scispace - formally typeset
Search or ask a question

Showing papers by "Tehran University of Medical Sciences published in 2009"


Journal ArticleDOI
TL;DR: Educational meetings alone or combined with other interventions, can improve professional practice and healthcare outcomes for the patients and is most likely to be small and similar to other types of continuing medical education, such as audit and feedback, and educational outreach visits.
Abstract: Background Educational meetings are widely used for continuing medical education. Previous reviews found that interactive workshops resulted in moderately large improvements in professional practice, whereas didactic sessions did not. Objectives To assess the effects of educational meetings on professional practice and healthcare outcomes. Search methods We updated previous searches by searching the Cochrane Effective Practice and Organisation of Care Group Trials Register and pending file, from 1999 to March 2006. Selection criteria Randomised controlled trials of educational meetings that reported an objective measure of professional practice or healthcare outcomes. Data collection and analysis Two authors independently extracted data and assessed study quality. Studies with a low or moderate risk of bias and that reported baseline data were included in the primary analysis. They were weighted according to the number of health professionals participating. For each comparison, we calculated the risk difference (RD) for dichotomous outcomes, adjusted for baseline compliance; and for continuous outcomes the percentage change relative to the control group average after the intervention, adjusted for baseline performance. Professional and patient outcomes were analysed separately. We considered 10 factors to explain heterogeneity of effect estimates using weighted meta-regression supplemented by visual analysis of bubble and box plots. Main results In updating the review, 49 new studies were identified for inclusion. A total of 81 trials involving more than 11,000 health professionals are now included in the review. Based on 30 trials (36 comparisons), the median adjusted RD in compliance with desired practice was 6% (interquartile range 1.8 to 15.9) when any intervention in which educational meetings were a component was compared to no intervention. Educational meetings alone had similar effects (median adjusted RD 6%, interquartile range 2.9 to 15.3; based on 21 comparisons in 19 trials). For continuous outcomes the median adjusted percentage change relative to control was 10% (interquartile range 8 to 32%; 5 trials). For patient outcomes the median adjusted RD in achievement of treatment goals was 3.0 (interquartile range 0.1 to 4.0; 5 trials). Based on univariate meta-regression analyses of the 36 comparisons with dichotomous outcomes for professional practice, higher attendance at the educational meetings was associated with larger adjusted RDs (P < 0.01); mixed interactive and didactic education meetings (median adjusted RD 13.6) were more effective than either didactic meetings (RD 6.9) or interactive meetings (RD 3.0). Educational meetings did not appear to be effective for complex behaviours (adjusted RD -0.3) compared to less complex behaviours; they appeared to be less effective for less serious outcomes (RD 2.9) than for more serious outcomes. Authors' conclusions Educational meetings alone or combined with other interventions, can improve professional practice and healthcare outcomes for the patients. The effect is most likely to be small and similar to other types of continuing medical education, such as audit and feedback, and educational outreach visits. Strategies to increase attendance at educational meetings, using mixed interactive and didactic formats, and focusing on outcomes that are likely to be perceived as serious may increase the effectiveness of educational meetings. Educational meetings alone are not likely to be effective for changing complex behaviours.

1,579 citations


Journal ArticleDOI
TL;DR: The antioxidant defense systems, free radicals production and their role in cancer and age related diseases and also some of the recent patent relevant to the field are reviewed.
Abstract: Chronic inflammation is a pathological condition characterized by continued active inflammation response and tissue destruction. Many of the immune cells including macrophages, neutrophils and eosinophils are involved directly or by production of inflammatory cytokine production in pathology of chronic inflammation. From literatures, it is appear that there is a general concept that chronic inflammation can be a major cause of cancers and express aging processes. Moreover, many studies suggest that chronic inflammation could have serious role in wide variety of age-related diseases including diabetes, cardiovascular and autoimmune diseases. Inflammatory process induces oxidative stress and reduces cellular antioxidant capacity. Overproduced free radicals react with cell membrane fatty acids and proteins impairing their function permanently. In addition, free radicals can lead to mutation and DNA damage that can be a predisposing factor for cancer and age-related disorders. This article reviews the antioxidant defense systems, free radicals production and their role in cancer and age related diseases and also some of the recent patent relevant to the field. Study of the role of free radicals in human diseases can help the investigators to consider the antioxidants as proper agents in preventive medicine, especially for cancer and aging processes.

