Search

Stream sediment geochemical survey is an efficient tool for regional prospecting of ore minerals. However, complex processes of dilution and enrichment made it difficult to be studied by conventional methods. One of the most important methods to separate anomalous areas are fractal and multifractal analysis; however, some techniques of the fractal analysis which are more popular and applicable, such as concentration-area, suffer from lack of a reliable interpolated map of stream sediments data. In this study, we introduce a simple workflow to separate anomalous areas in three steps: 1. a grid interpolation method is developed to produce continues geochemical surface based on geometry of Sample Catchment Basin (SCB), 2. Although U-statistics, a powerful spatial based method, has no permission to work with Stream sediment data, the grid interpolation prepares a convenience (by converting stream sediment data from vector nature into point or pixel-based data) to apply it for this type of geochemical data, 3. Finally, the fractal analysis is applied for anomaly separation. In other words, the transformation into pixel-based nature in the first step is followed by using U-statistics (or any spatial method) to compensate spatial relation among the pixels. Once an accurate interpolated map is computed in the first two steps, fractal analysis is capable to effectively separate different populations (i.e. background and anomaly) with the highest accuracy and validity. This workflow is implemented on 305 stream sediment samples from Saqez area located on western part of Iran to delineate Au mineralization. Results show that anomalous areas of Au are successfully separated in the final categorical map, which is highly matched with the location of 5 high potential zones of Au known in this area. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of ProFile File cleaner and a nanostructured foam in removing debris from two rotary nickel-titanium instruments during and after instrumentation. Method and Materials: Twenty mandibular premolars were decoronated and instrumented up to either #40.04 RaCe (#40.04) or K3 (#40.04) instruments (n = 10). Each group of files was randomly divided into two groups: ProFile File cleaner and Nano Foam cleaner. The instruments were examined under a scanning electron microscope (SEM) before and after placement into the canals. Subsequently, instruments were introduced into each cleaner and examined again under SEM. The amount of debris removal from the instruments was determined by ImageJ software. Data were subjected to Kruskal-Wallis and Mann-Whitney tests at a .05 level of significance. Results: The amount of debris removal was significantly different between the groups (P = .002). The amount of debris removed was significantly higher in K3 with Nano Foam cleaner than ProFile File cleaner (P = .009). Conclusion: Nanostructured foam can remove debris from endodontic files, especially from those with complex cross-section. This method is recommended to help optimize debris removal with the further possibility of instrument sterilization and reduced risk of cross-contamination. [ABSTRACT FROM AUTHOR]

Objective: As the exact etiology of recurrent aphthous stomatitis remains unknown, its treatment has primarily been palliative to relieve the pain, associated inflammation, and duration of the lesions by using antibacterial mouthrinses, analgesics, and immunomodulators. Nevertheless, no treatment has been universally effective in management of recurrent aphthous stomatitis, which necessitates the search for novel therapeutic agents. The aim of this study was to assess the clinical efficacy of the aqueous extract of Rosa damascena, which has reported anti-inflammatory and antinociceptive properties, in the treatment of recurrent aphthous stomatitis. Method and Materials: This was a randomized, doubleblind, placebo-controlled investigation. Fifty patients were enrolled in this 2-week study; the clinical efficacy of the mouthwash on pain, size, and number of ulcers in the test group was compared with that of the placebo group on days 4, 7, 11, and 14. Results: There were no statistically significant differences between baseline parameters. However, statistical analysis indicated a significant difference on days 4 and 7 between the placebo and test groups for all parameters. Conclusion: This study showed that mouthwash containing Rosa damascena extract was more effective than the placebo in the treatment of recurrent aphthous stomatitis. (Quintessence Int 2011;42:483-491) [ABSTRACT FROM AUTHOR]

Background & Objective: Coronary angiography has become the largest interventional diagnostic test in recent years. As it has had large effects on anxiety and satisfaction of patients in treatment and care; the objective of the present study is to survey the reasons for which the patients, referring to cardiac ward of Valiasr hospital in Fasa, refuse to undergo coronary angiography. Materials & Methods: In this cross-sectional study, 60 individuals candidate for coronary angiography were selected. The samples were selected via census. The tool for collecting the data was a researcher-made questionnaire. The data were analyzed by SPSS-15 software, descriptive statistics, Mann-Whitney test, and Kruskal- Wallis test. Results: The mean age of the samples was 58/9±12/8 years. Financial problems, fear and anxiety, lack of awareness, and lack of confidence in the physician's diagnosis were the most important factors. The effect of fear has been reported more in women compared to men for refusing coronary angiography (p=.037). Conclusion: According to the above results, financial problems, fear and anxiety, lack of awareness, and lack of confidence in the physician's diagnosis are the factors effective in accepting coronary angiography. Therefore, more contrivances are needed to eliminate these effective factors; in order to prepare cardiac patients, who are candidate for coronary angiography, a tranquility to accept and to perform angiography. [ABSTRACT FROM AUTHOR]

Introduction: Critical thinking training is one of the most important missions of educational institutes. Hence, academic libraries as an inseparable operational unit of higher education must help their users to benefit from information resources and facilities providing them with the chance to develop and improve critical thinking capability. This study aimed to investigate significant barriers to and inhibitive factors on providing suitable environment for developing and improving critical thinking in university libraries from the viewpoints of students in Boushehr University of Medical Sciences and Persian Gulf University. Methods: In this descriptive survey, the barriers to critical thinking development in academic libraries was investigated according to the viewpoint of 793 students from Bushehr University of Medical Sciences and Persian Gulf University in 2013-14 academic years. Students were selected by stratified proportional sampling. Data was collected through a valid and reliable researcher-made questionnaire categorized using 5-point Likert scale. The questionnaire was validated using experts’ viewpoints and its reliability was approved through estimation of Chronbach’s Alpha (0.84). Data were analyzed using descriptive statistics, one-sample t-test, Mann Whitney Test, and Kruskal-Wallis. Results: Mean scores in areas of linguistic barriers (weighted mean: 3.59), users’ inherent barriers (weighted mean: 3.49), users’ social and psychological barriers (weighted mean: 3.38), and logical barriers (weighted mean: 3.34) were higher than cut-off point of 3 and placed in significancy level of (p=0.0001). These barriers were identified as most important ones from the viewpoints of students. Conclusion: By encouraging students to ask and seek and creating a suitable environment for sharing ideas, university libraries and librarians can help their users in improving their linguistic communication. Holding educational workshops to promote information literacy skills, ability to seek, analyze, evaluate and judge the value and validity of information, as well as conducting educational tours on how to use library facilities could eliminate major factors in developing critical thinking that are lack of ability in determining informational needs and different levels of identification and utilization of retrieved information. [ABSTRACT FROM AUTHOR]

This study explored the prevalence and related risk behaviors for hepatitis C (HCV), hepatitis B (HBV), and human immunodeficiency virus (HIV) among a sample of male injection drug users (IDUs) in Arak, Iran. One hundred male IDUs attending methadone maintenance clinics between April and September 2012 were enrolled and evaluated for HCV, HBV, and HIV infection. The majority of study participants (56%) had evidence of HCV exposure, 6% had evidence of HBV, and 19% were HIV-infected. Coinfections were frequent; 15% had evidence of HIV and HCV, 6% had evidence of HBV and HCV, and 5% had serologic markers for all three infections. Most (84%) were susceptible to HBV infection. A history of any syringe sharing (54%) and syringe sharing in prison (25%) were common. In bivariate analyses, a history of any syringe sharing and syringe sharing in prison were both associated with all three viral infections. The high prevalence of HCV, HBV, HIV, and coinfections among IDU in Arak is concerning and indicates rapid disease spread outside of Iran's main urban centers. Prevention efforts should expand vaccination for IDUs who are nonimmune to HBV and continue to target syringe sharing with efforts such as needle exchange programs, including inside prisons. [ABSTRACT FROM PUBLISHER]

