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1.  HER2 Ile655Val Single Nucleotide Polymorphism in Patients with Ovarian Cancer 
Background
The association between HER2 Ile655Val single nucleotide polymorphism and cancer is controversial.
Objectives
The aim of our study was to investigate this polymorphism in patients with ovarian cancer.
Patients and Methods
Genomic DNA was extracted from peripheral blood leukocytes of 107 patients and 130 healthy women. HER2 gene polymorphism was assessed by PCR-RFLP.
Results
No significant difference was observed in genotype and allele frequency between patient and control groups according to HER2 Ile655Val polymorphism. The disease stage, age, and histological type were also not associated with the polymorphism.
Conclusions
Our data showed that HER2 Ile655Val single nucleotide polymorphism was not significantly associated with onset, histological type, age, and stage of ovarian cancer in Iranian patients.
doi:10.5812/ircmj.2173
PMCID: PMC3589767  PMID: 23487505
Carcinoma, Endometrioid; HER2; Polymorphism, Single Nucleotide
2.  Intra-familial Transmission of Hepatitis B virus Infection in Zahedan 
Background
The household transmission of hepatitis B virus (HBV) is a major health problem. The prevalence rate of this infection is reported about 11% to 57% among family members of HBsAg carriers.
Objectives
This study was conducted to evaluate serological determinants of chronic hepatitis B infection, especially HBsAg positivity, among family members of asymptomatic HBsAg positive carriers in Zahedan (Southeast of Iran).
Patients and Methods
In a cross-sectional study, data were collected from the total number of 454 HBsAg positive cases and 1817 members of their family by trained interviewers and a validated questionnaire. In addition, blood samples were obtained and titrated to detect serologic markers of hepatitis B. All subjects were recruited following informed consent to the study.
Results
In total, 454 chronic HBsAg carriers (66% male) with mean age of 36 ± 10 years and 1817 of their family members were included in the study. The prevalence rate of HBsAg and HBcAb positivity among household members were 19.3% (n = 351) and 51% (n = 573), respectively. The frequency of HBV markers was different by age groups. The highest prevalence rate of HBsAg (34.9%) and HBcAb (31.9%) positivity were found in the age group of 21-30 years old. Importantly, the mothers of index cases had the highest prevalence of HBsAg positivity compared to their spouses who had the lowest proportion (53.2% vs. 8.4%, P < 0.001).
Conclusions
In family members, HBsAg positivity was four times greater than the general indigenous population. Considering the importance of close contacts for transmission, it was more prevalent in mothers of index cases compared to their spouses, suggesting more efficient mother-to-child than sexually transmission of HBV. It was also more prevalent in those having a history of hepatitis B in their maternal family compared to those with paternal one, probably due to more efficient transmission from infected mothers to children. The lower prevalence of HBsAg positivity in lower age groups could be attributed to vaccination of Iranian infants since 1993 and the screening of HBsAg positive mothers during the last two decades.
doi:10.5812/ircmj.2282
PMCID: PMC3589768  PMID: 23487536
Carrier States; Hepatitis B; Transmission; Iran; Prevention and control; HBV Seroprevalence
4.  Bilateral Chemical Burns of the Cornea Due to Limewater: A Specific Case 
doi:10.5812/ircmj.2614
PMCID: PMC3589770  PMID: 23487571
Chemical Burns; Bilateral; Cornea
5.  Combined Aplasia of Sphenoid, Frontal, and Maxillary Sinuses With Hypoplasia of The Ethmoid Sinus 
doi:10.5812/ircmj.2627
PMCID: PMC3589771  PMID: 23486210
Aplasia, Hypoplasia; Paranasal sinus; Sphenoid sinus
6.  Outcome of Cochlear Implantation in Post-Meningitis Deaf Children 
doi:10.5812/ircmj.3394
PMCID: PMC3589772  PMID: 23486288
ENT; Pediatrics; Pediatrics Surgery
7.  Successful Management of Total Knee Replacement in a High Responder Hemophilia Patient With a History of Inhibitor 
The development of inhibitors against administered clotting factors may render replacement therapy ineffective for some hemophilia patients. Such patients are therefore at the highest risk of developing arthropathy. Elective orthopedic surgery (EOS) in hemophilic patients having such inhibitors remains a rare, expensive, and difficult surgery, whose management represents a significant challenge. We report the case of a 35-year-old man with a severe form of hemophilia A (factor VIII < 1%), who was suffering from repetitive spontaneous hemarthrosis, especially in his knee joints that had consequently become more susceptible to bleeding. The patient had a history of high levels of factor VIII inhibitor (> 5.0 Bethesda Unit [BU]/ml) as shown by the factor VIII inhibitor assay; therefore, we began treatment with factor VIIa for his mild-to-moderate bleeding (90 µg/kg intravenous bolus injections). The interval between injections varied with the severity of the hemorrhage in each bleeding episode. The inhibitor level reduced to 3.1 BU/ml after three months, to 1.6 BU/ml after six months, and disappeared completely after one year of treatment. We administered factor VIII at a dose of 50 IU/kg every eight hours during the first three post-operative days, then continued administration with a dose of 40 IU/kg every 12 hours for another four days, and observed a very good response to treatment with no bleeding. Recombinant activated factor VII (rFVIIa) is not an inhibitor-removal strategy, but an inhibitor-bypassing product. However, in our patient, the treatment of mild-to-moderate bleeding with short-term use of rFVIIa and no exposure to factor VIII caused a gradual reduction in the inhibitor level over a period of 1 year.
