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Low birth weight (LBW) is the main known determinant mortality in under 1 year old children particularly in neonates. The aim of this research is to study the rate of LBW and evaluation of some effective factors in LBW, such as: Difference races, residential conditions, maternal age, parity. This research is analytic-descriptive and cross-sectional study. The study population consists of 2183 newborns that are given birth in Dezyani Hospital during 1996. These samples were chosen by systemic randomized technic (3:1). Information was gathered by a questionnaire. The findings show that LBW rate was 6.3% in population under study, which in male and female newborns were 5.7% and 6.9% respectively. The LBW rates in newborns with mothers age?18 years old and those with ?35 years were 1.8% and 1.4% folds higher than LBW rates for newborns with mothers age 19-35 years. The LBW percentage for primiparous women were 1.9 folds to multiparous who had 2-4 deliveries. LBW rates for newborns with Systanie race were approximately 1.8 folds higher than newborns with Torkman ethnic. The results of this study indicate factors such as: Maternal age, race, parity, affect on LBW rates.

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Background&Objective: The proper treatment for early-stage Hodgkin’s disease is controversial. The purpose of this study was to evaluate the therapeutic outcomes of various treatment strategies in supradiaphragmatic clinical early-stage Hodgkin’s disease. Materials&Methods: This retrospective study reviewed the medical records of 105 eligible patients (49 stage I, 59 stage II) who were treated at radiotherapy- oncology departments of Qaem and Omid hospitals in Mashhad (Iran) from April 1995 to April 2000. 26 patients had B symptoms and 5 had large mediastinal mass. Treatment of patients consisted of chemotherapy alone (43 cases), radiotherapy alone (46 cases, 40 mantle and 6 Total nodal irradiation) and combined modality (16 cases). Survival rates were calculated by Kaplan- Meier model. Log-rank test was used to compare the survival profile between groups. Results: The median age of patients was 25 years with a male to female ratio of 1.56: 1. In comparison with radiotherapy only group, Primary chemotherapy and combined modality groups had significantly more cases with unfavorable factors such as B symptoms, Large mediastinal mass, ESR>40 and stage II. For chemotherapy, combined modality and radiotherapy groups the 5-year progression free survival was 72.5%, 82.5% and 56.2% (P<0.05) and the 5-year disease specific survival was 82.9%, 91.6% and 82.5% respectively. Conclusion: Despite having more cases with unfavorable factors, patients who underwent chemotherapy or combined treatment had lower relapse rates compared to radiotherapy only group. However, there was not a significant difference in 5-year disease specific survival rates between these groups.

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Background & Objective: Surgery and /or radiotherapy are major local treatments for esophageal carcinoma. The results of radiotherapy alone have been unsatisfactory. The purpose of this study was to evaluate the treatment outcome of definitive chemoradiotherapy for patients with esophageal SCC.

 

Materials & Methods: This prospective histological descriptive study was done on 190 nonmetastatic esophageal SCC patients which received definitive chemoradiotherapy (55-64 Gy, Cisplatin 80-100 mg/m2 day 1-5FU 750-1000 mg/m2, 24h infusion days 1-4) with curative intent in cancer research center, Mashhad University of Medical Sciences between Jan 2000-Jan 2004. At least one course of chemotherapy was prescribed concurrently with radiotherapy.

 

Results: There were 99 male and 91female patients with the median age of 65 (range, 25-87). The median radiation dose prescribed was 60 Gy (range, 55-64) and median chemotherapy courses was 4 (range, 1-8). With a median follow-up time of 12 months (range, 3-60), one, two and three-year survival rates were 67.8%, 48.7% and 36.3% respectively and median survival was 22 months. Reduction of symptoms was shown in 84% of patients with dysphagia. 109 patients remained disease free with a median follow-up of 14 months (range, 3-60), among which 34 were followed more than 24 months. We found 81 cases (42.6%) with treatment failure during the follow-up (34 locoregional failure, 14 distant metastases, 33 distant metastases accompanied with locoreginal failure).

 

Conclusion: Although definitive chemoradiotherapy can result in long term disease free survival and even cure in a subset of patients with SCC of esophagus, locoregional failure and distant metastasis has remained the main causes of treatment failure.