Statement of the Problem: Premedication is expedient in reducing the psychological trauma from recalling the unpleasant pre-anesthetic phases, hence, inducing a trouble-free anesthesia. Purpose: This study aimed to determine the effectiveness of oral midazolam in co-operation of the subjects before general anesthesia and in recalling the pre-anesthetic phases, performed on children candidate for dental treatment under general anesthesia. Materials and Method: In this prospective clinical trial study, 62 healthy non-cooperative children, candidate for dental treatment under general anesthesia, were randomly divided into study and control groups. The children received 20ml orange juice, 20 minutes before starting the anesthesia. The juice of the test group contained 0.5mg/kg of midazolam and that of the control group included no medication. The induction and the maintenance process of anesthesia were similar in both groups. The manner of subjects when separated from parents, their cooperation during intravenous catheterization, and recalling the pre-anesthetic events were recorded. Data were analyzed by adopting chi-square and Mann-Whitney tests. Results: Most of the children in the test group had a comfortable separation from parents, restful IV catheterization and 90% of the subjects did not recall the pre-anesthetic events. Conclusion: Under the circumstances of this study, it could be concluded that 0.5mg/kg oral midazolam premedication is effective for comfortable separation of children from parents and restful IV catheterization and also forgetting the pre-anesthetic events. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Fixed retainers were developed to maintain incisor alignments after orthodontic treatments. Although the effects of fixed retainers on periodontal health are clinically studied, no studies have still evaluated the histological changes in the periodontium after the placement of thefixed retainers. Purpose: The aim of this study was to evaluate the effects of customised retainers on periodontium histologically. Materials and Method: Forty pairs of maxillary and mandibular central incisors of twenty rabbits were randomly divided into four equal groups: The first group was considered as the control and in the second group, Fiber Reinforced Composite (FRC), in the third group, 0.014 inch stainless steel (SS) wire and in the fourth group, 0.175 inch multistrand stainless steel (MSS) wire were bonded on the labial surfaces of the incisors. After sixty days; animals' periodontium were evaluated histologically. Results: The number of bone resorption lacuna in the control group was significantly less than FRC and 0.014 SS groups. The periodontal vessel count and their diameter in the control group was significantly lower than the other groups. The pulp vessel count and their diameter in controls were significantly more than the 0.014 SS and the 0.175 MSS groups. Conclusion: Findings of this study suggest that FRC fixed retainer might cause detrimental effects on the periodontal ligaments and supporting bone and the 0.014- inch and 0.175- inch fixed retainers can cause hyalinization and possibly the necrosis of the pulp. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the frequency of each poisoning and its related death in our center as a sample of Tehran in six consecutive years (2006 to 2011). Methods: All poisoned children and adults referring to Loghman-Hakim hospital poison center and hospitalized in the study period were enrolled and evaluated. Results: In 108,265 patients, the most common causes of poisoning were anti-epileptics and sedative-hypnotics (22.3%). The most common causes of death were pesticides (24.84%) and narcotics (24.75%). In drugs of abuse, opium was more prevalent in the early period of the study but was replaced by methadone later. Conclusion: It seems that national policies for drug control and prevention of suicide have not been efficient enough. We expect to see Iran in the first 50 countries with regard to suicide and to maintain the first place in narcotic abuse if enough attention is not provided. [ABSTRACT FROM AUTHOR]

Aim This study aimed to assess the efficacy of thalidomide for treatment of experimental endometriosis. Methods This study was a parallel-group, double-blind, stratified, randomized controlled animal trial with 1:1 allocation ratio. Endometriosis was induced experimentally in 23 mature, nulligravid, female Sprague- Dawley rats, weighing approximately 200 g and aged 2 months. A checkpoint surgery was performed 6 weeks later. Then, the rats were randomly allocated into the thalidomide (22 mg/day p.o.) and control (0.5 mL saline 0.9%/day p.o.) groups of nine. After 6 weeks, they were killed. Before each laparotomy, blood for leukocyte and lymphocyte counts and during them, implants for histopathology and peritoneal fluid for interleukin ( IL)-6, tumor necrosis factor-α and vascular endothelial growth factor ( VEGF)- A concentrations (by enzyme-linked immunoassay) were collected. Allocation and stratified randomization were done using a computer, based on the obtained histopathology scores of the implants of the checkpoint surgery. Results The histopathology scores (the main outcome measure) were 2.00 ± 1.55 versus 0.44 ± 1.01 ( P = 0.035). The comparisons of after-treatment counts of leukocytes, lymphocytes, VEGF- A and IL-6 between the two groups were statistically significant. Conclusion The results of this study are in favor of therapeutic implication of thalidomide in experimental endometriosis in rats. This is the first time thalidomide has been evaluated on endometriosis in an animal model. [ABSTRACT FROM AUTHOR]

Objective: To investigate the possible mechanism through which Artemisinin induced apoptosis in pancreatic cell line. Methods: Column chromatography, thin layer chromatography (TLC) and proton NMR spectroscopy were used to purify Artemisinin. The flowcytometry was employed to detect apoptosis and reactive oxygen species (ROS). Results: The results indicated that 50% inhibiting concentration (IC value) for pancreatic cell line (RIN) was 45 μmol/L of Artemisinin. Artemisinin had no cytotoxic effect on the growth of peripheral blood lymphocytes. The mechanism of apoptosis was evaluated by measuring intracellular ROS. It was shown that Artemisinin-induced apoptosis occurred independently of the binding of CD95L to CD95 receptor in the RIN cells. Moreover, Artemisinin, in a dose-dependent manner, could significantly increase the level of ROS. Conclusion: Artemisinin can induce apoptosis in the RIN cells via the generation of ROS and triggering the intrinsic pathway of cell death. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to determine if normobaric hyperoxia (HO) pre-conditioning offers durable neuroprotection against cerebral ischaemia and its effects on NCX1 expression. Methods: Rats were divided into two experimental groups. The first group was exposed to 95% inspired HO for 4 hours/day for 6 consecutive days (HO). The second group acted as control and was exposed to 21% oxygen in the same chamber. Each main group was sub-divided to middle cerebral artery occlusion (MCAO-operated) and intact (without any surgery) sub-groups. After 2, 5, 10 and 15 days from pre-treatment, MCAO-operated sub-groups were subjected to 60 minutes of right MCAO. After 24 hours reperfusion, neurologic deficit score and infarct volume were measured in MCAO-operated sub-groups. The NCX1 expression levels of core, penumbra and sub-cortex regions were assessed in sham-operated and intact sub-groups. Results: Pre-conditioning with HO decreased neurologic deficit score and infarct volume, and increased expression of NCX1 in penumbra and sub-cortex. These effects of hyperoxia disappeared gradually during 15 days after pre-treatment. Conclusions: Although further studies are needed to clarify the mechanisms of time course of neuroprotection, HO partly is associated with expression of NCX1 consistent with an active role in the genesis of ischaemic neuroprotection. [ABSTRACT FROM AUTHOR]

