[Urinary and breast milk iodine concentrations in lactating mothers and its association with certain demographic characteristics in an area with iodine sufficiency]

Introduction: lactating mothers and breastfed infants are most vulnerable to iodine deficiency. The aim of this study was to assess the iodine status of lactating mothers and its association with certain demographic characteristics in an area of iodine sufficiency

Materials and Methods: in this cross-sectional study, 264 lactating mothers, 3-5 days postpartum were randomly selected from health care centers. Breast milk, urine, and salt samples were collected from each mother. Demographic factors including age, education, occupation, date of last pregnancy, parity, gravidity, type of delivery and use of iodine containing supplement during pregnancy were assessed

Results: a total of 254 lactating mothers, aged 28.2 +/- 4.9 years completed this study. Median [interquartile range [IQR]] maternal urinary iodine concentration [UIC] and breast milk iodine concentration [BMIC] was 82 [42-146] and 241 [167-337] [micro]g/L, respectively. Significant correlations were observed between maternal UIC and BMIC [r =0.177, P=0.007]. In multiple linear regression, maternal UIC value was associated with occupation [P=0.010] and parity [P=0.014]; a significant association was observed between BMIC and occupation [P=0.039] and the iodine content of salt [P=0.043]

Conclusion: the present findings indicate that despite lactating mothers being mildly iodine deficient, as defined by median UIC, the iodine levels of breast milk were within an optimal range. In an area with iodine sufficiency, parity, occupation and iodine content of salt are major determinants of iodine status among lactating mothers

[Anti-tumor compounds of higher basidiomycetes fungi: a review of novel known mushroom derivatives with anti-tumor function]

In the Eastern and ancient communities, use of fungi in treatment of diseases has a long history. However, this topic in the Western and modern societies has not been good known. Cancer is a life-threatening disease with a lot of side effects on patients. Cancer therapeutic failure and high mortality justifies taking advantage of the experimental methods to discover anticancer drugs and find new ways for treatment. In the recent decade, many researchers have concluded that some of the higher basidiomycetes fungi are capable of producing metabolites with anti-cancer effects. Some researchers have shown that two groups of metabolites derived from some mushrooms include low molecular weight [such as Epoxyquinone, Cerebrosid, Hispidin, Illodin M and S] and high molecular weight [such as Lentinan, Schizophyllan, Polysaccharide krestin and Calvacin] affect cancer cells in various ways. These compounds can interfere to the cellular pathways such as inflammation and metastasis through the increase of antioxidant capacity, direct cytotoxic effect, disrupt the vessel-creating, increasing of apoptosis, inhibiting the proliferation of tumor cells and increase of tumor cells death with stimulate and activate of the immune system. Although studies on standardization of certain compounds isolated from natural or semi-synthetic effectively mushroom continues, it is necessary to continue efforts on finding the most effective chemical compounds. Hence, in this study we reviewed scientific literatures [1952-2015] with using combination of key words into internet search engine Google and Thomson Reuters Web of Knowledge. The purpose of this paper is presenting the most important mushroom's methabolites with antitumor effects and results of researches about the use of them for treatment of cancer

Protective effects of hydro-alcoholic extract of Allium cepa on biochemical and morphometric parameters of mice kidneys exposed to formaldehyde

Background and Aim: Formaldehyde is an air contaminant which has wide applications in industry and medicine and its destructive effects have been reported on the body systems. The aim of this study was to investigate the influence of different doses of onion extract on biochemical parameters and histopathology of mice kidneys exposed to formaldehyde

Material and Methods: 48 adult male mice were randomly divided into six groups. The control group did not receive any injection. The second group received formaldehyde 10 mg/kg for 14 days and the 3[rd], 4[th] ,5[th] and 6[th] groups received 5,10,20 and 40 mg/kg/day of onion extract respectively in addition to intraperitoneal doses of formaldehyde

