مجله دانشگاه علوم پزشکی مازندران
پیاپی 110 (اسفند 1392)

Background and

One of the main goals of nursing education is training appropriate and efficient nurses. The purpose of this study was to discover the perceptions of nursing students and their teachers about professional competency of academic staff.

In this qualitative content-analysis approach study, the data were collected through unstructured in-depth interviews [30 individual and 1 focusing (Focus Group) interviews]. The participants were chosen using purposeful sampling from Mazandaran University of Medical Sciences, Iran, during July 2012 to June 2013. Formal or conventional qualitative content analysis was performed.

11 categories and 4 themes were achieved. The themes included making the theoretical training efficient and useful (with 4 subthemes), gaining qualificative nursing science and skills (with 4 subthemes), making the clinical education efficient and effective for students (with 8 subthemes), and making the evaluation logical and objective (with 3 subthemes).

This study found four basic themes of professional competency of academic staff and the indicators related to these features according to nursing students and their teacher's viewpoints. These findings can be used for designing evaluation and assessment tools for professional competency of academic staff.

Background and Beta-thalassemia is an autosomal recessive disease characterized by reduction or complete absence of beta-globin gene expression. This study aimed to find out and determine the spectrum of beta-globin gene mutations and especially rare mutation in beta-carrier couple in Babolsar, north region of Iran. This is very important in perinatal diagnosis of thalassemia. This descriptive study was carried out on 158 beta-carrier couples identified using hematologic testing in Babolsar thalasemia counseling center during years 2001-2011. They were referred to cytogenetic centers for consoling beta-globin gene mutations. Amplification-refractory mutation system-polymerase chain reaction (ARMS-PCR) and Restriction fragment length polymorphism (RFLP) were used for identification beta-globin gene mutations. More than 20 kinds of common mutations were studied on 316 individuals (632 chromosome), among them, mutation IVSII-1 (G>A) was the most common (72.4%). About 90% of mutations was consisted of four mutation, IVSII-1 (G>A), C22 (G>T), C30 (G>C), and C8 (-AA). 5% of mutations was consisted of rare mutations, C26 (HgbE), C6 (HgbS), IVSII-848 (C>A), and IVSI-130 (G>A, I). The most common beta-globin chain mutation was IVSII-1 (G>A) that is the same in Iran northern provinces (Guilan, Mazandaran, and Golestan). SCA (C60) and HgbE (C26) that are rare beta-globin gene mutations were seen this area, that are not seen in other regions of Iran.

Background and Previous Research shows the use of plasmids containing genes TSA to be useful as vaccines for Leishmania major. Recently, the role of interleukin-22 (IL-22) in tissue repair has been demonstrated. In this research, the effect of IL-22 on encoding TSA gene of Leishmania major in BALB/c mice was assessed. pcDNA3 plasmid containing the gene encoding TSA protein (pcTSA) of Leishmania major, along with the cytokine IL-22 was used. 60 BALB/c mice were divided to 4 groups of 15. Control groups received pcDNA3 and PBS and a group was vaccinated intramuscularly with the TSA gene containing plasmid. Fourth group received plasmid containing the gene for the TSA and IL-22 protein. IL-4 and interferon gamma (IFN-γ) levels (MTT test) were used to evaluate the cellular immunity and IgG2a, IgG1 and Total IgG levels [enzyme-linked immunosorbent assay (ELISA) method] to evaluate the humoral immunity. Measuring the diameter of the lesions and the age and weight of the mice was performed. The simultaneous use of plasmid containing the gene encoding protein TSA and IL-22 significantly increased the mean level of IFN-γ and reduced the mean level of IL-4 compared to the other groups. While the mortality rate at 27th week after intervention was 100 % in the control group, the surveillance rates of pcTSA and pcTSA + IL-22 groups were 80%. pcTSA + IL-22 group had the highest weight in 30th week. pcTSA + IL-22 group had significantly smaller lesions compared to control and pcTSA groups. Results show the efficacy of pcTSA + IL-22 in improving the vaccination of cutaneous leishmaniasis.