Background: Childbearing for the first time is a unique experience. Quality of life is an important indicator in health studies. This study aimed to assess the quality of life of women who were conceived by ARTs and had successful childbirth for the first time and to compare it with quality of life in women who become pregnant naturally and similarly had successful childbirth for the first time. Materials and Methods: This was a cross sectional comparative study. The accessible sample was recruited from patients attending an infertility clinic and two obstetric and gynecology clinics in Tehran, Iran, during March 2010 to March 2011. In all 276 patients were approached. Of these, 162 women (76 women in natural conception group and 86 women in assisted reproduction technologies group) who met the inclusion criteria were entered into the study. Quality of life was assessed using the 36-item Short Form Health Survey (SF-36). Women completed the questionnaire at two time points: i. last trimester and ii. first month after delivery. Comparison was made between two groups using Mann-Whitney U test and paired samples t test. Results: Comparing the SF-36 scores between women in natural conception group and ARTs group before childbirth, it was found that natural group had better condition on physical functioning, role limitation due to physical problems, bodily pain and social functioning, while the ARTs group reported better status on general health, vitality, role limitation due to emotional problems, and mental health. However, after childbirth, the ARTs group reported a better condition almost on all measures, except for physical functioning. Comparing differences in obtained scores between two groups before and after childbirth, the results showed that improvements in health related quality of life measures for the ARTs group were greater in all measures, expect for general health. Conclusion: The findings from this study suggest that health-related quality of life was improved in women who became a mother for the first time by either method. Comparing to women who became mother by natural conception, women who received ARTs showed better quality of life from this first successful experience. [ABSTRACT FROM AUTHOR]

Background: Genome instability is a main cause of chromosomal alterations in both somatic and germ cells when exposed to environmental, physical and chemical genotoxicants. Germ cells especially spermatozoa are more vulnerable to suffering from DNA damaging agents during spermatogenesis and also more potent in transmitting genome instability to next generation. Methods: To investigate the effects of γ-rays on inducing abnormalities manifested as numerical Chromosome Aberrations (CA) and Micronucleus (MN) in preimplantation embryos, adult male NMRI mice were irradiated with 4 Gy of γ-rays. They were then mated at weekly intervals with superovulated, nonirradiated female mice in 6 successive weeks. About 68 hr post coitous, four to eight cell embryos were retrieved and fixed on slides using standard methods in order to screen for CA and MN. Results: In embryos generated from irradiated mice, the frequency of aneuploidy and MN increased dramatically at all post-irradiation sampling times as compared to the control (p<0.01). The frequency of embryos expressed MN was much higher than chromosomally abnormal embryos, although the trend of MN formation was similar to chromosomal abnormalities seen in corresponding sampling times. Conclusion: Irradiation of sperms at any stages of spermatogenesis may lead to stable chromosomal abnormalities affecting pairing and disjunction of chromosomes in successive preimplantation embryos that are expressed as MN. Although chromosome analysis of embryos showed various types of chromosomal abnormalities, MN assay provide a simpler and faster technique for investigating the genotoxicity of agents affecting embryos at preimplantation stages. [ABSTRACT FROM AUTHOR]

Background: Although various anthropometric methods are available for assessing body composition, these have not been compared in Iranian adolescents. The objective of the present study was to compare body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR) and sum of four skinfolds as predictors of percentage body fat (PBF) and diagnosis of excess adiposity in Iranian adolescents. Methods: In this cross-sectional study, all anthropometric measurements were made in133 adolescents (65 boys and 68 girls), aged 10-18 years.PBF was determined using the bioelectrical impedance analysis method. Linear regression and receiver operating characteristic (ROC) analysis were used to analyze the data. Potential covariates including sex, age, and pubertal stage were adjusted. Results: R2adj of models for BMI, WC, WHR, WHtR, and skinfolds were 0.67, 0.56, 0.19, 0.56, and 0.56, respectively (P < 0.001). The AUC value of BMI to differentiate between normal and obese adolescents was 0.92 (P < 0.001). The AUC of BMI was significantly higher than those of WC, WHR, and WHtR (P < 0.05). Conclusions: The performance of BMI is better than other anthropometric indices in predicting PBF and diagnosing excess adiposity in Iranian adolescents. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to investigate the effects of omega-3 fatty acids on depression and chronic inflammation in hemodialysis patients. Method: Fifty-four maintenance hemodialysis patients were randomized to ingest two omega-3 (each containing 180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid) or placebo capsules, three times daily for 4 months. Main outcome measures: Beck Depression Inventory (BDI) score and serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, ferritin, intact parathyroid hormone (iPTH), and ratios of IL-10 to IL-6 and IL-10 to TNF-α were measured at baseline and at the end of the study. Results: Omega-3 supplement lowered BDI score significantly after 4 months of intervention. Among pro- and anti-inflammatory mediators, only serum ferritin level and IL-10 to IL-6 ratio showed significant changes in favor of omega-3 supplement during the study. In linear regression model adjusted for baseline values, omega-3 treatment was a significant predictor of reduced serum CRP, ferritin, and iPTH levels, and increased IL-10 to IL-6 ratio. No significant association was found between the anti-inflammatory and anti-depressant effects of omega-3 supplement. Conclusions: Supplemental use of omega-3 fatty acids decreases depressive symptoms in hemodialysis patients apart from their anti-inflammatory effects. [ABSTRACT FROM AUTHOR]

Introduction: Epidemiological considerations indicate the importance of prevention, diagnosis and treatment planning. The aim of this study was to assess the prevalence of different types of traumatic dental injuries (TDI) and their etiology in patients referred to Shiraz Dental School in order to find a reliable preventive pattern for TDI. Materials and methods: This descriptive-analytical study examined the files of 314 patients, who referred to Shiraz Dental School (2008-2012), with 554 traumatized teeth. The variables investigated included age, sex, type of the involved tooth, type of TDI, place of occurrence, reason for injury and intervals between injuries and the time of referral to Shiraz Dental School . Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis and comparison of TDIs based on demographic data using SPSS 16 )α=0.05). Results: Of all the patients, men and women accounted for 65.9% and 34.1%, respectively. The mean age was 17.37 years. In average, the number of traumatized teeth in all the files was more than 1 tooth. The most frequent traumatized teeth were permanent maxillary first incisors (64.4%). Falls were the most frequently cited etiological factors in TDI (33.7%), followed by car accidents (25.2%) and complicated crown fracture was the most common TDI (20.2%); 64.9% of patients had referred to Shiraz Dental School less than one month after trauma. No significant differences were observed between males and females in the frequency and mean age of the trauma types (p value > 0.005). Conclusion: Based on the results of the present study, falls (33.8%) and car accidents (25.2%) were the most frequent etiologic factors for TDI, respectively, with the streets as the most frequent place of accidents (44.9%). [ABSTRACT FROM AUTHOR]

Background And Objectives: Thyroid dysfunction is a common health problem affecting millions of patients worldwide. Autoimmune thyroid disorders are among the most common autoimmune disorders. In this population-based study, we assessed the prevalence of abnormal thyroid function, antithyroid antibodies and the probable relationship between them in Shiraz, southern Iran. Methods: Serum thyrotropin (TSH) was determined in 981 subjects (66.8% female and 33.2% male; mean age: 39.1 ± 14.3 years), who were selected with stratified random sampling. Because of the preponderance of females over males, we performed the statistical analyses using sex-weighted data (50% for each sex). Also, antithyroid peroxidase antibodies (TPOAb), and antithyroglobulin antibodies (TgAb) were measured in two random subgroups of 376 and 537 patients respectively). Thyromegaly detected on physical examination. Results: In this cross-sectional study, 8.1% of participants had elevated serum TSH level and 3.4% had low serum TSH level. A statistically significant relationship was found between gender and thyromegaly and TSH values. Positive TPOAb and positive TgAb were detected in 17% and 5.1% of participants respectively. In addition, a significant relationship was observed between elevated TSH levels and positive results for both antibodies. Detectable levels of thyroid antibodies correlated with female sex, while no correlation was observed between detectable levels of thyroid antibodies and thyromegaly. Conclusion: Thyroid disorders, especially elevated TSH level, are common. It seems that autoimmune mechanisms are strongly involved in the etiology of hypothyroidism in this area. [ABSTRACT FROM AUTHOR]

