Iranian Red Crescent Medical Journal
Year:2016 | Volume:18 | Issue:11|Papers Count:20

Background: Kaposi’s sarcoma (KS) remains the most common alignancy among HIV-infected patients. Human herpes virus type- 8 (HHV-8) is regarded as the infectious etiological agent of Kaposi’s sarcoma (KSHV). Diagnostic procedures associated with KSHV are not routinely performed in HIV-infected subjects.Objectives: The main objective of this study is to obtain information on KSHV epidemiology in Iranian HIV-infected individuals.Patients and Methods: In the present cross-sectional study, 109 patients with established HIV infection, who visited a governmental and referral center for HIV screening in Tehran (Tehran west health center (TWHC)) between May 2014 and July 2015 were enrolled according to the convenience sample strategy. After peripheral blood collection, isolation of plasma and peripheral blood mononuclear cell (PBMC) compartments, DNA extraction was performed. KSHV DNA was analyzed by nested polymerase chain reaction (nested PCR) using primers from ORF-26 (virus minor capsid).Results: Among all 109 HIV-infected patients, 67 (61.5%) were male, with an age range of 2 - 64 years (mean±standard deviation 35.8±13.3). KSHV DNA was found in PBMC and plasma samples of six (5.5%) and four (3.6%) patients, respectively.Conclusions: This study revealed a considerable prevalence of KSHV DNA, during latent and lytic phases, among HIV-infected patients.Risk factors for KSHV infection acquisition and concurrent.0+infection with HIV were also evaluated. Diagnosis of KSHV in the group could be helpful for prognosis of Kaposi’s sarcoma and clinical management.

Background: Gastric Helicobacter pylori is extremely common worldwide.Objectives: The aim of this study was to assess the effectiveness of combination of Nigella sativa and honey (Dosin) in eradication of gastric H. pylori infection.Patients and Methods: Nineteen patients who had positive result for H. pylori infection by urea breath test (UBT) without a past history of peptic ulcer, gastric cancer or gastrointestinal bleeding, were suggested to receive one teaspoon of the mixture of Dosin (6 g/day of N. sativa as ground seeds and 12 g/day of honey) three times a day after meals for two weeks. The second UBT was used to detect the presence of H. pylori four weeks after completion of the test. In addition, symptoms of dyspepsia were scored before and after the study and analyzed with Wilcoxon signed-rank test.Results: Fourteen patients completed the study. Negative UBT was observed in 57.1% (8/14) of participants after intervention. The median and interquartile range (IQR) of total dyspepsia symptoms was significantly reduced from 5.5 (5 - 12) to 1 (0 - 4) (P=0.005).All the patients tolerated Dosin except for one who was excluded due to mild diarrhea. No serious adverse events were reported.Conclusions: Dosin was concluded to be an anti H. pylori and an anti-dyspeptic agent. Further studies are recommended to investigate the effect of Dosin plus antibiotics (concurrently or following another) on gastric H. pylori infection.

Background: It seems that there is a relationship between consanguinity and profound hearing loss but there is little data about the association of consanguinity and hearing loss in Iran.Objectives: The aim of this study is to demonstrate the causes of profound bilateral sensorineural hearing loss among Iranian samples who are candidates for cochlear implantation.Methods: This study was retrospective, analytical, and designed to collect information about profound hearing impaired cases referred to the Baqiyatallah Cochlear implantation center using enumeration. A total of 310 children with profound hearing impairments participated in this study. They were aged from 6 months to 4 years old. The study was done between January 2007 and April 2009. Chi-square tests were used to show whether there was any statistical difference between the incidence of marital consanguinity of their parents and the normal population.Results: Sixty-five percent of those 310 children had parents who had married with their relatives. Of the 203 (65%) parents that had consanguineous marriages, 132 were first cousins, which includes the children of two brothers (37 [11.8%] patrilateral parallel cousins), the children of two sisters (38 [12.2%] multi-lateral parallel cousins), or the children of a brother and a sister (57 [18.3%] cross cousins). Fifty-four (17.4%) of the parents were second cousins and 17 (5.2%) were beyond second cousins. Also, hearing loss etiology was obvious in 237 (76.3%) of the patients with profound hearing loss but was unknown in 73 (23.7%). Hereditary was identified as the most common cause in 33% of the cases.Conclusions: Our data demonstrated a 65% occurrence of consanguineous marriage among the parents of deaf children, which is statistically different from the percentage of consanguineous marriage among Iranian population (38%). This indicates an obvious relationship between severe hearing loss and consanguineous marriage.

