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Introduction: It is well recognized that hearing is critical to speech and language development, communication, and learning. Otoacoustic emission (OAE) is an efficient and sensitive method to identify subjects at risk for auditory impairment. Infants who require admission to neonatal intensive care unit are reported to be at 10-20 times greater risk for hearing impairment. The porpuse of this study was to investigate the incidence of hearing impairment in neonates screened by OAE. Materials and Methods: In a cross-sectional study, 148 newborns having risk factors for hearing impairment reffering to Taleghani hospital of Arak and Aboozar hospital of Ahwaz were evaluated. All clients had normal otoscopic findings. Transient evoked (TEOAE) and distortion-product otoacoustic emissions (DPOAEs) were measured in both ears. If the results of otoacoustic emissions were not normal, these tests were repeated one month later. Patients who did not pass the second stage were reffered for comprehensive auditory evaluations. Data analysis was performed using Kolmogrov-Smirnov and t-tests. Results: 41 and 28 cases could not pass the examining test at the first TEOAE and DPOAE examination, respectively. Also, 23 and 16 cases did not pass the examining test at the second TEOAE and DPOAE evaluations, respectively. These participants underwent auditory brainstem response evaluation and 11 of them had abnormal responses. In 5 cases of confirmed ones, hearing impairment was due to aminoglycoside side effects. Conclusion: OAE hearing screening of at-risk newborns is a clinically beneficial approach to early detection of hearing impairment. Regarding the high prevalence of hearing loss in our subjects (7.43%), prevention of its complications is highly recommended in this population.

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Introduction: Cecal volvulus is an emergency surgical acute abdomen. In this condition cecum, ileum terminal and ascending colon becomes twisted on its mesenteric anticlock wise direction rotation ranging 180-360 degrees. The cecal volvulus is caused by a lack of fixation of cecum to retroperitoneum. The usual presentation consists of severe colicky abdominal pain with asymmetric abdominal distension. In this article two cases of cecal volvulus are presented. Cases: The first case was a 74 year old female which presented with sudden abdominal pain & asymmetrical severe distension following 3 days constipation. After Plain abdominal x-ray and abdominal CT scan, right hemicolectomy was performed. The second case was a 70 year old female who following 4 days constipation was presented with abdominal pain and distension. Supine and erect abdominal x-ray showed colon hyperaeration and multiple air-fluid levels. The gangrenous colon was resected and colostomy was done. Conclusion: Despite other causes of intestinal obstruction or sigmoid volvulus which can sometimes be treated medically, the treatment of cecal volvolus is always surgery and consisted of cecum and ascending colon resection.

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Background: Leukemia is a malignant and progressive disease. Over-expression of inhibitors of apoptosis proteins (IAPs), such as survivin and its anti-apoptotic variants, including sur-ΔEx3, is the main cause of resistance to apoptotic effects of chemotherapy drugs. In the present study, the effects of CBX on apoptosis and expression level of survivin and sur-ΔEx3 and K562 cells (experimental model of chronic myeloid leukemia) were investigated. Materials and Methods: In this experimental study, human K562 cells were cultured and exposed to CBX. Trypan blue exclusion test was used to evaluate growth inhibitory and viability effects of the drug. Fluorescent microscopy (acridine orange/ ethidium bromide double staining) and DNA electrophoresis were applied to the study of apoptosis. The expression level of survivin and sur-ΔEx3 was studied by semiquantative RT- PCR. Results: The results showed that after the 48 h treatment of K562 cells with 150 µM CBX, significant growth inhibitory and apoptotic effects (up to 50%) were induced. In addition, after 2-4 h of treatment with CBX (150 µM), down-regulation of survivin and sur-∆Ex3 were observed. However, the expression level of survivin and sur-ΔEx3 increased to the level of control cells with longer treatment times (6-12 h). Conclusion: Noticing the apoptotic and down-regulatory effects of CBX on survivin and sur-∆Ex3 expression, this drug can be used as a potential candidate for further studies on CML treatment, especially for inhibition of drug resistance in leukemia cells.

