Tehran University of Medical Sciences

About: Tehran University of Medical Sciences is a education organization based out in Tehran, Iran. It is known for research contribution in the topics: Population & Medicine. The organization has 35661 authors who have published 57234 publications receiving 878523 citations. The organization is also known as: TUMS.

Nursing staff shortages and job satisfaction in Iran: issues and challenges.

Abstract: In most countries, nurses are the largest group of health-care professionals that provide direct and indirect care to patients in a variety of health settings. The quality of care is strongly linked to their performance, and shortages of nursing staff cause suffering and diminished patient care. In 2008, it was estimated that there were 90 026 nurses in Iran, but health-care facilities need approximately 220 000 nurses in order to deliver optimal nursing care. This review article provides a detailed description of the nursing shortage and related factors in Iran. It is hoped that this will inform both Iranian and international policy-makers and administrators about the current situation in this country.

Gut-brain Axis and migraine headache: a comprehensive review.

Abstract: The terminology “gut-brain axis “points out a bidirectional relationship between the GI system and the central nervous system (CNS). To date, several researches have shown that migraine is associated with some gastrointestinal (GI) disorders such as Helicobacter pylori (HP) infection, irritable bowel syndrome (IBS), and celiac disease (CD). The present review article aims to discuss the direct and indirect evidence suggesting relationships between migraine and the gut-brain axis. However, the mechanisms explaining how the gut and the brain may interact in patients with migraine are not entirely clear. Studies suggest that this interaction seems to be influenced by multiple factors such as inflammatory mediators (IL-1β, IL-6, IL-8, and TNF-α), gut microbiota profile, neuropeptides and serotonin pathway, stress hormones and nutritional substances. Neuropeptides including CGRP, SP, VIP, NPY are thought to have antimicrobial impact on a variety of the gut bacterial strains and thus speculated to be involved in the bidirectional relationship between the gut and the brain. According to the current knowledge, migraine headache in patients harboring HP might be improved following the bacteria eradication. Migraineurs with long headache history and high headache frequency have a higher chance of being diagnosed with IBS. IBS and migraine share some similarities and can alter gut microflora composition and thereby may affect the gut-brain axis and inflammatory status. Migraine has been also associated with CD and the condition should be searched particularly in patients with migraine with occipital and parieto-occipital calcification at brain neuroimaging. In those patients, gluten-free diet can also be effective in reducing migraine frequency. It has also been proposed that migraine may be improved by dietary approaches with beneficial effects on gut microbiota and gut-brain axis including appropriate consumption of fiber per day, adhering to a low glycemic index diet, supplementation with vitamin D, omega-3 and probiotics as well as weight loss dietary plans for overweight and obese patients.

