Oleuropein induces apoptosis in gastric cancer cell lines by regulating mir-34a, mir-21, and related genes: An experimental and bioinformatic study

Gastric Cancer (GC) is one of the most prevalent malignancies worldwide. Oleuropein, as a natural phenolic compound with anti-cancer characteristics, is a good option with low side effects to overcome the adverse impact of conventional treatments in cancer. This research evaluated Oleuropein's anti-cancer and apoptotic activities and the anti-migratory effects by modulating potential target genes in epithelial-mesenchymal transition (EMT). Bioinformatic analysis was performed to predict possible Oleuropein's target genes. Then the importance of these genes was shown by UALCAN, Gene Expression Omnibus (GEO), and The Cancer Genome Atlas (TCGA) datasets in gastric cancer. Finally, the association between the selected genes was shown by Cytoscape network analysis. The MTT assay, DAPI staining, flow cytometry, and real-time PCR were applied in the current study. The results showed that the viability of cells was decreased, and the apoptosis rate increased in the Oleuropein-treated group. These findings revealed that Oleuropein regulated the expression of the apoptotic and metastatic genes and microRNAs in GC cells.

Reported side-effects following Oxford/AstraZeneca COVID-19 vaccine in the north-west province, Iran: A cross-sectional study

While the vaccination was introduced as a promising tool to control the Coronavirus disease 2019 (COVID-19) pandemic, concerns about vaccine-related side effects had grown. Due to the widespread administration of the COVID-19 vaccine worldwide for the first time, it was necessary to evaluate the safety and potential side effects in recipients. This study aims to assess, the incidence of adverse effects following Oxford-AstraZeneca vaccination and identify their related factors. In this cross-sectional survey-based study, 453 volunteers participated, including 235 men and 218 women. The reported adverse reactions from recipients of the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccine were collected by using a questionnaire. The findings showed that the incidence of adverse reactions, such as neurological, systematic, gastrointestinal, respiratory, and local symptoms were significantly higher after the first dose compared to the second dose. Systematic symptoms were the most prevalent reported side effects after the first and second dose injection. The demographical study of participants showed that individuals aged 18-34 and females were more prone to present adverse events following vaccination. However, no significant relationship was found between the occurrence of side effects and the recipients' body mass index. Despite the life-saving role of vaccination against SARS-CoV-2, it may have some adverse reactions in recipients. The severity and frequency of side effects were different. So, they were dependent on several factors, including gender and age. Altogether, post-vaccination adverse reactions were mild and tolerable.

Adverse Effects Reported and Insights Following Sinopharm COVID-19 Vaccination

Vaccines are promising strategies for controlling COVID-19; however, COVID-19 vaccine side effects play a central role in public confidence in the vaccine and its uptake process. This study aimed to provide evidence on the post-vaccination early side effects of the BBIBP-CorV (Sinopharm) vaccine. This cross-sectional survey-based study was conducted between November 2021 and January 2022 among recipients of the BBIBP-CorV vaccine, using a questionnaire-based survey. Our final sample consisted of 657 participants, including 392 women. Among the study cases, only 103 (15.7%) participants received one dose of vaccine, and the rest received both doses (N = 554, 84.3%). Systemic symptoms (first dose: N = 187, both doses: N = 128) were the most commonly reported events after vaccination, and among them, injection site pain (first dose: 19.3%, both doses: 12.9%) was the most prevalent adverse effect. All reporting events were mild and resolved in less than 3 days without hospitalization. Among the participants, females and young people aged 35-65 were more prone to manifest side effects (N = 169, 53.3%) after the vaccine injection. Furthermore, our results revealed that the recipients who were suffering from underlying diseases, including diabetes, renal disorder, and respiratory illness, reported fewer adverse responses after vaccination in comparison with healthy individuals. Vaccination against SARS-CoV-2 may lead to some adverse reactions in recipients. However, the frequency of post-vaccination early side effects differed in people, but all responses were slight and temporary.

The evaluation of the MMP-2/TIMP-1 ratio in peptic ulcer and its association with refractory helicobacter pylori infection

BACKGROUND

Helicobacter pylori (H. pylori) is one of the leading causes of peptic ulcers, and its treatment is a worldwide challenge. Matrix metalloproteinases and their inhibitors influence the development and healing of peptic ulcers. This study aimed to evaluate the ratios of matrix metalloproteinase-2 (MMP-2) to tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with peptic ulcers that are sensitive or resistant to H. pylori treatment and compare them with healthy individuals.

