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Background: Hypertension is one of the most important risk factors in the etiology of cardiovascular and renal diseases both in children and adults. Due to the absence of a blood pressure (BP) normograph in children living in Tehran, this study was conducted in Autumn 2002 to determine the BP status in children 7-11 years old and its relationship with age, sex, height and weight.
Materials and Methods: This descriptive study was carried out on 1061 children (boys and girls). The age, sex, height, weight and systolic and diastolic BP were measured according to the standard procedures, then 50th, 75th, 90th and 95th percentiles of BP were tabulated.
Results: The data showed that systolic and diastolic BP increased by height and weight. Also, the 90th and 95th percentiles of systolic BP was equal in boys and girls aged 7 and 8 years however, it was higher in girls aged 9, 10 and 11 years. The diastolic BP at 90th and 95th percentile was equal in boys and girls aged 7, 8 and 9, but it was higher in girls aged 10 and 11 years. When BP percentile of American children was compared to the Iranians it was found that boys and girls living in Tehran had a lower systolic and diastolic BP than that of Americans.
Conclusion: These data show that, in addition to age and sex, other factors such as height, weight, race, nutrition, genetics and environment have influence on normal range of BP in children. Therefore, each society should have their own standard BP normograph for their populations. Similar studies with more samples are highly recommended.

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Background: Approximately 90% of hospitalized clients receive some type of infusion therapy. Phlebitis is a common complication of i.v. therapy. In numerous studies, application of drugs such as antiseptics, heparin, steroids and filter administration have been tested to reduce phlebitis occurence. Subsequently, the present study was carried out with the aim of efficacy of topical nitroglycerin on severity and occurence of phlebitis in 2004. Materials and Methods: This study was a randomized double – blind controlled clinical trial. The investigated units consisted of 82 patients, who were prescribed intravenous catheter. In this research, the samples were randomly divided into two equal groups: control group and experimental group. These two groups were matched according to their age and medication received .After the placement of the catheter, nitroglycerine ointment (1.5 centimeter) or placebo ointment was applied to the distal section of the injection place and every 12 hours the site of cannulation was examind for signs and severity of phlebitis and ointmet was readministerd and bandaged. This was repeated at intervals of 24, 36, 48, 60 and 72 hours. The data were collected by using checklist. The results were analyzed using T-test and X2 and relative risk was plotted. Results: The results showed that occurrence and severity of phlebitis in experimental group was significantly lower than control group after applying the ointment. (P =0.001). Moreover, the results showed that longevity of catheter was higher in treatment group than in control group. Conclusion: According to the above findings, the hypothesis of this research was approved .The results can be applied to nursing service , nursing education and nursing research .

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Background & Objectives: Nutritional habits and behavior are acquired and established during childhood and can remain through the whole life. Proper nutrition in childhood results in enhancing the child growth and development and hinders the risk of chronic diseases in adulthood. Regarding the significance of nutritional training of school children, this study was conducted with the aim of determining the effect of nutrition education on knowledge and nutritional practice of grade five elementary school children about junk food intake in Tabriz from 2004 to 2005.
Materials & Methods: This experimental study was conducted on 487 students (from 16 schools ) in two control and treatment groups. In this research two teaching styles (lecturing without teaching aids - and with teaching aids and group discussion) were performed for twelve sessions for the students. Data collecting tool was a questionnaire whose reliability and validity had been confirmed in advance. To investigate the effect of intervention of nutrition education in junk food consumption Solomon method was used.
Results: The results obtained from this study showed no significant difference between mean knowledge and practice of the students in control and education groups before intervention. However, after nutrition education there was a significant difference (P=0.005) between mean score of knowledge and practice in two groups and the mean score of practice in treatment group increased from 87.8± 31.95 before intervention to 104.6±28.34 after intervention and the mean score of knowledge increased from 22.4±16.49 before intervention to 42.6±25.68 after intervention. In addition, knowledge and practice increased significantly in two groups (P=0.005). The results were more favorable in girls than in boys (P=0.005).
Conclusion: Nutrition education plays a crucially important role in improvement of knowledge and practice , particularly in school. Replacement of junk food with nutritious, healthy food will reduce the complications posed by consumption of junk food. Parents, education also seems essential to reduce the consumption of junk food.