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Background and Objective: One of the most important routes of hepatitis B virus (HBV) transmission is from asymptomatic carrier mothers to their infants. It has been concluded that over 50% of Iranian carriers have contracted the infection perinatally, making this the most likely route of transmission of HBV in our country. In this study, we assessed the rate of HBV infection in children were born to HBsAg positive mothers that received hepatitis B immunoglobulin (HBIG) and the first dose of vaccine at birth and the second and third of doses of vaccine at 1 and 6 months of age, respectively. Materials and Methods: In this descreptive study, 123 infants born from HBsAg positive mothers assessed and serum sample of these subjects were tested by ELISA technique for detection of HBsAg, Anti-HBs and Anti-HBc markers. Data were then analyzed by the chi-square and fisher exact tests. Results: From 31241 pregnant women with delivery during this 5-years study about 140 (0.45%) of them were HBsAg positive. Children born to these mothers follow-up and 123 serum samples of them tested for serologic markers of HBV infection. HBsAg was found in 0.8% of the children and 91.9% had one or more serologic markers of HBV infection. Protective rate (Anti-HBs positive) and Anti-HBc positive were 82.1% and 8.9% respectively. Conclusion: This study showed that after having focuced on the vertical transmission route for many years, and implementing strategies such as vaccination and HBIG injection to neonates of HBsAg positive mothers, nowadays it seems that we should pay attention to horizontal route of HBV transmission in this area.

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Background and Objective: Previous studies have shown that vitamin D is involved in host immune response toward Mycobacterium tuberculosis (MTB). The aim of this study was to determine if administration of vitamin D can improve treatment outcome and whether is able to increase the rate of sputum clearance of MTB in patients with pulmonary tuberculosis (PTB). Materials and Methods: This randomized clinical trial study was conducted on 96 patients with lung tuberculosis in Ahvaz, Iran during 2008-09. The patients were 18>=years old with sputum positive for acid fast bacillus. Patients were placed in two equal groups as cases and controls. Cases were treated by standard anti TB regimen plus 800 IU/day vit D orally. Controls were treated only by standard anti TB regimen. Follow up sputum examination for presence AFB was performed at the end of month 1, 2, 3, 4 and treatment period. Data were analyzed in SPSS-16 by using descriptive statistics test, chi square and fisher exact test. Results: Mean±SD age of cases and controls was 39.1±17.8 and 38.3±17.6 years, respectively. Overall cure rate in case and control was 93.8% and 95.8% respectively, with no significant difference. The rate of negative sputum of cases in the end of months 1, 2, 3, 4 and treatment period was 66.7%, 78.5%, 93.8% and 93.8% respectively, and for controls was 35.4%, 66.7%, 91.7% and 95.8% respectively. There was significant difference between two groups in the end of first and second month (P<0.05). Conclusion: This study showed that vitamin D as a supplemental drug does not improve the overall treatment outcome among lung TB patients, but it may be able to increase the rate of sputum clearance of Mycobacterium tuberculosis.

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Background and Objective: Child abuse is a common phenomenon with variety of reasons; the most important one is mother psychiatric disorders. Concurrent interventions in the family can recover the mother and reduce child abuse. This study was done to evaluate the effect of therapeutic intervention on general health of child abused mothers. Methods: This clinical trial study was conducted on 57 children and their child abused mothers whom referred to child psychiatry and pediatric department of Imam Hossien hospital, Tehran, Iran during November 2009- April 2010. Children and their families were visited by a psychiatrist and depend on the child and the family after either pharmaceutical or psychological interventions was taken. Parent management training was done for all mothers in 8 weekly sessions. General health questionnaire were filled by mothers before intervention in the third and sixth months following the intervention. Results: Total score of general health, depression and anxiety of child abused mothers were 31.3±1.90, 5.26±0.66, 8.10±0.46, respectively. It was significantly increased after six months intervention in comparison with pre-intervention (37.3±2.34, 7.48±0.72, 10.44±0.58, respectively). Conclusion: Appropriate therapeutic intervention and parent management training for mothers can improve general health of child abused mothers.

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Catalase is the one of the most important antioxidant enzymes that is found abundantly in liver and kidney. The alteration in activity and function this latter enzyme are widely investigated in various types of cancer to understand the cancer mechanism and its treatment. The changes in the catalase activity levels in a variety of cancer cells is as a specific property of tumor tissues due to the reducting catalase activity at mRNA level. In this review, various reports that examined the alterations in catalase activity and resistance to chemotherapy and its complications in the literature are summarized and discussed. Due to the important role of hydrogen peroxide in various stages of cancer process, catalase alters this process by detoxification of hydrogen peroxide. Chemotherapy increase free radicals to destroy the tumor cells, then, catalase activity reduced their impact on cancer cells. On the other hand, it might be concluded that production of drug resistance in chemotherapy is resulted due to increasing catalase activity. Therefor it seems catalase has contradictory influence on the treatment and development of cancer.