Background and

Astigmatism is a common optical dysfunction, effective on various visual outcomes and one of the important criteria of refractive surgery. The aim of present study was to evaluate the correlation between refractive, corneal and residual astigmatism in refractive surgery candidates.

In this cross-sectional descriptive, analytical study, 200 patients referred to the Farabi hospital, Iran, for refractive surgery were enrolled. Refraction survey and topography were done to determine refractive, corneal and residual astigmatism for all of participants and statistical analyses were performed.

Overall, 400 eyes of 200 subjects with the average age of 28.2 ± 6.24 participated in this study. 62.7% of cases were women. According to spherical equivalent, 94.2% were myope, 3.3% were hyprope and 78.9% had refractive astigmatism more than 0.75 D. Mean spherical equivalent refractive errors was -3.59 ± 1.95 D in myopic group and 2.72 ± 0.97 D in hyperopic group; mean astigmatism was 1.97 ± 1.3 D in myopic and 1.3 ± 1.37 D in hyperopic group. The correlation ratio was (r = 0.223) between lenticular and refractive astigmatism (P < 0.001), (r = 0.111) between lenticular and corneal astigmatism (P = 0.027), and (r = 0.942) between refractive and corneal astigmatism (P < 0.001).

Significant correlations were found between refractive, corneal, and residual astigmatism; there was a strong correlation between corneal and refractive astigmatism; and 81% of the changes in refractive astigmatism could be justified with corneal astigmatism changes. Separating the type of astigmatism and determining its origin (cornea or lens) could be helpful for refractive surgery.

Background and Due to the increasing information about illnesses and deaths, classified map is of appropriate methods for analyzing this type of data. Standardized infection rates are commonly used in disease mapping but had many defects. This study aimed to compare the Poisson regression models and empirical Bayes models to prepare geographical map of tuberculosis incidence in Mazandaran province, Iran. The standardized incidence rates were conducted using two methods of empirical Bayesian smoothing and without consideration of spatial correlation using data from 2005 to 2011. The incidence rate of tuberculosis was 8.14 during the studied period. Poisson regression model showed that the variables of gender and disease were significantly effective on incidence rate. Using an empirical Bayes approach based on the smoothing, we found 2 clusters in west, 3 clusters in center and 2 clusters in east ofv Mazandaran province. Using Poisson regression models, we found significant effect of gender and disease on incidence rate. Poisson regression model is better to prepare geographical map of a disease.

Background and In the last step of preparation of nanoparticles, glutaraldehyde (GA) is added to stabilize the formed nanoparticles. There are several reports indicating the harmful effects of glutaraldehyde on different organ systems and tissues. The aim of this study was to evaluate the effects of different cross-linking methods like using ultraviolet (UV) irradiation, glucose and combination of these methods on nanoparticles. Nanoparticles were prepared by desolvation method and in the last step were cross-linked by four different methods. Nanoparticles were compared with each other based on properties like size, zeta potential [by Photon correlation spectroscopy (PCS)], Fourier transform infrared spectroscopy (FTIR), scanning electron micrograph, cellular uptake and toxicity. All nanoparticles had the same range of size (100-200 nm) and only the zetapotential of UV treated group had significant difference with glutaraldehyde group. The results of scanning electron micrograph and FTIR assay were the same for all groups. Cross-linking by combination of UV and glucose had less toxic effects and more viable cells (76.59 ± 7.67 percent) compared to glutaraldehyde (40.08 ± 6.60 percent) (P < 0.01). Cellular uptake of nanoparticles cross-linked with UV and glucose and glutaraldehyde showed similar results. These findings support the idea that using combination of UV and glucose as cross-linking method can be an appropriate alternative method for toxic glutaraldehyde with less toxic effects.

