Evaluation of phosphatase and tensin homologue (PTEN) expression in gastric cancer and its relationship with histopathological findings / Evaluación de la expresión del homólogo de fosfatasa y tensina (PTEN) en el cáncer gástrico y su relación con los hallazgos histopatológicos

Introduction Phosphatase and tensin homologue (PTEN) is an important tumour suppressor in multi-step tumorigenesis. To establish the role of PTEN in gastric cancer progression, we examined the PTEN expression degree in gastric cancer tissues. We also explained the connection between PTEN expression and histopathological findings. Materials and methods Our study was cross-sectional and made up of 50 patients with known gastric cancer. Immunohistochemical staining for PTEN was done on gastric cancer tissues. Tumour behaviour was estimated by histopathological assessments. Results Twenty-seven (54%) of the 50 patients had PTEN staining. The evaluation of the connection between PTEN expression and demographic data and tumour behaviours revealed no meaningful relationship between PTEN expression and patients’ age, gender, tumour site and size, tumour type, tumour grade and stage, neural, and lymphovascular invasion (P-value>0.05). Conclusion PTEN expression level is expected to be a significant molecular event in the progression of gastric cancer and may be a predictive marker for gastric cancer behaviours dependent on society. (AU)

Introducción El homólogo de fosfatasa y tensina (PTEN, por sus siglas en inglés) es un importante supresor tumoral en la tumorigénesis de múltiples pasos. Para establecer el papel de PTEN en la progresión del cáncer gástrico, examinamos el grado de expresión de PTEN en tejidos gástricos cancerosos. También explicamos la conexión entre la expresión de PTEN y los hallazgos histopatológicos. Materiales y métodos Nuestro estudio fue transversal y se realizó en 50 pacientes con cáncer gástrico comprobado. La tinción inmunohistoquímica para PTEN se empleó en tejidos de cáncer gástrico. Los comportamientos tumorales se estimaron mediante evaluaciones histopatológicas. Resultados De 50 pacientes, 27 (54%) tenían tinción PTEN. La evaluación de la conexión entre la expresión de PTEN y los datos demográficos y los comportamientos del tumor no reveló una relación significativa entre la expresión de PTEN y la edad, el sexo, el sitio, el tamaño del tumor, el tipo de tumor, el grado o el estadio del tumor, la invasión neural ni tampoco la invasión linfovascular de los pacientes (valor de p>0,05). Conclusión Se espera que el nivel de expresión molecular de PTEN sea unhito en la progresión del cáncer gástrico y resulte un marcador predictivo de los comportamientos del cáncer gástrico dependientes de la sociedad. (AU)

Evaluation of phosphatase and tensin homologue (PTEN) expression in gastric cancer and its relationship with histopathological findings / Evaluación de la expresión del homólogo de fosfatasa y tensina (PTEN) en el cáncer gástrico y su relación con los hallazgos histopatológicos

Introduction Phosphatase and tensin homologue (PTEN) is an important tumour suppressor in multi-step tumorigenesis. To establish the role of PTEN in gastric cancer progression, we examined the PTEN expression degree in gastric cancer tissues. We also explained the connection between PTEN expression and histopathological findings. Materials and methods Our study was cross-sectional and made up of 50 patients with known gastric cancer. Immunohistochemical staining for PTEN was done on gastric cancer tissues. Tumour behaviour was estimated by histopathological assessments. Results Twenty-seven (54%) of the 50 patients had PTEN staining. The evaluation of the connection between PTEN expression and demographic data and tumour behaviours revealed no meaningful relationship between PTEN expression and patients’ age, gender, tumour site and size, tumour type, tumour grade and stage, neural, and lymphovascular invasion (P-value>0.05). Conclusion PTEN expression level is expected to be a significant molecular event in the progression of gastric cancer and may be a predictive marker for gastric cancer behaviours dependent on society. (AU)