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Background and Objective: Squamous carcinoma accounts for the majority of esophageal carcinoma worldwide. This study was done to evaluate the survival rate of patients with esophageal cancer in Iran.

Methods: This historical cohort study was carried outon 105 patients with esophageal squamous cell carcinoma whom admitted to Firoozgar hospital in Tehran, Iran during 2009-14. Patients with esophageal squamous cell carcinoma were treated with chemoradiation either with or without surgery.

Results: The mean age of patients was 63 years. Frequency of esophageal cancer in both sexes in the age group 51-60 years was higher than other groups. 5-year survival in patients with esophageal cancer treated with chemoradiation without surgery was 9.5% and in patients treated with chemoradiation with surgery was 31.7 % (P<0.05). One-year, three-year and five-year survival rate in patients were treated with chemoradiation with or without surgery was 68.5%, 38% and 22.8%, respectively.

Conclusion: The survival rate of patients with esophageal cancer is very low, but the treatment with chemoradiation with surgery can increase life expectancy of patients.

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The kangaroo care method in newborn is a way of protecting the baby through skin to skin contact between newborn and their parents. This review study was done by using the keywords including kangaroo mothre care, neonatal, skin to skin contact and preterm. All related articles were published in Pubmed, Sience direct, Google scholar, SID, and Magiran were studied during 2000 to 2016. Finally, 36 articles were reviewed which were similar according to objectives, method of work, sample size, analysis method, and conclusion. Reviewing the selected articles showed that skin to skin contact among newborn and their parents regulated the body temperature of the neonate, increased the newborn's immune system, reduced infection and mortality rate, regulated heart and respiratory rate, increased the growth and weight gain in low birth weight neonates, reduced the stress and crying, increased prolong and stable periods of sleep, and also creates an emotional bond between the parents and the neonates. Kangaroo care method not only helps to care for the early stages of growth of premature neonate, but also increases the general health of the newborn and mother. This care can be used as an inexpensive and highly beneficial method for neonate's growth and health in human.

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Background and Objective: Parents of children with autism have difficulty in their daily activities and social relationships and have a low quality of life. The negative effect of having a low intelligence or disabled child is more likely to cause tension and pressure on mother than the other family members. This study was conducted to determine the quality of life of mothers with autism children compared to mothers with normal children.
Methods: This case-control study was performed on 36 mothers with autistic child and 114 mothers with healthy children in Gorgan (Iran) during 2015. Sampling was done randomly and the data gathering tool was SF-36 quality of life standard questionnaire.
Results: The quality of life of mothers with autistic child had a significant reduction in comparison with the quality of life of mothers with healthy child (P<0.05). Also, items of quality of life including  general health, social function, and role limitation due to psychological, emotional and physical functioning in the group of mothers with autistic children were significantly lower than mothers with healthy ones (P<0.05).
Conclusion: Mothers with autistic children had low quality of life. Therefore, it is recommended to design suitable programs for improving the health status and quality of life as a priority of health care plans.

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Background and Objective: Elimination disorders such as nocturnal enuresis, urinary incontinence during the day, and fecal incontinence are common problems in childhood. This study aimed to evaluate the effectiveness of training mothers with the Adler-Dreikurs approach for reducing anxiety in children with elimination disorders.
Methods: This field trial was done in 2021 on the mothers of 20 children with elimination disorders who had been referred to the Pediatric Gastroenterology Clinic in Gorgan with a pretest, posttest, and follow-up approach. At the physician's discretion, the children's problem had no anatomical origin. Urinary incontinence and fecal incontinence in children were identified only by psychological symptoms and functional elimination disorders. The mothers were divided into an experimental group (n=10) and a control group (n=10). The experimental group received the Adler-Dreikurs training program in 12 sessions of 90 minutes. The research instrument was the Spence Children's Anxiety Scale – Parent (SCAS-P) (2001), which was completed by the mothers in three stages: pretest, posttest, and 2-month follow-up. Sub-components of anxiety including generalized anxiety, social phobia, obsessive-compulsive, specific phobia, and separation anxiety were also measured.
Results: Mean general anxiety scores in the pretest, posttest, and follow-up stages were 69.1±4.04, 45.8±6.1, and 47.8±5.94 in the experimental group and 69±6.58, 67.8±4.89, and 67.6±5.59 in the control group, respectively. There was a significant difference in all subcomponents of child anxiety in the posttest and follow-up stages between the experimental group and the control group (P<0.05). This difference was also present during the follow-up period except for the obsessive-compulsive subcomponent.
Conclusion: Training mothers through the Adler-Dreikurs approach can reduce anxiety in children with elimination disorders.
 

