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Aim: The aim of this study was to compare the survival of composite resin restorations retained by glass fiber posts or reversed-orientated (upside-down) metal posts in severely decayed primary anterior teeth after 6, 12, and 18 months., Materials and Methods: A total of forty-four 3- to 5-year-old children with bilateral severely decayed primary maxillary canines were included. Patients were treated under general anesthesia. After pulpectomy, an intracanal post was seated in the primary maxillary canine on each side: either a glass fiber post or a metallic post in reversed orientation and teeth restored with light-cured composite. Survival rate of each technique was evaluated at predetermined follow-ups and data were analyzed with McNemar's test (α = 0.05)., Results: The difference in survival of restorations retained by two types of posts was not statistically significant in clinical and radiographical evaluations after 6, 12, and 18 months. The survival rate of reversed-orientated metal and glass fiber posts after 18 months was 81.1 and 67.6% respectively (p = 0.14)., Conclusion: Reversed-orientated metal post did not show lower clinical survival compared with glass fiber posts in 18-month follow-up. Hence, reversed-orientated metal post can be considered as a potential method to obtain retention for composite restorations in severely decayed primary anterior teeth. How to cite this article: Vafaei A, Ranjkesh B, L0vschall H, Erfanparast L, Jafarabadi MA, Oskouei SG, Isidor F. Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts. Int J Clin Pediatr Dent 2016;9(2):109-113.

Objective: The aim of the present study was to determine effects of Resistant Starch (RS2) on metabolic parameters and inflammation in women with type 2 diabetes (T2DM)., Methods: In this randomized controlled clinical trial, 60 females with T2DM were divided into intervention (n = 28) and placebo groups (n = 32). They received 10 g/d RS2 or placebo for 8 weeks, respectively. Fasting blood sugar (FBS), glycated hemoglobin (HbA1c), lipid profile, high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured at baseline and at the end of the trial. Paired t test, unpaired t-test and ANCOVA were used to compare the quantitative variables. The data were analyzed using SPSS software version 13.0., Results: RS2 decreased HbA1c (-0.3%, -3.6%), TNF-α (-3.4 pg/mL, -18.9%), triglyceride (-33.4 mg/dL, -15.4%), and it increased HDL-c (+9.4 mg/dL, +24.6%) significantly compared with the placebo group (p < 0.05). Changes in FBS, total cholesterol, low-density lipoprotein, hs-CRP and IL-6 were not significant in the RS2 group compared with the control group. RS2 can improve glycemic status, inflammatory markers and lipid profile in women with T2DM., Conclusions: Although findings of the present study indicated positive effects of RS2 on inflammation and metabolic parameters, more studies are needed to confirm efficacy of RS2 as an adjunct therapy in diabetes., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Colorectal cancer is the third most common cancer in Iran. The increasing trend of colorectal cancer incidence in Iran and the close relationship with the geographical location are the underlying reasons for this study., Data Source: Eleven databases, including MEDLINE, EMBASE, SCOPUS, and four other databases, for articles in Persian were searched from April 2014 to October 2014. Additional data were obtained from an online survey of the Central Library of Tabriz Faculty of Medicine., Study Eligibility Criteria: In this systematic review and meta-analysis, we included studies reporting different measures of incidence, age-standardized incidence rates, and crude incidence rates. All rates (per 100,000 person-years) were standardized to the world standard population., Study Appraisal and Synthesis Methods: A preliminary review of the title and abstracts of these articles was used to exclude any that were clearly irrelevant. The full text review determined whether the article was relevant to our topic. All the potentially relevant manuscripts were reviewed by two other investigators (S.D., M.G.). A total of 39 studies (10 Persian and 29 English articles) from different provinces and diverse areas of Iran, were analyzed in this study using comprehensive meta-analysis software. For accuracy studies, we used estimated rates for males and females with 95 % confidence intervals., Results: Age-standardized incidence rates were obtained based on the random effects model and were 8.16 (95 % CI: 6.64 to 9.68) and 6.17 (95 % CI: 5.01 to 7.32) for males and females, respectively. The random crude rates were 5.58 (95 % CI: 4.22 to 6.94) for males and 4.01 (95 % CI: 3.06 to 4.97) for females., Conclusions: Colorectal cancer incidence rates rise due to individual and environmental risk factors as well as improvement in the registry system and increase in access to health services. A more executed organized and structured system for collecting cancer data, in all cities and rural areas of the country, is an essential priority.

Research suggests a relatively sizable rate of unintended pregnancies in some subgroups of Iranian women, but there is no concise, standard scale to measure the pregnancy intention of Iranian women. Therefore, the psychometric properties of the Persian version of the London Measure of Unplanned Pregnancy (LMUP) were investigated. The Persian version of the LMUP was tested on randomly selected married women aged 15-49 years in the city of Ajabshir, East Azerbaijan province, north-west of Islamic Republic of Iran. The scale's face validity and internal consistency was examined and its construct validity was tested by exploratory factor analysis. The internal consistency of the scale was acceptable (Cronbach alpha coefficient 0.87). Structural indicators of the Kaiser-Meyer- Olkin measure (0.85) and Bartlett test of sphericity (P < 0.001) verified interpretability of the exploratory factor analysis output. Applicability of the Persian version of the LMUP is accepted. Further investigation is needed to understand cultural norms that might influence Iranian women's responses to queries about pregnancy intentions.

