Photocatalytic removal of toxic dyes, liquorice and tetracycline wastewaters by a mesoporous photocatalyst under irradiation of different lamps and sunlight

Simple recyclable K₅CoW₁₂O₄₀/TiO₂ was synthesized and used to remove methyl orange, rhodamine B, direct red 16 and crystal violet toxic organic dyes, liquorice industrial wastewater and tetracycline (TC) as an antibiotic. Photoactivity of the catalyst was checked out under irradiation of various lamps (such as 18 W fluorescent, 300 W Xenon, LED and IR lamps). The best efficiency was obtained by fluorescent lamp at catalyst loading of 3 g/L, initial pH of 5, initial dye concentration of 5 ppm, complete degradation was achieved after 30 min contact time. Mechanistic investigation showed that·O₂ radicals and h⁺ are majorly responsible for photodegradation in this process. Electrochemical investigation, Nyquist, Bode, Mott-Schottky, Tauc plots and photoluminescence proved that using this photocatalyst delay the electron-hole recombination, increase the lifetime of excited electron, extend light absorption to visible region and improve the light absorption capacity. This photocatalyst work well under winter sunlight. Also 97% and 84% dye removal was obtained for liquorice with 300 and 1000 COD at optimal condition. This catalyst showed similar activity for TC wastewater. Photocatalyst was characterized by FE-SEM, EDX, AFM, FT-IR, XRD, PL, DRS, EIS, BJH and BET.

Vitamin C ameliorates the adverse effects of dexamethasone on sperm motility, testosterone level, and spermatogenesis indexes in mice

BACKGROUND:

Dexamethasone (DEX) is a common medicine that is capable of causing malformation in the male reproductive system. The aim of this study was to investigate the effect of vitamin C (Vit-C) on spermatogenesis indexes and daily sperm production (DSP) in adult mice treated with DEX.

METHODS:

Male Naval Medical Research Institute (NMRI) mice were divided into four groups: Control, DEX (7 mg/kg/day), Vit-C (100 mg/kg/day), and DEX +Vit-C and treated for 7 days with intraperitoneal injection.

RESULTS:

A significant increase in the mean levels of serum and tissue malondialdehyde (MDA) and apoptosis of Leydig cells was found in the DEX group compared to the control group. Sperm motility, DSP, tubular differentiation index, meiotic index, spermatogenesis index, the mean number of spermatocytes, round and long spermatids, and Leydig cells, and also serum testosterone level decreased in the DEX group compared to the control group. The results of this study indicate that Vit-C can significantly prevent the adverse effects of DEX on the mean number of spermatocyte, spermatid, and Leydig cells, tubular differentiation, meiotic and spermatogenesis index, DSP, sperm motility, and the mean levels of serum MDA.

CONCLUSION:

In conclusion, our results showed that coadministration of Vit-C and DEX prevents the adverse effects of DEX on the spermatogenesis indexes and DSP.

Molecular epidemiology of environmental Cryptococcus species isolates based on amplified fragment length polymorphism

OBJECTIVE

Cryptococcosis is a major opportunistic fungal infection caused by members of the genus Cryptococcus, mainly those belonging to the Cryptococcus neoformans/Cryptococcus gattii species complexes. Here, we report a comprehensive molecular epidemiological study of the environmental distribution of Cryptococcus isolates in Shiraz, Iran with review of litreature.

METHOD

A total of 406 samples were obtained from Eucalyptus trees and 139 samples from pigeon droppings. Cryptococcus species identification and genotyping were performed by amplified fragment length polymorphism (AFLP) fingerprinting sequencing and sequencing of the ITS rDNA region.

RESULTS

Majority of the isolates belonged to the Naganishia taxon (n=69) including N. albida (formerly C. albidus, n=62), N. globosa (formerly C. saitoi, n=4), N. adeliensis (formerly C. adeliensis, n=2), N. diffluens (formerly C. diffluens, n=1), and the identified C. neoformans isolates (n=25) belonged to genotype AFLP1/VNI (n=22) and AFLP1B/VNII (n=3).

CONCLUSION

More research efforts should be employed to isolate C. gattii species complex from environmental niches in Iran and provide additional evidence related to novel molecular types.

Regulatory effects of the novel synthesized Indole-3-carbaldehyde on expression of cell cycle genes: A study on Cyclin D and P21 expression by acute promylocytic leukemia cell line (NB4)

This article has been withdrawn. The Publisher and the editor apologize for any inconvenience this may cause.

Prevalence and risk factors of alcohol and substance abuse among motorcycle drivers in Fars province, Iran

PURPOSE

The aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.

METHODS

This is a cross sectional study which is performed at Shiraz city of Iran. Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the day. The data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.

RESULTS

A total of 414 drivers with a mean ± SD age of (27.0 ± 9.3) years participated in the study. Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving, poor maneuvering, and driving over the speed limit (both p < 0.001). It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p=0.008).

CONCLUSION

Screening for alcohol and substance consumption among motorcycle drivers is an efficient way to identify drivers that are at a greater risk for road traffic accidents.

