Background: Type 1 DM (T1DM) is caused by an autoimmune destruction of pancreatic ß cells. We proposed a novel stimulation using a low-level laser therapy (LLLT) through acupuncture points to stimuli the stem cells to be adult pancreatic ß cells. This study aimed to identify an optimal dose of low-level laser therapy (LLLT) for treatment of type 1 diabetes mellitus (T1DM).

Methods: An experimental study was performed with a pretest-posttest control groups design. The intervention was tested in rats (Rattus novergicus, Wistar strain). The rats were made diabetic by injection of streptozotocin (STZ). Rats were treated with different doses of LLLT in 4 groups. The tested laser doses were 0.2 joules (group L1), 0.3 joules (group L2), 0.4 joules (group L3), and 0.5 joules (group L4). The therapy was performed by perpendicularly attaching laser probe to the animal body, at the acupuncture point pishu (BL-20) on respective sides.

Results: Rats in the L2 group were performing better compared to others. The highest decrease of blood glucose level was found in group L2. Two rats in the L2 group achieved normal blood glucose level upon laser therapy. The dose of laser therapy in the L2 group of 0.3 joules was found to be the optimum dose.

Conclusion: Clinical and statistical analyses indicated that 0.3 joule was the optimal dose for LLLT in our animal model. Further investigation of LLLT in human is warranted and validation of the identified dose in future studies should be pursued.

Background: It is very important when teaching ethics to nurse students to select an educational method and materials that are relevant to their future career as clinical nurses. The aim was to determine the effect of implementing nursing ethics codes as a combined plan in North Khorasan’s University of Medical Sciences.

Methods: This research was an action research conducted in School of Nursing and Clinical setting at Bojnurd, North Khorasan Province, Iran, from September 2013 until September 2015. Data was collected through checklists and interviews with small groups and then analyzed. First, the researchers explored the difficulties in imposing nursing ethics codes. Then a combined plan was considered to solve the ethical codes’ problem. To perform this combined plan, a combination of interferences from three different levels of scope, which are students, college, and clinic, was considered. Permission from the Bojnourd’s Nursing and Midwifery College Educational Council was obtained for this study.

Results: The results of this study showed that 65.5% of students had given the right answers to ethical codes. More than half of the students remarked that respecting the rights of patients and nurses was the most important code. More than half believed that there was a system to supervise the implementation of ethical codes. The results from the ethical rounds with students showed that disobedience to ethical codes occurred in the three fields which are clinical staff, educator, and student administrators. This study offered a practical model for implementing professional ethics code based on Iran’s sociocultural background. Along, this study was done to satisfy the need for ethical education and conduct according to these professional ethics code in the college and the clinical setting.

Conclusion: It is recommended that a suitable evaluation system should be considered to get the feedback from the implementation of this combined plan of teaching professional ethics codes.

Background  In the history of Persian literature, Rumi is a unique figure in terms of the extent of information and ideas, excitement, outpouring, diversity of themes, full awareness of the human psyche, and the knowledge of pain, understanding the causes of diseases and their treatment.

Methods: This is a qualitative study using analytical deduction method. Resources related to the subject matter, the meaning, and implication of cognitive-behavioral concepts, symbols, emblems, and parables in Masnavi and other works of Rumi were studied.

Results: The results indicate Rumi believes that psychological disorders such as depression do not belong to individuals with a history of childhood psychological trauma but it is common in all humans, and it can result from repeated vain thoughts and personal cognitive distortions. From the perspective of Rumi, a seeker prevents the penetration of negative automatic thoughts into psyche (inherent self) by mastering the subjective identity (self). On the contrary, disability and succumbing to the influx of mental automatic and dysfunctional thoughts are the main causes of mental illness; their repetition and continuity end in the dissociation from his inherent self.

 Conclusion: For Rumi, staying away from primordial nature and separation from essence brings the drought and coldness of December that makes human life and existence cold, dry, and barren. Continuation of this condition causes the emergence of mental illness such as depression.

Background: Rhinosinusitis is one of the most concerning illness due to high medical cost and its negative effect on the respiratory tract. The etiology of chronic rhinosinusitis remains unknown. The main cause of chronic rhinosinusitis with or without nasal polyp is bacterial infections; thus antibiotics remain a main therapeutic intervention. Prescription of broad spectrum antibiotics and the inappropriate combination of antibiotics are the main factors of antibiotic resistance. This study aims to obtain the pattern of aerobic and anaerobic bacteria in chronic rhinosinusitis patient (with or without nasal polyp) and its sensitivity pattern, in Medan, Indonesia. Methods: This is a case series. Samples were patient with chronic rhinosinusitis who had undergone functional endoscopic sinus surgery (FESS). Results: The most common aerobic bacteria found is Klebsiella oxytoca (21.7%), and it is sensitive to ceftriaxone, cefotaxime, levofloxacin, and meropenem. While for the anaerobic bacteria, one patient was positive for Peptostreptococcus and it is sensitive to chloramphenicol. Conclusion: The most common bacteria in the maxilla in patients with chronic Rhinosinusitis with and without polyps in Medan are the aerobic bacteria Klebsiella oxytoca and anaerobic bacteria Peptostreptococcus. It is suggested that the antibiotic prescribed should be based on microbiology examination.

