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Background: Cerebrovascular accident (CVA) is a dangerous process that results in tissue damages and imposes heavy costs on societies. Therefore, finding a parameter for CVA prognosis and a way for its treatment is important. Considering some contradictory findings regarding the relationship between the highly sensitive - C reactive protein (hs-CRP) and ischemic CVA, this study aimed to evaluate the level of hs-CRP in patients with stroke. Materials and Methods: This case-control study was carried out on 40 patients (case) with acute ischemia (age range, 45-80 years) referred to Kashan Shahid-Beheshti hospital during 2009-2012 and 40 healthy subjects (control). Two groups were matched for age and gender; they did not have the underlying diseases increasing the level of hs-CRP. The hs-CRP was measured in the patients and then compared. Moreover, the patients' clinical status was evaluated on admission using the Scandinavian Neurologic Stroke Scale. Results: Each group consisted of 22 women and 18 men. In both groups, the mean hs-CRP value in women was significantly higher than the men. There was no significant difference between the two groups in the mean hs-CRP value. Conclusion: There is no direct relationship between hs-CRP level and ischemic cerebral stroke. [ABSTRACT FROM AUTHOR]

Sanitary landfill releases two pollutants into the environment, leachate and gases. Leachate may be treated by evaporation to attain acceptable discharge limits for various types of contaminants. One of the most important operational problems with evaporation is scaling. As ultrasound can affect many leachate compounds, this study was done to test its influence on scale treatment using evaporation. In order to determine the effect of sonication on leachate evaporation, some leachate samples were sonicated at a frequency of 25 kHz and 500 W. Sonication periods were tested in the range of 10-40 min on leachate samples. Evaporation and distillation were performed on leachate samples. The tests demonstrated that 90% of the leachate was distilled. When evaporation-distillation processes were carried out, chemical oxygen demand (COD) reduction was 83.56%. However, when sonication was used, COD reduction was 86.56-88.36% for 10-40 mi sonication, respectively. During evaporation, a part of total Kjeldahl nitrogen (TKN) remained in the concentrate and the rest entered into the distillate. In case where sonication was applied, TKN reduction was 83.70% and 89.71% for 10 and 40 min, respectively. Sonication had no considerable effect on EC and heavy metals reduction. When using sono-evaporation, efficiency of scale removal (ESR) reached 95.97%. [ABSTRACT FROM AUTHOR]

Background: The prevalence of preterm labor in Iran is 6-10%, accounting for 80% of neonatal morbidity. The most effective tocolytic agents to delay the preterm labor have not yet been known. Therefore, this study aimed to compare the effects of Indomethacin (ICN) and Magnesium-sulfate (MgS) in delaying preterm labor and also to assess the maternal complications associated with the two drugs. Materials and Methods: This randomized clinical trial study was performed on 24-32 week pregnant women (n=60) at risk for preterm labor referred to Shabih-Khani maternity hospital in Kashan. The women were divided into two equal groups: intravenous MgS (control) or ICN rectal suppository (intervention) groups. Then, the delaying of preterm labor and also the maternal morbidity were assessed in both groups. Results: No significant difference was seen in maternal and sociodemographic variables between the two groups. The delaying of preterm labor was the same for both groups and no case of preterm labor was seen in women during the first 48 hours of hospitalization. Moreover, there was no significant difference in variables (e.g. the maternal age, the number of gravida, gestational age, symptoms on admission, the number of prior preterm labors and a history of preterm labor) between the two groups. The most common complication in both groups was nausea. There was no case of oligohydramnios in the indomethacin group. Conclusion: Although the delaying of preterm labor was the same in both groups, MgS administration requires permanent nursing care. It seems that ICN can be used as one of primary tocolytic treatments in preterm labor. [ABSTRACT FROM AUTHOR]

Background: Job stress, the most important factor in reducing organizational productivity and the cause of psychosomatic disorders, today is more prevalent among the healthcare staff. Therefore, the aim of the present study was to assess the level of job stress among the nursing staff of Kashan hospitals during 2009. Materials and Methods: This descriptive cross-sectional study was performed on 190 nurses of Kashan hospitals using the Osipow questionnaire consisted of two parts: demographic data and six stress-inducing work roles (role overload, role insufficiency, role ambiguity, role boundary, responsibility and physical environment). In addition, job stress was divided into four (subnormal, normal, moderate and severe) levels. Results: Results indicated that the 95.3% of nursing staff were found to have a normal level of job stress. No significant relationship was seen between the job stress and gender; however, there was a significant relation between the role insufficiency, role boundary, responsibility and physical environment and gender. Moreover, no significant relationship was found between the job stress and some factors (e.g. age, education, marital status, income and type of hospital). The most frequent job stressors among the men and women were responsibility (90.2%) and role ambiguity (40.9%), respectively. Conclusion: Role ambiguity, responsibility and workload are the major sources of stress among the nursing staff. [ABSTRACT FROM AUTHOR]

