2) patient compliance, (3) self-efficiency, and (4) return on investment. PE can improve both treatment outcomes and consequently patient satisfaction and health, as well as the productivity of the service provider. However, increasing self-care and patient adherence are among the positive effects of this engagement on the patient, and return on investment is still a challenge for PE.

Introduction: Competency-based education seeks to bridge the gap between the labor market and the academic education system. Due to the problems of graduates of this field in the professional contexts, this study endeavored to up to date the curriculum of the field based on the expected job qualifications of the health system. Methods: This qualitative and applied study with the focus-group discussion method was conducted in the Faculty of Management and Medical Education of Shahid Beheshti University of Medical Sciences in the academic year 2019. To discuss the group, 13 faculty members and experts, graduates as well as two hospital managers were selected to identify the differences between academic learning and the professional requirements, and then to evaluate the content and topics of the Master of Health Services Management course. At the end of the group's consensus, notes were taken on the agreed results. Results: The data analysis revealed that the essential competencies are like this: leadership, effective teamwork, problem-solving, system thinking, and quality improvement. Changes were suggested in the content of existing courses, like working abilities with STATA software, expertise to design solutions by systems thinking methodologies, awareness of the ultimate challenges of the decisions without supporting evidence, and capacity to compare and criticize strategic planning process and outcomes. Conclusion: Findings revealed that modifications to current courses' content were suggested by adding new curriculum approaches to cover the required skill set. Given changes in the formal curriculum is a time-consuming process, transforming the content of existing courses is recommended.

Background and Aim: Ventilator-acquired pneumonia is common in invasive mechanical ventilatory patients. There are various methods to prevent and reduce the incidence of ventilator-acquired pneumonia, one of which is the use of combined mouthwashes. The purpose of this study was to evaluate the effect of combined mouthwash on the prevention of ventilator-acquired pneumonia. Materials and Methods: In this clinical-trial study, patients were randomly selected and divided into control and study group. The patients with GCS = 3 and brain death and mechanical ventilation less than 48 hours were excluded from the study. The control group received 0.2% chlorhexidine for mouthwash and the study group received gentamicin 2%, colistin 2% and vancomycin 2%. Mouthwashes were used until the creation of pneumonia symptoms, patient mortality, and endotracheal intubation. Statistical analysis was completed after the study. Results: The incidence of pneumonia was 19 (30.64%) in the study group and 16 (25.8%) in the control group (P = 0.23). In the study group, 39 (62/9%) patients and in the control group 40 patients (64/5%) were discharged (P = 49/0). Cultures endotracheal secretions were reported negatively in 40 patients (5.64%) of study group and 45 patients (58.72%) in control group (P = 0.04). The isolated bacteria in the study group included 11 cases of Acinetobacter (50%), four cases of Pseudomonas (18.18%), two cases of E.coli (9.09%), two cases of Klebsiella (9.09%) and three cases of Gram -positive (16.63%). Also these bacteria were reported as 11 cases of Acinetobacter (64.7%), three cases of Klebsiella (17/64%), two cases of Pseudomonas (11.76%), one case of E.coli (5.9%) in control group (P = 0.001). Conclusion: This study showed that a mouthwash with a combination of Gentamicin-Clestin and Vancomycin, compared to chlorhexidine, was not more effective in preventing ventilator-associated pneumonia in patients undergoing mechanical ventilation.