730 citations


Journal ArticleDOI
TL;DR: In this paper, the authors identify a gene that is mutated or deleted in autosomal recessive hyper-IgE syndrome and perform genome-wide single nucleotide polymorphism analysis to locate copy number variations and homozygous haplotypes.
Abstract: Background The genetic etiologies of the hyper-IgE syndromes are diverse. Approximately 60% to 70% of patients with hyper-IgE syndrome have dominant mutations in STAT3, and a single patient was reported to have a homozygous TYK2 mutation. In the remaining patients with hyper-IgE syndrome, the genetic etiology has not yet been identified. Objectives We aimed to identify a gene that is mutated or deleted in autosomal recessive hyper-IgE syndrome. Methods We performed genome-wide single nucleotide polymorphism analysis for 9 patients with autosomal-recessive hyper-IgE syndrome to locate copy number variations and homozygous haplotypes. Homozygosity mapping was performed with 12 patients from 7 additional families. The candidate gene was analyzed by genomic and cDNA sequencing to identify causative alleles in a total of 27 patients with autosomal-recessive hyper-IgE syndrome. Results Subtelomeric biallelic microdeletions were identified in 5 patients at the terminus of chromosome 9p. In all 5 patients, the deleted interval involved dedicator of cytokinesis 8 (DOCK8) , encoding a protein implicated in the regulation of the actin cytoskeleton. Sequencing of patients without large deletions revealed 16 patients from 9 unrelated families with distinct homozygous mutations in DOCK8 causing premature termination, frameshift, splice site disruption, and single exon deletions and microdeletions. DOCK8 deficiency was associated with impaired activation of CD4 + and CD8 + T cells. Conclusion Autosomal-recessive mutations in DOCK8 are responsible for many, although not all, cases of autosomal-recessive hyper-IgE syndrome. DOCK8 disruption is associated with a phenotype of severe cellular immunodeficiency characterized by susceptibility to viral infections, atopic eczema, defective T-cell activation and T h 17 cell differentiation, and impaired eosinophil homeostasis and dysregulation of IgE.

441 citations


Journal ArticleDOI
TL;DR: Overall, growing evidence suggests that hepatic insulin resistance is sufficient to induce several components of the metabolic syndrome and promote progression to cardiovascular disease.

392 citations


Journal ArticleDOI
TL;DR: The health and disease profile in Iran has made the transition from the dominance of communicable diseases to that of noncommunicable diseases and road traffic injuries.
Abstract: Background The objective of this study was to estimate the burden of disease and injury in Iran for the year 2003, using Disability-Adjusted Life Years (DALYs) at the national level and for six selected provinces.

381 citations


Journal ArticleDOI
TL;DR: The first national estimate on the prevalence of the metabolic syndrome and its components and the first ethnic-specific cutoff point for waist circumference in the Eastern Mediterranean Region are provided and can be used in the region.
Abstract: OBJECTIVE The purpose of this study was to provide the first national estimate on the prevalence of the metabolic syndrome and its components and the first ethnic-specific cutoff point for waist circumference in the Eastern Mediterranean Region. RESEARCH DESIGN AND METHODS This national survey was conducted in 2007 on 3,024 Iranians aged 25–64 years living in urban and rural areas of all 30 provinces in Iran. The metabolic syndrome was defined by different criteria, namely the definition of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), the International Diabetes Federation (IDF) criteria, and the modified definition of the NCEP/ATP III (ATP III/American Heart Association [AHA]/National Heart, Lung, and Blood Institute [NHLBI]). RESULTS The age-standardized prevalence of the metabolic syndrome was about 34.7% (95% CI 33.1–36.2) based on the ATP III criteria, 37.4% (35.9–39.0%) based on the IDF definition, and 41.6% (40.1–43.2%) based on the ATP III/AHA/NHLBI criteria. By all definitions, the prevalence of the metabolic syndrome was higher in women, in urban areas, and in the 55- to 64-year age-group compared with the prevalence in men, in rural areas, and in other age-groups, respectively. The metabolic syndrome was estimated to affect >11 million Iranians. The optimal cutoff point of waist circumference for predicting at least two other components of the metabolic syndrome as defined by the IDF was 89 cm for men and 91 cm for women. CONCLUSIONS The high prevalence of the metabolic syndrome with its considerable burden on the middle-aged population mandates the implementation of national policies for its prevention, notably by tackling obesity. The waist circumference cutoff points obtained can be used in the region.