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Background and Objectives: Thalassemia is a hereditary hemolytic anemia requiring life-long transfusion treatment. The frequent blood transfusion has some side effects, including immunologic reaetions and non-immunologics such as iron overload and transmission of some infections such as HBV, HCV and HIV. This cross-sectional study was aimed to investigate the transfusion effects in patients referred to the Adult Thalassemia Clinic, Tehran.
Materials and Methods: For data collection, the patients were asked for the history of transfusion reactions, their files of medical records were surveyed with concern to transfusion status and reactions, and some laboratory data including serum ferritin and TTI were also collected. The results were analyzed using SPSS software.
Results: Foun hundreds and forty one patients comprises of 53% males and 47% females with mean age of 22.6 years were studied. They consisted of 362 (82.1%) thalassemia major and 79 (17.9%) thalassemia intermediate. The mean of ferritin level was 1856.4 ng/dl. From the studied subjects, 7 (1.6%) had history of delayed hemolytic disorder, 25 (6.1%) presented with allergy and 41 (9.9%) showed febrile transfusion reaction. The remaining 368 subjects (82.4%) showed no evidence of transfusion reactions. The records showed that 117 patients (28.4%) were HCV Ab positive, 369 (88.7%) were HBsAb positive and 80 (19.2%) were HBcAb positive, 3(0.7%) HBsAg positive. According to this results, 300 patients (70.3%) were vaccinal positive; 66 (15.5%) were immune to HBV from past infections; 40 (9.4%) were negative and 3 (0.7%) were carrier of HBV. Totally, 366 (85%) patients were immune to HBV. We had no case of HIV positive.
Conclusion: Transfusion reaction and their documentation are very important for blood transfusion services and programming. Unfortunately, there is no statistic records of these reactions in the hospitals or there may be some unclassified data in the patients’ files. Regular co-operation between hospitals and blood transfusion centers is required for collecting the information and finding total incidence of transfusion reactions. Hemovigilance or computerized network between blood bank centers in hospitals and Iran transfusion organization is the best way for collecting such data.

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Background and Objective: Hospitalization of a family member especially in the intensive care units (ICUs) is a crisis that can cause anxiety in the whole family. The present study was conducted to determine some effective factors that can lead to anxiety in families of patients hospitalized in Rasht ICUs in 2006. Materials and Methods: In this cross–sectional study 218 family members of 130 inpatients of Rasht Poorsina and Razi hospital ICUs were selected. Data were collected using researcher–made and hospital anxiety depression (HADS) questionnaires. Results: The results showed that the majority (77.1%) of patients’ family members were anxious. The anxiety odd ratio (OR) by logistic regression showed that anxiety rate increased with the decrease of patients’ consciousness level (OR= 9.726 per additional point), family members’ sex (OR= 6.171), making decision by family members (OR= 6.433) and older age (OR= 0.939 per additional year). Conclusion: The results confirmed the role of several important factors in inducing anxiety to the ICU inpatients’ families which require further consideration. These factors are recommended to be investigated upon admission and provide nursing care for preventing and overcoming anxiety in both patients and families.

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Background and Objective: Nowadays cardiovascular diseases have affected more women than men. A healthy diet and physical activity are two essential factors in life style Unhealthy life style have direct effect on these risk factors. A survey of women’s lifestyle due to their important role in family life style can help to recognize problems as well as to establish guidelines for society family health Promotion programs. Materials and Methods: In this descriptive cross-sectional study, life style and risk factors of cardiovascular diseases was evaluated by standard Monica questionnaire in Zanjan. In this study 997 women older than 20 years were analyzed. Results: The majority of the subjects had a good knowledge about the effect of exercise (66/7%) and the attitude (4/62%) on cardiovascular disease prevention. But a few of them had appropriate performance (24/1%). There was a significant statistical difference in the level of blood cholesterol (P=0/02) fasting blood sugar (P=0/03) and blood pressure (P=0/02) and physical activity and exercise. But there was no significant statistical difference in the level of knowledge about diet with the level of blood cholesterol, sugar, hypertension and their performance. Conclusion: Knowledge alone doesn’t guarantee the performance of individuals. An intervention in order to improve the health behaviors is necessary.

