Human milk from healthy women contains numerous nutrients such as antioxidants which are necessary for newborns. The aim of this study was to evaluate the changes of total antioxidant capacity (TAC) and free radical scavenging activity in human milk during the first six month period of lactation and also its relationship to maternal plasma. A total of 505 milk samples (colostrum, transitional and mature milks) collected from 115 healthy women with full term newborns. Blood plasma was obtained from 58 women at 3 months postpartum. The TAC of samples were measured by Ferric Reducing/Antioxidant Power assay and free radical scavenging activity were evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals. TAC was obviously higher in colostrums than transitional and mature milks. Similar results were observed for DPPH radical scavenging activity of the samples. There was a high significant correlation between the results of these two methods. The relationship between the antioxidant content of human milk and maternal plasma was also significant. These data suggest that using colostrum, with high antioxidant potential during the first days of life is vital; moreover, reduction in total TAC during the course of lactation may needs more attention about nutritional status.

BackgroundAnxiety is the most common mental disorder in end-stage renal disease patients. The use of aromatherapy as a treatment for anxiety has increased substantially in most countries.ObjectivesThis study aimed to investigate the effect of inhaling rose water aromatherapy on anxiety in hemodialysis patients.MethodsThis randomized controlled clinical trial was carried out in the hemodialysis ward of Birjand Vali-Asr hospital on 46 patients who were randomly divided into control and experimental groups. The standard state-trait anxiety inventory of Spielberger was used to investigate the anxiety level of the samples. The experimental group inhaled rose water for 4 weeks, but the control group did not undergo any intervention. At the end of week 2 and week 4, the participants’ anxiety was measured, and the results were statistically analyzed.ResultsMean scores of state and trait anxiety in the experimental group before intervention were 47/47 ± 7/6 and 49/56 ± 13/8, respectively; those after week 4 following the intervention were reduced to 37/1 ± 6/5 and 42/9 ± 10/1; inhalation of rose water fragrance in the experimental group caused a significant decrease (P < 0.001) in the state and trait anxiety levels compared with controls (P = 0.43).ConclusionsAccording to the present study, rose water noticeably reduces the anxiety of hemodialysis patients. Therefore, inhalation of rose water can improve the patient’s emotional and spiritual condition during hemodialysis treatment.

BackgroundInfection with the hepatitis B virus (HBV) is an important global health problem. Knowledge of the geographic distribution pattern of HBV infection can help to control the spread of the disease.ObjectivesTo determine the prevalence of HBV infections and risk factors for the disease for the first time in Birjand, Southeastern Iran.MethodsThis was an analytical cross-sectional study conducted in 2013 - 2014 of 5235 HBV cases in Birjand, South Khorasan Iran. Subjects aged 15 - 70 y were selected using the cluster sampling method. Blood samples were taken and tested at a reference laboratory for the hepatitis B core antibody (anti-HBc). Seropositive specimens were tested for the hepatitis B surface antigen (HBsAg).ResultsThe mean age (± SD) was 39.07 (± 14.04) y, and 786 (15%) subjects were anti-HBc positive. The prevalence of HBsAg was 1.6% (n = 85). The prevalence of anti-HBc seropositivity was significantly higher in subjects with a lower level of education (P = 0.09), older subjects (P = 0.001), intravenous (IV) drug users (P<0.05), subjects with piercings (P < 0.001), and subjects with a positive history of familial HBV or HCV infection (P < 0.05). It was also significantly higher in those who drank alcohol (P = 0.09) or had a history of blood transfusions (P = 0.001), cupping (P = 0.004), hospital admission (P = 0.03), or endoscopy (P = 0.002). The rate of HBsAg positivity was significantly higher in subjects with a history of cupping (P=0.03), a positive history of familial HBV or HCV infection (P < 0.05), and older subjects (P = 0.015).ConclusionsAlthough the frequency of HBsAg seropositivity in the present study was close to that observed in the overall Iranian population, the seroprevalence of anti-HBc was higher, possibly due to the exposure of the elderly to more risk factors. The risk factors were similar. These included a history of blood transfusions, cupping, hospital admission, endoscopy, or familial HBV/HCV infection, in addition to piercings and drug abuse.

BackgroundHepatitis B virus, with 8 known distinct genotypes, is one of the most serious health problems which results to liver injuries. The surface gene of Hepatitis B virus completely overlaps with the polymerase gene. Mutations in the RT gene result in changes in the overlapping hepatitis B surface antigen.ObjectivesThe present study aimed to evaluate the genotypes and prevalence of mutations in a segment of S and RT gene in HBV isolates in Southern Khorasan, Iran.MethodsThis was a population-based study comprising 5,235 randomized samples for HBV screening. A nested-polymerase chain reaction (PCR) test was followed by direct sequencing, and the sequences blast with present sequences of NCBI database for genotyping. Alignment and phylogenic analysis was performed using MEGA-6 software, and mutation pattern of this segment was finally surveyed in Bioedit software.ResultsThe mean age was 39.07 ± 14.04 years, with 52.2% female and 47.8% male. All isolates belonged to HBV genotype D, sub-genotype D1. The most amino acid substitutions of surface protein were Q129H (34.42%) and A168V (8.2%), other escape mutants observed in this study were P127L/T, S117G, T125M, S143L, D144E and E164D. In the RT gene, Q149K was the most frequently identified amino acid substitution (9.83%), followed by L122F (8.19%), N118D/T (6.55%), L157M (4.91%), and H124Y (3.27%).ConclusionsThis finding represents an ongoing dominancy of HBV genotype D in Eastern Iran, corresponding to other parts of Iran. There were a lot of variations in the S gene leading to an escape mutation, some of which affected the corresponding area of the RT region.