Background: Considering the importance of chemical and physical parameters such as temperature, moisture, pH and carbon to nitrogen (C:N) ratio in producing compost, the purpose of this study was to evaluate these parameters in producing compost by stack method. Materials and Methods: This descriptive study was carried out on municipal solid waste generated in Kashan during a 63-day period from Oct 3 to Dec 4, 2010. Compost samples were taken from the top one-third, the center and also the bottom of the compost pile and mixed; the compost pile was aerated (if necessary). Thereafter, samples were analyzed for carbon and nitrogen content using Fourti method. Results: The initial temperature of the compost pile was 38°C and then increased to 65°C at the 9th day, and reached to 26°C at the last day of composting. The moisture at the beginning of the process was 67.5%, increased to 73% at the 5th day and decreased to 38% at the last day. The initial pH of the compost was 5.5, increased during the compost process, and reached an optimal value of 7.7 at the end of the process. The C:N ratio at the beginning of the process was 35:1 and in mature compost decreased to 12.5:1. Conclusion: Presence of actinomycetes and the dark-brown color of the prepared compost on the 63rd day of composting indicate that the compost meets the required standards. Consequently, the implementation of this method is suitable for tropical cities like Kashan. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis caused by leishmania protozoa can be considered as a zoonotic disease. This disease caused major health problems in some parts of Iran. Aran and Bidgol city (Isfahan province, Iran) is considered as one of the endemic foci of cutaneous leishmaniasis (Salak). For success in controlling the disease and to provide the necessary training for high-risk groups, the epidemiological data of disease in the region is required. Materials and Methods: This cross-sectional study was carried out on 94 patients admitted to the health center of Aran and Bidgol from April to September 2009. The demographic and epidemiologic data were collected and analyzed. Results: Thirty percent (30.8%) of patients were in the age group of 1-9 years. The number of patients in urban areas was more than that of rural areas and in men more than women. Most of these cases were seen in Aran and Bidgol city (52.1%) and then in Abuzeydabad city (22.3%), respectively. Moreover, most cases of disease were found in July(37.2%) and 54.3% and 45.7% of cases were dry and wet cutaneous sores, respectively. Conclusion: It seems that the high incidence of disease in age group of 1-9 years is due to the susceptibility of this age group to leishmaniasis. Therefore, regulating the control training programs in this group is suggested. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression is a serious problem that may have negative effects on mother and family mental health. Considering that several theories have been proposed to explain the epidemiologic and demographic factors associated with the postpartum depression, the aim of this study was to identify the factors related to postpartum depression in Kashan. Materials and Methods: In this cross-sectional study, 50% of all health centers in Kashan were randomly selected during 2007-8. All of 204 mothers referred during 2-3 months of postpartum with minimum literacy (primary education) showed willingness to complete the questionnaire which included two parts: demographic and psychosocial questions and BDI (Beck Depression Inventory). Data were analyzed using Chi-square test, CI, OR, and logistic regression. Results: Seventy seven (37.7%) out of 204 mothers referred to Kashan health centers experienced postpartum depression (0.31-0.44). There was a statistically significant relationship between seven demographic and psychosocial factors and postpartum depression, in logistic regression (P<0.001), three factors (husband's appropriate behavior, intimate relationship with family, and no prior history of depression) were remained in the model. The findings indicated that the mentioned factors can reduce the incidence of postpartum depression. Conclusion: According to the results, factors including husband's appropriate behavior, intimate relationship with family and no prior history of depression may reduce the incidence of postpartum depression. [ABSTRACT FROM AUTHOR]

Background: Bread is a valuable source of proteins, minerals and calories. Baking soda prevents the absorption of bread and more salt used in the production of bread causes different diseases. This study aimed to determine the amount of soda and salt used in bakeries of Mehrdasht. Materials and Methods: This cross-sectional descriptive study was performed on 50 bakeries of Mehrdasht city during 2009-10. A total number of 400 samples were randomly collected from all bakeries in four steps (two loaves from first batch). The measurement of PH and salt was done in accordance with the standard method of Institute of Standard and Industrial Research of Iran (ISIRI, 1999). Results: The PH less than 6.2 was seen in 91.5% of samples and the most PH values above 6.2 were in Lavash bread (12.5%). In 64.5% of samples, the amount of salt was more than the standard. A significant difference was seen between the amount of baking soda and the season while no significant difference was seen between the type of bread and the salt consumption (P=0.042). Conclusion: The amount of baking soda used in the bakeries of this city is not high; either bakers had no enough knowledge about the amount of salt used for production of bread or had more other reasons to use more or less salt than the standard. Therefore, drastic measures to control the amounts of baking soda and salt in bakeries are recommended. [ABSTRACT FROM AUTHOR]

Background: The main mission of any hospital in a health care system is to promote care quality for patients and to meet their needs and expectations. The aim of this study was to evaluate the quality of hospital services from the viewpoint of patients admitted to Kashan educational hospitals. Materials and Methods: In this cross-sectional study, 390 patients admitted to Kashan educational hospitals were selected based on the stratified sampling and their points of view were evaluated using SERVQUAL questionnaire during 2008-9. The quality attributes of the questionnaire consisted of seven dimensions (e.g. physician's empathy, physician's availability, the reliability of physician performance, nurse's responsibility, nurse's empathy, drugs management and tangibility of services). Validity and reliability of the questionnaire were confirmed using content validity and Cronbach's alpha coefficient (0.93), respectively. The data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. Results: The mean age of the respondents was 45.72±18.36 years and 54.1% of subjects were men. There was a significant difference among the mean of seven dimension scores and the total quality dimension. Moreover, a significant difference was observed in the quality score mean of different dimensions among hospitals. The highest and lowest means of quality score were for physician's empathy (3.97±0.75) and tangibility of the services (3.76±0.58), respectively. Conclusion: From the patients' viewpoint, educational hospitals have made good progress in providing hospital services; however, different quality scores among quality dimensions in any hospital signify that the health care administrators should pay more attention on the quality improvement programs to improve patients' satisfaction. [ABSTRACT FROM AUTHOR]