Context: One of the most common complications of pregnancy is gestational diabetes mellitus (GDM), which is increasing worldwide. Experimental and epidemiological studies have shown that higher intake of n-3 long-chain polyunsaturated fatty acids may decrease the risk of various diseases such as diabetes. The objective of this study was to assess the effect of fish oil supplementation on the prevention and treatment of GDM.Evidence Acquisition: This systematic review was performed by searching several databases, including PubMed, Scopus, Google Scholar, the Cochrane Library, ProQuest, Science Direct SID, Magiran and Iran Medex since 1983. The researchers also searched for references in reviewed clinical trial articles in which fish oil supplementation was compared with placebo or no supplementation.Results: Only two published and in-press articles are included in this review. Based on these studies, docosahexaenoic acid (DHA) - enriched fish oil (800 mg/d) had no effect on prevention of GDM [0.97 (95% CI: 0.74, 1.27)]. Furthermore, omega-3 fatty acid supplementation containing 180mgof eicosapentaenoic acid (EPA) and 120mgDHA had beneficial effects on insulin resistance in women with GDM (change from baseline: 1.5±7.5 vs 3.5±8.5 mIU/mL, P=0.02) but did not influence fasting plasma glucose, homeostatic model assessment-Beta cell function (HOMA-B), the quantitative insulin sensitivity check index (QUICKI), or lipid profiles (P>0.05).Conclusions: There is not enough evidence to support or refute the routine use of fish oil supplements during pregnancy for the prevention or treatment of diabetes. It is suggested that further randomized controlled trials be conducted to evaluate the role of fish oil supplementation in pregnancy.

Background: Social anxiety is one of the most common psychological disorders that exists among children and adolescents, and it has profound effects on their psychological states and academic achievements.Objectives: The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on diminishing social anxiety disorder symptoms and improving the self-esteem of female adolescents suffering from social anxiety.Patients and Methods: Semi-experimental research was conducted on 30 female students diagnosed with social anxiety. From the population of female students who were studying in Tehran’s high schools in the academic year of 2013 - 2014, 30 students fulfilling the DSM-5 criteria were selected using the convenience sampling method and were randomly assigned to control and experimental groups. The experimental group received eight sessions of MBCT treatment. The control group received no treatment. All participants completed the social phobia inventory (SPIN) and Rosenberg self-esteem scale (RSES) twice as pre- and post-treatment tests.Results: The results from the experimental group indicated a statistically reliable difference between the mean scores from SPIN (t (11) =5.246, P=0.000) and RSES (t (11) =-2.326, P=0.040) pre-treatment and post-treatment. On the other hand, the results of the control group failed to reveal a statistically reliable difference between the mean scores from SPIN (t (12) =1.089, P=0.297) and RSES pre-treatment and post-treatment (t (12) =1.089, P=0.000).Conclusions: The results indicate that MBCT is effective on both the improvement of self-esteem and the decrease of social anxiety. The results are in accordance with prior studies performed on adolescents.

