Assessing angiogenesis factors as prognostic biomarkers in breast cancer patients and their association with clinicopathological factors.

INTRODUCTION: Angiogenesis is fundamental for tumor growth and metastasis across many solid malignancies. Considerable interest has focused on the molecular regulation of tumor angiogenesis as a means to predict disease outcomes and guide therapeutic decisions. METHODS: In the present study, we investigated the prognostic value of transforming growth factor beta (TGF-ß), epidermal growth factor (EGF), fibroblast growth factor (FGF), delta-like ligand 4 (DLL4), and vascular endothelial growth factor (VEGF) in the serum of 120 women diagnosed with breast cancer using ELISA as well as examined their associations with clinical parameters and the outcome of the disease. RESULTS: Our results demonstrated that the serum concentration of TGF-ß and EGF were remarkably higher in patients with higher tumor size, end stages of the disease, and positive lymph node involvement compared to patients with lower tumor size, early stages of the disease, and negative lymph node involvement. In addition, we found a significant correlation between the serum concentration of VEGF and the level of EGF, FGF, and DLL4 in patients with breast cancer. Furthermore, both univariate and multivariate analyses showed that TGF-ß and EGF can be used as end-stage predictors. DISCUSSION/CONCLUSION: Based on our findings, increasing the level of angiogenesis factors is significantly associated with higher tumor size and late stages of the disease in patients with breast cancer. Moreover, measuring the level of angiogenesis factors could lead to better prediction of disease outcomes and choosing the best treatments for patients.

The effect of Triticum sativum (wheat) germ on postpartum pain: A double-blind clinical trial.

OBJECTIVE: Postpartum pain (PP pain) is a common problem after vaginal delivery. Some herbs are used to reduce PP pain. Due to the anti-inflammatory properties of Triticum sativum (wheat) germ, this study was conducted to investigate the effect of wheat germ on PP pain. MATERIALS AND METHODS: This is a randomized, double-blind, placebo-controlled clinical trial performed on 90 women who had a vaginal delivery and complained of moderate to severe PP pain. The participants were randomly divided into two groups. In the intervention group, a capsule containing 500 mg of wheat germ was taken every 6 hr for 2 days and in the control group, a placebo capsule was taken in the same order. The severity of PP pain was measured before and one hour after receiving the capsule by using the Visual Analogue Scale. RESULTS: The two groups were not different in terms of pain severity before the intervention. The PP pain in women with moderate pain was significantly reduced in both groups, the reduction was greater in the wheat germ group (GEE=0.04) but this reduction was not significant. The PP pain in women with severe pain was significantly reduced in both groups, however, the reduction was significantly greater in the wheat germ group (GEE=0.63, p=0.007). Moreover, the results showed that the use of mefenamic acid in the wheat germ group was significantly lower than the control group (p=0.04). Moreover, no side effect was reported after consuming the wheat germ. CONCLUSION: It seems that wheat germ reduces severe PP pain. Further research on this plant is recommended.

Simultaneous determination of methadone and morphine at a modified electrode with 3D ß-MnO2 nanoflowers: application for pharmaceutical sample analysis.

The present research synthesized manganese dioxide nano-flowers (ß-MnO2-NF) via a simplified technique for electro-catalytic utilization. Moreover, morphological characteristics and X-ray analyses showed Mn in the oxide form with ß-type crystallographic structure. In addition, the research proposed a new efficient electro-chemical sensor to detect methadone at the modified glassy carbon electrode (ß-MnO2-NF/GCE). It has been found that oxidizing methadone is irreversible and shows a diffusion controlled procedure at the ß-MnO2-NF/GCE. Moreover, ß-MnO2-NF/GCE was considerably enhanced in the anodic peak current of methadone related to the separation of morphine and methadone overlapping voltammetric responses with probable difference of 510 mV. In addition, a linear increase has been observed between the catalytic peak currents gained by the differential pulse voltammetry (DPV) of morphine and methadone and their concentrations in the range between 0.1-200.0 µM and 0.1-250.0 µM, respectively. Furthermore, the limits of detection (LOD) for methadone and morphine were found to be 5.6 nM and 8.3 nM, respectively. It has been found that our electrode could have a successful application for detecting methadone and morphine in the drug dose form, urine, and saliva samples. Thus, this condition demonstrated that ß-MnO2-NF/GCE displays good analytical performances for the detection of methadone.

The Effect of the Timing of Umbilical Cord Clamping on Hemoglobin Levels, Neonatal Outcomes and Developmental Status in Infants at 4 Months Old.