After 14 days, tissue preparation was done and using stereological technique, the sizes of the kidneys and glomeruli were measured. Also, serum urea and creatinine levels were measured. Data were analyzed by SPSS software

Results: We found significant decrease in the number of renal glomeruli in all of the groups that received onion and also decrease in the volume of glomeruli in the group which had received 10 mg onion/day, compared to those in the control group [P = 0.000]. There were significant increase in the level of urea in the groups which had received doses of 10 and 20 mg of onion and in the creatinine levels of the groups which had received daily doses of 5, 20 and 40 mg of onion compared to those in the control group [P = 0.000]

Formaldehyde caused renal damage and an increase in the levels of urea and creatinine as well as a decrease in the number and volume of the glomeruli of the kidneys

Conclusion: Administration of daily doses of 40 mg hydro-alcoholic extract of onion for two weeks caused protective effect on kidney tissue exposed to the formaldehyde

[Conceptual model to improve portal services of private hospitals in Tehran]

Introduction: The main purpose of this article is to suggest a model to improve the portal services of private hospitals in Tehran

Methods: This research was practical and used evaluative survey research method. Research population of this evaluative survey included all of Tehran's private hospitals having portals as well as ten top international hospital portals. Data were gathered in March 2014 using researcher made checklist including 14 criteria and 77 index with their weight scores. Data were described using tables and graphs. Independent T test was used to statistically test the results

Results: Research findings demonstrated that Tehran private hospital portals, except for Contact Information and Page Design criteria, in most other criteria were in inappropriate conditions. On the contrary, international hospital portals except for Page Update criterion, in most of the criteria were in desirable condition

Conclusion: The findings demonstrate that Iranian hospital portals should plan to cover the gap in the quality of their portals compared with those of international hospital portals. The results also indicate that any suggesting model for Tehran private hospitals should enjoy 2 levels and 4 layers

[Evaluation of occupational exposure with vinyl chloride monomer in the plastic production industry in Tehran]

Growth of the plastics industry in recent decades has been dramatic. Poly Vinyl Chloride is one of the most widely used plastics in the world that granules in the thermal process decompose to Vinyl Chloride Monomer and is released in work air environment. This study aimed to evaluate occupational exposure and estimate workers' exposure with vinyl chloride monomer risk. A cross-sectional study of 100 workers at two Plastic factories in Tehran [A, B] was performed. Personal monitoring of workers to Vinyl Chloride Monomer was conducted by Optimized Method No.1007 from NIOSH. Atmospheric conditions, such as temperature, pressure, air velocity, and relative humidity were measured simultaneously along with personal monitoring. Quantitative risk assessment of workers was computed in the form of Standard Mortality Rate and incident rate cancer. Statistical analysis of data was conducted by SPSS version 19. Climatic parameters in the plant A and B for a relative humidity were 43.77 +/- 16.71 and 37.16 +/- 14.45% and temperature 20.95 +/- 3.34 and 21.05 +/- 2.20 degree C, air pressure 87.48 +/- 0.54 and 87.41 +/- 0.64 kPa and air velocity 0.13 +/- 0.08 and 0.10 +/- 0.06 meters per second were measured respectively. Occupational exposure to Vinyl Chloride Monomer plants A and B were 1.01 +/- 0.51 and 0.72 +/- 0.30 as ppm respectively. Quantitative risk of exposed workers based on Standard Mortality Rate was estimated 1.06 +/- 0.03 times of the population without exposure. Incident rate cancer based on accounting measures of integrated risk Information System was calculated per 1000 person exposure population. The correlation of Standard Mortality Rate and the risk of cancer incidence was statistically significant [R[2] :0.88]. Thirty one percent of workers had higher exposure to Vinyl Chloride Monomer than the occupational exposure limits [1 ppm]. In the present workers' exposure in this study is lower than international workforces reported in decades ago, but higher than studies recently published. The results clearly describes occupational hazard of workers in the current Iranian recession situation. The application of control system in the form of engineering control measure, especially in the coming years with projected economic growth, is justified for securing workers health and well-being.

