Iranian Red Crescent Medical Journal
Volume:17 Issue: 11, Nov 2015

Investigating the prevalence of diseases and causes of hospitalization of Iranian pilgrims in Iraq can be helpful for healthcare programmers in scheduling a healthy and joyful trip for pilgrims and reducing their mortality and morbidity. The main purpose of this study was to determine the frequency of Iranian pilgrims’ referral cases to Karbala and Najaf hospitals in Iraq during a 5-month period in 2012. Patients and In this cross-sectional study، medical records of all patients referred to Iraqi hospitals from Iranian clinics during a 5-month period from 16 January 2012 until 14 June 2012 was recorded. A checklist، including demographic data and diagnostic causes were prepared and completed by general practitioners. Then، the completed forms were checked and delivered to health surveillance supervisors. A total of 177 referral cases from Iranian clinics to Iraqi hospitals were recorded in 5 months. Most of these referrals were due to cardiovascular diseases with 38. 6%، then comes trauma with 26. 55%، and finally renal failure in need of dialysis with 12. 43%. About 80. 2% of the patients were discharged، 13% of them were sent to Iran، and 6. 2% died. Around 90% of deaths were due to heart diseases. Considering the high prevalence of cardiovascular diseases and fractures in Iranian pilgrims، the necessity of self-care education to diminish such rates is substantial.

It has been demonstrated that HER3 plays an important role in some human cancers and the HER3 expression is associated with worse survival in solid tumors. This study was conducted to compare HER3 expression in epithelial lining of radicular cysts (RCs), dentigerous cysts (DCs) and odontogenic keratocysts (OKCs). This was a descriptive-analytical study, which assessed all 57 paraffin blocks of RCs, DCs and OKCs (21 RCs, 16 DCs, 20 OKC) from pathological archive of Dentistry College of Zahedan, Iran. The HER3 expression in cytoplasm and membrane was examined by immunohistochemical method. The data collected was analyzed using SPSS16 by ANOVA and Chi-square. P < 0.05 was considered as statistically significant. The HER3 expression had positive results in 52.4% of OKC, 50% of DC and only 20% of RC samples. There was a significant difference between HER3 expression in OKCs and RCs. The HER3 expression in developmental odontogenic cysts was higher than that in inflammatory odontogenic cysts. The higher rate of HER3 expression in OKC may justify inherent growth potential, stimulation-independent proliferation capability, invasive growth and high recurrence rate of the cyst accepted today as a tumor.

Fixed prosthodontics is a routine dental treatment and microleakage is a major cause of its failure. The aim of this study was to assess the marginal microleakage of four cements in metal ceramic restorations with adapted and open margins. Sixty sound human premolars were selected for this experimental study performed in Tehran، Iran and prepared for full-crown restorations. Wax patterns were formed leaving a 300 µm gap on one of the proximal margins. The crowns were cast and the samples were randomly divided into four groups based on the cement used. Copings were cemented using zinc phosphate cement (Fleck)، Fuji Plus resin-modified glass ionomer، Panavia F2. 0 resin cement، or G-Cem resin cement، according to the manufacturers’ instructions. Samples were immersed in 2% methylene blue solution. After 24 hours، dye penetration was assessed under a stereomicroscope and analyzed using the respective software. Data were analyzed using ANOVA، paired t-tests، and Kruskal-Wallis، Wilcoxon، and Mann-Whitney tests. The least microleakage occurred in the Panavia F2. 0 group (closed margin، 0. 18 mm; open margin، 0. 64 mm) and the maximum was observed in the Fleck group (closed margin، 1. 92 mm; open margin، 3. 32 mm). The Fleck group displayed significantly more microleakage compared to the Fuji Plus and Panavia F2. 0 groups (P < 0. 001) in both closed and open margins. In open margins، differences in microleakage between the Fuji Plus and G-Cem as well as between the G-Cem and Panavia F2. 0 groups were significant (P < 0. 001). In closed margins، only the G-Cem group displayed significantly more microleakage as compared to the Panavia F2. 0 group (P < 0. 05). Paired t-test results showed significantly more microleakage in open margins compared to closed margins، except in the Fuji Plus group (P = 0. 539). Fuji Plus cement exhibited better sealing ability in closed and open margins compared to G-Cem and Fleck cements. When using G-Cem and Fleck cements for full metal ceramic restorations، clinicians should try to minimize marginal gaps in order to reduce restoration failure. In situations where there are doubts about perfect marginal adaptation، the use of Fuji Plus cement may be helpful.