Background: Family physician plans in Iran face several challenges, one of which is developing attractive and efficient contracts that motivate physicians to participate in the plan.Objectives: This study aimed to elicit GPs’ preferences for family physician contracts.Patients and Methods: In a cross-sectional study using the conjoint analysis technique, 580 GPs selected from the family physician database in Iran in 2014. Through qualitative and quantitative methods, 18 contract scenarios were developed via orthogonal design i.e., the impact of each attribute is measured independently from changes in other attributes and a questionnaire was developed. Data were collected through this questionnaire and analyzed using the ordered logistic regression (OLR) model.Results: The results show that “quotas for admission to specialized courses” is the strongest preference of GPs (b=1.123). In order of importance, the other preferences are having the right to provide services outside of the specified package (b=0.962), increased number of covered population (b=0.814), capitation payment+15% bonus (b=0.644), increased catchment area to 5km (b=0.349), and increased length of contract to five years (b=0.345).Conclusions: The conjoint analysis results show that GPs concerned about various factors of family physician contracts. These results can be helpful for policy-makers as they complete the process of creating family physician plans, which can help increase the motivation of GPs to participate in the plan.

Introduction: Dressler Syndrome should be considered in the differential diagnosis of chest pain, especially in patients who are in a late stage of the evolution of the ischemic process.Case Presentation: A 46-year-old male was admitted to the emergency department due to pleuritic chest pain. Two weeks before this admission, he presented with a typical angina episode, likely an ST segment elevation myocardial infarction (STEMI), and did not receive reperfusion therapy or any medical care. The patient’s electrocardiogram showed diffuse ST segment elevation and PR segment depression, and his blood tests showed positive myocardial necrosis markers. A coronary angiography showed a proximal occlusion (not recanalized) of the circumflex artery. There was a late gadolinium enhancement area seen through cardiac magnetic resonance imaging (CMR), suggestive of recent trans mural infarction, pericardial injury, and pleural effusion (inflammatory).Conclusions: These findings strongly suggest the diagnosis of delayed post-infarction pericarditis, or Dressler Syndrome, a rare disease in the age of reperfusion therapy. Although rare, it is a syndrome that must be considered in the differential diagnosis of chest pain.

Background: There are very limited data for Iranian populations on the predisposing genetic factors for acute coronary syndrome (ACS).Objectives: The objective of the present study was to investigate the association of the angiotensin II type 1 receptor (AT1R) gene polymorphism and ACS in an Iranian population.Patients and Methods: This cross-sectional study was conducted among 263 subjects (97 men and 166 women). Patients (n=128) aged 30 - 80 years with chest pain were recruited from the emergency department of Ghaem Hospital (Mashhad, Iran). A 12-lead electrocardiograph plus creatine kinase MB (CK-MB) levels were used as the basis for the diagnosis of myocardial ischemia. The control group was selected from age-matched healthy subjects (n=135). Non-enzymatic kits were used for extraction of DNA from blood samples. Polymerase chain reaction (PCR) was performed to amplify the DNA fragments. For restriction fragment length polymorphism (RFLP) determination, the DdeI enzyme was used to digest the amplified DNA fragments. Statistical analyses were performed using SPSS version 13.0.Results: There was no statistical difference in the genotype frequency of patients and healthy subjects with regard to age and gender (P>0.05).Conclusions: The AT1R A1166C polymorphism appeared not to be associated with the presence of ACS in the population studied.

Context: Hepatitis is a term used to describe any type of hepatitis inflammation. Screening for the virus antigen during pregnancy is mandatory in some parts of the world and is recommended in others. so that, most women are aware of and understand the disease if they have it when they are pregnant. Thus, the major concerns of these women are both the virus transmission to the fetus and the effects of hepatitis B on pregnancy outcome.Evidence Acquisition: According to a specific protocol, we searched in the Pub med, Scopus, ISI web of science from 1990 to February 2015 to find the original articles, which investigated the hepatitis B effects in pregnant women with normal singleton pregnancy who were previously diagnosed with inactive CHB or were incidentally found to be HBsAg positive in routine antenatal blood test.We included any cohort, case control and cross sectional studies if they had a healthy control group and reported one or more considered maternal or prinatal outcomes in pregnant women. Meta-analysis was performed with Review manager 5.4 and Stata 11 software. We assessed the effect size that was pooled odds ratio (OR) and 95% confidence intervals (CIs) using the random effects model. We explored statistical heterogeneity using the chi-squared (Chi2), I2 and tau-squared (Tau2) statistical tests.Results: From a total of 156 identified studies, 56 studies were chosen for a detailed review, and 18 studies which met the inclusion and exclusion criteria were included in the meta analysis. Among the included studies, the outcomes were small for gestational age (SGA) large for gestational age (LGA), intra uterine growth restriction (IUGR), fetal distress, fifth minutes apgar score, first minute Apgar score, low birth weight (LBW) and Fetal Macrosomia.Conclusions: In this study, hepatitis B had a cause effect on LGA and fetal Macrosomia. Among the other considered adverse pregnancy outcomes; it didn’t have any significant effect.