354 citations


Journal ArticleDOI
TL;DR: Sixteen interrelated SNP subtypes were defined by genotyping both extant and extinct strains of M. leprae from around the world and showed a strong geographical association that reflects the migration patterns of early humans and trade routes, with the Silk Road linking Europe to China having contributed to the spread of leprosy.
Abstract: Reductive evolution and massive pseudogene formation have shaped the 3.31-Mb genome of Mycobacterium leprae, an unculturable obligate pathogen that causes leprosy in humans. The complete genome sequence of M. leprae strain Br4923 from Brazil was obtained by conventional methods (6x coverage), and Illumina resequencing technology was used to obtain the sequences of strains Thai53 (38x coverage) and NHDP63 (46x coverage) from Thailand and the United States, respectively. Whole-genome comparisons with the previously sequenced TN strain from India revealed that the four strains share 99.995% sequence identity and differ only in 215 polymorphic sites, mainly SNPs, and by 5 pseudogenes. Sixteen interrelated SNP subtypes were defined by genotyping both extant and extinct strains of M. leprae from around the world. The 16 SNP subtypes showed a strong geographical association that reflects the migration patterns of early humans and trade routes, with the Silk Road linking Europe to China having contributed to the spread of leprosy.

349 citations


Journal ArticleDOI
TL;DR: The results of this study suggest that celecoxib may be an effective adjuvant agent in the management of patients with major depression and anti‐inflammatory therapies should be further investigated.
Abstract: Background: The pathophysiology of depression is associated with the hyperactivity of immune inflammatory responses. Cyclooxygenase-2 inhibitors such as celecoxib reduce the production of pro-inflammatory cytokines. The purpose of the present investigation was to assess the efficacy of celecoxib as an adjuvant agent in the treatment of major depression in a six-week double blind and placebo controlled trial. Methods: Forty adult outpatients who met the DSM-IV-TR criteria for major depression participated in the trial. Patients have a baseline Hamilton Rating Scale for Depression score of at least 18. Patients were allocated in a random fashion: 20 to fluoxetine 40mg/day plus celecoxib 400mg/day (200mg bid) (morning and evening) and 20 to fluoxetine 40mg/ day plus placebo. Patients were assessed by a psychiatrist at baseline and after 1, 2, 4, and 6 weeks after the medication started. Results: Although both protocols significantly decreased the score of Hamilton Rating Scale for Depression over the trial period, the combination of fluoxetine and celecoxib showed a significant superiority over fluoxetine alone in the treatment of symptoms of major depression. There were no significant differences in the two groups in terms of observed side effects. Conclusion: The results of this study suggest that celecoxib may be an effective adjuvant agent in the management of patients with major depression and anti-inflammatory therapies should be further investigated. Depression and Anxiety 26:607–611, 2009. r 2009 Wiley-Liss, Inc.

344 citations


Journal ArticleDOI
TL;DR: Acne is a common disorder in Iranian adolescents, with a low rate of moderate to severe acne, and a genetic background is suggested, with mother's acne history being the most important prognostic factor.

337 citations


Journal ArticleDOI
TL;DR: A strikingly high prevalence of a number of chronic non-communicable diseases and their risk factors among Iranian adults is documented and urgent preventive interventions should be implemented to combat the growing public health problems in Iran.
Abstract: The burden of non-communicable diseases is rising globally. This trend seems to be faster in developing countries of the Middle East. In this study, we presented the latest prevalence rates of a number of important non-communicable diseases and their risk factors in the Iranian population. The results of this study are extracted from the third national Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007), conducted in 2007. A total of 5,287 Iranian citizens, aged 15–64 years, were included in this survey. Interviewer-administered questionnaires were applied to collect the data of participants including the demographics, diet, physical activity, smoking, history of hypertension, and history of diabetes. Anthropometric characteristics were measured and serum biochemistry profiles were determined on venous blood samples. Diabetes (fasting plasma glucose ≥ 126 mg/dl), hypertension (systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or use of anti-hypertensive drugs), dyslipidemia (hypertriglyceridemia: triglycerides ≥ 150 mg/dl, hypercholesterolemia: total cholesterol ≥ 200 mg/dl), obesity (body mass index ≥ 30 kg/m2), and central obesity (waist circumference ≥ 80 cm in females and ≥ 94 cm in males) were identified and the national prevalence rates were estimated. The prevalence of diabetes, hypertension, obesity, and central obesity was 8.7% (95%CI = 7.4–10.2%), 26.6% (95%CI = 24.4–28.9%), 22.3% (95%CI = 20.2–24.5%), and 53.6% (95%CI = 50.4–56.8%), respectively. The prevalence of hypertriglyceridemia and hypercholesterolemia was 36.4% (95%CI = 34.1–38.9%) and 42.9% (95%CI = 40.4–45.4%), respectively. All of the mentioned prevalence rates were higher among females (except hypertriglyceridemia) and urban residents. We documented a strikingly high prevalence of a number of chronic non-communicable diseases and their risk factors among Iranian adults. Urgent preventive interventions should be implemented to combat the growing public health problems in Iran.