Background: Antenatal hydronephrosis (AH) is commonly found on evaluation of pregnant women and 20-30 % of neonates have vesicoureteral reflux (VUR). In order to diagnose VUR, we required invasive testing and exposure of the neonate to radiation. The concentrations of a matrix metalloproteinase, MMP9, and its inhibitor TIMP1, were analyzed in hydronephrotic newborns with VUR and were compared to those without reflux. Methods: The neonates with a history of prenatal hydronephrosis were enrolled in two groups based on imaging study results, the neonates with VUR and without VUR. Neonates with a normal prenatal history and postnatal ultrasound were placed in a third group. We measured the random urinary levels of MMP9, TIMP1, and creatinine, their cut-off values and the MMP9/Cr and MMP9/TIMP1/Cr ratio was calculated, and an ROC curve was drawn. Results: Sixty-nine neonates were enrolled in three groups; 27 patients (20 male, seven female) with AH and VUR were in group 1, 23 neonates (19 male, four female) without VUR were placed in group 2, and 19 (15 male, four female) acted as controls in group 3. The differences between the three groups and the normal and total hydronephrotic groups were statistically significant for MMP9, the MMP9/Cr, MMP9/TIMP1, and MMP9/TIMP1/Cr ratios. The urinary TIMP1 and TIMP1/Cr ratios were not significantly different between the groups. A cut-off value of MMP9 was measured as 358.5 ng/ml (sensitivity [sens] 74 %, specificity [spec] 78 %) and was used to compare groups 1 and 2. For groups 2 and 3, this cut-off was 181.00 pg/ml (sens 91 %, spec 89 %). The cut-off values measured for the MMP9/TIMP1 ratio were 30.32 (sens 70 %, spec 61 %) and 9.85 (sens 96 %, spec 89 %) to compare groups 1 and 2, and 2 and 3, respectively. We found no valuable cut-offs for the TIMP1 and TIMP1/Cr values. There was no difference between neonates with mild, moderate, and severe VUR according to urinary biomarker concentrations. Conclusions: Evaluation of urinary levels of MMP9, or the MMP9/Cr, MMP9/TIMP1, or MMP9/TIMP1/Cr ratios may help us to differentiate the newborns with hydronephrosis and VUR from those without reflux. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate and compare the bacterial safety of handmade and commercial ready-to-use enteral feeding formulas used in an Iranian teaching hospital. Methods: In this experimental study, a total number of 70 samples (21 handmade formulas sampled at two sampling times, i.e. the time of preparation and 18 h after preparation, and 28 commercial ready-to-use formulas) were studied. Total count of viable microorganisms, coliform count and Staphylococcus aureus count for all samples were conducted. Results: Out of 42 handmade samples, 16 samples (76%) had total viable counts greater than 10³ CFU/g in the first sampling time and 17 samples (81%) had total viable counts greater than 10³ CFU/g in the second sampling time. Also, 11 (52%) had coliform contamination in the first sampling time which reached 76% (16 samples) in the second sampling time. Regarding contamination with S. aureus, 5 samples (24%) were contaminated in the first- and 13 samples (62%) were contaminated in the second-sampling time. Out of 28 commercial formulas, 27 samples (96%) had total viable counts greater than 10³ CFU/g. Also, 24 samples (86%) were contaminated with S. aureus and 27 samples (96%) were contaminated with coliforms. In order to compare these two formulas, the results of Mann-Whitney test showed that contamination of ready-to-use formulas in all three microbiological samples was significantly more than that for handmade samples. Conclusions: The results of the present study indicate that the microbial safety of enteral feeding solutions in this hospital is much lower than standard values, demonstrating that the development of protocols for clean techniques in the preparation, handling and storage of both commercial and handmade enteral feeds is necessary. [ABSTRACT FROM AUTHOR]

Background: Detection of women at risk for dystocia will allow physicians to make preparations and treatment decisions that can minimize maternal and neonatal morbidity. We aimed to determine the risk factors for dystocia in nulliparous women. Methods: This case series enrolled 447 nulliparous women who presented with a single pregnancy in the vertex presentation and gestational age of 38-42 weeks. Maternal anthropometric measurements were obtained upon admission. We defined dystocia as a cesarean section or vacuum delivery for abnormal progression of labor as evidenced by the presence of effective uterine contractions, cervical dilation of less than 1 cm/h in the active phase for 2 h, duration of the second stage beyond 2 h, or fetal head descent less than 1 cm/h. Data were analyzed by SPSS software version 11.5. Kruskal-Wallis, logistic regression, chi-square, Student’s t test and the Mann-Whitney tests were used as appropriated. Results: The state anxiety score (OR=10.58, CI: 1.97-56.0), posterior head position (OR=9.53, CI: 4.68-19.36), fetal head swelling in the second stage of labor (OR=6.85, CI: 2.60-18.01), transverse diagonal of Michaelis sacral ≤9.6 cm (OR=6.19, CI: 2.49-15.40), and height to fundal ratio <4.7 (OR=2.68, CI: 1.09- 10.60) were significant risk factors for dystocia. Conclusion: Critical care during labor and delivery in women who have a height to fundal height ratio of <4.7 or transverse diagonal of Michaelis sacral ≤9.6 cm, an anxiety score greater than moderate, and posterior head position or fetal head swelling during the second phase could play an effective and important role in preventing dystocia. [ABSTRACT FROM AUTHOR]