Background and Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are the most commonly used drugs for pain relief after impacted third molar surgery. Recently, new generation of these drugs have been introduced that act more selectively and have lower gastrointestinal side effects. As to our knowledge, there are not enough studies about the effectiveness of these drugs; the objective of this study was to compare celecoxib with ibuprofen and acetaminophen codeine. This randomized clinical trial was done on 180 patients from whom attending Department of Oral and Maxillofacial Surgery of Tehran University of Medical Sciences, Iran. Patients were divided into three groups to use a single dose of celecoxib 100 mg, ibuprofen 400 mg or acetaminophen codeine (acetaminophen 300 mg + codeine 20 mg) after surgery. A questionnaire was given to the patients to mark their pain intensity. Considering the time of use of rescue medication, ibuprofen was the best and acetaminophen codeine the worst, although there was significant difference between ibuprofen and celecoxib. In addition, considering the pain intensity, ibuprofen and celecoxib were comparable, and both were superior to acetaminophen codeine. According to the almost comparable effectiveness of ibuprofen and celecoxib, celecoxib can be the drug of choice when ibuprofen has contraindications.

Background and Toxoplasma gondii is a protozoon with worldwide distribution. In spite of increasing information about its biology, treatment of toxoplasmosis is restricted to a few drugs and unfortunately using of each of drugs is associated with significant side effects in patients. It seems that investigation on alternative drugs is necessary. In case group, concentrations of 1, 5 and 10 µg/ml of ketotifen were prepared and added to RPMI (Roswell Park Memorial Institute) medium containing peritoneal macrophages. After 60 minutes, incubation and adding Toxoplasma gondii tachyzoites to medium, the inhibitory rate of different concentrations of ketotifen on entrance of Toxoplasma tachyzoites into macrophages in 30 and 60 minutes were evaluated. Control group did not receive ketotifen. The best efficacy of ketotifen in inhibition of entrance of Toxoplasma tachyzoites into macrophages was observed in 10 µg/ml and in 60 minutes (72.90 ± 1.70) (P < 0.05). The findings of this research show that ketotifen is a suitable drug for inhibiting the entrance of Toxoplasma gondii tachyzoites into nucleated cells in vitro.

Background and Pediculosis is a worldwide public health concern. This descriptive study was performed on primary-school-aged children to determine the prevalence of pediculosis and its risk factors in Mazandaran Province, Iran, on basis of geographic information system (GIS). A random sampling method was used to select 45237 school-aged children from Sari to Ramsar cities during September 2012 to June 2013. Data were collected from the selected schools by five trained nursing inspectors. A detailed questionnaire was filled for each child prior to hair examination following which examination was carried out to detect head lice as well as eggs/nits. Data were analyzed chi-square test. Finally, the GIS map was obtained in province informational chart. 823 primary-school children (of 45237) were infected with lice in Mazandaran Province. The mean infection prevalence was 1.4% in cities 5.64% in rural area from Sari to Ramsar. There were significant relationships between pediculosis and some factors (P < 0.05). GIS map revealed that the contamination was less in west than in east and central regions. Increasing awareness and training of teachers and parents, as well as improving standards of personal health can significantly reduce the prevalence of pediculosis.

Background and Regarding the effective role of plant flavonoids in the prevention and treatment of diabetes mellitus, in this investigation, induction of P19 stem cells differentiation into insulin producing cells by flavonoids of methanol extract of Cichorium intybus L. leaf was examined. Initially, flavonoids of methanol extract of Cichorium intybus L. leaf were concentrated. The P19-derived embryonic bodies were cultured in α-MEM (Minimum Essential Medium) containing 15% fetal bovine serum for three days. To induce the differentiation, the cells treated with the concentrations of 50, 100 and 200 µg/ml of flavonoids of methanol extract of Cichorium intybus L. leaf for 12 days. Untreated P19 cells and embryonic bodies were used as controls. Dithizone staining, immunoflorecence and real-time polymerase chain reaction (RT-PCR) techniques were used to demonstrate the differentiated cells. Differentiated P19 cells by different concentrations of extract shown positive reaction to dithizone staining. Most percentage of positive dithizone cells was reached in concentration of 100 µg/ml. Immunoflorecence method showed that differentiated P19 cells were able to express the pancreas beta cell-specific markers. Pdx-1 gene expression in the cells was demonstrated by RT-PCR technique. The flavonoids of methanol extract of Cichorium intybus L. leaf are able to induce differentiation of P19 stem cells to insulin producing cells.