Introducción El homólogo de fosfatasa y tensina (PTEN, por sus siglas en inglés) es un importante supresor tumoral en la tumorigénesis de múltiples pasos. Para establecer el papel de PTEN en la progresión del cáncer gástrico, examinamos el grado de expresión de PTEN en tejidos gástricos cancerosos. También explicamos la conexión entre la expresión de PTEN y los hallazgos histopatológicos. Materiales y métodos Nuestro estudio fue transversal y se realizó en 50 pacientes con cáncer gástrico comprobado. La tinción inmunohistoquímica para PTEN se empleó en tejidos de cáncer gástrico. Los comportamientos tumorales se estimaron mediante evaluaciones histopatológicas. Resultados De 50 pacientes, 27 (54%) tenían tinción PTEN. La evaluación de la conexión entre la expresión de PTEN y los datos demográficos y los comportamientos del tumor no reveló una relación significativa entre la expresión de PTEN y la edad, el sexo, el sitio, el tamaño del tumor, el tipo de tumor, el grado o el estadio del tumor, la invasión neural ni tampoco la invasión linfovascular de los pacientes (valor de p>0,05). Conclusión Se espera que el nivel de expresión molecular de PTEN sea unhito en la progresión del cáncer gástrico y resulte un marcador predictivo de los comportamientos del cáncer gástrico dependientes de la sociedad. (AU)

Evaluation of phosphatase and tensin homologue (PTEN) expression in gastric cancer and its relationship with histopathological findings.

INTRODUCTION: Phosphatase and tensin homologue (PTEN) is an important tumour suppressor in multi-step tumorigenesis. To establish the role of PTEN in gastric cancer progression, we examined the PTEN expression degree in gastric cancer tissues. We also explained the connection between PTEN expression and histopathological findings. MATERIALS AND METHODS: Our study was cross-sectional and made up of 50 patients with known gastric cancer. Immunohistochemical staining for PTEN was done on gastric cancer tissues. Tumour behaviour was estimated by histopathological assessments. RESULTS: Twenty-seven (54%) of the 50 patients had PTEN staining. The evaluation of the connection between PTEN expression and demographic data and tumour behaviours revealed no meaningful relationship between PTEN expression and patients' age, gender, tumour site and size, tumour type, tumour grade and stage, neural, and lymphovascular invasion (P-value>0.05). CONCLUSION: PTEN expression level is expected to be a significant molecular event in the progression of gastric cancer and may be a predictive marker for gastric cancer behaviours dependent on society.

Correlation of Magnesium Level with Cardiac and Hepatic Hemosiderosis Measured by T2*MRI Technique and Age in Patients with Thalassemia Major.

Background: Given the association of hypomagnesemia with cardiac arrhythmia, the aim of this study was to investigate the relationship between serum magnesium levels with age and T2* magnetic resonance imaging (MRI) findings of the heart and liver in patients with thalassemia major (TM). Materials and Methods: In a descriptive cross-sectional study, a total of 62 patients with ß-thalassemia major aged 11-48 years were selected at the Amir-Kabir Hospital, Arak, Iran. Serum magnesium, ferritin, and iron levels of patients were measured, and the rate of cardiac and hepatic hemosiderosis of patients was extracted according to the routine T2*MRI method. Results: The mean age of the patients at diagnosis was 32.6 years. The comparison of TM patients with and without hepatic/cardiac hemosiderosis demonstrated that mean levels of serum ferritin, serum iron, and age were significantly higher in TM patients with cardiac hemosiderosis than in hepatic/cardiac non-hemosiderosis (P < 0.05); however, there was no significant difference in mean levels of serum magnesium in TM patients with and without hepatic/cardiac hemosiderosis (P = 0.279). Interestingly, the correlation of age with serum magnesium levels in TM patients revealed a statistically significant and moderate inverse correlation (r = -0.56, P = 0.013). Conclusion: Hypomagnesemia may occur in a time-dependent manner. It is recommended that, in addition to cardiac and hepatic T2*MRI, serum magnesium levels be measured by using magnesium replacement if necessary.

