Evaluation of Serum Vitamin B12 Levels in Patients with Colon and Breast Cancer: A Case-Control Study.

Background: It has been shown that increased serum levels of vitamin B12 may be associated with some malignancies. This study aimed to compare the serum levels of vitamin B12 in patients with colon and breast cancer and healthy individuals. Materials and Methods: In this case-control study, 140 patients with colon and breast cancer were compared with 140 healthy individuals matched in age, gender, and socioeconomic status. Serum levels of vitamin B12 were measured through the Electrochemiluminescence method in both groups. The normal serum level of vitamin B12 was between 200 and 800 pg/ml. Results: Among 280 enrolled subjects, 60 had serum vitamin B12 levels higher than 800 pg/ml. Forty-six (32.9%) patients had high serum vitamin B12 levels, compared to 14 (10.0%) subjects in the control group (P = 0.001). The mean serum vitamin B12 level was significantly higher in the patients (380.4 ±540.2 pg/ml vs. 278.0 ±314.08 pg/ml, P =0.001). There was no statistically significant difference in serum levels of vitamin B12 in patients with breast and colon tumors (P = 0.8). A significant positive correlation was observed between serum levels of vitamin B12 and tumor stage (P = 0.001, r = 0.49). Conclusion: The findings of this study showed that serum levels of vitamin B12 in patients with colon and breast cancer are higher than in healthy individuals and are positively associated with the stages of cancer.

Effectiveness of sodium bicarbonate and zinc chloride mouthwashes in the treatment of oral mucositis and quality of life in patients with cancer under chemotherapy.

AIM: The purpose of the study is to evaluate the effectiveness of sodium bicarbonate and zinc chloride mouthwashes on oral mucositis and quality of life in patients undergoing chemotherapy. DESIGN: The present study was a randomized controlled trial study. METHODS: One hundred forty-four patients with a cancer diagnosis were randomly assigned into three groups: sodium bicarbonate mouthwash (n = 48), zinc chloride mouthwash (n = 48) and placebo group (n = 48). The severity of mucositis and quality of life were examined blindly at the baseline and 3-week follow-up. RESULTS: The grade of oral mucositis decreased at the end of the third weeks in the sodium bicarbonate and zinc chloride groups rather than the placebo group (p < .001). The severity of oral mucositis in the sodium bicarbonate and zinc chloride groups decreased from end of the first week until third week (p < .001). In addition, there was significant difference in the severity of oral mucositis among the groups at the end of the second (p = .014) and the third weeks (p < .001). Also, there was a statistically significant difference in quality of life scores between the sodium bicarbonate and zinc chloride mouthwash with the placebo group (p < .001). CONCLUSION: Zinc chloride and sodium bicarbonate mouthwashes were effective in treating and reducing the severity of oral mucositis, and subsequently improving quality of life in patients with cancer under chemotherapy. Therefore, we can recommend zinc chloride and sodium bicarbonate at the beginning of chemotherapy to improve oral health and promoting quality of life in these patients.

Epidemiologic and Pathologic Study of Pancreatic Cancer in Hamadan, Iran (2008 to 2018).

PURPOSE: Pancreatic cancer is the seventh leading cause of cancer death in cases. The study was conducted to determine the epidemiologic and pathologic of pancreatic cancer METHODS: A case series study was conducted retrospectively at Beheshti Hospital in Hamadan, Iran. A total of 409 cases that had been diagnosed with pancreatic cancer from 2008 to 2018 were reviewed. The variables included age, gender, occupation, pathological type, location involved, early symptoms, metastasis status, prognosis, and treatments were extracted from the files and recorded in checklist. Data were analyzed by using SPSS/20 software. RESULTS: Pancreatic cancer has been increasing trend in terms of time (2008-2018). Pancreatic cancer was most common age in the sixth decade of life and is more common in men than women. There was a significant relationship between aging and the incidence of pancreatic cancers (P < 0.05). Most of the subjects were urban (50.4%). The frequencies of smoking, alcohol, and drugs were 34.5, 15.6, and 14.0%, respectively. Also, there was no statistically significant relationship between smoking, alcohol, and drugs and pancreatic cancer (P > 0.05). The frequency of pancreatic cancers included adenocarcinomas (66.7%), unknown (25.2%), mucinous adenocarcinomas (4.2%), and carcinoma (3.9%), respectively. CONCLUSION: Pancreatic cancer has been increasing trend in terms of time. Pancreatic cancer was most common age in the sixth decade of life and is more common in men than women. The most common type of pancreatic cancer was adenocarcinoma. Diagnosis usually occurs at higher stages. More preventive considerations were found to be beneficial among this population.

Effectiveness of zinc chloride mouthwashes on oral mucositis and weight of patients with cancer undergoing chemotherapy.

BACKGROUND: Oral mucositis is one of the most emerging and debilitating complications of chemotherapy during the treatment period, which strongly affects the nutritional status and physical and mental condition of these patients. Zinc increased protein synthesis and improved cell membrane stability so passible effective in prevent and treat oral mucositis and promote oral health. Therefore, this study aimed to evaluate the effect of zinc chloride mouthwash on the prevention, incidence, and severity of oral mucositis in cancer patients undergoing chemotherapy. METHODS: The present study was a randomized control trial study. 96 patients with a cancer diagnosis selected from one oncology clinic in the west of Iran. Then they assigned randomly to the zinc chloride group and placebo group. The patients in each group should rinse their mouths every 8 h two times and each time 2 min with 7.5 ml from mouthwash. The severity of mucositis and weight loss examined blindly at the baseline and 3-week follow-up. RESULTS: The incidence and severity of oral mucositis between groups were significant higher at the end of the second (p < 0.002) and third (p < 0.001) week. The mucositis severity decreased well during the third weeks in the zinc chloride group. The difference in the weight loss was significant higher between the zinc chloride and the placebo group (p < 0.01). CONCLUSION: Zinc chloride mouthwash was effective in preventing and reducing the severity of oral mucositis and improving weight in patients undergoing chemotherapy. Trial registration We can therefore recommend more studies examine the effects zinc chloride as preventive care at the beginning of chemotherapy to improve oral health and subsequently preventing weight loss in these patients.