New Species of the Genus Eryngyothrips (Thysanoptera, Thripidae) from Iran

A new thrips species, Eryngyothrips veisii sp. n. (Thripidae, Thripinae) is described and illustrated based on individual specimens collected from Choqasabz Forest Park (Ilam Province), western Iran. This new species is most similar to E. discolor Bhatti, but is readily distinguished from the latter by divided ferna, prothorax color yellowish brown, absence of metanotal campaniform sensilla, and the longest postocular setae pair III.

The prevalence and effective factors of crash helmet usage among motorcyclists in Iran

Background:

Crash helmet plays an important role in protecting the deriver's head during crashes and reduces the rate of severe injuries and fatalities. Although it has been proved that wearing the crash helmet can save the deriver’s life by around 42%; previous studies showed that the rate of wearing crash helmet has not been acceptable in Iran. Due to the huge number of motorcyclists on the roads in Iran, the use of crash helmet is an important area of research. The aim of this study was to assess the factors that could possibly relate to or affect the use of crash helmet by the motorcyclists.

Methods:

This is an observational study on 414 motorcyclists in Shiraz, Southern Iran. All participants completed a questioner containing demographic features, crash helmet use, motorcycle license, and the reasons for using motorcycles.

Results:

All the participants were males and aged from16 to 64 years with mean age 27±9.28. The results of logistic regression model revealed that only the drivers who had motorcycle license (OR=2.73, C.I: 1.40-7.24), employed the motorcycle for reasons other than pleasure (OR=3.18, C.I: 1.42-7.37) and been driving for 10 or more years (OR=1.92 95% C.I: 1.12-3.30) had greater rate of wearing crash helmet. Interestingly, educational levels, age, and other demographical variables had no relationship with crash helmet usage.

Conclusions:

It is believed that in order to increase the rate of crash helmet use, it is necessary to enact obligatory requirement for driving license by motorcyclists and increase the legal age for motorcycle driving.

The Prevalence of Substance use and Associated Risk Factors Among University Students in the City of Jahrom, Southern Iran

Background:

Substance use among college students in Iran is a serious problem. Determining the pattern of substance use among University students is an important issue for implementing prevention and treatment programs.

Objectives:

The present survey attempts to determine the prevalence of substance usage and associated risk factors among the students of Jahrom University of Medical Sciences and Islamic Azad University of Jahrom, Jahrom, Iran.

Patients and Methods:

This cross-sectional study was carried out from December 2012 to February 2013 and included 1149 randomly selected students of two Jahrom universities. A standard questionnaire was used for data gathering. Data were analyzed using the SPSS version 15 for Windows. T-test and Chi-square T-test and Chi-square and Logestic regression tests were used for data analysis.

Results:

Tobacco (28.3%), alcohol (13.0%), and cannabis and marijuana (5.2%) were the most common substances used by the students. The prevalence of substance use among the male students was significantly higher (OR: 1.5, 95%CI: 1.42 - 2.68, P < 0.001). The risk of at least single episode of substance usage was higher among the students which were living alone (OR: 3.03, 95%CI: 1.74 - 5.28, P < 0.001) The most important motivators for beginning substance use were curiosity, in 46.4%, and seeking pleasure, in 28.8%.

Conclusions:

Substance usage is considered as a risk factor for students’ health among University students in Iran. Design of educational courses addressing the detrimental effects and dire consequences of substance usage could help to improve control programs. Universities could improve their drug abuse control programs by focusing on the high risk groups determined by relevant studies.

Stroke specific quality of life questionnaire: Test of reliability and validity of the Persian version

BACKGROUND

The aim was to assess the reliability and the validity of the translated version of the stroke specific quality of life (SS-QOL) questionnaire in Iranian post-stroke patients.

METHODS

This project was performed at the Shiraz University of Medical Sciences, Shiraz, Iran, between 12 April 2010 and 24 February 2011. The English version of the SS-QOL was translated into Persian by "forward-backward" translation, cognitive inquiring and cultural adaptation process. The reliability and internal consistency were measured by Cronbach's alpha coefficient. Validity was assessed using convergent and divergent validity through Spearman's correlation coefficient.

RESULTS

Our study included 117 post-stroke patients, consisting of 57 (48.7%) men and 60 (51.3%) women. The mean age of the patients was 81.60 ± 7.52 (range 60-88) years. The Persian version of the SS-QOL proved reliable (Cronbach's α = 0.96). Internal consistency was excellent for both demographic and patients' clinical characteristics (Cronbach's α ≥ 0.70). The scaling success rates were 100% for convergent validity of each scale. Divergent validity for all 12 scales was considered acceptable, whereas each scale had a 100% scaling success rate for convergent validity.

CONCLUSION

The Persian version of SS-QOL should be mentioned as a noteworthy instrument to specify different aspects of health related QOL of patients suffering stroke and hence that clinicians, researchers and epidemiologist can exploit it trustfully.

Chorionic morphine, naltrexone and pentoxifylline effect on hypophyso-gonadal hormones of male rats

BACKGROUND

Knowledge about harmful effects of morphine on hormone secretion seems to be necessary. The aim of the present study was to evaluate the effect of pentoxifylline on side effects derived by morphine on hypophyso-gonadal hormones of male rats.

