ABSTRACT
Based on WHO reports, smoking is an epidemic in developing countries. One of important issues about this behavior is its distribution pattern in family members. The main purpose of this study was to evaluate if cigarette smoking had a tendency to cluster or aggregate in the families and what the determinants were. Using a multi-stage random cluster sampling approach, a household survey was conducted in Kish Island in 2009. We used the Alternating Logistic Regressions algorithm to model to show the familial aggregation. The odds ratio for the aggregation of cigarette smoking between family members was 1.63 [1.29-2.06] which increased to 1.96 [1.50-2.55] after adjustment for demographic factors. There was no significant correlation between siblings' cigarette smoking nor was between spouses but the pairwise odds ratio for parents offspring was significant. In other words, cigarette smoking in at least one of the parents increased the odds of being a smoker in offspring significantly. The study showed that the smoking behavior aggregated in families significantly. The inter-parent offspring aggregation was the main component of the familial aggregation. Higher education and age-gender interaction were determinants of smoking in the families. The programs for prevention and cessation of this behavior in the community might be more successful if they were designed in a family-based rather than an individual- based approach
Subject(s)
Humans , Female , Male , Family , Family Health , Logistic ModelsABSTRACT
The purpose of this investigation was to compare empirically predictive ability of an artificial neural network with a logistic regression in prediction of low back pain. Data from the second national health survey were considered in this investigation. This data includes the information of low back pain and its associated risk factors among Iranian people aged 15 years and older. Artificial neural network and logistic regression models were developed using a set of 17294 data and they were validated in a test set of 17295 data. Hosmer and Lemeshow recommendation for model selection was used in fitting the logistic regression. A three-layer perceptron with 9 inputs, 3 hidden and 1 output neurons was employed. The efficiency of two models was compared by receiver operating characteristic analysis, root mean square and -2 Loglikelihood criteria. The area under the ROC curve [SE], root mean square and -2Loglikelihood of the logistic regression was 0.752 [0.004], 0.3832 and 14769.2, respectively. The area under the ROC curve [SE], root mean square and -2Loglikelihood of the artificial neural network was 0.754 [0.004], 0.3770 and 14757.6, respectively. Based on these three criteria, artificial neural network would give better performance than logistic regression. Although, the difference is statistically significant, it does not seem to be clinically significant
Subject(s)
Regression Analysis , Health SurveysABSTRACT
While long-term exposure to air pollutants is associated with an increase in heart diseases and mortality, little information is available about the short-term effects of air pollution. This case-crossover study assessed the relationship of particulate matter [PM[10]] and carbon monoxide [CO] levels with hospital admission for acute coronary syndrome in Tehran, Islamic Republic of Iran. We interviewed 250 patients with a first episode of acute coronary syndrome and obtained data from hospital records and Tehran Air Quality Control Company. The risk of acute coronary syndrome was significantly associated with elevated concentrations of CO the day before the event [OR 1.18; 95% CI: 1.03-1.34] but not significantly with PM[10] [OR 1.00; 95% CI: 0.99-1.02]. Stratification by age, sex, diabetes, hypertension and smoking status did not affect the results, but women were more susceptible than men to CO levels [OR for women/men 1.68; 95% CI: 1.25-2.26]
Subject(s)
Humans , Male , Female , Air Pollutants/adverse effects , Particulate Matter , Carbon Monoxide/adverse effects , Sex Distribution , Risk AssessmentABSTRACT
The purpose of this study was to assess the relationship between psychological stresses and noise stresses on printery workers in Tehran, Iran. Hence, 267 workers were randomly selected. The Leq and Lmax were measured and the psychological stresses such as depression, anxiety, aggression and job satisfaction were also studied by the relevant questionnaires. The data were statistically analyzed by Pearson correlation test. The results demonstrated that there was no significant statistical relationship between noise and psychological stresses. In addition, by using Spearman regression method, the influence of variables such as age, gender and job history on psychological stresses caused by Leq and Lmax was studied and the results only revealed that the aggression caused by Leq increased in young personnel [P=0.02] as well as, anxiety caused by Lmax increased accompanied by increasing the job history and age of the workers [P=0.002 and P=0.007]. Therefore, more variables must be taken into consideration to judge about noise induced psychological stresses in workplaces