Background and

Fish and seafood are considered as important sources of high-quality protein, minerals and polyunsaturated fatty acids, but they can contribute significantly to human dietary exposure to environmental pollutants. This study was carried out to assess the concentration of Pb in kutum as the most consumed fish and to determine the estimated daily/weekly intake (EDI/EWI) for comparisons to the tolerable daily/weekly intake (TDI/TWI).

Forty kutums were collected from Bandar Anzali and Roodsar stations, Iran, during January 2012. After preparation and chemical digestion, Pb concentration was determined using Furnace Atomic Absorption Spectrophotometry (SHIMADZU AA/680).

The mean accumulated concentrations of Pb in the kutum from Bandar Anzali and Roodsar stations were 2.55 ± 0.54 and 1.66 ± 0.25 mg/kg dry weight, respectively. The observed EDI and EWI of Pb from Bandar Anzali and Roodsar stations were 0.001-0.009 and 0.0009-0.006 mg/kg, respectively.

The observed EDI and EWI of Pb in the kutum from Bandar Anzali and Roodsar stations were lower than stipulated guidelines by the FAO/WHO Joint Expert Committee and therefore, were not considered to pose adverse effects to consumers.

Background and The aim of this study was to assess the prevalence of suicidal ideations in patients under hemodialysis and determination of psychological, clinical and demographic characteristics to early and accurate identification of the disease and prevention of the side effects in future. This descriptive-analytical study was performed on 180 patients admitted to dialysis ward of Imam Khomeini and Fatemeh Zahra hospitals (Sari, Iran) in 2011 based consensus sampling method. First, the General Health Questionnaire (GHQ) was filled by the patients and then, the patients asked to complete the Suicide Ideation questionnaire-concept scale (SSI). Of the 180 patients, 24 (13.3%) were positive for suicidal ideations in GHQ questionnaire, of which, 17 (70.8%) were women. There was a significant relationship between the risk of suicidal thoughts and suicide risk in SSI questionnaire and gender, age, educational level, occupation and duration of dialysis. The prevalence of suicidal ideations among all the studied patients was 10.5%. Considering our reports, it can be concluded that psychological problems in hemodialysis patients can seriously influence their life.

Background and Several studies have identified the role of several risk factors for breast cancer. This study aimed to investigate the performance rate of breast cancer screening methods and its relationship with breast cancer risk factors in women of Mazandaran province, Iran. In this descriptive analytical study, the sample was 1416 women of over 20 years of Mazandaran province. Questionnaire was completed by interviewers visiting rural and urban households. Data were analyzed using descriptive and inferential statistical methods. The performance rate was 14.3% for regular monthly breast self-exam (BSE) and 20.7% for the regular annual clinical breast examination. Among breast cancer risk factors, 12.9% of menarche before 12 years of age, 6.9% of delayed menopause (above 55 years of age), 9.5% of history of benign breast diseases, 3.9% of hormone therapy, 6.1% of positive family history in first-degree relatives, and 10% of positive family history in second-degree relatives were seen. There was a significant correlation between a history of benign breast disease with clinical examination and mammography performance (P < 0.001). Despite the risk factors of breast cancer, the performance rate of breast cancer screening methods among women at high risk for breast cancer was very low and poor.

Background and Cancer is the third leading cause of death in Iran. Mazandaran and Golestan provinces, especially in northern countries, have a high incidence of gastrointestinal cancer. Therefore, we aimed to find the geographic distribution of standardized mortality rates of this disease and to mark differences between the cities on a map. The data related to the cases of death from gastrointestinal cancer during the years 2001 to 2005 were recorded in the provinces of Golestan and Mazandaran. Generalized Poisson regression model was used for data standardization; then, the mapping was done. 5715 people died from cancer of the gastrointestinal tract, 65.18 percent in Mazandaran and 34.82 percent in Golestan. Standardized mortality rates in the central parts of the provinces showed a little less. From the city of Chaloos to the border of the city of Gorgan, standardized mortality ratio (SMR) of most of the regions was between 0.9 and 1. From the border of the city of Gorgan to end of eastern geographical boundaries of Golestan Province, the obtained standardized mortality ratio was more than 1. The regression model could partly eliminate heterogeneity of standardized mortality ratio. Changes in mortality rates from cancers of the gastrointestinal tract in Mazandaran and Golestan provinces on the map represent a high-risk area, which remarks the impact of geographical and social-economic region.