METHODS

In this study, 95 patients were included and divided into two groups sensitive (41 patients) and resistant to treatment (54 patients). The results were compared with a control group of 20 participants with normal endoscopy and H. pylori-negative. After obtaining written informed consent, five ml of venous blood was taken to determine their serum MMP-2 and TIMP-1 levels using an enzyme-linked immunosorbent assay.

RESULTS

In patients with H. pylori-induced peptic ulcers, the MMP-2/TIMP-1 ratio was significantly higher than the healthy controls (P < 0.05). MMP-2 level was associated with patients' response to treatment (P < 0.05). The MMP-2/TIMP-1 ratio was higher in patients with simultaneous gastric and duodenal ulcers (P < 0.05).

CONCLUSION

It seems that peptic ulcer disease caused by infection with H. pylori increases the MMP-2/TIMP-1 ratio in patients with peptic ulcers. However, it might not be a good predictor of refractory H. pylori-induced peptic ulcer disease.

Role of leukocytes and systemic inflammation indexes (NLR, PLR, MLP, dNLR, NLPR, AISI, SIR-I, and SII) on admission predicts in-hospital mortality in non-elderly and elderly COVID-19 patients

Background

Systemic inflammation indices, including neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), derived neutrophil/lymphocyte ratio (dNLR), neutrophil/lymphocyte*platelet ratio (NLPR), aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIR-I), and systemic inflammation index (SII) are well-expressed inflammatory indices that have been used to predict the severity and mortality of various inflammatory diseases. This study aimed to investigate the role of systemic inflammatory markers in predicting mortality in non-elderly and elderly COVID-19 patients.

Methods

In a retrospective study, laboratory parameters were examined for 1,792 COVID-19 patients (elderly = 710 and non-elderly = 1,082). The ability of inflammatory markers to distinguish the severity of COVID-19 was determined by receiver operating characteristic (ROC) analysis, and survival probability was determined by the mean of Kaplan–Meier curves, with the endpoint being death.

Results

In the non-survivor non-elderly and elderly patients, the parameters PLR, MLR, dNLR, NLPR, AISI, SIR-I, and SII were significantly higher than in the surviving patients. WBC count (HR = 4.668, 95% CI = 1.624 to 13.413, P &lt; 0.01), neutrophil count (HR = 6.395, 95% CI = 2.070 to 19.760, P &lt; 0.01), dNLR (HR = 0.390, 95% CI = 0.182 to 0.835, P &lt; 0.05), and SII (HR = 10.725, 95% CI = 1.076 to 106.826, P &lt; 0.05) were significantly associated with survival. On the other hand, in elderly patients, it was found that WBC count (HR = 4.076, 95% CI = 2.176 to 7.637, P &lt; 0.001) and neutrophil count (HR = 2.412, 95% CI = 1.252 to 4.647, P &lt; 0.01) were significantly associated with survival.

Conclusion

WBC count and neutrophil count in non-elderly and elderly patients, were reliable predictors of mortality.

Serum Brain-Derived Neurotrophic Factor (BDNF) in COVID-19 Patients and its Association with the COVID-19 Manifestations

COVID-19 is a systematic disease that frequently implies neurological and non-neurological manifestations, predominantly by inducing hypoxia. Brain-derived neurotrophic factor (BDNF) is a key factor in regulating functions of nervous and respiratory systems and has been strongly related to hypoxia. Therefore, this study planned to investigate BDNF association with the COVID-19 manifestations especially neurological impairments and the infection-induced hypoxia. We enrolled sixty-four COVID-19 patients and twenty-four healthy individuals in this study. Patients were divided into two groups, with and without neurological manifestations, and their serum BDNF levels were measured by enzyme-linked immunosorbent assay (ELISA). COVID-19 patients had significantly lower BDNF levels than healthy individuals (p = 0.023). BDNF levels were significantly lower in patients with neurological manifestations compared to healthy individuals (p = 0.010). However, we did not observe a statistically significant difference in BDNF levels between patients with and without neurological manifestations (p = 0.175). BDNF’s levels were significantly lower in patients with CNS manifestations (p = 0.039) and higher in patients with fever (p = 0.03) and dyspnea (p = 0.006). Secondly, BDNF levels have a significant negative association with oxygen therapy requirement (p = 0.015). These results strongly suggest the critical association between dysregulated BDNF and hypoxia in promoting COVID-19 manifestations, particularly neurological impairments.