BackgroundStroke, or cerebrovascular accident (CVA), is the second leading cause of death in the world and based on the World Health Organization (WHO) report in 2006, it is responsible for 9.9% of all deaths in the world which over 85% of these deaths occurred in developing countries.ObjectivesThe aim of this study was to investigate the data related to the frequency, risk factors, types and mortality of stroke in Birjand city.Patients and MethodsA retrospective cohort of consecutive patients with diagnosed stroke who were admitted to hospital (the only neurological center of Birjand) between 2002 and 2008 was designed. A stroke was defined according to clinical features and CT-scan which was confirmed by agreement of a staff neurologist. Collected data included date of admission, age, sex, and hospital outcome as well as related risk factors.ResultsTotally, 1219 stroke (85.4% ischemic type) with the mean age of 69.6 ± 12.9 years and female: male ratio of 1.09 was included in over 6 years. The stroke hospital admission rates were 48.6 and 103.4 /100,000 population /year in the first and the last year of the study, respectively. There was an increasing trend in stroke incidence rate during the study (P < 0.01). The most common epidemiological risk factors for stroke in our region were hypertension, cardiac diseases, a history of stroke, diabetes mellitus, dyslipidemia, and smoking (54.7, 24.4, 20.1, 14.9, 12.2, and 9%, respectively). Overall in-hospital mortality rate was 17.1%.ConclusionsThe stroke hospital admission rate might be increasing in Birjand. Therefore, health care administrators and public health authorities must work harder to promote the knowledge and practice of society about the stroke related risk factors and prevention methods.

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BackgroundChildhood overweight and obesity have increased progressively in developing countries and nowadays they are considered as a global epidemic.The aim of the present study was to determine prevalence of overweight and obesity in 2–5 year-old children in kindergartens of Birjand in 2008.FindingsThis cross- sectional and descriptive- analytical study was conducted on 500 children, who were 2–5 years-old, in kindergartens of Birjand selected through census. It was found that prevalence of overweight was 10.6% (11.7% in females and 9.6% in males) and obesity 7.6% (6.3% in females and 9.6% in males). Prevalence of overweight and obesity were statistically significant regarding birth weight, mother's occupation and father's level of education.ConclusionPrevalence of overweight and obesity in pre-schoolchildren is more than that of 7–18 year-old group in Birjand, but it is less than the result of similar studies in Tehran and most studies in other countries. Further studies are recommended to identify risk factors in obese children. Periodic studies are necessary to compare the changes in prevalence of obesity in children in future.

Trauma is one of the most important issues of most healthcare systems accompanying with head trauma in the most cases. We sought to determine the scoring system and initial Computed Tomography (CT) findings predicting the death at hospital discharge (early death) in patients with traumatic brain injury based on Marshall and Rotterdam CT scores. This is a cross sectional study on traumatic neurosurgical patients with mild-to-severe traumatic brain injury admitted to the emergency department of Emam Reza Hospital, Birjand University of Medical Sciences. Patients≥18 years old with TBI during last 24 hours with GCS≤13 were included and exclusion criteria were multiple trauma, penetrating injuries, previous history of anticoagulant therapy, pregnancy, not willingness for participation. Their initial CT and status at hospital discharge, one and three months (dead or alive) were reviewed, and both CT scores were calculated. We examined whether each score is related to death using SPSS11 by The Mann–Whitney U at the level of p≤0.05. Overall, 98 patients were included. Mean age was 43.52±21.29. Most patients were male (63.3%). Mean Marshall and Rotterdam CT scores were 3.2±1.3 and 2.5±1. The mortality at two weeks, one moth and three months were 19.4%, 20.4%, and 20.4%. Rotterdam CT score was significantly different based on type of hematoma. Median GCS score in alive and dead patients on 2 weeks were 10 and 4 (p=0.0001), at one month were 10 and 4 (p=0.0001), and at three months were 10 and 4 (p=0.0001). The median Marshall CT score on 2 weeks were 2 and 4 (p=0.0001), at one month were 2 and 4 (p=0.0001), and at three months were 2 and 4 (p=0.0001). The median Rotterdam CT score on 2 weeks were 2 and 4 (p=0.0001), at one month were 2 and 3 (p=0.001), and at three months were 2 and 3 (p=0.001). The Rotterdam CT score was significantly correlated with mortality at two weeks, one month and three months (p=0.004, p=0.001, and p=0.001, respectively). The Marshall CT score was not significantly correlated with mortality at any time. The Rotterdam CT score was more accurate for prediction of mortality on 2 weeks (ROC80.9), at one month (ROC80.7), and at three months were (ROC80.7) than The Rotterdam CT score (ROC 76, 74.1, and 74.1, respectively). This study concluded that The Marshall CT score was more accurate for prediction of mortality on 2 weeks, at one month, and at three months were than The Marshall CT score with higher ROC. The correlation of the Rotterdam CT score with mortality was significant.