334 citations


Journal ArticleDOI
TL;DR: Compounds containing ephedra, CQ, ginseng, bitter melon, and zingiber were found to be effective in the management of obesity.
Abstract: This review focuses on the efficacy and safety of effective herbal medicines in the management of obesity in humans and animals. PubMed, Scopus, Google Scholar, Web of Science, and IranMedex databases were searched up to December 30, 2008. The search terms were “obesity” and (“herbal medicine” or “plant”, “plant medicinal” or “medicine traditional”) without narrowing or limiting search elements. All of the human and animal studies on the effects of herbs with the key outcome of change in anthropometric measures such as body weight and waist-hip circumference, body fat, amount of food intake, and appetite were included. In vitro studies, reviews, and letters to editors were excluded. Of the publications identified in the initial database, 915 results were identified and reviewed, and a total of 77 studies were included (19 human and 58 animal studies). Studies with Cissus quadrangularis (CQ), Sambucus nigra, Asparagus officinalis, Garcinia atroviridis, ephedra and caffeine, Slimax (extract of several plants including Zingiber officinale and Bofutsushosan) showed a significant decrease in body weight. In 41 animal studies, significant weight loss or inhibition of weight gain was found. No significant adverse effects or mortality were observed except in studies with supplements containing ephedra, caffeine and Bofutsushosan. In conclusion, compounds containing ephedra, CQ, ginseng, bitter melon, and zingiber were found to be effective in the management of obesity. Attention to these natural compounds would open a new approach for novel therapeutic and more effective agents.

Journal Article
TL;DR: While interventions on modifiable environmental risk factors should be considered as the main modality to reduce gastric cancer development, surveillance programmes for early detection of cancer in highly selected groups may increase overall survival rates in potential patients in this country.
Abstract: Although the global incidence of gastric cancer has been decreased dramatically in recent decades, it is the most common cancer in north and northwest Iran. The wide variation in incidence across different geographical areas and higher proportion of cardia cancer are two main characteristics of gastric cancer in Iran. Current investigations indicate that a high prevalence of H.pylori infection, high dietary intake of salt and smoking are the main environmental factors of gastric cancer in Iran. Gastroesophageal reflux disease is another contributing factor in populations with a higher incidence of gastric cardia cancer. While interventions on modifiable environmental risk factors should be considered as the main modality to reduce gastric cancer development, surveillance programmes for early detection of cancer in highly selected groups may increase overall survival rates in potential patients in this country.

Journal ArticleDOI
27 Mar 2009-BMJ
TL;DR: Drinking hot tea, a habit common in Golestan province, was strongly associated with a higher risk of oesophageal cancer, and a strong agreement was found between responses to the questions on temperature at which tea was drunk and interval from tea being poured to being drunk.
Abstract: Objective To investigate the association between tea drinking habits in Golestan province, northern Iran, and risk of oesophageal squamous cell carcinoma. Design Population based case-control study. In addition, patterns of tea drinking and temperature at which tea was drunk were measured among healthy participants in a cohort study. Setting Golestan province, northern Iran, an area with a high incidence of oesophageal squamous cell carcinoma. Participants 300 histologically proved cases of oesophageal squamous cell carcinoma and 571 matched neighbourhood controls in the case-control study and 48 582 participants in the cohort study. Main outcome measure Odds ratio of oesophageal squamous cell carcinoma associated with drinking hot tea. Results Nearly all (98%) of the cohort participants drank black tea regularly, with a mean volume consumed of over one litre a day. 39.0% of participants drank their tea at temperatures less than 60°C, 38.9% at 60-64°C, and 22.0% at 65°C or higher. A moderate agreement was found between reported tea drinking temperature and actual temperature measurements (weighted κ 0.49). The results of the case-control study showed that compared with drinking lukewarm or warm tea, drinking hot tea (odds ratio 2.07, 95% confidence interval 1.28 to 3.35) or very hot tea (8.16, 3.93 to 16.9) was associated with an increased risk of oesophageal cancer. Likewise, compared with drinking tea four or more minutes after being poured, drinking tea 2-3 minutes after pouring (2.49, 1.62 to 3.83) or less than two minutes after pouring (5.41, 2.63 to 11.1) was associated with a significantly increased risk. A strong agreement was found between responses to the questions on temperature at which tea was drunk and interval from tea being poured to being drunk (weighted κ 0.68). Conclusion Drinking hot tea, a habit common in Golestan province, was strongly associated with a higher risk of oesophageal cancer. Reza Malekzadeh and other authors of this population based case-control study talk about the effect of tea drinking and oesophageal cancer in Golestan province, northern Iran

