[Evaluation of chemical quality of drinking water in Divandareh villages with emphasis on nitrate concentration]

Nowadays, the increasing concentration of pollutants in water resources, especially ground water, has been a matter of concern. Nitrate has been considered as a chemical indicator of water pollution for a long time. The aim of this study was to determine the chemical characteristics of drinking water and changes of nitrate in drinking water in Diwandareh villages. This was a cross-sectional study to determine the quality of drinking water of 30 villages in Divandareh. A total of 60 samples were obtained in two phases from water supplies and were analyzed according to the standard methods. Descriptive statistics, Piper, Schuler and Wilcox diagrams were used to interpret the results. The results showed that apart from nitrate, the concentrations of the other chemical quality parameters were below the standard limits. The mean and standard deviation of nitrate during the first and second stages of sampling in water sources were 26.13 +/- 25.61 mg L[-1] and 28.47 +/- 29.80 mg L[-1], respectively. According to Schuler diagram, the drinking water quality was moderate to good. Although the mean nitrate concentration in 80% of samples was lower than the latest national standard for nitrate, continuation of the current trend, particularly in the agricultural activities and uncontrolled use of groundwater resources in agriculture will change and lower the quality of water. Therefore, monitoring of agricultural practices and fertilizer use are necessary

[Comparative effects of adjunctive low-dose doxycycline with omega-3 fatty acid versus low-dose aspirin on chronic periodontitis]

Host modulation therapy has been considered as a new modality for treatment of periodontal disease. Omega-3 fatty acid has shown inhibitory and anti-inflammatory properties in treatment of inflammatory conditions such as perio-dontitis. This study compared the efficacy of omega-3 fatty acid and low-dose aspirin with doxycycline in treatment of chronic periodontitis. Forty-five patients with chronic periodontitis were selected and their clinical periodontal parameters were measured. They received phase I of periodontal therapy and were randomly divided into three groups. Each group randomly received one of the following daily drug regimens: omega-3 fatty acid plus aspirin [80mg], doxycy-cline [20mg] and the placebo [control]. Clinical parameters were measured again after six weeks. Wilcoxon test, paired t-test, Kruskal-Wallis test and one-way ANOVA were used to analyze the data. The mean values of bleeding on probing [BOP], periodontal pocket depth [PPD] and clinical attachment loss [CAL] in both test groups decreased significantly compared to the placebo group [P<0.05]. The reductions in the omega-3 group were significantly greater than those in the doxycycline group [P<0.05]. Omega-3 fatty acid can improve clinical parameters of periodontal disease, even better than doxycycline, which is routinely used for HMT

[Determination of the numerical scores of occupational hazards and their predisposing factors among nurses working in educational hospitals in Arak city]

The outcomes of work hazards in nurses include rising the rate of absence, frequent referral to the doctor, decreasing productivity and increasing the financial burden. The purpose of this study was to determine the numerical scores of occupational hazards and their predisposing factors in nurses working in educational hospitals in Arak city. This was a descriptive study accomplished with 102 employed nurses selected using a convenience sampling method. Data was gathered using a tool consisted of three parts: demographic data, predisposing factors to occupational hazards, and occupational hazards' score questionnaire. The collected data was analyzed using descriptive and inferential statistics. The numerical scores of occupational hazards in showed the presence of chronic fatigue [238], stress [209], pain in back [208] and foot [201]. The most predisposing factors to occupational hazard in the environmental dimension were lack of suitable supportive equipment [261] and calmness and relaxation in the work environment [217]. In administration-implementation dimension, the predisposing factor was working more than one shift and nurse shortage in the ward [261]. In the educational dimension, lack of enough knowledge about how to reduce work-induced fatigue [222] was the predisposing factor to work hazards. There was a significant correlation [P=0.02] between chronic fatigue and inadequate protective equipment. In addition, there was a significant correlation [P<0.001] between working for more than one shift and Inadequate knowledge about how to reduce work induced fatigue. The most common occupational hazard in the nurses was chronic fatigue. Nurses encounter with many predisposing factors in hospitals. Provision of nursing care to the society depends on nurses' optimum physical and emotional health. Therefore, in order to promote nurses' health, the establishment of occupational hazards' risk reduction committees is recommended