Background and Aflatoxins are of the most important groups of mycotoxins recognized to be teratogen, mutagen, and carcinogen. Aflatoxins have been detected in a number of foods including cereals and cereal products. Beers are often derived from malted cereal grain; most commonly malted barley and malted wheat. Contaminated cereals to aflatoxins results in malt and beers consumption with them. This study was carried out to evaluate the content of aflatoxins in 100 non-alcoholic beers collected randomly from supermarkets of Lorestan province, Iran, in first six-month of 2013. Aflatoxins were cleaned up with immune affinity column, separated by reversed-phase high-performance liquid chromatography (HPLC) and detected using florescence detector. No aflatoxin contamination was observed in any of the samples. According to the results, it seems there is no concern for aflatoxin contamination in beer. This is the first survey on aflatoxin contamination in non-alcoholic beers in Iran.

Background and Urolithiasis is one of the most common diseases of urinary tract. Abdominal colic pain, nausea and vomiting, and hematuria are the major clinical complains. Renal stones may obstruct urinary tract, and then damage the kidney. Medical treatment, removing the stones by extracorporeal shock wave lithotripsy, percutaneous lithotripsy, and ureteroscopic lithotripsy are common treatments but they are expensive and may result in significant complication. The aim of this research was finding a new medication for dissolution of urinary stones with less complication and cost. Variable concentrations of some fractions of the extract of Juniperus communis fruit (500, 1000 and 2000 µg/ml solutions) were used in vitro on urinary stones brought out from human kidney. Neutral (normal saline), positive (sodium bicarbonate) and negative (acetic acid) control groups were also prepared. Significant findings were obtained in urinary stones composed of calcium oxalate (50%), calcium hydrogen phosphate (20%), magnesium ammonium phosphate, (10%) and ammonium urate (20%). The weight of dry powder of stones in normal saline decreased from 1458 mg to 1162, 1124, 1136, 1144, 1096, 1126, and 1130 mg after exposure to increasing concentrations of some fractions of the extract of Juniperus fruit. In addition, the ratio of calcium oxalate in normal saline aqueous solution plus stone increased from 70% to 80% after using some fractions of the extract of Juniperus fruit. Some fractions of the extract of Juniperus fruit can dissolve urinary stone in vitro.

Background and

Recently, using agricultural wastes as a biosorbent in removal of heavy metals has been concentrated. The aim of this study was evaluation of Canola residuals on removal of cadmium from aqueous solutions.

This experimental study was performed in laboratory scale in a batch system. The effect of parameters such as contact time (5, 10, 15, 30, 45, 60, and 120 minutes), pH (2, 4, 6, and 7), initiative concentration of cadmium (15, 30, and 60 mg/l) and adsorbent doses (0.2, 0.6,1 g/100 ml) was evaluated. The sampled solutions of cadmium with known concentrations in 100 ml were prepared in Erlen Mayer of 150 ml. The samples were analyzed by atomic absorption spectrometry PG-999 instrument in wavelength of 228 nm. The results were compared using the Langmuir and Freundlich isotherms and kinetic models.

Maximum removal of cadmium was 95% happened in primary five minutes. Optimum pH was 6. Adsorption ability of cadmium increased with increasing initiative concentration of cadmium and adsorbent dose. The adsorption isotherm obeyed Freundlich model and the adsorption kinetic followed pseudo-second-order reaction.

Based on the results, Canola residues could be used as a low-cost and efficient biosorbent for treatment of wastewater with cadmium.

