Search

Background: Dysmenorrhea is a major individual and public health problem in women. Recently, according to the high prevalence of dysmenorrhea, different medical treatments including herbal medicines have been used. Objective: The aim of this study is to evaluate the effect of ginger on dysmenorrhea severity in students in Qazvin University of Medical Science, Iran. Methods: In this randomized clinical trial, 100 female students aged 18 to 25 years with moderate to severe dysmenorrhea were included. The participants were allocated to two groups of control and intervention by randomization. The intervention group were received 500 mg of ginger tablet and 250 mg of Mefenamic Acid capsule twice a day and the control group took placebo and Mefenamic Acid 250 mg capsule two times a day from two days before and within the first three days of the onset of the Menstrual period. Pain intensity were measured with VAS tool before and two months after the prescription of drugs. Results: The results of our study showed the pain intensity after the intervention in the first month, was significantly less than the control group (3.72 vs 5.44) (P

Background & Aims: Obesity which is produced due to excessive accumulation of fat in body compartments could result from imbalance between intake and consumption of energy and is related to the food habits of each person. The aim of this study was to assess obesity and its relationship with female adolescents’ food habits in Tehran. Material & Methods: It was a predictive correlational study. The sample consisted of 385, 14-18 year old female students in west of Tehran. The students were recruited by multistage random sampling. Data was collected by Food Frequency Questionnaire, caliper, tape measure and measurement scale and analyzed by ANOVA, Pierson correlation and multiple regression tests using SPSS-PC (v.14). Results: According to the findings, %18 of the students were overweight and obese based on Triceps skin fold thickness and %15 were overweight and obese based on body mass index. Frequency of daily consumption of bread and cereals, rice, fat, soft drinks and egg among overweight and obese students were significantly higher than other groups (p

Background & Aims: Self- efficacy is closely related with different dimensions of the elderly life such as their health and quality of life. This study was conducted with the aim of determining the self- efficacy of the elderly living in rest homes and its relationship with their personal characteristic in west Tehran. Material & Methods: It was a descriptive, cross- sectional study. The sample consisted of 100 above 60 years old males and females elderly who were living in rest- homes of west Tehran for six consecutive months at least. Sample selection was done using stratified sampling with proportionate allocation during 2010. Data collected with GSE-10 and analyzed using T-test, ANOVA, Shefe exact test, and Regression analysis with SPSS (v.16). Results: The mean score for general self- efficacy was 21.44±3.83 (of maximum of 40 according to GSE-10). ANOVA showed that the difference between the three age groups of 60-70, 71-80, and about 81was significant (p=0.001). Self- efficacy of men was more the women (p=0.003). There was a significant relationship between the elderly self- efficacy and their education (p=0.05), and duration of living in rest- homes (p=0.011). Linear regressions showed that the general self- efficacy was mostly related with sex (β1.54, p=0.004). Conclusion: Regarding the low level of self- efficacy of the elderly living in the rest- homes, especially the women, more attention should be paid to promotion of their self- efficacy, by heath care professionals. Interventional studies is recommended to assess the effect of appropriate programs on the elderly self- efficacy

Background & Aim: Breast feeding is the most important and decisive factor in Children’s state of health and nutrition, especially in societies with lower socio-economic status. Beastfeeding plays an important role in child health and development. Acordingly this study was carried out with the aim of determining the ralationship between breastfeeding and child weigth gain up to the end of 24 months of age. Material & Methods: It was a correlational predictive study. The sample consisted of 307 mothers of 2-3 years old children who have been visited for monitoring their children’s growth in heath canters of west of Tehran. They were recruited by stratified sampling method. Mothers & children’s data was collected by questionnaire & analyzed using SPSS-PC-(v.10). Results: pearson correlation test indicated that there is no significant relationship between breastfeeding duration & children’s weight in 6 and 12 months of age. However, there was a converse significant relationship between breastfeeding duration and the children’s weight in 24 months of age (p=0.003). There was also a significant relationship between the children’s sex and their weight in 6, 12 and 24 months of age (p=0.000). No significant association was found between children’s weight in 6, 12 and 24 months of age and mothers’ age, number of deliveries, mothers’ level of education and job status, participation in educational courses for breast feeding, and the time of breastfeeding initiation after delivery. Conclusion: children fell within normal limits for weight when breastfeeding duration was longer and vice versa. Regarding the undesirable effects(eg. malnutrition and obesity) of shortening the breastfeeding period on child health, provision of support as well as education about breastfeeding continuation is recommended

Background and Aims: In recent decades reduction in physical activity had become as one of important factors in increasing obesity in all people especially in adolescents. The aim of this study was to determine relationship between physical activity and triceps skin Fold Thickness in adolescent girls. Material and Method: It was an anticipational correlational study. Three hundred eighty five girls in high school were selected randomly. They neither had known physical/mental diseases, nor were engaged in sport teams. They also had not special diets. Data collection was done by IPAQ (short form) and caliper. Analysis was done by ANOVA, Chi square, and Spearman correlation using SPSS - PC (14version). Results: Data indicated that almost half of student had low physical activity and according to triceps skin fold thickness they were included in over weight and obess group. However, no significant correlation was seen between physical activity and skin fold thickness. Conclusion: Although there was no correlation between Physical activity and obesity, but systematic programs to enhance adolescent’s activity and to promote their health could be commended.

