Iranian Red Crescent Medical Journal
Volume:20 Issue: 2, Feb 2018

It is believed that smoking is the gateway to use substances and illicit drugs. Due to an increase in smoking among students, we thought there is a need for more efficient ways to prevent smoking among the young and adolescents.
This study aimed to develop an extended version of the Health Belief Model (HBM) with elements of Health Literacy (HL) to assess whether an educational intervention could be effective in smoking prevention based on this new development in 2016.
This was a quasi-experimental study performed on 130 students living in dormitories of Shahid Beheshti University of Medical Sciences in Tehran, Iran, who were recruited and assigned to experimental and control groups (each containing 65 students). The experimental group received six electronic educational sessions via telegram application while the control group received no intervention. The data were collected using a questionnaire containing items on HBM, smoking preventive behaviors, and a measure of HL (the HL inventory for adults-HELIA). The questionnaire was completed at three time-points: before, immediately and three months after the intervention. The significance level was set at 0.05.
Before the intervention, there was no significant difference in the demographic and background variables, the underlying level of knowledge, preventive behaviors, HL, and all the constructs of the model between the groups (P > 0.05). After the intervention, comparing two groups showed that the mean scores of knowledge, preventive behaviors, HL, and all components of the model changed significantly in the experimental group compared to the control group (P 0.05).
This study showed that educational intervention by Telegram application based on HBM and HL was effective in promoting the adoption of smoking preventive behaviors among university students.

Helicobacter pylori infection is a major global gastric infection and has been associated with changes in haematological parameters. The present study aimed at establishing the effect of H. pylori infection on haematological parameters.
We conducted a case-control study among 98 patients and 62 controls in Kosti teaching hospital in Sudan from July 2014 to July 2015. All patients and controls were investigated for complete blood count, peripheral blood picture, and Helicobacter pylori infection. Data were analysed using SPSS Version 23 at 95% confident interval.
There was a significant effect of H. Pylori infection on all haematological parameters p ≤ 0.001, except for MCHC, WBCs, and total differential p ≥ 0.001, at the rate of 89.80%, infection was recorded in patients with gastritis. However, after 1 month follow- up, the Hb, PCV, MCV Retic, and platelet count for GIa were found to be not significant p ≥ 0.001 for all; 12.11 ± 1.11 g/dL, 40.33 ± 3.09 %, 81.36 ± 3.5 fL and 1.38 ± 0.84 %, 233700.0000 ± 34947.7400 cmm3, respectively. On the other hand, GIb, Hb, PCV, MCV, Retic and platelet counts were reported to be significant p ≤ 0.001, for all; 10.33 ± 1.82 g/dL, 33.99 ± 3.48%, 111.01 ± 7.89 fL, 3.20 ± 1.24 % and 112895.6000 ± 41043.0500 cmm3. In the GII, all were found to be significant p and lt, 0.001, 8.58 ± 1.93 g/dL, 30.86 ± 3.10 %, 60.13 ± 4.44 fL 4.53 ± 1.84%, 317818.2000 ± 91442.7600 cmm3, except for the retic and platelet count p ≥ 0.001.
There was a significant effect of H. pylori infection on haematological parameters. The complete blood count and peripheral blood picture revealed that group Ia, group Ib, and group II were normocytic anemia, macrocytic anemia, and microcytic anemia, respectively.

Long and repeated heating causes multiple physical and chemical changes in oil, which may result in serious biological damages upon consumption.
This study investigated the effects of heated oils used in fast food restaurants on metabolic, inflammatory, and oxidative stress markers in rats.
The experimental clinical study was performed during summer 2016 in Shiraz, Iran. For 13 weeks, 32 Sprague-Dawley rats received one of the 4 diets: Group 1: basal diet mixed with 15% w/w heated oil containing total polar compounds (TPC) = 12.5% (TPC 12.5); Group 2: basal diet with 15% unheated oil used in group 1 (control TPC 12.5); Group 3: basal diet with 15% heated oil with TPC = 35% (TPC 35); and Group 4: basal diet with 15% unheated oil used in group 3 (control TPC 35). At weeks six and 13, blood samples were collected for determination of fasting glucose, lipid profile, liver enzymes, and inflammatory and oxidative stress markers. Blood pressure was measured on the 13th week. Histopathological examination of liver slices was performed after euthanization of rats. Statistical analysis was done using the SPSS software.
On the 13th week, the TPC 35 group had higher plasma glucose (.4 mg/dL, P Long-term consumption of fried foods from fast food restaurants may have detrimental impact on blood pressure, serum glucose and lipids, inflammatory and oxidative stress markers, and liver histology.