Background: Many workers suffer from low-back pain. Type and severity of spinal complaints have relationship with work load. Lack of adherence to ergonomics recommendations among the important causes of low-back pain. Objective: To assess the effect of 3 ergonomics training programs on the prevalence of low-back pain among workers of an Iranian automobile factory. Methods: In a parallel-design 4-arm randomized clinical trial, 760 active workers of an automobile factory were studied. 503 workers were found eligible and randomized into 3 intervention groups (n=252), and a control group (n=251). The intervention groups consisted of 3 arms: 84 workers were educated by pamphlet, 84 by lectures, and 84 by workshop. Nordic questionnaire was used to determine the prevalence of spinal complaint before and 1-year after the interventions. The trial is registered with the Iranian Randomized Clinical Trial Registry, number IRCT2013061213182N2. Results: Out of 503 workers, 52 lost to follow-up leaving 451 workers for analyses. The prevalence of low-back pain at the baseline was not significantly different among the studied arms. 1-year after the interventions, the prevalence did not change significantly from the baseline values for the lecture and pamphlet group. However, the prevalence of LBP experienced during the last year significantly (p=0.036) decreased from 42% to 23% in participant took part in the workshop. Conclusion: Training of automobile factory workers in ergonomics is more effective by running workshop than giving lecture or disseminating pamphlet. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency may be a risk factor for negative outcome in pregnancy, such as pre-term labour, low birthweight, intrauterine growth retardation and gestational diabetes. This study aimed to evaluate the relationship between vitamin D and pre-eclampsia. This was a case-control study of 59 pre-eclamptic women and 59 healthy pregnant women selected in two hospitals in Ahvaz, Iran. Women with term singleton pregnancy, nulliparous and of reproductive age were selected. Venous blood samples (2 mL) were taken and the level of 25-dihydroxy vitamin D (25- OH- D) was measured. If the levels of 25- OH- D were less than 10 ng mL−1, between 10 ng mL−1 and 29 ng mL−1 and more than 30 ng mL−1, they were considered as indicating deficient, insufficient and normal 25- OH- D concentrations, respectively. The independent t-test, Mann- Whitney U-test, chi-square and logistic regression were used for analysing the data. Vitamin D deficiency was significantly higher in the pre-eclampsia group [odds ratio ( OR) = 24.04, confidence interval ( CI) = 2.10-274.8, P = 0.01]. Older women (30-35 years) were more likely to develop pre-eclampsia compared with the control group ( OR = 10.36, CI = 2.18-49.09, P = 0.003). The results showed that women with body mass index ( BMI) <20 were more likely to develop pre-eclampsia. The ages between 20 years and 30 years and normal BMI were not the risk factors for pre-eclampsia. Vitamin D deficiency has a statistically significant relationship with pre-eclampsia. It seems that the serum vitamin D levels are low in Iranian women because of their particular lifestyle and they may need more than 400 IU day−1 vitamin D supplement during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Weaning from mechanical ventilation is a frequent nursing activity in critical care. Nature-based sound as a non-pharmacological and nursing intervention effective in other contexts may be an efficient approach to alleviating anxiety, agitation and adverse effects of sedative medication in patients undergoing weaning from mechanical ventilation. Objectives: This study identified the effect of nature-based sound therapy on agitation and anxiety on coronary artery bypass graft patients during weaning from mechanical ventilation. Methods: A randomised clinical trial design was used. 120 coronary artery bypass graft patients aged 45-65 years undergoing weaning from mechanical ventilation were randomly assigned to intervention and control groups. Patients in the intervention group listened to nature-based sounds through headphones; the control group had headphones with no sound. Haemodynamic variables, anxiety levels and agitation were assessed using the Faces Anxiety Scale and Richmond Agitation Sedation Scale, respectively. Patients in both groups had vital signs recorded after the first trigger, at 20 min intervals throughout the procedure, immediately after the procedure, 20 min after extubation, and 30 min after extubation. Data were collected over 5 months from December 2012 to April 2013. Results: The intervention group had significantly lower anxiety and agitation levels than the control group. Regarding haemodynamic variables, a significant time trend and interaction was reported between time and group (p < 0.001). A significant difference was also found between the anxiety (p < 0.002) and agitation (p < 0.001) scores in two groups. Conclusions: Nature-based sound can provide an effective method of decreasing potential adverse haemodynamic responses arising from anxiety and agitation in weaning from mechanical ventilation in coronary artery bypass graft patients. Nurses can incorporate this intervention as a non-pharmacological intervention into the daily care of patients undergoing weaning from mechanical ventilation in order to reduce their anxiety and agitation. [ABSTRACT FROM AUTHOR]

Cooking methods have been implicated in the etiology of gastrointestinal cancers, reflecting exposure to potential carcinogens as results of cooking. We used a validated food frequency questionnaire and a pretested cooking method questionnaire in 3 groups: 40 esophageal squamous cell carcinoma (ESCC) cases from a high-risk area in northeast of Iran, 40 healthy subjects from the same high-risk area, and 40 healthy subjects from a low-risk area in Southern Iran. We compared the frequency of boiling, grilling, and frying, and the frying score among these 3 groups. We also calculated “frying index” by multiplying the frequency of each fried food item by its frying score. Mean frying to boiling ratios were 18.2:1, 12.8:1, and 2.6:1 for cases, high-risk controls, and low-risk controls, respectively (P< 0.01). Reuse of cooking oil for frying was reported in 37.5% of the ESCC cases, 25% of high-risk controls, and 7.5% of low-risk controls (P< 0.001). Frying index was higher in the high-risk than in the low-risk controls (P< 0.001) and in cases than in the high-risk controls (P< 0.05) after adjusting for smoking, opium use, rural residence, education, and ethnicity. High-temperature cooking and frying may be associated with increased risk of ESCC in high-risk areas. [ABSTRACT FROM PUBLISHER]

Aim The purpose of this study was to evaluate nurses' reporting of medication errors. Background Improvement in medication error reporting is one of the major challenges in today's health care environments. Methods This was a descriptive survey of nurses working in medical, surgery, orthopaedic, gynaecology and obstetric wards in hospitals affiliated to Iran University of Medical Sciences, using stratified multistage sampling. Data were collected between November 2008 and May 2009 using a researcher-designed questionnaire. Data were described and explored using Kruskal-Wallis, one-way analysis of variance and Mann-Whitney's test. Results The response rate was 93% ( n = 286).The mean number of medication errors 'reported' per nurse during 3 months was 1.33 [standard deviation ( SD) = 4.18, median = 0, interquartile range ( IQR) = 0-0, range = 70-0]. The mean number of errors made was 19.5 ( SD = 30.27, median = 10, IQR = 1-25, range = 181-0). None of the individual and organisational characteristics reported were significantly related to reporting of medication errors. Failure to record vital signs (e.g. pulse, blood pressure etc.) before and after administering certain medicines was the most frequently reported medication error. Conclusion More errors were made than were reported and this requires further investigation. Implications for Nursing Management The reporting of medication errors is a problem in health care systems worldwide, including Iran. Considering the significant difference between the nurses' actual and reported medication errors, managers should monitor medication errors. Educational initiatives are needed to improve understanding of the importance of medication administration. [ABSTRACT FROM AUTHOR]

Study design:Case-control study.Objectives:(i) To describe the prevalence of sexual dysfunction in chronic low back pain (CLBP) patients, (ii) to compare the range of sexual function outcomes between patients with CLBP and healthy controls and (iii) to investigate which factors are associated with sexual function within the cohort of individuals with CLBP.Setting:Low back pain (LBP) clinic of Qazvin University of Medical Sciences, Qazvin, Iran.Methods:A total of 702 patients with CLBP and 888 healthy controls participated in the study. The Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF) and Premature Ejaculation Diagnostic Tool (PEDT) were used to evaluate sexual function. In addition, quality of life, anxiety, functional status and pain intensity were assessed in patients. Univariate and multiple linear regression analyses were performed for the identification of factors associated with sexual function.Results:The prevalence of sexual problems in female patients with CLBP was 71.1% (n=177) while the corresponding figure for healthy women was 36.8% (n=161). Erectile dysfunction was present in 59.5% of male patients and in 24.5% of healthy males. Higher sexual function in both male and female patients with CLBP were being younger, lower duration of back pain, lower BMI, higher education level, being unemployed, physically active shorter sick leave, lower level of pain intensity, lower disability, higher family income, lower levels of depressive and anxiety symptoms, and higher psychical functioning and mental functioning.Conclusions:CLBP patients report considerably higher prevalences of sexual problems compared with healthy controls. Sex therapy and sexual management should be added to routine care and treatment of patients with CLBP. [ABSTRACT FROM AUTHOR]