Background: Asthma is the most common chronic disease in childhood. Several factors have been considered as the disease risk factors. The neonatal phototherapy has recently been recognized as the main childhood risk factor. The aim of this study was to evaluate the relationship between the neonatal phototherapy and childhood asthma. Materials and Methods: This analytical case-control study was conducted on the asthmatic children with a history of neonatal icterus as the case group and those with no history of neonatal icterus as the control group with similar characteristics (age, gender, type of delivery and birth weight). Twenty-eight out of 200 subjects in the case and 34 in the control group had the inclusion criteria. Phototherapy and its duration were compared in the case and control groups. Data were analyzed using chi-square and t-test. Results: Twenty-six (92.8%) subjects in the case group and 20 (58.8%) subjects in the control group had a past history of phototherapy (P=0.002). The mean number of days for neonatal phototherapy in the case and control groups was 4/9 and 3/2, respectively (P<0.001). Conclusion: This study shows that neonatal phototherapy, as well as its duration, is an effective factor affecting childhood asthma. So, the phototherapy must be avoided except in rare situations with the least duration. [ABSTRACT FROM AUTHOR]

Background: Dyspepsia is one of the most common ailments today and Helicobacter pylori infection is known as one of the common causes of dyspepsia in adults and children. Histopathologic diagnosis of Helicobacter pylori is a standard method and biopsy samples can be obtained by invasive endoscopy method. The current study was designed to evaluate the diagnostic value of stool antigen test of Helicobacter pylori as a non-invasive method. Materials and Methods: One-hundred dyspeptic patients (50 men and 50 women) with a mean age of 43.3±17.13 referred to GI clinic of Kashan Shahid Beheshti Hospital from 2005 to 2007 were involved in this study. In upper gastrointestinal endoscopy, mucosal biopsy was taken from antrum and corpus; simultaneous examination of the stool antigen sample for diagnosing of Helicobacter pylori was evaluated using ELISA method (positive titer>1/1). Data were collected and analyzed for sensitivity, specificity, positive predictive value and negative predictive value. Results: The sensitivity, specificity, positive predictive value and negative predictive value in stool antigen test were %83.3, %79.4, 88.7% and 71.7%, respectively. There was a direct correlation between the severity of Helicobacter pylori infection and stool antigen titer in biopsy samples. Conclusions: The stool antigen test as a noninvasive method of diagnosing Helicobacter pylori can be regarded as an affordable alternative to the invasive biopsy procedure. [ABSTRACT FROM AUTHOR]

Background: Noise induced hearing loss (NIHL) is one of the most important occupational diseases worldwide. NIHL has been found to be potentiated by simultaneous carbon monoxide (CO) exposure. This study was performed to evaluate the protective effect of Nacetylcysteine (NAC) administration on potentiating effect of CO on NIHL in rabbits. Materials and Methods: In this experimental study forty-two male adult white rabbits were divided into seven groups (n=6 for each group). Group 1, as control (no exposure to noise or CO and no injection); Group 2, noise exposure (100 dB for 40 h); Group 3, noise+CO exposure; Group 4, noise exposure+NAC administration (325 mg/kg); Group 5, noise+CO exposure+NAC administration, Group 6, NAC administration alone and Group 7, CO exposure (700 ppm for 40h). Audiometric test of rabbits was assessed by Auditory Brain stem Response (ABR) test in three stages: before exposure, 1 hour and 14 days post exposure at 1, 2, 4 and 8 kHz frequency. Results: The administration of NAC attenuated temporary and permanent ABR threshold shift caused by noise exposure and simultaneous exposure to noise plus CO. NAC administration blocked the potentiating of temporary threshold shift by CO at 1, 2, and 4 KHz frequency and also blocked potentiating of permanent threshold shift by CO at all frequencies. Conclusion: NAC as an antioxidant agent can attenuate temporary and permanent noise induced ABR threshold shifts and provides protective effect against potentiating of NIHL by CO in rabbits. [ABSTRACT FROM AUTHOR]

Background: Work-related musculoskeletal disorders are considered as one of the most common occupational diseases and injuries. The high prevalence of the disorders has been reported in automobile industries due to numerous risk factors. This study was conducted to determine the prevalence of musculoskeletal disorders and the work-related risk factors in an automobile factory in Tehran. Materials and Methods: This cross-sectional study was performed on 145 workers in an automobile factory in Tehran during 2009-10. The prevalence of disorders was evaluated with standard Nordic questionnaire and work-related risk factors with KIM index. Data analyzed using chi-square test. Results: Musculoskeletal disorders were most commonly seen in tire installing (92.8%) and exhaust storage installing (88.4%) units. It was least common in door installing (43.7%) unit. Awkward posture, load lifting, back bending and torsional movements were the most important work-related risk factors for the disorders. A significant relationship was observed between prevalence of musculoskeletal disorders and occupational risk level (P<0.05). Conclusion: Ergonomics programs and specific ergonomic interventions are necessary to correct work-related problems in the work stations of this industry. [ABSTRACT FROM AUTHOR]

