Iranian Red Crescent Medical Journal
Year:2017 | Volume:19 | Issue:12|Papers Count:13

Background: Respect to women’ s autonomy in vaginal child birth is a key factor of maternity care. Engaging women in decisionmakingin vaginal delivery helps women have a positive experience of delivery. Objectives: In this content analysis of qualitative study we explored experiences of mothers and midwives in women’ s role in normalvaginal childbirth. Methods: This study was conducted in 2013-2014 in Iran. Overall 23 women and midwives were evaluated in this study. Data collectedfrom 12 women and 11 midwives via in-depth semi structured interviews. Participants were selected from governmental andprivate hospitals in Mashhad and Kerman, Iran. Data analysis was performed using conventional content analysis with MAXqdasoftware (version, 2007). Results: Mothers’ and midwives’ experiences about women’ s role in vaginal childbirth could be organized and categorized in onetheme, referred to “ Empowerment of women in vaginal childbirth” . This theme consists of two subthemes: “ attempts to exhibitself-assertion” and “ quest for information” and four categories of compromise with the labor process, cooperation with midwife, finding delivery sources during pregnancy and seeking delivery information in labor. Conclusions: Attention to women active role in vaginal child birth could improve women experience of vaginal delivery.

Background: Contovir is a mixture of herbal extracts (Tanacetum vulgare, Rossa canina, Urtica dioica) that is supplemented withselenium. Objectives: This study aimed to add Contovir to the classic treatment of recurrent respiratory papillomatosis (RRP) in order todecrease the severity and extent of the disease, elongate the surgical intervals and improve the sense of patient well-being. Furthermore, we had to adjust the prescribed drug dosage, since there were no previous findings available. Patients and Methods: This is a case study of RRP patients treated with Contovir as an adjuvant to the classic treatment, fromMarch 2011 to February 2013, at an academic tertiary hospital (Rasoul-e-Akram hospital). All patients underwent surgical removal ofpapilloma and then were prescribed Contovir. Disease severity was quantified based on Derkay’ s staging system. Results: Eight patients were enrolled in this study. The extent and severity of the disease improved in six cases. One had no response, and the severity of disease increased in one patient. Patients with supraglottic lesions had better responses to Contovir adjuvanttherapy. No immediate or long-term side effects were reported. Conclusions: Although Contovir has been found to be an advantageous adjuvant for RRP treatment, further studies are called forto verify these findings.

Dear Editor, Migraine prophylaxis represents a better choice thansymptomatic drugs, both for safety and for effectiveness. Today, drugs such as calcium channel blockers, beta-blockers, gabapentin, and topiramate are still usedfor migraines with and without aura, with results oftensatisfactory; however, in some cases with adverse effectslimiting the use. A new class of drugs in migraineprophylaxis concerns endocannabinoids, modulating substancesthe nervous mechanisms of neuroinflammation, that cause migraine pain. Anandamide (AEA) and Palmitoylethanolamide(PEA) have proved to be useful in migraineprophylaxis, suggesting their influence in neuroinflammationprocesses is opening the way for interestingtherapeutic perspectives...

