Showing papers in "Archives of Iranian Medicine in 2012"

Intra-articular injection of autologous mesenchymal stem cells in six patients with knee osteoarthritis.

Abstract: Background: Osteoarthritis (OA) is a progressive disorder of the joints caused by gradual loss of articular cartilage, which naturally possesses a limited regenerative capacity. In the present study, the potential of intra-articular injection of mesenchymal stem cells (MSCs) has been evaluated in six osteoarthritic patients. Methods: Six female volunteers, average age of 54.56 years, with radiologic evidence of knee OA that required joint replacement surgery were selected for this study. About 50 ml bone marrow was aspirated from each patient and taken to the cell laboratory, where MSCs were isolated and characterized in terms of some surface markers. About 20-24×10 6 passaged-2 cells were prepared and tested for microbial contamination prior to intra-articular injection. Results: During a one-year follow-up period, we found no local or systemic adverse events. All patients were partly satiso ed with the results of the study. Pain, functional status of the knee, and walking distance tended to be improved up to six months post-injection, after which pain appeared to be slightly increased and patients’ walking abilities slightly decreased. Comparison of magnetic resonance images (MRI) at baseline and six months post-stem cell injection displayed an increase in cartilage thickness, extension of the repair tissue over the subchondral bone and a considerable decrease in the size of edematous subchondral patches in three out of six patients. Conclusion: The results indicated satisfactory effects of intra-articular injection of MSCs in patients with knee OA.

Reliability and Validity of the Modifiable Activity Questionnaire (MAQ) in an Iranian Urban Adult Population

Abstract: Background: The purpose of this study is to evaluate the validity and reliability of a Persian translation of the Modio able Activity Questionnaire (MAQ) in a sample of adults from Tehran, Iran. Methods: There were 48 adults (53.1% males) enrolled to test the physical activity questionnaire. A sub-sample included 33 participants (45.5% males) who assessed the reliability of the physical activity questionnaire.The validity was tested in 25 individuals (48.0% males). The reliability of two MAQs was calculated by intraclass correlation coefo cients. The validation study was evaluated with the Spearman correlation coefo cients to compare data between the means of 2 MAQs and the means of 4 physical activity records. Results: Intraclass correlation coefo cients between 2 MAQs for the previous year's leisure time was 0.94; for occupational, it was 0.98;and for total (leisure and occupational combined) physical activity, it was 0.97. The Spearman correlation coefo cients between the means of the 2 MAQs and means of the 4 physical activity records was 0.39 (P = 0.05) for leisure time, 0.36 (P = 0.07) for occupational, and 0.47 (P = 0.01) for total (leisure and occupational combined) physical activities. Conclusions: High reliability and relatively moderate validity were found for the Persian translated MAQ in adults from Tehran. However, further studies with larger sample sizes are suggested to more precisely assess the validity of the MAQ.

Cancer incidence in Golestan Province: report of an ongoing population-based cancer registry in Iran between 2004 and 2008.

Abstract: Background: Golestan Province, at the western end of the Asian esophageal cancer (EC) belt in northeastern Iran, was reported to have one of the highest worldwide rates of EC in the 1970s. We have previously shown a declining incidence of EC in Golestan during the last decades. This study reports additional new results from the Golestan Population-based Cancer Registry (GPCR). Methods: The GPCR collected data from newly diagnosed (incident) cancer cases from all 68 public and private diagnostic and therapeutic centers in Golestan Province. CanReg-4 software was used for data entry and analysis based on the guidelines of the International Agency for Research on Cancer (IARC). Age-standardized incidence rates (ASR) of cancers were calculated using the 2000 world standard population. Results: From 2004 through 2008, 9007 new cancer cases were reported to the GPCR. The mean (SD) age was 55.5 (18.6) years, and 54% were diagnosed in men. The ASRs of all cancers were 175.3 and 141.1 per 100,000 person-years for males and females, respectively. Cancers of the stomach (ASR:30.7), esophagus (24.3), and lung (15.4) were the most common cancers in males. In females, breast cancer (ASR:26.9) was followed by malignancies of the esophagus (19.1) and stomach (12.4). The diagnosis of cancer was based on histopathological reports in 71% and on death certificate only in 9% of cases. Conclusions: The EC incidence rate continues to decline in Golestan, while the incidence rates of stomach, colorectal, and breast cancers continue to increase.