OBJECTIVES: Delayed umbilical cord clamping (DCC) increases blood transfer to newborns. Hence we investigated the effect of the timing of DCC on hemoglobin levels, neonatal outcomes and developmental status in infants at four months old. MATERIALS & METHODS: This clinical trial examined infants born to 400 pregnant women immediately upon birth and at the age of four months in Isfahan, central Iran in 2016. A table of random numbers was used to randomly allocate the newborns to intervention group with a 90-120-sec delay in umbilical cord clamping and the control group with a clamping delay of below 60 sec, and blood samples were taken from their umbilical cords. The Ages and Stages Questionnaire was used to evaluate the infants' developmental status. RESULTS: Umbilical cord hemoglobin was significantly higher in the intervention group compared to in the controls (P=0.024). No significant differences were observed between the two groups in terms of neonatal complications except neonatal jaundice was significantly more common in the intervention group (P=0.025), although the need for phototherapy was not different between the groups. Overall, no significant differences were observed between the two groups in terms of developmental status at four months old; however, the infants had better problem-solving skills in the DCC group (P=0.015). CONCLUSION: Despite elevating hemoglobin, DCC has no effects on infant development except in terms of problem-solving skills. Further studies are recommended on the effects of DCC on infant development.

The Effect of Zizyphus Jujube Fruit Lotion on Breast Fissure in Breastfeeding Women.

Nipple fissure is a common problem during breastfeeding. Zizyphus Jujube Fruits is one of the oldest medicinal plants which can heal wounds through its antimicrobial and anti-inflammatory properties. This study aimed to determine the effect of jujube lotion on the recovery of breast fissure. This double-blind clinical trial recruited 100 primiparous lactating women who were randomly divided into two groups. In Jujube group, mothers used 0.5 mL of Fruit Lotion, and in control group mothers applied 4-5 drops of their breast milk five times a day, after breastfeeding. Both groups were examined on the 7th and 14th days after childbirth. The damage severity was assessed using the Amir scale and the presence or absence of nipple discharge was recorded. A significant difference was observed between the two groups in the extent of nipple damage before intervention on the 3rd day after childbirth and after intervention on the 7th and 14th days after childbirth (P = 0/02، P = 0/000). No significant difference was observed in sore nipple discharge between the two groups before the study and on the 7th day, while a statistically significant difference was observed between the two groups on the 14th day (P = 0/1, P = 0/01). The finding of this study revealed that the Zizyphus jujube fruits lotion heals nipple fissure faster and better than breast milk.

Adaptation to maternal role and infant development: a cross sectional study.

OBJECTIVE: To assess the correlation between adaptation to maternal role (AMR) and infant development. BACKGROUND: Maternal role is an important key in infant's care and development. Previous findings demonstrated an inconsistency in the effect of the mother's adaptation on each domain of infant's development. METHODS: This cross-sectional study was conducted on 260 healthy mothers and healthy infants attending health centres affiliated to Shahid Beheshti University of Medical Sciences in Tehran in 2016. Data were collected using the 'AMR in Iranian Primiparous Women Questionnaire' and the 'Ages and Stages Questionnaire' (ASQ). The correlation between adaptation to maternal role and infant development was assessed using partial correlation analysis adjusted for age and gender. RESULTS: In all 14 infants had developmental delay giving a prevalence rate of 5.4%. The mean AMR score was 123.9 (SD =13.1) and there was no significant correlation between the AMR total score and infant development (r = 0.06, p = 0.27). However, significant correlation were observed between some aspects of adaptation to maternal role and infant development such as the 'support and consolidation of the couple's relationship' and 'communication' (p = 0.04); the 'concern and anxiety' subscale and 'gross motor skills' (p = 0.03), the 'attachment to the child' subscale and 'personal-social development' (p = 0.02) and the 'emotional development' subscale with 'personal-social development' domain (p = 0.004). CONCLUSION: The findings suggest that correlation exists between some aspects of adaptation to maternal role and infant development.

The comparison of socioeconomic status, perceived social support and mental status in women of reproductive age experiencing and not experiencing domestic violence in Iran.