Hypremesis Gravidarum (HG) is a common disease in pregnancy during the first trimester. Patients suffering from HG commonly present with dehydration, nutritional depletion, electrolyte imbalance, and the loss of at least 5% of body weight. Although the psychological etiology of HG is not clear, it has been shown that psychiatric symptoms are extensively present in patients with HG.
The aim of this study was to investigate the relationship between temperament, attachment style and hyperemesis gravidarum.
This case-control study was conducted at Kırıkkale University Hospital in Kırıkkale, Turkey, between May 2015 and May 2017. A total of 98 pregnant women suffering from HG in their first trimester of pregnancy (HG group) and 95 healty pregnant women in their first trimester of pregnancy (control group) were included in the study. Adult attachment styles were determined as secure, fearful, preoccupied, and dismissing. The evaluation of temperament was done using the TEMPS-A scale.
The mean secure attachment style score in the HG group was 3.9 ± 0.9 and significantly lower than the mean attachment style score (4.6 ± 1.1) in the control group (P = 0.001). In the TEMPS-A scale, patients with HG showed significantly higher mean depressive (9.7 ± 3.8) and mean anxious scores (13 ± 2.3) than those of the control group (6.6 ± 2.9 and 8 ± 0.9, respectively) (P = 0.001 and P = 0.040, respectively).
This study revealed that HG patients had more common depressive and anxious temperament characteristics and lower secure attachment style than non-HG patients. Due to the fact that attachment and temperament styles are relatively stable throughout life, we thought that psychiatric problems may play a role on development of HG.

Breast cancer is widespread in Iran and exercise training is an adjuvant strategy for managing this illness.
The aim of this study was to investigate the effects of aerobic training on tumor growth and its relationship with changes in adiponectin, leptin, and ghrelin in mice with breast cancer.
In this animal experimental study, which was conducted during year 2016 in Iran, 20 female BALB/c mice were randomly divided to two groups: Tumor Control (TC) and Exercise (E). The MC4L2 cancer cells were injected in the mice. The E group then performed progressive aerobic training for six weeks. Tumor volume, food intake, weight, and muscle endurance of all mice were measured weekly. At six weeks, the mice were sacrificed and tumor, gastrocnemius muscle, and heart weights were measured. Level of cytokines/hormones were quantified using the Enzyme Linked Immunosorbent Assay (ELISA) methodology in tumor, serum, muscle, and adipose tissue.
Aerobic exercise training was associated with a significantly decreased growth rate and final weight of the tumor (1.11 versus 2.74 g) compared to the TC group (P Aerobic exercise training in mice with breast cancer attenuated tumor burden and cachexia, and improved appetite, muscle size and function and fitness relative to non-exercising controls.

The current study aimed at investigating the effect of using Entonox gas during sedation and analgesia induction in pediatric candidates of bone marrow aspiration.
It was a single-blind, randomized clinical trial. All pediatric candidates of first time bone marrow aspiration were included and allocated to either group 1 or 2, using a random number table. In group 1, a combination of midazolam, fentanyl, ketamine, and propofol was injected intravenously. In group 2, the mentioned combination was injected intravenously and Entonox gas was used for patients’ ventilation. The goal was to reach level 4 sedation based on the Ramsay sedation scale. If needed, extra propofol was injected intravenously every minute. Physician and the helping nurse satisfaction of the procedure were evaluated. Duration of the procedure, the administered dosage for each patient, occurrence of any complications, and the recovery time were recorded.
A total of 88 cases with the mean age of 6.8 ± 3.6 years, and mean weight of 25.4 ± 12.5 kg were included in the study (50% female). Baseline and demographic data of the groups showed no significant difference. Propofol consumption was significantly lower in group 2, for whom Entonox gas was prescribed, compared with group 1 (P-value It is likely that Entonox prescription during bone marrow aspiration in pediatric leads to decrease in consumption of propofol to provide proper sedation, shorter recovery time of the patients, and increased satisfaction in both the physician and nurse in charge of performing the procedure.