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the main cause of hospital infection. The aim of present study was to investigate the molecular characteristics of Staphylococcus aureus (SA), to detect mecA gene, and to type SCCmec in the strains isolated from patients at Kashan Shahid Beheshti Hospital. Materials and Methods: This descriptive study was carried out on SA isolates (n=150) collected from the clinical samples at Kashan Shahid Beheshti Hospital, Iran during 2009. The identification of all tested isolates were confirmed using Gram's stain, coagulase, DNase and manitol salt agar. In addition, the genotypes of SCCmec in the MRSA isolates were determined by multiplex PCR. Results: Eighty seven (58%) out of 150 SA isolates were confirmed as MRSA harboring mecA gene detected by PCR. Thirty four out of 87 (39.1%) were HA-MRSA and the remainig 53 (60.9%) were CA-MRSA. The multiplex PCR assay for SCCmec complex of MRSA strains (n=87) showed that 3(3.4%) samples were SCCmec type I, 12(13.8%) SCCmec type II, 8(9.2)% SCCmec type IVb, 4(4.6%) SCCmec type IVd and 3(3.4%) SCCmec type V. Conclusion: More than 50% of SA strains were positive for mecA gene and more than 60% of them were CA-MRSA. Moreover, SCCmec type II was the predominant strain of the identified MRSA. [ABSTRACT FROM AUTHOR]

Background: Kawazaki is an acute febrile vasculitis accompanied by cardiovascular complications. This study was conducted for the evaluation of clinical and paraclinical findings of Kawasaki disease among the children admitted in Kashan Shahid Beheshti Hospital. Materials and Methods: This cross-sectional study was carried out on 69 children diagnosed as Kawasaki. Medical documents of all cases were reviewed during the years 1998-2008 and all of the registered patients were invited to perform echocardiographic and cardiologic studies. Results: Sixty-nine out of 44 Kawasaki patients (63.8%) were male and the remaining 25 (36.2%) were female. 37% of cases were admitted in spring. All patients had fever, 89.9% elevated ESR and 24.6% elevated LDH. Among the 71.20% of cases albumin was lower than the normal range and 51.2% and 40% had elevated ALT and AST, respectively. 18.8% of Kawasaki patients had unqualified Kawasaki. Among the 2 cases with cardiac complication the serum albumin was lower than the normal. An ascending trend for the incidence of Kawasaki was seen since1998 till 2008. Conclusion: Considering the rising incidence of Kawasaki in recent years, paying careful attention to the disease signs, specially unqualified cases of Kawasaki in terms of on-time prescribing of Intravenous Immunoglobulin (IVIG), prevention of complications and also the evaluation of serum albumin level seems very important. [ABSTRACT FROM AUTHOR]

Background: Patients with morbid obesity have different signs .The overall morbidity rate among the patients with 50% over-weigh is twice. Many types of operations are invented to overcome the problem, one of which is gastric banding with mesh. Materials and Methods: Thirty patients treated with gastric banding with mesh were identified for this study. A prosthetic mesh was used to create a small upper gastric pouch. All patients were checked 1 and 6 months post operation. Moreover, 14 patients were followed 12 mouths after the operation. Results: Ninety percent of the patients were female and the rest were male. The average age of 43.3% of the patients was between 30-40 years and 60% of them have one or more comorbid disease in the beginning of the study. Early and late complication was seen in 6.7% and 26.7% of the patients, respectively. The morbidity rate was 0%. The mean primary weight was 123±22.2 kg with a BMI of 46.9±7.1. After 1 mouth the mean weight excess was 10±4.6 kg, the mean BMI 43±7.3 (P<0.0001), and the mean BMI excess 3.9±1.8. In the end of the study the mean BMI was 31.5±5.1 and the mean BMI excess 16.8±6.6. Conclusion: This study shows that the acceptable rate of BMI excess is 1, 6 and 12 mouths after the gastric banding. Moreover, 6 months post operation many of the complications of obesity were improved. Considering the limited and reversible complications of the procedure, gastric banding with mesh can be used as a useful treatment of very obese patients. [ABSTRACT FROM AUTHOR]

Background: Considering the increased antimicrobial resistance to Staphylococcus aureus and also the importance of vancomycin as a treatment, the aim of this work was to determine the minimum inhibitory concentration (MIC) of vancomycin, the pattern of antibiotic susceptibility, removing the isolates producing beta-lactamase enzyme and determining the risk factors for prevalence of methicillin-resistant Staphylococcus aureus (MRSA) isolated from clinical samples in Shahid Beheshti Hospital of Kashan-Iran. Materials and Methods: This descriptive study was carried out on 150 Staphylococcus aureus isolates. The sample strains were identified using gram staining, catalase test, tube coagulase test, growth on manitol salt agar medium and the DNAase test. The antibiotic sensitivity test was determined by disk diffusion method on nine antibiotics. MIC of vancomycin was determined using Broth Microdilution Method. The production of betalactamase enzyme was performed using acidometry method. Results: Among the 150 Staphylococcus aureus isolates, MIC value was 0.5-4 μg/mL. The highest MIC of vancomycin was 2 μg/mL. All of isolates were sensitive to vancomycin. Mean age of patients was 31.3+25.8. Penicillin and vancomycin revealed the highest and the lowest resistant rate, respectively (93% and 0%). Resistance to methicillin was 62%. Eightyseven percent of the isolates produced enzyme beta lactamase. Risk factors for prevalence of methicillin resistant Staphylococcus aureus were high age and previous antibiotic therapy. Conclusion: Considerining the vancomycin as the selective antibiotic, on following the preventive guideline, preparing the antibiogram and adding MIC test are recommended. [ABSTRACT FROM AUTHOR]