Background: Larger mean platelets volumes (MPV) are thrombogenic and frequently seen after ST-segment elevation myocardial infarction (STEMI). This study aimed to examine the association of MPV and resolution of ST-segment after thrombolysis in STEMI patients as and its impact on clinical outcome., Methods: Patients presenting to the emergency department with the diagnosis of first STEMI and were referred to thrombolysis were screened. Patients with ≥50% ST-segment resolution (STR) 90minutes after thrombolysis were assigned as "Responder" and those with <50% STR were assigned as "Non-Responders". Demographic, clinical comorbidities and risk factor were recorded along with and angiographic data. In-hospital occurrence of major adverse cardiac events (MACE), including acute heart failure (AHF), reinfarction and death were investigated. Additionally, the patients were followed for 6 additional months after their discharge from the hospital., Results: STR≥50% was seen in 60.2% of patients after thrombolysis. Responders had significantly lower MPV (P=0.001) and the critical MPV values were 8.0 femtoliter (fL) and 8.2fL in predicting STR and MACE. Patients with MPV ≥8.2fL had lower probability of STR and higher rates of AHF (P<0.001), and MACE (P=0.001) compared to the patients with lower platelet volume. In multivariate regression, MPV was an independent predictor of STR (P<0.001) as well as MACE (HR=4.8, 95% CI of 1.8-12.4; P=0.001). Triple vessel disease was another independent factor that predicted MACE., Conclusion: Higher MPV's at admission were associated with lower STR and higher occurrence of major adverse cardiac events in patients receiving thrombolytic therapy for first time STEMI., (Published by Elsevier Ltd.)

Background: administrative healthcare data are among main components of hospital information system. Such data can be analyzed and deployed for a variety of purposes. The principal aim of this research was to depict trends of administrative healthcare data from HIS in a general hospital from March 2011 to March 2014., Methods: data set used for this research was extracted from the SQL database of the hospital information system in Razi general hospital located in Marand. The data were saved as CSV (Comma Separated Values) in order to facilitate data cleaning and analysis. The variables of data set included patient's age, gender, final diagnosis, final diagnosis code based on ICD-10 classification system, date of hospitalization, date of discharge, LOS(Length of Stay), ward, and survival status of the patient. Data were analyzed and visualized after applying appropriate cleansing and preparing techniques., Results: morbidity showed a constant trend over three years. Pregnancy, childbirth and the puerperium were the leading category of final diagnosis (about 32.8 %). The diseases of the circulatory system were the second class accounting for 13 percent of the hospitalization cases. The diseases of the digestive system had the third rank (10%). Patients aged between 14 and 44 constituted a higher proportion of total cases. Diseases of the circulatory system was the most common class of diseases among elderly patients (age≥65). The highest rate of mortality was observed among patients with final diagnosis of the circulatory system diseases followed by those with diseases of the respiratory system, and neoplasms. Mortality rate for the ICU and the CCU patients were 62% and 33% respectively. The longest average of LOS (7.3 days) was observed among patients hospitalized in the ICU while patients in the Obstetrics and Gynecology ward had the shortest average of LOS (2.4 days). Multiple regression analysis revealed that LOS was correlated with variables of surgery, gender, and type of payment, ward, the class of final diagnosis and age., Conclusion: this study presents trends in administrative health care data residing in hospital information system of a general public hospital. Patterns in morbidity, mortality and length of stay can inform decision making in health care management. Mining trends in administrative healthcare data can add value to the health care management.

While it has been proven that the handling properties of mineral trioxide aggregate (MTA) are improved upon mixing it with propylene glycol (PG), this study sought to evaluate how PG affects the microhardness of MTA in terms of setting quality. MTA was mixed with different proportions of distilled water (DW) and PG to prepare 5 groups (n = 30). The DW/PG percent proportions used in Groups 1-5 were 100/0, 80/20, 50/50, 20/80, and 0/100, respectively. The mixed MTA was condensed into acrylic molds. Half of the samples of each group were evaluated on Day 4, the other half on Day 28. The results indicated that PG reduces the microhardness of MTA, thus adversely affecting its setting process. Group 2 (80% DW/20% PG) best improved the handling of MTA without a significant reduction in setting quality.

Background: A potential specific problem of patellar tendon graft in ACL reconstruction is the possibility of graft-tunnel mismatch which could be more problematic with anatomic ACL reconstruction where the femoral tunnel is placed low on the lateral wall of the lateral femoral condyle. The occasional occurrence of this mismatch raises the question that whether a correlation exists between patient height and patellar tendon length. The purpose of the present study was to measure patellar tendon length as an anthropometric finding and to evaluate whether a correlation exists between patient height and patellar tendon length., Methods: Intra-operative measurement of patellar tendon length was carried out in 267 consecutive patients during bone-patellar tendon-bone (BTB) graft ACL reconstruction. Patient age, gender, height were recorded. The patellar tendon measurements were done independently by two surgeons and the possible inter-observer errors were checked. The data were analyzed using the Pearson correlation., Results: The mean length of the patellar tendon was 46.4 ± 4.8 mm (Mean ± SD) with a range of 32-61 mm. The mean patient height was 177 ± 7 cm (Mean ± SD) with a range of 159-197 cm. A weak positive correlations were found between patient height and patellar tendon length (Pearson r = 0.24, P< 0.001). The linear regression equation for patellar tendon length (y, in millimeters) as a function of patient height (x, in centimeters) can be expressed as y=16.54 + 0.17x., Conclusions: Our study showed a weak correlation between patellar tendon length and patient height. This finding is in contrast to the usual measurements in human anthropometry in which taller individuals have normally longer tendons and ligaments. The graft-tunnel mismatch may be the result of this variation.