Background and Aim: Rapid infant weight gain has been shown to predict later obesity risk however, it is unclear which factors influence infant diet and weight gain. The purpose of this research was to examine the relationship between body mass index before pregnancy and weaning the child to the end of the age 24- months. Material and Method: This is a correlational study in which 307 mothers of children aged 2-3 years were selected fro/ Tehran West Health Center. stratified sampling method was used and data were collected by questionnaire and mothers' and children's records. Results: There was not a statiustically significant relationship between the body mass index before pregnancy and weaning children at the age of six months. ANOVA statistical test (p=0.02 and p≤0.0001) indicated that there was a statistical significant relationship of the child weaning at the ages of 12 and 24 months with the body mass index before pregnancy. Also, t- test showed that there was a statistical significant relationship between the sex of the child and weaning at the ages of 6,12 and 24 months (p≤0.0001). Conclusion: There is definitely a significant relationship between body mass index and child weaning at the ages of 12 and 24 months. Maternal behaviors shape many aspects of children's development. As a result, it is necessary that obese and overweight mothers receive education and counseling to prevent obesity in their children.

Background & Aim: Breast feeding promotes the child health. World Health Organization recommends breast feeding to be continued till the end of 2 years old, but, sometimes, the process of breastfeeding stops earlier in mothers bearing an excess weight. The mother with excess weight has less successful effort than the others in feeding the babies with their own milk. The aim of this study was to determine the relation between body mass index before pregnancy and durationm of breast feeding. Material & Method: This was a correlational study. Sample consited of 307 mothers who had children with 2-3 years old and had been visited in Tehran West Health Center for their children growth monitoring. The subjects were selected based on stratified sampling method and data was collected by questionnaire and from medical records. Results: This study showed a statistically significant relationship between body mass index and duration of breast feeding (P=0.002). Among different indicators, the type of delivery and the time of the first breasteeding were of greater importance and left a significant impact (P

Background & Aim: Women’s satisfaction from prenatal care, can lead to increase using the services and ultimately improve pregnancy outcomes. The purpose of this study was to investigate the relationship between women’s satisfaction with prenatal care services and demographic characteristics of the pregnant women. Material & Method: This study used a descriptive correlational design. Data collection instrument was a questionnaire. The satisfaction dimensions were the accessibility, coordination, communication of the personnel, availability, and the received information regarding prenatal care, quality, and the cost of the services.The study subjects consisted of 530 Iranian women living in the west of Tehran, who gave birth and attended to the health clinics, at 6 week postnatal period. Results: Most of the women (69.8%) had good level of satisfaction with provided prenatal care and 21.9% were satisfied at the level of excellence. The women were more satisfied with accessibility, received information, communication, quality of services. There was a statistically significant positive association between education levels, economical status, and health situation during pregnancy and women’s satisfaction with prenatal care services (P

Background & Aim: Monitoring of patients' temperature is an important nursing clinical procedure. Body temperature is usually taken at different sites including pulmonary artery, rectal, oral, and axillary areas. Currently, infrared tympanic temperature measurement method is increasingly used as a convenient, noninvasive and rapid method. However, accuracy and precision of this method has been questioned. The aims of this study were (a) to determine accuracy and comparing tympanic temperature with rectal temperature as a gold standard and (b) to determire Precision (Repeatability) of tympanic temperature with single measurement. Material & Method: This was a descriptive-comparative study with the sample size of 336 subjects, executively selected from the patients who admitted to Rasool Akram Hospital in Tehran. The patients were 16-85 years old. The tympanic temperatures were measured using the Braun ThermoScan type 6020 and the rectal temperatures were measured using the type M9380226 that both thermometers had 0.1 ºC internal error. The tympanic temperatures were measured twice per side with 1 minute of cooling off in each subject. Result: Paired t-test showed that there was statistical difference between right and left tympanic temperature with rectal temperature (P