Happiness has a considerable impact on elderly quality of life. Reminiscence therapy can be an effective intervention in increasing the positive emotions among elderly. This study was performed to investigate the effect of reminiscence therapy on Iranian elderly women’s happiness. Patients and This randomized clinical trial conducted on 32 elderly women (census sampling) attending the jahandidegan daycare elderly center IN Gorgan city, Iran, in 2013. Happiness scores of 4 phases were measured: before, the third session, the sixth session and one month after the intervention. Three instruments were used in this study including a demographic questionnaire, the mini mental state examination test, and Oxford happiness questionnaire. The intervention group participated in six sessions of narrative group reminiscence that were held in three consecutive weeks, two sessions per week. The control group was also participated in six sessions of group discussions that were held in three consecutive weeks, two sessions per week. Data analysis was performed the chi-square, independent t-test, Paired t-test. From a total of 32 elderly women, 29 cases completed the study. No significant differences were found between the two groups in terms of demographic characteristics. The mean happiness scores before the intervention between the two groups were not significantly different (P = 0.824). Comparison of the mean happiness scores of the intervention group in the four measurement times revealed a significant difference only after the third and sixth sessions (P = 0.03), and no significant difference was found between the mean happiness scores of the control group in the four measurement times. The elderly participating in the matched group sessions can be effective in increasing positive emotions.

Heart secondary tumors are much more common than primary tumors. These two types of tumors differ not only by their source but also by their symptoms and location in heart chambers. This report presents a 66-year-old heavy smoker female with a history of pulmonary lobectomy due to lung adenocarcinoma, hysterectomy due to myoma, and lumpectomy due to benign breast mass, who had symptoms of right heart failure for months. Physical examinations followed by imaging showed a mass in her right atrium, which was most likely, a myxoma. After a successful surgical excision, histopathological findings confirmed the diagnosis. More studies are needed to evaluate a possible combination between these soft tissue masses. A right atrium myxoma in a patient with a history of multiple soft tissue tumors has been limited to only a few cases. This may suggest a genomic affinity or similarity; if so, those with multiple different type soft tissue masses should be screened for a heart mass before the mass becomes complicated.

Many factors influence the organizational commitment of employees. One of these factors is job designing since it affects the attitude, beliefs, and feelings of the organization employees. We aimed to determine the relationship between job characteristics and organizational commitment among the employees of hospitals.Patients and In this descriptive and correlational study, 152 Iranian employees of the hospitals (physicians, nurses, and administrative staff) were selected through stratified random sampling. Data gathered using 3-part questionnaire of “demographic information”, “job characteristics model,” and “organizational commitment,” in 2011. Study data were analyzed using SPSS v. 16. There was significant statistical correlation between organizational commitment and variables of educational level (P = 0.001) and job category (P = 0.001). Also, a direct and significant correlation existed between motivating potential score and job feedback on one hand and organizational commitment on the other hand (P = 0.014). According to the results, managers of the hospitals should increase staff’s commitment through paying attention to proper job designing.

Hemifacial microsomia (HFM) is a birth defect involving craniofacial structures derived from the first and second branchial arches. Although it is a relatively uncommon malformation, it is the second most common craniofacial birth defect after cleft lip and palate (CL/P). This is a case report about the successful orthodontic treatment of a patient with mild hemifacial microsomia (HFM), using a non-surgical orthopedic and orthodontic treatment approach. The aim of this approach was to make the best noninvasive modality to treat HFM. A 7-year-old boy with a mild HFM presented with a convex profile and slight chin deviation. Orthopedic treatment performed using a hybrid functional and high pulls headgear. Treatment continued by fixed orthodontic straight wire appliance to achieve perfect occlusion. Excellent esthetic and functional results achieved; total treatment duration was about 72 months.