Background: A combination of the oils of sesame, hemp, wild pistachio, and walnut has been used for treatment of skin disorders, including wound burns, in some parts of Kerman, Iran. Evaluation of this remedy in the form of a pharmaceutical formulation in animal models can pave the way for its future application in wound burn healing in humans.Objectives: This experimental study investigated the healing potential of a new formula (NF) based on folk medicine from Iran for the treatment of third degree burns in mice. The formula was a combination of the oils of four plants: sesame (Sesamum indicum L.), wild pistachio (Pistacia atlantica Desf.), hemp (Cannabis sativa L.), and walnut (Juglans regia L.) Methods: Twenty-four mice were selected based on simple random sampling. Twenty-five percent of the total body surface area was burned by exposure to boiling water, according to the Walker-Mason method. NF and silver sulfadiazine (the positive control) were applied topically twice a day for 21 days. The burned area in the negative control group was left untreated. Epithelialization time and the percent of wound contraction were measured during the treatment period. The process of wound repairing was evaluated using histological (H and E and trichrome staining) and immunohistological (anti-pancytokeratin) methods.Results: When compared to the controls, NF significantly improve dwoundcontraction after day 10. Epithelialization time in the NF group was significantly faster than in the other groups (20 vs.25.5 days) (P<0.001). Histopathological and immunohistochemical findings confirmed the efficacy of the NF.Conclusions: A new therapeutic remedy was introduced for the treatment of burn wounds. Further clinical and molecular studies are suggested to determine the exact mechanism (s) involved in the burn wound healing effect of NF.

Background: Breast cancer is the most common cancer in women, and the second leading cause of cancer deaths. The detection and treatment of this cancer may create mental pressure and lower mood levels, causing anxiety, depression, stress, and pain for the patients.Objectives: The aim of this study was to determine the effects of Swedish massage on mood disorders in breast cancer patients undergoing radiotherapy at the cancer institute of the Imam Khomeini hospital at the Tehran University of Medical Sciences.Patients and Methods: This study consisted of a clinical trial including 100 patients with breast cancer. The participants were chosen randomly, with their consent, by the use of polling, to be included in the intervention group (which received a Swedish massage three times a week, for 30 minutes, over five weeks) and control group (which received routine care). At the beginning of the intervention and after 5 weeks, the mood disorders of the patients, including anger, anxiety, depression, and any positive affect, were assessed using the affective control scale (ACS) questionnaire.Results: Before the intervention, there was no significant difference in the average of the overall scale between the intervention and control groups in the subscales of anger, anxiety, depression, and positive affect (P=0.469). The average of the overall scale in the Swedish massage group decreased from 3.52±0.65 to 2.42±0.76 when compared to the pre-intervention conditions, and to (P<0.001) after the intervention. Moreover, the values for the control group were 3.41±0.94 for the pre-intervention and 3.38±0.9 after the intervention (P=0.620).Conclusions: When compared to the control group, the Swedish massage showed an improvement in the mood disorders of women with breast cancer.