doi:10.5812/ircmj.3406
PMCID: PMC3589773  PMID: 23486529
Orthopedics; Hemophilia A; Hemophilia B; Inhibitor
8.  The Effect of an Intervention Based on the PRECEDE- PROCEED Model on Preventive Behaviors of Domestic Violence Among Iranian High School Girls 
Background
Domestic violence is one of the major health problems among women. Promoting preventive behaviors of domestic violence among women and girls can play crucial role in reducing this health problem.
Objectives
This study was conducted to evaluate the effect of an intervention based on PRECEDE-PROCEED Model on preventive behaviors of domestic violence among Iranian high school girls.
Patients and Methods
An interventional study was completed during 2010-2011 in 10 high schools in the district 17 of Tehran municipality with 510 female students. We used the components of the PRECEDE-PROCEED Model for planning, implementation and evaluation of the program. Based on the results of need assessment, an appropriate environmental and educational intervention was implemented in the intervention group. Changes in predisposing, reinforcing, enabling factors and especially preventive behaviors immediately and two months after the intervention activities were assessed by questionnaires based on PRECEDE-PROCEED Model.
Results
The intervention had significantly positive effect on predisposing, enabling and reinforcing factors immediately and two months after the intervention (P < 0.05). Repeated measures Analysis of variance showed a significant positive increase in preventive behaviors score in the intervention group from baseline to two months.
Conclusions
The PRECEDE-PROCEED Model can be applied as a conceptual framework for identifying the relevant behavioral and environmental risk factors associated with domestic violence. Development and implementation the skills-based education using this model can lead to the promotion of preventive behaviors of domestic violence and reduction in domestic violence cases.
doi:10.5812/ircmj.3517
PMCID: PMC3589774  PMID: 23486646
Domestic Violence; Health Education; Health Promotion; Iran
9.  Serum Homocystein Level in Patients With Scleroderma 
Background
Systemic Sclerosis (SSc) is a systemic connective tissue disease. In this study, we compared the serum Homocystein (Hcy) level between patients with SSc and normal control group.
Objectives
The current study was conducted to determine whether serum Hcy levels are elevated in SSc patients and whether there is any correlation between Hcy levels and RP, Gastro intestinal and lung involvement.
Patients and Methods
Forty one patients who fulfilled the diagnostic criteria for SSc (39 females and 5 males) and Forty four community-based healthy individuals (sex and age matched) were enrolled in to the study. Serum Hcy, vitamin B12, and folate levels were determined.
Results
Thirty three patients (70.45%) had GI involvement, twenty two patients (50%) had lung involvement and twenty seven patients (61.36%) had Raynaud’s phenomena. Mean serum Hcy level in control group was 22.78 ± 6.018 μmol/L and in case group was 19.43 ± 7.205 μmol/L, shows that the serum Hcy level in control group was significantly higher than patients (P = 0.020).