Isolation of free-living amoebae from Sarein hot springs in Ardebil province, Iran

Free-living amoebae [FLA] are a group of ubiquitous protozoan, which are distributed in the natural and artificial environment sources. The main aim of the current study was to identify the presence of FLA in the recreational hot springs of Sarein in Ardebil Province of Iran. Seven recreational hot springs were selected in Sarein City and 28 water samples [four from each hot spring] were collected using 500 ml sterile plastic bottles during three month. Filtration of water samples was performed, and culture was done in non-nutrient agar medium enriched with Escherichia coli. Identification of the FLA was based on morphological criteria of cysts and trophozoites. Genotype identification of Acanthamoeba positive samples were also performed using sequencing based method. Overall, 12 out of 28 [42.9%] samples were positive for FLA which Acanthamoeba and Vahlkampfiid amoebaewere found in one [3.6%] and 11 [39.3%] samples, respectively. Sequence analysis of the single isolate of Acanthamoeba revealed potentially pathogenic T[4] genotype corresponding to A. castellanii. Contamination of hot springs to FLA, such as Acanthamoeba T[4] genotype [A. castellanii] and Vahlkampfiid amoebae, could present a sanitary risk for high risk people, and health authorities must be aware of FLA presence

[Validity of naked eye single tube red cell osmotic fragility test [NESTROFT] in screening of beta-thalassemia trait]

Background and aim: Thalassemia is the most common single gene disorder which is not completely cured. It is needed to find a reliable and cost-effective prevention method for screening the disease. For the next step, it is needed to give proper education, genetic consulting and prenatal diagnosis for the patients and finally selective termination of affected fetuses. The aim of this study was to evaluate effectiveness of the Naked Eye Single Tube Red Cell Osmotic Fragility Test [NESTROFT] as a screening test for beta-thalassemia trait

Methods: In this descriptive -analytical study, NESTROFT was applied to a total of 158 subjects who were divided into three groups. Group I was comprised of 51 individuals belonging to parents whom at least one of the children was suffering from beta-thalassemia major, group II was consisted of 51 normal individuals and finally group III was comprised of 56 individuals with iron deficiency

Results: The findings of this study showed that sensitivity of the test was as high as 100 percent and specificity was 86.9 percent. The predictive value of the positive test was 78.5 percent and the negative test was as high as 100 percent. False positive results were obtained in 14 cases with iron deficiency

Conclusion: NESTROFT emerged as a highly sensitive, inexpensive and easy to perform test for exclusion of beta-thalassemia trait. It is therefore a suitable test for large-scale use in a developing country such as Iran, which has got limited financial and technical resources

[Study of-629C/A polymorphism of cholesteryl ester transfer protein gene in statin effects on plasma high density lipoprotein cholesterol level]

Cholesteryl ester transfer protein [CETP] plays pivotal role in HDL metabolism and in reverse cholesterol transport [RCT] pathway. CETP gene variants such as-629C/A that affect HDL cholesterol directly, modulates CETP gene transcriptional activity. This study was aimed to determine influence of-629C/A polymorphism of CETP in statin effects with regard to plasma HDL cholesterol levels. In this descriptive-analytical study, 196 adult patients with LDL-C more than 120mg/dL were divided into two groups base on lovastatin and atorvastatin using. Lipid profile was measured in all subjects before and after treatment and-629C/A polymorphism of CETP promoter was studied using polymerase chain reaction/restriction fragment length polymorphism method. Data were compared with paired t-test and ANOVA in SPSS software. Cholesterol was decreased and HDL was increased in AA genotype more than other genotypes by lovastatin, but ApoA1 was increased in CC genotype. ApoA1 also was increased in CC genotype more than AA or AC genotypes by atorvastatin. In CC genotype, lovastatin and specially atorvastatin increased ApoA1 in HDL particles more than other genotypes. Therefore, treatment with lovastatin and atorvastatin is more effective in patients with CC genotype for raising HDL particles activity