Context: Diabetic nephropathy is a common complication of diabetes mellitus with a higher incidence. Renin-angiotensin systemblockers, as the main treatment for patients with diabetic kidney disease, can not only reduce albuminuria, but also lead tohyperkalaemia and creatinine. Therefore, additional protective therapeutic interventions are needed. Evidence Acquisition: An electronic literature search was conducted in international and domestic databases including PubMed, Embase, CNKI, Scopus, Index Copernicus, DOAJ, and Wanfang database for trials up to January 2017. The search terms used wereas follow: "Diabetic Nephropathies", "vitamin D3", "Cholecalciferol", "Calcitriol", "Alfacalcidol", "Paricalcitol", and "Randomized ControlledTrial". Quality assessments were evaluated with the Newcastle-Ottawa Quality Assessment Scale. Data were extracted by 2independent reviewers (TJL and WGL). For all analysis, the standard mean difference (SMD) or odds ratio (OR) with 95% confidenceintervals (CIs) were calculated, and heterogeneity of the studies was analyzed using I2 statistics. Results: Twenty-four studies were (1, 978 patients) identified in the literature retrieve process. The assessment scores indicated thatall the admitted studies were reliable with scores ranging from 6 to 9. The pooled results indicated that vitamin D3 had a significanteffect in reducing albuminuria (MD =-0. 23, 95% CI:-0. 30,-0. 15) and that the vitamin D3 group had a low ratio of urinary microalbuminto creatinine than the control group (SMD =-0. 49, 95% CI:-0. 90,-0. 08). The results also revealed that vitamin D3 group had alower hs-CRP than the control group (MD =-0. 80, 95% CI:-1. 26,-0. 34). Conclusions: Based on the evidence of this study, vitamin D3 could be suggested as a recommended drug for patients with diabeticnephropathy in clinical practice.

To the Editor, The hepatitis D virus (HDV) is a RNA virus that needsthe hepatitis B virus (HBV) surface antigen (HBsAg) tocomplete its life cycle. HDV has a worldwide distribution; the infection is endemic in the Middle East, Mediterraneancountries, Central Africa, and northern parts ofSouth America. Clinical outcomes vary from asymptomaticto fulminant hepatitis; although, HDV is usuallyrelated to a severe form of hepatitis (2). HDV has no specificfunctional enzyme to be targeted for therapy, therefore, using Interferon (IFN)-based treatments are the onlyavailable treatment for a chronic HDV infection with lowefficacy around 10%-40%...

Background: Candida albicans is the most common pathogen in patients with vulvovaginitis. Secretory aspartyl proteinases (SAPs)are potential factors in the virulence of C. albicans. Antimicrobial peptides (AMPs) are recognized as a promising antimicrobialgroup of drugs with a membrane degradation mechanism. Occurrence of resistance to these drugs is quite rare. The impact ofrapid membrane degradation on AMPs is relative to the prevention or delay in drug resistance mechanisms in different microbes. Objectives: The purpose of this study was to compare the inhibitory effects of the designed NK95 peptide and caspofungin onexpression of SAP4-SAP6 genes from clinical vaginal isolates of C. albicans. Methods: In this experimental study, samples were collected from 350 women, who were suspected of vulvovaginal candidiasisand were referred to Zahedan gynecology clinics during 6 months. The clinical specimens were cultured in Sabouraud glucoseagar (SGA). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to identify the vaginalisolates of C. albicans. Afterwards, the NK95 peptide was designed and synthesized. Drug susceptibility test was carried out atdifferent concentrations of NK95 peptide and caspofungin. RNA extraction, cDNA synthesis, and quantitative Real-time PCR wereperformed on the clinical isolates before and after treatment with the designed peptide and caspofungin. Results: Based on the findings of this study, the minimum inhibitory concentration (MIC90), MIC50, and minimum fungicidal concentration(MFC) of C. albicans isolates were 62. 5, 31. 25, and 125  g/mL for the designed peptide, respectively. The SAP4 (45%), SAP5(85%), and SAP6 (73%) genes expressions significantly reduced at 48 hours after treatment with the designed peptide (P < 0. 05). Conclusions: Our findings showed that the designed NK95 peptide has antifungal effects on the clinical vaginal isolates of C. albicans. Moreover, it has potential down-regulating on expression of SAP4, SAP5 and SAP6 genes.