Microbial Susceptibility, Virulence Factors, and Plasmid Profiles of Uropathogenic Escherichia coli Strains Isolated from Children in Jahrom, Iran

Abstract: Background: Urinary tract infections (UTIs), including cystitis and pyelonephritis, are the most common infectious diseases in childhood. Escherichia coli (E. coli) accounts for as much as 90% of the community-acquired and 50% of nosocomial UTIs. Therefore, identio cation of E. coli strains is important for both clinical and epidemiological implications. Understanding antibiotic resistance patterns and molecular characterization of plasmids and other genetic elements is also epidemiologically useful. Methods: To characterize uropathogenic strains of E. coli, we studied 96 E. coli strains recovered from urine samples of children aged 1 month to 14 years with community-acquired UTIs in Jahrom, Iran. We assessed virulence factors (VFs), drug sensitivities, and plasmid proo les. Results: Drug sensitivities of the isolates were: 19.8% (ampicillin), 24% (trimethoprim-sulfamethoxazole), 29.2% ( tetracycline), 75.5% (nalidixic acid), 80.4% (ceo xime), 84.6% (gentamicin), 91.4% (cipro? oxacin), 96.8% (nitrofurantoin), 96.8% (amikacin) and 100% (imipenem). Totally, 76 isolates harbored plasmids with an average of 5.5 plasmids (range: 1 – 10) in each strain. Plasmid proo ling distinguished 22 different E. coli genotypes in all isolates that ranged in similarity from 50% to 100%. PCR showed that the prevalence of virulence genes ranged from 15.62% for hly to 30.2% for pap. Conclusion: These data mandate local monitoring of drug resistance and its consideration in empirical therapy of E. coli infections. Plasmid analysis of representative E. coli isolates also demonstrates the presence of a wide range of plasmid sizes, with no consistent relationship between plasmid proo les and resistance phenotypes. Plasmid proo les distinguished more strains than did the antimicrobial susceptibility pattern.

Potential Protective Effect of Honey Against Paracetamol-induced Hepatotoxicity

Abstract: Background:�3DUDFHWDPRORYHUGRVHFDXVHVVHYHUHKHSDWRWR(LFLW\�WKDWOHDGVW ROLYHUIDLOXUHLQERWKKXPDQVDQGH(SHULPHQWDODQLPDOV�� 7KHSUHVHQWVWXG\�LQYHVWLJDWHVWKHSURWHFWLYHHIIHFWRIKRQH\�D JDLQVWSDUDFHWDPROLQGXFHGKHSDWRWR(LFLW\�LQ�:LVWDUDOELQRUDWV ��:HKDYH� used silymarin as a standard reference hepatoprotective drug. Methods:�+HSDWRSURWHFWLYHDFWLYLW\�ZDVDVVHVVHGE\�PHDVXULQJELRFKHPLFD OSDUDPHWHUVVXFKDVWKHOLYHUIXQFWLRQHQ)\PHV��VHUXP� DODQLQHDPLQRWUDQVIHUDVH��$/7��DQGVHUXPDVSDUWDWHDPLQRWUDQVIH UDVH��$67���(TXDOO\��FRPSDUDWLYHHIIHFWVRIKRQH\�RQR(LGDWLYH� VWUHVV�

Rise in cesarean section rate over a 30-year period in a public hospital in tehran, iran

Abstract: Background: Numerous studies show a growing trend in cesarean section rates throughout the world, including Iran. However, existing evidence in our country is scant and previous reports are restricted to short time periods. The aim of the current study is to measure the trend in cesarean sections (CS) rates over the past 30 years in a referral hospital in Tehran. Methods: We routinely collected data on the demographic characteristics of all women who gave birth in the hospital during the study period. The mode of delivery and the personnel in charge of delivery has like wise been recorded for each birth during the study period. The data were extracted from medical records and entered into a structured checklist. Results: The rate of CS out of all deliveries increased from 14.3% in 1979 to 22.7% in 1989, 52.5% in 1999, and 85.3% in 2009 (P < 0.001). The most common reason for CS was a repeated section. The percentage of vaginal deliveries performed by midwives has not changed signio cantly and the number of both midwives and obstetricians per 1000 births has increased, from 2.8 to 15.4 midwives per 1000 births and from 5.5 to 23.0 obstetricians per 1000 births. Conclusion: Immediate strategies should be adopted to prevent the rising trend and increasing number of unnecessary CS in Iran.

Confounding Variables in Epidemiologic Studies: Basics and Beyond

Abstract: This article discusses the importance, denition, and types of confounders in epidemiology. Methods to identify and address co nfounding are discussed, as well as their strengths and limitations. The article also describes the difference among confounders, mediators, and effect modiers.