Background: Coronaviruses (CoVs) are large ribonucleic acid (RNA) viruses causing primarily respiratory disease in humans. A novel human coronavirus, subsequently named middle east respiratory syndrome coronavirus (MERS-CoV), was first reported in Saudi Arabia in September of 2012. With increasing numbers of infections and deaths from MERS-CoV, development of a rapid and reliable kit was crucial to prevent further spread of MERS-CoV.Objectives: In this study, we present two real-time reverse-transcription polymerase chain reaction (rRT-PCR) assays for in-house rapid and sensitive diagnostic testing of MERS-CoV, detecting the regions upstream of the envelope gene (upE) and open reading frame (ORF) 1b, respectively, for initial screening and final confirmation of MERS-CoV infection, as recommended by the world health organization (WHO).Materials and Methods: In this experimental study, acquiring patient samples was difficult; thus, according to WHO recommendations and standard protocols, we synthesized RNA sequences of upE and ORF1b genes as the template signatures and TaqMan based-diagnostic rRT-PCR assays were carried out using these synthetic genes for detection of MERS-CoV. In this research, we also inaugurated a cell-free system to transcribe these RNA sequences using the DNA templates synthesized.Results: The upE and ORF1b based one-step rRT-PCR assays were optimized by testing several times via different synthetic RNAs, and validation results were highly successful. The sensitivity obtained for upE was fewer than ten copies of RNA template per reaction and for ORF1b was 50 or fewer copies per reaction.Conclusions: This study showed that the developed rRT-PCR assays are rapid, reliable, reproducible, specific, sensitive, and simple tools for detection of MERS-CoV. Finally, a kit consisting of two assay signatures and controls was assembled, which canbe distributed to public health laboratories in Iran to support international MERS-CoV surveillance and public health response.

Context: The incidences of both gastroesophageal reflux disease (GERD) and metabolic syndrome (MetS) have increased in recent years, and it has been suggested that there is a probable association between the two. The aim of this review is to clarify whether or not MetS is a risk factor for the incidence of GERD.Evidence Aquisition: We searched the PubMed, ProQuest, Ovid, Science Direct, and Google Scholar databases up to February 2015 regarding the relationship between GERD and MetS as found in observational studies. Any studies that evaluated the association between the components of MetS and GERD, as well as any studies examining the association of MetS with Barrett’s esophagus or esophageal carcinoma, were excluded.Results: Thirteen studies met the eligibility criteria. The results of nine studies suggested that there was a higher prevalence of MetS among patients with GERD (P<0.05) and, thus, it could be considered as an independent risk factor for the incidence of GERD.However, in the one study was not observed significant association between GERD and MetS (P=0.71). Two studies in which the prevalence of GERD was compared between individuals with and without MetS showed a higher prevalence of GERD in patients with MetS (P<0.05). However, this finding was not observed in a similar study conducted among female participants, which reported that the different types of MetS were not important factors with regard to the prevalence of erosive esophagitis (P=Not significant).Conclusions: It can be concluded that MetS may increase the risk of GERD. Consequently, there might be potential benefits to treating the metabolic abnormalities in these patients.

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common form of liver disease in many parts of the world.Objectives: The aim of the present study was to identify the most important factors influencing NAFLD using a classification tree (CT) to predict the probability of NAFLD.Patients and Methods: This cross-sectional study was conducted in Kavar, a town in the south of Fars province, Iran. A total of 1, 600 individuals were selected for the study via the stratified method and multiple-stage cluster random sampling. A total of 30 demographic and clinical variables were measured for each individual. Participants were divided into two datasets: testing and training. We used the training dataset (1, 120 individuals) to build the CT and the testing dataset (480 individuals) to assess the CT. The CT was also used to estimate class and to predict fatty liver occurrence.Results: NAFLD was diagnosed in 22% of the individuals in the sample. Our findings revealed that the following variables, based on univariate analysis, had a significant association with NAFLD: marital status, history of hepatitis B vaccine, history of surgery, body mass index (BMI), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), triglycerides (TG), alanine aminotransferase (ALT), cholesterol (CHO0, aspartate aminotransferase (AST), glucose (GLU), albumin (AL), and age (P<0.05). The main affecting variables for predicting NAFLD based on the CT and in order of importance were as follows: BMI, WHR, triglycerides, glucose, SBP, and alanine aminotransferase. The goodness of fit model based on the training and testing datasets were as follows: prediction accuracy (80%, 75%), sensitivity (74%, 73%), specificity (83%, 77%), and the area under the receiver operating characteristic (ROC) curve (78%, 75%), respectively.Conclusions: The CT is a suitable and easy-to-interpret approach for decision-making and predicting NAFLD.