Context: In modern phytotherapy, Stachys lavandulifolia Vahl., a type of Stachys also known as Mountain Tea (Chay-e-Kouhi) has been widely studied based on its botanical and therapeutic characteristics over the recent decades.Evidence Acquisition: The present study investigated morphology, botanical characteristics, and some therapeutic activities of this plant and compares them with those of Marmazad, as the traditional equivalent of Stachys in traditional iranian medicine (TIM), to evaluate the similarities between Stachys and Marmazad. In this study by exploring morphology, botanical properties and therapeutic activities of Stachys from modern botany and Marmazad in TIM, comparing them and considering similarities between those botanical properties and some of therapeutic activities this outcome was drawn that what had been known as Marmazad in TIM nowadays is equal to Stachys or Chay-e-Kouhi in modern botany. The achieved findings from this comparison between botanical characteristics and therapeutic activities of Stachys based on modern researches and those of Marmazad by referring to traditional manuscripts revealed significant similarities between them. Also, there were some applications mentioned for Marmazad in TIM which could help new researchers in modern phytotherapy to deal with those dimensions of this herb which are not worked out yet.

Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality. The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people.Patients and This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process. The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01, P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep. It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research.

Although healthcare quality has considerably improved in many countries, pressure ulcer is still a major health challenge worldwide. The current study aimed to evaluate the effects of TWOT on the healing of pressure ulcers.Patients and This study was a randomized controlled trial, and the convenient sample including 100 patients hospitalized in two university-affiliated medical-surgical intensive care units and one neurology unit located in Qazvin, Iran were studied. Patients with stage II-IV pressure ulcer on the sacral or ischial areas were randomly assigned to either the control or the experimental groups. The experimental group received a 12-day transdermal wound oxygen therapy. Wound status was assessed seven times before the intervention, as well as two, four, six, eight, ten, and twelve days after the intervention. After 12 days of wound oxygen therapy, the number of patients with complete wound healing in the experimental group was significantly greater than that of the control group. Moreover, the total mean of wound area in the experimental group was significantly lower than that of the control group. Transdermal wound oxygen therapy can effectively promote wound healing in patients with pressure ulcers.

All recipients of kidney transplantation, especially those with posttransplant malignancy, are at risk of long-term graft failure. The purpose of our study was to evaluate the risk factors associated with graft survival after diagnosis of malignancy. Patients and To reach this purpose, we conducted a historical cohort study in Iran and 266 cases with posttransplant malignancy were followed up from diagnosis of malignancy until long-term graft loss or the date of last visit. These patients were taken as a census from 16 Transplant Centers in Iran during 22 years follow-up period since October 1984 to December 2008. A Cox proportional hazards model was performed to determine the important independent predictors of graft survival after malignancy. At the end of the study, long-term graft failure was seen in 27 (10.2%) cases. One-year and 2-year graft survival after diagnosis of cancer were 93.6% and 91.7%, respectively. The univariate analysis showed that the incidence of chronic graft loss was significantly higher in male patients with solid cancers, withdrawal of immunosuppressant regimen, no response to treatment, and tumor metastasis. In continuation, the Cox model indicated that the significant risk factors associated with graft survival were type of cancer (P < 0.0001), response to treatment (P < 0.0001, HR = 0.14, 95% CI: 0.06 - 0.32), metastasis (P < 0.0001, HR = 5.68, 95% CI: 2.24 - 14.42), and treatment modality (P = 0.0001). By controlling the modifiable risk factors and modality of treatment in our study, physicians can reach more effective treatment.