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Background: To date, several drugs have been proposed for the treatment of acute promyelocytic leukemia (APL) however, none of them has resulted in complete remission. Therefore, many efforts are in progress to find new drugs with the capability of inducing apoptosis. Recently, anti-carcinogenic effects have been reported for a drug named carbenoxolone (CBX) on several cell lines. In the present study, the effects of CBX on NB4 cell line, as an experimental model of APL, were examined. Materials and Methods: In this trial, NB4 cell line was cultured and treated with different concentrations of CBX (50-250µM) in various time intervals (12-48 hours). Trypan blue exclusion test was used to evaluate growth inhibitory and viability effects of the drug on NB4 cell line. Fluorescent microscopy (acridine orange/ethidium bromide double-staining) and agarose gel electrophoresis DNA were used to study apoptosis. Results: CBX induced growth inhibition of NB4 cells so that growth inhibition rates of NB4 cells, after the 48 hour of treatment with 50, 100, 150, 200, and 250 µM CBX were 32.65, 47.52, 60.73, 68.91, and 74.33%, respectively. Furthermore, the results of DNA fragmentation and fluorescent microscopy assays indicated that apoptosis is a major mode of cell death after treatment of NB4 cells with above concentrations of CBX. Conclusion: Noticing the growth inhibitory and apoptotic effects of CBX on human promyelocytic leukemia NB4 cells, it can be considered as a potential candidate for further studies on APL treatment.

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Background: Nucleostemin plays a critical role in controlling proliferation and self-renewal of stem cells and cancer cells. Thus, inhibition of nucleostemin expression could be a potent therapeutic approach in cancer treatment. In the present study, the effects of nucleostemin gene silencing in K562 cell line were studied. Materials and Methods: In this experimental study, after transfecting NS-specific siRNA into K562 cells, changes in nucleostemin gene expression pattern were determined by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Trypan blue exclusion test, MTT assay, and fluorescent microscopy were used to evaluate the growth inhibition and apoptosis of K562 cells, respectively. Flow-cytometery was utilized for evaluating the effects of nucleostemin gene silencing on cell cycle. Results: The results showed the high expression of nucleostemin gene in K562 cells. NS-siRNA transfection into K562 cells at 200 nM inhibited the nucleostemin mRNA level up to 55% after 48 hours when compared to corresponding control cells. Forty eight hours after transfection, the cell growth decreased up to 33.7%. In addition, the silencing of nucleostemin induced G1 cell cycle arrest. Furthermore, fluorescent microscopy assays indicated that apoptosis occurred 48 hours after silencing nucleostemin gene expression. Conclusion: Noticing the potent growth inhibitory and apoptotic effects of nucleostemin siRNA in human myeloid leukemia K562 cells, silencing this gene can be a potential target for inhibiting K562 cells as the stem cell model of chronic myeloid leukemia.

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Background: Since researchers were able to produce dendritic cells (DCs) from peripheral blood monocytes, many scientists have been in search of discovering the best way of producing dendritic cells and optimizing the DCs maturation processes in vitro to treat some diseases. The aim of this study was to investigate the maturation of DCs for tumor immunotherapy. Materials and Methods: In this experimental study, DCs were produced in two stages. In the first stage, monocyte cells were converted to immature DCs by GM-CSF and IL-4. In the second stage, immature DCs were made mature in the presence of human umbilical vein endothelial cells and PHA -activated T lymphocytes conditioned media and maturation factors. Results: The produced DCs with appropriate phenotype, phagocytosis ability, and proliferation of T lymphocytes stimulation traits could secrete high levels of cytokines. Conclusion: Endothelial cells and T lymphocytes conditioned media can produce Th1 and DC1 in vitro. Therefore, DCs produced through this method are suitable for immunotherapy treatment applications and cancer treatment through treatment cells.