Journal ArticleDOI
TL;DR: Overall, the available results strongly suggest that high‐temperature beverage drinking increases the risk of EC.
Abstract: Coffee, tea and mate may cause esophageal cancer (EC) by causing thermal injury to the esophageal mucosa. If so, the risk of EC attributable to thermal injury could be large in populations in which these beverages are commonly consumed. In addition, these drinks may cause or prevent EC via their chemical constituents. Therefore, a large number of epidemiologic studies have investigated the association of an indicator of amount or temperature of use of these drinks or other hot foods and beverages with risk of EC. We conducted a systematic review of these studies and report the results for amount and temperature of use separately. By searching PubMed and the ISI, we found 59 eligible studies. For coffee and tea, there was little evidence for an association between amount of use and EC risk; however, the majority of studies showed an increased risk of EC associated with higher drinking temperature which was statistically significant in most of them. For mate drinking, the number of studies was limited, but they consistently showed that EC risk increased with both amount consumed and temperature, and these 2 were independent risk factors. For other hot foods and drinks, over half of the studies showed statistically significant increased risks of EC associated with higher temperature of intake. Overall, the available results strongly suggest that high-temperature beverage drinking increases the risk of EC. Future studies will require standardized strategies that allow for combining data and results should be reported by histological subtypes of EC.

Journal ArticleDOI
TL;DR: The findings suggest that the SF-12 is a reliable and valid measure of health related quality of life among Iranian population, however, further studies are needed to establish stronger psychometric properties for this alternative form of theSF-36 Health Survey in Iran.
Abstract: The 12-item Short Form Health Survey (SF-12) as a shorter alternative of the SF-36 is largely used in health outcomes surveys. The aim of this study was to validate the SF-12 in Iran. A random sample of the general population aged 15 years and over living in Tehran, Iran completed the SF-12. Reliability was estimated using internal consistency and validity was assessed using known groups comparison and convergent validity. In addition, the factor structure of the questionnaire was extracted by performing both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: In all, 5587 individuals were studied (2721 male and 2866 female). The mean age and formal education of the respondents were 35.1 (SD = 15.4) and 10.2 (SD = 4.4) years respectively. The results showed satisfactory internal consistency for both summary measures, that are the Physical Component Summary (PCS) and the Mental Component Summary (MCS); Cronbach's α for PCS-12 and MCS-12 was 0.73 and 0.72, respectively. Known-groups comparison showed that the SF-12 discriminated well between men and women and those who differed in age and educational status (P < 0.001). In addition, correlations between the SF-12 scales and single items showed that the physical functioning, role physical, bodily pain and general health subscales correlated higher with the PCS-12 score, while the vitality, social functioning, role emotional and mental health subscales more correlated with the MCS-12 score lending support to its good convergent validity. Finally the principal component analysis indicated a two-factor structure (physical and mental health) that jointly accounted for 57.8% of the variance. The confirmatory factory analysis also indicated a good fit to the data for the two-latent structure (physical and mental health). In general the findings suggest that the SF-12 is a reliable and valid measure of health related quality of life among Iranian population. However, further studies are needed to establish stronger psychometric properties for this alternative form of the SF-36 Health Survey in Iran.

Journal ArticleDOI
TL;DR: Patients with developmental dysplasia of the hip may present with acetabular rim overloading, labral hypertrophy, and tear, and patients with evidence of abnormal hip morphologies may not benefit from hip arthroscopy and isolated treatment of the labrum; in fact, the latter may accelerate the process of arthritis in some patients.
Abstract: Patients with developmental dysplasia of the hip may present with acetabular rim overloading, labral hypertrophy, and tear. Our hypothesis was that isolated arthroscopic treatment of labral tear is likely to fail in most patients. We investigated 34 patients who underwent at least one arthroscopy of the hip for labral tear. Developmental hip dysplasia or other morphologic abnormalities of the hip were confirmed in all patients. Arthroscopy failed to relieve pain in 24 patients. We observed accelerated arthritis in 14 patients and migration of the femoral head in 13 patients. Sixteen patients underwent further surgery (further surgeries included periacetabular osteotomy [6 patients], femoroacetabular osteoplasty [7 patients], and total hip arthroplasty [3 patients]). At the latest follow-up, all patients but one were pain-free. Patients with evidence of abnormal hip morphologies may not benefit from hip arthroscopy and isolated treatment of the labrum; in fact, the latter may accelerate the process of arthritis in some patients.