The healthy behaviours and COVID-19 mortality among Iranian women: a case-control study

BACKGROUND

Women are among the susceptible groups to Coronavirus disease-19 (COVID-19) in Ardabil, north-west of Iran, despite the current global status. The underlying causes of high incidence and fatality rate of women in Ardabil are not fully understood. Hence, this study aimed to investigate the healthy behaviours in women of Ardabil and its relationship with COVID-19 mortality.

METHODS

We conducted a case-control study to compare the adherence to health protocols and behaviours with respect to COVID-19 between the infected (261 patients) and healthy (515 persons) women. Health protocols and behaviours such as using mask, gloves, disinfectants, history of travelling and contacting, and attending various gatherings and places during the COVID-19 pandemic along with demographic variables were defined as independent variables, and COVID-19 death rate was defined as the dependent variable. Multivariable logistic regression methods were used to explore the risk factors associated with COVID-19 mortality.

RESULTS

Chi-square and Fisher tests showed significant differences between infected and healthy women in terms of history of contact and traveling (p < 0.05), wearing mask (p < 0.001), going to work place (p < 0.001), and attend public gatherings (p = 0.038). Multivariable logistic regression disclosed that the age group over 80 years: 8.97 times (95% CI 2.27-29.85), women with underlying chronic diseases: 4.14 times (95% CI 1.61-10.64), and obese women: 3.01 times (95% CI 1.04-6.03) were more likely to die from COVID-19 than other women.

CONCLUSION

Considering the high incidence and mortality rate in Ardabil women due to COVID-19 and the corresponding health behavioural factors, special emphasis should be given to the increase of women awareness on the importance of healthy behaviours, diet, and life-style.

The sufficient vitamin D and albumin level have a protective effect on COVID-19 infection

There is limited information regarding the protective factors of SARS-CoV-2 infection. This research is focused on analyzing the role of vitamin D and albumin in the severity, progression, or possible prevention of COVID-19 infection. In this case–control study, 191 patients and 203 healthy individuals were enrolled. Blood samples were taken to test the albumin and vitamin D levels of both groups. Our results show a direct association of vitamin D deficiency with the infection of COVID-19 and severity. According to our findings, 84.4% of patients with COVID-19 in this study had vitamin D deficiency. Moreover, the average level of albumin was significantly decreased in those infected patients who had respiratory symptoms. In the present study, a considerable negative correlation was established between the levels of vitamin D and the severity of COVID-19 infection. This reflects on the immunomodulatory and inhibitory nature of vitamin D to the viral replication.

Factors Affecting Behaviors of Women with Breast Cancer Facing Intimate Partner Violence Based on PRECEDE-PROCEED Model

Introduction: More than half of women in Iran experience intimate partner violence (IPV). This study aimed to explore IPV in women with breast cancer (BC) in Ardabil, Iran. Moreover, the predictors of violence and women’s reactions against violence were examined.

Methods: Using a convenient sampling method, the current cross-sectional study was performed on 211 women with BC in northwest of Iran. To collect data, a questionnaire consisting of demographic characteristics and items based on PRECEDE-PROCEED model and women's reaction to violence was used. Data were analyzed using SPSS Ver. 20 and descriptive and inferential statistics.

Results: In this study, 190 (90%) subjects reported that they had experienced IPV in the preceding year. Only 27(12.8%) women were familiar with all forms of violence. Moreover, 141 (66.8%) and 160 (75.8%) women had no access to counseling centers and life skill training courses, respectively. Women mostly had adopted emotion-oriented coping strategies when facing IPV. The results of multivariate regression analysis indicated that enabling factors and knowledge were predictors of problem-oriented coping strategies in women.

Conclusion: Empowered women, for the most part, were better educated and had more access to social resources than others. Therefore, empowering women can help reduce the amount of violence they might have to encounter. It is essential that supporting and empowering centers for women be established in the society and efficient laws be enacted to fight IPV.

The Predictors of Sexual Satisfaction among Iranian Women with Breast Cancer

Background:

Breast cancer targets women’s sexual organs and deals with patients’ femininity. The low age of incidence and the late stage of diagnosis of the disease in Iran give rise to sexual dysfunction among patients. Identifying the severity of the disorder, and its determiners can specify the probable groups to be influenced.