Scaffold-free Adipose-derived Stem Cells (ASCs) Improve Experi- mentally Induced Osteoarthritis in Rabbits

Abstract: Background Osteoarthritis (OA) is the most common form of arthritis seen clinically. Current treatments for OA are limited to decreasing associated pain, maintaining or improving joint function, and minimizing disability. However, these treatments have no effect on the regeneration of hyaline cartilage. Since mesenchymal stem cells (MSCs) have been described as promising cell sources for cartilage repair, the present study was designed to examine whether intra-articular injection of scaffold-free adipose-derived stem cells (ASCs) obtained from subcutaneous adipose tissue could restore the matrix of arthritic knee joints in mature animals. Methods OA was induced in adult white New Zealand rabbits by unilateral anterior cruciate ligament transection (ACLT); the contralateral knee was considered the sham-operated group. At 12 weeks following surgery, the ASCs treated group was injected intra-articularly with a single dose of 1 × 10(6) cells suspended in 1 mL of medium. The control group received 1 mL of medium without cells and the sham-operated group received no treatment. All rabbits were sacrificed at 16 and 20 weeks after surgery. OA progression was evaluated radiologically, grossly, and histologically using hematoxylin and eosin, Safranin-O, and toluidine blue staining. Results At 12 weeks after surgery all knees subjected to ACLT showed radiological signs of OA. The findings showed significant differences in the quality of cartilage between ASCs-injected group compared to control group, particularly at 20 weeks after surgery. Conclusion This study suggests that ASCs obtained from subcutaneous adipose tissue could be a viable approach for treating OA.

Subjective sleep quality in urban population

Abstract: Background: Sleep disturbances are common among adult populations and can have a signicant effect on daytime activities. The aim of this study is to determine the prevalence of sleep problems and subjective sleep quality in the adult population of Tehran, Iran. Methods: From an urban community of Tehran, a random sample of 3400 adult men and women were selected by a cross-sectional design. Using the Persian version of the Pittsburgh Sleep Quality Index (PSQI), subjects were interviewed face-to-face. There were 3114 completed questionnaires returned and analyzed. Results: The mean age of the subjects was 43.57 (± SD 17.5) years. Overall 37% (95% CI: 35-39) of the population were categorized as poor sleepers. The PSQI > 5 showed 27% were males versus 35% among females. The global PSQI scores ranged from 4.20 ± 2.67 to 5.60 ± 3.74 for males and 5.03 ± 3.00 to 7.97 ± 4.31 for females by age groups. The difference across age groups for global PSQI score was signicant in females ( P < 0.01). Conclusion: The prevalence rate of sleep complaints in this population-based study was high. Females, older adults, widows and sepa- rated couple were the most important risk factors for sleep disturbances.

Xerostomia after radiotherapy and its effect on quality of life in head and neck cancer patients.

Abstract: Background: Xerostomia is one of the one complications following radiotherapy that can affect quality of life (QoL). This study aims to assess the severity of xerostomia in patients with head and neck cancers after radiotherapy and its effect on QoL. Methods: In this longitudinal prospective study, the severity of xerostomia and related QoL was assessed in 63 head and neck cancer patients who referred to the Radiotherapy Ward. Patients completed a xerostomia questionnaire (XQ) at the beginning, and 2, 4, and 6 weeks after treatment over a period of 6 months. Additionally, unstimulated saliva was collected using the spitting method at all 4 visits.

Musculoskeletal disorders and ergonomic hazards among Iranian physicians.

Abstract: BACKGROUND: The aim of this study was to determine the prevalence of musculoskeletal disorders (MSDs) and ergonomic hazards and their relationship among Iranian physicians who work in teaching hospitals. METHODS: A self-administered questionnaire was provided to 405 physicians in four teaching hospitals. The questionnaire had three major parts: the first part gathered individual and work-related data, the second was a modified version of the Standardized Nordic questionnaire for musculoskeletal symptoms, and the last part evaluated the duration of exposure to ergonomic hazards at work. RESULTS: Knee pain (19.8%) was the most common complaint among physicians, followed by low back (15.1%) and neck pain (9.8%). A total of 169 physicians (41.7%) reported symptoms in at least one part of their bodies. Prolonged sitting, standing, and neck flexion were the most common reported ergonomic hazards among participants. Multiple logistic regression analysis reported statistically significant associations for the outcomes of knee pain and symptoms in any part of the body with the work-related factors of years of employment and work hours per shift. CONCLUSION: The prevalence of musculoskeletal complaints among physicians was low, less than other health care workers, but similar to those reported in the general population. These musculoskeletal complaints were, however, associated with traditional work-related and ergonomic factors.

Fast food consumption in Iranian adults; dietary intake and cardiovascular risk factors: Tehran Lipid and Glucose Study.