Journal ArticleDOI
TL;DR: In this paper, the authors present the historical development and various methods currently used for building dental appliances and show the many benefits which can be achieved by using this new technology in various branches of dentistry.
Abstract: Purpose – The goal of rapid mechanical prototyping is to be able to quickly fabricate complex‐shaped, 3D parts directly from computer‐aided design models. The key idea of this novel technology is based upon decomposition of 3D computer models data into thin cross‐sectional layers, followed by physically forming the layers and stacking them up; “layer by layer technique.” This new method of modeling has raised many attentions in dentistry especially in the field of surgery and implantology. The purpose of this review study is to represent the historical development and various methods currently used for building dental appliances. It is also aimed to show the many benefits which can be achieved by using this new technology in various branches of dentistry.Design/methodology/approach – The major existing resources, including unpublished data on the internet, were considered.Findings – Although, creating 3D objects in a layered fashion is an idea almost as old as human civilization but, this technology has o...

Journal ArticleDOI
TL;DR: Amongst these useful herbs, some like Cinnamon, Silybum marianum, Garlic, Nigella, and Echium seem potential targets of future effective drugs for diseases in which free radical damage play a pathogenical role.
Abstract: Objective: This review focuses on the medicinal plants growing and having history of folk medicine in Iran and found effective as anti free radical damage in animal or human. Design: Embase, Scopus, Pubmed, Web of Science, Google Scholar, IranMedex, and SID databases were searched up to 2 February 2008. The search terms were antioxidant or "lipid peroxidation" and "plant, medicinal plant, herb, traditional, natural or herbal medicine" limited to Iran. Studies that assessed effects on cell lines or isolated organs, fetal toxicity, and reviews or letters were excluded. Antioxidative effect and lipid peroxidation inhibition were the key outcomes. Results: Forty-six animal studies on the efficacy of medicinal plants were reviewed. Lipid peroxidation was reduced in different clinical circumstances by Ferula szovitsiana, Nigella sativa, Rosa damascene petal, Phlomis anisodonta, Rose- mary, Zataria multiflora Boiss, Saffron, Amirkabiria odorastissima mozaffarian, Ficus carica Linn., Ziziphora clinopoi- des, Carica papaya, Chichorium intybus, Turmer, Eugenol, Curcumin, and Pistacia vera L. Human studies showed that Cinnamomum zeylanicum and Echium amoenum Fisch & C.A. Mey reduce lipid peroxidation and improve total antioxi- dant power in healthy subjects. Improvement of blood lipid profile was shown by Silybum marianum, garlic, and wheat germ. Conclusion: Amongst these useful herbs, some like Cinnamon, Silybum marianum, Garlic, Nigella, and Echium seem po- tential targets of future effective drugs for diseases in which free radical damage play a pathogenical role.

Journal Article
TL;DR: It is concluded that evaluation of blood oxidative stress parameters can be useful for monitoring exposed people and Supplementing of people in exposure to OPs with potent antioxidants such as vitamin E and C is recommended.
Abstract: The aim of this article is to provide a brief review of the current status of our knowledge related to organophosphates (OPs) and oxidative stress. For this purpose, we performed a systematic review on the literatures using Pubmed and Scopus databases without date limitation. A total of 127 articles including 112 experimental and 15 human studies were found relevant and reviewed. Data were categorized according to experimental and clinical studies. Occurrence of cell membrane lipid peroxidation, alteration in the levels of total antioxidant capacity, total thiol molecules, and protective effects of natural and synthetic antioxidants against OP-induced histopathological and biochemical alterations are the most important evidences for involvement of oxidative stress in OP-induced toxicity. It is concluded that evaluation of blood oxidative stress parameters can be useful for monitoring exposed people. Supplementing of people in exposure to OPs with potent antioxidants such as vitamin E and C is recommended. Much human studies with higher sample size and better exclusion of biasing factors are still needed.