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Background and Objective: Menopause is defined as the ability of fertility to infertility and has a significant role in personality, social and cultural aspects. Menopause has a special situation in reproductive health. One of the problems during the menopause period is decreasing of sexual desire or sexual satisfaction. Sexual aspects of postmenopausal women can promote their health and quality of life. This study was conducted to determine affecting agents on sexual satisfaction of postmenopausal women referring to healthcare clinics affiliated to Shahid Beheshti University of Medical Sciences in Tehran in 2007. Materials and Methods: In this descriptive study 270 menopause women were selected by convenience sampling method. A questionnaire was used for data collection comprising of two parts: demographic and sexual satisfaction questions. Results: Mean age of menopause women was 52.49 ± 4.93 years. A desirable sexual satisfaction rate was 58.9% and 66.3% had undesirable sexual satisfaction. Sexual desire dimension was associated with womens’ job (P<0.05). Sexual excitation dimension was associated with primary and intermediate education of postmenopausal women, intermediate husband's education and free job of spouses. Sexual orgasm and relaxation after coitus was associated with unmasturbation and sexual activity of their women. Total sexual satisfaction rate was associated with age of menopause (P< 0.01), primary and intermediate education of postmenopausal women (P< 0.05), primary and intermediate education of spouse and satisfaction rate from sexual activity (P< 0.01). Conclusion: Although postmenopausal stage is associated with decreased level of sexual hormones and drive intimate relationship with spouse, increasing education level leading to increasing knowledge and adaptation with menopause, can elevate sexual satisfaction.

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Background and Objective: Previous studies indicated that morphine consumption during pregnancy could inhibit embryos development. Present study further evaluated the effects of oral morphine consumption on the placenta lacunas development in ten day pregnant Wistar rats. Material and Methods: Female Wistar rats (W: 170-200 gr) were used in the present study. Experimental group were received morphine (0.05 mg/ml of tap water) after one night coupling with male rats for mating. On the day 10th of pregnancy, the pregnant animals were killed with chloroform and the placentas and uterus were removed surgically and fixed in 10% formalin for twenty days. The fixed placentas were processed and stained by H & E method and evaluated for their development. Thickness of layers, surface area of lacuna, as well as the number of cells in both maternal and fetal parts of the placentas was assessed by light microscopy. Results: Our results indicated that the layer thickness of fetal portion and surface area of lacuna of the fetal and maternal portion of placenta reduced in experimental group. In addition, maternal portion layer thickness and cell number of the fetal and maternal portion of placenta increased in the experimental group. Conclusion: Our results showed that oral morphine consumption could inhibit natural function of placenta lacuna and fetal cell development.

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Background and Objective: Leukocyte filters are effective for WBC reduction but they cannot inhibit passing plasma proteins and as a result repeated protein entry may produce allergic transfusion reactions. To deal with this problem, washed RBC method is used. The traditional wash method is an open system through which waste products are carried away in sewers with the risk of environmental pollution. Newly introduced approach for washed RBCs consists of a closed system whereby waste products enter into a bag. In this study, the two methods were compared.
Materials and Methods: The two open and closed wash methods were compared in terms of health system, leukoreduction, risk of transmission of infection and quality control.  In each method, 100 bags were washed, coded and then transmitted to different units of blood culture, flowcytometry as well as quality control. The data were collected and analyzed by SPSS14.
Results: 200 bags (100 for each method) were studied.  Microbiologically, there were no positive results for any of the methods. In quality control also there was not any significant difference in the two methods. In flowcytometry, we didn’t observe any significant correlation in leukocyte count in the two methods before washing (p=0.072), however. The correlation between them after washing (p<0.0001), demonstrating that the new method was better for leukoreduction.
Conclusion: The new washing system method was a superior way because it involves a closed system where waste products are discharged into a side bag and disposed as hospital waste. Meanwhile, this approach is more convenient for leukoreduction. In our country, since we still need a washing system for some transfusions, this method is deemed to be a decent and practical one because it impedes environmental pollution.