Background: Mizaj (Temperament) is one of the fundamental concepts of Persian Medicine (PM) and identifying this concept iscrucial for providing various healthcare recommendations and for the treatment of patients. In PM, various indices can indicate aperson’ s Mizaj, one of them is the happiness of people. From this perspective, people with warm Mizaj are happier than people withcold Mizaj. Objectives: The aim of this study was to assess the correlation between happiness and Mizaj. Methods: In order to conduct this Cross Sectional (descriptive-correlational) study based on convenience sampling method, 610participants completed the 29-item Oxford Happiness Questionnaire (OHQ) and the 10-item Mojahedi Mizaj questionnaire (MMQ). The study started since September, 2016 and ended in November, 2016 in Tehran, Iran. The collected data were compared by chisquaredtest. Results: The frequency of happy individuals in warm, temperate, and cold Mizaj groups was 85. 2%, 79% and 58. 2%, respectively. According to the results of chi-squared test, individuals with cold Mizaj were significantly less happy than people with warm andtemperate Mizaj. However, there was no significant difference between warm and temperate Mizaj groups. Moreover, the level ofhappiness in people with wet Mizaj was not significantly different from people with dry Mizaj. Conclusions: There is a significant correlation between happiness and an individual’ s Mizaj. Accordingly, one of the hypothesesregarding indices of Mizaj identification in PM is strengthened. This index can be used in researches associated with designing andvalidating Mizaj evaluative scales in PM to differentiate cold and warm Mizaj.

Background: Recently, HVBP has been a tool for improving the quality of healthcare services and managing costs. This study wasconducted to identify and propose an appropriate model of HVBP in the general selected teaching hospitals in Isfahan, Iran. Objectives: The purpose of this study was to propose an Iranian model of HVBP in the selected teaching hospitals in Isfahan, Iran, 2015-16. Methods: This study was a theoretical and qualitative study. It was cross-sectional and prospective in terms of time, direction, andtrend. The sample was determined purposefully in Delphi methods. Three types of Delphi methods were conducted including: theory, policy, and implementation Delphi. The sample size in Delphi methods respectively included 9, 13, and 21 that were selectedin type of experts sampling and cascading in 2015-16. Inclusion and exclusion criteria were designated to select sample in all threetypes of Delphi methods. Results: According to the results of the study, the proposed Iranian model of HVBP had seven dimensions including structure, process, outcome, patient experience, quality of clinical care, sensitivity of care team, and efficiency with the weight percentages of5, 5, 25, 20, 15, 15, and 15, respectively. Each of the dimensions had 5, 6, 5, 7, 5, 4, and 1 components/component, respectively. Conclusions: This study identified and proposed a model of HVBP in the Isfahan selected general teaching hospitals. The practicalapplication of the findings was to determine the dimensions and components of HVBP in Isfahan general teaching hospitals. According to the findings of this study, it is suggested that a series of related research be conducted to complete the identificationprocess of HVBP in Iran in other types of hospital settings.

Background: Theory-oriented interventions play a key role in promoting people’ sQOLand preventing the risk of immobility. Giventhis key role and due to the critical nature of nurses’ professional duties, this study was performed. Objective: The study aimed to determine the effect of a TTM-based intervention on level of physical activity in ICU nurses workingat hospitals affiliated to Guilan University of Medical Sciences. Methods: This randomized controlled trial first selected 82 nurses through the census method in order to determine their SOC, then assigned 68 nurses who were in the first three stages to case and control groups. Valid and reliable data collection tools wereused, including a demographic questionnaire and TTMconstructs (SOC, GPAQ, SE, DB, and POC). Path analysis of data was performedby Lisrel-8. 80. The inter-correlation matrix was determined within the model’ s constructs and between the constructs and the levelof physical activity in order to design and implement the intervention. Two-stage assessment was performed, once immediatelyafter the intervention and again six months later. The data obtained were analyzed using appropriate statistical tests and Pearsoncorrelation coefficient. Results: 82. 9% of the participants were in the first three stages of TTM. Immediately after the intervention, 55. 9% were in the preparationstage, 44. 1% in the pre-contemplation stage, and 76. 5% in the contemplation stage. Before the intervention, only 26. 5% werein the preparation and 44. 1% in pre-contemplation stages. There was a statistically significant difference (P = 0. 0001) between thecontrol and case groups immediately and six months after the intervention. Conclusion: TTM-based intervention led to the subjects’ placement in higher levels of SOC.