METHODS

32 male rats were divided into the 4 groups of OSS: control (received 40 g Sucrose/l drinking water and intraperitoneal injection of 1 l/kg normal saline), OMS: morphine group (received 0.4 mg/l + 40 g Sucrose/l in drinking water and intraperitoneal injection of 1 l/kg normal saline), NMS: morphine+naltrexane group (received 0.4 mg/l + 40 g Sucrose/l in drinking water and IP injection dose of 10 mg/kg/ml/day Naltrexane) and PMS: morphine + pentoxifylline group (received 0.4 mg/dl + 40 g Sucrose/l in drinking water and IP injection dose of 12 mg/kg/ml/day Pentoxifylline) for 56 days, respectively.

RESULTS

Serum levels of testosterone, LH, FSH hormones were measured. Pentoxifylline increased serum levels of testosterone, LH, FSH hormones compared to control, morphine and morphine-naltrexane groups.

CONCLUSION

Pentoxifylline has a significant efficacy for increasing serum levels of sexual hormones. Considering that Pentoxifylline is safe and cheap, with easy application, we suggest for the usage of this drug for improving semen parameter's quality before performing ART for the treatment of morphine addicts (Fig. 1, Ref. 31).

Hi-Plex targeted sequencing is effective using DNA derived from archival dried blood spots

Many genetic epidemiology resources have collected dried blood spots (predominantly as Guthrie Cards) as an economical and efficient means of archiving sources of DNA, conferring great value to genetic screening methods that are compatible with this medium. We applied Hi-Plex to screen the breast cancer predisposition gene PALB2 in 93 Guthrie Card-derived DNA specimens previously characterized for PALB2 genetic variants via DNA derived from lymphoblastoid cell lines, whole blood, and buffy coat. Of the 93 archival Guthrie Card-derived DNAs, 92 (99%) were processed successfully and sequenced using approximately half of a MiSeq run. From these 92 DNAs, all 59 known variants were detected and no false-positive variant calls were yielded. Fully 98.13% of amplicons (5417/5520) were represented within 15-fold of the median coverage (2786 reads), and 99.98% of amplicons (5519/5520) were represented at a depth of 10 read-pairs or greater. With Hi-Plex, we show for the first time that a High-Plex amplicon-based massively parallel sequencing (MPS) system can be applied effectively to DNA prepared from dried blood spot archival specimens and, as such, can dramatically increase the scopes of both method and resource.

Perihepatic Packing versus Primary Surgical Repair in Patients with Blunt Liver Trauma; an 8-year Experience

OBJECTIVE

To explore the pros and cons of early versus delayed intervention when dealing with severe blunt liver injury with significant hemoperitoneum and hemodynamic instability.

METHODS

This retrospective cross-sectional study was performed at the Nemazi hospital, Shiraz, Southern Iran, level I trauma Center affiliated with Shiraz University of Medical Sciences. The study population comprised of all patients who were operated with the impression of blunt abdominal trauma and confirmed diagnosis of liver trauma during an 8-year period. All data were extracted from patients' hospital medical records during the study period. The patients' outcome was compared between those who underwent perihepatic packing or primary surgical repair.

RESULTS

Medical records of 76 patients with blunt abdominal liver trauma who underwent surgical intervention were evaluated. Perihepatic packing was performed more in patients who have been transferred to operation room  due to unstable hemodynamics (p<0.001) as well as in patients with more than 1000 milliliters of hemoperitoneum based on pre-operative imaging studies (e.g. CT/US) (p=0.002).

CONCLUSION

We recommend that trauma surgeons should approach perihepatic packing earlier in patients who have been developed at least two of these three criteria; unstable hemodynamics, more  than  1000 milliliters hemoperitoneum  and  more  than  1600 milliliters of intra-operative  estimated blood  loss. We believe that considering these criteria will help trauma surgeons to diagnose and treat high risk patients in time so significant hemorrhage (e.g. caused by dilatational coagulopathy, hypothermia and acidosis, etc.) can ultimately be prevented and more lives can be saved.

Time analysis of fatal traffic accidents in Fars Province of Iran

OBJECTIVE

To analyze the time factor in road traffic accidents (RTAs) in Fars Province of Iran.

METHODS

This study was conducted in Fars Province, Iran from November 22, 2009 to November 21, 2011. Victims'information consisted of age, sex, death toll involving dri- vers or passengers of cars, motorcycles and pedestrians, and site of injury etc. Accidents were analyzed in relation to hour of the day, season of the year, lighting condition including sunrise, sunset, daytime and nighttime.

RESULTS

A total of 3 642 deaths (78.3% were males, and the ratio of males to females was about 3.6:1) were studied regarding their autopsy records. There was a steady increase in fatal accidents occurring at midnight to 15:59. The risk of being involved in a fatal traffic accident was higher for those injured between 4:00 to 7:59 than at other times (OR equal to 2.13, 95% CI 1.85-2.44). The greatest number of fatal RTAs took place in summer. Mortalities due to RTA during spring and summer were more pronounced at 20:00 to 23:59 and midnight to 3:59, whereas mortalities in fall and winter were more pronounced from 12:00 to 15:59.