Abstract: BACKGROUND: Although fast food consumption has drastically increased in Iran in recent years; there is a paucity of data in relation to the association between fast food consumption, dietary intake, and cardiovascular risk factors. This study aims to determine fast food consumption status among young and middle-aged Iranian adults, and to assess its impact on dietary intake and cardiovascular disease (CVD) risk factors. METHODS:This cross-sectional population-based study was conducted on 1944 young and middle-aged adults (840 men and 1104 women), who participated in the Tehran Lipid and Glucose Study (2006–2008). We collected dietary data by using a validated 168 item, semi-quantitative food frequency questionnaire. Total fast food consumption was calculated by summing up weekly consumption of the most commonly consumed fast foods in Iran. RESULTS: Mean consumption of fast food was 161g/week (95% CI: 147–175) for young adults and 108 g/week (95% CI: 101–115) for middle-aged adults. Mean dietary intakes of energy, fat, saturated fat, cholesterol, sodium, meat, and soft drinks increased significantly (P < 0.05), while carbohydrate and refined grain consumption decreased (P < 0.01) across tertiles of fast food in both age groups. In young adults, dietary energy density and protein intake increased significantly (P < 0.01) where as intake of non-starchy vegetables and carotenoids decreased (P < 0.05). In middle-aged adults dietary intakes of fiber, folate, calcium, and fruits significantly decreased across fast food tertiles (P < 0.05). After adjustment for confounders, there was an association between fast food consumption and body mass index (BMI; β = 0.104; P < 0.01) and waist circumference (WC; β= 0.083; P < 0.01) in young adults, and serum triglycerides (β = 0.072; P < 0.05), high density lipoprotein cholesterol (HDL-C; β = -0.051; P < 0.05), and atherogenic index of plasma (β = 0.056; P < 0.05) in middle-aged adults. CONCLUSION: The results show that increased consumption of fast foods is associated with poor dietary intake and some of the CVD risk factors in Iranian adults.

The association between diet quality indices and obesity: Tehran Lipid and Glucose Study.

Abstract: BACKGROUND: The aim of this study was to investigate the ability of diet quality indices in predicting obesity and abdominal obesity in a population in nutrition transition. METHODS: This study explored the association of the Mediterranean Diet Scale (MDS), Healthy Eating Index-2005 (HEI-2005), and Diet Quality Index-International (DQI-I) with body mass index (BMI) and waist circumference (WC) in a cross-sectional study after 6.7 years of follow-up in the Tehran Lipid and Glucose Study (TLGS) population. RESULTS: Out of 192 subjects who had BMI < 25kg/m2 and of 283 subjects who were free of abdominal obesity at baseline, 39.6% developed overweight and obesity and 43.1% developed abdominal obesity, respectively during 6.7 years of follow-up in the study population. In cross-sectional analysis, after adjusting for age, sex, energy intake, physical activity and smoking status, multivariate analysis of covariance did not show any significant results regarding the relation of the diet quality indices, BMI and WC. According to follow-up analysis, none of the indices had significant associations with BMI and WC after adjustments for confounders and baseline values of BMI and WC. CONCLUSION: Adherence to MDS, HEI-2005, and DQI-I could not predict BMI and WC in Iranian participants after 6.7 years of follow-up.

Antifungal Susceptibility of the Aspergillus Species by Etest and CLSI Reference Methods

Abstract: BACKGROUND: Because resistance to antifungal drugs is seen in patients, susceptibility testing of these drugs aids in choosing the appropriate drug and respective epidemiology. This study has investigated and compared susceptibility patterns of the Aspergillus specie sisolated from patients by the Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution (MD) assay and Etest method. METHODS: The minimum inhibitory concentrations (MICs) of various antifungal agents (amphotericin B, ketoconazole, itraconazole, and voriconazole) for 108 Aspergillus species isolated from patients were determined by CLSI M38-A broth MD and Etest. The isolates were obtained from clinical samples that included tissues, sputum, bronchoalveolar lavage, abdominal tap, and cerebrospinal fluid. RESULTS: As revealed by the MD method, 63.9% of the isolates were sensitive to amphotericin B and 36.1% were resistant.Etest revealed that 61.1% were sensitive to amphotericin B and 38.9% were resistant. As for ketoconazole, 108 isolates (100%) were shown to be sensitive through the MD method; while the Etest revealedan 88.9% sensitivity and 11.1% were resistant. All species were susceptible to voriconazole, according to both methods. The measure of agreement (Kappa Index) for these three drugs was satisfactory (≥0.6). According to the MD method, 69.4% of the species were susceptible to itraconazole, whereas 30.6% were not. For this drug, the Etest showed 86.1% susceptible and 13.9% resistant. CONCLUSION: Voriconazole was the most effective agent against isolates. Using RPMI agar, we found the Etest to behelpful, readily available, and easy to use for determining invitro susceptibilities of Aspergillus species to voriconazole, amphotericin B, ketoconazole, and itraconazole in the region of this study.