Background: Post-term pregnancy is an important factor in perinatal mortality and morbidity. Generally, to reduce perinatal mortality in pregnancy, the delivery isdonebefore adverse perinatal morbidity occurs. Toprevent prolonged pregnancy, labor is induced with chemical drugs and complementary therapies. Due to the side effects and contraindications of chemical medicine, the use of herbs has been investigated in the induction of labor in post-term pregnancy.Objectives: This study was done to identify the effect of chamomile on inducing labor in women with post-term pregnancy of Shahid Akbarabadi hospital in Tehran in 2013.Patients and Methods: This double-blind clinical trial study was performed in Iran on 80 post-term pregnant women with a gestational age of 40 weeks or more, a single pregnancy, 18 - 35 years old, cephalic presentation, an estimated fetal weight of 2500 - 4000 grams, an absence of uterine contraction, a cervical Bishop score of less than 4, the safety of the membrane, and low-risk pregnancy; they were randomly assigned to one of two groups of 40 women. Each of the participants was given a bottle containing 42 capsules (500mgeach) and took 2 capsules every 8 hours. The data were collected through the questionnaire of demographic observational, and examinal characteristics. Descriptive statistics, independent samples t-test, and Fisher’s exact test using SPSS (16/win) were used to determine and compare the effects of drugs on inducing labor in the groups.Results: After a week of using the first dose, the results showed that in 92.5% of the chamomile group and 62.5% in the placebo group, delivery symptoms started after taking the oral capsules, and there were significant statistical differences between the two groups for the onset of labor (P=0.003) There was a noticeable statistical difference between the two groups regarding the mean interval time to the onset of labor pain after taking the capsules (P=0.000).Conclusions: In this study¸ chamomile stimulated labor in post-term pregnancy. With further studies, chamomile, which has no chemical side effects, can be suggested for stimulating labor in post-term pregnancy.

Background: Today, indexes regarding longevity and life expectancy have increased; the most important issue now is how to spend time loving or in other words quality of life.Objectives: This study was aimed to evaluate effective indexes on quality of life related to health in western Iran in 2013.Materials and Methods: In this cross-sectional research, 918 families were selected among different counties of Ilam Province by multi-stage clustering sampling. The data collection instrument was a questionnaire used to measure the general economic and quality of life: the SF-36 health status questionnaire. Data were analyzed using multivariate regression models.Results: The mean age of the study participants was 32.979.5 years, and the mean score for their quality of life was 61.7412.31. There was a significant statistical relationship between people’s quality of life and their marital status, province of residency, income, economic situation, and life satisfaction (P<0.05). Also, there was a significant and inverse correlation between people’s age and quality of life (r=0.21), physical health summary (r=0.21) and mental health summary (r=0.08).Conclusions: The mean quality of life among the individuals studied was in the middle level, however, it is important to consider the different dimensions of their living situations, such as economic protections, social cooperation, ability to present suitable behaviors to solve problems, and living situation, especially among deprived people.

Background: Oral and dental health diseases can affect the general health of students.Objectives: The aim of this study was to identify the predictors of oral and dental health behavior using the health belief model (HBM) in female students in Teheran, Iran.Patients and Methods: This was a cross-sectional study framed by the HBM, including 400 female students living in district 5 of Tehran, Iran. The sampling technique used in this study was multi-stage stratified random sampling. The data on the HBM constructs (perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy) and demographic characteristics were collected using a self-administered questionnaire. Descriptive statistics, bivariate correlations, and linear regression were performed to analyze the data, using the SPSS software, version 18.Results: The results showed that there were relationships between the knowledge, perceived barriers, cues to action, and mother’s education with oral health behaviors. A multivariate hierarchical regression analysis was conducted with the barrier entered at step one, knowledge at step two, and cues to action at step three. Finally, the three variables accounted for 17% of the total variance in the oral and dental health behavior.Conclusions: The current study provided evidence for the utility of the belief-based model in the prediction of oral health behaviors. It could be suggested that oral health behavior can be promoted by reducing the perceived barriers and enhancing the students’ knowledge of oral and dental hygiene.