CONCLUSION

The high mortality rate of RTA is a major public health problem in Fars Province. Our results indicate that the time is an important factor which contributes to road traffic deaths.

Non alcoholic fatty liver disease in southern Iran: a population based study

BACKGROUND

Population based studies on prevalence and risk factors of NAFLD in Iranian population are few. The prevalence of NAFLD and non alcoholic steatohepatitis (NASH) in Iranians varies from 2.9% to 7.1% in general population and 55.8% in patients with type 2 diabetes mellitus.

OBJECTIVES

To determine the prevalence and determinants of non alcoholic fatty liver disease (NAFLD) in a sample of adult Iranian general population.

PATIENTS AND METHODS

This was a cross-sectional study being performed in Shiraz, southern Iran during a 10-month period from November 2010 to September 2011 through cluster random sampling of Iranian general population in Shiraz region. All individuals undergone anthropometric, blood pressure measurements, thorough medical history and physical examinations. Laboratory measurements included fasting blood glucose (FBS), lipid profile, complete blood count (CBC) and liver function tests. NAFLD was diagnosed by transabdominal ultrasonography.

RESULTS

819 subjects were included in this study among which were 340 males (41.5%) and 479 females (58.5%) with the mean age of 43.1 ± 14.1 years. NAFLD was diagnosed in 176 (21.5%) subjects. Patients with NAFLD were significantly older (P < 0.001), had higher proportion of male gender (P = 0.004) and had higher BMI (P < 0.001). They also had higher prevalence of hypertension (P < 0.001), high FBS (P < 0.001), high cholesterol (P = 0.026), high triglyceride (P < 0.001) and high waist circumference (P < 0.001). Taking all these together, patients with NAFLD had significantly higher prevalence of metabolic syndrome when compared to healthy subjects (P < 0.001).

CONCLUSION

The prevalence of NAFLD in this group of Iranian adult general population is 21.5%. NAFLD in Iranian population is associated with male gender, old age, obesity, and features of metabolic syndrome.

Data coverage of a cancer registry in southern Iran before and after implementation of a population-based reporting system: a 10-year trend study

Background

Cancer registries help to decrease the burden of cancers by collecting accurate and complete data. We aimed to measure the completeness of coverage of information recorded between 2000 and 2009 in a cancer registry program in Fars province, southern Iran.

Methods

The cancer registry program run by Shiraz University of Medical Sciences was investigated in two periods: pathology-based data from 2000 to 2007 and population-based data from 2007 to 2009. Completeness of yearly coverage was measured as the number of reported cases of cancer in each year divided by estimated cases based on 107.3 new cases per 100 000 individuals. The percentage of complete data registration (patient’s name, age, gender, address, phone number and father’s name) and correct cancer encoding was calculated for each year and compared to the maximum acceptable error rate for each item.

Results

A total of 29 277 non-duplicate cancer records were studied. Completeness of coverage varied from 22.68% in 2000 to 118.7% in 2008. Deficiencies in patients’ demographic data were highest for name in 2002 (0.09%), age in 2006 (2.36%), gender in 2001 (0.06%) and father’s name in 2001 (52.5%). Incomplete address (99.7%) and missing phone number (100%) were most frequent in 2000, and deficiencies in encoding information were highest in 2008 (6.36%).

Conclusions

The cancer registry program in Fars province (southern Iran) was considered satisfactory in terms of completeness of coverage and information about age. However, it was deficient in recording patients’ phone number and address, and father’s name. The error level for cancer encoding was unacceptably high. Enhancing hardware and software resources, education and motivation in all public and private sectors involved in the cancer registry program, and greater attention to epidemiological research are needed to increase the quality of the cancer registry program, including its completeness.

Time analysis of fatal traffic accidents in Fars Province of Iran

OBJECTIVE

To analyze the time factor in road traffic accidents (RTAs) in Fars Province of Iran.

METHODS

This study was conducted in Fars Province, Iran from November 22, 2009 to November 21, 2011. Victims'information consisted of age, sex, death toll involving dri- vers or passengers of cars, motorcycles and pedestrians, and site of injury etc. Accidents were analyzed in relation to hour of the day, season of the year, lighting condition including sunrise, sunset, daytime and nighttime.

RESULTS

A total of 3 642 deaths (78.3% were males, and the ratio of males to females was about 3.6:1) were studied regarding their autopsy records. There was a steady increase in fatal accidents occurring at midnight to 15:59. The risk of being involved in a fatal traffic accident was higher for those injured between 4:00 to 7:59 than at other times (OR equal to 2.13, 95% CI 1.85-2.44). The greatest number of fatal RTAs took place in summer. Mortalities due to RTA during spring and summer were more pronounced at 20:00 to 23:59 and midnight to 3:59, whereas mortalities in fall and winter were more pronounced from 12:00 to 15:59.

CONCLUSION

The high mortality rate of RTA is a major public health problem in Fars Province. Our results indicate that the time is an important factor which contributes to road traffic deaths.