Hydrogen Peroxide (H2O2) and Tumor Necrosis Factor alpha (TNF-α) increase Brain-Derived Neurotrophic Factor (BDNF) and Glial Cell Line-Derived Neurotrophic Factor (GDNF) expression. Athletics use anti-oxidant and anti-inflammatory supplementations to reduce H2O2 and TNF-α level. There is insufficient information about vitamin E supplementation on neurotrophic adaptations induced by intensive exercise training. Therefore, the aim of the present study was to investigate the effects of intensive exercise training in combination with vitamin E supplementation on BDNF and GDNF content of rat brain.
In an experimental study, 40 male Wistar rats were randomly assigned to Control (C), Sham (S), Vitamin E (V.TE), Exercise training (ET), Exercise training Vitamin E (ET.TE) groups, with 8 rats in each group. Exercise training on treadmill (27 m/minute) was carried out in combination with vitamin E supplementation (60 mg/kg/day) for six weeks. Statistical significance was determined at P Vitamin E supplementation increased brain vitamin E levels in V.TE and ET.TE groups (P = 0.001). Significant increments in the levels of H2O2 (P = 0.007), TNF-α, (P = 0.001), BDNF (P = 0.001), and GDNF (P = 0.001) in the ET group were shown; however, vitamin E supplementation could not change exercise-induced increases on the above-mentioned factors in the ET.TE group (the p-values were equal to 0.024, 0.001, 0.001, and 0.001 respectively).
Intensive exercise training increases BDNF and GDNF contents in the whole brain of rats, yet vitamin E does not influence neurotrophic adaptations induced by intensive exercise training.

Premenstrual syndrome (PMS) is one of the most common psychosomatic disorders in reproductive-aged females and due to its less severe symptoms, administration of non-pharmacological interventions as the first-line is emphasized.
The current study aimed at examining the effect of mindfulness-based cognitive-behavioral therapy on PMS symptoms.
The current randomized, controlled trial was performed on 40 students with PMS from Shahid Chamran University in Ahvaz, Iran in the academic year 2016 - 2017. Students were allocated into 2 groups (20 subjects in each) using simple random sampling method by the random number table. Students in the intervention group received eight 1-hour sessions of mindfulness-based cognitive-behavioral therapy weekly and the students in the control group received no intervention. The PMS symptoms were assessed using the daily symptom records (DSR) questionnaire, before, just after the completion of intervention, and one month later.
In the intervention group, the mean score of PMS symptoms immediately (27.65 ± 7.34) and one month after the completion of the intervention (28.15 ± 7.13) showed a significant reduction, compared with the pre-intervention scores (42±9.09) using the repeated measure test (P 0.05). Also, the symptoms of PMS significantly reduced in the intervention group in just after the intervention and the follow-up visit, compared with that of the control group (P According to the findings, mindfulness-based cognitive-behavioral therapy could reduce physical and behavioral symptoms of PMS in the studied students.

Non-governmental organizations (NGOs) are one of the essential measures of modern governments’ management to improve social, political, and developmental activities. They play an important role in the process of development in most countries.
The present study was conducted to design and validate the checklist of NGOs’ practice in Kerman (Iran) where the scope of their activities is increasingly more diverse and complex. The availability and access to a valid and reliable instrument is essential for intervention and promotion of non-governmental organizations.
The checklist was designed and validated from the literature review, existing reports, and current statutes of NGOs. Content and structure validity (exploratory and confirmatory factor analysis), and internal consistency were used to measure the psychometric components of the checklist. Our sample consisted of all 150 licensed NGOs in Kerman, and sampling was conducted from April 2014 to September 2015.
While the checklist showed acceptable content validity, exploratory factor analysis revealed 3 factors: (a) social influence, (b) social structure, and (c) participatory experience. Confirmatory factor analysis revealed that fit indices were acceptable as χ2 =1.65, CFI = 0.79, AGFI = 0.74, GFI = 0.82, and RMSEA = 0.1. The Cronbach`s alpha was 0.7.
Our results revealed that the checklist psychometric properties were acceptable. This checklist can be a start point for developing standard tools in the field of non-governmental organizations’ activity. In addition, this tool can be a guide for the evaluation and enhancement of NGOs’ activity.