Materials and Methods:

In a descriptive cross-sectional study, 144 women with breast cancer who underwent surgical and complementary therapies were included in the study. Data collection was done through questionnaires: FSFI, SSSW and the demographic and clinical information questionnaire.

Results:

The mean age of patients was 42.31 ± 5.18 years. 76 patients (52.8%) underwent partial mastectomy and complementary treatments, and 68 cases (47.2%) underwent total mastectomy and complementary treatments. All patients had sexual dysfunction in all dimensions. The average score of sexual satisfaction was 84.3±10 10. The lowest sexual satisfaction score (79.6 ± 9.6) belonged to patients with total mastectomy (P = 0.013). Regression analysis showed predictability of patients’ sexual satisfaction by type of treatment and sexual function (P = 0.002 and P = 0.003, respectively).

Conclusion:

Sexual dysfunction and the low level of sexual satisfaction in patients with significant predictive effect of treatment type and sexual function denote that the patients with breast cancer need to be assisted to have proper sexual function and satisfaction leading to higher quality of life.

Feasibility study on the use of 230 MeV proton cyclotron in proton therapy centers as a spallation neutron source for BNCT

Aim

The feasibility of using 230 MeV proton cyclotrons in proton therapy centers as a spallation neutron source for Boron Neutron Capture Therapy (BNCT) was investigated.

Background

BNCT is based on the neutron irradiation of a ¹⁰B-containing compound located selectively in tumor cells. Among various types of neutron generators, the spallation neutron source is a unique way to generate high-energy and high-flux neutrons.

Materials and Methods

Neutron beam was generated by a proton accelerator via spallation reactions and then the produced neutron beam was shaped to be appropriate for BNCT. The proposed Beam Shaping Assembly (BSA) consists of different moderators, a reflector, a collimator, as well as thermal and gamma filters. In addition, the simulated Snyder head phantom was utilized to evaluate the dose distribution in tumor and normal tissue due to the irradiation by the designed beam. MCNPX2.6 Monte Carlo code was used to optimize BSA as well as evaluate dose evaluation.

Results

A BSA was designed. With the BSA configuration and a beam current of 104 nA, epithermal neutron flux of 3.94 × 10⁶ [n/cm²] can be achieved, which is very low. Provided that we use the beam current of 5.75 μA, epithermal neutron flux of 2.18 × 10⁸ [n/cm²] can be obtained and the maximum dose of 38.2 Gy-eq can be delivered to tumor tissue at 1.4 cm from the phantom surface.

Conclusions

Results for 230 MeV protons show that with proposed BSA, proton beam current about 5.75 μA is required for this purpose.

Factors associated with delayed diagnosis of breast cancer; a study in North-West of Iran

Introduction: Delayed diagnosis and treatment of breast cancer leads to the presentation of the disease in advanced stages necessitating more invasive surgical interventions, increasing health care costs and mortality rate, and finally reduced patients’ survival. Objectives: This study aimed to investigate the factors associated with delayed diagnosis of breast cancer in the north-west of Iran. Patients and Methods: This retrospective cross-sectional study was conducted on 70 breast cancer patients referred to the cancer registry of Ardabil city, north-west of Iran. The time from the presentation of clinical symptoms to the initiation of treatment was determined by interviews to identify the system and patients’ delays. The data was analyzed in SPSS 19 with the level of significance as P<0.05. Results: The mean age of the patients was 43.3 ± 13.2 years. The means of total, patient, and system related delays were 9.4±1.6 weeks, 6.3 ± 9.9 weeks, and 3.1 ± 2.8 weeks respectively. Regression analysis showed that age, marital status, educational level, monthly income, fear of cancer, and residency were significantly associated with patients’ delay. Conclusion: Our results highlighted the important role of patients’ related factors in delayed diagnosis of breast cancer. Therefore, it is essential to educate individuals for timely referrals to physicians.

Treatment Effect of Ergocalciferol on Bone Metabolism Indexes and Parathyroid Hormone in Hemodialysis Patients

INTRODUCTION

Vitamin D deficiency is a common problem in end-stage renal disease patients under hemodialysis. Both active and nutritional vitamin D supplementation have been recommended for its treatment. In this study we aimed to evaluate the effects of treatment with ergocalciferol on bone metabolism indexes in hemodialysis patients.