Mechanical thrombectomy for cerebral venous sinus thrombosis: a comprehensive literature review

BACKGROUND

Endovascular treatment of cerebral venous sinus thrombosis (CVST) includes pharmacological and mechanical thrombolysis.

METHODS

The authors searched the English literature on CVST from 1990 to 2012 for all case reports or case series of mechanical thrombectomy.

RESULTS

A total of 64 patients were treated in all published studies. The techniques for mechanical thrombectomy included rheolytic thrombectomy with an AngioJet device (46.9%), clot retraction with the Penumbra system (4.7%), clot retraction with a Fogarty catheter (1.6%), clot retraction with a microsnare (3.1%), balloon venoplasty without stenting (18.7%), balloon venoplasty with stenting (4.7%), and an amalgam of techniques (18.7%). Nine (16.1%) patients died. At the most recent follow-up, 40 (62.5%) patients had no disability or minor disability and 7 (10.9%) patients had major disability.

CONCLUSION

Randomized multiinstitutional clinical trials with larger number of participants are needed to sufficiently compare the effect of intrasinus thrombolysis and mechanical thrombectomy to standard-of-care anticoagulation therapy.

Effect of thyroid dysfunctions on blood cell count and red blood cell indice

BACKGROUND

Thyroid hormones have a crucial role in metabolism and proliferation of blood cells. Thyroid dysfunction induces different effects on blood cells such as anemia, erythrocytosis leukopenia, thrombocytopenia, and in rare cases causes' pancytopenia. It also alter RBC indices include MCV, MCH, MCHC and RDW. Thus this study attempted to evaluate effect of hypo & hyperthyroidism on blood cell count and RBC indices.

MATERIALS AND METHODS

This study performed on 102 patients with hypothyroid (14.1 years), 84 with hyperthyroid (15.6 years) and 118 healthy individuals (15.2 years) as control group. Initially patients TSH level of patients was determined by ELISA method, and then according to TSH ranges (0.3-5.5µIU/mL) patients were divided into two Hyperthyroidism (TSH<0.3µIU/mL) and hypothyroidism (TSH>5.5µIU/mL) groups. Then, complete blood count was measured by cell counter. Finally, obtained results were analyzed by SPSS software.

RESULTS

Analyzes of obtained data revealed statistically significant difference between two groups of patients in RBC count, MCH, MCHC, RDW, HB and HCT(P-value<0.05), but the difference was not significant for WBC and PLT counts and MCV (P-value>0.05).

CONCLUSION

In case of patients with unknown hematological dysfunctions, must be evaluated for thyroid hormones.

Quality of life among Iranian patients with beta-thalassemia major using the SF-36 questionnaire

CONTEXT AND OBJECTIVE Patients with beta-thalassemia major (β-TM) experience physical, psychological and social problems that lead to decreased quality of life (QoL). The aim here was to measure health-related QoL and its determinants among patients with β-TM, using the Short Form-36 (SF-36) questionnaire. DESIGN AND SETTING Cross-sectional study at the Hematology Research Center of Shiraz University of Medical Sciences, in southern Iran. METHODS One hundred and one patients with β-TM were randomly selected. After the participants' demographics and disease characteristics had been recorded, they were asked to fill out the SF-36 questionnaire. The correlations of clinical and demographic factors with the QoL score were evaluated. RESULTS There were 44 men and 57 women of mean age 19.52 ± 4.3 years (range 12-38). On two scales, pain (P = 0.041) and emotional role (P = 0.009), the women showed significantly lower scores than the men. Lower income, poor compliance with iron-chelating therapy and presence of comorbidities were significantly correlated with lower SF-36 scores. These factors were also found to be determinants of worse SF-36 scores in multivariate analysis. CONCLUSIONS We showed that the presence of disease complications, poor compliance with iron-chelating therapy and poor economic status were predictors of worse QoL among patients with β-TM. Prevention and proper management of disease-related complications, increased knowledge among patients regarding the importance of managing comorbidities and greater compliance with iron-chelating therapy, along with psychosocial and financial support, could help these patients to cope better with this chronic disease state.

Reducing Social Disparity in Liver Transplantation Utilization through Governmental Financial Support

BACKGROUND

A high proportion of patients suffering from end stage liver disease are from low socioeconomic classes , which limits their access to liver transplantation as the most effctive treatment of this condition because of cost barrier.

OBJECTIVES

one of the most challenging aspects of liver transplantation is its affordability and utilization by those who need it the most.

PATIENTS AND METHODS

Since November 2005, Iran Ministry of Health had covered 100% of the costs of in-patient liver transplantation care. To determine the effects of this policy, patterns of utilization of liver transplantation were compared before and after implementation of the policy. Group one included 112 and group two included 120 individuals who received transplantation before (from early January 2003 to November 2005) and after (from November 2005 to the end of December 2007) the legislation entered into the effect, respectively. Socioeconomic characteristics of these patients were evaluated by data collected about house and car ownership, education level, employment status, and place of residence.