Glutamate antagonists such as topiramate have been proposed based on the glutamate hypothesis of schizophrenia because its properties encourage its exploration and possible development as a medication for the treatment of schizophrenia. A randomised, double-blind, placebo-controlled clinical trial was performed on 18- to 45-year-old patients with schizophrenia. Baseline information including vital signs, height, weight, smoking status, demographic characteristics, (past) psychiatric history, medication history and medication-related adverse effects were collected. Patients were randomly assigned to a topiramate or placebo group. Efficacy of medication was measured by administering Positive and Negative Syndrome Scale (PANSS), and tolerability of treatment was recorded on day 0 (baseline), day 28 and day 56. PANSS values (95% confidence interval) at baseline, day 28 and day 56 in the topiramate group were 96.87 (85.37-108.37), 85.68 (74.67-96.70) and 76.87 (66.06-87.69), respectively; compared with 101.87 (90.37-113.37), 100.31 (89.29-111.32) and 100.56 (89.74-111.37) in the placebo group. General linear model for repeated measures analysis showed that topiramate has lowered PANSS values significantly compared with the placebo group. Similar significant decline patterns were found in all three subscales (negative, positive and psychopathology sign). Clinical response (more than 20% reduction in PANSS) was significantly higher in topiramate-treated subjects than controls (50% vs 12.5%). Topiramate can be an effective medication in controlling schizophrenic symptoms, considering its effect on negative symptoms and controlling antipsychotic-associated weight gain. [ABSTRACT FROM AUTHOR]

Polymyxin E or colistin is an effective antibiotic against MDR Gram-negative bacteria. Due to unwanted side effects, the use of this antibiotic has been limited for a long time, but in recent years, the widespread of MDR Gram-negative bacteria infections has led to its reintroduction. Neurotoxicity and nephrotoxicity are the significant dose-limiting adverse effects of colistin. Several agents with anti-inflammatory and antioxidant properties have been used for the prevention of colistin-induced neurotoxicity. This study aims to review the preclinical studies in this field to prepare guidance for future human studies. The data was achieved by searching PubMed, Scopus, and Google Scholar databases. All eligible pre-clinical studies performed on neuroprotective agents against colistin-induced neurotoxicity, which were published up to September 2023, were included. Finally, 16 studies (ten in vitro and eight in vivo) are reviewed. Apoptosis (in 13 studies), inflammatory (in four studies), and oxidative stress (in 14 studies) pathways are the most commonly reported pathways involved in colistin-induced neurotoxicity. The assessed compounds include non-herbal (e.g., ascorbic acid, rapamycin, and minocycline) and herbal (e.g., curcumin, rutin, baicalein, salidroside, and ginsenoside) agents. Besides these compounds, some other measures like transplantation of mitochondria and the use of nerve growth factor and mesenchymal stem cells could be motivating subjects for future research. Based on the data from experimental (in vitro and animal) studies, a combination of colistin with neuroprotective agents could prevent or decrease colistin-induced neurotoxicity. However, well-designed randomized clinical trials and human studies are essential for demonstrating efficacy., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Purpose: Ferula gummosa ( F. gummosa ), a potent medicinal herb, has been shown to possess anticancer activities in vitro . The present examination evaluated the cytotoxic and apoptogenic impacts of F. gummosa gum on the U87 glioblastoma cells., Experimental Approach: MTT assay to determine the cell viability, flow cytometry by annexin V/FITC-PI to apoptosis evaluation, reactive oxygen species (ROS) assay, and quantitative RT-PCR were performed., Findings / Results: The results revealed that F. gummosa inhibited the growth of U87 cells in a concentration- and time-dependent manner with IC 50 values of 115, 82, and 52 μg/mL obtained for 24, 48, and 72 h post-treatment, respectively. It was also identified that ROS levels significantly decreased following 4, 12, and 24 h after treatment. The outcomes of flow cytometry analysis suggested that F. gummosa induced a sub-G1 peak which translated to apoptosis in a concentration-dependent manner. Further examination revealed that F. gummosa upregulated Bax/Bcl-2 ratio and p53 genes at mRNA levels., Conclusion and Implications: Collectively, these findings indicate that sub-G1 apoptosis and its related genes may participate in the cytotoxicity of F. gummosa gum in U87 cells., Competing Interests: All authors declared no conflict of interest in this study., (Copyright: © 2022 Research in Pharmaceutical Sciences.)