Purpose: The aims of this case-control study were to assess the correlation between some food habits in the last two decades and gastric cancer in East Azerbaijan of Iran., Materials and Methods: In this hospital based case control study, 616 patients (212 gastric cancer patients, 404 cancer free patients) were recruited. Food habits of patients over the past two decades were assessed with a structured questionnaire. We used conditional logistic regression analysis for estimating crude and adjusted odds ratios (OR) and their respective 95% confidence intervals (95%CI)., Results: In this study, over-eating, consumption of high fat milk and yogurt and especial types of cheese increased the risk of gastric cancer (All<0.05). Consumption of such especial cheeses such as Koze and Khiki increased the risk of gastric cancer by 12.6 fold (95% CI:1.99-79.36) and 7.36 fold (95% CI:1.33- 40.54), respectively. In addition, high fat food, moldy food, and pickled vegetables consumption as well as reuse of cooking oil for frying were significantly associated with gastric cancer risk. Furthermore, intake of Ghorme (deep fried meat) was positively correlated with gastric cancer risk (OR:1.31;95%CI: 0.91-1.87)., Conclusions: It can be confirmed that particular food habits which have been very common in East-Azerbaijan in the last two past decades increase risk of gastric cancer. According to our results and taking into account the long latency period of gastric cancer it can be concluded that nutrition education for a healthy diet should be performed from early childhood. However, further well designed cohort studies are needed to achieve more clear results.

Objective: Dietary patterns reflect diet and nutritional habits of individuals in a society. Various dietary patterns could influence leptin and adiponectin secretion from adipose tissue. These hormones are associated with metabolic diseases. It is suggested that the leptin-to-adiponectin (L/A) ratio might be a more useful diagnostic marker in predicting chronic diseases than leptin and adiponectin separately. The aim of this study was to investigate the association between various dietary patterns and L/A ratio in Iranian adults., Methods: This cross-sectional study was conducted on 150 apparently healthy subjects aged 25-50 years in Tabriz, Iran. Dietary patterns were determined using 132-item semiquantitative food frequency questionnaire on a 5-point scale. Weight, height, waist circumference (WC), as well as fasting serum leptin and adiponectin levels were measured to assess the association between dietary patterns and L/A ratio., Results: Four major dietary patterns were identified using a factor analysis approach: Western, healthy, mixed, and traditional dietary patterns. Linear regression analysis showed that a Western dietary pattern was negatively associated with serum adiponectin concentration, even after adjusting for the confounders (r = -0.19, p = 0.02). No statistically significant associations were found between any dietary pattern and leptin (r = -0.14, p = 0.06) or L/A ratio (r = -0.10, p = 0.09)., Conclusion: Our findings indicate an inverse association between a Western dietary pattern and serum adiponectin levels but not for serum leptin or L/A ratio.

Background: The aim of this study was to compare the effects of the second- and third-generation oral contraceptives on women's reproductive sexual function., Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial was conducted on 82 married women of reproductive age in Tehran. Samples were randomized into the groups receiving second- and third-generation oral contraceptive pills. Female Sexual Function Index (FSFI) tool was used before the intervention and 2 and 4 months after the intervention. Data analysis was carried out using analysis of variance (ANOVA) within repeated measures and P < 0.05 were considered significant., Results: There was a statistically significant difference in the positive and negative moods between the experimental and control groups before the intervention in the second and fourth months. The second-generation pills caused a decrease in sexual function in the second month and an increase in sexual function in the fourth month, but the third-generation pills led to an increase in sexual function in the second and fourth months. The increase in sexual function that resulted from using the third-generation pills was significantly higher than that resulted on using the second-generation pills., Conclusions: According to the results of this study, sexual functioning decreased in the second month of using the second-generation pills and sexual performance was significantly more on using the third-generation pills compared to second-generation pills. The most common type of oral contraceptive used in Iran is the second-generation oral contraceptive LD™ (low-dose estrogen), which is freely distributed in health centers. Therefore, it is necessary for women who wish to use these contraceptive methods to be educated and consulted before they start using them. The third-generation contraceptive pills can be recommended to women who wish to use oral contraceptives.

Background: Data on the physical strength capabilities of users are essential for designing the safe and usable products., Objective: The aims of this study were to characterise the wrist ulnar/radial (U/R) torque strength and individual strength differences among Iranian population., Methods: The study was conducted among 769 (391 males, 378 females) participants aged 5-74 years in the northwest of Iran. Measurements were carried out with both dominant and non-dominant hands using a digital angle torque adaptor installed in a jar-shaped measuring unit., Results: The results indicated that the mean wrist U/R torque strength exertion by females was 75% of that exerted by males. Strength exertion with the non-dominant hand was 8% lower than strength exertion of the dominant hand. A significant positive association was also found between the wrist U/R torque strength and body mass index., Conclusions: This additional information on the wrist torque strength can fill the gap in the strength data for Iranian population, or used by health and safety practitioners in the field.