Background: Maternal mortality rate (MMR) in Indonesia is still high, including in East Java Province. Although the successful decline in MMR has been achieved, more action still needed to maintain and accelerate the process. Several factors that affect the maternal mortality, especially referral factor, and districts maternal health services quality, need to analyze. This study was conducted to analyze the correlation between maternal mortality with labour referral and maternal health service quality in 10 regencies/cities in East Java Province, Indonesia. 

Methods: The case-control study among 2 groups of 5 regencies/cities with the highest and lowest MMR in East Java Province in 2015. The indicators used, were maternal referral relay in maternal mortality report, frequencies of antenatal care, labor by health care provider, puerperal health care, obstetric complication management, detection of high-risk pregnancy by community and healthcare personnel, and family planning program.

Results: Total number of maternal mortality in East Java province in 2015 was 531, with MMR were 89,6/100.000 living birth. From the comparative study, we found a significant difference in indicators of high-risk pregnancy detection by healthcare personnel (p=0,035) and obstetrics complications management (p=0,006). There were no significant differences in frequencies of antenatal care, labor by health care provider, puerperal health care, detection of high-risk pregnancy by the community, and family planning program in 10 regencies/cities in East Java Province, Indonesia. 

Conclusion: High-risk pregnancy detection by healthcare personnel and obstetrics complications management were related with MMR in 10 districts in East Java province, Indonesia.

Background: Psoriasis is a chronic, recidive inflammatory skin disease. The main pathogenesis process is currently unknown. This disease is known as a complex disorder, influenced by both genetic susceptibility and environmental factors.

Aim: This study is aimed to analyze and determine the distribution of single nucleotide polymorphism (SNP) in IL-6 gene of psoriasis vulgaris patients and control patients.

Method: This study uses a case-control design to compare SNP in the IL-6 gene between psoriasis vulgaris group and control group.

Results: The most common genotype of the IL-6 gene Rs 1800795 in psoriasis vulgaris patients is GG (dominant homozygous) with a total of 21 patients (46.7%). The most common genotype allele in the control group is Gc (heterozygous) with a total of 27 patients (60%). We observed a significant correlation between the groups (p = 0.044).

Conclusion:

Homozygote for IL-6 allele G (GG) is a prominent finding in the case group, while in the control group heterozygous allele (Gc) is a more common finding, thus suggesting that a patient with dominant homozygote alleles will have a more severe condition when compared to those who have the heterozygote alleles.

Background: Sepsis is the second leading cause of death in intensive care unit and one of the top 10 cause of deaths worldwide. In sepsis, an inflammation response occurs that leads to the tissue destruction. According to the Survival Sepsis Campaign in 2012, early management in septic patients with 30 ml/kg of crystalloid fluids will have better outcomes. Objective: This study aimed to determine the optimal crystalloid fluid in the resuscitation of septic patients. Method: This double-blinded study was held from March 2017- May 2017 in Haji Adam Malik General Hospital. A total of 40 patients who passed the inclusion and exclusion criteria were assessed for interleukin-6 changes before and after treatment with ringer acetate malate and ringer lactate. Results and Discussion: From 40 Patients who passed the criteria, we compared the administration of Ringer's acetate and Ringer's lactate malate in septic patients. The mean systolic and diastolic blood pressure were increased in both study groups (p <0.05) and a significant decrease in pulse rate was also present in both groups (p <0.001). In both groups, there was a significant decrease in interleukin-6 levels (p <0.001). Administration of ringer acetate malate leads to a stronger decrease of interleukin-6 compared to ringer lactate administration (p <0.001). Conclusion: Ringer's acetate malate in EGDT of septic patients is superior in decreasing interleukin-6 Compared with Ringer lactate.  

Background: One of geroprotectors for mammals are still polyvitaminic preparations, one of which is Lipovitam-beta. Purpose of research: to estimate Lipovitam-beta impact on the indices of hemostasis and blood rheology systems of aging rats.

Methods: We examined 193 healthy outbred male-rats at the age of 24 months being kept in conditions of vivarium and having traditional ration. In experimental group (98 rats) we investigated the impact of Lipovitam-beta feeding on the basis of 5.5 mg on 100 gr of body mass once in 5 days during 6 months on relevant indices. Control group was composed of 95 healthy male-rats. We estimated the basic indices of hemostasis, blood viscosity, aggregation and deformability of erythrocytes at the beginning and in 6 months of investigation.

Results: Lipovitam-beta application has led in case of rats from experimental group to reliable lowering of spontaneous and stimulated platelets' aggregation and activity weakening of plasma hemostasis. On the background of Lipovitam-beta feeding to rats we found lowering of blood viscosity and erythrocytes' aggregation index what was accompanied by increase of erythrocytes' deformability index.

Conclusion: Application of Lipovitam-beta to aging rats led to activity lowering of plasma hemostasis and platelets, improving rheological features what can positively influence microcirculation, the level of vital activity and forthcoming life duration.