RESULTS

Coverage of the costs allowed more illiterate and semiliterate people (P = 0.032) as well as more unemployed or unskilled workers to receive transplantation (P = 0.021). The number of transplantations also increased in children and geriatric age group. This legislation also led to greater countrywide regional coverage of indigent patients.

CONCLUSIONS

This survey provides evidence that coverage of the costs by Ministry of Health was effective in reducing social discrimination in utilization of liver transplantation, and narrowed the gap between low and high socioeconomic classes in Iranian society.

Acceptance and rejection of influenza vaccination by pregnant women in southern Iran: physicians' role and barriers

OBJECTIVE

Vaccination provides the most effective protection against maternal, fetal and neonatal complications of influenza infection. This study aimed to determine the uptake rate of influenza vaccination including 2009 pandemic H1N1 influenza and seasonal influenza vaccination and the reasons for acceptance or rejection among pregnant women.

RESULT

Mean age of the 416 pregnant women enrolled in this study was 27.06 ± 5.27 y. Only 25 (6%) of 397 women had history of vaccination. Of 383 (92.06%) pregnant women who had rejected vaccination, 116 (30.28%) declared that they lacked information about influenza vaccination and 44 (11.48%) felt that they did not need vaccination. Concerns about the safety of influenza vaccination were reported by only 2 women (0.52%). Of the 25 (6%) pregnant women who were vaccinated against influenza, 15 (60%) accepted because of advice they received from persons other than physicians, 5 (20%) believed that influenza vaccination is necessary for everyone, and 3 (12%) accepted because of a history of frequent influenza virus infections in previous years.

METHOD

This questionnaire based study was conducted at obstetrics and maternity hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. Pregnant women were interviewed individually and privately. SPSS was used for data analysis.

CONCLUSION

Most of the unvaccinated and vaccinated pregnant women lacked sufficient knowledge about influenza. Education of pregnant women about influenza vaccination and encouragement from physicians may have a remarkable effect on turning poor compliance into high flu vaccination uptake among pregnant women.

The Assessment of Relations between Socioeconomic Status and Number of Complications among Type 2 Diabetic Patients

BACKGROUND

The prevalence of diabetes mellitus among Iranian aged 25-64 estimated to be about 7.7%. The aim of current study was the assessment of socioeconomic status of diabetic patients and their complications.

METHODS

A cross sectional study was conducted on type 2 diabetic patients with complications in four major teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) during July 2009 to March 2010. All patients (530) were interviewed through a questionnaire with 85% response rate (450 patients). Skilled nurses were assigned as responsible for data collection. Collected data analyzed by Exact Fisher and χ2 tests using SPSS version 11.5.

RESULTS

The majority of patients had experienced one or more complications. Findings revealed that 50%, 33.6% and 16.4% of the patients suffered from one, two, and three complications of type 2 diabetes, respectively. Patients with cardiovascular complications included 22.2%, with both cardiovascular and eye complications (12.7%), and with cardiovascular, eye and foot ulcer together 14% of the respondents. Frequency of complications demonstrated significant relation with sex, age, educational level, type of occupation, duration of diabetes (P<0.001) and social class (P=0.002). The majority of patients (54.2%) belonged to low income group.

CONCLUSION

It seems patients with low socioeconomic status face more challenges in their social environment together with less psychological support. Health care systems are responsible to empower them to control their illness and feel a better life to live.

Residential segregation and infant mortality: a multilevel study using Iranian census data

BACKGROUND

There is a great amount of literature concerning the effect of racial segregation on health outcomes but few papers have discussed the effect of segregation on the basis of social, demographic and economic characteristics on health. We estimated the independent effect of segregation of determinants of socioeconomic status on infant mortality in Iranian population.

METHODS

For measuring segregation, we used generalized dissimilarity index for two group and multi group nominal variables and ordinal information theory index for ordinal variables. Sample data was obtained from Iranian latest national census and multilevel modeling with individual variables at level one and segregation indices measured at province level for socioeconomic status variables at level two were used to assess the effect of segregation on infant mortality.

RESULTS

Among individual factors, mother activity was a risk factor for infant mortality. Segregated provinces in regard to size of the house, ownership of a house and motorcycle, number of literate individual in the family and use of natural gas for cooking and heating had higher infant mortality. Segregation indices measured for education level, migration history, activity, marital status and existence of bathroom were negatively associated with infant mortality.

CONCLUSION

Segregation of different contextual characteristics of neighborhood had different effects on health outcomes. Studying segregation of social, economic, and demographic factors, especially in communities, which are racially homogenous, might reveal new insights into dissimilarities in health.

Mycobacterium aurum keratitis: an unusual etiology of a sight-threatening infection

Atypical fast-growing Mycobacterium species are usually identified after laser-assisted in situ keratomileusis, cosmetic surgeries, and catheter-related, pulmonary or soft tissue infections. We herein present the case of a 56-year-old man with purulent discharge, redness, and foreign body sensation in his left eye. He underwent two surgeries that partially controlled the infection but were not curative. Corneal transplantation was performed, and a biopsy of the excised cornea indicated Mycobacterium aurum infection, which was confirmed by polymerase chain reaction-restriction fragment length polymorphism analysis. This appears to be the first documented case of keratitis attributable to the non-tuberculous mycobateria M. aurum. The intractable extra-ocular progression of the disease in the absence of general signs or symptoms was notable. We suggest considering non-tuberculous mycobacteria among the probable causes of complicated keratitis or keratitis that does not respond to drug treatment, especially in regions where tuberculosis is endemic.