Background: According to the Iranian Traditional Medicine (ITM) resources, myrtle (Myrtus communis L. ) resolves swelling, woundsand injuries; itswoundexsiccation capability and tissue enforcement propertiesmaybe helpful in the treatment of the rhinosinusitis. Objectives: The objective of the current trial was to assess the effects of Myrtus communis aqueous extract in the treatment of chronicrhinosinusitis. Methods: A total of 38 patients referring to the Masih Daneshvari Hospital (Tehran, Iran) for the treatment of chronic rhinosinusitisduring the year 2016 were recruited for a double-blinded randomized placebo-controlled trial. They were randomly allocated in 2groups: 22 patients were in the treatment group and 16 patients in the placebo group. Recruitment was based on the European positionpaper on rhinosinusitis (EPOS). Patients’ data, including demographic information, SNOT22 questionnaire scores, and visualanalog scale (VAS), were gathered and recorded by an otolaryngologist. Patients were investigated with a CT scan of the paranasalsinuses at the beginning of the study. Results: A total of 13 patients (59. 1%) in the treatment group were female and 7 in the placebo group (43. 7%). The median age ofpatients in the treatment group was 38. 86 (18-68)andin the placebo group 39. 93 (22-75) years. Data analysis revealed thatsymptomsimproved in the treatment group after treatment in most parameters, according to the SNOT-22 parameters. However, most of theseimprovements, such as reduced concentration (1. 81  2. 01 vs. 0. 73  1. 32 in control vs. treatment group, respectively; P = 0. 055), frustrated/restless/irritable (1. 56  1. 97 vs. 0. 55  1. 1 in control and treatment groups, respectively; P = 0. 113), as well as ear pain(P = 0. 121), did not demonstrate a statistical significance. There was a significant improvement in symptom number 18 (reducedproductivity) in the SNOT-22 questionnaire (1. 69 1. 92 vs. 0. 77 1. 23 in control vs. treatment group, respectively; P = 0. 041). Conclusions: According to the present study findings, Myrtus communis L. syrup can be safely administered in patients with chronicrhinosinusitis and is effective in improving the outcomes of the disease.

Background: It is important to check the skin of neonates on a daily basis so that abnormal conditions and skin problems areidentified. Objectives: This study aimed at testing the validity and reliability of a revised Northampton Neonatal skin assessment tool in Turkish; a review to determine whether it is valid and reliable in the care of neonates. Methods: The research had a cross-sectional and methodological design. The data for the study was collected between 1st of January2015, and 20th of June 2015, at the neonatal intensive care unit (NICU) of a major training and research hospital in Istanbul/Turkey; 362 neonatal skin assessments were executed. The revised tool’ s language, face, content, construct validity, and reliability wereevaluated. Results: The intra-class correlation coefficient, which indicates interrater reliability, was 1. 00 in the study, representing 100% agreement. The Cronbach alpha internal consistency coefficient revealed that the tool’ s general reliability was at an acceptable level (C = 0. 71). Although the model was not found to be significant (Chi-square = 46. 22, df = 17, and P < 0. 001), the other model fit indicesfound RMSEA < 0. 07,  2/df < 3, and SRMR<0. 06, which meant that the data had an acceptable fit for the model. The model exhibiteda good fit because the CFI, NFI, GFI, and AGFI indices were close to 1. When the model fit indices were evaluated in combination, theCFA model generally had a good fit. The most significant and most prominent effect on the tool was the impact of NNS9 (level ofcare) indicator (b9 = 0. 86, t value = 17. 46 > 1. 96). Conclusions: The Turkish version of the revised northampton neonatal skin assessment tool is an appropriate, valid, and reliableinstrument to be used in the assessment of neonatal skin, especially of infants at the NICU. The tool may be recommended for usein the care of neonates.