Overexpression of human epidermal growth factor receptor 2 (Her2) protein has been shown in a variety of human malignant tumors. In some of these tumors, such as breast carcinoma, targeted anti-Her2 therapy has been considered as a promising therapeutic strategy.
The aim of this analytic descriptive study was to evaluate the immunohistochemical expression of Her2 and its relation to grade and muscular invasion of urothelial bladder tumor.
In this descriptive-analytic study, 179 paraffin-embedded tissue blocks from patients with urothelial bladder tumors were selected for immunohistochemistry (IHC) analysis using antibodies against Her2. IHC staining was evaluated according to the same criteria of breast carcinoma.
Her2 over expression was detected in 49 patients (27.4%) and was significantly associated with high tumor grade and bladder muscular involvement (P Her2/neu over expression is associated with aggressive behavior of urothelial bladder tumors. Assessment of Her2 status could be helpful to identify patients with a high probability of disease progression. Anti-Her2 therapy could be used in urothelial bladder cancers, however, this issue needs further studies.

Dry cupping has been used as a treatment for abnormal uterine bleeding in Iranian traditional medicine.
The present study aimed at evaluating the usefulness of dry cupping on excessive menstrual blood loss in menorrhagia with a well- validated menstrual pictogram compared to medroxyprogesterone acetate.
A total of 162 women with menorrhagia were enrolled in this prospective, randomized, controlled trial in Iran from 2015 to 2016. Written informed consent was obtained, then, patients were randomly allocated into dry cupping (3 sessions of interrupted and kinetic dry cupping during menstrual bleeding) or medroxyprogesterone acetate (10 mg/day throughout the luteal period) groups using a random number sequence. The number of bleeding days and objective estimation of menstrual blood loss using a pictorial blood loss assessment chart (PBAC) were recorded before the intervention and at specific intervals (1 and 3 months post-intervention).
At 1 and 3 months, PBAC scores were significantly lower in women treated with cupping compared with women treated with medroxyprogesterone acetate. These reductions in PBAC score were 214.9 mL with 95% CI (120.5 to 309.2) greater than medroxyprogesterone acetate at 1 month and 237.3 with 95% CI (143.0 to 331.7) at 3- month follow- up period. Reduction in the number of bleeding days in the cupping group for almost one day was better than the control groups at 1 and 3 months follow- up (Mean difference:-1.03, 95% CI (-1.78 to -0.26), P = 0.007).
Dry cupping is an effective treatment in reducing the intensity of bleeding during the menstrual period compared to medroxyprogesterone acetate.

Gastro-esophageal reflux disease (GERD) is one of the most widespread gastrointestinal disorders. In addition, there is increasing evidence that not all patients respond to its current remedies.
The aim of this pilot study was to investigate the effect of “Satureja hortensis L.” on improving the symptoms of mild to moderate GERD in adults.
In this double-blind, randomized, controlled, clinical trial, we evaluated the efficacy of “Satureja hortensis L.” compared to placebo in the symptoms of GERD in fifty-eight adults with GERD who referred to Hazrat Rasool-e-Akram hospital in Tehran, Iran, in 2015. In order to assess GERD symptoms, a standardized questionnaire of frequency scale (FSSG) was used before and after the intervention.
Regarding within-group changes, a significant decrease was observed in FSSG, dysmotility-like symptoms and acid reflux related scores in both groups of the study after the intervention compared to baseline (P According to the results of the current study, Satureja hortensis L. with the dose of 500 mg three times per day failed to improve the symptoms of GERD in adults compared to placebo. The significant reductions in the GERD scores in both groups seem to be related to the lifestyle modification that was prescribed to both groups.