Objective: Examine the possible beneficial effects of early, D-dimer driven anticoagulation in preventing thrombotic complications and improving the overall outcomes of COVID-19 intubated patients.Methods: To address COVID-19 hypercoagulability, we developed a clinical protocol to escalate anticoagulation based on serum D-dimer levels. We retrospectively reviewed all our first 240 intubated patients with COVID-19. Of the 240, 195 were stratified into patients treated based on this protocol (ON-protocol, n = 91) and the control group, patients who received standard thromboprophylaxis (OFF-protocol, n = 104). All patients were admitted to the Stony Brook University Hospital intensive care units (ICUs) between February 7th, 2020 and May 17, 2020 and were otherwise treated in the same manner for all aspects of COVID-19 disease.Results: We found that the overall mortality was significantly lower ON-protocol compared to OFF-protocol (27.47 vs. 58.66%, P < 0.001). Average maximum D-dimer levels were significantly lower in the ON-protocol group (7,553 vs. 12,343 ng/mL), as was serum creatinine (2.2 vs. 2.8 mg/dL). Patients with poorly controlled D-dimer levels had higher rates of kidney dysfunction and mortality. Transfusion requirements and serious bleeding events were similar between groups. To address any possible between-group differences, we performed a propensity-matched analysis of 124 of the subjects (62 matched pairs, ON-protocol and OFF-protocol), which showed similar findings (31 vs. 57% overall mortality in the ON-protocol and OFF-protocol group, respectively).Conclusions: D-dimer-driven anticoagulation appears to be safe in patients with COVID-19 infection and is associated with improved survival.What This Paper Adds: It has been shown that hypercoagulability in patients with severe COVID-19 infection leads to thromboembolic complications and organ dysfunction. Anticoagulation has been variably administered to these patients, but it is unknown whether routine or escalated thromboprophylaxis provides a survival benefit. Our data shows that escalated D-dimer driven anticoagulation is associated with improved organ function and overall survival in intubated COVID-19 ICU patients at our institution. Importantly, we found that timely escalation of this anticoagulation is critical in preventing organ dysfunction and mortality in patients with severe COVID-19 infection.

Introduction: Stimuli-responsive nanocarriers offer unique advantages over the traditional drug delivery systems (DDSs) in terms of targeted drug delivery and on-demand release of cargo drug molecules. Of these, chitosan (CS)-based DDSs offer several advantages such as high compatibility with biological settings. Methods: In this study, we surveyed the literature in terms of the stimuli-responsive nanocarriers and discussed the most recent advancements in terms of CS-based nanosystems and their applications in cancer therapy and diagnosis. Results: These advanced DDSs are able to release the entrapped drugs in response to a specific endogenous stimulus (e.g., pH, glutathione concentration or certain enzymes) or exogenous stimulus (e.g., temperature, light, ultrasound, and magnetic field) at the desired time and target site. Dual-responsive nanocarriers by the combination of different stimuli have also been developed as efficient and improved DDSs. Among the stimuli-responsive nanocarriers, CS-based DDSs offer several advantages, including biocompatibility and biodegradability, antibacterial activity, ease of modification and functionalization, and non-immunogenicity. They are as one of the most ideal smart multifunction DDSs. Conclusion: The CS-based stimuli-responsive multifunctional nanosystems (NSs) offer unique potential for the targeted delivery of anticancer agents and provide great potential for on-demand and controlled-release of anticancer agents in response to diverse external/internal stimuli.

Background: Nesfatin-1, a newly discovered calcium and DNA binding peptide, originate from nucleobindin 2 (NUCB2) precursors and expressed by central and peripheral nervous system, and peripheral tissues such as digestive organs and adipose tissues. It has the astonishingly large number of chemical messengers for full appetite and introduced as a potential anorectic factor with ability to modulate body weight and probably, energy homeostasis. Nesfatin-1/NUCB2 level in the circulation is elevated after meal intake and decreased during a fast. Its food intake suppression effect is independent from the leptin pathway, and act via the melanocortin signaling. On the other hand, Nesfatin-1 colocalizes with insulin in pancreatic beta islet cells and has been shown to increase insulin secretion. Methodology: PubMed databases were searched for “NUCB2 or nesfatin-1 or nucleobindin” with the combination of “diabetes mellitus”. Included papers were further searched manually for additional studies. The databases were searched up to 2015. Fifty one articles were selected for full text review. Result: Centrally controlled Nesfatin-1 was stated to raise peripheral and hepatic insulin sensitivity by reducing gluconeogenesis and stimulating peripheral glucose uptake in vivo. Conclusion: Nesfatin-1 has gain attention as a new target to generate, drug for treatment of endocrine nutritional and metabolic disorders like obesity and type 2 diabetes mellitus.