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Background and Objective: The production of Extended Spectrum Beta Lactamases (ESBLs) by Escherichia coli is the main cause of resistance to Cephalosporins.  In the past decade, CTX-M enzymes have become the most prevalent ESBLs in Europe, Canada, and Asia.  In this study, the frequency of ESBL-producing E.coli and molecular detection of the CTX-M-I group was investigated.
Materials and Methods: A total of 400 urine samples were collected from both hospitalized and out-patients in Khoy’s hospitals between November 2009 and April 2010.  Out of these samples, 188 were identified as  E.coli  by standard biochemical tests. The antibiotic Susceptibility tests to 10 antibiotics were performed by the-disk-agar diffusion (DAD) method. ESBL production was screened by phenotypic test that including disk diffusion agar and combined disk as recommended by the Clinical and Laboratory Standards Institute (CLSI). Screened isolates were investigated by PCR assay for detection of CTX-M-I group genes.
Results: The results show that out of 188 E.coli isolates identified, 56 (29.8%) were producing ESBls by phenotypic test. All isolates were sensitive to imipenem. Overall, 49 (87.5%) isolates were confirmed as CTX-M-I producer by PCR.
Conclusion: The results of this study showed that about 30% of the identified E.coli were producing ESBl. Therefore, we recommend to use molecular methods in such researches.

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Background and Objectives: Breast cancer (BC) is the most common invasive malignancy affecting women worldwide. The tumor-suppressor P53 gene (P53) is frequently mutated in breast tumors. To use P53 as a target for therapy, it is important to accurately assess p53 mutation status in tumor samples. Materials and Methods: A total of 102 tumor samples were collected from breast cancer patients referred to Tabriz hospitals between the 2007-2009 period. DNA was extracted by Proteinase K– Isopropanol method and then performed amplification and sequencing of P53 from exons 5 and 6. Results: Mutations in the P53 gene were detected in 17.6% of the patients. Including 7 polymorphisms (6.68%) and 11 mutations (10.78%). Overall, 18.2% of the mutations were found in codons 160 (ATG>AAG) and 163 (ATC>AAG) in exon 5. Also 81.8% of the mutations observed in exon 6: codon 193(CAT>AAT), codon195 (ATC>TTC), codon 195 (ATC>AAC), codon 198(GAA>TAA), codon 220 (TAT>TGT), codon 213 (CGA>CTA), and codon 214 (CAT>CG). No alteration observed in intron5 and all of polymorphism detected in 13399A>G nucleotide of exon 6. The majority of detected mutations are missense that located on DNA-binding domain of P53. This type of mutation usually leads to the production of a mutant protein with a compromised structure and altered DNA-binding capacity. Conclusion: This is the first report of its kind from the East Azarbaijan region. Our results indicate a rather high frequency of exon 6 mutations in P53 among patients with breast cancer. Furthermore, the mutation pattern appears differs from other regions. However, further studies are needed to determine the role of P53 mutations in breast cancer development.

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Background and Objectives: Previous studies have shown that polymyxin B sulfate and trimthoprim antibiotics are not individually effective on Yersinia enterocolitica and their closely related species. The aim of this study was to evaluate the synergistic effect of above antibiotics on Y. enterocolitica and their closely related species, from the clinical and the natural environment specimen collected in Iran, and compare them with the isolates that that were obtained from the Pasteur institute collection in France. Materials and Methods: In total, 73 species from Iran and 25 from the Pasteur institute in France were tested. The microdilution method was used for the MIC according to the standard protocol. Results: The synergistic effect was seen in all tested samples. However, the human species from the Pasteur institute were more sensitive than the Iranian human and the environmental species were less sensitive than clinical. The Y. enterocolitica isolates were less sensitive than the related species such as Y. intermedia, Y. fredriksenii, and Y. kristensenii. Conclusion: The synergistic effect polymyxin B sulfate and trimthoprim were more evident on other closely related Yersinia species Y. enterocolitica.