A supportive randomized clinical trial on Iranian infertile women with the history of infertility treatments dropout following unsuccessful ART cycle/s: A study protocol.

Introduction: Due to high dropout rate of infertility treatments and lack of any intervention for motivating infertile couples to continue treatments, the present study will be conducted with the aim of designing, implementing and determining the effectiveness of the proposed intervention in order to continue infertility treatments. Methods: & Analysis: We will conduct this study in two stages; a review of literature and past studies will be done to identify interventions that have been performed for infertile couples, and then an appropriate intervention with the aim of continuing infertility treatments for infertile women will be designed. After that a Delphi study will be designed in accordance with collected information of previous stages and will be approved by experts. In the second stage we will implement designed intervention of a randomized clinical trial on two groups of infertile women (control and intervention) with the history of infertility treatment dropout following unsuccessful cycle. We will use descriptive statistic in first and second stage. In second stage Chi square test and independent samples T test will be used to compare variables between groups and variables in study questionnaires before and after the intervention between two groups of study. Discussion: The present study will be the first study to be performed as a clinical trial on infertile women who have discontinued the treatments, with the aim of continuing treatments. Thereupon, it seems that the results of this study will be the basis for studies around the world to prevent premature cessation of infertility treatments.

Quality of life in terminally ill cancer patients: what is the role of using complementary and alternative medicines?

BACKGROUND AND PURPOSE: Cancer is the world's second greatest cause of mortality and a leading cause of death in both developed and developing countries. Patients employ a number of complementary and alternative medicine (CAM) methods to deal with the problems and difficulties of cancer, which can have an impact on their quality of life (QOL). The aim of the present study was to assess the correlation between QOL and the use of different CAM methods in terminally ill cancer patients. METHODS: This was a cross-sectional study. In southern Iran, 238 individuals with advanced cancer were studied in oncology centers and doctors' offices. During the months of January to August 2021, patients were selected using convenience sampling. A demographic information questionnaire, the EORTC core quality of life questionnaire, and the CAM questionnaire were used to collect data. RESULTS: The results showed that terminally ill cancer patients had a good quality of life. Last year, 85.7% of participants used at least one kind of CAM. Furthermore, 45.4% of participants used only one form of CAM, 30.3% used two types of CAM, 6.7% used three types of CAM, and 3.4% used four to five types of CAM. When all CAM users were compared to non-CAM users, CAM users had significantly higher social QOL and overall quality of life. Two subscales of QOL symptoms and function were correlated with cancer history, income, and use of CAMs, and the scores of QOL symptoms and function were greater in CAM users compared to non-CAM users. Among all the study variables, only the usage of CAM was correlated to overall QOL among terminally ill cancer patients. CONCLUSION: The current study found that using CAM could affect different aspects of QOL in terminally ill cancer patients. As a result, it is feasible that using CAM could help these people enhance their health and QOL.

Psychosomatic Symptoms in Terminally Ill Cancer Patients and Its Relation With Using Complementary and Alternative Medicines: A Cross-Sectional Study in Southeast Iran.