[ relationship between major depression and bone density]

Major Depression is associated with alterations in the neuroendocrine system, dysfunction of hypothalamic-pituitary-adrenal axis, and elevated blood cortisol levels. These changes may result in an increased risk of osteoporosis in depressed patients. The aim was studying the relationship between bone density and major depression. In a historical cohort study, we performed bone densitometry in 75 persons; 25 of them suffered from major depression, the remaining 50 were healthy volunteers as controls. The groups were matched for age, sex, BMI, supplemental calcium intake, regular exercise and menstrual status. Bone mineral density [BMD] was measured by the DXA method. The two groups were compared regarding T-score and BMD of lumbar and pelvic regions. BMD [gr/cm[2]] of total femur, femoral neck, and lumbar regions were all significantly lower in cases than controls, [0.94 +/- 0.13 versus 1.16 +/- 0.15, 0.92 +/- 0.12 versus 1.09 +/- 0.14, and 1.05 +/- 0.22 versus 1.32 +/- 0.21, respectively]. Osteoporosis was more frequent in patients with depression than in controls, 32% versus 4% in total femur region [Odds ratio: 5.4, CI 95%: 1.4%-20.3%], and 36% versus 14% in lumbar region [Odds ratio: 3.5, CI 95%: 1.1%-10.8%]. In this study major depression was associated with lower bone density and increased frequency of osteoporosis. Based on these findings, it seems reasonable to advice that patients with depression should be screened for osteoporosis

[Outcomes of goniotomy in primary congenital glaucoma]

To report the outcomes of goniotomy in young children with primary congenital glaucoma. This retrospective study included 26 eyes of 19 patients with primary congenital glaucoma who underwent goniotomy as the initial procedure. All patients were aged less than 3 years and had no history of previous ocular surgery. The main outcome measures were intraocular pressure [IOP], cup/disc [C/D] ratio, corneal diameter, success rate and complications. Surgical success was defined as IOP less than 20 mmHg [with or without medications] without progression of disc cupping or increase in corneal diameter. Mean age at the time of diagnosis was 10.5 +/- 12.2 [range 0-36, median 7.5] months. Mean follow-up period was 19.3 +/- 18.3 [range 2-62, median 12] months. Preoperatively, 20 eyes [76.9%] had corneal edema. Mean corneal diameter was 13.60 +/- 0.99 mm [range 12-16 mm] preoperatively which reached 13.98 +/- 1.08 mm [range 12-16 mm] at last follow-up [P=0.174]. Mean IOP was 27.74 +/- 6.07 [range 17-44] mmHg pre-operatively which decreased to 24.44 +/- 7.88 [range 11-40] mmHg at final follow-up [P=0.048]. Surgical success after the first goniotomy was 34.6%. The age of onset, level of IOP, C/D ratio, corneal clarity and corneal diameter did not significantly affect the surgical outcome. There was small hyphema in all patients postoperatively, which resolved rapidly in all except one who required surgical evacuation. Goniotomy is a safe and relatively effective procedure in young children with primary congenital glaucoma, but the success rate was low in our study; which can be attributed to the greater severity of the disease

[Validity of the Iranian version of the structured clinical interview for DSM-IV [SCID-I] in the diagnosis of psychiatric disorders]

To assess the validity of diagnoses obtained with the Iranian version of the Structured Clinical Interview for DSM-IV [SCID-I]. This study was undertaken in two stages: [a] translation of SCID-I into Persian [Iranian language], [b] assessing the validity of the Persian version in a sample of Iranian patients. We recruited 299 psychiatric patients- including inpatients and ambulatory cases- from 3 teaching hospitals. A trained SCID interviewer administered the SCID and then two psychiatrists developed a consensus diagnosis, using data from multiple sources. The degree of agreement between SCID interviews and psychiatrists' diagnosis ranged from "moderate" for obsessive-compulsive and major depressive disorders to "good" for bipolar disorder and schizophrenia. With the psychiatrists' diagnosis used as the gold standard, the SCID-based diagnosis showed high specificity and moderate to high sensitivity for most psychiatric diseases. The results of this study indicate that the Iranian version of the SCID is a valid instrument for diagnosis in clinical settings