Background and The aim of this study was to compare the proportion of natural killer (NK) and natural killer T (NKT)-like cells in dyspeptic disorders caused by Helicobacter pylori (H. pylori). In a case-control study, 27 patients with gastric cancer (GC), 25 patients with peptic ulcer (PUD), and 22 patients with non-ulcer dyspepsia (NUD) were enrolled. After endoscopic diagnosis, the proportions of NK cells subsets (CD3-CD56+ and CD3-CD16+), as well as NKT-like cells (CD3+CD56+) in peripheral blood were determined by flow cytometry. The frequency of CD8+ and CD8– NK cell subsets were also determined. H. pylori infection was confirmed in all study subjects using the rapid urease test and histopathology. The frequencies of CD3-CD16+ NK, CD3-CD56+ NK, and CD3+CD56+ NKT-like cells in patients with gastric cancer infected by H. pylori were significantly lower than those in patients with non-ulcer dyspepsia (P < 0.001, P = 0.050, and P = 0.020, respectively). However, these cell populations showed no significant difference between the PUD and NUD groups. Further analysis showed that high numbers of CD8– NK cells in the blood were CD56+ and CD16+ phenotypes. This study showed decreased numbers of NK and NKT-like cell populations in patients with gastric cancer compared to those with non-ulcer dyspepsia. It is thus suggested that these cells may limit the prolonged inflammation by H. pylori, which, in turn, reduce the risk of gastric cancer.

Background and

The diagnosis of iron overload in various organs such as heart and liver in patients with blood-transfusion-dependent thalassemia can greatly improve their quality of life. In this study, we investigated the relationship of T2*-weighted magnetic resonance imaging (MRIT2*) of heart and liver with ferritin levels; also assessed the factors affecting iron overload using generalized estimation equations (GEE).

53 patients with thalassemia major in Dr. Mohamed Kermanshahi hospital, Kermanshah, Iran, during 2011-12 were enrolled. To investigate the relationship of MRIT2* of heart and liver with serum ferritin levels in addition to linear models, quadratic, exponential and logarithmic data were fitted well. To identify factors influencing iron overload, generalized estimation equations was used.

Exponential model was more appropriate to describe the relationship of serum ferritin levels with MRIT2* of heart (R2 = 0.170) and quadratic model was more appropriate for liver (R2 = 0.277). Generalized estimation equations model showed that ferritin level (P < 0.001), splenectomy status (P < 0.001), desferal (P < 0.001), and osveral (P < 0.001) affected the iron overload.

Using generalized estimation equations model for longitudinal studies and studies of correlation between response variables is more reliable and needs smaller sample.

Background and Acute bacterial sinusitis is a very common disease among children. Empirical therapy for acute bacterial sinusitis often includes a 10-14-day period of β-lactamase. Azithromycin, a sustained high tissue level macrolide, due to its pharmacokinetic profile can be used once daily in a shorter treatment course of 3 to 5 days. This study aimed to compare azithromycin and common β-lactamases in treatment of acute bacterial sinusitis. In this randomized clinical trial study, the population consisted of children aged 1 month to 14 years, referred to a tertiary referral hospital from March to July 2011 with the diagnosis of acute bacterial sinusitis. Patients were divided into three groups randomly based on computer and azithromycin; amoxicillin and amoxicillin/clavulanic acid (co-amoxiclav) were prescribed to the group I, II and III, respectively. Signs and symptoms at the days of 2 to 4 and 10 to 14 were evaluated and the collected data were recorded. 155 patients were enrolled with the mean age of 23.23 ± 3.20 months. The response rate was more significant in the group receiving azithromycin compared to other groups (P = 0.0130 and P = 0.0001). On the other hand, the response rate between the two groups receiving amoxicillin and amoxicillin/ clavulanic acid was not significantly different (P = 0.1210). According to this study, further studies need to carry out in order to evaluate azithromycin as a first-line empiric therapy in sinusitis.

Background and The use of bioactive glass-ceramics in medicine has been noticed because of their ability in directly connection to bony tissue and bone repairing. Chitosan is also nontoxic material and biologically is compatible with the capability of biodegradation. However, due to the minimally invasive nature of injectable systems and their ability to make scaffold in place of using, they can take the shape of bone defect and eliminate the need for fabricated implants. The aim of this study was evaluation of rat's connective tissue reaction to injectable glass-ceramic-chitosan nanocomposite; it looks to be a good substitute synthetic material in filling bone defects and its production is possible in Iran. In this animal study, 40 rats were divided into 5 groups of 8. Polyethylene tubes filled with glass-ceramic-chitosan nanocomposite as case group and the empty tube as control group were implanted in subcutaneous tissue of rats. Biopsy samples from case and control sites were histologically examined after 7, 15, 30, 60, and 90 days and the number of inflammatory cells and blood vessels were counted. T and analysis of variance (ANOVA) tests were used to examine differences at the significance level of P < 0.05. Overall, no significant differences in severity of inflammation and vessel counts were found between case and control groups on different days (P > 0.05 for all). It seems that injectable glass-ceramic-chitosan nanocomposite was biocompatible.