Premarital health counseling for couples, especially in females is very important in community's health. In the premarital counseling, females are educated regarding reproductive health, such as methods of prevention of breast and cervical cancer that helps to family health promotion. The aim of this study, was to determine the effect of premarital health counseling on the females' awareness towards methods of prevention of breast and cerviced cancers. This study was a quasi experimental design. The aim of the study was to determine the difference of the subjects' awarness about methods of prevention of breast and cervical cancer at preintervention and post intervention. The mean & standard deviation of the achieved scores related to the awarenss were calculated. The sample size was 600 subjects who were attending in premarital health counseling program in selected health centers. The sampling method was consequence and the study tool was a questionnaire. The study finding, showed that the mean and standard deviation of samples’ age was 21.82 ± 3.94 and 47.4%. The majority of the subjects had a level of diploma degree in education and, 76.6% were housewives. The differences between the mean of their scores of the subjects' awarences in the two groups (who participated in the counseling and who did not) were significant (P

Prognancy is a natural process which may create some changes in different parts of body, such as oral and dental systems. The changes might lead to oral diseases if sufficient and permanent care is not provided. For example, improper nutrition, covert oral and dental problems can affect the health of dental organ and even the other parts of body. The aim of the study was to determine the relationship between awareness, attitude and practice of pregnant women regarding oral and dental care during pregnancy. The study sample consisted of 320 pregnant women in their 28th -42th week of pregnancy. In this study the stratified random sampling was used. The results showed that, 5.6% of the subjects had high awareness toward dental hygiene, whereas 65.9% and 28.4% of the women had moderate and low level of awareness respectively. In addition, 30% of the subjects had positive attitude toward dental care, whereas the majority (70%) had negative attitude. Regarding the performance of oral and dental care, only 34.4% had good practice. According to the results of the analysis, of variance there were correlation between variables of the awareness and attitude, awareness and practice and finally attitude and practice of the subjects (P=0.000). Also the correlation coefficient between the variables of awareness and attitude was more than the others (r=0.512). Based on the study findings, the investigators recommend that pregnant women should be educated effectively regarding oral and dental health awareness that might lead to good attitude and practice toward them. In addition it is recommended that the reasons of noncompliance of women toward dental higiene and not receiring dental care, should be assessed in future studies.

Pregnancy induced hypertension has impacts on birth weight in different gestational ages, and deciding on preventive modalities is mainly based on comprehension of birth weight in different gestational ages. To approach this objective we performed a comparative retrospective study and compared the birth weight of neonates of mothers with and without pregnancy induced hypertension in different gestational ages with the participation of 250 hypertensive and 458 nonhypertensive mothers. Finding revealed significant differences between hypertension in pregnancy and birth weight in 36th and 37th weeks of gestation (P=0.15) and (P=0.019) respectively. The differences varied according the number of pregnancies, for instance, meanwhile, for nulliparas in 36th, 38th, 39th and 41st weeks, it was respectively, (P=0.008), (P=0.022), (0.033) and (P=0.49), in multiparas, with less that 5 pregnancies in 39th week the P value was (0.49), but in women with 5 and/or more pregnancies there was not any significant differences. According to the findings pregnancy-induced hypertension will results in fetal low weight in different weeks of gestation. So, the researchers recommend useful services to be provided in different weeks of pregnancy.

Disabled women as well as those without disability have the right to receive reproductive health care services. Since women with mobility impairment face diverse obstacles in receiving reproductive health care, reviewing these services received by them is of grate importance. Determining the reproductive health care services received by women with mobility impairment during disability period, we conducted a descriptive study in which questionnaires were used to collect the data, and the investigation was done on 241 handicapped women, ranged in age from 15-49 and all, members of Iranian handicapped society. The results revealed that 2.9% of the sample group had received sexual counseling before and after marriage, and less than half of them had participated in the family planning care service with all elements (except weight measuring and first visit pelvic exam). All elements of prenatal care (except blood and urine tests) were done for less than 40% and for 35% of the participants prenatal recommendations (except nutrition and breast feeding) were considered, Furthermore, all periodical prenatal care (except dentist visit) were done for about 60% -75% of disabled women and those who had Pap smear tests, breast self exam instructions, and breast physical exam by health staff were respectively 14%, 4.6% and 6.2%, besides, mammography was done for nobody in the group of more than 40 years old. Overall, according to the results it is estimated that only a small percentage of women with mobility impairment received reproductive health care. Therefore, further studies to explore obstacles faced by disabled women are recommended. Also it is suggested that available necessary services for cited citizens to be provided.