Background and Aims: Due to the contradictory results of previous research and the lack of a specific study to address the effective nursing interventions in the early diagnosis of cancer, the purpose of this study was to determine the effect of nursing interventions on early diagnosis of cancer., Methods: This systematic review and meta-analysis were conducted during the last 5 years from 2015 to September 30, 2020. The articles related to the nursing interventions to early diagnosis of cancer were achieved from PubMed, Cochrane Library, Embase, ISI, Scopus databases, and Google and Google Scholar search engines. Risk-ratio with a 95% confidence interval (CI) between the intervention and control groups was determined using the fixed-effect model, and the Mantel-Haenszel method and I2 showed the heterogeneity of studies. Stata V16 software was used for meta-analysis., Results: The effect of an intervention on early diagnosis of breast cancer was evaluated using mammography, clinical breast examination, and breast self-exam. A total of 300 individuals participated in the study. RR results in the intervention group showed the effectiveness of nursing interventions on breast cancer detected early in both the mammography and colonoscopy (RR, 1.18 95% CI 0.57, 1.79. P =0.00 and RR, 0.58, 95% CI 0.42, 0.75, P = 0.00, respectively)., Conclusion: A variety of nursing interventions including education, consultation, patient guidance, and reminders can have a positive impact on the early detection of cancers., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Introduction: The unpredictable challenges and conditions of COVID-19 can cause mental health problems. In such a situation, one of the most important psychological problems is the fear and anxiety of death. Death anxiety can affect the quality of patient care services and the job satisfaction and mental health of nurses., Methods: This is a descriptive cross-sectional study in which 110 nurses working in the intensive care units of hospitals affiliated to the Tehran University of Medical Sciences were selected by the convenience sampling method from April to September 2016. The data collection tools used in the study include a demographic questionnaire and a Templer death-anxiety questionnaire., Findings: The results showed that the level of death anxiety in nurses working at COVID-19 intensive care units is associated with age, working hours per week, childbearing, several patients needing end-of-life care, cases of direct participation in resuscitation operations, cases of patient death observations, and satisfaction with personal protective equipment ( P < o.o5)., Conclusion: Increasing the nurses' awareness of the critical situations of COVID-19, management measures, improving the working environment, social support, and increasing personal protective equipment seem to be the effective factors in protecting the intensive care unit nurses against COVID-19 and reducing death anxiety., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Introduction: An emergency is a serious, unexpected situation which may lead to injury, loss of life and damage to property and often needs urgent interventions. Emergency calls can bring urgent life-saving intervention in such situations. Although access to emergency lines for all persons of a society is one of the effectiveness indexes of this critical service, in most countries, these lines are not accessible for disabled people., Case Presentation: This study examined the issue of emergency number accessibility for disabled people in the I.R. of Iran. Two persons who had been poisoned by carbon monoxide died because their deaf-mute father could not communicate with the Emergency Medical Service Center (EMSC). This led to the Emergency Medical Service Management Center (EMSMC), in collaboration with Iranian Society of Deaf People Family (ISDPF), developing a system that is a combination of short message system (SMS) and location-based information (LBI) to facilitate the communication of such disabled persons with EMSMCs. The system did not receive any emergency message until this report is provided., Conclusion: Because emergency call service has not been available for disabled people in Iran until now, emergency service organizations should take a proactive approach in developing a reliable and easy to use a method with the current technologies. These organizations should also provide information about the installed systems for end-users.

Background: Physical rehabilitation, as one of the rehabilitation disciplines, can play a great role in humanitarian reliefs. The effectiveness of physical rehabilitation services is completely dependent on time of intervention, the importance of good timing in providing services during disasters is not well understood. The objective of this study was to systematically review the physical rehabilitation services provided in disasters and emergencies., Methods: An electronic search of PubMed, Scopus, Cochrane, and PEDro (Physiotherapy Evidence Database) was undertaken from Jan 2000 to Sep 2017. All English studies reporting physical rehabilitation services in natural and man-made disasters were selected regardless of study design. The included studies were analyzed by descriptive and analytical method., Results: Thirteen studies were included after reviewing by title, abstract and full text in this study. Most of the physical rehabilitation studies come back to recent years. Most of the disaster physical rehabilitation services were physiotherapy and occupational therapy. The physical rehabilitation experts have been attended in the affected area from the few first hours until several months after disasters in order to provide the required services to the affected population., Conclusion: There are few studies about physical rehabilitation services provided in the disaster-affected areas and this study showed that the services were limited and at different times. Physical rehabilitation services post disasters should have a comprehensive service model, like other health services. Therefore, it is necessary to conduct further studies to achieve this aim., Competing Interests: Conflict of interest The authors declare no conflicts of interest.

Background: Internationally, inclusion of physical rehabilitation services during early disaster response is relatively new. The aim of the study was to gain an understanding of disaster relief physical rehabilitation in Iran., Methods: A qualitative study design was employed and sixteen semi-structured interviews were conducted for data collection. Content analysis was used for data analysis. The participants in this study were purposively selected among people who experienced the Bam (2003) and Varzaghan (2012) earthquakes., Results: Three main themes were explored including: indispensable intervention, barriers to continuous intervention and opportunities for intervention. Almost all participants reiterated the importance of effective physical rehabilitation services during disasters. Some participants mentioned significant barriers for delivering such services in the context of Iran. The lack of an effective responsible body, weak disaster-related competencies and under-prioritization by government were among other barriers. On a more positive note, some interviewees talked about national programs that could facilitate service delivery., Conclusions: Providing disaster relief physical rehabilitation has faced many barriers in Iran. However, there are some facilitators in the country that could help provide these services. Finally, the feasibility of post-disaster physical rehabilitation services delivery completely depends on the current national rehabilitation system.

Studies indicate there are a variety of contributing factors affecting physician test ordering behaviour. Identifying these behaviours allows development of behaviour-based interventions. Methods Through a pilot study, the list of contributing factors in laboratory tests ordering, and the most ordered tests, were identified, and given to 50 medical students, interns, residents and paediatricians in questionnaire form. The results showed routine tests and peer or supervisor pressure as the most influential factors affecting physician ordering behaviour. An audit and feedback mechanism was selected as an appropriate intervention to improve physician ordering behaviour. The intervention was carried out at two intervals over a three-month period. Findings There was a large reduction in the number of laboratory tests ordered; from 908 before intervention to 389 and 361 after first and second intervention, respectively. There was a significant relationship between audit and feedback and the meaningful reduction of 7 out of 15 laboratory tests including complete blood count (p = 0.002), erythrocyte sedimentation rate (p = 0.01), C-reactive protein (p = 0.01), venous blood gas (p = 0.016), urine analysis (p = 0.005), blood culture (p = 0.045) and stool examination (p = 0.001). Conclusion The audit and feedback intervention, even in short duration, affects physician ordering behaviour. It should be designed in terms of behaviour-based intervention and diagnosis of the contributing factors in physicians' behaviour. Further studies are required to substantiate the effectiveness of such behaviour-based intervention strategies in changing physician behaviour.

