Background: growth retardation and nutritional deficiencies is common in children with cerebral palsy and can influence their motor function.

Objectives: This is a cross-sectional study aiming at evaluation of growth and minerals status in children with CP ,  finding association between macro and micro minerals deficiencies and some factors like age, sex, type and severity of CP and severity of malnutrition in these children.

Patients and methods: One hundred patients with CP underwent anthropometric measurements and Malnutrition was assessed according to Gomes, Waterlow, Cole, and WHO classifications.Ten patients were excluded from study due to hemolysis of blood samples. Serum analysis for mineral’s concentration was done. Also motor functions were evaluated in these children according to GMFCS (gross motor function classification system)  and MACS ( manual ability classification system) classifications and statistical analysis of patient’s data was done using Chi-square and ANOVA tests.

Results: Of these 90 participants 30% had severe wasting and 38.9% had severe stunting. What is new in our study is  we found zinc deficiency is common among these children in comparison to previous studies. Also We found an  association between serum P level and age variant (p=0.03) and between  high grades of GMFCS and Zn deficiency (p=0.04). Also correlations were significant between severe malnutrition and spastic quadriplegic type and between stunting and wasting with spastic quadriplegic CP.

Conclusion: Malnutrition and growth retardation is common in children with CP. As  improvement in nutritional status has an impact on motor function and  life quality in children with CP, more attention is recommended to be paid on their nutritional status and feeding problems.

Background: In this connection, we put in our work the following aim: to define the potential of simvastatin and non-medication combined impact on regular blood elements' aggregative features of patients with arterial hypertension and dyslipidemia.

Methods: In our investigation, we took 55 patients of middle age with arterial hypertension of 1-2 degree, risk 3 with dyslipidemia of IIb type. For dyslipidemia correction, all the patients were prescribed simvastatin, hypolipidemic diet and graduated exercise. Registration of clinical and laboratory indices was made before the start of treatment, in 6, 12, 18, 52 and 104 weeks of therapy. We applied biochemical, hematological and statistical methods of investigation. Control group was composed of 26 healthy volunteers of the middle age examined once.

Results: Application to patients of simvastatin, hypolipidemic diet and graduated exercise during 104 weeks positively influenced lipid composition and level of lipid peroxidation in plasma and regular blood elements taking the given indices on the control level for 12 weeks. Fulfilled therapy normalized in patients with arterial hypertension and dyslipidemia erythrocytes' aggregative abilities (aggregates' quantity decreased by 47,1% during 6 weeks, and ability to platelets' aggregation (aggregation inhibited with ADP on 74,1%, with collagen - on 47,1%) and neutrophils (aggregation weakened with lectin on 58,3%, with phytohemagglutinin - on 37,2% during 12 weeks.

Conclusion: Simvastatin reception on the background of non-medication by patients with arterial hypertension and dyslipidemia normalizes lipid composition and level of lipid peroxidation in plasma and regular blood elements for 12 weeks of investigation. These patients' therapy lowers erythrocytes' aggregative abilities for 6 weeks, and platelets' and neutrophils' - for 12 weeks of therapy.

Background: Numerous factors may underlie an acute transfusion reaction. The readily available data showing the prevalence and the risk factors of transfusion reactions in Bali are scarce. Objectives: Our study aimed to reveal the prevalence and the risk factors of acute blood transfusion in Pediatric Patients in Sanglah General Hospital, Bali, Indonesia. Methods: A cross-sectional study using consecutive sampling was conducted from August 2015 to August 2016 (13 months). We collected the data from the medical records of our pediatric patients in the pediatric wards, neonatal intensive care unit (NICU), and pediatric intensive care unit (PICU). We examined the relationship between the occurrence of acute transfusion reactions and the types of blood transfusion, the history of blood transfusion, and the age of the patients. Results: A total of 107 acute transfusion reactions occurred from 3,251 blood transfusions. When acute transfusion reactions occurred, the patients were more likely to be over 12 months old compared to 0 to 12 months old (POR=2.81, 95%CI 1.78-4.58, p<0.05). Alternatively, when the transfusion reactions occurred, the patients were more likely to receive thrombocyte concentrate transfusion compared to other blood components (OR=8.11, 95%CI 5.36-12.31, p<0.05). Conclusion: The prevalence of acute transfusion reactions was 3.3%. The pediatric patients who had acute transfusion reactions were more likely to be over 12 months old or more likely to receive a platelet concentrate.