Background: Cancer patients face various problems and complications, which they address through various complementary and alternative medicines (CAM). The aim of this study was to investigate the relationship between CAM and psychosomatic symptoms in terminally ill cancer patients. Methods: This cross-sectional study was performed on 221 terminally ill cancer patients (based on metastatic stage and according to the physicin diagnosis) in southeastern Iran. Convenience sampling was used to select terminally ill cancer patients. Using questionnaires like the demographic and clinical information questionnaire, Edmonton Symptom Assessment Scale (ESAS), Hospital Anxiety and Depression Scale (HADS), CAM questionnaire and satisfaction with the use of CAM, the researcher was able to compile a comprehensive picture of the population. Results: The mean age of the participants was 51.66 ± 13.34 years. The majority of the samples were female, married, educated, and unemployed. The mean score for the physical symptoms of the participants according to ESAS was 22.25 ± 17.57 which was less than the midpoint of the scale (the possible score of ESAS was 0-100). Only 2.7% (n = 6) and 0.9% (n = 2) of the participants had mild and moderate anxiety, respectively, and the other participants' anxiety levels were normal. Only 7.7% (n = 17) and 4.1% (n = 9) of the participants had mild and moderate depression, respectively, and the other participants' depression levels were normal. Last year, 87.3% of the participants used at least one type of CAM. Aside from prayer, 42.1% of the participants used at least one type of CAM in the last year. Prayer was used by 83.7% of the participants, medicinal plants by 35.8%, massage by 9.5%, dietary supplements by 3.6%, wet cupping by 3.2%, relaxation and meditation by 2.7%, dry cupping by 2.4%, and acupuncture by 0.5%. The common reason for using CAM was to reduce the stress and anxiety caused by cancer and to treat it. There were no significant differences in physical and psychological symptoms between the CAM-users and non-CAM users. Conclusion: Patients with cancer have a relatively low level of psychosomatic symptoms, and the primary reason for using CAM was to relieve stress and anxiety associated with cancer and treat it. However, psychosomatic symptoms were the same for CAM and non-CAM users. Because so many people with cancer use CAM, future studies should look into why and how CAM is used.

A systematic review and meta-analysis on dropout of infertility treatments and related reasons/factors.

Dropout of infertility treatments is a common phenomenon and many patients avoid continuing infertility treatments. Determining the total rate of treatment dropout, and related factors was the objective of the present systematic review and meta-analysis study. We performed an electronic literature search in Web of Science, Scopus, Embase, Cinhal, ProQuest and Medline databases and a manual search in Google scholar by using a set of Standard keywords. We included descriptive studies in English or Persian, from August 2000 to 2019. Finally, we extracted data of 25 papers for systematic review and 11 papers for meta-analysis. Data analysed by RevMan software. The results of the meta-analysis analysed by the random-effects model and studies heterogeneity analysed using the I2 calculation index. We tried to control high heterogeneity (because of the small amounts of p value and chi-square and large amount of I2) with statistical methods such as subgroup analysis and using random-effects model. The results showed that factors related to treatment, psychological and demographic/personal factors are the most common factors for dropout. It seems that educational and supportive programs on psychological, financial, therapeutic, demographic and personal factors can play an important role in reducing the incidence of infertility treatment's drop out before completing the course of treatment.

Hyperbilirobinemia and Its Effect on Auditory Perception and Speech Intelligibility in Cochlear Implanted Children (Cochlear Implantation Outcomes in Children Who Have Experienced Hyperbilirobinemia).

The goal of this study was to investigate the probable difference in auditory perception and speech intelligibility performance amongst cochlear implanted children who experienced hyperbilirubinemia or auditory neuropathy in comparison to the cochlear implanted children with unknown etiology for hearing loss. This case-control study was carried out on 106 cochlear implanted children with mean age of 32.36 ± 11.98 months who were purposively selected and allocated into four groups. Out of the total, 30 had no specific etiology for hearing loss, while the others had experienced auditory neuropathy or hyperbilirubinemia with/without blood exchange. The auditory perception and speech intelligibility performance of all the participants who had received auditory verbal therapy were assessed after 6 and 12 months of rehabilitation. Then, the data was analyzed, using the Statistical Package for Social Sciences-version 21(SPSS-21). Results indicated poor auditory perception and speech intelligibility performance of the cochlear implanted children with hyperbilirubinemia and blood exchange (P ≤ 0.05), while the participants in the control group with no specific etiology for hearing loss, the children with hyperbilirubinemia with no blood exchange, and those who suffered from auditory neuropathy performed better, respectively. Also, a significant correlation between auditory neuropathy and hyperbilirubinemia was observed. Despite lower improvement of auditory perception and speech intelligibility of the hearing impaired children who were experiencing moderate to severe degrees of hyperbilirubinemia or auditory neuropathy, cochlear implantation is highly recommended not only for children with unknown etiology for severe hearing loss but also for this group of hearing impaired children.