Background and The identification of risk factors and their interactions is important in medical studies. The aim of this study was to identify interaction of risk factors of cerebral palsy in 1-6-years-old children. In this cross-sectional study, 225 children aged 1-6 years were enrolled during 2008-2009. Logic feature selection approach was used to identify interactions between risk factors. Data analysis was carried out using R2.15.2 software. The logical components [(positive history of current pregnancy = 0) × (consanguinity= 1) × (premature rupture of membrane= 0) × (asphyxia = 1)] and [(consanguinity = 1) × (premature rupture of membrane= 1) × (asphyxia = 1)] were significantly identified. The logic regression as a newly method has the ability of recognizing and modeling of potential interactions between risk factors of diseases such as cerebral palsy.

Background and Multiple sclerosis (MS) is an autoimmune disease of the central nervous system with the prevalence of about 2.5 million people worldwide; about half of these patients have reported having trouble in sleeping. This study aimed to investigate the rate of sleep disorders in patients with multiple sclerosis. This was a cross-sectional study on patients with multiple sclerosis in Kermanshah city, Iran, in 2011. Based on the list of MS society, 120 patients by convenient sampling were selected. Two-part questionnaire was used in this study; the first part was researcher-made questionnaire including demographic characteristics and the second part was Global Sleep Assessment (GSA) questionnaire, which validity and reliability have been confirmed to evaluate sleep disorders. The patient's mean age and mean disease duration was 34.68 ± 9.13 and 9.28 ± 5.57 years, respectively. From 120 samples, 32 (26.7%) were men and 88 (73.3%) were women. More than 87 percent of the subjects suffered from sleep problems and the most frequent problems were anxiety, sleep onset, and sleep continuity. Individual's characteristics such as gender, marital status, educational level, employment status, and type of illness had a profound impact on certain types of sleep-related disorders. The results of this study indicate that the majority of people with with multiple sclerosis somehow involved with sleep-related problems. This problem can severely affect daily activities, social relationships and overall quality of life.

Background and There are several oral problems in pediatrics interact with normal functioning, general health and quality of life. The most common problem is tooth decay and periodontal diseases. This study aimed to assess Intern's knowledge level about teeth and mouth health in educational hospital affiliated to Tehran Medical Universities, Iran. In this cross-sectional descriptive study, 391 interns in educational hospital affiliated to Tehran and Shahid Beheshti Universities of Medical Sciences and Islamic Azad University were studied in 2011. The information was gathered via a researcher-made questioner. The mean age of participants was 25.18 ± 1.25 year; 44.2% were men and the others were women. The mean knowledge score was 4.87 ± 1.73 of 15. The age, sex, and duration of education did not have any effect on the interns’ knowledge. According to this study and many other similar studies, it seems that the interns in educational hospital do not have enough information and knowledge about pediatrics teeth and mouth health. It is recommended to insert new learning programs in their educational curriculums to have enough information and proper knowledge about as first line visitors of patients.

Background and

Heavy metal contamination of aquatic ecosystems is a major concern for animals and human health. Pollutants such as heavy metals accumulate the food chain and at the end, they transmit to the human body. In this research, the concentrations of nickel, lead and cadmium in Barbus grypus of Dez River, Iran, were determined and compared with international standards.

30 Barbus grypus were caught from the central area of Dez River (city of Dezful). Then, the fishes were digested in concentrated nitric acid, and nickel, lead and cadmium concentrations were measured using graphite furnace device.

The concentrations of lead, cadmium and nickel in the gill tissues were 0.281 ± 0.013, 0.156 ± 0.009, and 0.315 ± 0.070 ppm, respectively. The concentrations of lead and cadmium were significantly higher in gill tissue compared to muscle (P < 0.05).