Mineral trioxide aggregate (MTA) has been used successfully for the treatment of necrotic immature teeth as part of a 2-step apical barrier. Recently, some researchers have used MTA powder instead of wet-mix MTA. It has also been used in a single-step approach in order to decrease the number of patient appointments. The aim of this study was to evaluate the bacterial microleakage of MTA powder in comparison with wet-mix MTA, in single or 2-step barrier approaches. This ex vivo study was carried out on 70 extracted single-rooted teeth. The canals were enlarged to simulate immature teeth. The prepared specimens were assigned to 4 experimental (n = 15) and 2 control (n = 5) groups. In Group 1, a wet paper point was placed in the canal following placement of wet-mix MTA. In Group 2, a dry paper point was placed on wet-mix MTA. In Group 3, the samples were treated similar to Group 1, but MTA powder was used instead of wet-mix MTA. In Group 4, the same procedures were followed as Group 3 except that a dry paper point was used. Microleakage of the samples was compared using a 2-chamber bacterial leakage apparatus. Results showed that there were no significant differences in the number of leaked samples or rate of leakage over time (P > 0.05) among the experimental groups. It can be concluded that MTA used in a single step approach has the same resistance against bacterial penetration as in a 2-step approach, and MTA powder provides the same sealing ability as wet-mix MTA.

Objectives: The study examined the predictive ability of selected demographic and socio-psychological characteristics in explaining excessive mobile phone use (EMPU) behavior and problematic use in a sample of university students on the basis of the social cognitive theory., Methods: The sample consisted of 476 randomly selected university students in Tabriz, Iran. The study was cross-sectional in nature. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to non-experimental nature of the study., Results: It was found that having boyfriend/girlfriend increases the likelihood of EMPU while self-efficacy to avoid EMPU decreases it. Self-efficacy to avoid EMPU, self-regulation, observational learning, self-control, and attitude toward EMPU were predictors of mobile phone problematic use. The results provided a proper fit for a conceptual model of reciprocal determinism., Conclusion: Although social cognitive constructs may predict mobile phone problematic use, they are not useful in predicting the behavior of EMPU., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Purpose: To investigate the long-term effect of testicular torsion on sperm parameters and testis structure in order to introduce a novel mice azoospermic model for spermatogonial stem cell transplantation., Materials and Methods: Unilateral testicular torsion was created. The animals were divided into two groups each containing 15 mice. They underwent 2 and 4 hours of unilateral testicular ischemia, respectively. All animals in this experiment were aged matched. The experimental (n = 5) groups were studied 2, 4 and 10 weeks after testicular ischemia reperfusion. Moreover, the left testes and epididymis were removed for sperm analysis and for weight and histopathological evaluation. Finally isolated spermatogonial stem cells were transplanted in the testes that underwent 2 hours of ischemia reperfusion, two weeks post-surgery., Results: All the investigated parameters demonstrated a sharp decline at 2, 4 and 10 weeks after testicular torsion, whereas 2-hour ischemia was found to be less injurious in testicular tissue structure. Two months after xenotransplantation, the transplanted cells were localized in the basal of the seminiferous tubules of the recipient ischemic testes., Conclusion: Torsion can cause permanent azoospermia in mouse. Also Testicular torsion 2 weeks after the 2 hours ischemia reperfusion may prove useful for recipient preparation for SSCs transplantation in mouse.

From environmental viewpoint, the most important advantage of compact fluorescent lamps (CFLs) is reduction of green house gas emissions. But their significant disadvantage is disposal of spent lamps because of containing a few milligrams of toxic metals, especially mercury and lead. For a successful implementation of any waste management plan, availability of sufficient and accurate information on quantities and compositions of the generated waste and current management conditions is a fundamental prerequisite. In this study, CFLs were selected among 20 different brands in Iran. Content of heavy metals including mercury, lead, nickel, arsenic and chromium was determined by inductive coupled plasma (ICP). Two cities, Tehran and Tabriz, were selected for assessing the current waste management condition of CFLs. The study found that waste generation amount of CFLs in the country was about 159.80, 183.82 and 153.75 million per year in 2010, 2011 and 2012, respectively. Waste generation rate of CFLs in Iran was determined to be 2.05 per person in 2012. The average amount of mercury, lead, nickel, arsenic and chromium was 0.417, 2.33, 0.064, 0.056 and 0.012 mg per lamp, respectively. Currently, waste of CFLs is disposed by municipal waste stream in waste landfills. For improving the current conditions, we propose by considering the successful experience of extended producer responsibility (EPR) in other electronic waste management. The EPR program with advanced recycling fee (ARF) is implemented for collecting and then recycling CFLs. For encouraging consumers to take the spent CFLs back at the end of the products' useful life, a proportion of ARF (for example, 50%) can be refunded. On the other hand, the government and Environmental Protection Agency should support and encourage recycling companies of CFLs both technically and financially in the first place., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Aims and Objectives: To determine and compare the effects of four methods of subcutaneous heparin injection on pain and bruising in abdomen and thighs., Background: Subcutaneous heparin injection is a common nursing clinical intervention. Nurses frequently inject heparin subcutaneously and this action often results in some complications such as bruising, haematoma, pain and induration in the injection site. There are also some other factors inducing complications associated with heparin injection, including the injection site and the injection duration., Design: A quasi-experimental within-subject design., Methods: This study was conducted on 90 patients with COPD hospitalised in two ICU wards at two teaching hospitals in urban areas of Iran. They were administered heparin subcutaneously, 4000 units every 12 hours. Each patient received four injections in their abdomen and thighs, using four different methods. The number and size of bruising at the injection site were measured through a flexible millimetre ruler, 48 hours after each injection. The severity of pain was measured through pain visual analogue scale immediately after each injection. Collected data were analysed by descriptive and analytical statistics using spss 11.5 software., Results: In the method 15 seconds injection duration and waiting for 5 seconds before withdrawing the needle, the number of bruising was significantly lower and size of bruising was significantly smaller, but no significant difference was found in the severity of pain. However, in other methods, the severity of pain in thighs was significantly higher than in abdomen, but no statistically significant difference was reported between the size and number of bruising in abdomen and thighs., Conclusions: The method 15 seconds injection duration and waiting for 5 seconds before withdrawing the needle is recommended to be used for subcutaneous heparin injection by clinical nurses. As to the results, the severity of pain in abdomen was lower than in thighs., Relevance to Clinical Practice: This study proposed a suitable method for subcutaneous heparin injection in order to reduce pain and bruising., (© 2013 John Wiley & Sons Ltd.)