Introduction: A variety of genetic predisposing factors and environmental factors are known to influence the pathogenesis of type-1 diabetes (T1D). This study intended to investigate the association of cytotoxic T-lymphocyte associated protein 4 (CTLA4) and interleukin 2 receptor subunit alpha (IL2RA) gene polymorphisms with type 1 diabetes in children of northwest of Iran. Methods: Genomic DNA was extracted by salting-out method. PCR amplification and direct sequencing methods were used for genotyping of CTLA4 (exon 1) and IL2RA (intron 1) genes in all patients and controls. SNPStats was used to calculate odds ratios (ORs), 95% confidence intervals (CIs), and p values. Results: In this study, the frequency of G allele and GG genotype of CTLA-4 (+49A/G) polymorphism in T1D patients were significantly different from those in the controls (26% vs. 11%, p = 0.006). Moreover, a significant difference was observed between patients and control group in the allele frequencies of the new SNP (chr2:203868145) that was identified in exon one of CTLA4 (14% vs. 3%, p = 0.006). The results showed that the GG homozygous genotype of +49 A>G was associated with increased glycemic level in T1D patients in the study population (95% CI = 10.47, p = 0.0067). However, no significant association was found between IL2RA (ss52580101C>A) polymorphism and T1D patients (2% vs. 4%, p = 0.41). Conclusion: The results further support the association of T1D with +49A>G SNP in the CTLA4 gene in the population of northwest of Iran. However, no significant relationship was observed between ss52580101C>A polymorphism of IL2RA gene and T1D in this study.

Thiopurine s-methyltransferase (TPMT) plays a key role in the metabolism of the drug; 6-MP in children with acute lymphoblastic leukemia (ALL). The wild-type TPMT*1 allele and mutant alleles are associated with normal and intermediate enzyme activity, respectively. In patients with intermediate or deficient TPMT activity, normal dose of the drug may cause serious side effects such as bone marrow toxicity. The aim of this study was to assay the enzyme activity by HPLC for right ordering of chemotherapy drug doses in the patients. TPMT activity was measured in RBC of healthy adults (n=73) and children (n=10). Also, TPMT (*2, *3A, *3B and *3C) genotype of the samples were assessed by ARMS-PCR and RFLP-PCR. No indication of gender and age differences in the TPMT activity was found. This study showed that the HPLC method was sensitive, accurate and precise and can be used in routine clinical laboratory tests.

Introduction: The oxidative stress has been proposed as an important case of exudative age-related macular degeneration (E-ARMD). The aim of the present study was to investigate homocysteine (Hcy), asymmetric dimethylarginine (ADMA) and oxidized low-density lipoprotein cholesterol (Ox-LDL-C) levels, the factors involved in oxidative stress, in the patients with E-ARMD. Methods: In a cross-sectional study, 45 patients with E-ARMD were compared with 45 sex- and age-matched healthy controls. The levels of biochemical factors, Hcy, ADMA, and of Ox-LDL were estimated by standard methods in both study groups. Results: The levels of Hcy (15.4 ± 7.2 vs. 10.7 ± 3.7 μM, P = 0.001), Ox-LDL (52.2 ± 13.8 vs. 37.8 ± 10.8 U/l, P = 0.001), and ADMA (0.84 ± 0.23 vs. 0.71 ± 0.26 μM, P = 0.012) were significantly higher in the patients with E-ARMD than those in the controls. In the patient group, there was a positive and significant correlation between serum Ox-LDL and Hcy concentrations (r = 0.719, P = 0.001), but no correlation was found between serum ADMA and Ox-LDL (r = 0.010, P = 0.900) and also between serum Hcy and ADMA levels (r = -0.070, P = 0.600). Conclusion: The high levels of Hcy as an oxidant agent and ADMA as an endogenous nitric oxide synthase inhibitor can lead to increase Ox-LDL levels, and they may have important roles in oxidative stress, which can be a trigger in E-ARMD.