MATERIALS AND METHODS

In a randomized controlled trial, 40 hemodialysis patients were randomly allocated to the intervention (n = 20) and placebo (n = 20) groups. During the study, 4 patients in the placebo and 1 in the intervention group were excluded. Patients received calcitriol, 0.25 mg/d, with ergocalciferol, 50 000 IU, or placebo weekly for 3 months. Serum levels of 25-hydroxyvitamin D, calcium, parathyroid hormone, and alkaline phosphatase were measured before and after treatment.

RESULTS

25-hydroxyvitamin D levels were significantly improved in the intervention group (12.00 ± 4.90 ng/mL versus 29.89 ± 9.48 ng/mL, P < .001), but the placebo group had no improvement (14.23 ± 7.62 ng/mL versus 13.87 ± 8.04 ng/mL, P > .05). There was no significant changes in serum calcium, parathyroid hormone, or alkaline phosphatase levels in each group. Eight patients (42.1%) in the intervention compared to zero cases in the placebo group had normal 25-hydroxyvitamin D levels after treatment (P = .004). No cases of hypercalcemia were seen in the studied patients.

CONCLUSIONS

Treatment with ergocalciferol could significantly improve vitamin D deficiency with no significant effects of serum calcium or parathyroid hormone levels.

Mediating Factors in Early Diagnosis of Breast Cancer: from Initial Changes in Health to Breast Cancer Detection

Background:

Breast cancer is one of the most frequently occurring cancers in women throughout the world. In Iran, according to available reports, 70% of patients with breast cancer are detected at the advanced stages of the disease.

Materials and Methods:

This study is of descriptive-analytic cross-sectional type.160 female patients was selected. The data in this study was collected via face to face interview using a questionnaire based on the Anderson’s delay model. Data were analyzed using SPSS 22 and the significance level was considered to be 0.05.

Results:

The results showed that presence of mass was the first symptom in many of women, i.e., 76 cases (47.5%). not only the presence of mass in the breast, but also any other symptom, hadn’t been taken as a serious problem initially by women. Non-improvement of the symptoms and exacerbation of the symptoms was considered as a symptom of illness by patients. After considering the changes as the symptoms of illness, patients had tried to treat the disease through different methods of self-treatment. The failure of the self-treatment in controlling the symptoms, had directed the patients toward seeking for medical services. Out of 160 patients, 49 patients (39.6%) changed the time of their appointment with doctor. 110 cases (68%) out of 160 patients, rather than initiating relevant diagnostic procedure related to the disease, had received non-specific and non-related therapeutic measures.

Conclusion:

Pondering on the results yields that patient-related delays, resulting from their lack of awareness of the disease, cultural factors, and fear, can only play an important role in postponement of visiting a physician, but in the diagnosis of disease it is the inability of general practitioners in performing differential diagnoses, and making request for related diagnostic measures which can significantly increase the lag time until the onset of the main treatment.

Epidemiological study of snakebites in Ardabil Province (Iran)

Introduction

Average annual incidence of snakebite worldwide is between 5.5 to 1.2 million, and at least 125,000 of them are fatal. In Iran, around 4,500–11,000 snakebites occur annually, and a small number of them are fatal. Snake bites can cause intoxity and immediate death in patients, and the aim of this study was to investigate the epidemiological study of snakebites in Ardabil Province.

Methods

This study was a cross-sectional that has been done on 67 snakebite patients who were admitted to the Imam Khomeini Hospital of Ardabil during 2008–2013. Information included: age and sex of victims, region of incidence, site of bite, hospitalized duration and symptoms. Data analyzed by descriptive statistical methods using SPSS version 19.

Results

There was significant difference between the two sexes (p=0.001). There was no significant difference between the mean age of male and female victims (p=0.68). Most of the victims were in the age group of 20–29 years (34.3%). All snakebites happened in rural areas. There was no significant relation between gender of victims and the residential location of victims (p=0.32). Most snakebites happened during 11 a.m. to 4 p.m. (32.8%). Most of the snakebites occurred in spring and summer seasons. Results showed that most of the bites in yearly months was seen in the summer season and the difference between seasons is significant. (p=0001). Most snakebites, with 38 cases (56.7%), were observed on lower limbs and among them right limbs with 20 cases (52.6%) had the greatest number. There was significant difference between organs of bites in victims because the most organs were in the right lower limb (p=0.002). Of all cases, 66 (98.5%) were injured by a species of viper snake. All patients, showed symptoms of pain, swelling, erythema and ecchymosis bite. Twenty-seven (40.3%) of all cases, suffered fainting. Nausea and vomiting were two other common symptoms. The antidote used in patients was 5.1±1.3 vials. The mean incidence rate of snakebite was an estimated 4.1 per 100000.