Undoubtedly, the time that women spend for household physical activities is varied in different countries. They do shopping, cooking, dish and cloth washing, child care, general cleaning, bed making, painting and etc. while, there is no standard time for doing household physical activities, it is important that employed women pay attention to their leisure time and self care. To assess the kind and time of household physical activities in employed women a cross sectional study was carried out with 300 women selected through stratified and random sampling method and data were gathered through questionnaires. Finding indicated that the mean of hours women spent for household activities within a week was 29.58. Most of the contributors said that they spent time on cooking, dish washing, organizing their houses and shopping. We found a significant relation between the mean of hours and age, marital status, the age of the last child and body mass index (B.M.I) (P=0.000), it means that the mean of hours was less in women between 19-29 years of age, B.M.I

Background : The knowledge of women about methods of cooking food materials is very important in keeping family members healthy. Objective : To assess the knowledge of women who live in ray city about methods of cooking food materials. Design : This was a field study in which the knowledge of women about cooking food materials were determined by using a questionnaire. Samples : 200 women who were living in ray city and were responsible in preparing food for their families. Were selected randomly in two sequence. Results : The findings indicated that only 18.5% of women had a good knowledge about cooling food materials. Conclusion : According to research findings it is recommended to use different strategies to improve women's knowledge about preparing food for their families. Also similar researches in different social groups or in rural and urban women will help to use better strategies.

Background : Heart failure is a chronic disease with relapsing nature. As a result the recurrent hospitalization of patient with heart failure has become a major topic of discussion in the field of health care. Various studies has shown that home visit exert a positive influence on readmission and mortality rate in these patients. Objective : To determine the effect of home visit on readmission rate in patients with cardiac failure. Design : This was a field trial with control group. Three home visits were carried out in the cases but not in the control group over a six-ninth period. At the end, the number of admission in the two group were compared. Samples : 100 patients diagnosed with heart failure were enrolled by continuous sampling into the study and then distributed into 50 cases and 50 controls. Results : Result indicated that the case group experienced fewer readmission during the 6month period of the study than the control group the difference being statistically significant [z=2.096and p= 0.044]. Hospital stay was also shorter in cases than in controls, the difference again being statistically significant [t=20.39 and p= 0.017]. Discussion : The result showed that home visit lead to a reduction in rehospitalization rates in patients with heart failure. Therefore, it is recommended that regular, systematic home visit can lessen complications and prevent deterioration of the disease, thereby reducing re-admission rates in these patients.

One of the most serious kinds of hepatitis is hepatitis B. This condition is more common than AIDS, and is 100 time more contagious. In Iran the most common cause of acute and chronic hepatitis, liver cirrhosis, and also hepatocellar carcinoma in adults, is hepatitis B. more than two billion people are infected and more than 350 million of individuals are carriers of this virus in the entire world. The carriers are main source for distributing virus in communities and annually at least, one million people in the entire world die because of this virus and its complications. According to studies in Tehran, 3.6 percent of men, and 1.6 percent of women, are carriers of Ag HBs, and also 37 percent of volunteers for blood donors have antibody of HBs Ab in their blood. This situation shows that almost 40 percent of Iranians have been contacted to this virus, but of them, 3 percent remained the carriers of antigen.

Background: Many researchers believe that exercise during pregnancy positively effects normal delivery, controls babies' weight and reduced the length of labor. Objective: To find out the effect of physical exercise during pregnancy on pregnancy outcome in primiparous women. Design: This study was a controlled field trial. Data were collected by means of questionnaire and monitoring the length and the umbra of time the women in trial group performed exercise. Data about pregnancy outcome were gathered using labor and newborn records and were compared in two groups (women doing and not doing physical exercise during pregnancy). Samples: 160 primiparous women were selected consecutively and assigned randomly to one of trial or control group (80 in each group). Results: There were no significant between two groups except that the second stage of labor was shorter and the mean of babies' birth weight was smaller for the trial group. Conclusion: The results not only indicate no harm for mother or baby by doing physical exercise during pregnancy but also seems that it shortens the second stage of labor and controls babies' weight. It is suggested to encourage women to do exercise and not stop doing it during pregnancy if they are already used to do it.

Background : The attachment between mother and child is one of the most beautiful relationship which is establishes long before birth. A mother who is attached to her fetus is ready to have a good relationship with her newborn. Objective : To determine the effect of touching fetus during pregnancy on maternal fetal and maternal newborn attachment. Design : The study was a single blind controlled clinical trial. Maternal total attachment was measured 2 weeks after abdominal touch in case group and compared with that of control group. Mother's attachment with her newborn was measured at first breast feeding in both groups. Samples : 100 primigravida mother, 32-35 week pregnant randomly divided in two groups, 50 mothers in case group (with fetal touch) and 50 in control group (without fetal touch) Results : There was no significant difference between two group regarding fetal attachment behaviors, but maternal newborn attachment behaviors were significantly improved in case group (p=0.000). Conclusion : Regarding findings, it is suggested that by providing simple interferences, such as touching the fetus on can try to strengthen the relation between mother and her newborn.

Background: Factors effecting menopausal age are many, including body mass index (8M!), menstural and reproductive history. Objective: To determine the relation between 8MI, menstural and reproductive factors and menopausal age . Design: It was a correlational study. The data was drawn from one group of women. Variables were correlated using proper statistical tests. Sample: Three hundred menopausic women were chosen by cluster random sampling. The study was conducted in north of Tehran. Result: Findings indicated that menopausal age was posetively related to 8MI, duration of menstural cycle, and number of pregnancies. The age of first pregnancy had an inverse effcet. Conclusion: The age of first pregnancy is an important factor that needs special attention and program planning.