Conclusions
Serum Hcy level is significantly lower in SSc patients than in control group. There is no statistically significant correlation between serum Hcy level and organ involvements.
doi:10.5812/ircmj.3672
PMCID: PMC3589775  PMID: 23486724
Scleroderma, Systemic; Homocysteine; Autoimmunity; Raynauds Disease
10.  Comparison of Colonic J-pouch and Straight Coloanal anastomosis after Low Anterior Resection 
Background
The tendency towards sphincter preserving for low rectal cancers with low anterior resection, has led to the technique of straight coloanal anastomosis (SCAA) or colonic J-pouch anal anastomosis (CPAA).
Objectives
The aim of our study was to compare functional outcomes, complication rates and quality of life (QoL) after LAR with either a straight or colonic J pouch anastomosis.
Patients and Methods
In 88 patients with rectal tumors located in lower third, who were candidate for LAR with coloanal anastomosis. They were divided for reconstruction using either SCAA (n= 47) or CPAA (n= 41) from January 2007 to May 2009. Functional results were assessed after closure of temporary loop ileostomy, 6 months postoperatively. Quality of life (QoL) was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30.
Results
The two groups were matched for gender, age, and preoperative chemotherapy and radiotherapy. There were no significant differences between the SCAA and CPAA groups relative to anastomotic leakage. Among patients with CPAA, the mean of 24 hours bowel movements, daytime bowel movements, incontinence scores, and incidence of urgency were significantly lower than those in the SCAA group. Also, patients with a CPAA had a significantly better quality of life.
Conclusions
CPAA provided not only better functional results than SCAA, but also improved quality of life, thus may be the better choice.
doi:10.5812/ircmj.3804
PMCID: PMC3589776  PMID: 23486745
Rectal Cancer; Straight Coloanal Anastomosis; Colonic J-Pouch Anal Anastomosis; Low Anterior Resection; Quality of Life
11.  Sequence Characterization of cDNA Sequence of Encoding of an Antimicrobial Peptide With No Disulfide Bridge from the Iranian Mesobuthus Eupeus Venomous Glands 
Background
Scorpion venom glands produce some antimicrobial peptides (AMP) that can rapidly kill a broad range of microbes and have additional activities that impact on the quality and effectiveness of innate responses and inflammation.
Objectives
In this study, we reported the identification of a cDNA sequence encoding cysteine-free antimicrobial peptides isolated from venomous glands of this species.
Materials and Methods
Total RNA was extracted from the Iranian mesobuthus eupeus venom glands, and cDNA was synthesized by using the modified oligo (dT). The cDNA was used as the template for applying Semi-nested RT- PCR technique. PCR Products were used for direct nucleotide sequencing and the results were compared with Gen Bank database.
Results
A 213 BP cDNA fragment encoding the entire coding region of an antimicrobial toxin from the Iranian scorpion M. Eupeus venom glands were isolated. The full-length sequence of the coding region was 210 BP contained an open reading frame of 70 amino with a predicted molecular mass of 7970.48 Da and theoretical Pi of 9.10. The open reading frame consists of 210 BP encoding a precursor of 70 amino acid residues, including a signal peptide of 23 residues a propertied of 7 residues, and a mature peptide of 34 residues with no disulfide bridge. The peptide has detectable sequence identity to the Lesser Asian mesobuthus eupeus MeVAMP-2 (98%), MeVAMP-9 (60%) and several previously described AMPs from other scorpion venoms including mesobuthus martensii (94%) and buthus occitanus Israelis (82%).
Conclusions
The secondary structure of the peptide mainly consisted of α-helical structure which was generally conserved by previously reported scorpion counterparts. The phylogenetic analysis showed that the Iranian MeAMP-like toxin was similar but not identical with that of venom antimicrobial peptides from lesser Asian scorpion mesobuthus eupeus.
doi:10.5812/ircmj.4024
PMCID: PMC3589777  PMID: 23486842
Scorpions; Venoms; Antimicrobial Peptide Pharbitis; Reverse Transcriptase Polymerase Chain Reaction; Meucin-25, Mesobuthus Eupeus
12.  Assessing the Effect of Quantitative and Qualitative Predictors on Gastric Cancer Individuals Survival Using Hierarchical Artificial Neural Network Models 
Background
There are numerous unanswered questions in the application of artificial neural network models for analysis of survival data. In most studies, independent variables have been studied as qualitative dichotomous variables, and results of using discrete and continuous quantitative, ordinal, or multinomial categorical predictive variables in these models are not well understood in comparison to conventional models.
Objectives
This study was designed and conducted to examine the application of these models in order to determine the survival of gastric cancer patients, in comparison to the Cox proportional hazards model.