Prevalence of thalassaemia, iron-deficiency anaemia and glucose-6-phosphate dehydrogenase deficiency among Arab migrating nomad children, southern Islamic Republic of Iran

This study investigated the prevalence of iron-deficiency anaemia, glucose-6-phosphate dehydrogenase [G6PD] deficiency and beta-thalassaemia trait among Arab migrating nomad children in southern Islamic Republic of Iran. Blood samples were analysed from 134 schoolchildren aged < 18 years [51 males, 83 females]. Low serum ferritin [< 12 ng/dL] was present in 17.9% of children [21.7% in females and 11.8% in males]. Low haemoglobin [Hb] correlated significantly with a low serum ferritin. Only 1 child had G6PD deficiency. A total of 9.7% of children had HbA2 >/= 3.5 g/ dL, indicating beta-thalassaemia trait [10.8% in females and 7.8% in males]. Mean serum iron, serum ferritin and total iron binding capacity were similar in males and females. Serum ferritin index was as accurate as Hb index in the diagnosis of iron-deficiency anaemia. A high prevalence of beta-thalassaemia trait was the major potential risk factor in this population

[Health promotion behaviors and its correlation with anxiety and some students' demographic factors of alborz university of medical sciences]

Introduction: Health promotion behavior is one of the health criteria. On the other hand, depression, anxiety and stress are the most common psychological problems among students. The aim of this study was to determine health promotion behaviors and its relation with anxiety and some students' demographic factors of Alborz University of Medical Sciences

Materials and Methods: In this descriptive-correlational study, 160 students of the Alborz university were selected through simple random sampling method. The data collection instruments was a demographic questionnaire, [Spielberger Anxiety Inventory] with 40 items and Health- Promoting Lifestyle Profile II [HPLP-II] questionnaire with 52 questions

The validity of instruments was determined by content validity and the reliability was obtained by internal consistency and alpha Cronbach coefficient for Spielberger Anxiety Inventory [alpha=0.90] and for [HPLP-II] questionnaire [alpha=0.92]

The data was analyzed with SPSS/18

Findings: Anxiety prevalence among students was 58.9 percent in this study. Among subsets of health promoting behaviors, spiritual growth index with a mean [2.99???0.56] and physical activity index with a mean [2.16???0.64], were assigned to the highest and lowest scores, respectively. Between health promoting behaviors and gender [P<0.0001] and being native and study of non-school related books [P=0.001] a significant relationship was found. The relation between anxiety and health promoting behavior was decreasing; hence the strongest significant relationship was between anxiety and spiritual development index [-0.56]

Conclusion: The results indicate anxiety among over than half of students, reverse relationship between health promoting behaviors and anxiety and inappropriate health behaviors, especially in the aspects of health promoting physical activity and nutrition among students. Conducting this research in other universities is recommended

gabapentin effective on pain management after ar-throscopic anterior cruciate ligament reconstruction? a triple blinded randomized controlled trial

Acute pain is common after arthroscopic surgeries and it is one of the most important causes of patient dissatisfaction, admission time and increased morbidity, Gabapentin with anti-hyperalgesic effects can play a critical role in pre-emptive analgesia methods. The aim of this study was to assess the efficacy of gabapentin in pain management after surgery and the rate of drug consumption in patients who are candidate for anterior cruciate ligament [ACL] reconstruction arthroscopic surgery. In this randomized, triple blind clinical trial, 114 patients who were candidate for arthroscopic ACL reconstruction were divided into two groups of gabapentin [G] and placebo [p], with 57 patients in each group. The intervention group received gabapentin 600 mg and a placebo was administered in control group. Patients received on-demand pethedine for pain management. The primary outcome was pain intensity according to the visual analogue scale [VAS] and the secondary outcome was the amount of opioid consumption and incidence of side effects [including: dizziness, sedation, nausea and vomiting] at 6 and 24 h visits. The mean pain intensity in G group at both the 6 and 24 hour visits was significantly lower than the control group [Both p<0.0001]. Also, patients in the gabapentin group consumed less opioid at both visits in comparison to the placebo group [p<0.001, p=0.032]. The incidence rate of sedation, dizziness, nausea and vomiting was similar in both groups. In arthroscopic ACL reconstruction, administering a preoperative single dose of 600mg gabapentin may decrease both pain intensity and opioid consumption