Tehran environmental and neurodevelopmental disorders (TEND) cohort study: Phase I, feasibility assessment.

PURPOSE: To advance knowledge about childhood neurodevelopmental disorders and study their environmental determinants, we conducted a study in Tehran, Iran to assess the feasibility of prospective birth cohort study. METHODS: We evaluated participation of pregnant women, feasibility of sampling biological material, and health care services availability in Tehran in four steps: (1) first trimester of pregnancy; (2) third trimester of pregnancy; (3) at delivery; and (4) two to three months after delivery. We collected related data through questionnaires, also various biological samples were obtained from mothers (blood, urine, milk and nails-hands and feet) and newborns (umbilical cord blood, meconium, and urine samples) from February 2016 to October 2017. RESULTS: overall 838 eligible pregnant women were approached. The participation rate was 206(25%) in our study and about 185(90%) of subjects were recruited in hospitals. Out of 206 participants in the first trimester, blood, urine, hand nail, and foot nail samples were collected from 206(100%),193(93%), 205(99%), and 205(99%), respectively. These values dropped to 65(54%), 83(69%), 84(70%), and 84(70%) for the remaining participants 120(58%) in the third trimester, respectively. Also, we gathered milk samples from 125(60%) of mothers at two to three months after delivery. CONCLUSION: Our findings suggest that hospitals were better places for recruitment of subjects in a birth cohort in Tehran. We further concluded that birth cohort study recruitment can be improved by choosing appropriate gestational ages. Obtaining the newborn's urine, meconium, and umbilical cord blood were challenging procedures and require good collaboration between hospital staff and researchers.

Evaluation of the Role of -137G/C Single Nucleotide Polymorphism (rs187238) and Gene Expression Levels of the IL-18 in Patients with Coronary Artery Disease.

OBJECTIVES: Interleukin-18 (IL-18) is a proinflammatory and proatherogenic cytokine, and its genetic variations may contribute to the development of coronary artery disease (CAD). We sought to investigate the role of -137G/C polymorphism and gene expression levels of IL-18 in patients with CAD. METHODS: The study population included 100 patients with angiographically proven CAD and 100 matched controls. Total RNA and DNA were extracted from leukocytes using appropriate kits. The genotype of -137G/C polymorphism and gene expression level of IL-18 was determined using allele-specific polymerase chain reaction (PCR) and real-time (RT)-PCR assay, respectively. RESULTS: The genotypic and allelic distribution of IL-18 -137G/C polymorphism was not significantly different between the two groups (p > 0.050). Moreover, the -137G/C polymorphism did not increase the risk of CAD in dominant and recessive genetic models (p > 0.050). However, subgroup analysis of CAD patients revealed that the IL-18 -137G/C polymorphism was significantly associated with increased risk of CAD in hypertensive patients (odds ratio (OR) = 7.51; 95% confidence interval (CI): 1.24-25.17; p = 0.019) and smokers (OR = 4.90; 95% CI: 1.21-19.70; p = 0.031) but not in the diabetic subpopulation (p = 0.261). The genotype distribution of IL-18 -137G/C genetic polymorphism was significantly different among patients with one, two, and three stenotic vessels (p < 0.050). The gene expression level of IL-18 was significantly higher in the CAD group than the control group (p < 0.001). Moreover, the carriers of CC genotype had significantly lower gene expression levels of IL-18 than carriers of GG genotype (p < 0.050). CONCLUSIONS: The -137G/C polymorphism of IL-18 may be associated with the CAD risk in hypertensive and smoker subgroup of CAD patients. The -137G/C polymorphism seems to play an important role in determining the severity of CAD. Increased IL-18 gene expression level is a significant risk factor for the development of CAD. The CC genotype of -137G/C polymorphism is associated with lower IL-18 gene expression levels.

Comparison of Gene Expression Profiles in Human Germinal Vesicle Before and After Cytoplasmic Transfer From Mature Oocytes in Iranian Infertile Couples.

