What is the best imaging method for patients with a presumed acute stroke?

Evidence-based answer: It depends on whether the stroke is ischemic or hemorrhagic. For early detection of ischemic stroke, magnetic resonance imaging (MRI) using diffusion-weighted imaging (DWI) is highly sensitive and specific, whereas computed tomography (CT) is less sensitive but about as specific (strength of recommendation [SOR]: B, a meta-analysis of lower quality RCTs). MRI using DWI and CT are probably comparable for detecting acute hemorrhagic stroke (SOR: B, a cohort study). When thrombolysis is being considered and hemorrhage must be ruled out rapidly, either test is acceptable if it can be performed and interpreted within 45 minutes of patient arrival, although MRI typically costs about twice as much as CT (SOR: C, expert opinion)

The effect of education for iron consumption based on the theory of planned behavior in pregnant women in Mashhad

Background and aim: Iron is an essential element for women of reproductive age, especially in the period before pregnancy and during this period. This study was aimed to investigate the consumption of iron to prevent iron deficiency anemia based on the theory of planned behavior on pregnant women in Mashhad city. Methods: This quasi-experimental study was done on 160 pregnant women referred to health center No. 1 in Mashhad town who were allocated to case (80) and control (80) groups randomly in 2014. Intervention was done in four 75- minute sessions. Data were collected using a questionnaire made by researcher based on the theory of planned behavior and blood lab exam (Ferritin). Questionnaires were distributed and completed immediately, and 3 months after educational intervention were repeated again. Results: The average rates of knowledge, attitude, perceived behavioral control and intention to use of iron intervention group was increased 3 months after the intervention significantly (P0.05). Conclusion: Regarding the effect of education in promoting iron consumption in pregnant women, it is suggested that iron supplementation promotion workshops should be held in health centers with the aim of preventing iron deficiency anemia in health centers

Nursing Instructors and Students, Views Related to Discrimination in Nursing Care: A Qualitative Study

Background: One of the moral challenges in the healthcare system is discrimination in providing care to patients. The present study aimed to report the experiences of nursing instructors and students regarding discrimination in nursing care.Methods: This qualitative study was conducted using conventional content analysis through semi-structured interviews with 8 nursing instructors and 13 nursing students. The participants were selected using the purposive sampling method. Data collection continued until data saturation. Data were analyzed using Graneheim and Lundman’s proposed method. Data collection and analysis were concurrent. Results: According to the findings, “Discrimination paradigm,” “Discrimination as a negative concept,” and “The role of nursing instructors” (teaching moral values, being a role model, and evaluating moral standards) were identified as the main categories. Conclusion: According to the results of this study, nursing instructors are recommended to introduce moral topics to students, act as role models for them, and teach them how to deal with ethical challenges

Comparative study of measuring body temperature by mercury and digital thermometer‏

Background and Aim: Mercury is a dangerous substance for human health and mercury thermometers are major pollutant for environment. Using less dangerous and less expensive devices like digital thermometer can be an alternative for mercury thermometers. The aim of this study was to compare the body temperature measurement by mercury and digital thermometer. Material and Method: In this descriptive- analytical study, 542 patients (331 Female and 211 Males) were selected through convenience sampling. Data was gathered by demographic information form. Body temperature was measured simultaneously by digital and mercury thermometer while each thermometer was placed axillary, and after 5 minutes they were read by a nurse. Results: The mean temperature measured by mercury and digital thermometer was 36.48±0.84 and 36.51±0.87, respectively. There was no statistical significant difference between measurement by mercury and digital thermometer. For detecting fever, digital thermometer had 85.4% and 95.7% sensitivity and specificity respectively. Positive and negative predictive value for digital thermomentr were 81.1% and 96.8%, respectively. Conclusion: Regarding low sensitivity of digital thermometer, it can be concluded that mercury thermometer is still suitable device to detect fever

Perceptions of Employees on Psychological Factors Affecting Obesity: A Qualitative Study