Surveillance of ventilator-associated pneumonia in a neonatal intensive care unit: characteristics, risk factors, and outcome

Abstract: BACKGROUND: This study determined the incidence, characteristics, risk factors, and outcomes of ventilator-associated pneumonia (VAP) in newborns hospitalized in a Neonatal Intensive Care Unit (NICU) in Tehran, Iran. METHODS: A prospective cohort study was carried out in the NICU of Mahdieh Hospital over a period of one year, from December 2008 to November 2009, on all neonates mechanically ventilated for more than 48 hours. VAP was diagnosed in accordance with the CDC definition of nosocomial pneumonias for patients younger than 12 months. Risk factors relevant to the development of VAP were studied. Multiple logistic and Cox regression analysis were performed to determine independent predictors for VAP and survival rate, respectively. RESULTS: There were 81 neonates enrolled. VAP occurred in 14 (17.3%), at a rate of 11.6/1000 days on the ventilator. Gram negative bacteria were the predominant etiologic agents. The most common bacterial isolates from the endotracheal aspirate were E. coli (21.4%), Klebsiella (21.4%), and Pseudomonas (14.1%). The only VAP predictor was sputum [odds ratio (OR) = 5.11, P = 0.02]. Mortality rate for VAP was 2/14 (14.3%). Duration of mechanical ventilation [hazard ratio (HR) = 0.96, P = 0.01], birth weight (HR = 0.81, P < 0.001), and purulent tracheal aspirate (HR = 0.25, P < 0.006) were independent predictors of overall survival. CONCLUSIONS: VAP occurs at a significant rate in mechanically ventilated newborns. Additional studies are needed to accurately determine the incidence and risk factors in order to develop effective preventive and therapeutic protocols.

Prevalence of Psychiatric Disorders in the General Population of Kashan, Iran

Abstract: Background: Mental health is one of the most important public health issues because of its major contribution in decreasing the global �������� ������ ������� �������������� �������������� �������������� �������������� ��������������� ���� ���� ������������������ ��������� ��������������� ���������������� �������������� ���� ����������� �������� ������ ��������������� ��������������!� �����"�����#�� ���� �������������� ���� ��������� $�%��&�����'���������� ���������������� �������������� ����� Heanszel tests. Results: The prevalence of mental disorders in Kashan was 29.2%. In women it was 35.5%, and in men, 21.2%. The most prevalent disorders were mood (9.3%) and anxiety disorders (4.7%). Among the 505 subjects with mental disorders based on clinical interviews, 162 (32.1%) suffered from mood disorders, 129 (25.6%) anxiety disorders, 21 (4.2%) psychotic disorders, 16 (3.4 %) neurologic disorders, 17 (3.4%) dissociative disorders, and 120 (23.7%) had other disorders. In this study, 7.8% of the subjects had more than one mental disorder. In the case of mood disorders, major depression (8.2%) was the most common; as for anxiety disorders, generalized anxiety disorder (7.2%) was the most prevalent. The prevalence was higher in people aged 56–65 (35.8%), widows (35.8%), the illiterate (42.8%), and the

Polycyclic aromatic hydrocarbons and esophageal squamous cell carcinoma.

Abstract: Esophageal cancer (EC) is the 8th most common cancer and the 6th most frequent cause of cancer mortality worldwide. Esophageal squamous cell carcinoma (ESCC) is the most common type of EC. Exposure to polycyclic aromatic hydrocarbons (PAHs) has been suggested as a risk factor for developing ESCC. In this paper we will review different aspects of the relationship between PAH exposure and ESCC. PAHs are a group of compounds that are formed by incomplete combustion of organic matter. Studies in humans have shown an association between PAH exposure and development of ESCC in many populations. The results of a recent case-control study in a high risk population in northeastern Iran showed a dramatic dose-response relationship between PAH content in non-tumor esophageal tissue (the target tissue for esophageal carcinogenesis) and ESCC case status, consistent with a causal role for PAH exposure in the pathogenesis of ESCC. Identifying the main sources of exposure to PAHs may be the first and most important step in designing appropriate PAH-reduction interventions for controlling ESCC, especially in high risk areas. Coal smoke and drinking mate have been suggested as important modifiable sources of PAH exposure in China and Brazil, respectively. But the primary source of exposure to PAHs in other high risk areas for ESCC, such as northeastern Iran, has not yet been identified. Thus, environmental studies to determining important sources of PAH exposure should be considered as a high priority in future research projects in these areas.