Impact of Lifestyle on Health

Abstract: Lifestyle is a way used by people, groups and nations and is formed in specific geographical, economic, political, cultural and religious text. Lifestyle is referred to the characteristics of inhabitants of a region in special time and place. It includes day to day behaviors and functions of individuals in job, activities, fun and diet. In recent decades, life style as an important factor of health is more interested by researchers. According to WHO, 60% of related factors to individual health and quality of life are correlated to lifestyle (1). Millions of people follow an unhealthy lifestyle. Hence, they encounter illness, disability and even death. Problems like metabolic diseases, joint and skeletal problems, cardio-vascular diseases, hypertension, overweight, violence and so on, can be caused by an unhealthy lifestyle. The relationship of lifestyle and health should be highly considered. Today, wide changes have occurred in life of all people. Malnutrition, unhealthy diet, smoking, alcohol consuming, drug abuse, stress and so on, are the presentations of unhealthy life style that they are used as dominant form of lifestyle. Besides, the lives of citizens face with new challenges. For instance, emerging new technologies within IT such as the internet and virtual communication networks, lead our world to a major challenge that threatens the physical and mental health of individuals. The challenge is the overuse and misuse of the technology. Therefore, according to the existing studies, it can be said that: lifestyle has a significant influence on physical and mental health of human being. There are different forms of such influences. Consanguinity in some ethnicity is a dominant form of life style that it leads to the genetic disorders. Reformation of this unhealthy life style is a preventing factor for decreasing the rate of genetic diseases (2). In some countries, the overuse of drugs is a major unhealthy life style. Iran is one of the 20 countries using the most medications. They prefer medication to other intervention. Furthermore, in 15–40% of cases they use medications about without prescription (3). Pain relievers, eye drops and antibiotics have the most usage in Iran. While self-medications such as antibiotics have a negative effect on the immune system, if the individual would be affected by infection, antibiotics will not be effective in treatment. Overall, 10 percent of those who are self-medicated will experience severe complications such as drug resistance. Sometimes drug allergy is so severe that it can cause death (4). Finally, variables of lifestyle that influence on health can be categorized in some items: Diet and Body Mass Index (BMI): Diet is the greatest factor in lifestyle and has a direct and positive relation with health. Poor diet and its consequences like obesity is the common healthy problem in urban societies. Unhealthy lifestyle can be measured by BMI. Urban lifestyle leads to the nutrition problems like using fast foods and poor foods, increasing problems like cardiovascular (5). Exercise: For treating general health problems, the exercise is included in life style (6). The continuous exercise along with a healthy diet increases the health. Some studies stress on the relation of active life style with happiness (7, 8). Sleep: One of the bases of healthy life is the sleep. Sleep cannot be apart from life. Sleep disorders have several social, psychological, economical and healthy consequences. Lifestyle may effect on sleep and sleep has a clear influence on mental and physical health (9). Sexual behavior: Normal sex relation is necessary in healthy life. Dysfunction of sex relation is the problem of most of societies and it has a significant effect on mental and physical health. It can be said that dysfunctional sex relation may result in various family problems or sex related illnesses like; AIDS Substance abuse: Addiction is considered as an unhealthy life style. Smoking and using other substance may result in various problems; cardiovascular disease, asthma, cancer, brain injury. According to the resent studies in Iran, 43% of females and 64% of males experience the use of hubble-bubble (10). A longitudinal study shows that 30% of people between 18–65 years old smoke cigarette permanently (11). Medication abuse: It is a common form of using medication in Iran and it is considered as an unhealthy life style. Unhealthy behaviors in using medication are as followed: self-treatment, sharing medication, using medications without prescription, prescribing too many drugs, prescribing the large number of each drug, unnecessary drugs, bad handwriting in prescription, disregard to the contradictory drugs, disregard to harmful effects of drugs, not explaining the effects of drugs. Application of modern technologies: Advanced technology facilitates the life of human beings. Misuse of technology may result in unpleasant consequences. For example, using of computer and other devices up to midnight, may effect on the pattern of sleep and it may disturb sleep. Addiction to use mobile phone is related to depression symptoms (12). Recreation: Leisure pass time is a sub factor of life style. Neglecting leisure can bring negative consequences. With disorganized planning and unhealthy leisure, people endanger their health. Study: Study is the exercise of soul. Placing study as a factor in lifestyle may lead to more physical and mental health. For example, prevalence of dementia, such as Alzheimer's disease is lowerin educated people. Study could slow process of dementia.

The extended clinical phenotype of 64 patients with dedicator of cytokinesis 8 deficiency.

Abstract: Background Mutations in dedicator of cytokinesis 8 (DOCK8) cause a combined immunodeficiency (CID) also classified as autosomal recessive (AR) hyper-IgE syndrome (HIES). Recognizing patients with CID/HIES is of clinical importance because of the difference in prognosis and management. Objectives We sought to define the clinical features that distinguish DOCK8 deficiency from other forms of HIES and CIDs, study the mutational spectrum of DOCK8 deficiency, and report on the frequency of specific clinical findings. Methods Eighty-two patients from 60 families with CID and the phenotype of AR-HIES with (64 patients) and without (18 patients) DOCK8 mutations were studied. Support vector machines were used to compare clinical data from 35 patients with DOCK8 deficiency with those from 10 patients with AR-HIES without a DOCK8 mutation and 64 patients with signal transducer and activator of transcription 3 (STAT3) mutations. Results DOCK8-deficient patients had median IgE levels of 5201 IU, high eosinophil levels of usually at least 800/μL (92% of patients), and low IgM levels (62%). About 20% of patients were lymphopenic, mainly because of low CD4 + and CD8 + T-cell counts. Fewer than half of the patients tested produced normal specific antibody responses to recall antigens. Bacterial (84%), viral (78%), and fungal (70%) infections were frequently observed. Skin abscesses (60%) and allergies (73%) were common clinical problems. In contrast to STAT3 deficiency, there were few pneumatoceles, bone fractures, and teething problems. Mortality was high (34%). A combination of 5 clinical features was helpful in distinguishing patients with DOCK8 mutations from those with STAT3 mutations. Conclusions DOCK8 deficiency is likely in patients with severe viral infections, allergies, and/or low IgM levels who have a diagnosis of HIES plus hypereosinophilia and upper respiratory tract infections in the absence of parenchymal lung abnormalities, retained primary teeth, and minimal trauma fractures.