Background: Hemocytometer parameters can be important biomarkers for some types of cancers and diseases. There is a need toevaluate their biomarker potential in thyroid diseases. Objectives: The current study aimed at contributing to potential biomarker researches to diagnose papillary thyroid carcinoma(PTC) and benign multinodular goiter (BMG), evaluate the role of these markers to determine the PTC characteristics and contributeto clarification of controversial issues. Methods: The study was designed as a retrospective observational study. The study included 389 patients who underwent totalthyroidectomy at private Sani Konukoglu hospital (Sanko University, School of Medicine, Gaziantep, Turkey) due to BMG or PTCdiagnosis from November 2011 to May 2017. The study subjects were divided into 3 groups. Groups 1, 2, and 3 were subjects with BMG, PTC, and the control, respectively. The comparisons were made among the groups in terms of hemocytometer parameters. In thegroup with the thyroid papillary carcinoma diagnosis, the relationship between the hemocytometer parameters and the bilateraltumor presence, single-sided multicentrite, and tumor diameter (size) were investigated. Results: Red cell distribution width (RDW) levels were 15. 50 2. 39, 15. 68 2. 16, and 12. 5 1. 51 in the BMG, PTC, and control groups, respectively. Mean platelet volumes (MPV) were 7. 97 1. 19, 8. 05 1. 20, and 7. 23 1. 39 in the BMG, PTC, and control groups, respectively. MPV and RDW values were significantly lower in group 3 compared with the groups 1 and 2 (P < 0. 0001). Plateletcrit (PCT)values were 0. 22 0. 05, 0. 23 0. 06, and 0. 19 0. 05 in the BMG, PTC, and control groups, respectively. PCT was significantly lowerin the group 3 compared with the groups 1 and 2 (P = 0. 0001). In PTC group, no significant relationship was observed between anyof the examined hematological parameters in terms of multicentric and bilateral tumor presence. Conclusions: RDW, MPV, haemoglobin content, and PCT were significantly higher in the BMG and PTC groups. This increase wasnot specific for either of the 2 groups. No significant difference was found between any of the hemocytometer parameters andthe multicentricity and bilaterality of PTC. But, a possible correlation was observed between activated partial thromboplastin time(aPTT), hemoglobin content, and tumor size.

Context: Hepatitis C virus (HCV) has been the main cause of post transfusion hepatitis. Long-term hepatitis can ultimately result incirrhosis and hepatocellular carcinoma. Viral hepatitis, especially HCV infection, is a major health concern in the Middle East. Thecurrent study carried out a systematic search concerning HCV seroprevalence among blood donors in Middle Eastern countries. Evidence Acquisition: Articles were identified through searching databases including PubMed, Scopus, and Web of Science. Wereviewed systematically all studies reporting HCV seroprevalence among blood donors in Middle Eastern countries. Results: A total of 5662 relevant records were identified by the electronic search, of which a total of 47 studies were identified aseligible papers that were meta-analyzed for the pooled seroprevalence of HCV among blood donors. Overall, HCV seroprevalenceamong blood donors in Middle Eastern countries was estimated 0. 88% (95%CI = 0. 79%-0. 97%). The highest pooled HCV seroprevalencerate was related to Egypt (5. 76% [95%CI = 3. 30%-8. 22%]), Libya (1. 56% [95%CI = 0. 99%-2. 13%]), and Yemen (1. 09% [95%CI = 0. 69%-1. 50%]) while the lowest pooled seroprevalence rate was in Iran and Israel with the rates of 0. 14% (95%CI = 0. 12%-0. 17%) and 0. 16%(95%CI = 0. 06%-0. 25%), respectively. Results of annual HCV seroprevalence suggest that there is a decrease in seroprevalence rate ofHCV over time among blood donors in Egypt, Iran, Oman, Lebanon, Libya, and Saudi Arabia. Conclusions: Our results showed that the trend of HCV seroprevalence over time among Middle Eastern blood donors was decreasing. It suggests that recent safety measures implemented in Middle Eastern countries have been effective.