Background: Preeclampsia is the leading cause of morbidity and mortality in pregnant women and the fetus. In preeclampsia, glomerular endotheliosis occurs due to endothelium dysfunction in the kidney. Supplementation with L-Arginine is postulated to improve glomerular endotheliosis. The aim of this study is to investigate the effect of L-Arginine on improving glomerular endotheliosis in an animal model of preeclampsia.

Method: This is an analytical experiment research which was conducted in November 2016 to January 2017 in Biomedical Laboratory Faculty of Veterinary Medicine, University of Airlangga, Surabaya. Thirty pregnant mice (Mus musculus) were used in this research. The mice were divided equally into three groups, normal pregnant mice (K1), pregnant mice model of preeclampsia (K2), and preeclampsia pregnant mice treated with L-Arginine (K3). The kidneys were then obtained surgically and examined with immunohistochemistry examination. Data were analyzed by using one-way ANOVA and Post-hoc test.

Results: The mean score of glomerular endotheliosis were 0.44±0.42 for K1, 1.34±0 for K2, and 0.62±0.45 for K3. There was a significant difference between K1 and K2 (p=0.0000), and also between K2 and K3 (p=0,000).

Conclusion: L-Arginine is effective on improving glomerular entoheliosis in a mouse model of preeclampsia. 

Background: The prevalence ratio of heart failure is significantly increased, especially in low and middle-income countries. Adoption of self-care behaviors effectively and efficiently might be reducing the costs in result of heart failure outcomes and complications from the disease. This study aimed to determine the effects of the continuous care model on self-care behaviors in heart failure patients.

Methods: A Randomized controlled trial with Pre-test/Post-test control group design was conducted on some 80 patients with heart failure. The subjects in this study were randomly assigned to intervention (n=40) and control group (n=40). In the experimental group, Continuous care model applied for a period of three months from April to the end of June 2016, and self-care behaviors in heart failure patients in the two groups before and after the implementation of continuous care models were compared. Data collection tools included two parts: Demographic characteristics and specific questionnaire of self-care heart failure index. The data were analyzed by SPSS v. 20, chi-square, independent T, and paired test.

Results: The mean score of the Self-Care Behaviors before the intervention, at the intervention and control group were 28.33 ± 12.72 and 26.99 ± 1.96 respectively (P= 0. 663). But after the intervention, mean score of the Self-Care Behaviors in the intervention and control groups were 50.86 ± 11.96 and 28.93 ± 10.96 respectively (P < 0.0001).

Conclusion: Implementation of the continuous care model can lead to improve self-care behaviors in heart failure patients. 

Introduction: The prevalence of stroke is increasing among young populations in Iran and among adult populations in other countries. The highest risk factors are related to cardiovascular diseases and blood pressure, and the most prevalent type of stroke is hemorrhagic stroke. The present study was aimed at comparing individual and familial situation and history of diseases in female and male patients suffering from stroke admitted in Alzahra, Feyz, and Kashani Hospitals, Isfahan in 2015-16.

Method: The present study is a descriptive quantitative research. The statistical population included all patients with stroke who had referred to Alzahra, Feyz, and Kashani Hospitals in Isfahan. The study sample consisted of 180 records documented in those hospitals. The study instrument was a researcher-designed checklist. The collected data were analyzed by descriptive and analytical methods using SPSS software.

Results: The highest number of mortality caused by stroke was related to hemorrhagic stroke to which hypertension is known as the risk factor. It was also concluded that there was no significant difference between female and male patients in terms of age, sex, place of residence, and marital status.

Conclusion: According to the results of the present study, all patients suffering from stroke experience various physical problems; therefore, different factors cause stroke, and physical disabilities are predictable in such patients, and new protocols are required to improve life conditions among such patients.

Background: The new anticancer is urgently needed due to the high resistance and recurrence of breast cancer. Previous study reported that a new chalcone derivative, (e)-1-(4’-aminophenyl)-3-phenylprop-2-en-1-on, has a potential cytotoxicity against T47D breast cancer cell line. In this study we investigated the anticancer activity of (e)-1-(4’-aminophenyl)-3-phenylprop-2-en-1-on against DMBA-induced mammary cancer in Sprague Dawley rat and its effect on microRNA-21 expression.