OBJECTIVE: To evaluate the effect of cytoplasm transfer from mature oocytes to germinal vesicle(GV)s on promoting the maturation of cytoplasm of GV at the mRNA level. MATERIALS AND METHODS: Sixty six in vitro fertilization (IVF) operations between June 2012 and November 2013 were included in this study. Totally 120 GVs were obtained. Normal GVs were categorized into 3 groups (n = 40) randomly: the first comprised oocytes that did not receive the cytoplasm of mature oocytes; the second group comprised oocytes that did not receive the cytoplasm of mature oocytes but were incubated for 24 h; and the third group comprised oocytes that received 10-15% the cytoplasm of mature oocytes and were then incubated for 24 h. Each group was separately analyzed by quantitative polymerase chain reaction (qPCR) and the expression levels of selected genes were assessed. RESULTS: The expression levels of genes involved in the cytoplasmic maturity, and energy-producing mitochondria were significantly higher in the pooled oocytes of 2(nd) control group than those of the 1(st) control and intervention groups (p < 0.001). The genes involved in the meiosis, spindle check point, DNA repairing and cell cycle checkpoint did not have any expression in the 1(st) and intervention groups; however, these genes were expressed in the 2(nd) group, significantly. In the 2(nd) group, the highest expression level was observed for genes involved in the DNA repairing and cell cycle checkpoint. In the intervention group, none of the genes were expressed except for energy-producing mitochondria gene; even in this case, the expression level of this gene in this group of oocytes was significantly lower than that in other groups (p < 0.001). After 24 h meiosis assumption was significantly higher in the third group than in the second group (95% vs. 68%, p < 0.001). CONCLUSION: The cytoplasm transfer technique is not effective in cytoplasmic maturity of the recipient GV oocytes. In contrast, 24-hr in-vitro culture is associated with increased expression of studied genes in GVs.

A randomized controlled trial of gonadotropin-releasing hormone agonist versus gonadotropin-releasing hormone antagonist in Iranian infertile couples: oocyte gene expression.

BACKGROUND: The main objective of the present work was to compare the effects of the gonadotropin-releasing hormone agonist (GnRH-a) and GnRH antagonist (GnRH-ant) on the gene expression profiles of oocytes obtained from Iranian infertile couples undergoing in vitro fertilization (IVF). METHODS: Fifty infertile couples who underwent IVF between June 2012 and November 2013 at the Infertility Center of Tehran Women General Hospital, Tehran University of Medical Sciences, were included in this study. We included women that had undergone IVF treatment because of male factor, tubal factor, or unexplained infertility. The women randomly underwent controlled ovarian stimulation (COS) with either the GnRH-a (n = 26) or the GnRH-ant (n = 24). We obtained 50 germinal vesicle (GV) oocytes donated by women in each group. After the sampling, pool of 50 GV oocytes for each group was separately analyzed by quantitative polymerase chain reaction (qPCR). RESULT: The expression levels of Adenosine triphosphatase 6 (ATPase 6), Bone morphogenetic protein 15 (BMP15), and Neuronal apoptosis inhibitory protein (NAIP) genes were significantly upregulated in the GnRH-ant group compared to the GnRH-a group, with the fold change of 3.990 (SD ± 1.325), 6.274 (SD ± 1.542), and 2.156 (SD ± 1.443), respectively, (P < 0.001). Growth differentiation factor 9 (GDF9) mRNA did not have any expression in the GnRH-a group; however, GDF9 mRNA was expressed in the GnRH-ant group. Finally, it was found that the genes involved in the DNA repairing and cell cycle checkpoint did not have any expression in either group. CONCLUSION: The present study showed, for the first time, the expression levels of genes involved in the cytoplasmic maturity (BMP15, GDF9), adenosine triphosphate production (ATPase 6), and antiapoptotic process (NAIP), in human GV oocytes were significantly higher in the GnRH-anta group than in the GnRH-a group in COS. Higher expression level of these genes when GnRH-ant protocol is applied, this protocol seems to be a more appropriate choice for women with poly cystic ovarian syndrome, because it can probably improve the expression of the aforementioned genes. TRIAL REGISTRATION: Current Controlled Trials: IRCT 2014031112307 N3.