Introduction: Uterine leiomyomas are the most common benign solid tumors of the female pelvis. Retroperitoneal myomas are extremely rare and usually malignant with the common location being in the pelvis.Case Presentation: Our case involved a woman who was suffering from dysparonia and radiculating right pelvic pain. The pelvic examination revealed a palpable tender mass of about 3-4 cm in size in the right adnexa near the pelvis bone. An orthopedic consultation was in favor of the mass being of gynecologic origin. A retroperitoneal approach on the right side revealed a 3 cm mass in the right obturator fossa.Conclusions: The most common place for a myoma is in the uterus. However, other sites have also been presented as case reports. Most smooth muscle tumors originating in the retroperitoneum are malignant. Retroperitoneal sites for myomas are mostly in the pelvis (73.1%). The frequent symptoms of retroperitoneal masses, including myoma, are discomfort, fatigue, weight loss, and radiating pain. The common sonographic findings in these patients is a pelvic solid mass with heterogeneous features. Surgical excision is the main treatment of retroperitoneal smooth muscle tumors.

Introduction: Methanol is a highly toxic substance and methanol poisoning results in severe health situations. Methanol poisoning occurs when it is consumed by various methods such as orally, by inhalation, and transdermally. Transdermal poisoning is rarely seen and causes severe health complications.Case Presentation: A 59-year-old male patient was admitted to the emergency room due to blurred vision and knee pain. He had wrapped alcohol soaked cotton around his knees because of pain, and left it for 10 hours at night. Onphysical examination the knees only exhibited redness. Upon fund uscopic examination, signs of poisoning were not seen, but a high anion gap metabolic acidosis was shown by arterial blood gas analysis. Hemodialysis was performed for severe acidosis and the patient was admitted to the ICU. The patient was treated and discharged from the ICU without sequelae.Conclusions: Methanol poisoning presents to the emergency department in our country with many different situations and with varying histories. In different parts of the world, transdermal intoxication cases maybe more prevalent and they maybe overlooked, therefore, we aimed to present this case.

Background: Using various models of behavior change, a number of studies in the area of nutrition education have confirmed that nutrition habits and behaviors can be improved.Objectives: This study sought to determine the effects of education on patterns of dietary consumption among medical students at the military university of Tehran, with a view to correcting those patterns.Methods: In this quasi-experimental study, 242 medical students from the Military University of Tehran were chosen by convenience sampling and then divided into control (n=107) and intervention groups (n=135) by block randomization. The self-administered questionnaire involving six categories of item (knowledge, perceived benefits, perceived barriers, perceived threats, self-efficacy and behavior) has been validated (Cronbach alpha>0.7 for each).Results: Following the educational intervention, the mean score of knowledge, health belief model (HBM) structure, and behavior of students in relation to healthy patterns of food intake increased significantly (P<0.05). The mean pre-intervention knowledge score was 6.76 (1.452), referring to threats to HBM constructs including perceived threat 2.93 (1.147), perceived benefits 7.28 (1.07), perceived barriers 5.44 (1.831), self- efficacy 4.28 (1.479), and behavior 8.84 (2.527). The post-intervention scores all improved as follows: knowledge 8.3 (1.503), perceived threats 3.29 (1.196), perceived benefits 7.71 (0.762), perceived barriers 5.9 (1.719), self- efficacy 4.6 (1.472), and behavior 9.45 (2.324). This difference in mean scores for knowledge, health belief structures and employee behavior before and after educational intervention was significant (P£0.05).Conclusions: The significant improvement in the experimental group’s mean knowledge, HBM structures, and behavior scores indicates the positive effect of the intervention.