Prevalence of dyspepsia and its correlation with demographic factors and lifestyle in Shiraz, Southern Iran

Dyspepsia is a common disorder that can present many clinical dilemmas in patient management. Although not life-threatening, the symptoms are long-lasting, interfere with daily activities and have a significant impact upon quality of life. The aim of this study was to determine prevalence of dyspepsia and its relationship with demographic and socioeconomic factors, and lifestyle in an apparently healthy population in Shiraz, southern Iran. In a population-based study, 1978 subjects aged 35 years or older were interviewed from April to September 2004. A questionnaire consisting of demographic factors, lifestyle data and gastrointestinal symptoms was completed for each participant. The validity and reliability of the questionnaire were determined. The prevalence of dyspepsia was 29.9%. The dyspeptic patients were classified as having ulcer-like [27.9%], dysmotility-like [26.2%] or unspecified dyspepsia [45.9%]. The prevalence was higher in females, water-pipe smokers, NSAIDs users, and in those with psychological distress, recurrent headache, anxiety, nightmares and past history of gastrointestinal disease. Dyspepsia had an inverse relationship with consumption of pickles, fruits and vegetables, and with duration of meal ingestion. Subjects with dyspepsia symptoms were more likely to restrict their diet, take herbal medicine, use over-the-counter drugs, consult with physicians and consume medication advised by their friends. This study reveals that dyspepsia has a high prevalence in Shiraz, southern Iran and is associated with several demographic factors, lifestyle and health-seeking behavior

Outcome and characteristics of patients on the liver transplant waiting list: Shiraz experience

The only curative therapy for end-stage liver disease is transplantation but due to a shortage of available donor livers the waiting list mortality is high. This study aimed to evaluate the outcome and characteristics of patients on the waiting list for liver transplantation in Shiraz, southern Iran during the period from April 2004 to March 2007. Medical records of all chronic liver disease patients >/= 14 years that were on the waiting list for liver transplantation at the Nemazee Hospital Organ Transplant Center during April 2004 to March 2007 were reviewed. Hospital records were used to retrieve demographic, clinical and laboratory data. Records of the referring gastroenterologists provided information about the etiology and complications of liver disease. The patients were followed at the end of the study period by clinic visits or telephone contact. There were 646 patients on the waiting list for liver transplant during April 2004 to March 2007. Hepatitis B was the most common etiology of liver disease [31.2%]. Of those on the waiting list, 144 patients 22.3%] underwent liver transplant and 166 [25.7%] died while waiting for a transplant. The mean waiting period for transplant was 6.6 months. Receiving a transplant was correlated with the etiology of liver disease and Rh blood group [p<0.05] but had no significant association with gender or ABO blood type. Among non-transplanted patients, survival was lower in those who had a history of encephalopathy, SBP or uncontrolled ascites and in patients with a Child-Turcotte-Puph [CTP] class C and/or a Model of End-stage Liver Disease [MELD] score >/= 15. Hepatitis B virus is the most common cause of end-stage chronic liver disease amongst patients on the waiting list for liver transplant in Shiraz, southern Iran. Patients with a MELD score >/= 15 particularly those with a history of SBP, hepatic encephalopathy or uncontrolled ascites are recommended for waiting list enrollment

prevalence of Pediculus capitis among school children in Fars province, southern Iran

Pediculus capitis or head louse infestation affects millions of children worldwide, especially those in the 5-11 years age group. This study aimed to determine the prevalence of head pediculosis among school children in urban and rural areas of Fars Province, southern Iran. All school children of age 6-11 yr from both genders in all urban and rural areas of the province were screened for head louse infestation by examination of their hair and scalps. Parents of all infested children were also examined. The study was repeated in different seasons in the same areas. Moreover, infested children were treated with 5% permethrin shampoo and re-examined one week later for any relapse. The general prevalence of head louse infestation in primary school students was 0.49% in autumn, 0.37% in winter and 0.20% in spring. In the mentioned seasons, the prevalence of P. capitis was higher among females and in rural areas [P=0.001]. Although treatment with permethrin shampoo failed in females, it was successful in all infected males from both regions in autumn and spring and in males from urban areas in winter. Head louse infestation is uncommon among Fars Province school children in rural and urban areas and should not be considered a public health priority. However, due to the higher prevalence of pediculosis in low socioeconomic group and rural area in our region, it seems that health promotion, particularly early detection and effective management strategies should target this group in the province

12-years surveillance of poliomyelitis and acute flaccid paralysis in Fars Province, Southern Iran

Following the widespread use of poliovirus vaccine in the mid-1950s, the incidence of poliomyelitis declined rapidly in many industrialized countries. The aim of this study was to determine the surveillance of poliomyelitis and acute flaccid paralysis [AFP] in Fars Province, southern Iran to detect poliovirus wherever it may circulate. From 1995 to 2006, in a cross-sectional study, all patients over 15 years of age with flaccid paralysis in Fars Province of Iran were enrolled. The surveillance medical officers visited every AFP case, took clinical histories, and performed clinical examinations. Two stool samples were collected from each reported case within 14 days of the onset of paralysis and sent to WHO-accredited laboratories for poliovirus isolation and intra-typic differentiation. AFP cases from which stool sample of wild poliovirus was isolated were classified as confirmed poliomyelitis. Those AFP cases whose cultures for poliovirus were negative were referred to an expert panel. Whenever possible, nerve conduction velocity tests, electromyography, and other diagnostic modalities such as brain and vertebral MRI were performed along with a detailed neurological examination at least three weeks after the onset of paralysis. The non-polio AFP rate was 227 [mean: 18.91 per year]. Only one case of poliomyelitis was reported in the first year of surveillance. Other 226 cases had non-polio AFP. The most common cause of paralysis among these patients was Guillain-Barre syndrome [66%]. The non-polio AFP rate is almost in agreement with the estimated incidence of AFP in the population aged 0-15 years worldwide. Routine coverage with three doses of OPV with supplementary immunization activities has reportedly reached over 95% of all target children. The existing system must be closely monitored and actively supported to maintain and constantly improve performance

Clinical characteristics of colorectal cancer in Southern Iran, 2005

Colorectal cancer is the second leading cause of cancer-related mortality and represents a major public health problem in developed countries. The objective of present investigation was to determine the epidemiologic aspects and clinical characteristics of colorectal cancer in Shiraz, southern Iran. This was a retrospective study carried out during 2000-2005, and comprised 491 subjects with pathologically documented colorectal cancer. They were registered in Fars Cancer Registry, affiliated to Shiraz University of Medical Sciences, southern Iran. A questionnaire including data on demographic information, histological types of cancer, site of primary cancer and metastasis were completed by trained interviewers. Among 491 subjects, 57.2% were male and the most common age was 65-75 years. Patients under 45 years of age represented 22.8% of all colorectal cancer cases while 32% were over 65 years old. Those with a history of cancer in their first-degree relatives included 26.9% of the patients. Adenocarcinoma was the most common reported histological type of cancer [96.1%]. Among all subjects, 60.7% suffered from abdominal pain, 28.4% abdominal distention and 28.0% rectal bleeding. Other symptoms included diarrhea/constipation, nausea/vomiting, urogenital problems and mass sensation. The most common sites of metastasis were lung, brain and ovary