Introduction: Obesity has now become an epidemic in Iran and there is convincing evidence that psychological factors play an important role in obesity and overweight. Given the key role of employees, as valuable human resources, in providing services and the increasing sedentary lifestyle among them, the current study aimed to explore governmental employees’ perceptions of psychological factors that affect obesity. Method: This qualitative study was conducted through content analysis. In total, 4 focus group discussions were held with groups of 8 subjects (32 subjects). Semi-structured interviews were conducted on a diverse sample of 35 obese or overweight governmental employees between February 2014 and January 2015. All interviews were audio recorded and were analyzed using the Strauss and Corbin method. Results: As a result of data analysis, the 3 main categories of poor adaptability in stressful periods, low self-efficacy, and motivators emerged. Poor adaptability in stressful periods consisted of the 5 main subcategories of periods of university entrance exam, soldiering, career, marriage, and childbirth. Low self-efficacy was explored in the 2 main subcategories of lack of positive model and the sense of lack of control over circumstances. Motivators included the subcategories of pleasure and apprehension. Conclusion: This study showed that perceptions of employees on psychological factors influencing obesity differed. Therefore, further researches, both qualitative and quantitative, are required in this field. Keywords: Grounded theory, Obesity, Qualitative stud

Antihypertensive effect of Iranian Crataegus curvisepala Lind.: a randomized, double-blind study.

Abstract The aim of the present study was to investigate the potential antihypertensive effects of extracts of the flavonoid-rich Iranian flower, Crataegus curvisepala Lind., a member of the Rosaceae family. The hydroalcoholic extract of the leaves and flowers were studied in a double-blind, placebo-controlled clinical trial to determine its effects. A total of 92 men and women with primary mild hypertension, aged 40-60 years, were selected and divided randomly into two groups, receiving either hydroalcoholic extract of C. curvisepala Lind

Cytotoxicity of Silver Nanoparticles on Human Gingival Epithelial Cells: An In Vitro Study

Objective: Nanosilver has numerous applications in medicine due to its potent antibacterial activity. However, data regarding the bio-safety of its effective concentrations is scarce. This study aims to assess the toxicity of silver nanoparticles on human gingival epithelial cells under in-vitro  conditions.Methods: This in vitro study evaluated the toxic effects of filtered and unfiltered nanosilver solution on human gingival epithelial cells obtained from the Pasteur Institute of Iran using the methylthiazol tetrazolium bromide (MTT) assay (mitochondrial function)and membrane leakage of lactate dehydrogenase (LDH) at 24, 48 and 72h time points. The concentrations of silver nanoparticle solution used were 0.05, 0.1, 0.2, 0.5, 1, 2, 5, 10, 20 and 50µg/ml.Results: The MTT assay showed that nanosilver solution at high concentrations (20 and 50µg/ml) significantly decreased the viability of cells at all time points. The lower non-fatal concentrations at 24 and 48h were capable of causing cell death or significantly inhibit cell growth at 72h. The LDH assay demonstrated that death of epithelial cells only occurs at high concentrations of nanosilver (20 and 50µg) and no significant toxicity was seen at lower concentrations.Conclusion: Based on the results, silver nanoparticles have toxic effects on human gingival epithelial cells and this effect is time and dose-dependent

Assessment of Physical Activity of Adolescents in Isfahan

In spite of multiple benefits of physical activity (PA) for children and adolescents, health, as well as for prevention of chronic diseases later in life, detailed data concerning their PA is limited in our community. To determine the PA duration and intensity, as well as the energy expenditure in adolescents by a simple self-report. This cross-sectional study was performed among 2000 students, ages 11-18, selected by multi-stage random sampling and with equal proportion in both genders in middle and high school levels in Isfahan. A simple self-administered questionnaire consisting of 9 scales of PA from inactivity (0.9 METs) to vigorous activity (>6 METs) used in European countries was validated and filled out by 100 selected samples. Overall, 1894 filled questionnaires (94% of total) were returned. Statistical analysis was performed using the Student t and Pearson correlation tests at P<0.05. The mean age of subjects studied was 14.7±1.1 years in girls and 14.5+ 1.2 years in boys. The mean daily PA with an intensity of more than 2 METs in boys was significantly higher than girls 36.9±6.8 vs. 26.6 + 4.2,respectively, (P<0.001). The daily energy expenditure by activities with more than 2 METs of intensity in the middle school students was 1000.3 + 128.5 Kcal in girls, and 2395.6+172.4Kcal in boys (P<0.001). Considering the high school students, these values were 1469.8 + 190.7 and 2146.3 + 399.7 Kcal, respectively (P<0.001). In both genders, PA duration and level was lower in high school than middle school students. A significant inverse relationship was found between the mean daily PA with the mean weight (r=-0.64, P<0.001), and with the mean body mass index (r=-0.71, P<0.001). Findings of the present study provide a simple and valid self-report questionnaire and shows an undesirable PA level in adolescents especially females and high school students. This finding emphasizes the necessity to pay more attention to PA promotion in youth, and to provide facilities in this regard

Do Intervention Strategies of Women Healthy Heart Project (WHHP) Impact on Differently on Working and Housewives?