Background & Objective: Increase trend of overweight in recent years has become a concerning matter, which is a health alarm for children. Therefore, the present study investigated the impact of health promotion programs with collaborative approach on the weight of overweight school age girls. Materials & Methods: This quasi-experimental study was conducted in 2013, in which 80 overweight students in Firozabad were selected by non-randomized method and were divided into case and control groups. The data collecting tools were demographic information check list, electronic scale, and stadiometer. In the case group, health promotion programs with three stages of assessment, supportive planning, and evaluation was administered for three months. Children’s weights in both groups were evaluated before and three months after intervention. The results were analyzed by SPSS software version 16. Results: Case and control groups were equal from the view point of average weight before the intervention (P>./05).While after intervention, "independent T test" showed a significant different between two groups in average weight after intervention (P

Background and Objectives: Coronary angiography can cause a high degree of anxiety in patients. Regarding the effect of pre-angiography education on the anxiety level of patients, nocertain investigation was found considering the effect of video education in native language. The aim of this study was to investigate the effects of video education based on the patientchr('39')s native language on the anxiety level of coronary angiography candidates. Methods: In this quasi-experimental study 160 patients hospitalized for coronary angiography were randomly divided into two groups: control (n =80) and experimental (n =80) in Imam Khomeini Therapeutic and Educational Center of Ardabil. The data were collected using demographic characteristics questionnaire and Spielbergerchr('39')s state trait anxiety inventory (STAI) questionnaire. For the experimental group, an educational film was presented in Turkish language about the necessary actions before, during and after coronary angiography. The control group only received the routine preparations of the ward. The state anxiety levels in both groups before and after the education were measured and compared. Data were analyzed using Chi-square test, independent T-test and paired T-test. p

زمینه و اهداف: بیمارستان سازمان پیچیده‌ای با سطح پاسخگویی بالا است که نقش مهمی را در نظام مراقبت‌های سلامت ایفا می‌کند. در این مطالعه با استفاده از مدل ویزبورد به ارزیابی جامع سازمانی بیمارستان امام حسین دانشگاه شهید بهشتی در سال 1394 پرداخته شده است. مواد و روش‌ها: این مطالعه از نوع توصیفی- تحلیلی و کاربردی می‌باشد. جامعه آماری شامل کارکنان بیمارستان مورد بررسی بوده است. برای جمع آوری داده‌ها از پرسشنامه استاندارد تشخیص سازمانی استفاده شد. تجزیه وتحلیل داده‌ها به کمک نرم افزار SPSS و استفاده از آزمون‌های تی یک نمونه‌ای و آنووا انجام گرفت. تمام مراحل مطالعه حاضر با در نظر گرفتن موازین اخلاقی اجرا گردید. یافته‌ها: در مجموع 306 نفر در این مطالعه شرکت کردند. میانگین کلی نمرات ابعاد 7 گانه برابر با 4/14بوده که نشان دهنده ضعف بیمارستان مورد بررسی از نظر عناصر داخل سازمان است. نتایج آزمون تی یک نمونه‌ای نشان داد که تنها ابعاد هدف گذاری، رهبری و نگرش به تغییر دارای وضعیت مطلوبی می‌باشند. بعد هدف گذاری با میانگین 3/88 قوی‌ترین و بعد پاداش با میانگین 4/85 ضعیف‌ترین بعد شناخته شده است. همچنین در بین متغیر میزان تحصیلات و متغیر پاداش نیز ارتباط معنی دار دیده شده است. نتیجه‌گیری: مطالعه ما نشان داد که بیمارستان امام حسین در برخی از ابعاد سازمانی داری مشکل است. گرچه اداره یک بیمارستان نمی‌تواند مشابه با سازمان‌هایی دیگر قلمداد شود ولی می‌توان با تعدیل روش‌های تقویت ابعاد سازمانی در بیمارستان و کاهش موانع و مشکلات موجود در بهتر شدن شرایط گام برداشت.

BACKGROUND: Fragile X syndrome is a genetic mental retardation syndrome caused by an unstable mutation in thefragile X mental retardation 1 gene (FMR1) on the X chromosome. FMR1 CGG repeat alleles are categorized accordingto number as normal, intermediate, premutation, and full mutation alleles. Considerable information is available, fromreported studies, on the structure of the full mutation alleles. METHODS: This review focused on the characterization of FMR1 CGG repeat size alleles in the premutation andintermediate ranges. RESULTS: The premutation and intermediate carriers, previously thought to be clinically unaffected, are recentlyknown to be at increased risk of premature ovarian failure (POF), fragile X-associated tremor/ataxia syndrome(FXTAS), autism, emotional problems, late-onset neurodegenerative deficits, and neurocognitive deficits. A number ofstudies have suggested that the underlying cause might be RNA toxicity resulting from abnormally high levels of FMR1mRNA in these alleles. CONCLUSIONS: It can be concluded that abnormality of FMR1 gene has different clinical presentations, especially insmall alleles, and should be considered more by physicians in clinics. KEYWORDS: FMR1 Gene, FXS, Permutation alleles, POF, FXTAS