Subject(s)
Noise , Stress, Psychological , Aggression , Anxiety , Depression , Job Satisfaction , Occupational HealthABSTRACT
Many researchers have studied survival [time to death] of gastric cancer patients. Although gastric cancer diagnosed in early stages can be cured by surgery, chance of relapse still exists after operation. Hence, we should consider both events, that is, relapse of the disease and death, in order to be able to make a more precise estimation for survival of the patients. The purpose of this study was to use the competing risks method to estimate the cumulative incidence functions [CIF] of the relapse of disease and death and consequently to estimate the postoperative disease-free survival. A total of 330 patients admitted to Iran Cancer Institute and operated between March 1995 and March 1999 were enrolled in the study. They were followed up for at least 5 years to estimate their 5-year disease-free survival. Information on their demographic, clinical, and therapeutic characteristics, as well as on the type and time of occurrence of the first event [relapse of disease or death] after surgery was collected from their medical records. The direct parametric method was applied to estimate CIFs of relapse of the disease and death, while to adjust the effects of some covariates the parametric regression model was used. Data analysis was done using the R software and a p-value <0.05 was considered statistically significant. The findings were compared with the results obtained on the basis of data analysis in which the competing events were not considered. The median follow-up time was 37.9 months. Of all the patients 13% experienced relapse and 60.9% death as the first event after surgery. The CIFs of relapse of disease and death 5 years after operation, with due consideration of covariates, were estimated at 11.0% and 68.6%, respectively. Age, stage of disease, and complementary treatment were statistically associated with the CIF of death, while only complementary treatment was related to the CIF of relapse. Older patients and those in more advanced stages of disease were more likely to die after operation. Moreover, while complementary treatment after operation decreased the CIF of relapse of disease, it increased the CIF of death. The disease-free survival of patients 5 years after surgery was 20.4% [considering the effects of some covariates]. The competing risks method is recommended for analyzing survival data because of its capability in considering different events and, therefore, making it possible to make more precise estimations. By using this method, considering smaller variance estimates for model parameters and also narrow confidence intervals for the cumulative incidence functions of competing events, it is expected to obtain more precise results. Unfortunately, the results have revealed that the disease-free survival of gastric cancer patients is low in Iran
ABSTRACT
Each year almost 400,000 people are diagnosed with oesophageal cancer worldwide. Wide variation in incidence has been reported both between countries and in different ethnic groups and populations within a country. The area with the highest reported incidence for oesophageal cancer is the so-called Asian 'oesophageal cancer belt', which stretches from eastern Turkey through north-eastern Iran, northern Afghanistan and southern Russia to northern China. In the high risk area of Gonbad in Iran, world age-standardised rates are more than 200 per 100,000 and the male/female ratio is reported as 0.8:1.0.This study aimed to assess the risk factors and demographic factors influencing survival of patients with esophageal cancer in north of Iran using weibull and log-logistic regression models. Demographic and clinical data of 359 patients with confirmed diagnosis of esophageal cancer from Babol Cancer registry utilized for our model. parametric and weibull models were employed to analyze the data. The Akaike information criterion [AIC] was also considered as a criterion to select the best model[s]. All p values as 0.05 were considered as statistically significant. The sample study consisted of 62.7% men and 37.3% women. Estimated survival rates in 1, 3, and 5 years following diagnosis were 23%, 15%, and 13% respectively. According to AIC criterion, the hazard rate of non-monotonic and rejection proportional hazards assumption [p<0.05], log-logistic model was more efficient than weibull model. Family history of having cancer in patients showed a significant difference in both models. It is concluded that early detection of people with a family history of cancer can be effective as an important factor in reducing the risk of death in patients with esophageal cancer
ABSTRACT