[Examination with two types of semmes Weinstein monofilaments as screening tools for diabetic peripheral neuropathy]

Diabetic neuropathy is one of the more common complications plaguing individuals with type 2 diabetes. The development and progression of such complications are responsible for much of the morbidity and mortality related to this disease. This investigation evaluated accuracy of lily and Semmes-Weinstein monofilaments examination for diabetic peripheral neuropathy screening. Our study population consisted of 150 patients treated for diabetes mellitus at the Diabetes Clinic of the Ahvaz Jundishapur University of Medical Sciences. The samples were chosen on the basis of a non-randomized sampling. All patients were tested for sensory neuropathy using two types of monofilament [Semmes Weinstein monofilament examination 8, and 10-grams]. In the next phase EMG-NCV were examined. Sensitivity and specificity two types of monofilaments were analyzed. The 10-g monofilaments had a sensitivity ranging from 38.5% to 51.3% at sites 1-4, and specificity between 73 to 87.4 the sensitivity and specificity of the 8-g monofilament were 41 to 51.3% and 72.1 to 86.5% respectively. Two types of monofilaments at with 51.3 and 74.8% sensitivity and specificity respectively sites 1 and 4 was the most useful diagnostic test for DPN. These data suggest that the monofilaments may be the optimum methodology for identifying individuals at risk of diabetic peripheral neuropathy. Hence, we recommend screening of patients for neuropathy as soon as they are diagnosed with diabetes

[Therapeutic effect of corneal collagen cross-linking in necrotizing herpetic stromal keratitis, report of two cases]

To evaluate the effectiveness of corneal collagen cross-linking with UV-A and riboflavin [CXL] for treatment of refractory herpes simplex virus necrotizing keratitis. Two patients with a diagnosis of HSV necrotizing stromal keratitis referred to Khalili hospital eye emergency room and who were resistant to conventional treatment underwent CXL. Response to treatment was evaluated clinically by speed of reepithelialization and decrease in stromal infiltration. One patient had history of previous corneal graft because of HSV kerstitis and had a good response to CXL. Another patient had a relatively good response, but recurrence was occurred. Although CXL seems promising in the treatment of patients with refractory necrotizing keratitis, in some cases it may less effective and recurrence is possible

[Concept of the quality of the educational services in cardiac rehabilitation]

Achieving quality educational services is one of the current health system challenges; and nurses have a great role in this regard. Although quality educational services are a complex concept; so it is important to clarifying and exploring the related components. The study aimed to describe the components underlies to quality educational service in a cardiac rehabilitation program qualitatively and introduce some of the related problems. This is a qualitative study using qualitative content analysis method.Study population consisted of health practitioners working at health and research centers affiliated to Isfahan University of Medical Sciences, cardiac patients including inpatient and out patient service users and their assistants [family members]. Data were gathered through conducting unstructured interviews with a purposive sample of 25[consisted of 3 physicians, 6 nurses, 1 dietarian, 13 patients and 2 patient assistant]. The study was begun at 1386 and data analysis was completed at 1388. The rigor of the study was achieved applying Guba and Lincoln directions. The concept of quality educational services in cardiac rehabilitation is described using four underlying concepts namely fittingness, comprehensiveness, authenticity and orderliness that are the elements of quality educational services in the cardiac rehabilitation program. Based on the findings, paying attention to audiences' special needs and capabilities are important determinants in providing quality educational services in the cardiac rehabilitation program. Hereby the audiences could receive the trustful and responsive services. We suggest organizing the education and information giving routs. It would result in service comprehensiveness that could save the service taking opportunities. The existed problems were inadequate fittingness, poor coordination in the services and poor referral system that were resulted in poor response to some of the audiences needs. [Quality educational services] is a context based concept. Considering the cardiac rehabilitation, it was emphasized on providing need based services fitted to users' capabilities, attending to various bio-psycho-social aspects at both person and family levels and serving the services through predefined and coordinated pathways. It is necessary to nurses as one of the key members of cardiac rehabilitation team that consider such emerged elements in service management and direct care delivery to the cardiac patients and their families. Future researches on emerged concepts are worthy to suggest