Intraobserver reproducibility of retinal nerve fiber layer measurements using scanning laser polarimetry with variable corneal compensation in glaucoma suspect patients

To quantify the intraobserver reproducibility of retinal nerve fiber layer [RNFL] measurements using scanning laser polarimetry with variable corneal compensation in glaucoma suspect patients. Twenty-six eyes of 26 glaucoma suspect patients were included. Complete ophthalmologic examination and standard automated perimetry were performed for all of them. RNFL measurements were done using GDx- VCC [Laser Diagnostic Technologies, San Diego, CA] by an experienced operator. The test repeated immediately by the same operator. Patients were 24 to 70 years old [55.9 +/- 11.5 years]. Twenty patients were female and 6 patients were male. Eighteen patients were ocular hypertensive and 8 patients had large cup to disk ratios. None of them had glaucomatous field defect in standard perimetry. The mean coefficient of variation for measurements of TSNIT average [Avg], superior Avg, inferior Avg, TSNIT-SD and nerve fiber indicator [NFI] were 0.77, 0.95, 0.91, 0.81 and 0.98 respectively. The mean coefficient of variation of GDx-VCC was 88.4 for the 5 main parameters [TSNIT Avg, superior Avg, inferior Avg, TSNIT-SD, and NFI]. GDx-VCC showed a good test-retest correlation and acceptable intraobserver reproducibility. NFI may be the most reproducible major GDx-VCC parameter in glaucoma suspect patients

[Validity of a Farsi translation of the composite international diagnostic interview [CIDI] to diagnose schizophrenia and bipolar disorder]

The Composite International Diagnostic Interview [CIDI] is a comprehensive, standardized diagnostic interview for the assessment of psychiatric disorders. There have been few studies on the validity of the CIDI. The objective of present study was to assess the validity of a Farsi translation of the complete CIDI and its psychosis/mania module in five referral clinical psychiatric settings. Two hundred and three as well as 104 consecutive admissions were interviewed using the complete and the psychosis/mania module, respectively. Within two days of the CIDI interview, two last year residents of psychiatry or psychiatrist who were blind to the CIDI diagnosis completed the Clinical diagnostic checklists [based on DSM-IV and ICD-10 criteria] simultaneously and reached the consensus diagnosis. Data analysis was performed using SPSS 11 to determine the validity of CIDI. The sensitivity and specificity for the diagnosis of schizophrenia was 0.12 and 0.96 using DSM-IV criteria. According to ICD-10 criteria, the results were the same with 0.19% sensitivity and 0.96% specificity. The sensitivity for the diagnosis of bipolar I disorder was low [0.21 using DSM-IV criteria and 0.17% using ICD-10] and specificity, high [0.90 compared to DSM-IV and 0.89 compared to ICD-10 criteria]. The results were rather similar for the psychosis/mania module of CIDI. This study suggests that the Farsi translation of both the complete CIDI and the psychosis/mania module of CIDI have good specificity, but poor sensitivity for the diagnosis of schizophrenia and of bipolar I disorder

[Genetic analysis of FMF in a small village with high frequency in North West of Iran]

Familial Mediterranean Fever [FMF] is an inherited inflammatory disorder which caused by mutations in the MEFV gene. The disease is common among Turks, Armenians and Arabs, whereas no data from the neighbor countries is available. We studied an 8 years old boy with periodic fever and recurrent abdominal pain. Genotype analysis was performed by reverse-hybridization for 12 most frequent variants. Result indicated the patient and several individuals in the family were compound heterozygote or homozygote for the mutations. Genetic analysis for the other individuals without any clinical features in the village showed an allelic frequently of 22%, which is the highest rate reported to date

[Evaluation of bone mass in postmenopausal women presenting with back pain]