The main goal of the present study was to develop a new sensitive and specific PCR based method for Identification of Cryptosporidium sp. using novel primers from 18S ribosomal RNA. Cryptosporidiosis in high-risk host groups particularly in neonates and immuno-compromised individuals may result in death. To the best of our knowledge this is the first study regarding develop a new PCR based method to diagnose the cryptosporidiosis in Iran. A total of 850 human fecal samples from patients clinically suspected to cryptosporidiosis and 100 healthy and diarrheic cattle stool specimens were collected. The simplified formol-ether concentration method was carried out for all samples. They were then examined microscopically by modified Ziehl-Neelsen staining method. Total DNA was extracted by QIA amp DNA stool mini kit. PCR and nested-PCR was carried out by using designed primers. Twenty nine cases of cryptosporidiosis infection in human and 30 samples from cattle microscopically were positive. The described primary and nested PCR method could detect all Cryptosporidium positive samples from human and cattle. Regards to suspected negative samples in primary PCR examination, the Nested PCR could approve two more positive results. Furthermore, Nested PCR analysis was able to detect one more case which was negative in both microscopically examination and primary PCR. Specificity of the test was 100%. Sensitivity of Nested PCR in comparison to our gold standard; microscopy after Ridley concentration modified ziehl-Neelsen, was 100%. Our developed PCR based method by using new primers devised from 18S ribosomal RNA revealed the ability for identification of the Cryptosporidium species such as C. parvum and C. huminis with high specificity and sensitivity
Subject(s)
Humans , Animals , Cryptosporidium , RNA, Ribosomal , Polymerase Chain ReactionABSTRACT
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. Socio-demographic and clinical data of 484 patients with GI cancer collected during the years 1990-1991were 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. 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. 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
Subject(s)
Humans , Male , Female , Survival , Mortality , Survival Rate , Survival Analysis , Life TablesABSTRACT
Although breast cancer in men is uncommon, its incidence rates has an increasing trend. Due to its low incidence, there are few studies in this subject and limited information is available. The purpose of this study was to investigate clinicopathological characteristics and survival of male breast cancer [MBC] in Fars Province, south of Iran. The data for this study were obtained from the population based cancer registry of Vice-Chancellor for Health Affairs of Shiraz University of Medical Sciences and Shiraz hospitals between January 1, 1989 and January 1, 2008, including 64 patients with MBC. Demographic, clinical and pathological aspects were investigated. The Kaplan-Meler method was used for the determination of survival rate and Log Rank test for the comparison. The Cox proportional hazards model was used for the multiple analysis. The patients' mean age at the time of diagnosis was 60,3 years [SD=12.7]. The most frequent age group [26.6%] was 51-60 years. The most common symptom [96.8%] was a palpable mass. The majority of patients [44.4%] had a symptom duration of less than or equal to 6 months. 56.3% of the patients had a tumor size of 2-4.9 cm. Forty six percent of the cases had axillary lymph node involvement. The median survival time was 10.0 years [95% confidence interval [CI]: 6.0-14.0]. The 5 year overall survival rate was 66.0% [95% CI=51.08-81.0%]. The median survival time of patients with axillary lymph node involvement was 8.2 years [95% CI=6.7-9.6] and for the cases without involvement was 12.0 years [95% CI=8.4-15.2]. In addition to axillary lymph node involvement, positive family history in contrast to negative family history and left tumors in comparison with right tumors were poorer prognostic factors in univariate analysis respectively [p=0.006, p=0.031]. In multiple analysis, axillary lymph node involvement was an independent predictor of poorer survival [Hazard ratio=1.6, 95% CI=1.1-6.4, p=0.030] and the other variables did not have a significant effect. The mean age of MBC in this series is lower than that in western countries. It is compatible to the mean age of female breast cancer which is approximately one decade less than that in developed countries. The survival rate of MBC is relatively lower than that in western countries. Axillary lymph node involvement is an important prognostic factor in the survival of MBC. Multicenter population based studies with greater number of patients are required for better estimation of different aspects of MBC in Iran
ABSTRACT