Perceived organizational support and job involvement in the Iranian health care system: A case study of emergency room nurses in general hospitals.

BACKGROUND AND OBJECTIVES: Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them. MATERIALS AND METHODS: This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test. RESULTS: Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029). DISCUSSION: The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always considered by managers to improve job involvement.

Effects of expiratory ribcage compression before endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation.

AIM AND OBJECTIVES: To investigate the effects of expiratory ribcage compression (ERCC) before endotracheal suctioning on the arterial blood gases (ABG) in patients receiving mechanical ventilation. BACKGROUND: Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients receiving mechanical ventilation. Chest physiotherapy techniques such as ERCC before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretions and improving alveolar ventilation. DESIGN: A prospective, randomized, controlled cross-over design. METHODS: A randomized controlled cross-over trial with a convenience sample of 70 mechanically ventilated patients was conducted from 2006 to 2007. The patients received endotracheal suctioning with (experiment-period) or without (control-period) an antecedent 5-min expiratory ribcage. All the patients experienced both periods with at least a 3-h washed-out interval between the two periods. ABG were measured 5 min before and 25 min after endotracheal suctioning. RESULTS: The statistical tests showed that the levels of partial pressure of oxygen (PaO2 )/fraction of inspired oxygen (FiO2 ), partial pressure of carbon dioxide (PaCO2 ) and arterial oxygen saturation (SaO2 ) in the experimental period at 25 min after the intervention were significantly different from the control period. The tests also revealed that the levels of these variables at 25 min after suctioning were also significantly different from baseline values. However, these differences were clinically significant only for PaO2 /FiO2 . CONCLUSION: By improving the levels of PaO2 /FiO2 , ERCC can reduce the patients' need for oxygen and hence it can at least reduce the side effects of oxygen therapy. RELEVANCE TO CLINICAL PRACTICE: Improving PaO2 /FiO2 levels means less need for oxygen therapy. Hence, by applying ERCC we can at least minimize the side effects of oxygen therapy.

The effects of green tea consumption on metabolic and anthropometric indices in patients with Type 2 diabetes.

BACKGROUND: This study aims at investigating the possible effects of different daily doses of green tea (GT) intake for eight weeks on certain anthropometric, metabolic, and oxidative stress biomarkers of diabetic patients. MATERIALS AND METHODS: This randomized clinical trial included 63 patients with type 2 diabetes (30 males and 33 females). After a two-week run-in period without green tea, they were randomly assigned into one of the three groups, with a different daily intake of green tea; four cups of green tea per day (n = 24), two cups of green tea per day (n = 25), and the control group (n = 14) with no green tea intake for two months. At baseline and after the intervention, blood tests, dietary, and anthropometric variables were assessed. The patients were instructed to maintain their usual dietary intake and normal physical activity. RESULTS: Consumption of four cups of GT per day caused a significant decrease in body weight (73.2 to 71.9) (P < 0.001), body mass index (27.4 to 26.9) (P < 0.001), waist circumference (95.8 to 91.5) (P < 0.001), and systolic blood pressure (126.2 to 118.6) (P < 0.05) in this group. No significant change was seen in the other groups and between group comparisons. The metabolic and oxidative stress parameters did not show any significant differences within and between groups. CONCLUSION: Drinking four cups of green tea led to a significant reduction in weight and systolic blood pressure.

A Randomized, Controlled Trial of Levonorgestrel Vs. The Yuzpe Regimen as Emergency Contraception Method among Iranian Women.