Pathogenesis and glycemic management of type 2 diabetes mellitus: a physiological approach

Abstract: Type 2 diabetes (T2DM) is an incompletely understood chronic, progressive multifactorial disease with insulin resistance and decreased β-cell function playing dominant roles in its genesis. The worldwide incidence of the disease is rapidly increasing to pandemic proportions. The increase in incidence of T2DM is attributable to changes in lifestyle, diet and obesity, but other causes remain to be defined. The disease is a major cause of early mortality due to atherosclerosis and cardiovascular disease (CVD), and is the leading cause of blindness, leg amputations, and chronic renal disease. Hyperglycemia inT2DM becomes manifest once insulin secretion is no longer adequate for the metabolic demands of the individual. The approach to glycemic management of the disease is increasingly based on understanding the underlying pathophysiology. Efforts to maintain and preserve β-cell function during the earlier phases of the disease may have important implications in prevention of subsequent complications of T2DM. Finally, the approach to glycemic management of the disease should be individualized by considering the psycho-socio-economic condition of each patient, and glycemic targets should reflect presence of comorbid conditions, age of the patient, the stage of their disease in terms of duration, presence of macro- and micro-vascular complications, and propensity for severe hypoglycemia.

Current status of liver transplantation.

Abstract: Liver transplantation (LTx) is the treatment of choice for patients with end-stage liver disease (ESLD). Improvement in outcomes (allograft and patient survival) has led to widespread use of LTx worldwide. However, new problems that include severe organ shortage, recurrence of primary disease, opportunistic infections, and development of de novo malignancies are the major problems affecting further implementation of LTx.

Evaluation of the efficacy of zinc sulfate in the prevention of chemotherapy-induced mucositis: a double-blind randomized clinical trial.

Abstract: Background Oral mucositis is a serious complication of chemotherapy that results in painful debilitating inflammation, necessitating the administration of analgesics. There is no cure for mucositis. Some studies have evaluated the effect of zinc sulfate on mucositis. The present study aims to evaluate the effect of oral zinc sulfate on prevention of mucositis, xerostomia, and pain induced by chemotherapy. Methods This double-blind, randomized controlled trial was carried out on 50 adult patients who underwent chemotherapy during 2008-2009. Patients were divided in two groups. Patients in the intervention group were administered three, 220 mg zinc sulfate capsules daily until the end of their chemotherapy treatment. Patients in the placebo group received three placebo capsules daily, which were similar in shape, taste, and color to the zinc sulfate capsules. Data were analyzed by SPSS version 17 software, using the independent samples t-test, Mann-Whitney U and Friedman tests. Results The incidence of grade 3 mucositis was lower in the zinc sulfate group. In the first follow up, grade 3 mucositis was detected in 10% of patients. In the placebo group, grade 3 mucositis was seen in 46.6% of patients. By the fourth follow up, grade 3 mucositis was detected in 3.33% of patients in the intervention group and in 20% of patient in the placebo group. At the end of the study there was no grade 3 mucositis detected in the zinc sulfate group, whereas there were 3.57% of patients in the placebo group with grade 3 mucositis. The results also showed that zinc sulfate decreased the effects of xerostomia and pain in patients under chemotherapy treatment. Conclusion It can be concluded that zinc sulfate might decrease the intensity of mucositis.

An epidemiologic study of animal bites in Ilam Province, Iran.

Abstract: BACKGROUND: In Iran, the number of stray dogs in cities and villages necessitates epidemiologic investigations. This study has undertaken an epidemiologic survey in Ilam, Iran with regard to animal bites during 1999-2009. METHODS: This was a cross-sectional descriptive study. The data due to animal bites was collected from patients and analyzed. RESULTS: The number of animal bites reported was 4420, which included 3032 men (68.3) and 398 women (31.7). Most animal bites were reported in the 10-19 year-old (1172, 26) age group. The feet were the most commonly attacked body part, which was reported in 3177 cases (71.8). Most bites were from dogs (3942 cases, 89.15). Of cases, 3419 (77.3) resided in rural areas while 1001 (22.7) were urban residents. The number of patients with incomplete vaccinations was 3596 (81.3) compared to 824 (18.7) completely vaccinated patients. CONCLUSION: The present study showed a high incidence of animal bites in Ilam, which necessitates the importance of rabies prevention and control. It is recommended that the sanitation authorities provide for and implement measures to determine beneficial ways to avoid and control rabies infection in this part of Iran. © 2009 by Academy of Medical Sciences of the I.R. Iran.

Effects of soy on metabolic biomarkers of cardiovascular disease in elderly women with metabolic syndrome.