Expected survival using models of life table compared with survival of gastrointestinal tract cancer patients in north of iran

BACKGROUND

Northern regions of Iran have been encountered to dominate malignancies of gastrointestinal (GI) tract. We came to examine the total excess mortality due to the GI cancer in Mazandaran province.

METHODS

Socio-demographic and clinical data of 484 patients with GI cancer collected during the years 1990-1991 were available from Babol Cancer Registry. Patients were followed up for 15 years by the year 2006. Using the West Coale-Demeny life table model, a number of five life tables for men and four for women, corresponding to each birth cohort, were constructed. Observed survival was obtained using the Kaplan-Meier method and compared with the Expected survival calculated using the direct adjusted method represented by STEIN et al.

RESULTS

The sample of subjects encompassed 66.3% men and 33.7% women with mean age 58.26 ± 10.90, and endoscopy was the general method for cancer detection. Esophagus accounted for 74.2%, and stomach and colorectal accounted for 22.7% and 3.1% of GI cancers, respectively. Survival rate in 15 years following diagnosis was nearly 6%. Comparing patient and expected survival curves showed a significantly reduced survival for patients of each GI cancer over the whole period and especially during the first two years after diagnosis.

CONCLUSION

Patients experienced reduced survival associated with the development of GI cancers. Considering individuals in a population come from different cohorts, adjustment by constructing distinct life tables for different birth cohorts is recommended. The West model is recommended as a first choice to represent mortality in countries whose registration systems are exposed to various errors.

Helicobacter pylori infection in patients with epilepsy

BACKGROUND

The possible role of Helicobacter pylori (HP) infection in extra-intestinal diseases has been suggested. The main purpose of this study was to determine the frequency of infection with HP in two groups of patients with epilepsy: patients with idiopathic generalized epilepsy (IGE) and patients with temporal lobe epilepsy (TLE), compared to healthy controls.

METHODS

In this cross-sectional study a random sample of adult patients above 18 years of age with a diagnosis of IGE or TLE were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, from January 2009 through June 2011. A group of healthy individuals were included as control group. For all patients and controls a urea breath test (UBT) was requested.

RESULTS

Thirty-four patients with IGE, 28 patients with TLE and 33 individuals as control were recruited. Positive UBT was observed in 21 individuals (61.8%) with IGE, 50% (14 patients) of patients with TLE and 72.7% (24 individuals) in control group. The difference between patients with IGE and control group was not significant (P=0.3). The difference between patients with TLE and control group was not significant either (P=0.068).

CONCLUSION

The rate of HP infection was not higher in patients with epilepsy compared to healthy individuals. At the moment, there is not enough epidemiological data to support the role of HP infection in patients with either IGE or TLE.

Ecology of malaria vector Anopheles culicifacies in a malarious area of Sistan va Baluchestan province, south-east Islamic Republic of Iran

A study was done of the bionomics, insecticide susceptibility and irritability status of Anopheles culicifacies in Sistan va Baluchestan province. Sampling was performed to determine the following parameters: species identification, seasonal activity, adult and larval susceptibility tests, irritability tests, anthropophily index and sporozoite rate. An. culicfacies adults were susceptible to all tested pyrethroid insecticides. An. culicfacies started to appear indoors in late May, showing 2 peaks in June and September. Fenitrothion, cyfluthrin and permethrin had the least irritancy effect and DDT the highest. Only 2/860 females tested were infected with Plasmodium spp. (sporozoite rate: 0.25%). ELISA testing of 250 blood meals derived from night-biting collections of female mosquitoes from humans and cows revealed that only 12.5% were human-fed.

Diffuse intracerebral calcification in a beta-thalassaemia major patient with hypoparathyroidism: a case report

Beta-thalassemia major is a complex medical problem found worldwide. Endocrinopathies are some of the most frequent dysfunctions found in these patients. Iron overload in different organs is responsible for multiple endocrine complications particularly in the absence of adequate chelation therapy. One of the most prevalent endocrine complications of thalassemia major is hypoparathyroidism. It can cause cerebral calcifications in the basal ganglia but seldom outside of the extrapyramidal system. There are few studies about intracerebral calcification due to hypoparathyroidism in patients with thalassemia major. We report the case of a 14 year-old girl who came to our Center with the chief complaint of a generalized tonic-clonic seizure. The patient was known to have beta-thalassemia major since she was 9 months old. Computerized tomographic scan of the brain was done which showed diffuse intracranial calcifications in deep white matter, posterior fossa, basal ganglia and both thalami. Laboratory and neuroimaging assessments revealed the diagnosis of hypoparathyroidism. We strongly recommend periodic assessment and tight control of serum calcium level in all patients with betathalassemia major. Prompt treatment with oral calcium supplements and an active form of vitamin D can prevent hypoparathyroidism and its neurologic complications. Comprehensive evaluation and treatment of other endocrinopathies in accordance with hypoparathyroidism is suggested.