BACKGROUND: Given the significant health effects of domestic violence against women, the present study was conducted in 2016, in Tehran, Iran in order to compare the socioeconomic status, perceived social support and mental status in women of reproductive age experiencing and not experiencing domestic violence. METHODS: This descriptive-analytical cross-sectional study was conducted on 500 women. The data collection tools used included questionnaires: demographic information, Socioeconomic, Beck's Depression, Spielberger's Anxiety, Cohen's Perceived Stress, Sarason's Perceived Social Support and WHO's Domestic Violence Inventory. RESULTS: The results showed that 43.2% of women said they had experienced at least one case of domestic violence, among which 16.4%, 15% and 36.6% of women had experienced physical, sexual and emotional-verbal types of violence, respectively. The mean age (p less than 0.001) and educational level (p=0/018) of violated women and their spouses (p less than 0.001) were lower than those of non-violated women. Furthermore, violated women experienced lower socioeconomic status (p less than 0.05), higher perceived stress (p less than 0.008), higher depression (p less than 0.001), and higher overt anxiety (0.002. They also perceived lower levels of social support (p less than 0.001). CONCLUSIONS: The issue of domestic violence was rather prevalent in the participants of the present study, particularly the younger, less educated and more socioeconomically deprived communities and families.

Comparison between the lifestyles of university students with and without premenstrual syndromes.

INTRODUCTION: Premenstrual syndrome is a common disorder in reproductive age and it is associated with decreased quality of life in women. In view of various factors contributing to outbreak of PMS (premenstrual syndrome) among women, the present study intended to compare lifestyles of university students with and without premenstrual syndromes living in dormitories of Qazvin University of Medical Sciences in 2015. METHODS: The descriptive cross-sectional study recruited 200 university students with and without PMS from students living in dormitories. Data were collected using questionnaires of premenstrual symptoms, questionnaires for diet, perceived stress, and unhealthy behavior. Data were analyzed using descriptive statistics, independent samples t-test, Mann-Whitney, Chi-square, and logistic regression in SPSS version 23. RESULTS: The results showed that nutrition style (p=0.001), perceived stress (p=0.001), and exposure to passive tobacco smoke (p=0.001) were different between the two groups. Logistic regression analysis showed that nutrition style (p=0.001, OR=0.861), exposure to passive tobacco smoke (p=0.008, OR=2.059), and stress (p=0.001, OR=1.088) were different in both groups. CONCLUSION: The research results proved that lifestyle, especially healthy eating habits, and decreasing stress and unhealthy behavior can influence PMS. Therefore, interventions are recommended to improve PMS symptoms.

Path Analysis Association between Domestic Violence, Anxiety, Depression and Perceived Stress in Mothers and Children's Development.

OBJECTIVE: Given that several factors involved in the incidence or exacerbation of developmental disorders in children, the present study aimed to investigate the relationship between some of the risk factors affecting mothers' health and development in children using path analysis. MATERIALS & METHODS: The present cross-sectional analytical study was conducted on 750 mothers and their children in health centers in Tehran, Iran in 2014 enrolled through multi-stage random sampling. Data were collected using a demographic and personal information questionnaire, the Perceived Stress Scale, Beck's depression Inventory, Spielberger' anxiety inventory, the WHO domestic violence questionnaire and an ages & stages questionnaire for assessing children's development. Data were analyzed using SPSS.19 (Chicago, IL, USA) and Lisrel 8.8. RESULTS: Developmental delay was observed in 12.1% of the children. The mean stress score was 23.94±8.62 in the mothers, 50.7% of whom showed mild to severe depression, 84.2% moderate to severe anxiety and 35.3% had been subjected to domestic violence. The path analysis showed that children's development was affected directly by perceived stress (ß=-0.09) and depression (ß=-0.17) and indirectly by domestic violence (ß=-0.05278) and anxiety (ß=-0.0357). Of all the variables examined, depression had the biggest influence on development in the children (ß=-0.17). The proposed model showed a good fit (GFI=1, RMSEA=0.034). CONCLUSION: Children's development was influenced indirectly by domestic violence and anxiety and directly by perceived stress and depression in mothers. It is thus suggested that more concern and attention be paid to women's mental health and the domestic violence they experience.

The Relationship Between Blood Lead Level and Preeclampsia.

INTRODUCTION: Lead is a heavy metal to which people are commonly exposed. One of the possible mechanisms of tissue damages caused by this toxic metal is oxidative stress, which in turn may cause numerous pregnancy complications such as preeclampsia. The present study was conducted to determine the relationship between maternal Blood Lead Level (BLL) and preeclampsia. METHODS: The present case-control study was conducted on 158 pregnant women admitted to a hospital in Zanjan, Iran, from August 2015 to March 2016. To measure their BLL, 1.5 cc of blood was drawn from each participant. The demographic and obstetric details of the patients were recorded in a form. The potentiometric method was used to test the samples. The data obtained were analyzed by SPSS version 22, using Mann-Whitney U test, the Chi square, independent-samples t-test, Pearson product-moment correlation, and simple linear regression analysis. RESULTS: The mean BLL was 6.24±1.74 µg/dl in the control group and 8.04±3.4 µg/dl in the preeclampsia group. The two groups were matching in terms of the mother's age and education and the household income. A significant relationship was observed between BLL and preeclampsia (p=0.028), as per every unit of increase (1 µg/dl) in BLL, systolic blood pressure increased by 0.014 mm Hg and diastolic blood pressure by 0.013 mm Hg (p=0.004). CONCLUSION: The results obtained suggest a relationship between BLL and preeclampsia. Global health measures should be taken to remove the exposure to lead so as to reduce its absorption by pregnant women.