The results indicate that the concentrations of nickel, lead and cadmium in Barbus grypus of Dez River were less than the World Health Organization standards.

Background and Sexual health is a state of physical, mental and social well-being in relation to sexuality. This study aimed to determine the status of sexual function, its dimensions, and its socio-demographic predictors in women of reproductive age in Tabriz, Iran, in 2013. Data were collected by Female Sexual Function Index (FSFI) scale and socio-demographic questionnaire. General liner model analysis was used for modeling of socio-demographic predictors of sexual function. The mean score of sexual function was 65.9 ± 15.8 of the possible range of 0-100. Prevalence of sexual dysfunction was 66%. Sufficiency of household income for expenses and the level of satisfaction of spouse were predictors of sexual function in women. With attention to significant impact of the sexual function on health of women and their families, determining the effective factors on sexual satisfaction can assist strengthening of families.

Background and

While taking care of patients with stroke is stressful for caregivers, being aware of the principles of caring for these patients increases caregivers’ self-esteem. The purpose of this study was to determine the effect of family-based education on the caregivers’ awareness and self-esteem.

This clinical trial study was conducted on 88 caregivers selected by convenience sampling and randomly divided into two equal groups of case and control (n = 44). Data gathering devices were demographic questioner, awareness questioner, and Rosenberg’s self-esteem scale which were completed before and one month after the educational intervention. Educating the subjects was performed in 5 sessions. Data were analyzed using chi-square, paired and independent t tests.

There was not any significant difference between mean scores of awareness and self-esteem of the groups before the intervention (P = 0.821). One month after the intervention, the mean scores of awareness and self-esteem were increased considerably in case group compared with controls (P < 0.001). In addition, the study demonstrated a positive correlation between knowledge and self-esteem in case group members (P < 0.001).

Family-based education of the caregivers of patients with stroke increases their awareness and self-esteem lead to efficient care of the patients.

Congenital hyperinsulinism is a rare disorder can be associated with serious brain damage and neurodevelopmental delay in neonates. This disorder is an uncommon cause of neonatal hypoglycemia and most of the affected newborns are results of term pregnancies. In this paper, we report a case of persistent hypoglycemia due to congenital hyperinsulinism in a preterm neonate who also had hypertrophic cardiomyopathy. We describe the importance of early diagnosis and intervention in neonates who have persistent hypoglycemia unresponsive to medical treatments and we recommend performing of echocardiography in these patients.

Stomoxys calcitrans has spread throughout the world and can be found anywhere food and weather conditions are desired. This is the first report of fly biting in Iran caused by Stomoxys calcitrans in Ravand, West of Kashan, central of Iran. Based on our survey, traditional home aviary in the garden courtyard was the development and breeding place of these flies. These flies can painfuly bit during the day. The larvaes and pupa were removed from birdhouse floor and transported to Entomology laboratory of Environmental Health Group, Kashan University of Medical Sciences. Laboratory tests determined that larvaes and pupa belonged to Stomoxys calcitrans species. By using insecticide spraying in the aviary floor by Sevin, bitings were stopped. The present study was the first report on the stable fly bites in Iran. Consumption remaining of vegetables as food in aviary house would attract reproduction of the Stomoxys calcitrans flies.

Background and Burn is an important life-threatening disturbance for human. The purpose of this study was reviewing natural products recommended by resources of Iranian traditional medicine (ITM) for treatment of burn. We investigated the books of philosophers of Iranian traditional medicine; written sources from the 9th century AD with the words of "Hergh" and "Fire burn" were studied. Bibliography of sources, name of products (plant, animal or mineral), using methods, and the nature of the products were recorded. More details of these natural products were evaluated in recent databases with focusing on burn treatment. 89 natural products to treat burns were presented in 11 traditional written sources. 46.1% of the products were in more than one source. 76.4% of the products were of herbal origin, 15.7% of mineral origin, and 7.9% were of animal origin. Most of the presented products had cold and dry nature. 18% of Materia have been described to have amazing effect or to be extremely beneficial. Some of reported products in the study are approved by the new standard and scientific methods; but most of the cases are not. This is a suitable issue for researchers that would like work on Iranian traditional medicine.