Objective: To investigate vitamin D status and its association with components of the metabolic syndrome (MetS) in adolescent girls attending high school in Boukan, Iran during winter 2012., Design: A cross-sectional study., Setting: High schools of Boukan city, Iran., Subjects: A sample of 216 girls aged 14-17 years was selected by multistage random sampling from four districts of Boukan. Weight, height, waist circumference, blood pressure, daily energy intake, physical activity and serum 25-hydroxyvitamin D (25(OH)D), fasting blood glucose, TAG and HDL-cholesterol levels of all participants were evaluated. Serum 25(OH)D level <20 ng/ml was defined as vitamin D deficiency., Results: Mean serum 25(OH)D was 7.26 (sd 2.81) ng/ml and 96 % of the participants had vitamin D deficiency. According to age-modified definitions of the National Cholesterol Education Program Adult Treatment Panel III, MetS was diagnosed in 10.6% of the participants. In multivariable regression analysis after adjustment for BMI, energy intake and physical activity level, serum 25(OH)D was inversely associated with fasting blood glucose (β = -0.143, P = 0.04). No significant relationship was found between serum 25(OH)D and other components of MetS., Conclusions: The high prevalence of vitamin D deficiency warrants national polices and interventions towards improving this major health problem among adolescent girls. Low 25(OH)D level was significantly associated with increased fasting blood glucose. Prospective studies are needed to determine the effects of vitamin D deficiency on the development of MetS and related metabolic diseases in adolescent girls.

Background: Breast cancer is the most common female malignancy in the world. Beta glucan can be a hematopoietic and an immune modulator agent in cancer patients. The aim of this trial was to determine the effect of beta glucan on white blood cell counts and serum levels of IL-4 and IL-12 in women with breast cancer undergoing chemotherapy., Materials and Methods: This randomized double-blind placebo-controlled clinical trial was conducted on 30 women with breast carcinoma aged 28-65 years. The eligible participants were randomly assigned to intervention (n=15) or placebo (n=15) groups using a block randomization procedure with matching based on age, course of chemotherapy and menopause status. Patients in the intervention group received two 10-mg capsules of soluble 1-3, 1-6, D-beta glucan daily and the control group receiving placebo during 21 days, the interval between two courses of chemotherapy. White blood cells, neuthrophil, lymphocyte and monocyte counts as well as serum levels of IL-4 and IL-12 were measured at baseline and at the end of the study as primary outcomes of the study., Results: In both groups white blood cell counts decreased after 21 days of the intervention, however in the beta glucan group, WBC was less decreased non significantly than the placebo group. At the end of the study, the change in the serum level of IL-4 in the beta glucan group in comparison with the placebo group was statistically significant (p=0.001). The serum level of IL-12 in the beta glucan group statistically increased (p=0.03) and comparison between two groups at the end of the study was significant after adjusting for baseline values and covariates (p=0.007)., Conclusions: The findings suggest that beta glucan can be useful as a complementary or adjuvant therapy and immunomodulary agent in breast cancer patients in combination with cancer therapies, but further studies are needed for confirmation.

Purpose: Breast cancer is the most common malignancy of women worldwide. Radiotherapy consists of a vital element in the treatment of breast cancer but relative side effects and different radioactive responses are limiting factors for a successful treatment. Doxorubicin has been used to treat cancers for over 30 years and is considered as the most effective drug in the treatment of breast cancer. There are also many chronic side effects that limit the amount of doxorubicin that can be administered. The combined radio-drug treatment, with low doses, can be an approach for reducing side effects from single modality treatments instead of suitable cure rates., Methods: We have studied the effect of 1, 1.5, and 2 Gy doses of 9 MV X-rays along with 1 µM doxorubicin on inducing cell death, apoptosis and also p53 and PTEN gene expression in T47D and SKBR3 breast cancer cells., Results: Doxorubicin treatment resulted in upregulation of radiation-induced levels of p53 and downregulation of PTEN at 1 and 1.5 Gy in T47D breast cancer cells, as well as downregulation of p53 mRNA level of expression and upregulation of PTEN mRNA level of expression in SKBR3 breast cancer cell line. In addition, doxorubicin in combination with radiation decreased the viability of breast cancer cell lines in the both cell lines., Conclusion: Low doses of doxorubicin, with least cell toxicity, may be an effective treatment for breast cancer when used in conjunction with ionizing radiation.