Correlation Between Mothers' Depression and Developmental Delay in Infants Aged 6-18 Months.

BACKGROUND: Regarding the importance of children's developmental status and various factors that delay their development, this study was conducted to examine the correlation between mothers' depression levels and the developmental delay in infants. METHODS: This descriptive study was performed on 1053 mothers and their infants' age 6 to18 month-old in medical centers affiliated with Shahid Beheshti University of Medical Sciences, Iran, in 2014-2015. The participants were selected through multi-stage random sampling. The following instruments were used in this study: A demographic and obstetric specification questionnaire, infant specification questionnaire, the Beck Depression Inventory, and the Ages and Stages Questionnaire to determine the status of the children's development. The data were analyzed using SPSS19 software, Mann-Whitney; independent T-test and logistic-Regression tests were used. RESULTS: The results showed that 491 mothers (46.7%) suffered mild to extremely severe depression. The delay in infant development was 11.8%. The Mann-Whitney test showed a correlation between mothers' depression levels and developmental delay in infants (P=0.001). Moreover, there was a significant correlation between mothers' depression and developmental delays in gross-motor and problem-solving skills (P<0/05). In logistic model age of infants showed significant correlation with developmental delay (P=0.004 OR=1.07), but unwanted pregnancy, gender of infants, type of delivery and socioeconomic status had no correlation with developmental delay. CONCLUSION: Given the correlation between mothers' depression and infant development, it is recommended to screen mothers for depression in order to perform early interventions in developmental delay.

The effect of wheat germ extract on premenstrual syndrome symptoms.

Pre-menstrual syndrome is one of the most common disorders in women and impairs work and social relationships. Several treatment modalities have been proposed including herbal medicines. Considering the properties of wheat germ, this study aimed to determine the effects of wheat germ extract on the symptoms of premenstrual syndrome. This triple blind clinical trial was conducted on 84 women working in hospitals affiliated to Hamadan University of Medical Sciences. Subjects completed daily symptom record form for two consecutive months. After definitive diagnosis of premenstrual syndrome, they were randomly divided into two groups of 50 people. Then, for two consecutive months, 400 mg capsules of wheat germ extract or placebo were used three times a day, from day 16 until day 5 of the next menstrual cycle. Wheat germ significantly reduced physical symptoms (63.56%), psychological symptoms (66.30%), and the general score (64.99%). Although the severity of symptoms decreased in both groups, this reduction was more significant in the wheat germ extract group (p < 0.001). On the other hand, physical symptoms decreased only in the wheat germ extract (p < 0.001) and there was no statistically significant difference in the placebo group. No complications were observed in any of the groups. It seems that using wheat germ extract reduces general, psychological and physical symptoms.

Effects of wheat germ extract on the severity and systemic symptoms of primary dysmenorrhea: a randomized controlled clinical trial.

BACKGROUND: Primary dysmenorrhea is one of the most common disorders in women and the main cause of absenteeism from work and school. OBJECTIVES: Considering the anti-inflammatory properties of wheat germ, the present study examined the effects of wheat germ extract on the severity and systemic symptoms of primary dysmenorrhea. PATIENTS AND METHODS: This triple-blinded clinical trial was performed on 80 employed women in hospitals affiliated with Hamadan University of Medical Sciences (Hamadan, IR Iran). Subjects were allocated to two groups of 45 patients. Three 400-mg capsules of wheat germ extract or placebo were used daily, between the 16th day of the menstrual cycle to the fifth day of the next menstrual cycle for two consecutive months. Pain intensity was measured by a visual analogue scale thrice a day and a four-point verbal rating scale was employed to assess systemic symptoms. RESULTS: Pain severity decreased only in the wheat germ extract group (P < 0.001) and there was no statistically significant change in the placebo group. In the wheat germ extract group, the pain severity decreased from 4.701 at baseline to 1.120 at the second cycle. The reduction in total scores of systemic symptoms of dysmenorrhea was statistically significant only in the wheat germ extract group (P < 0.001) and there was not a statistically significant change in the placebo group. It revealed statistically significant differences in systemic symptoms associated with dysmenorrhea including fatigue, headache, and mood swings in experimental group. CONCLUSIONS: Wheat germ extract seems to be an effective treatment for dysmenorrhea and its systemic symptoms, probably because of its anti-inflammatory effects.

Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women.

BACKGROUND: Nipple fissure is a common disorder during breastfeeding. With high prevalence of nipple fissures and its impacts on breastfeeding, as well as the existence of evidence in favor of the application of peppermint as an antiinflammatory and antiinfection herb, the purpose of this study is to determine the effect of Menthol essence on improving nipple fissures in the primiparous breastfeeding women. MATERIALS AND METHODS: This study was conducted using a clinical trial method. Samples were divided randomly into two groups of 55 women. The women in the peppermint group applied four drops of Menthol essence on their nipple and areola after each feeding. The control group applied four drops of their own milk on the nipple and areola after each feeding. Then, the two groups were studied on days 10 and 14 postpartum. For intensity of pain, the visual analog scale (0-10 cm) and to measure the severity of damage, Amir scale (1-10 cm) were applied and the existence or lack of nipple discharge was also recorded. The data were analyzed using SPSS 17 software. RESULTS: The mean intensity of pain and nipple fissure before treatment (8.55 ± 1.74) and day 10 after delivery (4.26 ± 1.57) and before treatment and day 14 after delivery in the case group (1.32 ± 1.02) had a significant difference (P < 0.001). Nipple discharge between the two groups, before treatment (%75.2) and day 10 after delivery (%31.6) and before treatment and day 14 after delivery (%15.7), the case group had a significant difference (P < 0.001). CONCLUSION: Menthol essence can improve nipple fissures in the primiparous breastfeeding women.

Comparison of lifestyle in women with polycystic ovary syndrome and healthy women.

Given the high prevalence of polycystic ovary syndrome (PCOS), and that a lifestyle is recognized effective in development of many diseases, this study aimed to compare lifestyle of women with PCOS and healthy women. Nor are there sufficient studies on the difference between lifestyle of these people with that of healthy people. Furthermore, studies show that changes in lifestyle improve this disease. This descriptive-comparative study was conducted on 65 women with PCOS and 65 healthy women of 18 to 45 years old who presented to hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2013. The subjects were selected using multi stage random sampling method. The data were collected using questionnaires for diet, International Physical Activity Questionnaire, and unhealthy behaviors and were analyzed in SPSS v. 17, using descriptive statistics, Man-Whitney, independent t, Chi-square and logistic regression tests. The results showed there was a significant relationship between PCOS and inappropriate diet (p=0.009), low physical activity (p=0.009), but no relationship was observed between PCOS and unhealthy behaviors. Given the results obtained, training and awareness raising is necessary for women and girls especially about appropriate diet and regular physical activity.

Correlation between high-risk pregnancy and developmental delay in children aged 4-60 months.

BACKGROUND: The future development of children is considered more than ever now due to the advances in medical knowledge and thus the increase in survival rates of high-risk infants. This study investigated the correlation between high-risk pregnancy and developmental delay in children aged 4-60 months. METHODS: This descriptive study was conducted on 401 mothers and their children (4-60 months) who visited health service centers affiliated to Isfahan University of Medical Sciences, Iran, in 2011. Sampling was carried out in several stages, and the Ages and Stage Questionnaire was completed by the participants. Data were analyzed with SPSS 18 software and independent t-test; Mann-Whitney and logistic-regression tests were used. RESULTS: The average age of children in the low-risk pregnancy group was 22±16 months, and that in the high-risk pregnancy group was 18.9±14.8 months. The majority of children were female (53.1%). The prevalence of high-risk pregnancies was 80.5%, and the prevalence of developmental delay was 18.7%. Multiple pregnancies, low birth weight, habitual abortions, maternal medical disorders in pregnancy, and gestational diabetes had significant correlations with developmental delay in children (P<0.04). In the logistic model, male gender, low birth weight, family marriage, and maternal medical disorders during pregnancy showed significant correlations with developmental delay in children (P<0.05). Additionally, abnormal body mass index (BMI) and social and economic status showed probability values close to the significance level (P = 0.05), whereas other high-risk pregnancy variables had no correlation with developmental delay in children. A correlation between high-risk pregnancy and developmental delay (P = 0.002) and fine motor delay was observed (P = 0.02), but no correlation was observed between high-risk pregnancy and other developmental domains. CONCLUSION: This study showed that some high-risk pregnancy variables had a significant correlation with developmental delay. Moreover, a significant correlation was observed between high-risk pregnancy and fine motor developmental delay.