Methods: Twenty four female rats were divided into 6 groups. The first group, G1 received corn oil. The groups 2 to 6 (G2, G3, T1, T2, and T3) were induced by DMBA (dissolved in corn oil) 20 mg/kgBW for 5 weeks. After breast nodule observed, G2 received vehicle and G3 received tamoxifen. Whereas, T1, T2, T3 received (e)-1-(4’-aminophenyl)-3-phenylprop-2-en-1-on with different doses, ie. 5, 15, and 45 mg/kgBW/day for 21 days, respectively. Tumor size was measured every weeks for 21 days and on day 22, plasma and breast tissues were collected to examine the miR-21 expression by qRT-PCR and histopathological feature, respectively.

Result: The result showed that significantly decreased tumor growth (p<0.05) and better histopathological malignant grading in G3, T1, T2, T3 were observed. Moreover, significantly reduced miR-21 relative expression (p<0.05) in G3, T1 and T2 were also observed. 

Conclusion: (e)-1-(4’-aminophenyl)-3-phenylprop-2-en-1-on has potential anticancer activity on DMBA-induced mammary cancer in Sprague Dawley rat through its activity on miR-21 expression. Hence, (e)-1-(4’-aminophenyl)-3-phenylprop-2-en-1-on might be a new anticancer candidate in the future.

Background:  Acute Myocardial Infarction (AMI) is an emergency medical condition which still has high mortality and morbidity. In recent decades, its prevalence has a tendency to increase, parallel with other chronic diseases. One of suspected contributing factor in AMI is the presence of C1562T polymorphism on MMP-9 gene which increases plasma MMP-9 concentration and destabilizes the plaque. However, this notion needs further confirmatory studies, as there are several contradictive reports regarding their association. This Study aimed to determine the relationship between C1562T polymorphism with the increase of MMP-9 concentration in AMI. Method: A cross-sectional was conducted in Cardiovascular Centre of Sanglah General Hospital. The peripheral blood samples were obtained from subjects, and the DNA and blood plasma was isolated. The polymorphism was detected using PCR and RFLP while MMP-9 concentration was determined by ELISA. Results: The average concentration of plasma MMP-9 was found to be at 8.33 ng/mL which ranged from 0.74 ng/mL until 31.93ng/mL. The proportion of MMP-9 C1562T polymorphism was 20% of all subjects. The average concentration of MMP-9 was higher than cut-off standard which is 0.6 ng/mL. Analysis within the group revealed that CT-genotype had significantly higher average MMP-9 compared with CC phenotype (11.27 ng/mL vs. 7.65 ng/mL). Conclusion: C1562T polymorphism appears to be significantly associated with AMI by increasing the concentration of MMP-9 in blood plasma.

Background: The Child-Pugh score is an internationally accepted system for grading the severity of chronic liver disease such as cirrhosis. It assesses the severity of the liver disease to avoid subjectivity and inconsistency. However, some non-invasive serological markers may also be useful to evaluate the stage of liver fibrosis in determining the severity of cirrhosis. Some of the known markers are Arginase-1 (ARG-1), IL-13, fibronectin (FN), tissue inhibitor of metalloproteinases-1 (TIMP-1), and metalloproteinases-1 (MMP-1). Objective: To evaluate the correlation between the circulating levels of ARG-1, IL-13, FN, TIMP-1, MMP-1 with the score Child-Pugh in cirrhosis patients. Materials and Methods: We conducted a cross-sectional study enrolling fifty-six patients of the chronic liver with Child-Pugh A, B, and C. The score was calculated based on the value of serum bilirubin, serum albumin, internationalized normal ratio (INR), and the severity of ascites and hepatic encephalopathy. Serum ARG-1, IL-13, FN, TIMP-1, MMP-1 were analyzed using an enzyme-linked immune sorbent assay. The differences were analyzed using Mann-Whitney test, Spearman’s correlation (univariate analysis), and multivariate analysis by the multi-regression test. Results: There was a significant correlation of ARG-1 serum with Child-Pugh scores (r = -0.589, p<0.05). However, we did not find a significant correlation between the Child-Pugh scores and the IL-13 (r=0.238, p=0.078), FN (r=-0.151, p=0.265), TIMP-1 (r=-0.158, p=0.244), and MMP-1 (r = -0.006, p = 0.967) with the Child-Pugh scores. Conclusion: The serum marker of ARG-1 was found correlated with the severity of the chronic liver disease.