Abstract: BACKGROUND: This study ascertained the effects of soy, in the forms of textured soy protein (TSP) and soy nuts, on lipid profiles, apolipoproteins, inflammatory and prothrombotic markers, and blood pressure in elderly women diagnosed with metabolic syndrome (MetS). METHODS: This was a 12-week parallel, randomized, controlled trial conducted in rural health centers of Babol, Iran. Participants were 75 women, ages 60–70 years, who were diagnosed with MetS. Subjects were randomized to one of the following 3 groups: i) soy nut (35g/d), ii) TSP (35g/d), and iii) control. Blood biochemical markers measured at baseline and at the end of the study included: triglycerides (TG), cholesterol, HDL-C, LDL-C, VLDL-C, ApoB100, ApoAI, C-reactive protein (CRP), and fibrinogen. RESULTS: Soy nuts significantly improved LDL-C, VLDL-C, and ApoB100levels (P < 0.05), while fewer, significant improvements were observed in these variables in the TSP group compared to mean changes from baseline (P < 0.001). Similar results were found for ApoAI in the treatment groups (P < 0.01). Serum total cholesterol (TC) decreased significantly in the treatment groups compared with the control group (P < 0.005). Differences from the control group in terms of TG, HDL-C, fibrinogen, CRP, and blood pressure were not significant. CONCLUSION: Both forms of soy improved lipid profiles. The group that consumed soy nuts had greater improvement than the TSP group. Therefore, moderate daily intake of soy may be a safe, inexpensive, and practical method to improve the risk of cardiovascular disease (CVD) and reduce the need for medical treatment. IRCT ID: IRCT 138804212130N1

Trends in Change of Mental Health Status in the Population of Tehran between 1998 and 2007

Abstract: Introduction: According to a WHO report, the world will face great changes in the epidemiology of diseases in next three decades. Infectious and communicable diseases will be replaced by mental disorders at an alarming rate (9), making psychiatric disorders the most common cause of disability and premature death. This study compares trends and changes in the mental health of the residents of Tehran

Suicide epidemiology and characteristics among young Iranians at poison ward, Loghman-Hakim Hospital (1997-2007).

Abstract: Background: Suicide is a critical public health problem. In developing countries, the highest suicide rate is found in young adults with remarkable increasing rate. In this study, we have evaluated the epidemiology and characteristics of 8–16-year-old individuals who attempted suicide and were hospitalized in Loghman-Hakim Hospital, Tehran, Iran from 1997 to 2007. Methods: A total of 6414 hospitalized patients, ages 8–16, who attempted suicide and were residents of Loghman-Hakim Hospital were investigated. We performed a retrospective chart review to study the characteristics of cases in a 10-year period by review of psychiatric and medical records. Results: Out of 6414 patients 22.6% were male, 5978 patients were 12–16 years old and the rest were aged 8–12 years. During the 10

Nasopharyngeal carrier rate of Streptococcus pneumoniae in children: serotype distribution and antimicrobial resistance.

Abstract: BACKGROUND:This study aimed to define the nasopharyngeal carrier rates, serotype distribution, and antimicrobial resistance patterns of Streptococcus pneumoniae in healthy children less than ten years-old in Tehran. METHODS: This was a cross-sectional study conducted from November 2008 until January 2009. Nasopharyngeal specimens were collected by trained investigators from 1300 healthy children recruited from 20 randomly selected day care centers and 50 elementary schools in Tehran and inoculated into blood agar. Positive cultures that grew alpha-hemolytic colonies were gram-stained and serotypes of the isolates identified by the Quellung reaction. All isolated pneumococci were tested for sensitivity to different antibiotics by the disc diffusion method. RESULTS: The carrier rate for Streptococcus pneumoniae was 44.1%. Serotypes 19, 6, 14, 17, 20, 23, and 21 were most common, found in decreasing order from 11.9% to 6.1%. Only 38.56% of isolates belonged to strains covered by the heptavalent pneumococcal vaccine. Most (69.4%) were resistant to one or more antimicrobial agents: tetracycline (69.85%), clarithromycin (57.2%), azithromycin (54.9%), co-trimoxazole (11.8%), penicillin (9.2%), and vancomycin (1.5%). All isolates were sensitive to rifampin and meropenem. CONCLUSION: This study has revealed the nasopharyngeal carrier rate, serotype distribution and antibiotic sensitivities of Streptococcus pneumoniae strains in children from Tehran. Our findings may have implications on the type and efficacy of pneumococcal conjugate vaccines that should be used for prevention of pneumococcal invasive disease in Iranian children.

High Prevalence of Hepatitis C Infection among High Risk Groups in Kohgiloyeh and Boyerahmad Province, Southwest Iran

Abstract: Background: Detection of Hepatitis C virus (HCV)-infected people in each community assists with infection prevention and control. This study aims to evaluate the prevalence of HCV infection among high risk groups in Kohgiloyeh and Boyerahmad Province, Southwest Iran. Methods: This was a cross-sectional study conducted from 2009-2010 in Kohgiloyeh and Boyerahmad Province. High risk groups for HCV were the subjects of this study. Blood samples were taken from 2009 individuals at high risk for HCV that included inmates, injecting drug users (IDUs), health care workers, patients on maintenance hemodialysis, hemophilic patients, and those with histories of blood transfusions. Patients were residents of Yasuj, Gachsaran, and Dehdasht (3 main townships in the province). Samples were analyzed by ELISA for antiHCV antibodies. Demographic features of participants were recorded by a questionnaire during sample collection. Data were analyzed by SPSS version 13 software. Results: Of 2009 subjects, HCV antibodies were detected in 172 (8.6%). Rate of infection was higher in males (11.4%) compared to females (3.2%). Rate of infection in inmates was 11.7% while this rate was 42.4% in IDUs, 4.2% in health care workers, and 6.1% in thalassemic patients. Signio cant correlation was found between HCV infection, history of imprisonment, and thalassemia. Conclusion: Results of this study have provided epidemiologic features of HCV and its risk factors in Kohgiloyeh and Boyerahmad Province, Southwest Iran. This information may assist in preventing the spread of HCV infection in this and other similar settings in the region. The o ndings of this study may help in improving surveillance and infection control in the community through management and monitoring of infected individuals.