Cadaver dissection stands as a crucial component in medical curricula around the world, although computer-based multimedia programs have been introduced in order to replace the need for cadaver donations. Due to a decrease in the number of unclaimed bodies and rather few donations, there is an insufficient number of cadavers for anatomical studies in Iran. This study was carried out to evaluate medical students' awareness and willingness regarding body donation in Kashan University of Medical Sciences, Iran. In this study, a questionnaire was designed to focus on the cultural acceptability and personal willingness to donate one's body after death. Students from the university's anatomy classes (n = 331) participated in this study. Seventy-seven percent of the students expressed their agreement toward the idea of utilizing body donation services, though only 25.4% of participants were willing to donate their own bodies. None of the demographic factors were associated with cultural acceptability or personal willingness towards body donation. These findings indicated that besides "payment", other factors were associated with students' willingness to become donors. All factors of awareness except "previous awareness of organization" were associated with cultural acceptability. In this study, students suggested that encouraging people to register for body donation using mass media (25.6%) and teaching students to respect cadavers in the dissection environment (24.8%) were the best solutions for addressing the lack of cadavers. These findings indicated that a lack of awareness about body donation might be the main factor responsible for unwillingness towards body donation; therefore, improving the public's awareness and addressing the willingness of students regarding body donation may help overcome the current lack of donated cadavers. Anat Sci Educ 10: 120-126. © 2016 American Association of Anatomists., (© 2016 American Association of Anatomists.)

Introduction: Tendons are vulnerable to various types of acute or chronic injures. Different methods have been investigated to achieve better healing. Phenytoin is a drug which could stimulate fibroblasts to produce collagen. This experimental study was performed to assess the effect of phenytoin on tendon healing in a rat model of tendon rupture., Methods: Thirty healthy rats were divided into 3 groups, 1) Sham group; 2) Tendon rupture; 3) Tendon rupture+phenytoin (100 mg/kg intraperitoneally) for 21 days. On 21st day after tendon injury, the rats were anesthetized and tendon tissue was sampled for studying by light and electron microscopy., Results: Qualitative and quantitative microscopic comparisons of the repair tissues of both groups were made on the 21st day. The results obtained from light and electron microscopy studies showed that tendon tissue healing was significantly better in phenytoin group compared to the control group (p < 0.05)., Conclusions: Systemic administration of phenytoin may have a positive effect on tendon healing by increasing fibroblast quantity, fibrillar collagen synthesis, vascularity, and suppressing inflammation (Tab. 2, Ref. 25).

Purpose: To evaluate the effect of Black cumin (Nigella sativa Linn.) pre-treatment on renal ischemia/reperfusion (I/R) induced injury in the rats., Methods: A total of 40 male Wistar rats were randomly allocated into five equal groups including Sham, I/R model and three I/R+ Black cumin (0.5, 1 and 2%)-treated groups. I/R groups' kidneys were subjected to 60 min of global ischemia at 37°C followed by 24 h of reperfusion. At the end of reperfusion period, the rats were euthanized. Superoxide dismutase, catalase and glutathione peroxidase activities as well as reduced glutathione and renal malondialdehyde contents were determined in renal tissues. Kidney function tests and histopathological examination were also performed., Results: High serum creatinine, blood urea nitrogen and uric acid as well as malondialhehyde (MDA) levels, and low antioxidant enzyme activities were observed in I/R rats compared to the sham rats. Pre-treatment with Black cumin for three weeks prior to IR operation improved renal function and reduced I/R induced renal inflammation and oxidative injury. These biochemical observations were supported by histopathological test of kidney sections., Conclusion: Black cumin significantly prevented renal ischemia/reperfusion induced functional and histological injuries.

Objectives: The aim of this study was to evaluate the effects of ground black seeds on renal tubular cell apoptosis following ischemia/reperfusion (I/R) injury in rats., Materials and Methods: Forty male Wistar rats were randomly allocated into 5 equal groups including Sham, I/R model and three I/R+ black seeds (5, 10 and 20%)-treated groups. I/R groups' kidneys were subjected to 60 min of ischemia followed by 24 h of reperfusion. Microscopically, apoptosis of tubular cells was assessed by terminal deoxynucleotidyltransferase-mediated dUTP nick-end labelling (TUNEL) method., Results: The apoptotic cells of renal tubules were increased significantly (P<0.01) in I/R group than those in sham operation group. The TUNEL positive cells in black seeds (10% and 20%) treatment groups decreased significantly (P<0.05)., Conclusion: Inhibition of apoptosis may be responsible for the protective effects of black seeds in rats with renal I/R injury.

Background: Postoperative pain is an important factor affecting anesthesia and surgery., Objectives: The present study assessed the effects of 1200 mg gabapentin, an anticonvulsant drug that acts through voltage-dependent calcium channels, for the control of postoperative pain in patients undergoing abdominal hysterectomy., Methods: Fifty patients undergoing hysterectomy were enrolled in the present study. Subjects received either 1200 mg gabapentin or placebo 2 h before surgery. The amount of morphine consumption and level of postoperative pain at 2 h, 6 h, 12 h and 24 h after surgery were measured., Results: There were no significant differences in age, duration of surgery and anesthesia, or body mass index between the two groups. The mean intensity of pain in the gabapentin group was significantly lower than in the placebo group. The mean amount of morphine used in the placebo group (5.2 ± 2.8 mg) was significantly higher than in gabapentin group (1.2 ± 0.29 mg; P=0.001). Nausea and vomiting in the placebo group was more common than in the gabapentin group (P=0.001). The time interval for initial ambulation after surgery was significantly shorter in the gabapentin group (12.24 ± 2.18 h) compared with the placebo group (15 ± 3.61 h; P=0.002)., Conclusion: 1200 mg gabapentin reduced postoperative pain and the need for opioids, and enabled earlier ambulation of the patient. Significant side effects were not observed.