Introduction: Thalassemia is the most common genetic disorder in the world. Children with major thalassemia face much lifelong stress and anxiety related to invasive methods of treatment including venipuncture and blood transfusion that cause discomfort and anxiety symptoms in children and changes their physiological indicators.

Methods: The aim of this study was to evaluate the effect of foot reflexology massage on vital signs and anxiety after blood transfusions in children with thalassemia. It was a quasi-experimental study, which conducted on 60 children with thalassemia who had inclusion criteria. Patients randomized into three groups of reflexology massage, regular massage, and control group. The level of anxiety in patients assessed by an anxiety measurement based on the Observational Scale of Behavioral Distress-Revised (OSBD-R) and patients’ vital signs measured 20 minutes before blood transfusion.

Results: A significant difference (p=0.0001) observed between the vital signs of children in reflexology massage group before and after the intervention. The average score for patient's anxiety before and after the intervention for reflexology massage group (p=0.003) and regular massage group (p=0.005) was significantly different, but in the control group showed no significant difference before and after the intervention (p=0.09). After the intervention, the mean score of anxiety in patients of the three groups was statistically significant (p=0.0001).

Conclusion: The results of this study confirm that foot reflexology massage affects vital signs of children with thalassemia undergoing a blood transfusion and reduces their anxiety. 

Background: Olfactory dysfunction is one of the chronic rhinosinusitis symptoms. A large number of patients with chronic rhinosinusitis without polyps whose treated by Functional Endoscopic Sinus Surgery (FESS) need to be investigated using Sniffin ' sticks test before and after surgery. Objective: The aim of this study is to investigate the role of olfactory function improvement after FESS in patients with chronic rhinosinusitis without polyps. Methods: This study is an experimental study using one group pre-post test design. The measurement of the threshold, discrimination, identification, and TDI scores were assessed by Sniffin’ stick test in 3 periods (before FESS, 2 weeks and 4 weeks after FESS intervention). Results: The mean value of the TDI score before FESS performed was 19.43 ± 7.32 (hyposmia), 2 weeks after the operation was 26.9 ± 5.78 (hyposmia), and 4 weeks after the operation was 33.25 ± 3.86 (normosmia).There is a significant mean difference in thresholds, discrimination, identification, and olfactory function (TDI) scores in patients with chronic rhinosinusitis without polyps before FESS, 2 weeks after the procedure, and 4 weeks after FESS. Conclusion:There was a significant improvement in olfactory function after FESS performed in patients with chronic rhinosinusitis without polyps.

Background: An overtraining or a practice of an excessive intensity without a sufficient recovery period may induce myocardial injury. Objective: The aim of this study was to reveal myocardial changes in overtrained rats through a histo-pathobiological analysis. Methods: We enrolled 24 male Wistar rats for 6 weeks. As many as 8 rats or the control group swam 15 minute/day, 5 days/week. The overtrained group consisted of 24 rats swam for 90 minutes, twice a day, daily. After sacrificing, the hearts were excised for pathological preparation slides. Results: The overtrained group’s slides showed an increase in chromatin fragmentation in the myocardial structure. The left ventricle wall thickness was also greater in overtrained groups than the control. Necrotic bodies were found in the myocardium of overtrained groups, but none in the control group. Conclusion: We found the negative effects of an overtraining to the myocardium. Avoiding overtraining is necessary to avoid a myocardial injury.