Inflammation in sporadic colorectal cancer.

Abstract: Chronic in? ammation plays a pivotal role in the development of colorectal cancer (CRC) in patients with in? ammatory bowel disease (IBD). An orchestrated interplay of immune cells with numerous in? ammatory mediators including reactive oxygen and nitrogen species, cyclooxygenase 2, and several cytokines promotes colitis-associated cancer (CAC). Recent o ndings have shown that in? ammatory pathways not only are important in the development of CAC but are also involved in the pathogenesis of sporadic CRC. Hereby, we review the existing experimental and clinical evidence that suggest a link between in? ammation and tumorigenesis in sporadic CRC.

Epidemiology of four main nosocomial infections in Iran during March 2007 - March 2008 based on the findings of a routine surveillance system.

Abstract: BACKGROUND: Annually, around six million patients are admitted to hospitals in Iran. Information about the prevalence of nosocomial infections (NIs) is necessary for both appropriate management and establishment of preventative measures in hospitals. This article is based on the findings of the Nosocomial Infection Surveillance System (NISS) which has been providing information on NIs in Iran since March 2007. METHODS: NISS covers 95 hospitals throughout Iran, each with over 200 beds. There are four main infections: urinary tract infection (UTI), surgical site infection (SSI), bloodstream infection (BSI) and pneumonia (PNEU) included in NISS. Reports are completed on forms that have been provided based on national guidelines. In all selected hospitals there is one designated nurse who conducts infection control activities and is trained in the detection and reporting of NIs based on NISS guidelines. RESULTS: During March 2007 – March 2008, a total of 1,879,356 patients were admitted to the selected hospitals. The total detected NIs were 10557 with a prevalence of 0.57%. Of these, UTI was the most prevalent infection (32.2%) and BSI was the least (16.3%). Based on gender, females had more UTI, whereas PNEU was the highest in males. Of reported NIs, 9% were detected in children less than five years of age and included BSI (45%), PNEU (20%), SSI (19%) and UTI (16%). There were 26% reported NIs in the age group over 65 years, of which the most prevalent infections were UTI (42%) followed by PNEU (31%), SSI (15%) and BSI (12%). NIs were most often detected in intensive care units (ICUs; 26.7%), followed by surgery wards (12.8%). CONCLUSION: In comparison with other studies and the World Health Organization (WHO) estimates, the rate of NIs appears to be less according to NISS. NISS has the capability to provide basic information for efficient management and control measures, in addition to indicating variations in NIs based on gender, age and location (hospital ward). In order to have a more realistic estimate of NIs and strengthen NISS, it is advisable to conduct a point prevalence study.

Elevated serum visfatin levels in patients with acute myocardial infarction.

Abstract: Background Visfatin, a novel adiopocytokine, has been proven to be a proinflammatory mediator involved in the process of atherosclerosis. Visfatin has been shown to play a role in plaque destabilization as it is found abundantly in foam cell macrophages within unstable atherosclerotic plaques. The present study is designed to investigate the potential association between serum vistafin levels and the risk of acute myocardial infarction (AMI). Methods There were 72 patients (mean age: 61.57 ± 11.40 years) as cases who presented with first-time AMI that were assessed 8 hours after the incident. The control group consisted of 83 healthy volunteers (mean age: 60.30 ± 8.32 years). Plasma visfatin levels were measured using enzyme immunoassay in both groups. Biochemical parameters were analyzed. Blood pressure, body mass index (BMI), waist circumference, diabetes, and hypertension were recorded. Results Serum visfatin levels were significantly higher in patients with AMI (12.77 ± 8.06 ng/ml) compared to controls (6.57 ± 2.96 ng/ml, P ≤ 0.001). We found that a visfatin level > 7.244 ng/ml (log visfatin > 0.86) had a sensitivity of 70% and a specificity of 75% for predicting AMI. Conclusion We have detected high levels of visfatin in patients with AMI. It can be concluded that proinflammatory cytokines such as visfatin may play a role in the development of atherosclerosis as well as destabilization of the atherosclerotic plaque.