Background We evaluated left ventricular ( LV) subclinical systolic dysfunction in diabetes mellitus patients using two-dimensional speckle tracking echocardiography ( STE) for early detection of changes in LV longitudinal strain ( ST) or synchronized contraction. Methods To determine ST and LV dyssynchrony, 37 normal coronary and normotensive diabetes mellitus patients with LV ejection fraction >50% were enrolled and compared to 39 nondiabetic normal coronary and LV function subjects. The cases underwent standard conventional transthoracic echocardiography and tissue Doppler imaging ( TDI) and STE. End-systolic ST and time-to-peak systolic strain (Ts) were measured in 18 LV segments. Results Conventional parameters were similar between diabetic and nondiabetic subjects. In diabetic patients, significant reduction in global and segmental ST adjusted for age and body mass index, independently correlated with early diastolic velocity at the septal mitral valve annulus by TDI (P = 0.001), ratio of transmitral early and late diastolic velocities (P < 0.001), relative wall thickness (P = 0.014), glycosylated hemoglobin (P < 0.001), and fasting blood sugar (P < 0.001). These correlations were not found in the nondiabetic patients. After adjustment, presence of diabetes mellitus remained an independent correlate of reduced LV global longitudinal ST (R = 0.688, P = 0.003). Delay of Ts between the anteroseptal and posterior walls and all the LV segments was markedly higher in the diabetic group regardless of diastolic dysfunction. Conclusion In diabetic patients with normal coronary and ejection fraction, segmental and global end-systolic longitudinal ST decreased and differences between Ts among LV segments increased irrespective of diastolic dysfunction at early stage. These results suggest that there might be early detectable changes in systolic function in the natural course of diabetes mellitus by STE study. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the effectiveness of oral n-acetyl cysteine, as a potential nephroprotective agent, in preventing and/or attenuating amphotericin B-induced electrolytes imbalances. Methods: During a one year period, patients were to receive conventional amphotericin b for any indication for at least one week and were randomly allocated to receive either placebo or 600 mg oral n-acetyl cysteine twice daily during the treatment course of amphotericin b. Demographic and clinical data of the study population were gathered. Different aspects of amphotericin b nephrotoxicity including decrease of glomerular filtration rate, hypokalemia, hypomagnesemia, renal magnesium and potassium wasting were assessed. Each patient was monitored for any adverse reaction to n-acetyl cysteine. Sixteen and 14 patients in the n-acetyl cysteine and placebo groups completed the study, 3incidences of hypokalemia (75 % versus 70 %; P = 0.724) and hypomagnesemia (30 % versus 20 %; P = 0.468) did not differ significantly between placebo and NAC groups, respectively. Although the rate of AmB nephrotoxicity was higher in the placebo than in the NAC group (60 % versus 40 %), this difference was not statistically significant ( P = 0.209) even after adjusting for probable associated factors of amphotericin b nephrotoxicity ( P = 0.206). The incidence as well as time of onset of electrolyte abnormalities also did not differ significantly between placebo and n-acetyl cysteine groups. About 44 % of n-acetyl cysteine recipients experienced new onset nausea and a mild unpleasant taste during the study. Conclusion: Oral n-acetyl cysteine during the amphotericin B treatment course was not significantly effective in preventing or mitigating different features of its nephrotoxicity including decrease of glomerular filtration rate, hypokalemia, hypomagnesemia, and renal potassium as well as magnesium wasting. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis B is one of the world's major health concern. The etiological agent of this infection is hepatitis B virus (HBV), which can evade the immune system response. Transforming growth factor beta 1 (TGF-β1) can act against HBV by suppressing the viral replication. The TGF-β1 also plays an important role in preventing liver damage in chronically HBV infected patients. Objectives: In this study, the association of TGF-β1 +915G/C and -509C/T gene polymorphisms with chronic hepatitis B was evaluated in Iranian patients. Materials and Methods: A population-based case–control study was conducted in Taleghani Hospital, Tehran. A number of 220 patients with chronic hepatitis B and the same number of healthy control subjects were designated the case and the control groups. The PCR-Restriction Fragment Length Polymorphism Method (PCR-RFLP) method was used for genotyping both polymorphisms. Ten percent of the control samples were sequenced to confirm the results. Results: No statically significant differences in genotype distribution and allele frequency were observed for both polymorphisms between healthy controls and patients with chronic hepatitis B. Conclusions: There was no association between TGF-β1 -509C/T and +915G/C polymorphisms with chronic hepatitis B and it seems that these changes don not play a significant role in increasing the risk of chronic infection in Iranian patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is little data available on job stress dimensions and their relationship to musculoskeletal disorders (MSDs) among Iranian nurses. OBJECTIVES: The objectives of this study were to investigate job stress dimensions and examine their relationship to MSDs among nurses of Shiraz University of Medical Sciences (SUMS) hospitals. METHODS: In this cross-sectional study, 385~randomly selected nurses of SUMS participated. The Persian version of Job Content Questionnaire (P-JCQ) and Nordic MSDs questionnaire were used for data collection. Descriptive statistics and Mann-Whitney U test were applied for data analysis. RESULTS: Decision latitude and social support dimensions had low levels, but psychological and physical job demands as well as job insecurity dimensions had high levels among the nurses. 89.9% of the subjects experienced some form of MSDs during the last 12 months. Lower back symptoms were the most prevalent problem reported (61.8%). Physical isometric loads was the only sub-scale that had significant relationship with MSDs. CONCLUSIONS: In the majority of cases, subjects were exposed to high levels of job stress. MSDs prevalence was high. Based on the results, any interventional program for MSDs prevention should focus on reducing physical and psychological job demands as well as increasing decision latitudes. [ABSTRACT FROM AUTHOR]

The article discusses the impact of the duration of bed rest and sandbag compress to reduce the back pain, negative feelings and promote physical comfort towards patient with coronary heart disease. It highlights the use of cardiac catheterization (CC) as a diagnostic procedure in patients with coronary angiography. It suggests the safety of changes in patient position in the early period of postcatheterization bed rest.

Objective: The aim of present study was to verify possible cognitive dysfunction in the patients with Juvenile Myoclonic Epilepsy (JME) and its correlation to factors related to epilepsy and patients demographic variables . Material and Methods: Thirty two consecutive patients with JME and 32 healthy controls were evaluated in neuropsychological domains including orientation, mental control, logical memory, forward and backward digit spans, visual memory, associative learning, and memory quotient (using Persian version of Wechsler Memory Scale (WMS)-Revised), preservative errors (using Wisconsin Card Sorting Test (WCST)), Stroop Test (color and word), IQ score (using Raven's Progressive Matrices test), and depression (using the Persian version of Beck Depression Inventory (BDI)). SPSS 11.0 (SPSS Inc., Chicago, Illinois, USA) software was used for statistical analysis. Student's t-test and the Mann-Whitney U-test were used for independent normally and non-normally distributed continuous variables, respectively. Results: Our study showed significant differences between patients with JME and control group with respect to scores of mental control (p=0.015), forward digit span (p=0.004), total digit span (p=0.008) and IQ (p=0.003). In addition, age, education level, duration of epilepsy and medication showed an impact on several cognitive functions in the patients with JME . Conclusion: It is indicated that JME is associated with impairment in specific cognitive domains, despite any evidence in favor of depression. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is the most intervening factors in producing mechanical low back pain (LBP). We aimed to evaluate the correlation between radiologic signs of osteoarthritis and functional status in patients with chronic mechanical LBP. Methods: Severity of osteoarthritis and disability were evaluated with Kellgren and Lawrence Grading Scale (K&L) by simple lumbar X-ray and Oswestry Disability Questionnaire (ODQ) respectively. Results: Although there was no significant correlation between ODQ and K&L score in general, the correlation was seen in female group (P = 0.024, r = 0.207). Conclusions: Mechanical LBP provides more disability in females suffering from more advanced osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery (CABG). Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO (700 IU/ kg), and the control group, receiving standard medication and CABG surgery plus normal saline (10 cc) as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG. Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days (47.05±6.29 vs. 45.90±4.97; P=0.334) and 30 days after surgery (47.27±28 vs. 46.62±5.7; P=0.69). There were no differences between the EPO and control groups in the wall motion score index at 4 (P=0.83) and 30 days after surgery (P=0.902). In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters (LVESD and LVEDD, respectively), as compared to the control group. Conclusion: Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG. [ABSTRACT FROM AUTHOR]