Initial presentation of acute lymphoblastic leukemia with osteoporosis and multiple spontaneous bone fractures

Acute lymphoblastic leukemia [ALL] is the most common childhood malignancy. Skeletal abnormalities have been described in association with ALL including osteoprosis and bone fractures. Different factors including the disease itself or soluble products of malignant cells and treatment agents like cytotoxic drugs, methotroxate, corticosteroids and radiotherapy may be responsible for defective bone homeostasis in these patients. Orthopedic conditions and pain may be the first manifestation of acute leukemia and it is important for physicians to recognize the skeletal manifestation of acute childhood leukemia because of a delay in diagnosis has adverse effect on survival. We present a child with ALL that refer with multi bone fractures as a first manifestation of the disease

[Does high dose erythropoietin administration reduce ischemic stroke complications?]

Ischemic brain strokes consist two Third of all strokes and their complications bear a lot of cost and disability for the patient and society. In this study we seek for the effect of Erythropoietin on ischemic brain strokes' outcome according to NIHSS [National Institutes of Health Stroke Scale] changes. This study is a RCT. All patients with focal neurologic deficit with primary suspicion of brain stroke underwent neuroimaging evaluations. After confirmation of new ischemic brain stroke, the patients with inclusion criteria randomized into two groups of cases and controls. NIHSS was defined for each patient and all patients received a routine treatment protocol. Erythropoietin 16000 IU as a bolus intravenous dose was given to case patients as soon as neuroimaging study confirmed new ischemic stroke and continued as 8000 IU each 12hr up to total dose of 56000 IU during 3 days. Patients were re-evaluated at days 14 and 28 and NIHSS was assessed by another neurologist blinded to patient's group. Finally NIHSS changes of both groups were compared with each other. Evaluations revealed that in days 14 and 28 during follow up, Erythropoietin was effective in NIHSS [P-value: 0.0001]. This effect is of value in LOC Commands [P:0.024], facial palsy [P:0.003], motor arm [P:0.0001], motor leg [P:0.0001], sensory [P:0.009] and best language [P:0.023]. Administration of High dose erythropoietin in first 24 hours can be effective on the reduction of ischemic stroke complication. However, a larger scale clinical trial is warranted

[Health beliefs and performance regarding pap smear test in Zarandieh city women's]

Cervical cancer is the commonest malignancy among women in developing countries. Pap smear is only one proven strategy for the prevention by diagnosis of cervical cancer. The assessment of Health Belief Model construct about the performance s of Pap smear Test and its effective factors among Women's urban centers in Zarandieh. This is a cross-sectional analytical study carried out with 265 Urban Women in Zarandieh. This survey was done by completing a questionnaire based on health belief model. Data were analyzed using chi-square tests, independent samples t-test, logistic regression and descriptive statistics. The mean age of participants was 34.6 +/- 4.25 years, and the mean score of all the constructs in this group was higher than that in the group with no history of pap smear [P<0.001].The most common reasons for testing was recommendation by health workers [71%]. Among those who were never tested, low levels of perceived susceptibility [79%] were the most common barrier. Significant differences were detected between those tested and not tested in mean of score of all the variables HBM [sensitivity, benefits, barriers, threat and intensity perceived][p<0.001]. Based on the findings of this study, health care professionals must design educational program about cervical cancer in which both the benefits of Pap smear test and other HBM constructs including sensitivity are utilized