Hypothyroidism is the most common endocrine disorder in children and presented with various sign and symptoms; its diagnosis needs a high index of suspicion. We report 3 cases with unusual presentations of hypothyroidism and with delay in diagnosis that referred to Pediatric Endocrine Outpatient Clinic in Mashhad University of Medical Sciences, Mashhad, Iran with different clinical manifestations. They had decreased Thyroxin (T4) and increased thyroid stimulating hormone (TSH) levels. One case had mental retardation and deafness, but the other two cases had normal neurodevelopment. Some additional interesting findings were as follows: short stature, delayed bone age, teeth eruption impairment, hair loss, anemia and hypercholesterolemia, persistent and long-term constipation that had led to several abdominal surgeries. After a year of hormonal replacement therapy, their growth parameters and hematological values improved. We recommend thyroid hormonal evaluation for any children with short stature, especially with delayed bone age, in order to detect and treat hypothyroidism at the right time. It seems that more attention to pediatric growth is necessary.

Small cell esophageal carcinoma (SCEC) is a highly aggressive and rare neoplasm. This study aimed to report the characteristics, prognostic factors, and treatment outcomes of 22 patients with SCEC. Patients and This brief report was carried out by reviewing the medical records of 22 patients with newly histologically proven SCEC that were treated between 2000 and 2010 at 2 tertiary academic hospitals. All the potential prognostic variables, including the patients’ characteristics, tumor features, and treatment modalities were analyzed to establish their influence on the patients’ survival rates. This study was conducted on 7 males and 15 females with a median age of 61 years. Dysphagia and weight loss were the most prevalent symptoms. According to the results, 14 patients (64%) had limited diseases and 8 cases (36%) had extensive diseases. In those with extensive diseases, liver, lung, and lymph nodes (LNs) were the most metastatic sites. Besides, most tumors were located in lower (50%) and middle (32%) part of the esophagus. Most patients (91%) were treated with sequential (55%) or concurrent (36%) chemoradiation (CRT). Surgical resection was also performed for 7 patients. Chemotherapy regimen consisted of cisplatin and etoposide in 14 patients (64%). The median follow up time was 12 months. The 1, 3, and 5-year overall survival rates were 27%, 14%, and 4%, respectively. Yet, no prognostic factors were found because of the small sample size of the study. Primary SCEC is a rare and highly aggressive tumor. However, prognosis is poor and long-term survival is exceptional. CRT could be an appropriate alternative to operation.

Working in respiratory intensive care unit (RICU) is multidimensional that requires nurses with special attributes to involve with the accountability of the critically ill patients. The aim of this study was to explore the appropriate nursing care strategy in the RICU in order to unify and coordinate the nursing care in special atmosphere of the RICU. This conventional content analysis study was conducted on 23 health care providers working in the RICU of Sina and Shariati hospitals affiliated to Tehran university of medical sciences and the RICU of Baqiyatallah university of medical sciences from August 2012 to the end of July 2013. In addition to in-depth semistructured interviews, uninterrupted observations, field notes, logs, patient’s reports and documents were used. Information saturation was determined as an interview termination criterion. Intelligence care emerged as a main theme, has a broad spectrum of categories and subcategories with bridges and barriers, including equality of bridges and barriers (contingency care, forced oriented task); bridges are more than barriers (human-center care, innovative care, cultural care, participatory care, feedback of nursing services, therapeutic-professional communication, specialized and independent care, and independent nurse practice), and barriers are higher than bridges (personalized care, neglecting to provide proper care, ineffectiveness of supportive caring wards, futility care, nurse burnout, and nonethical-nonprofessional communications). Intelligence care is a comprehensive strategy that in addition to recognizing barriers and bridges of nursing care, with predisposing and precipitating forces it can convert barriers to bridges.

Bleaching treatments decrease shear bond strength between orthodontic brackets and teeth; although definite results have not been reported in this regard. This study determined the effects of different bleaching protocols on the shear bond strength of orthodontic brackets to teeth. This experimental study was performed in Iran. Forty-eight extracted human premolars were randomly assigned into four groups. In the control group, no bleaching treatment was performed. In groups 2 - 4, the bleaching procedures were performed using carbamide peroxide 45%, carbamide peroxide 20% and diode laser, respectively. Two weeks later, brackets were bonded to teeth and thermocycled. The shear bond strengths of the brackets to the teeth were measured. Data was analyzed by one-way ANOVA and Dunnett post-hoc test.Significant differences were found between control group and all other groups (P < 0.001); and also between groups 2 and 3 (P < 0.05). No significant differences were found between the other groups. The bleaching procedures using 20% carbamide peroxide and 45% carbamide peroxide and diode laser significantly decreased shear bond strength of brackets to the teeth. 45% carbamide peroxide had a more significant effect on bond strength compared to 20% carbamide peroxide. The difference in bond strength was not significant between laser group and either carbamide peroxide groups.