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Background and Objective: Stridor is considered as a serious adverse complication of intubation that may lead to respiratory distress, reintubation, and further complications. Intravenous steroids including dexamethasone are assumed as an effective therapy. However, their associated side effects pose a limit on their usage. This study was carried out to elucidate the effect of intravenous dexamethasone with inhaled budesonide on the reduction of post-extubation stridor in ICU patients. Materials and Methods: This randomized clinical trial study included 80 intubated patients with extubation during their stay in the ICU ward. Prior to the extubation, a cuff-leak test was performed for all patients, and those with either negative test results or less than expected were randomly assigned to two groups of A or B (n= 40 each). Group A received 8 mg/8 hr of intravenous dexamethasone, while group B received aerosolized budesonide (0.5 mg/6 hr). Both groups received their medications starting 24 hours prior to the extubation until 24 hours afterwards. All of the patients were examined for stridor for 24 hours following the extubation. The data were collected and analyzed by SPSS-16 software using t-test, Chi-square, Fisher, and Mann-Whitney tests. Results: Post-extubation stridor occurred in 62.5% of the patients in the dexamethasone group vs. 52.5% of the budesonide group. However, this difference is not statistically significant (P= 0.36). Similarly, the difference between the stridor scores for the two groups was not significant either (P= 0.26). Conclusion: Our results show that the effect of intravenous dexamethasone vs. inhaled budsonide was similar on the restriction of post-extubation stridor. Nonetheless, using aerosolized budesonide is recommended due to its fewer associated side effects.

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Background and Objective: Infant exposure to environmental tobacco smoke is a major public health problem. The aim of this study was to determine the effects of environmental tobacco smoke exposure on infant weight. Materials and Methods: This was a prospective cohort study. Participants of this study were 51 exposed and 51 non-exposed infants whose weight was measured in three periods of 5-7 days of age and also 2 and 4 months of age. Environmental tobacco smoke exposure of infants and their urinary cotinine were assessed by a questionnaire. The urine samples were collected during each follow-up. For data analysis, independent t test, chi-square and Fisher's Kappa tests were used. Results: Mean urinary cotinine levels over 5-7 days, 2 months and 4 months of age in the exposed group was significantly higher than in the non-exposed group (P<0.001). The mean weight of the exposed group was significantly lower than the non-exposed group in 2 and 4 months of age (P<0.001(. Conclusion: The results of this study show the weigh loss among infants exposed to environmental tobacco smoke, so we suggest further studies with longer follow-up periods and in all aspects of infants’ life.

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Background and Objective: Patients’ hospitalization is always stressful for their family members. Belief in God and religiousness are assumed to have vigorous preventive effect on psychiatric disorders, stress and anxiety. Reliance on God can decrease the concerns resulting from severe diseases. When an individual suffers from a long- lasting and complicated disease and its consequent disabilities, trusts in God, would be helpful to admit disease consequences which subsequently prevents or at least diminishes psychological adverse effects. Materials and Methods: This descriptive-correlative study analyzed the level of anxiety in 100 family members of hospitalized patients admitted to the intensive cardiac care units. The anxiety levels in patients’ family members were analyzed using HADS (Hospital Anxiety Depression Scale) and Religious Beliefs Measurements Scale. The reliability and validity of the scales had already been confirmed by Aghamohammadi and coworkers. The results were analyzed using statistical procedures of Chi-square and correlation tests and logistic regression. Results: 53.2% of the individuals were suffering from anxiety and 56.4% had depression. In persons with no anxiety or depression the relation with strong religious beliefs was significant as shown by Chi-square test (P<0.05). However, 31.2% and 33.2% of the patients’ family members who had depression and anxiety respectively, showed a meaningful relation with average religious beliefs (P<0.05). Conclusion: Religious beliefs have a positive effect on reducing depression and anxiety. Reinforcement of beliefs can reduce depression side effects such as suicide attempts, addiction, immoral actions, personality disorders and sexual disorders.

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Background and Objective: Anxiety is a displeasing feeling of fear and worry associated with a psychological and physiological state of somatic, emotional, cognitive, and behavioral complications. Most students experience some degree of anxiety prior to their examinations. Among various non-drug methods, recitation of Quran can be listened to and used as a beneficial method to reduce anxiety level. Materials and Methods: This study was performed on 62 secondary school students who were randomly assigned into two groups of control (n=31) and treatment (n=31). Data were obtained by a questionnaire composed of demographic data and Sarason Test Anxiety Questionnaire. At the outset of the experiment, pre-exam anxiety levels were measured in both groups. Then, the treatment group listened to the recitation of the Holy Quran as long as 20 minutes while the control group sat for 20 minutes in their place. Anxiety levels were measured again at the end of the experiment. Data were analyzed using paired and independent t-tests. Anxiety scores were compared between the two groups before and after the intervention. Results: The mean anxiety scores in the treatment group before and after the intervention were 17.52 and 14.48, respectively. The paired t -test analysis showed a significant difference in the control group before and after the intervention (P<0.05). The mean anxiety scores in the treatment group before and 20 minutes after the intervention were 17.39 and 17.1, respectively. The independent t- test analysis showed no significant difference in the control group before and after the intervention (P> 0.05). Conclusion: The results indicated that listening to the recitation of the Holy Quran would have beneficial effects on reducing anxiety. Listening to the Holy Quran can be considered as a non-pharmacologic method, safe and a reasonable approach to reduce anxiety before the exam.