Patients and Methods
We studied the postoperative survival of 330 gastric cancer patients who suffered surgery at a surgical unit of the Iran Cancer Institute over a five-year period. Covariates of age, gender, history of substance abuse, cancer site, type of pathology, presence of metastasis, stage, and number of complementary treatments were entered in the models, and survival probabilities were calculated at 6, 12, 18, 24, 36, 48, and 60 months using the Cox proportional hazards and neural network models. We estimated coefficients of the Cox model and the weights in the neural network (with 3, 5, and 7 nodes in the hidden layer) in the training group, and used them to derive predictions in the study group. Predictions with these two methods were compared with those of the Kaplan-Meier product limit estimator as the gold standard. Comparisons were performed with the Friedman and Kruskal-Wallis tests.
Results
Survival probabilities at different times were determined using the Cox proportional hazards and a neural network with three nodes in the hidden layer; the ratios of standard errors with these two methods to the Kaplan-Meier method were 1.1593 and 1.0071, respectively, revealed a significant difference between Cox and Kaplan-Meier (P < 0.05) and no significant difference between Cox and the neural network, and the neural network and the standard (Kaplan-Meier), as well as better accuracy for the neural network (with 3 nodes in the hidden layer). Probabilities of survival were calculated using three neural network models with 3, 5, and 7 nodes in the hidden layer, and it has been observed that none of the predictions was significantly different from results with the Kaplan-Meier method and they appeared more comparable towards the last months (fifth year). However, we observed better accuracy using the neural network with 5 nodes in the hidden layer. Using the Cox proportional hazards and a neural network with 3 nodes in the hidden layer, we found enhanced accuracy with the neural network model.
Conclusions
Neural networks can provide more accurate predictions for survival probabilities compared to the Cox proportional hazards mode, especially now that advances in computer sciences have eliminated limitations associated with complex computations. It is not recommended in order to adding too many hidden layer nodes because sample size related effects can reduce the accuracy. We recommend increasing the number of nodes to a point that increased accuracy continues (decrease in mean standard error), however increasing nodes should cease when a change in this trend is observed.
doi:10.5812/ircmj.4122
PMCID: PMC3589778  PMID: 23486933
Survival; Life Expectancy; Proportional Hazards Model; Neural Networks
13.  Long-Term Results of stereotactic Brachytherapy (Temporary 125Iodine Seeds) for the Treatment of Low-Grade Astrocytoma (Grade II) 
Background
Treatment of low-grade astrocytoma (WHO grade II) (LGA II) remains a challenge. There is limited information regarding the long-term effects of stereotactic brachytherapy (SBT) (temporary 125Iodine seeds) on patients with LGA II.
Objectives
The purpose of this study was to evaluate disease control and survival after stereotactic brachytherapy in patients with circumscribed and relatively small size tumors.
Materials and Methods
A retrospective review of 29 patients, treated between 1991 and 2011, was conducted to evaluate survival, complications, and local disease control after stereotactic brachytherapy. They belonged to a larger group of 48 cases with low-grade gliomas, treated with stereotactic brachytherapy. The demographic and clinical characteristics in patients including age, sex, and survival time were extracted from records.
Results
Thirteen patients were male and 16 were female, with the median age of 29 years (range, 2.5 – 64 years). The median follow-up was 95 (range, 6 – 240) months. Based on Pignatti classification, 10 patients were at low- and 19 patients at high-risk. The median overall as well as progression-free survivals for patients were 135 months (95% confidence interval: 76 – 194) and 96 months (95% confidence interval: 1 – 199), respectively. Five- and 10-year progression-free survivals were 41.4 % and 34.5 %, respectively, and the 5- and 10-year overall survivals were 65.5 % and 44.8%, respectively. Progression-free survival was not significantly higher in smaller size tumors (P = 0.224), nor for spherical versus non-spherical tumors (P = 0.307). There was no treatment-related morbidity after stereotactic brachytherapy, and no radiogenic complications occurred during the follow-up period. Mortality due to tumor progression occurred in 4 patients (14%), and 11 patients were alive at the last follow-up.