Abnormal eating behavior, unhealthy weight control methods, and eating disordered symptoms have risen among college students. The aim of this study was to examine disordered eating attitudes and their relationship with anthropometric and body composition indices in physical education students in Tabriz, the capital of East Azerbaijan province, Iran.Patients and This cross-sectional study was conducted on 210 physical education students, 105 males and 105 females aged 18 to 25, who were selected by systematic random sampling from physical education faculty of Tabriz University in Tabriz, Iran, in 2013. Eating attitude test (EAT-26) was used for the assessment of disordered eating attitudes. In addition, anthropometric and body composition indices were assessed. About 10% of the studied subject had disturbed eating attitudes; significantly more males (15.4%) reported an EAT-26 ≥ 20 (disordered eating attitudes) than females (4.8%) (P < 0.05). In males, the EAT-26 score was positively correlated with weist perimeter (WP) (r = 0.21, P < 0.05) and the waist-to-hip ratio (r = 0.26, P < 0.01). In females, the EAT-26 score was positively correlated with weight (r = 0.19, P < 0.05) and the WP (r = 0.28, P < 0.01). In females, weight (P < 0.05), body mass index (BMI) (P < 0.05), WP (P < 0.01), and waist-to-hip ratio (P < 0.05) were significantly different between disordered eating attitude and healthy subjects, while in males there was no significant difference between the two groups regarding the anthropometric and body composition indices. Abnormal eating attitude was notable among physical education students in Tabriz, Iran. It seems that some anthropometric indices such as BMI and central obesity indices were related to the increase of disordered eating attitude.

Context: Functional dyspepsia (FD) is a functional gastro-intestinal disorder with high prevalence. Among various treatment options, treatment by complementary and alternative medicines especially herbal remedies also practiced. Traditional Iranian medicine (TIM), a valuable resource of valid applied studies of ancient Iranian scholars, recommends numerous medicinal plants to treat dyspepsia symptoms. In this study, through investigation of TIM references, we aimed to identify medicinal plants for treatment of digestion insufficiency.Evidence Acquisition: In this qualitative study, dyspepsia symptoms including fullness, early satiety, bloating, nausea, and belching were checked under reliable sources of traditional medicine. Then medicinal plants recommended for the treatment of the symptoms were extracted from the books. Likewise, for investigating the pharmacological properties of medicinal plants used for the relieving of dyspepsia symptoms, electronic databases such as PubMed, Scopus, Google Scholar and some Iranian databases like SID and IranMedex were employed. The study yielded 105 plants from 37 families which could treat various dyspepsia symptoms; fifty-seven plants, mainly from Apiaceae, Lamiaceae, Amaryllidaceae and Zingiberaceae had digestive effects. In this research, based on the information in TIM reference texts, we obtained 58 plants effective for bloating, 40 for nausea, 37 for appetite loss and 7 for belching. In human clinical trials conducted on medicinal plants effective for FD symptoms, 7 single plants were used. Finding the medicinal plants effective on digestion insufficiency based on TIM could suggest a better strategy for the relieving of dyspepsia symptoms. Traditional Iranian medicine prescribes medicinal plants based on each patient’s personal characteristics and practices multiple target therapies.

