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The clinical benefits of rituximab in systemic sclerosis (SSc) are still contentious. The present meta-analysis aimed to systematically assess rituximab’s safety and efficacy profile in SSc patients. A systematic online query was performed in PubMed, Scopus, Web of Science, and Embase. The studies on the application of rituximab for patients with SSc were reviewed comprehensively for over two years. In terms of efficacy profile, mRSS, MS, LVEF, sPAP, FVC, DLCO, TLC, FEV, DAS, severity activity, HAQ-DI and SF36 were assessed for organ involvement and quality of life. The level of biological and immunological markers was also evaluated in SSc patients treated with RTX. In total, 24 studies met the criteria. Although they did not have a high quality, they were free from heterogeneity and publication bias. The pooled results revealed a long-term improvement in mRSS and MS. HAQ-DI was improved to 0.78 after 12 months, and DAS was significantly reduced to 0.33, 0.23, and 0.24 following 6, 12, and 24 months of treatment, respectively (p = 0.00 for both parameters). The rest of the parameters remained stable over time in patients with SSc. The pooled analysis of these patients demonstrated that the induction of death, cancer, infection, and infusion were 9, 5, 18 and 10%, respectively. Based on the pooled results of this meta-analysis, rituximab improves skin score and disease indices and stabilizes organ involvement in SSc patients. Rituximab seems to possess reasonable safety, similar to previous data from other autoimmune diseases.

Aims: Investigators have identified sufficient self-care as an important factor in reducing health-care costs and improving health outcomes in cardiac patients. Therefore, the purpose of the present study was to determine the relationship between perceived social support (PSS) and self-care behaviors (SCBs) in patients with ischemic heart disease. Materials and Methods: The present work was a cross-sectional study. Patients with ischemic heart disease were selected using the convenience sampling method. Data gathering tools used in this study were questionnaires of Zimet multidimensional social support and Miller self-care. The data were analyzed in SPSS 18 software using Spearman's correlation and Mann–Whitney tests by significant coefficient

Background: Preconception care is an opportunity to change unhealthy behaviors which in turn reduces unplanned pregnancy and plays an important role in reducing maternal and infant mortality. The aim of this study was to determine the level of preconception care and its related factors in pregnant women. Methods: This cross-sectional study was conducted on 394 pregnant women referred to Gorgan health centers in 2017. Samples were selected by multi-stage stratified sampling method from Gorgan health centers in Golestan province. Data was gathered using self-report questionnaire. Data analysis was performed using chi-square test, Fisher's exact, and Kruskal-Wallis tests in SPSS-16. The P-value less than 0.05 were considered significant. Results: 32.7% of women were received complete preconception care and 17.8% had no pre-pregnancy care. Only 44.2% of women used folic acid daily since the first trimester of pregnancy. Most of pregnant women (63.7%) performed triple screening laboratory test (FBS, CBC, TSH). Preconception care was more successful in mothers with higher level of education (p

BACKGROUND Pancreatic cancer is considered as the most deadly tumor among gastrointestinal cancers because of its poor prognosis. The frequently deregulated pathway in the cancer cell is associated with an increased expression of various genes, including the synthesis of fatty acids. We aimed to evaluate the level of serum fatty acid synthase (FASN) as a diagnostic marker for early diagnosis of pancreatic cancer. METHODS Serum FASN levels were measured by ELISA in 92 patients with pancreatic adenocarcinomas and in 92 healthy controls. Logistic regression analysis was used to identify independent predictors of certain diagnostic categories. RESULTS Serum FASN levels were significantly higher in patients with pancreatic cancer than in healthy controls (1.35 [0.98-2.3] ng/mL vs 1.04 [0.19-1.34] ng/mL, p < 0.001) and in smokers compared to non-smokers (1.41 [0.79-2.52] ng/mL vs 1.07 [0.21-1.74] ng/mL, p < 0.001). FASN levels and smoking were associated with increased risk of PC (1.54 [1.1- 2.14] ng/mL, p = 0.011 and 5.69 [2.68-12.09] ng/mL, p < 0.001, respectively). CONCLUSION Elevated serum FASN levels in patients with pancreatic cancer indicate the need for the production of large numbers of lipids for the survival and proliferation of human cancer cells and the diagnostic value of FASN as a new diagnostic biomarker.