Journal ArticleDOI
TL;DR: It is found that various dimensions of SES, such as education, wealth and being married were all inversely related to OSCC, and the strongest inverse association was found with education.
Abstract: Background Cancer registries in the 1970s showed that parts of Golestan Province in Iran had the highest rate of oesophageal squamous cell carcinoma (OSCC) in the world. More recent studies have shown that while rates are still high, they are approximately half of what they were before, which might be attributable to improved socio-economic status (SES) and living conditions in this area. We examined a wide range of SES indicators to investigate the association between different SES components and risk of OSCC in the region. Methods Data were obtained from a population-based case–control study conducted between 2003 and 2007 with 300 histologically proven OSCC cases and 571 matched neighbourhood controls. We used conditional logistic regression to compare cases and controls for individual SES indicators, for a composite wealth score constructed using multiple correspondence analysis, and for factors obtained from factors analysis. Results We found that various dimensions of SES, such as education, wealth and being married were all inversely related to OSCC. The strongest inverse association was found with education. Compared with no education, the adjusted odds ratios (95% confidence intervals) for primary education and high school or beyond were 0.52 (0.27–0.98) and 0.20 (0.06–0.65), respectively. Conclusions The strong association of SES with OSCC after adjustment for known risk factors implies the presence of yet unidentified risk factors that are correlated with our SES measures; identification of these factors could be the target of future studies. Our results


Journal ArticleDOI
TL;DR: IgA-deficient patients with concomitant immune defects such as defects in specific antibody production have higher rates of recurrent infections and bronchiectasis, which necessitates more effective monitoring.
Abstract: IgA deficiency (IGAD) is the most common primary antibody deficiency. Although many affected individuals have no apparent symptom, selected patients suffer from recurrent mucosal infections, allergies, and autoimmune diseases. We aimed to investigate the clinical features in relation to immune function of Iranian patients with symptomatic IGAD. Thirty-seven patients (21 male and 16 female), aged 4–32 years, were evaluated in this study. Patients were followed for a total of 131 patient years with a mean follow-up of 3.5 years per patient. The most prevalent presentations were recurrent infections occurring in 27 subjects, followed by allergy in eight cases and autoimmunity in two patients. However, during the follow-up period, 35 patients developed infections in respiratory and gastrointestinal tracts, necessitating medical care. Apart from infections, allergy was the most frequent complaint (31 cases); the major features were asthma, atopic dermatitis, and allergic rhinoconjunctivitis. Autoimmune diseases were documented in ten cases; thyroiditis was the most common. In 31 patients who received unconjugated pneumococcal polyvalent vaccine, antibody response against polysaccharide antigen was measured before and 28 days after vaccination. One fourth of vaccinated patients were hyporesponsive to vaccine; four of these patients developed bronchiectasis. The patients with IGAD were classified into two groups: group 1 (14 cases) consisted of patients with IGAD and other associated immune defects, such as immunoglobulin G (IgG) subclass deficiency and defective specific antibody production. Group 2 (23 cases) had isolated IGAD without other immunological abnormalities. There was a significantly increased number of lower respiratory tract infections in group 1 compared with group 2 (P = 0.006). Moreover, four patients of group 1 had bronchiectasis whereas none of the patients in group 2 developed this complication (P = 0.015). Subclassification of IGAD regarding the existence of associated immune defects is useful in terms of morbidity and planning for medical care. IgA-deficient patients with concomitant immune defects such as defects in specific antibody production have higher rates of recurrent infections and bronchiectasis, which necessitates more effective monitoring.

Journal ArticleDOI
TL;DR: In this paper, the results of intravitreal bevacizumab (IVB) injection alone or in combination with IVT versus macular laser photocoagulation (MPC) as a primary treatment of diabetic macular edema (DME) were compared.

Journal ArticleDOI
TL;DR: Preschool children who watch more TV are fatter and are less active, and activity influences TEE, but despite TV viewing being linked to lower physical activity, the relation between TV viewing and fatness is not mediated by physical activity.

Journal ArticleDOI
TL;DR: In this article, the effect of such parameters as polymer ratio, CaCl2/Alginate ratio and N/P ratio on the particle size distribution and loading efficacy was studied.

Journal ArticleDOI
TL;DR: Yogurt containing two probiotic bacteria strains, L. acidophilus and B. lactis, had a cholesterol-lowering effect in hypercholesterolemic subjects.
Abstract: Background and Aims: Hypercholesterolemia is the most important risk factor for cardiovascular diseases. In this study, we compared the effect of consuming probiotic yogurt with tha