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Background: There are various factors effective in the appearance of metastasis that have been surveyed and recognized in different studies. However, the appearance of metastasis by determination of these factors cannot be predicted. One of the models used for the analysis of recurrent data and consideration of heterogeneity between patients is frailty model. Materials and Methods: In this survival study, 133 women with breast cancer were treated in Fayazbakhsh Hospital, Tehran, during 2005-2007. All patients were followed until April 2011. Frailty model was employed for the analysis of data and gamma frailty distribution was assumed with the average one and Ө variance. All statistical methods were run in R software. Results: Disease-free survival rates for 3 and 5 years were 0.78 and 0.72, respectively. During the follow-up period, the risk of metastasis was estimated to be 43%. Two factors were identified as the prognostic factors in the appearance of metastasis: tumor malignancy grade and the number of positive lymph nodes. Frailty variance was 4.27 (P=0.001). Conclusion: The significant variance of frailty component in the model indicates that patients who have identical explanatory variables face different levels of risk experiencing metastasis. Also, specific characteristics of the patients are important in the incidence of metastasis.

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Background: In recent years, changes in the composition of Iranian population into aged population have increased the need for more information about the quality of life (QOL) of this group. Proper planning for this age group for increasing their quality of life depends on the identification of factors associated with QOL. The aim of the current study was to assess the quality of life and its relationship with the quality of diet in elderly people aged 60 years and more living in the urban areas of Markazi province. Materials and Methods: This cross-sectional study was carried out on 165 elderly people in the urban areas of Markazi Province in 2010. Data obtained via general and QOL (SF-36) questionnaires and three 24-hour recalls on food. The quality of diet was measured using Healthy Eating index. Results: The means of total SF-36, physical and mental components scores were 55.66, 51.32 and 57.30, respectively. Additionally, the average overall healthy eating index score was 82.83. The results showed that the total, physical, and mental components of SF-36 scores in the elderly were positively associated with the healthy eating index but not significantly (P=0.2). QOL and diet scores were significantly associated with age, sex, education, previous employment, income, leisure activities, exercise, insurance, smoking, present disease, and drug consumption (P<0.05). Conclusion: The results showed that the QOL in the elderly was not related to their quality of diet.

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Background: Multiple sclerosis (MS) is a chronic progressive  disease  of the central nervous system with signs and symptoms such as fatigue and balance that are disable. The purpose of this study was to assess the effect of training which instructions focus of attention on postural sway of multiple sclerosis patients.

Materials and Methods: The present quasi-experimental study used a pretest-posttest design. The subjects with the age of 27-42, expanded disability status scale 1-4 and were purposefully and voluntarily selected and randomly allocated to the experimental and control groups. Training program for groups was carried out in 3 weeks, five sessions per week, and each session lasted about one hour. Berg Balance Scale was used to measure balance. The data was analyzed by using analysis of independent and dependent sample t-test at a significance level of p≤0.05.

Results: The results showed that significant improvements observed in balance (p≤0.05). Also significant differences observed between  post hoc scores in the experimental and control groups (p≥0.05).

Conclusion: According to research findings, the exercise walking program on textured surface resulted in considerable improvements in balance in multiple sclerosis. Also, the respective specialists can use these exercies as a complementary treatment along with the drug therapy for patiens with multiple sclerosis.

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Background: Childbirth is a stressful event that requires a mental adjustment. Optimism is one of the important determinants of psychological adjustment which is a combination of interest and positive attitude. The purpose of this study was to determine the effect of optimism training during pregnancy on attitude and intentions to choose the mode of delivery in nulliparous women.

Materials and Methods: In this clinical trial , 64 primipar pregnant women with normal pregnancies, 34-30 weeks, without indication for cesarean section referring to the health centers in Mashhad in 2014 were selected and were randomly divided into two groups , A (trained) and B (no training). Optimism training during 5 session of the 60-minute, with the group participation of participants and active exercises was conducted. Data were analyzed with using the software SPSS and statistical tests including variance analysis, Fischer exact test, willcoxon, Square-Chi and paired t-test.