Background: The aim of this study was to evaluate respiratory problems via pulmonary function testing in cement transport workers at Incheh Borun border in northeast of Iran in 2016. Methods: The study was conducted on 358 male workers. All subjects were evaluated for respiratory symptoms via pulmonary function testing and completion of the American Thoracic Society questionnaire. Results: Mean age of workers was 34.8±12.87 yr (age range 16-79 yr). Mean duration of employment was 6.1±4.36 yr. Most workers (75.4%) were illiterate or had elementary education. In addition, 56 (15.6%) subjects were smokers. Only three individuals (0.3%) had obstructive pattern. There was a significant relationship between age of workers and frequency of respiratory problems (P

Background: Breast milk is the most suitable nutrition for the neonates. Breast milk and breastfeeding duration can contribute to decreased mortality rate, intestinal bleeding, and various neonatal diseases (e.g., digestive and respiratory diseases). It can also reduce the risk of diabetes and obesity in childhood and adulthood. Therefore, the estimation of breastfeeding duration and recognition of the effective factors in this regard can lead to designing and implementing appropriate programs, which can provide the foundations for the modification of breastfeeding behavior. Methods: This survival study was conducted on 501 mothers with healthy and single birth neonates born within March 21, 2011-September 21, 2012 with active medical records in Aqqala city, Golestan province, Iran, in the second half of 2014. The data were collected from the information registered at the archives of health centers by in-person visiting. In addition, some of the information was collected through phone contacts. The duration of breastfeeding was estimated in month. Data analysis was carried out using the Cox regression in the STATA software, version 11. Results: According to the results, the mean and median of breastfeeding were 20.44 and 22 months, respectively. According to the Cox regression, maternal ethnicity, living with family, birth spacing, type of milk consumed along with complementary nutrition, and type of neonatal nutrition during the hospital stay of the infant had a significant relationship with the early cessation of breastfeeding. Conclusion: Based on the findings of the present study and the identified factors affecting the breastfeeding duration, it seems necessary to provide the essential trainings for the young mothers and pregnant women to avoid of reducing the duration of breastfeeding. These educations can be included in the programs of the Health centers of the universities and urban and rural medical clinics. &nbsp

Background: Tranexamic acid and vitamin C are potent antifibrinolytic and oxidative stress agents that reduce blood loss and transfusion blood in cardiopulmonary bypass (CPB). Objectives: The aim of this study was to evaluate the efficacy of tranexamic acid (TA) and tranexamic acid combined with vitamin C (TXC) on drainage volume (blood loss) and atrial fibrillation (AF) in patients undergoing cardiac bypass surgery in Gorgan, Shafa hospital, Iran. Methods: This study is a double-blind randomized clinical trial. A sample size of 120 candidates of cardiac bypass surgery were included in this prospective study. Patients were randomly assigned to treatments in two groups. In both groups, 50 mg/kg tranexamic acid was administered intravenously directly before sternotomy: group A (N = 58) patients received tranexamic acid (TA) only and group B (N = 62) tranexamic acid with vitamin C (TXC) half an hour before surgery and 2 g vitamin C with 100 mL 0.9% saline were injected. Subsequently, during 4 days after surgery, 1000 mg of vitamin C and 100 cc 0.9% saline was infused every day. Intraoperative and postoperative blood loss (volume of blood in the drain) and atrial fibrillation complications were recorded for 24 hours after the operation. Results: The patients who received vitamin C had less bleeding during operation and in the early hours post-operation. Patients in (TA) group had mean drainage of 34.41 milliliter more than patients in (TXC) group (P < 0.001). Chi-square test showed that arrhythmia (AF) condition was the same in the two groups during 14 times of study (four times during operation and ten times up to 24 hours after the operation), and AF arrhythmia in the two groups was less than 5%. Conclusions: In this study tranexamic acid with vitamin C have a positive effect on the amount of drainage (blood loss) and there was no significant difference in the incidence of AF between two groups.

Background: Leishmaniasis occurs with an incidence of 0.5–1.5 million new cases annually, and is also endemic in 88 countries across the world. Aim: Presently, we aimed to investigate the status of Cutaneous Leishmaniasis (CL) in Golestan Province in North of Iran. Methods: A retrospective survey was conducted on existed data of 6873 patients with CL who attended to Health Centers in Golestan Province during 2010 to 2017 years. Data were collected using patient sheets and online registry form of CL. Descriptive statistical methods such as mean and standard deviation, and Chi-square test were employed to report and analyze results. p-Value

Malnutrition is a major health problem in hospitalized pediatric patients. It is reported that the number of malnourished pediatric patients varies between 21% and 80% according to the level of the country's development. It is essential that patients who are malnourished or at risk for malnutrition be identified as soon as they are admitted to the hospital. A recent study applied 3 nutritional risk …