BACKGROUND: We aimed to compare acceptability of Levonorgestrel with the Yuzpe regimen among Iranian women based on their side-effects and resulting changes in the amount and pattern of menses. METHODS: Five hundred twenty nine participants aged 15-49 having regular menses and one act of unprotected intercourse within 72 h were included in the double-blind, controlled trial in 2006-2007 and randomly assigned into LNG (n=263) and HD (n=266) groups, receiving Levonorgestrel 0.75 mg given 12 h apart and ethinyl estradiol 100 µg plus 0.5 mg Levonorgestrel 0.5 mg repeated after 12 h, respectively. RESULTS: The participants receiving Levonorgestrel experienced significantly lower side-effects in the case of nausea, vomiting, and dizziness (P<0.05). The changes occurred in the amount and pattern of menses were the same for both groups (P>0.05). No significant difference was observed between the efficiencies of the treatments. CONCLUSION: Significantly lower side-effects of Levonorgestrel can be considered as greater acceptability and translated to higher efficiency.

The relationship between perceived life changes and depression in caregivers of stroke patients.

Most people with stroke are being cared for at home by family caregivers. Giving care is stressful, and family caregivers are predisposed to care-related complications such as life changes and depression. This article is a report of a study that examined the relationship between the perceived care-related life changes and depression in family caregivers of people with stroke, and it identified predictors influencing depression and perceived care-related life changes. A convenience sample of 60 family caregivers completed one demographic data sheet and two questionnaires: Bakas Caregiving Outcomes Scale and Center for Epidemiologic Studies Depression Scale. Data were collected in a 1-month period in 2008. According to the findings, the mean score of the subjects on the Bakas Caregiving Outcomes Scale was -5.70, representing an overall negative change related to the caregiving role. The prevalence of people at a risk of depression or being depressed was 40%. Correlation analysis showed that, as perceived life changes score decreases (change for the worst), the score for the feeling of depression increases (r = -.692, p ≤ .001). Stroke survivors' functional disability significantly predicted both perceived care-related life changes and depression in caregivers. Assessment of caregivers of people with stroke for depressive symptoms should be incorporated in the initial nursing assessment process. The perceived life changes among caregivers should be closely monitored, and follow-up meetings should be planned to support caregivers. The functional disability in people with stroke could be a valuable criterion for planning care for their caregivers.

Comparison of coping strategies in Iranian adolescents with cancer and their parents.

The diagnosis and treatment of cancer in adolescence requires that adolescents and their parents learn to adjust to the changes associated with cancer. This article presents results about the relationship between parental and adolescent coping. This study examined 120 adolescents in Iran with cancer (aged 11-18) and their parents. Coping was assessed using the Coping Strategies Inventory. Findings showed that there was a positive linear correlation between adolescents' engagement coping and disengagement coping and that of their parents. Logistic regression analysis indicated that 35.5% of engagement coping of adolescents and 24.1% of adolescent disengagement coping was dependent on the parents' coping strategies. Results indicated that adolescents were able to adapt to cancer within the context of a strong family. Nurses may be able to promote adolescent coping strategies by teaching engagement coping to patients' families.

Prayer in Iranian cancer patients undergoing chemotherapy.

UNLABELLED: Chronic illnesses such as cancer are very stressful events and prayer is a valuable coping strategy for Muslim cancer patients. This study was conducted to assess the impact of prayer in Iranian cancer patients undergoing chemotherapy. A descriptive cross sectional survey was conducted on 360 cancer patients over 20 years of age who were able to read and write. Data collection employed Meraviglia's prayer questionnaire. Mean scores of prayer activity, prayer experience and attitude toward prayer were, respectively, (94.5+/-12.98), (51.2+/-7.49) and (38.2+/-4.84). Mean of total scores was (184.05+/-21.67). Significant relationships were observed between age, marital status and educational level with prayer activity, prayer experience and attitude toward prayer (P< or = 0.001). Also the relationship between sex and prayer activity was significant (P< or = 0.01). CONCLUSION: Individual characteristics had an important effect on prayer. It is suggested that health care providers can augment holistic care to these patients by encouraging prayer.