A field study was conducted to evaluate the illumination levels, to examine the effect of lighting conditions (including lighting characteristics and disturbances) on employee satisfaction, job performance, safety and health, and to compare the employees' perception of lighting level with actual illuminance levels in a hospital setting using both questionnaire and physical illuminance measurements. The illumination levels varied across different locations within the hospital and were lower than standards for 52.2% of the workplaces surveyed. Most respondents indicated that at least one of the four lighting characteristics (i.e. light level, type of light sources, light colour and use of daylight) was inappropriate, and that at least one of the three lighting disturbances (i.e. flickering lights, glare and unwanted shadows) was a major disturbance to them. The employees' perceptions of illuminance generally reflected the actual illuminance levels. The more appropriate maintenance or installation of lighting fixtures was rated as the most appropriate for improving lighting. The findings suggest that environmental ergonomics should be given a more prominent role in hospital building and workplace design to support safer healthcare facilities (for staff and potentially for patients)., Practitioner Summary: Good lighting is essential to improve employee performance, health and safety. The findings suggest that quantitative physical measurements should be supplemented by qualitative subjective assessments to provide a more holistic approach where specific details about the lighting condition in each working environment are incorporated from the workers' perspective.

E-waste is one of the fastest-growing waste streams in Iran, owing to an increase in consumption of electrical and electronic equipment. Nevertheless, as is the case in some other countries, E-waste management has not received sufficient attention. For the successful implementation of any waste management plan (including an E-waste management plan), the availability of sufficient and accurate information on the quantities and composition of the waste generated and on current management conditions is a fundamental prerequisite. At present, in Iran, there is no available and accurate information that describes the characteristics and generation rate of E-waste or the actual practice of management and handling of the waste. For this initial study, eight electronic products were selected for the determination of their E-waste generation rate in the country, and two cities, Tehran and Tabriz, were selected for assessment of the current condition of E-waste management. The study found that the amount of E-waste generation in the country for the eight selected electronic items alone was 115,286, 112,914 and 115,151 metric tons in 2008, 2009 and 2010, respectively. Of the types of electronic items included in the study, televisions, with an average of 42.42%, and PCs, with an average of 32.66% accounted for the greatest proportions of the total mass of E-waste generated during 2008-2010. Currently, despite the fact that primary legislation for E-waste management (as part of general waste legislation) exists in Iran, this primary legislation has not yet been implemented. In practical terms, there is no definite policy or plan for the allocation of funds to prepare suitable equipment and facilities for the management and recycling of E-waste at the end of the products' useful life. Proposed improvements in current conditions are identified, first by considering other countries' experiences and then suggesting specific practical policies, rules, and regulations that should be established and applied to all levels of E-waste management. One of the most attractive E-waste management policies is an extended producer responsibility (EPR) programme in combination with a training programme at different levels of society. An approach consisting of a mandated product take back is proposed for implementing EPR in Iran. Meanwhile, the Health Ministry and the Environmental Protection Agency should strictly supervise E-waste collection, storage, and recycling and/or disposal, and the Trade and Industry Ministries must have more control over the import and production of electronic goods.

Introduction: Root fracture is not an instant phenomenon but a result of gradual development of tiny craze lines in tooth structure. Recent studies have shown that canal instrumentation has the potential to cause dentinal cracks. The purpose of this study was to evaluate and compare the formation of dentinal cracks caused by ProTaper rotary system to hand instrumentation., Materials and Methods: This in vitro study was carried out using 57 mandible incisor teeth. The teeth were decoronated. The roots were then examined to exclude cracked samples. A standard model for PDL simulation was used. The teeth were randomly divided into two experimental and one control group (n=19). The teeth in the experimental groups were prepared using hand or ProTaper Universal rotary instrumentation. The teeth in the control group were left unprepared. The teeth were then sectioned horizontally 3 and 6 mm from the apex, and the number of various dentinal defects was recorded using a dental operating microscope. The differences between groups were analyzed with Fisher's exact test., Results: The hand group demonstrated significantly more defects than the control group (P=0.001). However, there was no significant difference between the rotary compared to the control and hand groups (P>0.05). There was no significant difference between groups with regards to fracture (P>0.05). Other defects including internal, external and surface cracks were more frequent in the hand than in the control or rotary groups (P=0.02), but the difference was not significant between the rotary and control groups (P>0.05)., Conclusion: Canal preparation, whether hand or rotary, produces structural defects in dentin. The ProTaper rotary system when used according to the manufacturer's instructions, tends to produce fewer cracks and can be considered a safe preparation technique.

Objective: To evaluate the impacts of using SMS on improving laboratory test levels and Knowledge, Attitude, Practice (KAP) and Self Efficacy (SE) of patients with type 2 diabetes mellitus (DM) in Iran., Materials and Methods: In this randomized controlled trial study, a total of 81 type 2 diabetes patients were randomly assigned into two groups exp. group (n = 43) and cont. group (n = 38). Only exp. group received 4 messages weekly consisted of diet, exercise, medication taking and. The researchers provided the intervention for 12 weeks. Data were collected with results of laboratory tests and KAP, SE reliable and valid questionnaires and demographic characteristics list. Data gathering at the baseline of the study and after 3 months intervention and was analyzed by SPSS11.5 software using descriptive and inferential statistics methods., Results: The results of this study showed that exp. group compared with cont. group improved significantly in HbA1C (p = 0.024), LDL (p = 0.019), cholesterol (p = 0.002), BUN (p ≤ 0.001), micro albumin (p ≤ 0.001), knowledge (p ≤ 0.001), practice (p ≤ 0.001) and self efficacy (p ≤ 0.001)., Conclusion: The finding of this study demonstrate the effectiveness of intervention using SMS via mobile phone in the management of type 2 diabetes mellitus (DM). Thus, further studies are recommended for wide usage of distance education with mobile phone utilization.