Conclusions

Possible risk factors include male gender and young age. It was also found that the stings reach peak in the morning and noon. These reports are all in rural areas, and mostly occurred in the warm months. Snakebites in rural parts around Ardebil were prevalent. Severe side effects were rare, but the incidence of other complications was common among the victims.

Factors Affecting Preferences of Iranian Women for Breast Cancer Screening Based on Marketing Mix Components

BACKGROUND

According to recent statistics, the breast cancer rate is growing fast in developing countries. In North West Iran, the incidence of breast cancer after esophageal and gastric cancers has the highest rate. Previous studies have also indicated that women in this region show reluctance to do breast cancer screening. There is a great need for change to promote breast cancer screening among women. Social marketing is a discipline that uses the systematic application of commercial marketing techniques to promote the adoption of behavior by the target audience.

MATERIALS AND METHODS

In the present qualitative study, thirty-two women with breast cancer were interviewed about their experiences of breast cancer screening. A semi-structured interview guide was designed to elicit information specific to the 4 P's in social marketing.

RESULTS

Three main categories emerged from the analysis: price, service and promotion. Subcategories related to these main categories included factors effective in increasing and decreasing cost of screening, current and desirable features of screening services, and weakness of promotion.

CONCLUSIONS

Screening programs should be designed to be of low cost, to meet patients' needs and should be provided in suitable places. Furthermore, it is essential that the cultural beliefs of society be improved through education. It seems necessary to design an executive protocol for breast cancer screening at different levels of primary health care to increase the women's willingness to undergo screening.

Association of High Sensitive CRP Level and COPD Assessment Test Scores with Clinically Important Predictive Outcomes in Stable COPD Patients

BACKGROUND

High sensitive CRP (hs-CRP) is used as a marker of systemic inflammation in chronic obstructive pulmonary disease (COPD). However, we hypothesize that the raised hs-CRP is not closely related to the multiple consequences of COPD. This study was undertaken to investigate the association of COPD assessment test (CAT) score with SpO2, FEV1, body mass index (BMI), obstruction, dyspnea and exercise capacity (BODE) index and COPD exacerbation rate and compare it with the association to serum hs-CRP level.

MATERIALS AND METHODS

Sixty patients with stable COPD referred to the pulmonology clinic of Ardabil Imam Khomeini Hospital were included in this study. SpO2, 6-minute walk distance (6MWD), body mass index, BODE index, and pulmonary function test as well as exacerbation rate were determined in COPD patients. Then, the CAT questionnaire was completed by patients. Serum level of hs-CRP was measured in all patients and 15 controls. We statistically compared the relationships and correlations among the variables.

RESULTS

Hs-CRP level was significantly raised in patients (P=0.005). In these patients, the correlation of hs-CRP level with BODE index was significant (P=0.008). However, the correlation of hs-CRP with SpO2 and FEV1 was not significant (P=0.47 and P=0.17, respectively). Also, the correlation of CAT score with SpO2, FEV1, BODE index, and exacerbation rate in the previous year was significant (P<0.001, P<0.001, P<0.001 and P=0.017, respectively).

CONCLUSION

SpO2, FEV1, BODE index and exacerbation rate are more correlated with CAT scores than with the serum level of hs-CRP in stable COPD patients. The findings of this study should be considered in management of stable COPD patients.

Exploratory study of factors affecting continuity of cancer care: Iranian Women's perceptions

BACKGROUND

Today, breast cancer is increasing in nearly all societies. Currently, cancers are the third leading cause of death in Iran after cardiovascular diseases and accidents. Of the cancers, breast cancer is spreading particularly rapidly among Iranian women. Negative effects of discontinuation of care on patient survival have been well documented. Inhibiting or facilitating factors affecting continuity of care at different stages of the patient care continuum should be identified.