Polymorphisms within exon 9 but not intron 8 of the vitamin D receptor are associated with the nephropathic complication of type-2 diabetes

The impact of several environmental and genetic factors on diabetes and its complications is well documented but there is an urgent need to understand more about genetic risk factors associated with this disease. The present study was aimed at examining the two single nucleotide polymorphisms (SNP) in intron 8 and exon 9 of the vitamin D receptor (VDR) gene in nephropathic and non-nephropathic type-2 diabetic patients. In this clinical study, peripheral blood samples were obtained from 100 type-2 diabetic patients, 100 nephropathic type-2 diabetic patients and 100 healthy controls. DNA was extracted and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed to examine two SNP polymorphisms within the VDR gene. Our results showed a significant difference in the Taq-1 evaluated genotypes of exon 9 in the VDR gene of diabetic individuals with (P=0.012) and without (P ≤ 0.001) nephropathy. Analysis of the Taq-1 evaluated alleles of nephropathic (P=0.917) and non-nephropathic (P=1.000) did not show a significant difference. We also evaluated the intron 8 Apa-1 alleles in patients with (P=0.480) and without nephropathy (P=0.543) and determined there were no differences between these groups. Our results also showed that the frequency of Apa-1 genotypes did not differ in nephropathic (P=0.224) and non-nephropathic (P=0.236) diabetic patients. Based on our results, it can be concluded that VDR and its functional polymorphism in exon 9 may play an important role in pathogenesis of type-2 diabetes and more investigations are required to clarify their role in nephropathy.

Metaplot: a novel stata graph for assessing heterogeneity at a glance

BACKGROUND

Heterogeneity is usually a major concern in meta-analysis. Although there are some statistical approaches for assessing variability across studies, here we present a new approach to heterogeneity using "MetaPlot" that investigate the influence of a single study on the overall heterogeneity.

METHODS

MetaPlot is a two-way (x, y) graph, which can be considered as a complementary graphical approach for testing heterogeneity. This method shows graphically as well as numerically the results of an influence analysis, in which Higgins' I(2) statistic with 95% (Confidence interval) CI are computed omitting one study in each turn and then are plotted against reciprocal of standard error (1/SE) or "precision". In this graph, "1/SE" lies on x axis and "I(2) results" lies on y axe.

RESULTS

Having a first glance at MetaPlot, one can predict to what extent omission of a single study may influence the overall heterogeneity. The precision on x-axis enables us to distinguish the size of each trial. The graph describes I(2) statistic with 95% CI graphically as well as numerically in one view for prompt comparison. It is possible to implement MetaPlot for meta-analysis of different types of outcome data and summary measures.

CONCLUSION

This method presents a simple graphical approach to identify an outlier and its effect on overall heterogeneity at a glance. We wish to suggest MetaPlot to Stata experts to prepare its module for the software.

Effect of breastfeeding on cognitive performance in a British birth cohort

This cohort study investigated the effect of early life nutrition on later performance in developmental milestones and cognitive tests. Structural equation modelling was carried out on follow-up data from a national birth cohort of 5362 children born in 1 week of 1946 in Britain. Children who were breastfed longer showed earlier developmental milestones. After adjusting for sex, social group and milestones, those children scored higher in verbal tests. Path analysis showed that breastfeeding may have an effect even into adult life. The chain of path coefficients from breastfeeding to developmental milestones at early ages, to cognitive scores at ages 8-15 years, to reading tests at age 26 years and to memory and visual tests at age 43 years were significant in females but not in males.

Extrusion Foam Coating of Coaxial Cables using Butane as Physical Blowing Agent

This paper presents an experimental study on manufacture and characterization of an insulating foam coating in the coaxial cables where a physical blowing agent (butane) is used. Coaxial cables with foam insulator are widely used in communication industries. The insulating foam plays a key role in the attenuation properties of the coaxial cables. In this research work, an extrusion setup was prepared to produce foam insulated coaxial cable using butane as the physical foaming agent. The effect of die geometry (die gap and die outlet diameter) on foam morphology and loss-attenuation were investigated using a blend of LDPE (90%)-HDPE (10%) as the main material. The results show that an acceptable low loss-attenuation is achievable via using a polyethylene compound and adjusting processing parameters.

Opium use in a rural area of the Islamic Republic of Iran

Because of its geographic proximity to the major drug production centres, there is easy access to narcotic drugs in the Islamic Republic of Iran despite efforts by governmental and nongovernmental organizations. Using a structured questionnaire as a basis for conversation, local health workers interviewed 310 residents of a rural area in Babol province about opium use. The self-reported rate of opium use, adjusted due to a bias in the sex ratio of the sample, was 8.9%. All the 42 opium users reported opium use at least 2-3 times per week in the previous 3 months. Opium was smoked by 95.2% and taken orally by 4.8%; there was no injecting use. There was no reported use of other substances, including alcohol. There was a statistically significant relationship between opium use and male sex, unemployment and cigarette smoking.