<p class="abstract"><strong>BACKGROUND:</strong> The purpose of this study is to evaluate the possible difference of the impact of Women Healthy Heart Project on lifestyle, as well as physical/biochemical parameters of working women and housewives.</p> <p><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This was a community-based intervention study conducted over 5 years (2002-2007) in the counties of Isfahan and Najafabad (intervention areas) and Arak (control). Pre-study situation analysis of women was followed by 5 years of wide-ranging interventions (educational/environmental) conducted by various organizations using different methodologies. The interventions were aimed at modifying/improving lifestyle by increasing physical activity, encouraging healthy eating, and tobacco use cessation. The organizations involved in performing the interventions included the local radio and television authority, health/treatment centers, the Red Crescent Society, Municipalities, the Relief Committee, the Center for Retirees&rsquo; Welfare, and the Literacy Campaign Organization. After 5 years, final phase same as first phase was planed. The subjects studied in all phases` the pre- and post-intervention phases consisted of 10586 women aged above 18 years. Demographic data, obesity index, smoking, physical activity and eating habit were assessed before and after the study. Data were analyzed using SPSS-15 using Student&rsquo;s t-test, chi-square test, the general linear model of ANOVA, and logistic regression.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> We studied 10586 women (6105 and 4481 women, pre- and post-intervention, respectively). Mean age of working women was 34.14 &plusmn; 10.09 and 34.08 &plusmn; 9.35 years before and after the study, respectively. Mean age of housewives before and after the study was 40.05 &plusmn; 14.61 and 40.36 &plusmn; 15.32 years, respectively. Interventions conducted during 5 years improved eating habits and decreased tobacco use in working women and housewives. In every phase of the study, there was a significant age difference between housewives and working women (P &lt; 0.001). Hence data were adjusted according to age in each phase. Overall physical activity of housewives and working women increased, but the percentage of passive smokers among housewives remained unchanged. Waist circumference and waist-to-hip ratio changed significantly in housewives following interventions (P &lt; 0.001). The parameter which improved significantly in working women was waist circumference (P &lt; 0.05). However, after adjusting for age, no significant difference was seen between working women and housewives following interventions.<strong></strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Community-based interventions, especially those directed at housewives, can lead to significant improvements in lifestyle and cardiovascular risk reduction. It seems that working women require tailored interventions to suit their conditions. Although short-term outcomes may seem insignificant, persistence and continuity of lifestyle changes may lead to reduced prevalence of cardiovascular diseases. Then longer-term studies are warranted.</p><p class="abstract"><strong>Keywords:</strong> Women, housewives, working, risk factors, lifestyle modification.</p

Likelihood of Breast Screening Uptake among Reproductive-aged Women in Ethiopia: A Baseline Survey for Randomized Controlled Trial

BACKGROUND፡ Breast cancer is the most devastating public health problem affecting women in developed and developing world. Therefore, this study was aimed to assess the likelihood of taking breast self-examination as abreast screening behavior among reproductive age women.METHODS: A community based cross-sectional study was conducted on 810 reproductive-age women. Intervieweradministered questionnaires were used to collect data. Studyparticipants were selected using systematic sampling method. Data were analyzed using SPSS version 24.0.RESULTS: The likelihood of performing breast self-examination was 54.3%. However, the comprehensive knowledge of the participants was 11.5%. As independent predictors, perceived severity of breast cancer [AOR (95%CI) = 2.05 (1.03 to 1.07)] and self-efficacy [AOR (95%CI) = 2.97(0.36-0.99)] were positively associated with the likelihood of performing breast selfexamination whereas districts [AOR (95%CI) = 0.58 (0.37 to 0.91)] and place of residence [AOR (95%CI) = 0.69 (0.51 to 0.93)] were negatively associated with the likelihood of performing breast selfexamination. The HBM Model explained 64.2% of the variance in this study.CONCLUSION: Although the likelihood of performing breast selfexamination was relatively good, the comprehensive knowledge of the women was very low. Therefore, breast cancer screening education must address knowledge and socio-cultural factors that influence breast screening through awareness creation using appropriate behavioral change communication strategies.