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as a Churg-Strauss syndrome, is a rare systemic vasculitis. Central nervous system (CNS) involvement is described in rare cases. Acute spinal subdural hematoma (SSDH) is an uncommon condition presented with acute severe, radiating pain in the back area, and symptoms of spinal cord compression. The association of these two rare entities has been rarely reported so far.
A 32-year-old female known case of limited scleroderma for 12 years and EGPA for six years with presentation of eosinophilia, high P-ANCA, and skin vasculitis, was admitted to the rheumatology ward of Faghihi hospital related to Shiraz University of Medical Science in Iran (May 2016) due to new necrotizing vasculitis lesions on her hands, dyspnea, bilateral crackles, and eosinophilia. During this hospital admission, while receiving methylprednisolone, low dose aspirin, and prophylactic heparin, she developed severe upper back pain and neck rigidity and in her imaging studies, thoracic spinal subdural hematoma was seen.
This article describes a case of EPGA presented with a non-traumatic acute subdural thoracic hematoma in addition to her classic symptoms along with limited scleroderma. This suggests that non-traumatic spontaneous acute spinal subdural hematomas should be considered in manifestations of EPGA and early recognition could be helpful for appropriate management.

Rodenticides are considered a global challenge to public health. Two major compounds in this category include aluminum phosphide and zinc phosphide. However, simultaneous use of aluminum phosphide and zinc phosphide has not been reported in the literature.
We present the case of a 20-year-old female, who was poisoned with both a rice tablet and powdered rat poison. She was admitted to Shahid Beheshti hospital of Babol University of Medical Sciences, Babol, Iran in July 2016. Resuscitative and supportive measures were applied, including prophylactic intubation, gastric lavage with a bicarbonate solution, and intravenous administration of N-acetylcysteine (NAC), magnesium sulfate, calcium gluconate, and bicarbonate compounds. In case of a blood sugar level above 100 mg/dL, regular insulin was infused. After the diagnosis of phosphine-induced cardiomyopathy, digitization with digoxin was prescribed for the patient.
This case report presents the possible positive effects of digoxin, insulin, and antioxidant therapy on simultaneous poisoning with aluminum phosphide and zinc phosphide.

Dengue fever remains an infectious disease that reaches epidemic proportions in many tropical countries. Its management remains a challenge, more so in patients, who have chronic medical conditions that require fluid restriction, such as dengue fever.
This case report will investigate the management of fluid replacement in a chronic heart failure patient with dengue fever, Mr ZK, in a district hospital of the state of Selangor in Malaysia a year ago. His fluid requirement was managed based on the existing guidelines, his clinical status, and blood parameters. He was safely discharged after three days of hospital stay without any of the complications of chronic heart failure or dengue fever.
Management of dengue fever in patients, who have fluid restriction as one of their management regimens remains a huge challenge, requiring regular monitoring, and good clinic acumen. This was one of the elements explored in this case report.

Gastric bezoars are formed by accumulation of non - digestible material in the stomach. They are found mostly in patients with delayed gastric emptying or special psychiatric diseases. Therapeutic options are medical dissolution therapy and endoscopic techniques. Surgery options are kept for refractory or emergency cases.
We report 2 cases of successful non surgery, endoscopic treatment of huge gastric bezoars, which were refractory to medical dissolution therapy and conventional endoscopic techniques such as bezoar fragmentation by polypectomy snare, Basket, Argon Plasma Coagulation device, and different types of foreign body retrieval forceps. In June 2015 and September 2017 in the Namazi hospital (Shiraz University of Medical Sciences, Iran) bezoars fragmentation were conducted successfully by electrohydraulic lithotripsy catheter (Nortech Aoutolith and copy, Northgate technologies, INC.) under direct visualization during the endoscopy. This instrument is primarily designed to crush urinary tract and bile ducts stones avoiding open surgery. Taking the advantages of its capabilities, we used electrohydraulic lithotripsy catheter for huge gastric bezoar fragmentation.
In the endoscopic treatment refractory gastric bezoars, electrohydraulic lithotripsy can be used as an excellent alternative option to surgery. This technique is safe, feasible, and uncomplicated without any need for surgery.