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Background and Objective: It seems that using a combination of aerobic and anaerobic exercises (resistance exercises) can induce beneficial physical, psychological, and social effects on hemodialysis patients who are encountered with various stressors. This study aimed to determine the effect of combined aerobic and anaerobic exercises on quality of life in hemodialysis patients. Materials and Methods: In this study we used a pre and post semi-experimental design with two comparison groups. The subjects consisted of 74 patients from two hemodialysis centers affiliated to Zanjan University of Medical Sciences. All subjects were randomly allocated into two groups. Kidney Disease Quality of Life-Short Form (KDQOL-SF) was used to assess quality of life in patients with kidney disease. Results: The results showed that the mean and standard deviation of quality of life before the intervention in the combined exercises group was 47.7 ± 15.56 and in the aerobic exercise group was 41.1 ± 11.51. But after the intervention, the mean and standard deviation of quality of life in the combined exercises group increased to 77.1±28.06 and in the aerobic exercise group increased to 56.4 ± 12.78 indicating significant differences between the two groups (P<0.0001). Both aerobic and combined exercises increased quality of life in hemodialysis patients. Though, the effect of the combined exercises during the hemodialysis was outstanding in enhancing quality of life in hemodialysis patients in comparison to aerobic exercises alone. Conclusion: The results of this study suggest that the aerobic exercises, especially combined exercises in hemodialysis patients may lead to an increase in their quality of life.

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Background and Objective: Throughout the history, medicinal plants have established their roles as therapeutic and remedial agents. Green tea contains polyphenolic compounds including flavonoids and catechins alleged to exert biological effects. Taking advantage of Green tea effects on male sex hormones, the study was an attempt to assess its effects on female sex hormones and gonadotropins in rats.

Materials and Methods: In this experimental study, 15 female Wistar rats were allocated to 3 groups of 5. Two groups received green tea1.5% and 3.5%, respectively as the only source of drink whilst the control group received only tap water. Blood samples were taken at the end of the 28^th day and serum concentration of LH, FSH, estrogen, and progesterone was measured.

Results: The results illustrated that serum LH and estrogen significantly decreased in groups receiving green tea compared to the control group (p<0.001, p<0.05, respectively). Serum FSH increased to a small extent, though not significantly. In the meantime, serum progesterone showed a significant increase in groups receiving green tea compared to the control group (p<0.001).

Conclusion: Our study asserts that green tea decreases LH and estrogen and increases progesterone without any significant effect on FSH level.

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Background and Objective: Doxorubicin is one of the most effective chemotherapeutic agents against solid tumors. Doxorubicin causes cardio-toxicity via production of free radicals and depletion of anti-oxidants. However, the use of anti-oxidants can decrease doxorubicin-induced cardio-toxicity. Apium graveolens (celery) contains anti-oxidant compounds. Hence, this study was an attempt to figure out if it can protect heart cells against oxidative stress of doxorubicin.

Materials and Methods: The cells were incubated with different concentrations of Apium graveolens (celery) extract for 4 hours which continued in the presence of 5µM doxorubicin for 24 hours. Cell viability and the apoptotic induction were determined using 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium (MTT) and propidium iodide (PI) staining assays, respectively.

Results: Celery extract increased toxicity of doxorubicin at a concentration of 125-500 µg/ml. Also apoptosis was induced in the presence of doxorubicin at a concentration of 250 and 500µg/ml.

Conclusion: Results showed that celery has no toxicity effect on heart cells alone. However, this extract could not protect cells against doxorubicin- induced cardiotoxicity. A number of mechanisms may instigate this effect such as augmentation of free radicals, increased drug delivery into the cells and expression of apoptotic proteins. Further research is needed to decide upon accuracy mechanism.