Introduction: Nurses are the largest group working in hospitals and play a key role in health care systems. They are also considered important members of health team.  Therefore, they are very effective in society's and one's health. Objective: This article aimed to study the relationship of emotion dysregulation with psychoactive substance abuse among nurses. Method: This is a descriptive, correlational study. The targeted population consisted of all nurses working in hospitals of Kermanshah, Iran in 2016. A sample of 350 was selected using multi-stage cluster sampling. However, the number reduced to 341. The data were collected using three questionnaires: Gratz & Roemer (2004) Difficulties in Emotion Regulation Scale (DERS) and Bahremand et al. (2014) Psychoactive Substance Abuse Questionnaire. The data were analyzed in SPSS22 using Pearson correlation study and regression analysis. Result: Research findings showed a significant relationship between the components of emotional dysregulation with tend to consume psychoactive drugs there, and the relationship level (P <0/001) is significant. Conclusion: So it can be concluded that components of emotion regulation predicted the psychoactive substance abuse.

Introduction: Lack of expressing opinions by employees in organizations causes organizational silence. Researchers have identified two contributing factors for the organizational silence: Management fear of negative feedback and staff perceptions of management's complex ideas about them. Method: This article aimed to forecast organizational silence according to moral behavior styles. A total of 300 employees working in Mobile Telecommunication Company of Iran (MCI) were enrolled as the sample using simple random sampling. It was a correlational study. Data were collected using two questionnaires: Organizational Silence Questionnaire and Moral Behavior Questionnaire. Descriptive statistics (mean and standard deviation) and confirmatory factor analysis used for data analysis. For the hypothesis testing, path analysis, which is a part of SEM, was employed using LISREL. Result: The results showed that organizational silence had a significant relationship with moral behavior. Conclusion: The results help managers prepare the ground to receive feedback from employees with various moral behavior styles.

Keywords: Organizational Silence, Moral Behavior Styles.  

Background: For practice it is still very important to search ways of early correction of arterial hypertension displays with the help of non-medication. In this connection it seems to be important to identify the impact of regular athletic exercise on early developing of arterial hypertension, hemostatic and rheological abnormalities in persons of young age.

Methods: We investigated 99 young patients with arterial hypertension of the 1st degree. The patients were divided into two comparable groups. The first experimental group consisted of 57 persons who regularly - one hour a day, six times a week, during a year - experienced athletic exercises. The second experimental group consisted of 42 persons and was composed of patients who had no wish to train physically and take medicines. Control group was composed of 43 healthy persons of the same age. In all the examined patients we fulfilled the investigation of basic indices of hemostasis, blood viscosity, erythrocytes' aggregation and deformability. The data were processes by Student's t-criterion.

Results: Patients of both experimental groups initially were noted to have hemostasis activation and negative changes of blood rheological features. In a year of regular athletic exercise patients of the first experimental group reached normalization of arterial pressure. They also had decrease of platelets' aggregative ability (aggregation with ADP 2.13±0.16 Un) and activity weakening of hemostasis plasma link (INR 1.12±0.05, APTT 29.8±0.37 s) to control level. Avoidance of exercise in the second experimental group promoted further increase of functional activity of platelets and plasma hemostasis at simultaneous worsening of relevant blood rheological features.

Conclusion: At initial stages of arterial hypertension development in case of regular athletic exercise fulfilled by young patients it is quite possible to reach normalization of arterial pressure level, hemostasis activity and hemorheology.

Keywords: arterial hypertension, hemostasis, platelets, erythrocytes, blood viscosity, exercises.

Introduction: It is supposed that the serum level of Zinc relates to the cirrhosis.  We conducted this study to assess the serum zinc levels in patients with liver cirrhosis.

Methods and materials: In this descriptive analytic cohort, 80 patients over 18 years old, mean age 54.23±15.05 with liver cirrhosis referred to Imam Khomeini hospital outpatient’s clinic or hospitalized in the internal ward of this hospital in Ahwaz during 2015 were recruited.  The severity of the disease based on MELD and Child scoring system, encephalopathy, ascites, SBP, serum zinc levels in patients were measured, and the relationship between these variables and zinc serum level was investigated.

Results: The mean serum level was 61.36±25.07 and Zn deficiency observed in 22 patients (27. 5%). Regarding the etiology of cirrhosis, viral hepatitis (B, C) was the most common followed by cryptogenic, but the Zn serum level was not significantly different considering etiology of the cirrhosis. Moreover, the Zn serum level was not significantly different between groups with different ascites severity and  Child and MELD scoring system, but the difference was significant between groups with or without SBP and encephalopathy. Using regression test we showed that the correlation of Zn serum level with spontaneous bacterial peritonitis(SBP) and encephalopathy was significant and was not significant with etiology of cirrhosis, ascites and Child and  MELD scoring system.