This research is a quasi, experimental study in order to especify the effect of self-care training in reducing the epileptic seizures appearing in the epileptic patients referred to nerves clinics of the Medical science universities hospitals related to the Ministry of health, remedy and medical training of the city of Tehran in the year (1993-94) This research is done on a random basis on 68 epileptic patients suffering from the grandma epilepsy who have been referred to 5 nerves clinics. A 3-sections questionaire was completed by each patient at the presence of the researcher. 2 sections of which were designed to especify the individual especifications and the number of seizures appearing during 6 months before training, after appearance of seizure, and the kind of accidents created during the seizure. Then the neccessary coordination for a class establishment was organized with the subject group and the self care training class was held descriptively. later an educational booklet was given to the subject group.Three months after training, the third section of the questionaire which was included in the number of the seizures appearing during 3 months after the self care training, the reason and the kind of accidents created during the seizures, was completed by the units being researched and finally the findings were arranged in 29 tables. In reply to the second 'goal of the research: "to especify and to compare the number of seizures appearing during 6 months before self-care training in the subject group with the witness group at the same time, findings presented that majority of the units under research had 3-4 seizures and the comparison of the averages of seizures for both subject and witness group revealed no meaningful difference. And in reply to the third goal: "to especify the effect of self-care training through defining and comparing the occurances of seizures appearing in the same time in the subject and witness group during 3 months after self-care training and to test the research hypotheses" findings revealed that the majority of the subject group had 1-2 attacks while the majority of the withness group had 3-4. The comparison of the average number of attacks for both groups during 3 months, revealed a demographic meaningful difference and thus the hypotheses of the research was proved. In other words, the self-care training was effective in reducing the numbers of epileptic seizures appearance. In reply to the fourth goal "the reason behind appearance of seizures and the kind of accidents created during the attack along 6 months before and 3 months after the self-care training", findings confirmed that the most occurances of epileptic seizures were because of a stop or a change in drug usage, and the accident were mostly of the head stroke kind. In reply to the fifth goal "to especify the correlation between the individual characteristics and number of epileptic attacks in SUbject and withness group after self-care training". Demographic tests revealed no meaningful correlation. Based on the findings, suggestions for further research and implementations of the findings in different areas of health care practice were made

The present research is a field study in order to investigate scale and ways of doing breast self examination (BSE). 270 nurses employed by the medical sciences university’s hospitals related to the Ministry of Health, and Medical Education in city of Tehran are selected and involved in research on the basis of simple random sampling. The data collection tool was a protrayed questionnaire which was supplied by the researcher. The data is presented in statistical diagram and 24 tables. Relative and absolute frequency distribution descriptive Tables, Plus inferal statistics were employed for data analyzing. The results of the research indicated that most units being researched are between age groups of 25-29, married and mostly in fruitfulness age. therefore they had monthly periods and a few of them were pregnant or in past menoposal stage. Accordingly, most of them were uninformed of a mass existance in their breasts or a breast cancer experience in their near relatives. Findings cleared that, there is a meaningfull correlation between factors such as: age, the presence of breast cancer in near relatives and monthly periods , with the score of doing BSE. but, there was a reversed relation between age and score of doing BSE. Meanwhile, there was a direct and positive relation between factors such as: near relatives experienceing breast cancer and monthly periods, with the score of doing BSE. in other words, the samples who had monthly periods or had some experiences of breast cancer in their near relatives, scored more in doing BSE. According to the findings suggestion were made for further researches on other health care areas

This is a discriptive study with the main goal to identify personal, pregnancy and delivery characteristics of mothers given birth to mentally retarded child. This study has been conducted in the rehabilitation center in Tehran in 1994. A total of 150 women took part in this research, and the tool of was a check list which was completed by researcher through interview. The findings were illustrated in 34 tables and descriptive statistical were used to demonstrate the results. Considering demographic charactristics of mothers, it was revealed that during their pregnancy, 38% of subjects were between 20-30 years of age, 10% of subjects has had history of previous illness, 36.7% of subjects were closly related to their husbands and 33% had the history of handicap among their relatives. Considering the charactristics of pregnancy it was revealed that 12.7% of subjects didn,t receive any perinatal care, 37.3% of them had history of illness during their pregnancy and 11.3% of subjects have used drugs not prescribed by physician while 6% of these drugs were hotmons. Considering the condition of delivery, the results revealed that 14% of subjects had pre-term delivery and 6.7% of subjects has had forceps and vacuum delivery. Based on the findings, suggestion for further research and implementations of findings in health care practice were made.