Conclusions
The stereotactic brachytherapy for patients with circumscribed and relatively small size tumors appears to be a safe, feasible, and minimally-invasive treatment.
doi:10.5812/ircmj.4322
PMCID: PMC3589779  PMID: 23487004
Survival; Long-Term; Astrocytoma; Brachytherapy
14.  The Prevalence of Tb in HIV Patients and Risk Factor With Frequent Referral (Iran, 2009-10) 
Background
HIV infection significantly increases the risk of tuberculosis and this disease is one of the most common opportunistic infections in HIV Patients.
Objectives
The aim of this study was to determine of the prevalence of tuberculosis and risk factor among HIV patients.
Materials and Methods
In this cross-sectional study, from September 2009 to September 2010, 71 HIV patients who referred to teaching hospital in Tehran, Capital Iran were enrolled. Records of patients that admitted to hospital at least once a year and have positive test for HIV with ELISA and Western Blot were assessed. TB diagnosis testes included clinical finding, chest X-Ray and culture positive sputum.
Results
74.6 % and 38 % of them had prison history and history of addiction respectively, 28.2% of subjects co- infected with HIV / TB and 40% of patients were under treatment with anti-retroviral drugs. There was relationship Between TB and CD4 counts below 200 cells per micro-liters (P = 0.003), age (P = 0.000), anti-retroviral drugs (P = 0.001), discharge status (P = 0.004), prison history (P = 0.002) and alcohol and smoking (P = 0.01).
Conclusions
The prevalence rate of TB / HIV among intravenous drug abusers and prisoners was high also the prevalence of tuberculosis among HIV patients.
doi:10.5812/ircmj.4401
PMCID: PMC3589780  PMID: 23487151
HIV; Tuberculosis; Prevalence; Coinfection
15.  The Oncolytic Effect of Respiratory Syncytial Virus (RSV) in Human Skin Cancer Cell Line, A431 
Background
Oncolytic viruses have become of noticeable interest as a novel biological approach for selectively infecting cancer cells and triggering apoptosis in a number of malignant cells. Many researches are devoted to characterize more viruses with oncolytic properties.
Objectives
Evidences on the oncolytic feature of respiratory syncytial virus (RSV) are conflicting; therefore, this study was designed to elucidate the possible role of RSV on the modulation of cell growth and apoptosis in the skin cancer cells.
Materials and Methods
Plaque assay was used to determine RSV titers. The cytotoxic effect of RSV in A431 (skin carcinoma cell line) was determined using MTT assay. The detection of apoptosis was performed via Annexin-V-FITC staining method and analyzed with flow cytometry.
Results
The results indicated that A431 cell growth was inhibited following infection by RSV in a dose- and time-dependent manner. The most growth inhibitory effect of RSV was occurred at the MOI of 3, and 48 hour after infection. The inhibitory effect of RSV on the cell growth was accompanied by the induction of apoptosis in the skin cancer cells. The percentages of early and late apoptotic cells were increased following exposure to RSV in a concentration- and time-dependent manner.
Conclusions
This study delineated the beneficial role of RSV for growth regulation of skin cancer cells and highlighted the involvement of RSV in the induction of apoptosis in A431 cells. These findings might conduct evidence into the oncolytic properties of RSV in the skin cancer. Further studies are required to indicate intracellular targets for RSV-induced apoptosis in skin cancer cells.
doi:10.5812/ircmj.4722
PMCID: PMC3589781  PMID: 23487261
Oncolytic Viruses; Apoptosis; Skin Neoplasms; Flow Cytometry
16.  A Multicenter Study on the Prophylactic Application of Antibiotics in Aseptic Operations 
doi:10.5812/ircmj.4914
PMCID: PMC3589782  PMID: 23487365
Anti-Bacterial Agents; Aseptic; Analysis
17.  In vitro Cytotoxic and Antimicrobial Activity of Essential Oil From Satureja Intermedia 
Background
Many members of the genus Satureja have aromatic and medicinal characteristics. Objectives
Objectives
The purpose of the present work was to determine cytotoxic activity of the essential oil of S. intermedia CA Mey (Lamiaceae) on two human cancerous cell lines and its in vitro inhibitory effects against 11 pathogenic bacteria and fungi as well.
Materials and Methods
The essential oil was isolated by hydrodistillation and analyzed by combination of capillary GC-FID and GC-MS. The in vitro toxicological study was based on the MTT cytotoxicity assay and antimicrobial activity of the essential oil was studied according to the disc diffusion method and MIC value.