Medical waste management (MWM) is an important public health concern worldwide. Although physicians must participate in medical waste management, their personal and organizational predictors in this process are unknown. This study aimed to the determinants of physicians' knowledge, attitudes and practices related to MWM in eight hospitals of Mazandaran province, northern Iran. A validated, reliable self-administered questionnaire was used including 30 questions about the respondents' knowledge, attitudes and practices (KAP) and personal and professional variables. Of a total of 200 physicians, 150 persons completed the questionnaire (response rate of 75%). The average score (± SD) for physicians' knowledge was 6.50 (± 1.50) out of 10, whereas those for attitudes and practices were 4.44 (± 0.88) and 4.02 (± 1.35) out of 5, respectively. Surgeons and orthopaedists had the lowest scores, whereas para-clinical specialists and internal medicine specialists had the highest scores. The score of knowledge showed significant differences among speciality groups and the various speciality groups' scores differed significantly only for knowledge (P = 0.024) and the mean of total KAP was significantly different between educational and non-educational hospitals (P < 0.05). As hospital type and physician speciality was related to the KAP concerning MWM, therefore it is recommend that all hospitals should develop appropriate protocols for medical waste management based on the this variables using a participatory process with teamwork and continuous training.

This study aimed to compare the in vitro effects of coculture with Sertoli and SIM mouse embryo-derived thioguanine- and ouabain-resistant (STO) feeder layer cells on the efficiency of adult mouse spermatogonial stem cells (SSCs) colony formation. Sertoli and SSCs were isolated from testes, and their identity was confirmed using immunocytochemistry against Oct4, CDH1, PLZF and C-kit for SSCs and vimentin for Sertoli cells. SSCs were cultured in a simple culture system (control group) and on top of the Sertoli and STO feeder layers for 2 weeks. The number and diameter of colonies were evaluated during third, 7th, 10th and 14th day of culture, and the expression of the Oct-4, α6 and β1 integrins was assessed using quantitative RT-PCR. Significant differences were observed between the three groups, separately for each time (P < 0.05), with higher mean in number and diameter for Sertoli cells (P < 0.05). The results of RT-PCR showed higher gene expression of β1 integrin in Sertoli group, but no significant differences were observed in Oct-4 and α6 integrin gene expression among the three groups. Based the on the optimal effect of Seroli cells on the colony formation of SSCs, it is suggested to use these cells for better colonisation of SSCs., (© 2011 Blackwell Verlag GmbH.)

Background: The ability of mineral trioxide aggregate (MTA) to strengthen the tooth structure has been studied with contradictory results, and there is a lack of data in the case of Calcium-enriched mixture (CEM) cement as a novel endodontic biomaterial. The aim of the present study was to evaluate the reinforcing effect of MTA and CEM cement on simulated immature teeth., Materials and Methods: This ex vivo study was carried out on a total of 46 human maxillary incisors. Access cavities were prepared. Five teeth were randomly selected as negative control. The root length of the remaining teeth was standardized to 9 mm. Rotary files and peeso reamers were used to enlarge the canals. The prepared specimens were randomly assigned into three experimental (n = 12) and a positive control (n = 5) groups. In groups 1 and 2, the canals were filled with MTA or CEM cement, respectively. In group 3, a 5-mm MTA plug was placed, and the remainder of the canal was filled with composite resin. The canals of the positive control were kept unfilled. After 6 months, the teeth were tested for fracture strength in a universal testing machine. The groups were compared using Univariate analysis of variance (ANOVA)., Results: There were significant differences between fracture strength of experimental groups with that of both control groups (P<0.05). However, the differences among the three experimental groups were not statistically significant (P>0.05)., Conclusion: After 6 months, MTA and CEM cement exhibit distinct reinforcing effect on immature teeth.

Background: This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children., Methods: A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted., Results: The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses., Conclusions: The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran.

Excess body weight is a cardiovascular risk factor. The relationship between anthropometric indices and cardiovascular health is not completely understood. Carotid Intima-Media Thickness (CIMT) is a subclinical marker of atherosclerosis. This study aimed to investigate the best anthropometric obesity indicator for diagnosis of initial stage of atherosclerosis by CIMT. This cross-sectional study included 100 adult women, aged 18-50 years. Anthropometric indices were measured with standard protocol and CIMT was measured by non-invasive ultrasound. Receiver Operating Characteristics (ROC) curve analysis was carried out to determine the optimal cut-off values of anthropometric indices, and the best indices for atherosclerosis diagnosis. On ROC curve analysis the suggested appropriate cut-offs of waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), body mass index (BMI) and percentage body fat (%BF) were 96 cm, 0.86, 0.64, 31.29 kg/m² and 30.42%, respectively. The area under the ROC curve of BMI (AUC=0.74, 95%CI=0.62-0.86) and WHtR (AUC=0.74, 95%CI=0.63-0.85) were greater than other anthropometric indices. The AUC for WHR was the lowest among the studied obesity indices AUC=0.68 (95% CI=0.54-0.81). In our study, WHtR and BMI were the best diagnostic parameters of initial stage of atherosclerosis while WHR was the worst based on AUC.

Background: With regard to the willing and starting tobacco smoking among young people in Iran. The aim of the study was to model the underlying factors in predicting the behavior of tobacco smoking among employed youth and students in Iran., Methods: In this analytical cross-sectional study, based on a random cluster sampling were recruited 850 high school students, employed and unemployed youth age ranged between 14 and 19 yr from Iran. The data of demographic and tobacco smoking related variables were acquired via a self-administered questionnaire. A series of univariate and multivariate logistic regressions were performed respectively for computing un-adjusted and adjusted Odds Ratios utilizing SPSS 17 software., Results: A number of 189 persons (25.6%) were smoker in the study and the mean smoking initiation age was 13.93 (SD= 2.21). In addition, smoker friend, peer persistence, leaving home, and smoking in one and six month ago were obtained as independent predictors of tobacco smoking., Conclusions: The education programs on resistance skills against the persistence of the peers, improvement in health programs by governmental interference and policy should be implemented.