This survey was performed on 45 oncology nurses in three hospitals, and cancer institute in Tehran. The purpose of this study was investigating the stressors during the care of cancer patients and its importance from the oncology nurses’ view. Data gathering tool was a questionnaire with 42 questions, according to research specific goals and had two parts. First part included demographic characteristics and second part included diagnostic, therapeutic, caring and rehabilitating plans for assessing the nurses’ stressors. Finding of this study was presented in 10 figures and 39 tables. They are showed that oncology nurses during the diagnostic, therapeutic, and caring plans encountered with different amount of stressors. These stressors are: facing with patient and his/her family’s different reactions, unfavorable effect of chemotherapy and radiotherapy on nurse, facing with patient who had pain, don’t accessible necessary facilities for patient care and self care (nurse), observation of effect of disease on body and spirit, patient’s role and life and patient’s support for adaptation to these variations. Variables like age, gender, marital status, educational level, mean number of patient in a ward, type of ward, working shift and clinical working history had positive effect on their stressors.

If all pregnant women worry about their fetus, worries of pregnant nurses are more serious and actual. Which groups of women have more chance about hydatidform mole, amniotic fluid embolism or Sheehan’s syndrome? Fortunately, these complicated problems are very rare but what about daily injuries due to infectious diseases, radioactive substances, anticancer drugs and other chemical substances? Also, when you change position of patients, you may be injured. These instances can jeopardize your health and fetus. There are some worthy points that if you consider them, protect yourself and your fetus from any damage

Juanita Hernandez is an 18-month-old Hispanic, the younger of two children. Juanita was at the 25th percentile for height and weight at birth, but both measurements fell to just below the 5th percentile during her first year. For the last 6 months however, her rate of growth has been normal and her height and weight curves lie parallel to just below the 5th percentile. Juanita appears quite small, but her parents and older sibling also appear to be smaller than average. Her development is normal. Should she be referred for a diagnostic evaluation? The community health nurse (CHN) frequently encounters infants and young children who appear small for their ages. The difficulty in making correct assessments of these children can lead to over referral, costing the family and community time, money, and unnecessary concern. However, reluctance to refer may cause serious illness to be missed. What constitutes failure to thrive (FTT)? Is it a common problem? What are the components of a nursing assessment of small-for-age children? What referral criteria should be used? To address these questions, this article reviews the literature for the defining characteristics and incidence of FTT. Organic and nonorganic FTT are differentiated. Tools for nursing assessment of small-for-age children are discussed. Criteria for referral of small-for-age children to medical evaluation are suggested, and recommendations for further study are made.

EXTRACT: Although all pregnant women are worry about their fetus, it is more serious in pregnant nurses. We are not talking about Hydatidform mole, Amniotic fluid embolism, and Sheehans syndrome. Fortunately these disorders are rare. Instead what are serious for a pregnant nurse are infection diseases, radioactive materials, anticancer agents, and other chemicals. Meanwhile when a nurse remove patient in bed or give a good shape to a bed, it's possible to be hurt. In order to protect herself and her fetus from any damage, she should consult to an obstetrician about her job's details immediately, and be aware of securities in her job's environment.

Background/Objectives: This study investigates the impact of supercritical antisolvent (SAS) process parameters on the particle formation of telmisartan, a poorly water-soluble drug. Methods: A fractional factorial design was employed to examine the influence of the SAS process parameters, including solvent ratio, drug solution concentration, temperature, pressure, injection rate of drug solution, and CO₂ flow rate, on particle formation. Solid-state characterizations of the SAS process particles using XRD and FT-IR confirmed their amorphous nature. The effect of particle size on the kinetic solubility, dissolution, and oral bioavailability of telmisartan was also assessed. Results: Using a mixture of dichloromethane and methanol, telmisartan amorphous nano-microparticles with sizes between 200 and 2000 nm were produced. The key parameters, particularly drug solution concentration and temperature, significantly affected the particle size. Interestingly, the ratio of the solvent mixture also had a significant effect on the particle morphology. Further experiments were performed to determine the conditions for preparing telmisartan amorphous nano-microparticles with various sizes by controlling the solvent mixture ratio and the concentration of the drug solution. It was revealed that a reduction in the amorphous particle size enhanced both the kinetic solubility and dissolution rates, leading to a significantly increased in vivo oral bioavailability in rats compared to unprocessed telmisartan. Conclusions: These findings suggest that SAS processing, utilizing adjustments of process parameters, offers an effective strategy for enhancing the bioavailability of poorly soluble drugs by generating amorphous spherical nano-microparticles with optimized particle size.