Parasitic helminth infection has been shown to modulate pathological inflammatory responses in allergy and autoimmune disease. The aim of this study was to examine the effects of infection with a helminth parasite, Heligmosomoides polygyrus, on type 1 diabetes (T1D) in nonobese diabetic (NOD) mice and to elucidate the mechanisms involved in this protection. H. polygyrus inoculation at 5 weeks of age protected NOD mice from T1D until 40 weeks of age and also inhibited the more aggressive cyclophosphamide-induced T1D. Moreover, H. polygyrus inoculation as late as 12 weeks of age reduced the onset of T1D in NOD mice. Following H. polygyrus inoculation of NOD mice, pancreatic insulitis was markedly inhibited. Interleukin-4 (IL-4), IL-10, and IL-13 expression and the frequency of CD4(+) CD25(+) FoxP3(+) regulatory T cells were elevated in mesenteric and pancreatic lymph nodes. Depletion of CD4(+) CD25(+) T cells in vivo did not abrogate H. polygyrus-induced T1D protection, nor did anti-IL-10 receptor blocking antibody. These findings suggest that infection with H. polygyrus significantly inhibits T1D in NOD mice through CD25- and IL-10-independent mechanisms and also reduces the severity of T1D when administered late after the onset of insulitis.

The aim of the present study was to assess the incidence and age distribution of hepatic tumors of sheep as well as study of their histopathologic characteristics. For this purpose, 3000 slaughtered sheep, consisting of 284 rams with approximate age of 7 to 20 months and 2716 ewes with approximate age of 3 to 7 years, were inspected during a routine postmortem examination. This study was conducted at Tabriz abattoir in the East Azerbaijan province of Iran, in a course of 8 months from March to November 2006. In this survey, two livers were encountered tumoral. Representative sections of the tumors were stained with hematoxylin and eosin. Gross and microscopic features of these tumors supported diagnosis of hepatocellular carcinoma and cholangiocellular carcinoma for a seven-years-old crossbreed ewe and a five-years-old native breed ewe respectively. In this survey, 0.074% of slaughtered ewes had hepatic neoplasia. That is, the prevalence of hepatocellular carcinoma and cholangiocellular carcinoma in aged ewes was equally 0.037% in this study.

Background and Aim: The prevalence of childhood asthma varies among different nations and appears to have increased in recent years. It has been difficult to determine this prevalence precisely and compare the communities due to the lack of a standardized method. The International Studies of Asthma and Allergies in Childhood (ISAAC) has developed a written and video questionnaire to measure asthma prevalence and overcome these difficulties. This study was carried out to determine the prevalence of childhood asthma in Kashan, the central area of Iran, and to assess the agreement between the ISAAC written and video questionnaires and its gender relationship., Methods: Between December 2002 and June 2003, 2533 school children, aged 13-14 years, in Kashan secondary schools completed sequentially the ISAAC written and video questionnaires. The agreement between responses to the two questionnaires for reported "ever wheeze", "exercise wheeze", "night wheeze" and "night cough" was determined, using kappa coefficient and concordance., Results: The prevalence of asthma symptoms were significantly lower in the responses to the video questionnaire compared with the written questionnaire. Kappa coefficient showed only poor to fair agreement (kappa = 0.13-0.24) between video and written questionnaires, although the concordance between them always exceeded 60%., Conclusions: This study showed that reported asthma symptoms based on video questionnaires were significantly lower than the written questionnaire, and that there is low agreement between the two questionnaires which requires further investigation to explain the findings. In addition, this investigation revealed no significant difference between the genders for this low agreement.

Introduction: During recent years, in-hospital cardiopulmonary resuscitation (CPR) management has received much attention. However, the rate of survival after in-hospital resuscitation in Iran hospitals is not known. Therefore, a study was designed to evaluate the outcome of in-hospital cardiopulmonary resuscitation (CPR) in the city of Kashan, Iran, during a 6-month period during 2002., Material and Methods: A prospective descriptive study was conducted on all cases of in-hospital cardiopulmonary resuscitation. Necessary data including the age and sex of patients, shift, time from cardiac arrest until initiating of CPR, time from cardiac arrest until defibrillation, duration and result of CPR, were recorded in a checklist. Descriptive statistics presented., Results: A total of 206 cases of CPR were attempted during the research period. The study population consisted of 59.2% males and 40.8% females. The survival rate was similar for both sexes. Short-term survival was observed in 19.9% of cases and only 5.3% survived to discharge. The key predictors of survival to hospital discharge were CPR duration, time of cardiac arrest, time from cardiac arrest to initiation of CPR, and defibrillation within the first few minutes of cardiac arrest., Conclusions: Our study showed that it needs more attention to be paid to cardiopulmonary resuscitation management in Iran's hospitals. The results of this study could be an important first step toward a national study on the survival after cardiopulmonary resuscitation to provide accurate data on our performance with regards to the chain of survival.