Background After renal transplantation, postoperative pain is usually mild to moderate. Postoperative pain is a concern and administration of systemic analgesic may be difficult because of underlying co-morbidities and variable responses of the graft. The transversus abdominis plane ( TAP) block is one of the different approaches for postoperative pain relief following abdominal surgeries. We evaluated analgesic efficacy of TAP block on early postoperative pain by numeric rating scale ( NRS) and morphine consumption during the first 24 hours after kidney transplantation. Methods Forty-four patients, scheduled as kidney recipients were randomized into two equal groups and were anesthetized with the same technique. After the induction of anesthesia, 15 mL of 0.25% Bupivacaine plus 5 μ/ml epinephrine or saline was deposited into the transversus abdominis neuro-fascial plane on the side of surgery by ultrasound guide. Each patient was assessed by a blinded investigator using NRS at 1st, 4th, 8th, 12th, and 24th hour postoperatively. Results Demographic data were not significantly different between the study groups. There was significant difference in median of NRS score measured at all time points in the study groups ( P < 0.001). The 24-hour morphine consumption (mean ± SD) was 10.8 ± 9.5 mg in bupivacaine group compared with 41.2 ± 3.8 mg in the saline group ( P = 0.001). There was statistically significant reduction in intraoperative fentanyl consumption in the TAP group 120 ± 20 μg compared to the control group 358 ± 24 μg ( P = 0.001). In study group 4 patients and in control group 90 patients received morphine titration for pain relief ( P = 0.03). There was no complication in the study groups related to nerve block. Only two patients in saline group had nausea ( P = 0.07). None of our patients received any other oral or IV rescue medication. Conclusion Ultrasound TAP block can reduce postrenal transplantation pain and the amount of opioids consumption intraoperatively and during the first 24 hours after surgery in kidney recipients. [ABSTRACT FROM AUTHOR]

Objective: Because of high psychological burden and considerable costs of in-vitro fertilization, it is greatly important to identify all factors that may influence its results. In this study, general anesthesia and spinal analgesia used for oocyte retrieval were compared in terms of success in treating infertility among couples who had undergone in-vitro fertilization at an infertility center in Tehran, Iran. Methods: This cohort study that was based on analysis of patient records at Mirza Kochak Khan Hospital, Tehran University of Medical Sciences, in 2008-2009. In this study, the status of chemical pregnancy among those who experienced general anesthesia or spinal anesthesia for in-vitro fertilization for the first time were compared, and the possible effects of clinical and laboratory factors using logistic regression models were considered. Results: Considering the number of transferred embryos, underlying cause of infertility and fetus grade, it was found that practicing spinal anesthesia is significantly related to increased chance of chemical pregnancy (adjusted Odds Ratio=2.07; 95% CI: 1.02,4.20; p=0.043). Conclusion: According to analysis of recorded data in an infertility treatment center in Iran, it is recommended to use spinal anesthesia instead of general anesthesia for oocyte retrieval to achieve successful in-vitro fertilization outcome. This can be studied and investigated further via a proper multicentric study in the country. [ABSTRACT FROM AUTHOR]

ABSTRACT Urinary tract infection (UTI) is one of the most common bacterial infections affecting about 40% of women in some points in their lives. UTI can cause serious potential consequences such as life-threatening sepsis, if it is not treated by primary health care providers. Health behaviours play an important role in causing UTI. Self-efficacy, as an important moderator of the relationship between knowledge and behaviour, is an important prerequisite for behaviour change. The aim of this study is to investigate the effect of health education on knowledge, self-efficacy and health behaviours of women with UTI. This is a quasi-experimental study of the intervention and comparison groups, with pre-test and post-test design, conducted with 170 married women with UTI; referred to selected hospital laboratories in Tehran. The data collection tool was a self-made questionnaire which was answered by both groups, prior to the intervention and 12 weeks thereafter. The intervention was performed on the intervention group samples. On the basis of the study results, after the intervention the average score of the knowledge ( p = 0·002), self-efficacy ( p < 0·001) and health behaviours ( p < 0·001) of the intervention group had significantly increased compared to the comparison group. The findings showed that health education was effective in promotion of the knowledge, self-efficacy and health behaviours of women with UTI. [ABSTRACT FROM AUTHOR]

Background and Aims: In this in vitro study the long-term bond strength of self-adhesive resin cement and Conventional resin cements to human enamel and dentin was compared. Materials and Methods: 80 sections of intact human third molars were randomly assigned into eight groups according to the cement type [Rely X Unicem (RXU), Rely X ARC (RXA)], bond substrate (enamel, dentin) and the duration of water storage (24 h or 1 year). Rods of cements (0.75×1 mm) were prepared on the top surface of specimens using Tygon tubes. The micro-shear bond strength of the specimens was measured by micro-tensile tester. Data were analyzed using Wilcoxon signed ranks and Mann Whitney tests. Results: The bond strength of RXA and RXU cements to enamel after 24h were 18.56±4.08 MPa and 14.99±4.17 MPa, and after 1 year they were 19.41±6.24 MPa and 15.51±6.17 MPa, respectively. The bond strength of cements to dentin was 13.36±4.02 MPa and 14.16±4.69 MPa after 24h, and 14.63±5.96 MPa and 14.08±6.72 MPa after 1 year, respectively. Tooth substrate had significant effect only on the shear bond strength of RXA cement in 24h (P=0.01), while no other significant differences were noted in this study. Conclusion: According to results of this study, one-step self-adhesive resin cement and multi-step conventional resin cement are equally effective in bonding to enamel and dentin after 1 year water storage. [ABSTRACT FROM AUTHOR]

Background: Carpal tunnel syndrome is known as the most common entrapment neuropathy. Conservative treatments cannot reduce the symptomatic severity satisfactorily; therefore, effectiveness of Linum usitatissimum L. (linseed) oil on carpal tunnel syndrome, as a complementary treatment, was evaluated in the current study. Linseed oil is a well-known preparation in Iranian traditional medicine and its analgesic, anti-inflammatory and anti-oxidative effects have been shown in previous studies. Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted. One hundred patients (155 hands) with idiopathic mild to moderate carpal tunnel syndrome aged between 18 and 65 years old were randomized in two parallel groups. These two groups were treated during 4 weeks with topical placebo and linseed oil. In addition, a night wrist splint was prescribed for both groups. Symptomatic severity and functional status were measured using Boston Carpal Tunnel Questionnaire. In addition, median sensory nerve conduction velocity, motor distal latency, sensory distal latency and compound latency as electrodiagnostic parameters were measured at baseline and after the intervention period. Results: After the intervention, significant improvement was observed regarding Boston Carpal Tunnel Questionnaire symptomatic severity and functional status mean differences (p <0.001) in the linseed oil group compared with those in the placebo group. Also, regarding the mean differences of both groups, significant improvement of nerve conduction velocity of the median nerve was seen in the linseed oil group by a value of 2.38 m/sec (p < 0.05). However, motor distal latency and sensory distal latency of the median nerve showed no between-group significant changes (p = 0.14 for both items). Finally, compound latency was improved slightly in the case group, comparing mean differences between the groups (p <0.05). No significant adverse events were reported from using linseed oil. Conclusions: It seems that linseed oil could be effective in the management of mild and moderate carpal tunnel syndrome, especially in improving the severity of symptoms and functional status. In addition, its effect on electerodiagnostic parameters, especially on the nerve conduction velocity, can be considered as a valuable point. [ABSTRACT FROM AUTHOR]