Iranian Clinical Nurses' and Midwives' Attitudes and Awareness Towards Telenursing and Telehealth: A cross-sectional study.

OBJECTIVES: This study aimed to examine the attitudes and awareness of Iranian clinical nurses and midwives towards telenursing and telehealth also referred to as e-health. METHODS: The cross-sectional study was conducted from February to August 2019 in Iran. Nurses and midwives were randomly recruited from hospitals affiliated with Mashhad University of Medical Sciences in Mashhad, Iran using a stratified cluster random sampling method. Data were collected using a reliable and valid Persian-language questionnaire consisting of 32 close-ended survey items to examine Internet/computer access, daily Internet use and awareness of and general attitude towards telehealth and telenursing; statistical analyses were performed. RESULTS: A total of 523 nurses and midwives were included in this study (response rate: 94.4%). The mean age and duration of clinical practice were 33.36 ± 7.46 and 8.88 ± 6.73 years, respectively. The majority of participants recognised the definition of telenursing (66.7%) and telehealth (80.1%). A positive attitude towards telenursing and telehealth was reported by 73.0% of the participants. Clinical nurses and midwives with a master's degree were more aware of the definition of telehealth compared to those with undergraduate bachelor degrees (P = 0.03). Additionally, midwives significantly more frequently presented a positive attitude towards telehealth and telenursing compared to nurses (86.2% versus 71.2%; P = 0.01). CONCLUSION: The positive attitude of the current participants was an important factor in the promotion of telenursing and telehealth. The implementation of educational and infrastructure developmental programs can help speed up executional processes in these fields.

Effects of saffron (Crocus sativus) on sexual dysfunction among men and women: A systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis study evaluated the effect of saffron (Crocus sativus) on sexual dysfunction and its subscales (dimensions) among men and women. MATERIAL AND METHODS: PubMed/Medline, ScienceDirect, Google Scholar, as well as Scientific Information Database (www.SID.ir) and Magiran (as Persian databases) were searched without any time and language restrictions. Statistical pooling was done using the random effects model. RESULTS: A total of 5 studies comprising 173 participants were included in this systematic review and meta-analysis. The analysis showed a statistically significant positive effect of saffron on sexual dysfunction (Std diff in means=0.811; 95% CI, 0.356-1.265) and its subscales (Std diff in means=0.493; 95% CI, 0.261-0.724). Heterogeneity indexes such as Cochran Q index and I 2 indicated a heterogeneity among the included studies (Q=9:981, df:4, (p=0.041), I2=59.92%). There was no evidence of publication bias in these studies. CONCLUSION: In general, saffron was proven effective in improving sexual dysfunction and its subscales among participants; this effect was different on different dimensions of sexual dysfunction. Further studies are required to extend these initial findings.

Truck Drivers' Experiences and Perspectives Regarding Factors Influencing Traffic Accidents: A Qualitative Study.

Traffic accidents are a major public health problem, leading to death and disability. Although pertinent studies have been conducted, little data are available in Iran. This study explored the experiences of truck drivers and their perspectives regarding factors contributing to traffic accidents. Eighteen truck drivers, purposively sampled, participated in semi-structured interviews. Data were analyzed using qualitative content analysis. A main theme, lack of ability to control stress, emerged as a factor influencing the incidence of traffic accidents. This main theme was found to have three subthemes: poor organization of the job, lack of workplace facilities and proper equipment, and unsupportive environment. Although several factors were found to contribute to traffic accidents, their effects were not independent, and all were considered significant. Identifying factors that contribute to traffic accidents requires a systematic and holistic approach. Findings could be used by the transportation industry and community health centers to prevent traffic accidents.

A study of Iranian nurses' and midwives' knowledge, attitudes, and implementation of evidence-based practice: the time for change has arrived.

BACKGROUND: Evidence-based practice (EBP) leads to enhanced quality of care, and the individual and professional development of nurses and midwives. Therefore, it is important for nurses and midwives as well as all other healthcare providers and stakeholders to inform clinical decision-making and implement EBP. AIM: This study aimed to determine the EBP knowledge, attitudes, and practice of clinical nurses and midwives in Mashhad public hospitals in Iran. METHODS: The descriptive cross-sectional study was conducted with a stratified cluster, random sample of 240 employed nurses and midwives (response rate of 96%) in Mashhad, who held a Bachelor of Science degree and had at least 1 year of clinical experience. Two valid and reliable questionnaires were used to collect demographic and EBP data. Data were analyzed using SPSS version 11.5 software and descriptive and inferential statistics calculated. RESULTS: Participants' mean age was 31.0 (SD = 5.5) years and 80% (n = 194) were female. Most participants reported low knowledge or skills and practice of EBP, but moderate attitudes toward EBP. Significant differences between the mean scores on knowledge or skills, attitudes, and practice were identified by field of study. Nurses reported higher knowledge or skills and practice of EBP than midwives (p < .001). Nurses and midwives with master-s degrees displayed greater knowledge or skills and practice of EBP, and more positive attitudes than nurses with bachelor-s degrees (p < .001). LINKING EVIDENCE TO ACTION: Although clinical nurses and midwives apply EBP in clinical settings, it is necessary to develop their knowledge or skills and practice. The results of this study can be applied by educational planners, educational managers, and authorities to enhance the quality and consistency of EBP implementation. The results provide a base for future studies in this field.