Journal Article
TL;DR: The data reported by the Tehran Cancer Registry provide information on the cancer profile in Tehran metropolitan area and clearly shows the breast and stomach, prostate, and tobacco-related cancers as major cancer in this population.
Abstract: Background: There are no population-based data available for cancer in Tehran, a city that includes almost 10% of the Iranian population. This is the first report of cancer incidence in Tehran from a population-based cancer registry for the period of 1998 – 2001. Methods: The cancer registry collects data on all new cases of cancer diagnosed in the resident population of Tehran metropolitan area. Data collection is active and trained abstractors visit close to 120 data sources comprising cancer diagnostic laboratories, secondary- and tertiarycare hospitals, and imaging centers to abstract cancer cases. Results: During the period of 1998 – 2001, a total of 34,318 eligible cases were abstracted of which 24% were identified just by death certificates. The overall age-standardized rates (ASR) (adjusted to the world population structure) were 163.0 per 100,000 males and 141.8 per 100,000 females. The most frequently reported malignancies in males were stomach cancer (ASR 19.8), followed by cancers of the prostate (ASR 15.6), lung (ASR 14.9), bladder (ASR 13.3), non-Hodgkin's lymphoma (ASR 7.1), and esophagus (ASR 6.8). In females, the most frequently reported malignancies were breast cancer (ASR 31.4), followed by cancers of the stomach (ASR 10.0), lung (ASR 7.0), ovary (ASR 6.8), and esophagus (ASR 5.3). Conclusion: The data reported by the Tehran Cancer Registry provide information on the cancer profile in Tehran metropolitan area. It clearly shows the breast and stomach, prostate, and tobacco-related cancers as major cancer in this population. The observed cancer rates indicate that Helicobacter pylori eradication, tobacco control measures, and early detection of breast cancer are of importance for cancer control in this population.

Journal ArticleDOI
TL;DR: A 17-year-old boy with l-2-OHGA who developed an anaplastic ependymoma during the course of this disease is presented and a literature review is presented to indicate a possible increased risk of brain tumors among patients with l -2-hydroxyglutaric aciduria.
Abstract: l-2-Hydroxyglutaric aciduria (l-2-OHGA) is a rare autosomal recessive inherited encephalopathy. This inborn error, characterized by psychomotor retardation, progressive ataxia and typical magnetic resonance imaging findings, presents in early infancy. To make a definitive diagnosis, an anomalous accumulation of l-2-hydroxyglutaric acid must be detected in body fluids. Here, we present a 17-year-old boy with l-2-OHGA who developed an anaplastic ependymoma during the course of this disease. We also present a literature review including seven other patients who developed malignant brain tumors during the course of l-2-OHGA. This correlation may indicate a possible increased risk of brain tumors among patients with l-2-hydroxyglutaric aciduria.

Journal ArticleDOI
TL;DR: Evidence is given that clinical parameters can predict for mutation and help prioritize gene testing to reduce costs in HNP, and such strategy is cost-saving in the practice of genetics-based personalized health care.
Abstract: Multiple genes and their variants that lend susceptibility to many diseases will play a major role in clinical routine. Genetics-based cost reduction strategies in diagnostic processes are important in the setting of multiple susceptibility genes for a single disease. Head and neck paraganglioma (HNP) is caused by germline mutations of at least three succinate dehydrogenase subunit genes ( SDHx ). Mutation analysis for all 3 costs ∼US$2,700 per patient. Genetic classification is essential for downstream management of the patient and preemptive management of family members. Utilizing HNP as a model, we wanted to determine predictors to prioritize the most heritable clinical presentations and which gene to begin testing in HNP presentations, to reduce costs of genetic screening. Patients were tested for SDHB, SDHC , and SDHD intragenic mutations and large deletions. Clinical parameters were analyzed as potential predictors for finding germline mutations. Cost reduction was calculated between prioritized gene testing compared with that for all genes. Of 598 patients, 30.6% had SDHx germline mutations: 34.4% in SDHB , 14.2% SDHC , and 51.4% SDHD . Predictors for an SDHx mutation are family history [odds ratio (OR), 37.9], previous pheochromocytoma (OR, 10.9), multiple HNP (OR, 10.6), age ≤40 years (OR, 4.0), and male gender (OR, 3.5). By screening only preselected cases and a stepwise approach, 60% cost reduction can be achieved, with 91.8% sensitivity and 94.5% negative predictive value. Our data give evidence that clinical parameters can predict for mutation and help prioritize gene testing to reduce costs in HNP. Such strategy is cost-saving in the practice of genetics-based personalized health care. [Cancer Res 2009;69(8):3650–6]

Journal ArticleDOI
TL;DR: Diabetes is an expensive medical problem in Iran and planning of national programmes for its control and prevention is necessary.
Abstract: Aim/hypothesis The aim of the study was to determine the annual healthcare expenditures of an individual with diabetes in Tehran, between March 2004 and March 2005.