Conclusion; we discovered that Zn serum level in cirrhotic patients was lower than normal range (70micg/dl), moreover we proved that lower concentration of Zn is correlated with encephalopathy and spontaneous bacterial peritonitis.

Background: Iron dust is one of the many irritant substances present in the environment and acts as a pollutant in the air. Exposure to iron dust substances in the air is thought to result in disruption of nasal mucociliary transport when inhaled. PT. Gunung Gahapi Sakti Medan is one of the companies engaged in iron smelting by employing quite a lot of workers.

Objective: To know the relation of exposure to iron dust to the disruption of nasal mucociliary transport time at factory workers PT. Gunung Gahapi Sakti.

Method: The type of research conducted is an analytical study with cross sectional study design (crossectional study).

Results: Of 322 people, a total of 97 workers were selected based on inclusion and exclusion criteria. 18-28 years of age have more nasal mucociliary transport time ≤ 17 minutes, while employees aged 29-39 years and 40-50 years have a nasal mucosiliar transport time> 25 minutes. Women have a nasal mucociliary transport time ≤ 17 minutes, while male employees have mucociliary transport time of the nose> 17 minutes. The duration of 1-10 years has a mucociliary transport time of the nose ≤ 17 minutes, whereas those who have worked 11-20 years l have time Nasal mucociliary transport> 17 minutes. Workers on close exposure have a mucociliary transport time> 17 min, while exposure has a mucociliary transport time ≤ 17 min

Conclusions: The nasal mucociliary transport time of employees is prolonged or decelerated with increasing age and duration, and the mucociliary transport time of the nose in male employees is longer than in women. The workplace (location of exposure) also significantly affects the mucociliary transport of the nose.

Background: Prophylaxis fever and neutropenia using G-CFS are recommended in most chemotherapy regimens in women with breast cancer. Among common side effects of G-CFS injection, one can refer to skeletal pains. The present study was carried out in order to examine the level of pain and changes in blood cells in two methods of every day and every other day administration of G-CFS.

Methods: In the present clinical trial, 186 patients (93 in each group) were considered as the study sample. Ninety-three patients with breast cancer were given G-CFS on a daily basis, and then every other day in the next phase of their chemotherapy, the effect of these two methods on the number of WBC, Hb, PLT, and pain level in the patients were compared.

Results: There was no significant difference between the two administration methods regarding the number of white blood cells and platelet of the patients. The mean score of pain in every other day administration of G-CFS was 5.6 while it was 6.6 in the group with a daily administration, and this difference was significantly meaningful (p = 0.016). In patients with breast cancer, every other day compared to daily administration of G-CFS did not lead to any difference in the number of white blood cells and platelets.

Conclusion: There was no significant difference between the groups received G-CFS on an everyday basis and the one on an every-other-day basis in terms of leukocytopenia. It is recommended that G-CFS is administered on an every-other-day basis

Introduction: Self-care program makes it easy to cope with chronic conditions such as advanced renal diseases. So this study has done in order to evaluate effect of self care on patients undergoing hemodialysis .

Methods: This research is a Quasi experimental study conducted in the Sanandaj Hospitals affiliated to Kurdistan University of Medical Sciences in 2016. 60 patients were selected based on inclusion criteria and non-random purposive sampling in two intervention and control groups (each group 30 people). The 3-part questionnaire was used to collect data. The first part included demographic data , second part consisted of  questions about training needs, and the third section consists of  questions to assess the self-care of the studied samples. Data analyzed using SPSS version 16, descriptive and inferential statistics.

Results: Results showed that Patient's age ranges were between 25 to 70 years. Mean duration of hemodialysis in the intervention and control groups was 6.14 and 6.59 years respectively. in terms of training needs before the experiment, both groups are the same (P= 63.2). the results show that self-care score before intervention (P=0.618) is the same in both groups. After the intervention, there is the difference in self-care between the two groups, but this difference was not statistically significant (P=0.312).

Conclusion: Assessment of Self-care needs in patients undergoing hemodialysis needs education programs. These patients dependence brings about some compatibility issues which could be addressed rightfully leading to improvement of their self-care activities.