Back pain [BP] is a common symptom among the general population,particularly in the elderly subjects. It is the most common feature of osteoporosis [OP] as well as a symptom of vertebral fracture [VF]. In elderly women it may be a heralding symptom of OP and possibly a presenting feature of VF. The present study was designed to determine the frequency of low bone mass in postmenopausal women presenting with BP. 155 postmenopausal women with BP were studied. Bone mineral density [BMD] was measured with use of dual energy x-ray absorptiometry [DXA] with a single Norland Excell densitometer. BMD was determined in the femoral neck [FN] and L2-L4 region of lumbar spine [LS]. T-score and Z-score at both regions were determined. Frequency of OP and osteopenia at the FN and LS regions were detrmined according to WHO criteria. Patients with inflammatory musculoskeletal diseases, inflammatory back pain, infectious, or malignant spinal diseases, and history of rheumatic diseases or spinal surgery were excluded. Chi square and t tests were used for comparisons. The mean age and the mean menopausal duration of patients were 64 +/- 8 and 16 +/- 9 years respectively. Sixty-three percent of patients were 60 years or over. The mean BMD at the LS and FN were 0.70 +/- 0.13 gr/cm-2 and 0.79 +/- 0.18 gr/cm-2 respectively. The proportion of OP at the FN and LS were 30% and 56% respectively. The combined prevalence of OP at both FN and LS was 61.5%. The proportion of patients with Z-score<-1 and<-2 at the LS were 40% and 22% and at the FN were 37% and 11% respectively. In patients, aged 70 years and over, compared with patients below 70 years the BMD was decreased by 14% at the FN and 10% at the LS [P<0.02 and P<0.001 respectively]. Menopausal duration of over than 10 years was associated with 5.6 fold risk of OP. The results of this study indicate that, the majority of postmenopausal women with BP are osteoporotic or osteopenic at the LS or FN. So they are at increased risk of future vertebral or femoral neck fractures

[Measurement of intraocular pressure using schiotz vs tono-pen tonometers in patients with primary congenital glaucoma]

To compare the Tono-pen and Schiotz tonometers in measurement of intraocular pressure [IOP] in patients with primary congenital glaucoma. This study was conducted on 38 eyes of 20 patients with primary congenital glaucoma. All measurements were performed under general anesthesia. One minute after receiving Halothane 3% IOP was determined by Tono-pen and then by Schiotz tonometers. Data were analyzed by regression analysis and Bland-Altman bias plot. Mean age of patients was 19.4 +/- 14.5 months and 15 [75%] of them were male. Glaucoma was bilateral in 18 [90%] and unilateral in 2 [10%] subjects. Mean IOP measured by Tono-pen and Schiotz tonometers was 19.39 +/- 8.51 and 18.84 +/- 8.9 mmHg, respectively. These tonometers had good concordance in determination of IOP in primary congenital glaucoma according to the results of regression analysis and Bland-Altman bias plot. Considering the sample size of this study, the Tono-pen and Shiotz tonometers are highly concordant regarding intraocular pressure measurement in children with primary congenital glaucoma

[Success rate and complications of single-plate Molteno tube implantation in patients with glaucoma]

To evaluate the success rate and complications of single-plate Molteno tube implantation in patients with intractable glaucoma. This study was conducted on records of patients who underwent Molteno tube implantation from 1995 to 2000 and had at least 18 months of follow-up. Thirty six eyes of 35 patients including 20 male and 15 female subjects with mean age of 29.7 +/- 25.3 yr [range 3-77 yr] were enrolled in the study. Intraocular pressure [IOP] was 34.48 +/- 10.39 mmHg with use of 2.3 +/- 0.8 drugs which decreased to 17.97 +/- 7.63 mmHg with 1.9 +/- 1.2 drugs after 32.8 +/- 16.14 month of follow-up. [P<0.0001] Complete success [IOP /= 1 line in 10 [27.8%], decreased >/= 1 line in 8 [22.2%] and remained unchanged in 18 [50%] eyes. Postoperative complications occurred in 20 eyes [55.6%] including encapsulated bleb in 10 [27.8%], tube-iris touch in 4 [11%], flat anterior chamber in 3 [8.4%], tube-corneal touch in 2 [5.6%], and retinal detachment, tube-lens touch, and tube blockage each in 1 [2.8%]. Intraocular pressure dropped to zero in one eye and vision was lost. In eyes at high risk for trabeculectomy failure, implantation of the Molteno tube can be considered as a procedure with high success for controlling intraocular pressure and preservation of vision. Long term follow up is recommended to ensure adequate management of the frequent complications of this procedure