Background: This study aimed to investigate the relationship between health Related quality of life (HRQOL), motor ability and weight status in children., Methods: Two hundred forty children ages 9-11 yr who were selected via multi stage cluster sampling design from primary schools in the Shahre Qods at Tehran, Iran in 2007. HRQOL was assessed by the pediatric quality of life inventory (PedsQL). Motor abilities were determined by a Basic Motor Ability Test (BMAT). Body mass index was calculated to determine weight status., Results: Psychosocial, physical, and total health related qualities of life (all P< 0.05) were significantly lowered for obese when compared to normal weight participants. In contrast, the mean scores for each HRQOL domain in motor ability category were not significant. No significant interaction was apparent when examining HRQOL scores, BMAT variables and weight status., Conclusion: Regardless of motor ability levels, reducing body weight among children is a potential avenue for promoting improved HRQOL. Over weight boys reported significantly worse school performance than over weight girls, suggesting the importance in considering such dimensions in programs aimed at further understanding obesity in children.

Aim: The aim of this study was to compare prognostic factors between colon and rectal cancers., Background: Prognosis of Colorectal Cancer (CRC) may depend on the anatomical site., Patients and Methods: A total of 1219 patients with CRC diagnosis according to the pathology report of RCGLD cancer registry, from 1 January 2002 to 1 October 2007, were entered into the study. Demographic and clinico-pathological factors were analyzed using survival analysis., Results: From age at diagnosis, colon cancer had significantly better survival than rectal cancer (Multivariate Hazard Ratio (MVHR)=0.24; 95% Confidence Interval (CI) =(0.074-0.77)). Other factors, including marital status (MVHR =1.78; 95% CI =(0.33-9.62)), body mass index (BMI) (MVHR =1.21 and 1.54; 95% CI =(.30-4.85) and (.44-5.4) respectively for < 18.5 and >30 BMI groups), pathologic stage (MVHR =.64; 95% CI =(.21-1.98)) and alcohol history (MVHR =4.86; 95% CI =(.67-35.14)) were not significantly different between the two patient group but suggested a possible effect upon prognosis. Overall survival in rectum was better than that of colon., Conclusion: Our findings support this hypothesis that prognosis of CRC varies with tumor site.

Background: With a background of disparities in colorectal cancer (CRC) incidences/mortality across countries due to differences in exposure to various prognostic factors, this study aimed to evaluate the site-specific pattern for the survival of colon and rectal patients., Methods: A total of 1,283 patients with CRC diagnosis according to the pathology report of cancer registry of RCGLD from 1 January 2002 to 1 October 2007, were entered into the study. Data were analyzed using univariate and multivariate competing risk survival analysis., Results: Survival proportion of patients showed a significant trend for 1, 3 and 5 year survival in colon cancer (P< 0.001) but this wasn't significant for rectal cancer (P=0.078). Tumor grade and pathologic stage were the most important factors predicting the survival in colon and rectal cancers with stronger hazard in the rectal site for grade and stronger hazard in the colon site for stage. For colon site, in the well and moderate categories of tumor grade, shifting from early to advance stage and also shifting in tumor grade from well and moderate categories to poor tumor grade had a considerable effect in hazard ratios. For rectum site, well to moderate shifting in tumor grade increased the hazard of death and shifting from early to advance stage increased the hazard equal to 2.54 and 4.36 times within the well and moderate tumor differentiation, respectively. In shifting to advance CRC, colon site had generally worse hazard than the rectum., Conclusion: Due to the worse conditions of CRC patients as shifting to advance cancer, to improve the effectiveness of treatment and hence the survival of Iranian patients, we should pay more attention to early detection, in particular by implementing population based screening programmes.

Background: Gastric cancer (GC) is one the most common causes of death worldwide. Despite the decreasing rate of GC in the world through recent years, it is still the most common cancer in men and the fourth in the general population in Iran. This study aimed to assess the survival of patients with GC and to determine prognostic factors., Materials and Methods: A total of 471 patients with GC were followed from 21 March 2003 to 21 March 2007 in the Cancer Institute of Imam Khomeini Hospital. The patients' survival rate was determined by periodical refers. The survival period considered as the time from diagnosis up to death or the end of the study. The effects of gender, age at diagnosis, tumor site, pathologic stage of disease, type of treatment used, and metastasis were evaluated by log-rank test in a univariate analysis. In addition, all the variables were evaluated simultaneously by the Cox proportional hazard (PH) model. Data were analyzed using SPSS 16 software., Results: 357 (75.8%) out of 471 patients were male and 153 cases (32.5%) experienced death. The mean and median ages at diagnosis were 58.5 and 60.7 years respectively. Also, the survival mean and median were 41.8 ( 3.1) and 27 (1.7) months respectively. Gender, type of treatment, pathologic stage, the degree of differentiation were significantly related to survival., Conclusions: There was a potential effective role of age at diagnosis, gender of patients and pathologic stage of disease in cancer therapy in this part of Iran. Therefore, to reduce the risk of death in patients with GC, early diagnosis of patients at a younger age and also in primary stages must be targeted.