Background/objectives: Lifitegrast is an effective treatment for dry eye disease, reducing inflammation and improving the ocular surface condition. Owing to its high sensitivity to oxidation and hydrolysis, formulation studies are required to maintain the physicochemical stability of lifitegrast. This study aimed to overcome the instability of lifitegrast by developing a more stable eyedrop formulation by using citric acid and tromethamine to prevent the degradation of lifitegrast., Methods: Based on the Design of Experiment (DoE) approach, formulations were prepared at various concentrations of two stabilizers, citric acid and tromethamine. The stabilizers were carefully controlled to reduce the generation of degradation products. The eyedrops were stored under accelerated test conditions, and parameters such as appearance, pH, drug content, and impurities were evaluated., Results: The results showed that all critical quality attributes (CQAs) including appearance, pH, drug content, and impurities were maintained at stable levels under accelerated conditions, meeting established criteria. In addition, it was suggested that citric acid provided protection against oxidative stress, while tromethamine prevented hydrolysis caused by pH fluctuations., Conclusions: Consequently, it was concluded that the developed lifitegrast-containing eyedrop formulation exhibited improved physicochemical stability, validated through statistical analyses. These findings contribute to the development of stable eyedrops and provide a foundation for commercial production and clinical applications.

In this study, an amorphous solid dispersion containing the poorly water-soluble drug, bisacodyl, was prepared by hot-melt extrusion to enhance its therapeutic efficacy. First, the miscibility and interaction between the drug and polymer were investigated as pre-formulation strategies using various analytical approaches to obtain information for selecting a suitable polymer. Based on the calculation of the Hansen solubility parameter and the identification of the single glass transition temperature (Tg), the miscibility between bisacodyl and all the investigated polymers was confirmed. Additionally, the drug-polymer molecular interaction was identified based on the comprehensive results of dynamic vapor sorption (DVS), Fourier transform infrared spectroscopy (FT-IR), Raman spectroscopy, and a comparison of the predicted and experimental values of Tg. In particular, the hydroxypropyl methylcellulose (HPMC)-based solid dispersions, which exhibited large deviation between the calculated and experimental values of Tg and superior physical stability after DVS experiments, were selected as the most appropriate solubilized bisacodyl formulations due to the excellent inhibitory effects on precipitation based on the results of the non-sink dissolution test. Furthermore, it was shown that the enteric-coated tablets containing HPMC-bisacodyl at a 1:4 ratio ( w / w ) had significantly improved in vivo therapeutic laxative efficacy compared to preparations containing un-solubilized raw bisacodyl in constipation-induced rabbits. Therefore, it was concluded that the pre-formulation strategy, using several analyses and approaches, was successfully applied in this study to investigate the miscibility and interaction of drug-polymer systems, hence resulting in the manufacture of favorable solid dispersions with favorable in vitro and in vivo performances using hot-melt extrusion processes.

Nanoplastics (NPs) exposure to humans can occur through various routes, including the food chain, drinking water, skin contact, and respiration. NPs are plastics with a diameter of less than 100 nm and have the potential to accumulate in tissues, leading to toxic effects. This study aimed to investigate the neurotoxicity of polystyrene NPs on neural progenitor cells (NPCs) and hippocampal neurogenesis in a rodent model. Toxicity screening of polystyrene NPs based on their charge revealed that cationic amine-modified polystyrene (PS-NH 3 + ) exhibited cytotoxicity, while anionic carboxylate-modified polystyrene (PS-COO - ) and neutral NPs (PS) did not. NPCs treated with PS-NH 3 + showed a significant reduction in growth rate due to G1 cell cycle arrest. PS-NH 3 + increased the expression of cell cycle arrest markers p21 and p27, while decreasing cyclin D expression in NPCs. Interestingly, PS-NH 3 + accumulated in mitochondria, leading to mitochondrial dysfunction and energy depletion, which caused G1 cell cycle arrest. Prolonged exposure to PS-NH 3 + in C17.2 NPCs increased the expression of p16 and senescence-associated secretory phenotype factors, indicating cellular senescence. In vivo studies using C57BL/6 mice demonstrated impaired hippocampal neurogenesis and memory retention after 10 days of PS-NH 3 + administration. This study suggests that NPs could deplete neural stem cell pools in the brain by mitochondrial dysfunction, thereby adversely affecting hippocampal neurogenesis and neurocognitive functions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Detecting and identifying the origins of foodborne pathogen outbreaks is a challenging. The Next-Generation Sequencing (NGS) panel method offers a potential solution by enabling efficient screening and identification of various bacteria in one reaction. In this study, new NGS panel primer sets that target 18 specific virulence factor genes from six target pathogens ( Bacillus cereus , Yersinia enterocolitica , Staphylococcus aureus , Vibrio cholerae , Vibrio parahaemolyticus , and Vibrio vulnificus ) were developed and optimized. The primer sets were validated for specificity and selectivity through singleplex PCR, confirming the expected amplicon size. Crosscheck and multiplex PCR showed no interference in the primer set or pathogenic DNA mixture. The NGS panel analysis of spiked water samples detected all 18 target genes in a single reaction, with pathogen concentrations ranging from 10 8 to 10 5 colony-forming units (CFUs) per target pathogen. Notably, the total sequence read counts from the virulence factor genes showed a positive association with the CFUs per target pathogen. However, the method exhibited relatively low sensitivity and occasional false positive results at low pathogen concentrations of 10 5 CFUs. To validate the detection and identification results, two sets of quantitative real-time PCR (qPCR) analyses were independently performed on the same spiked water samples, yielding almost the same efficiency and specificity compared to the NGS panel analysis. Comparative statistical analysis and Spearman correlation analysis further supported the similarity of the results by showing a negative association between the NGS panel sequence read counts and qPCR cycle threshold (Ct) values. To enhance NGS panel analysis for better detection, optimization of primer sets and real-time NGS sequencing technology are essential. Nonetheless, this study provides valuable insights into applying NGS panel analysis for multiple foodborne pathogen detection, emphasizing its potential in ensuring food safety., Competing Interests: E-SH, BK, IC, JC, and JP were employed by Sanigen Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Park, Kwon, Ha, Kang, Choi, Kwak, Choi, Lee, Kim, Kim, Park and Lee.)