Results
Thymol (34.5%), γ-terpinene (18.2%) and ρ-cymene (10.5%) were the main components of the essential oil. The toxicological study on 5637 and KYSE cell lines showed IC50 values of 156 μg/ml. The essential oil exhibited considerable antimicrobial activity on tested bacteria and fungi.
Conclusions
From the results of the present study, it may be concluded that the essential oil of S. intermedia and its major constitutes are interesting in antibacterial and anticancer applications.
doi:10.5812/ircmj.4989
PMCID: PMC3589783  PMID: 23487431
Satureja; Gas Chromatography-Mass Spectrometry; Thymol
18.  Influenza Virus-like Particle Containing Two Different Subtypes of Hemagglutinin Confers Protection in Mice Against Lethal Challenge With A/PR8 (H1N1) and A/HK (H3N2) Viruses 
Background
Preventing the seasonal or pandemic outbreak of influenza can be powerful and cost-effective.
Objectives
In this study, we constructed a novel virus-like particle (VLP) platform that contains two hemagglutinin (HA) subtypes and evaluated immunogenicity of constructed VLP in mice.
Materials and Methods
This recombinant candidate vaccine model resulted in the expression of two HAs of H1N1 and H3N2 subtypes co-localized within a VLP. Following infection of insect cells with recombinant baculovirus co-expressing H1, H3 and M1 proteins, VLPs with size of 80–120 nm were self-assembled, budding, and released into the insect culture medium. The resulting VLPs which contained two different subtypes of hemagglutinin were purified by ultracentrifugation. The immunogenicity of VLPs was evaluated in mice following immunization.
Results
Our data showed that vaccination using VLPs elicited robust levels of serum IgG, and viral neutralizing antibodies against A/PR8 (H1N1) and A/HK (H3N2) viruses. Following challenge with lethal dose of A/PR8 (H1N1) and A/HK (H3N2, vaccinated mice were protected, displaying no sign of weight loss and mortality compared to non-vaccinated control mice.
Conclusions
VLPs can serve as a promising vaccination strategy to control influenza virus.
doi:10.5812/ircmj.6252
PMCID: PMC3589784  PMID: 23487492
Orthomyxoviridae; Virus-like particles; Influenza Vaccines
19.  Cancer and its Treatment in Main Ancient Books of Islamic Iranian Traditional Medicine (7th to 14th Century AD) 
Abstract
Islamic medicine is regarded as a comprehensive medical school with a long, glorious and worldwide reputation. Some of the physicians of this school are famous worldwide and have contributed valuable services to the scientific world. Given the dramatically increasing prevalence of cancer and the relative inefficacy of current medications, there is a great demand for the introduction of effective therapeutic approaches. To this end, integration of traditional medicine with modern medical treatments represents a promising option. In this essay, methods of diagnosis and treatment of cancer have been mentioned from the viewpoint of five famous physicians before the Mongolian attack who used Islamic medicine, namely Rhazes, Akhaveyni, Ahwazi, Avicenna and Jorjani. The ideas discussed dates back to a period between the eighth and fourteenth centuries.
doi:10.5812/ircmj.4954
PMCID: PMC3587862  PMID: 23482830
Cancer; Traditional, Medicine; Islamic Medicine
20.  Nurses' Emotional Intelligence Impact on the Quality of Hospital Services 
Background
Emotional intelligence is the potential to feel, use, communicate, recognize, remember, describe, identify, learn from, manage, understand and explain emotions. Service quality also can be defined as the post-consumption assessment of the services by consumers that are determined by many variables.
Objectives
This study was aimed to determine the nurses’ emotional intelligence impact on the delivered services quality.
Materials and Methods
This descriptive - applied study was carried out through a cross-sectional method in 2010. The research had 2 populations comprising of patients admitted to three academic hospitals of Yazd and the hospital nurses. Sample size was calculated by sample size formula for unlimited (patients) and limited (nursing staff) populations and obtained with stratified- random method. The data was collected by 4 valid questionnaires.
Results
The results of study indicated that nurses' emotional intelligence has a direct effect on the hospital services quality. The study also revealed that nurse's job satisfaction and communication skills have an intermediate role in the emotional intelligence and service quality relation.