MATERIALS AND METHODS

The current study implemented a qualitative method that provided tools to examine factors in detail. This study was conducted on 22 women, undergoing surgery and chemotherapy after being diagnosed with breast cancer. Content analysis was the technique adopted.

RESULTS

The effective factors in continuity of care from the patients' perception, based on the participant statements, were classified into three categories of evaluation of symptoms, psychological reactions, and care triggers with several subcategories.

CONCLUSIONS

According to the outcomes of the current study, it can be noted that, the patient experiences can be brought into use by health-care professionals and assist them in providing patient sand their families with adequate consulting services. It can also provide an opportunity for making interventions tailored to the community culture, and closer adherence of patients to the prescribed treatments.

Profile of acute carbon monoxide poisoning in the west province of Iran

OBJECTIVE

To document the epidemiology and risk factors of acute carbon monoxide (CO) poisoning in the west of Iran and specify potentially presentable characteristics.

STUDY DESIGN

Observational study.

PLACE AND DURATION OF STUDY

Imam Khomeini Hospital of Kermanshah, Iran, from July 2006 to March 2008.

METHODOLOGY

This study was conducted using the records of 143 cases of CO poisoning referred to the only centre for the reference of poisoning cases. Intent, age groups, source of poisoning and clinical presentation were noted and described as frequency.

RESULTS

One-hundred forty two cases (99.3%), were accidental and only one case (0.7%) was suicidal. Mortality was (21.7%, n=31). The highest mortality was found in the age groups of 20-30 years and below 10 years. The greatest frequency happened in autumn and winter. The clinical symptoms and manifestations of CO poisoning included headache (35.3%), nausea (25.4%), vomiting (21%), dyspnea (10.3%), and decrease in level of consciousness (8%). Gas water heaters (35%), room heaters (32%), stoves (24%) and other items (9%) were the principal sources of the individuals' exposure to CO.

CONCLUSION

CO poisoning is a serious public health problem in west of Iran (Kermanshah). The number of CO poisoning cases was highest in the colder seasons of the year, whereas the majority of the poisoning cases could be prevented.

Application of Haddon's matrix in qualitative research methodology: an experience in burns epidemiology

Background

Little has been done to investigate the application of injury specific qualitative research methods in the field of burn injuries. The aim of this study was to use an analytical tool (Haddon’s matrix) through qualitative research methods to better understand people’s perceptions about burn injuries.

Methods

This study applied Haddon’s matrix as a framework and an analytical tool for a qualitative research methodology in burn research. Both child and adult burn injury victims were enrolled into a qualitative study conducted using focus group discussion. Haddon’s matrix was used to develop an interview guide and also through the analysis phase.

Results

The main analysis clusters were pre-event level/human (including risky behaviors, belief and cultural factors, and knowledge and education), pre-event level/object, pre-event phase/environment and event and post-event phase (including fire control, emergency scald and burn wound management, traditional remedies, medical consultation, and severity indicators). This research gave rise to results that are possibly useful both for future injury research and for designing burn injury prevention plans.

Conclusion

Haddon’s matrix is applicable in a qualitative research methodology both at data collection and data analysis phases. The study using Haddon’s matrix through a qualitative research methodology yielded substantially rich information regarding burn injuries that may possibly be useful for prevention or future quantitative research.

Five year survival of women with breast cancer in Ardabil, north-west of Iran

Breast cancer is the most common cancer in women, and the major cause of cancer deaths in women 20-59 years old. The present retrospective study was undertaken to examine survival in all newly diagnosed breast cancer in Iran. One hundred and sixty-one breast cancer registered patients in 2003 were included in the study and followed up for 5-years from cancer diagnosis. Data were analyzed using life tables and Kaplan Meier for estimating relative survival rates and Cox's proportional hazard model to investigate the interaction between variables. The mean age of the patients at diagnosis was 45.5 (SD=12.3), ranging from 19 to 86 years. Of all patients 90 (56%) were alive and 71 (44%) were dead after five years. Using life table analysis, the overall relative 5-year survival rate was found to be 51% (SE=0.05). Using Cox regression model analysis variables such as age, surgery, location and drug therapy significantly influenced survival. According to the results, the overall 5-year survival rate in Ardebil province was lower than other places of Iran and most countries in the world and needs to be improved. Also, results showed that breast cancer screening programs, awareness regarding early detection of breast cancer and education of health care providers are necessary.