Introduction: The patients’ families in intensive care units (ICUs) experience excessive stress which may disrupt their performance in daily life. Empathy is basic to the nursing role and has been found to be associated with improved patient outcomes and greater satisfaction with care in patient and his/her family. However, few studies have investigated the nursing empathy with ICU patients. This study aimed to assess nursing empathy and its relationship with the needs, from the perspective of families of patients in ICU.Methods: In this cross-sectional study, 418 subjects were selected among families of patients admitted to ICUs in Tabriz, Iran, by convenience sampling, from May to August 2012. Data were collected through Barrett-Lennard Relationship inventory (BLRI) empathy scale and Critical Care Family Needs Intervention (CCFNI) inventories and were analyzed using descriptive and inferential statistical tests. Results: Findings showed that most of the nurses had high level of empathy to the patients (38.8%). There was also statistically significant relationship between nurses’ empathy and needs of patients’ families (p < 0.001). Conclusion: In this study we found that by increasing the nurse’s empathy skills, we would be able to improve providing family needs. Through empathic communication, nurses can encourage family members to participate in planning for the care of their patients. However, further studies are necessary to confirm the results.

زمينه و هدف: فرار بیمار از بیمارستان، یک مسئله بهداشتی درمانی مهم با هزینه‌های اقتصادی، اجتماعی و بهداشتی است. این مطالعه با هدف بررسی میزان فرار بیماران از بخش اورژانس و بار مالی آن در یک بیمارستان عمومی در شهر تهران انجام شد. مواد و روش‌ها: این مطالعه توصیفی و گذشته‌نگر در بخش اورژانس یک بیمارستان بزرگ عمومی و آموزشی شهر تهران انجام شد. با استفاده از پرونده‌های بیماران فراری در محدوده زمانی یکم مهر ۱۳۹۲ تا ۳۱ شهریور ۱۳۹۳، اطلاعات مورد نیاز جمع آوری شد. تحلیل داده‌ها با استفاده از روش‌های آمار توصیفی انجام شد. موازين اخلاقي از جمله محرمانه بودن نام بيماران و بیمارستان مورد پژوهش رعايت گرديد. يافته‌ها: براساس یافته‌ها، 774 نفر از بیماران بدون تسویه حساب و اطلاع به کارکنان، بیمارستان را ترک کرده بودند و نرخ فرار از اورژانس در این مطالعه 4/2 درصد بود. میزان فرار در بین بیماران جوان، مرد، متاهل و بدون بیمه بیشتر بود. میانگین صورتحساب پرونده هر بیمار فراری ۱،۴۴۹،۷۳۸ ریال و بیمارستان مذکور در مجموع مبلغ ۱،۱۲۲،۰۹۷،۲۱2 ریال متحمل خسارت مالی ناشی از فرار بیماران شده بود. نتيجه گيري: شناسایی افراد پرریسک برای مراقبت‌های بیشتر، کنترل منظم بخش‌های اورژانس، تجهیز این بخش به نیروی انسانی جهت رسیدگی سریع‌تر به وضعیت بیماران، ارتباط مناسب و تعامل با بیمار و همراهان او، آشنا کردن بیمار به سیاست ترخیص به میل شخصی و ثبت دقیق اطلاعات بیمار برای کاهش ریسک فرار یا دسترسی داشتن به او پس از فرار از استراتژی‌های پیشگیری و کاهش این رفتار است.