Conclusions
This paper reports a new determinant of hospital services quality.
doi:10.5812/ircmj.926
PMCID: PMC3587863  PMID: 23482866
Emotional Intelligence; Job Satisfaction; Communication
21.  Comparison Between Presence of Epstein Barr Virus in Nodal and Extra Nodal Diffuse Large B Cell Lymphoma of Head and Neck, an Iranian Experience 
Background
Epstein Barr Virus (EBV) is one of the most common viral infections in human population. EBV has a significant role in pathogenesis of Hodgkin's lymphoma, Burkitt's lymphoma and nasopharyngeal carcinoma. The role of EBV in non-Hodgkin’s lymphoma, diffuse large B cell (NHL - DLBL) in the head and neck is controversial.
Objectives
The purpose of this study is to find out the difference between the presence of Epstein Barr virus in nodal and extra nodal lymphoma of head and neck.
Patients and Methods
A total of 30 cases of DLBL in two separate groups were collected from pathology department. The first group was consisted of 15 patients with DLBL of neck lymph node and the other was consisted of 15 patients with extra nodal DLBL of head and neck mainly in palatine tonsil. Both immune-histo-chemical (IHC) study and polymerase chain reaction (PCR) for detection of late membrane antigen (LMP) were performed on formalin fixed paraffin embedded tissue.
Results
All 30 cases were negative for EBV in IHC method. But in PCR method, 10% of patients were positive for LMP gene. There were 2 positive cases in nodal lymphoma and 1 positive case in extra nodal lymphoma group.
Conclusions
Compare with PCR method, it seems that IHC is not a sensitive method for detection of EBV. Overall, the finding of EBV in NHL depends on site, type of lymphoma and the detection method.
doi:10.5812/ircmj.1302
PMCID: PMC3587864  PMID: 23482890
Epstein-Barr Virus Infections; Lymphoma, Non-Hodgkin; Antigens; Head and Neck
22.  In Vitro Antioxidant Properties Evaluation of 10 Iranian Medicinal Plants by Different Methods 
Background
There is an interest in finding new and safe antioxidants from natural sources such as medicinal plants.
Objectives
The aim of this study was to evaluate the antioxidant activity of ten Iranian medicinal plants extracts.
Materials and Methods
For antioxidant activity, the radical scavenging activity, reducing power and phenolic contents of ethanol plant extracts were determined. Gallic acid was used as standard reference with well-documented antioxidant activity.
Results
The highest antioxidant activity in terms of DPPH radical scavenging was found in Verbascum sinuatum L. Var (VS) with an IC50 equal to 263.52 ± 5.981 μg/ml and Rosa damascena Mill (RD) with and IC50 equal to 287.9 ± 5.675 μg/ml that are higher than gallic acid (IC50 = 25.32 ± 5.593 μg/ml). The highest antioxidant activity in terms of ferric reducing capacity was also found in Verbascum sinuatum L. Var extracts (in 85.08 ± 8.66 μg/ml concentration with absorbance 0.5). Also, this extract contains the highest phenolic compounds (8.53 ± 0.11 mg/g).
Conclusion
In this study, Verbascum sinuatum L. Var contains the highest level of phenolic compounds may be contribute to higher free radical scavenging activity and reducing power in comparison to the other plant extracts. Therefore this plant is a good candidate as natural antioxidant.
doi:10.5812/ircmj.1408
PMCID: PMC3587865  PMID: 23482923
Phenolic Compounds; Radical Scavenging; Power
23.  Post-Traumatic Stress Disorder and Related Factors in Parents of Children With Cancer in South-East of Iran 
Background
Post-traumatic stress disorder (PTSD) comprises a collection of symptoms following exposure to injury-causing accidents of life. It is estimated that the prevalence of PTSD in children with malignancy and their parents is between 10-30% and even several years after treatment of malignancy this disorderremain in 20-20% of these patients.
Objectives
This study investigated the prevalence of post-traumatic stress disorder in parents of children with cancer.
Materials and Methods
In this analytic-descriptive study, 256parents of children with cancer (mean age: 30.06 ± 14.6 years-old) that their children treated in pediatric hematology ward of Ali ebn-e Abitaleb (AS) teaching hospital of Zahedan city (south east of Iran) at 2009-2010 were evaluated. The demographic data and symptoms of PTSD were collected by standard questionnaire (based on DSM-IV). After data analysis was performed using statistical software SPSS (version 18).