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Background and Objective: Vaginal delivery is a natural physiological process that can be a critical experience for women. One of the factors involved in avoiding vaginal delivery is childbirth self-efficacy. Self-efficacy affects all aspects of behavior and emotional activities, including attachment. This study aimed to determine the relationship between childbirth self-efficacy and maternal attachment to the fetus in nulliparous pregnant women.
Methods: This descriptive-analytical study was conducted on 323 nulliparous pregnant women who attended health centers in Zahedan city from 2020-2021. Data were collected using participants’ demographic questionnaire, Lowe’s childbirth self-efficacy questionnaire, and Cranely’s maternal attachment to the fetus questionnaire.
Results: Maternal attachment style to the fetus showed a significant direct correlation with childbirth self-efficacy. Maternal attachment style to the fetus predicted childbirth self-efficacy (P=0.003, r=0.16), explaining 2.7% of the variance of childbirth self-efficacy.
Conclusion: The results suggest that helping mothers accept their motherly role and improving maternal attachment to the fetus can increase childbirth self-efficacy. Educational programs during pregnancy should include training related to strengthening maternal attachment to the fetus. As women with high childbirth self-efficacy have a greater ability to perform vaginal delivery, it may increase their desire for vaginal delivery.
 

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Background and Objective: The quality of life of mothers of children with autism spectrum disorder (ASD) is influenced by the problems of this disorder. Numerous interventions have been recommended for mothers with such children, including supportive interventions, cognitive-behavioral therapy (CBT), negative mood management training, parent-child interaction, and family-oriented interventions. One of these interventions is quality of life therapy. The present study was conducted aiming to determine the impact of training quality of life therapy on mothers with ASD children.
Methods: This clinical trial was conducted on 60 mothers of 6-13-year-old ASD children referring to the Ofogh Clinic in the city of Gonbad-e-Kavus, Golestan Province, during 2022-23. Mothers were selected by the convenience sampling method and were assigned to two 30-people control and intervention groups using the random number table. The psychotherapy training based on Frisch’s (2006) theory on the quality of life was implemented on mothers in the intervention group as a group in eight 90-minute sessions for two months. The World Health Organization Quality of Life Scale (WHOQOL-BREF) was used to measure the mothers’ quality of life.
Results: The mean and standard deviation of the total quality of life score of mothers in the intervention group (76.15±8.85) had a statistically significant increase in the post-test compared to the control group (64.82±10.15) (P<0.05). Also, the mean and standard deviation of the quality of life of mothers in the intervention group showed a statistically significant increase in the post-test in the dimensions of physical health (65.12±6.24), psychological health (69.55±7.52), environmental health (60.66±16.8), and general health (78.33±10.9) compared to the control group (P<0.05).
Conclusion: The quality of life of mothers with autistic children was improved by receiving quality of life-based therapy.

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Background and Objective: Type 1 diabetes is considered one of the most common chronic diseases during childhood. Diagnosis and presence of chronic disease in the child create tension, worry, and problems for parents, particularly for the mother who is responsible for taking care of the child. The present study was conducted to determine the effectiveness of resilience training on the self-esteem of mothers of children with type 1 diabetes.
Methods: This clinical trial was carried out on 60 mothers of children with type 1 diabetes referring to diabetes clinics in the cities of Gonbad-e-Kavus and Gorgan, Golestan province, during 2022-23. Mothers were selected by the convenience sampling method and using a random number table and were assigned to two 30-people control and intervention groups. The resilience training program was implemented for the intervention group in 5-people groups for nine 90-minute sessions during 2 months. The data collection tool consisted of a demographic questionnaire and the Coopersmith Self-Esteem Inventory (SEI) filled out in two pre-test and post-test phases. Scoring of poor, moderate, and strong self-esteem was carried out by obtaining scores of 26 and below, 27-43, and over 44.
Results: The mean and standard deviation of the overall self-esteem (22.73±3.26), social (7.32±0.79), occupational/social (7±1.46), and general self-esteem (44.73±5.03) dimensions had a statistically significant increase in the post-test in mothers of the intervention group compared to those in the control group (P<0.05). The mean and standard deviation of the self-esteem scores of mothers in the intervention group were evaluated as moderate at the onset of the study and strong at the post-test (P<0.05).
Conclusion: Resilience training culminated in increasing the self-esteem of mothers of children with type 1 diabetes.