[Prevalence of cataract in Tehran]

Purpose: to evaluate the prevalence of cataract, lens opacity, and other conditions of the lens among residents of Tehran aged 40 or above, Tehran-Iran

Methods: this study was performed as a part of the population based study on the prevalence of glaucoma among citizens older than 40 in Tehran. A total of 2 160 participants joined the study [50% response rate]. After performing a medical history interview, all participants were examined according to a standard protocol including refraction, visual acuity testing, and slit-lamp biomicroscopy of the anterior segment. Cataract was diagnosed as any lens opacity with visual acuity of 20140 or less in the absence of other causes of visual loss

Results: the prevalence of lens opacity among right eyes, left eyes, and overall was 29.4%, 30.6%, and 32.4%, respectively. Prevalence of cataract was 8.1% in right and 9.1% in left eyes, respectively. The overall prevalence of cataract was 12%. The rate of pseudophakia or aphakia was 3.9% in right or left eyes and 5.2% overall. The prevalence of cataract in male and female subjects was 14.3% and 10.6%, respectively. The prevalence of cataract among adults older than 50 [17.1%] was 9 times that of the 40-49 age group [1.9%]. The prevalence of lens opacity among males and females was 39.1% and 28.3%, respectively. The prevalence of lens opacity among adults older than 50 [45.7%] was more than 7 times that of the 40-49 age group [6.3%]. The prevalence of grade II lens opacification or over was 33.4%. The most frequent type of lens opacity was nuclear sclerosis followed by cortical and posterior subcapsular opacities

Conclusion: the prevalence of cataract and lens opacity in residents of Tehran aged 40 or over is significant especially among elderly indivisuals and it may be estimated that 240,000 persons in Tehran population have cataract and 648,000 have lens opacity, which is a matter of concern for our health system

[Efficacy of aqueous extract of Echium amoenum L. in the treatment of mild to moderate major depressive disorder: a randomized double blind clinical trial]

The aim of this study was to evaluate the efficacy and safety of a constant dose of aqueous extract of Echium amoenum. Thirty-five patients with mild to moderate major depressive disorder who had a score >/= 18 on the Hamilton Depression Rating Scale were enrolled in the study and randomly assigned to receive either placebo or 375mg of aqueous extract of Echinum amoenum. Patients were followed for 6 weeks. Efficacy was assessed by the Hamilton Depression Rating Scale, in week 0, 1, 2, 4, and 6. In the week 4 and 6, drug was superior to placebo. This difference was significant at the fourth week [p =0.018] and marginally non-significant at the sixth week. The extract of Echium amoenum did not cause more adverse effects than placebo during the study. It is concluded that the aqueous extract of Echium amoenum can be considered as an effective and safe treatment for major depressive disorder. However further studies in warranted

Treatment of nodular cutaneous leishmaniasis by pentostam

The main object of this study was to evaluate the treatment of the patients at early stages of nodular form of leishmaniasis by intralesional injection of sodium stibogluconate [Pentostam]. The study shows that the method recommended by WHO expert committee gives satisfactory results in nodular form in Iran

Cutaneous lesions with very long duration as a complication of leishmanization

A list of 28 patients is given in whom the duration of the sore at the site of leishmanization has been 3 to 7 years. The problem of cases of cutaneous leishmanjasis with long duration as a complication of leishmanization is discussed. Although this complication is very rare, i.e. a few hundreds among more than 2 million people inoculated, its effect on the leishmanization program has been Considerable as reflected in reports by dermatologists the situations in which leishmanization is recommended is discussed