Aim Sexuality is an important part of women's health, quality of life and general well-being. Vaginal laxity may cause sexual dissatisfaction thereby causing some women to demand vaginal tightening surgeries. This study aimed to evaluate the sexual function preoperative and 6 months after selective vaginal tightening in women of reproductive age in Iran with vaginal laxity. Methods A quasi-experimental study was carried out on 79 women with vaginal laxity. All the women were requested to complete the questionnaire, which contained sociodemographic and Female Sexual Function Index ( FSFI) questions preoperatively and 6 months after vaginal tightening. Data were analyzed using a paired Student's t-test, Wilcoxon rank sum test and Mann- Whitney U-test. Results The mean age of participants was 34.02 ± 5.30 years. The average total FSFI score increased from 24.19 ± 3.09 to 26.92 ± 3.41 ( P < 0.001) after surgery. The scores for libido, arousal, orgasm and satisfaction domain were significantly improved, but a high level of dyspareunia and low vaginal lubrication were noted ( P < 0.001). Conclusion Sexual function was improved 6 months after vaginal tightening. This indicates that elective vaginal tightening had a positive effect on the sexual function in women. However, the increase in dyspareunia and decrease in lubrication may limit the application of this type of surgery. Further studies with longer follow-up are required to verify the long-term results of vaginal tightening. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to evaluate the effects of N-acetylcysteine (NAC) on cardiac remodeling and major adverse events following acute myocardial infarction (AMI). Methods: In a prospective, double-blind, randomized clinical trial, the effect of NAC on the serum levels of cardiac biomarkers was compared with that of placebo in 98 patients with AMI. Also, the patients were followed up for a 1-year period for major adverse cardiac events (MACE), including the occurrence of recurrent myocardial infarction, death, and need for target vessel revascularization. Results: In patients who received NAC, the serum levels of matrix metalloproteinase (MMP)-9 and MMP-2 after 72 h were significantly lower than those in the placebo group ( p = 0.014 and p = 0.045, respectively). The length of hospitalization in patients who received NAC was significantly shorter than that in the placebo group ( p = 0.024). With respect to MACE, there was a significant difference between those who received NAC (14 %) and those patients on placebo (25 %) ( p = 0.024). Re-infarction took place in 4 % of patients in the NAC group as compared with 16.7 % in patients who received placebo ( p = 0.007). Conclusion: NAC can be beneficial in preventing early remodeling by reducing the level of MMP-2 and MMP-9. Moreover, NAC decreased the length of hospital stays in patients after AMI. By decreasing MACE, NAC could possibly be introduced as a 'magic bullet' in the pharmacotherapy of patients with AMI. Further studies are needed to elucidate NAC's role in this population. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is a risk factor in treatment outcomes of critically ill patients. This study was conducted to determine the impact of obesity on the likelihood of recovery from traumatic brain injury (TBI) in intensive care unit (ICU) patients. Methods: We carried out a prospective study on 115 head injury patients who were admitted to the ICU of Poursina Hospital, Rasht, in the one-year period between July 2006 and June 2007. Obese patients (body mass index [BMI] ≥ 30 kg/m) were compared with non-obese patients (BMI < 30 kg/m). Demographic information, acute physiology and chronic health evaluation scores, Injury Severity Scores (ISS), Glasgow Coma Scale scores, and ICU mortality incidences were recorded. Results: Obese patients had significantly higher ICU mortality rates compared to non-obese patients ( p = 0.02). Furthermore, we observed a trend towards a higher ICU mortality rate in obese patients with ISS > 25 ( p = 0.04). Moreover, obesity was associated with prolonged mechanical ventilation, ICU length of stay (ILOS), and hospital length of stay (HLOS) ( p < 0.001). Conclusions: Obesity was associated with increased ICU mortality and prolonged dependency on mechanical ventilation, ILOS, and HLOS in patients with TBI. However, further prospective studies with larger sample sizes are needed to substantiate these findings. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to investigate the effectiveness of an orientated tour in reduction of children's anxiety before elective surgeries. Anxiety is a common emotional reaction following surgical experience among children that can result in increasing postoperative pain, increasing analgesic use. Methods: The study was a blinded clinical trial; 70 children were randomized into two groups (intervention and control). All children received standard preoperative care, while those in the intervention group also received an orientated tour with their mother of the operation room the night before the surgery was carried out. The children's anxiety was assessed by the 'Child Drawing: Hospital' instrument and vital signs measured before and after intervention in both groups. Data were analyzed with SPSS ver. 11.5 software. Results: Anxiety decreased in the intervention group following implementation of the orientated tour ( P = 0.024). Following the orientated tour in the intervention group, respiration rate ( P < 0.000) and blood pressure ( P < 0.001 systolic and diastolic) were significantly reduced, while heart rate and body temperature were not significantly different to pre-intervention. Comparison changes of vital signs following the orientated tour between the two groups was not significant. Conclusion: Implementation of an orientated tour of the preoperative room can decrease anxiety levels in children before elective surgeries, but it has no clinical effect on vital signs. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis patients have a low immune response to the hepatitis B (HB) vaccine. The method of administration plays and intramuscular (IM) injection methods for the HB vaccine. Materials and Methods: This study was undertaken in hemodialysis centers. We recruited 50 patients after excluding those with histories of previous HB vaccination, immunosuppressive therapy, and who were positive for HBsAb, HBsAg, and HCV antibody. Patients were randomly assigned to receive HB vaccine by either the ID or IM injection methods. The timeline for vaccine administration was 0, 1, 2 and 6 months for both groups. The ID group received 2 µg of EngerixB in both the right and left anterolateral forearms, for a total dose of 4 µg; the IM group received 20 µg in two sites in the deltoid muscle, for a Results: HBsAb levels of at least 10 mIU/ml in the ID group versus 68% in the IM group. However the mean HBsAb titer in the ID group was 459±323.8 versus 294.6±277.5 mIU/ml in the IM group. Conclusion: group. The cost for the low dose HB vaccine in the ID group is less than the high dose vaccine for the IM group. Thus, [ABSTRACT FROM AUTHOR]

Background and Aim: Most of the researches are about bilingual children with specific language impairment and importance of it in recognition and treatment. This study aimed to assess verb morphology in bilinguals with specific language impairment (SLI) and compare them with normal bilinguals. Methods: Six bilingual (Azeri and Persian) children with specific language impairment at the age of 7-8 years were collected from clinics of Tehran, Iran. They were evaluated about verb morphology using narrative speech and specific language impairment test and then, compared with six age-matched and six other language-matched children as control group. Children with specific language impairment were diagnosed by exhibiting a significant delay (more than one year) in language that can not be explained by intelligence deficits, hearing loss or visual impairment. We used Man-Whitney test for comparing the groups. Results: Bilingual children with specific language impairment had delay in comparison with their age-matched group in subject-verb agreement (p=0.020) and articulating tense morphemes (p=0.019). They also had meaningful delay in using proper tense of verbs (past, present, and future) in comparison with languagematched control group (p=0.029). Conclusion: Comparison of typical development of bilingual children and bilinguals with specific language impairment shows that verb morphology is a good clinical marker for diagnosing and treatment of these children. [ABSTRACT FROM AUTHOR]