These days, bacterial detection methods have some limitations in sensitivity, specificity, and multiple detection. To overcome these, novel detection and identification method is necessary to be developed. Recently, NGS panel method has been suggested to screen, detect, and even identify specific foodborne pathogens in one reaction. In this study, new NGS panel primer sets were developed to target 13 specific virulence factor genes from five types of pathogenic Escherichia coli , Listeria monocytogenes , and Salmonella enterica serovar Typhimurium, respectively. Evaluation of the primer sets using singleplex PCR, crosscheck PCR and multiplex PCR revealed high specificity and selectivity without interference of primers or genomic DNAs. Subsequent NGS panel analysis with six artificially contaminated food samples using those primer sets showed that all target genes were multi-detected in one reaction at 10 8 -10 5 CFU of target strains. However, a few false-positive results were shown at 10 6 -10 5 CFU. To validate this NGS panel analysis, three sets of qPCR analyses were independently performed with the same contaminated food samples, showing the similar specificity and selectivity for detection and identification. While this NGS panel still has some issues for detection and identification of specific foodborne pathogens, it has much more advantages, especially multiple detection and identification in one reaction, and it could be improved by further optimized NGS panel primer sets and even by application of a new real-time NGS sequencing technology. Therefore, this study suggests the efficiency and usability of NGS panel for rapid determination of origin strain in various foodborne outbreaks in one reaction.

This study aimed to develop an improved sustained-release (SR) PLGA microsphere of exenatide using supercritical fluid extraction of emulsions (SFEE). As a translational research, we investigated the effect of various process parameters on the fabrication of exenatide-loaded PLGA microspheres by SFEE (ELPM_SFEE) using the Box-Behnken design (BBD), a design of experiment approach. Further, ELPM obtained under optimized conditions and satisfying all the response criteria were compared with PLGA microspheres prepared using the conventional solvent evaporation (ELPM_SE) method through various solid-state characterizations and in vitro and in vivo evaluations. The four process parameters selected as independent variables were pressure ( X 1 ), temperature ( X 2 ), stirring rate ( X 3 ), and flow ratio ( X 4 ). The effects of these independent variables on five responses, namely the particle size, its distribution (SPAN value), encapsulation efficiency (EE), initial drug burst release (IBR), and residual organic solvent, were evaluated using BBD. Based on the experimental results, a desirable range of combinations of various variables in the SFEE process was determined by graphical optimization. Solid-state characterization and in vitro evaluation revealed that ELPM_SFEE improved properties, including a smaller particle size and SPAN value, higher EE, lower IBR, and lower residual solvent. Furthermore, the pharmacokinetic and pharmacodynamic study results indicated better in vivo efficacy with desirable SR properties, including a reduction in blood glucose levels, weight gain, and food intake, for ELPM_SFEE than those generated using SE. Therefore, the potential drawback of conventional technologies such as the SE for the preparation of injectable SR PLGA microspheres could be improved by optimizing the SFEE process., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. Bioengineering & Translational Medicine published by Wiley Periodicals LLC on behalf of American Institute of Chemical Engineers.)

The emergence of enabling technologies for the analysis of circulating tumor cells has been shedding new lights into cancer management in the recent years. However, majority of the technologies developed suffer from excessive cost, time-consuming workflows, and reliance on specialized equipment and operators. Herein, we propose a simple workflow for the isolation and characterization of single circulating tumor cells using microfluidic devices. The entire process can be operated by a laboratory technician without relying on any microfluidic expertise and can be completed within few hours of sample collection., (© 2023. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)