Introduction: Multiple Sclerosis (MS) is one of the most common chronic diseases of the central nervous system which causes mental disorders including anxiety in patients. Since the peer group can better communicate with their counterparts and encourage them to choose appropriate healthy behaviors, this study was designed to examine the impact of peer educational program on anxiety of multiple sclerosis patients. Methods: This was a quasi-experimental study conducted in year 2011 in MS Society of Iran (Tehran). A convenient sample of 110 patients with MS was divided randomly into two equal groups (experimental and control). After preparing peer teachers, they held six training sessions for experimental group during six weeks. DASS-21 questionnaire was used to measure anxiety which was completed by both groups before and 4 months after the test. Data was analyzed using chi2, paired t, and independent t tests. Results: The findings of independent t test did not show any significant difference between anxiety scores of experimental and control group before intervention while a statistically significant difference was observed after intervention between the scores of two groups (p=.032). Paired t test showed a statistically significant difference in anxiety level in experimental group after intervention (p=.002), whereas the same test showed no statistically significant difference in control groups (p =.659). Conclusion: Peer group educational program reduced anxiety in patients suffering from MS. Hence the conduction of this program is recommended as an effective, affordable, and effective teaching method which did not require any special equipment.

Background In this study, we tried to show the efficacy of Intraperitoneal dexamethasone on relieving shoulder pain after gynecologic laparoscopy. Materials and Methods In this double-blind randomized clinical trial, 63 patients who were candidates for gynecologic laparoscopy were included. At the end of the procedure patients randomly received 16 mg dexamethasone (n=31) or placebo (n=32) intraperitoneally. Visual analogue scale (VAS) was used for clinical evaluation of pain severity during 24 hours after laparoscopy . A physician, who was not aware whether patients were treated with drug or placebo, evaluated the patients. Results The severity of pain in the dexamethasone group within 0, 2, 4, 8, 12, 24 hours after procedure was significantly less than in the placebo group (p < 0.001). The average consumption of opioids as analgesic/ sedative in the placebo group was more than the dexamethasone group (p=0.025). Conclusion Findings of this study show that the prescription of 16 mg of dexametha- sone (single dose) in the peritoneal cavity may significantly reduce the severity of pain after Laparoscopy in comparison with placebo and may decrease the need for narcotics as pain relief (Registration Number: IRCT201105306640N1).

Background and Objective: Sexual satisfaction is a significant factor in prevention of sexual disorders among women. There are many factors associated with sexual satisfaction. The aim of this study was to determine some factors related to women sexual satisfaction in Gachsaran, in South-West of Iran. Materials and Methods: This descriptive analytic study was done on 1014 women which refered to health centers in Gachsaran city during Jan-Jun 2008. Data was collected by self–reported questionnaires and analyzed by Chi-Squre and Pearson tests. Results: The scale of sexual satisfaction were 0.4%, 10.9%, 47.5% and 41.7% unsatisfied, low, moderate and fully satisfied, respectively. There was a correlation between sexual satisfaction and women age, couple age difference, length of marriage, family economical condition and contraceptive method (P

Psoriasis is a chronic relapsing disorder that involves the skin, nails and joints. With regard to the role of the immune system in psoriasis, the current study compared serum IgE concentration in patients with psoriasis with control group. Current case-control study was conducted in Dermatology clinic of Razi hospital, Tehran University of medical sciences, Tehran, Iran in 2012. Fifty-eight patients with psoriasis e referred to the clinic were assigned as patient group and 58 healthy subjects with matched age and sex as a control group. Patient's history, family history and demographic characteristics such as age and sex, duration and severity of disease using PASI, were collected and entered into a form. Consent form was obtained from participants. Serum IgE concentrations of both study groups were measured by electrochemiluminescence assay in the laboratory A total number of 58 patients with psoriasis, mean age of 44.15 (19-76 years) and 58 controls with matched age and sex were studied. Mean average of serum IgE concentration in the control group was 115.13 versus 200/06 concentration in patients group (P=0.16). Serum IgE concentration in 22.4% of patients versus 17.2% in controls was greater than normal concentration (P=0.48). No significant correlation was between serum IgE concentration and disease severity using PASI (P=0.11, r=0.21), neither a significant correlation with disease duration, age and gender. According to the present study, serum IgE concentrations are not greater in patients with psoriasis. IgE concentration is also not associated with the severity of psoriasis based on the PASI score, therefore, the role of IgE in psoriasis can be considered insignificant as some previous studies indicate.