Results
All parents who were studied had PTSD. The severity of PTSD in 111 of parents was mild, in 103 (40.2%) moderate and in 42 (16.4%) parents was severe. Furthermore, there were a significant correlation between the severity of PTSD with number of children, age of parents, gender, literacy, religion and economic state (P = 0.001).
Conclusions
Our results showed that factors such as age, sex, number of children, educational state and religion of parents with economic state of the family can effect on the severity of PTSD. As for role of parents of children with chronic disease especially malignancy diseases on decline of psycho-social disorders with mental and physical supports of their children should be given the necessary recommendations and educations regarding PTSD.
doi:10.5812/ircmj.2163
PMCID: PMC3587866  PMID: 23483014
Post-traumatic Stress Disorder; Parents; Malignant Neoplasm
24.  Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? 
Background
Pyogenic bacteria and especially Staphylococcus aurous (S. aurous) are the most common cause of chronic osteomyelitis. Not only treatment protocol of chronic osteomyelitis occasionally is amiss but also this malady responds to treatment difficultly.
Objectives
This study investigates antibiotic resistance pattern of S. aurous isolated from Iranian patients who suffer from chronic osteomyelitis by two methods: disk diffusion (Kirby bauyer) and E-test (Epsilometer test) to find Vancomycin susceptibility and MIC (Minimum inhibitory concentration).
Patients and Methods
One hundred and thirty one patients who suffer from chronic osteomyelitis which have been referred to both governmental and private hospitals at 2010 were tried out for culturing of osteomyelitis site (sites). Antibiotic susceptibility and MIC of isolated bacteria were investigated by Kirby bauyer and E-test respectively.
Results
Samples were collected from bone (73.4%), surrounding tissue (14.6%) and wound discharge (12%). S. aureus was isolated from 49.6% of the samples. According to disc diffusion, methicillin resistance S. aureus (MRSA) was 75% and Vancomycin resistance S. aurous (VRSA) was 0% and based on MIC, MRSA was 68.5% and VRSA was 0%. According to MIC experiments, maximum sensitivity was against to Vancomycin (90.2%) and ciprofloxacin (54.4%) respectively but based on disc diffusion, maximum sensitivity was against to Vancomycin (97.7%) and ciprofloxacin (43.2%), respectively (P = 0.001). E-test (9.8%) in comparison with Disc diffusion (2.3%) showed higher percent of intermediate susceptibility to Vancomycin (P = 0.017).
Conclusions
Comparison of antibiograms and MICs showed that Kirby bauyer technique especially for detection of VISA strains is not reliable comparison with E-test. Already VRSA strains have not detected in Iranian chronic osteomyelitis, Thus Vancomycin is the first choice for chronic osteomyelitis empirical therapy in Iran yet.
doi:10.5812/ircmj.2165
PMCID: PMC3587867  PMID: 23483042
Iran; Methicillin-Resistant; Osteomyelitis; Staphylococcus Aurous; Vancomycin Resistance
25.  Effects of Omeprazole Over Voice Quality in Muscle Tension Dysphonia Patients With Laryngopharyngeal Reflux 
Backround
Laryngopharyngeal reflux (LPR) is the backflow of stomach contents above upper esophageal sphincter, into the pharynx, larynx, and upper aerodigestive system.
Objectives
In this study, effects of omeprazole over voice quality in muscle tension dysphonia with laryngopharyngeal reflux was ınvestigated.
Patients and Methods
Nine patients, 7 males and 2 females, aged between 27-43 (mean age:31) were included to this study. The diagnosis of muscle tension dysphonia with LPR was established by video laryngoscopy, rigid scope 70º. The laryngeal changes related with LPR were evaluated according to Reflux Finding Score. The patients received omeprazole 20 mg twice a day for a period of 6 months. None of the patients received voice therapy. Vocal hygiene guidelines were also explained to the patients. Objective and subjective voice parameters (Jitter, shimmer, NHR, Voice Handicap Index, and Auditive analysis; Roughness, breathiness, and hoarseness) were evaluated in this study.
Results
After treatment with omeprazol, all the parameters showed an improvement in voice quality, but only VHI (P = 0) and shimmer (P = 0,018) are statistically significant.
Conclusions
For FD patients with LPR condition, we highly recommend that LPR treatment should be part of the treatment plan.
doi:10.5812/ircmj.2292
PMCID: PMC3587868  PMID: 23483094
Dysphonia; Stomach, Proton Pump Inhibitors

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