Results: Average attitude score towards c/s delivery in the study group, before and after training has a significant difference (p<0.001). Average attitude score towards natural childbirth was significantly higher in intervention group compared to the control group (p<0.002). Frequency of intentions to choose the mode of delivery in the study group, before and after training has a significant difference (p<0.033).

Conclusion: Reults showed that optimism training in creating a positive attitude towards natural childbirth and thus reducing the rate of elective c/s delivery is effective.

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Abstract

Background: Vitamin D was recognized with protective effects on nerve cells of Parkinson’s patients. The relationship between several VDR gene polymorphisms and age and risk of the disease was determined. Also, the relationship between VDR gene FOKI genotypes and PD was specified. The main goal of this study is to evaluate the relationship between polymorphic loci of FokI, TaqI, BsmI, ApaI and serum factor related to vitamin D metabolism in Isfahan population.

Materials and Methods: Case- control study of 125 Parkinson’s patients with their matched control individuals has been investigated based on Parkinson's disease brain bank criteria of Great Britain. After receiving consent, serum levels were measured. The genetic material was isolated by Miller protocol and polymorphisms has been analyzed and confirmed by repeated PCR-RFLP.

Results: Comparing the five serum factors between healthy subjects and patients with Parkinson's disease, we have  shown a significant reduction in the levels of calcium, ALP and PTH (p<0.01). However, none of the levels of vitamin D and phosphate show any kind of significant relationship between patients and control subjects. Concentration of blood serumic factors including calcium and PTH showed p-values less than 0.01 between Parkinson's patients and control subjects according to different genotypes containing FokI-F allele,ApaI-A allele and BsmI-b allele .

Conclusion: The result of this study showed that each of FokI and ApaI recessive alleles can influence serum calcium and parathyroid hormone between healthy individuals and Parkinson's patients significantly.

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Background and Aim The occupational environment, the type of work overload or underload, physical risks, how individuals adapt to the workplace, and face the family - work constitute the sources of stress or occupational distress. Job stress emerges as the duties and tasks assigned to people are more than their abilities. This study aimed to investigate the relationship between stress management training and work ethics of employees.
Methods & Materials This research was an applied study in terms of purpose, a mixed exploratory (qualitative and quantitative) study in terms of data, a content analysis (qualitative stage) and  cross-sectional survey (quantitative stage) in term of conduct. The study population in the qualitative section comprised experts (Experts in Psychology, Educational Management, and Social Medicine) according to the inclusion and exclusion criteria. In the qualitative section, the study population included experts and managers who had received stress management training. Sample size and sampling method in qualitative part was based on the principle of theoretical saturation, resulting in 12 people using purposive sampling method. In the quantitative part, the sampling was based on the Cochran’s formula, resulting in 220 people who were selected using cluster sampling method. 
Ethical Considerations This barcode research was presented to the Ethics Committee and registered in the system (IR.IAU.TNB.REC.1400.121). 
Results The results showed that to deal with stressful situations, three basic strategies of event-focused coping, anxiety-focused coping, and avoidance-focused coping strategies can be used for stress management training models. Overall, the components presented for coping with stressful conditions have the necessary and appropriate validities. All three main coping strategies (event-focused, anxiety-focused, and refusal-focused) are suitable for explaining and fitting. So, they all are reliable and confirmed in the current research questionnaire of coping with stress.
 Conclusion Strategies for coping with stressful situations have a different effect on people’s professional work ethics so that the event-focused coping strategy has a significant positive relationship with professional ethics. On the other hand, the anxiety-focused and avoidance-focused coping strategies have negative and decreasing relationship with professional ethics. The more emphasis on the event-focused coping strategy, the more would be the professional ethics of individuals and the more emphasis on the anxiety-focused and avoidance-focused coping strategies, the less would be the professional ethics of individuals..