Heart failure is a prevalent disease affecting about 4.9 million people in the U.S. and more than 22 million individuals worldwide. Using electric pacemaker is the most common treatment for the patients with heart conduction problems. The present study aimed to determine the factors affecting survival in the patients undergoing pacemaker implantation in the hospitals affiliated to Shiraz University of Medical Sciences. The aim of the present study was to identify the factors affecting the survival of the patients suffering from arrhythmia. Patients and This retrospective survival analysis was conducted on all 1207 patients with heart failure who had undergone permanent pacemaker implantation in the hospitals affiliated to Shiraz University of Medical Sciences from 2002 to 2012. The data were analyzed using non-parametric methods such as Kaplan-Meier method, life table, and Cox regression model. The risk factors of mortality were determined using multivariate Cox proportional hazards method.

Many pathogenic bacteria show different levels of antibiotic resistance. Furthermore, a lot of hospital-acquired infections are caused by highly resistant or multidrug-resistant Gram-negative bacteria. According to WHO, patients with drug-resistant infections have higher morbidity and mortality. Moreover, patients infected with bacteria that are resistant to antibiotics considerably consume more healthcare resources. In this study, we explored a physical method of converting drug-resistant bacteria to drug-sensitive ones. This is an in vitro case-control study, performed at the Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences (SUMS), Shiraz, Iran in 2014. All experiments were carried out using Gram-negative bacteria Klebsiella pneumonia and E. coli and Gram-positive Staphylococcus aureus and Streptococcus group A, isolated from hospitalized patients. The bacterial strains were obtained from the Persian Type Culture Collection, IROST, Iran (Klebsiella pneumonia PTCC 1290) and Bacteriology Department of Shahid Faghihi Teaching Hospital, Shiraz, Iran (E. coli, Staphylococcus aureus, and Streptococcus group A). The bacteria in culture plates were exposed to diagnostic ultrasound using a MyLab70XVG sonography system for 5 minutes. Then, the bacteria were cultured on Mueller-Hinton agar and incubated at 35°C for 18 hours. Finally, antibiotic susceptibility test was performed and the inhibition zone in both control and exposed groups were measured. Three replicate agar plates were used for each test and the inhibition zones of the plates were recorded. Compared with the results obtained from unexposed bacteria, statistically significant variations of sensitivity to antibiotics were found in some strains after short-term exposure. In particular, we found major differences (making antibiotic-resistant bacteria susceptible or vice versa) in the diameters of inhibition zones in exposed and non-exposed samples of Klebsiella pneumonia and Streptococcus. This study clearly shows that short-term exposure of microorganisms to diagnostic ultrasonic waves can significantly alter their sensitivity to antibiotics. We believe that this physical method of making the antibiotic-resistant population susceptible can open new horizons in antibiotic therapy of a broad range of diseases, including tuberculosis.

Several experimental and clinical studies support beneficial effects of Trigonella foenum-graecum (fenugreek) in the management of metabolic diseases and inflammatory disorders. The purpose of this study was to examine the effect of T. foenum-graecum seed extract in reducing the metabolic and inflammatory alternations associated with menopause. In this experimental study, 49 rats were divided into seven groups: (I) sham-control, (II) ovariectomized-control,(III and IV) ovariectomized treated with 50 and 150 mg/kg of T. foenum-graecum seed ethanolic extract, (V and VI) ovariectomized treated with 50 and 150 mg/kg of T. foenum-graecum hexanic extract, (VII) ovariectomized-positive control treated with 10 µg/kg of estradiol. The extracts were injected intraperitoneally one day after ovariectomy and the treatments were lasted for 42 days. Fasting blood glucose and body weight gain increased significantly in the ovariectomized-control group compared with that in the sham animals (P < 0.05). Administration of estradiol and T. foenum-graecum (50 and 150 mg/dL of hexanic extract and 150 mg/kg of ethanolic extract) significantly diminished the increase in glucose and body weight (P < 0.05). The serum level of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the ovariectomized control group was significantly higher than those in the sham animals (P < 0.05). Both hexanic and ethanolic extracts as well as estradiol were able to decrease level of these cytokines in the serum of ovariectomized rats (P < 0.05). The results of the present study show that administration of T. foenum-graecum corrects metabolic and inflammatory alterations associated with ovariectomy and has a potential for the management of menopause.