[ comparison of serum homocysteine, folate and vitamin B12 in postmenopausal women with low and normal bone mineral density]

Osteoporotic fractures are major health problems in contemporary societies which are associated with increased morbidity and mortality and substantial economic costs. Recently, increased plasma homocysteine [Hcy] level has been suggested as an independent risk factor for osteoporotic fractures. This study aimed to compare the level of plasma homocysteine, folate and vitamin B12 in Iranian postmenopausal women with low and normal bone mineral density [BMD]. In this case-control study which was performed from August 2006 to May 2007, BMD of 130 Iranian postmenopausal women were measured by dual energy X-ray absorbtiometry [DXA]. The subjects were assigned to one of the two groups of case [BMD<-1; n=67] and control [BMD>/=-1; n=63]. Fasting plasma Homocysteine, folate and vitamin B12 were also determined. BMD at the neck of femur and lumbar spine, together with other collected data were analyzed with SPSS and T-test. The mean age of the subjects was 58.1 +/- 6 years. The mean of Hcy level in the case group was 16.98 +/- 9.4 and in the control group was 12.39 M mol/L. The mean of vit-B12 in the case group was 598 +/- 801 and in the control group was 551.2 +/- 410 Pg/L. Mann-Whitney test exibited a significant difference. The mean of serum folate level in the case group was 5.2 +/- 2.9 and in the control group was 6.5 +/- 2.9 Ng/L. Hcy, folate and B12 were significantly related to low BMD. LS .T score was negatively related to Hcy level and FN T-score had a positive relation with folate and B12 [p=0.002, p=0.017 and p=0.007, respectively]. There was a relationship between folate and B12 and with increasing serum folate level, B12 level increased, too. The results suggest an association of vitamin B12 and folate with BMD. Whether this relationship is causal, remains unclear and demands further study

impact of educating parents of leukemic children on the patients' quality of life

The quality of life of children with leukemia is reduced by fear and anxiety of parents after diagnosis, lack of information about the disease, treatments, and care of the child. This study aims to evaluate the effect of educating parents of leukemic children on the patients' quality of life. In this interventional study, sixty parents of ALL children who met inclusion criteria were selected using simple random sampling method, and assigned to the experimental and control groups. The study tool included a valid and reliable questionnaire [TNO-AZL], that was filled in through interview by parents before and two months after the intervention for both groups. The first part of the questionnaire included demographic items and the second part [7 dimensions, each with 8 sections] contained questions related to the quality of life. The scores could range between 56 and 280 and a higher score represented a better quality of life. The intervention included three one-hour classes composed of lecture and question-answer sessions which were held for groups of 4-6 participants, accompanied by a booklet. Before the intervention, the quality of life score in the experimental and control groups was 180.83 +/- 14.43 and 174.28 +/- 20.72, respectively; after the intervention, these figures changed to 226.9 +/- 11.76 and 174.41 +/- 20.42 respectively. Paired samples T-test proved a significant increase in the quality of life in the experimental group. Parent education successfully increased the quality of life of leukemic children; therefore, parental consultation sessions and educational programs are recommended

Combined alpha-thalassemia and Hemoglobin J-Iran [beta 77 His --> Asp]. A Family Study in southern Iran

We report a 23-year-old man and three members of his family with Hb J-Iran confirmed by electrophoresis, chain separation by high performance liquid chromatography and sequencing. Alpha thalassemia was also confirmed in two family members. The substitution at beta 77 led to a higher negative charge of the beta J-Iran subunit, which enhanced its electrostatic attraction for the normal positively-charged alpha subunit. Therefore, more Hb J-Iran than Hb A forms in the red blood cells of heterozygotes. In alpha -thalassemia, the more attractive beta J-Iran subunit out-competes beta A subunits in forming assemblies with deficient alpha subunits, so even more Hb J-Iran was formed