Length of Stay [LOS] is an appropriate hospital indicator to evaluate hospital resource utilization rate, efficiency, and quality of services delivered. In this survey, we aimed to study hospital LOS and determine its association with clinical and non-clinical factors in Women Hospital in Tehran. In this cross-sectional study, we reviewed all 3421 charts of patients admitted in Oncology, Surgery and Obstetrics units in 2008. We used a data collection sheet and conducted interviews to collect the following data: distance from living area, medical insurance coverage types, admission and discharge months, days and times, inpatient units, final diagnoses and the number of diagnostic tests. The overall median of the LOS in the studied hospital was 50.8 hours. The medians were 48.5, 54.4, and 94.2 hours in the Obstetrics, Surgical and Oncology units, respectively. Results showed that the associated factors with the LOS were patient admissions on Thursdays, admitting by residents, the number of performed diagnostic tests [p<0.001], suffering from neoplastic diseases [p=0.005] and spouse jobs. Among the associated factors, policy makers and managers can only change the admission days and the number of diagnostic tests to decrease the LOS. Further researches are needed to find other factors associated with LOS
ABSTRACT
Due to its high prevalence, the survey on gastric cancer survival in Iran seems too important. In the case of relative long-term survival of the cases, using standard models is not conventional. So cure models are used to estimate the proportion of the cured patients that will never experience the event of interest and also to evaluate the survival function of susceptible individuals who may experience the event and effective factors. This study was carried out to determine the five-year survival rate of gastric cancer patients who have undergone surgical treatment. Three hundred and thirty gastric cancer operated patients with a maximum 10-year survival were enrolled in the study. The patients' life expectancy after surgery and cure fraction and their relationships with some variables were evaluated. Kaplan-Meier and Weibull Cure models were utilized for analyses. The five-year survival rate and the median life expectancy were 24% and 19.9 months, respectively. Univariate analysis using the Weibull model showed that age, existence/site of metastasis and stage of disease influenced on the probability of curing [P<0.05]. On assessing the simultaneous effect of different variables the age and stage of disease proved to be effective on curing [P<0.05], but none of the variables affected the life expectancy of patients [P>0.05]. Using the cure models is beneficial in situations which the population under study suggests the presence of subpopulation. The cure/immune model methodology may separeltery identify the sets of covariates related to the cured proportion and also the failure time distribution of uncured one
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To asses the status of two representative genes of cag PAl i.e cagA and cagE of Helicobacter pylori strains infecting Iranian patients suffered from various clinical outcomes using one-step PCR. A total of 120 H. pylori infected patients including non-ulcer dyspepsia, NUD [n=81], peptic ulcer disease, PUD [n=17], and gastric carcinoma, GC [n=22] referred for endoscopy or gastric resection to Amir Alam Hospital or Cancer Institute from 2005 to 2008 were assessed. The status of cagA and cagE genes was determined by gene specific PCR. 84.2% and 90.8% of the tested strains were positive for cagA and cage, respectively. 81.7% strains were positive for both cagA and cagE genes, whereas 8 [6.7%] were found double negative. The prevalence of cagA in GC patients [100%] was slightly higher than PUD patients [94.1%]. All of GC cases were infected with cagA-positive strains. The same distribution pattern was indicated for cagE gene in GC and PUD patients. The cagA-positive strains were significantly associated with GC as compared with NUD [P< 0.05] but this association did not gain statistical significance when cagE gene was assessed. The concurrent detection of cagA/cagE genes allowed rapid and specific clarification of cag PAI status. The strains with cagA/cagE genotype are predominant in Iran regardless of clinical outcome and create a distinct cluster pattern from those in the West and similar to those of East Asian countries. The current study also demonstrated that cagE gene can be explored as a better indication of cag-PAI in Iranian H. pylori strains
Subject(s)
Humans , Antigens, Bacterial , Bacterial Proteins , Peptic Ulcer , Stomach Ulcer , Polymerase Chain Reaction , Cross-Sectional Studies , DNAABSTRACT
Candidiasis associated with indwelling medical devices is especially problematic since they can act as substrates for biofilm growth which are highly resistant to antifungal drugs. Farnesol is a quorum-sensing molecule that inhibits filamentation and biofilm formation in Candida albicans. Since in recent years Candida tropicalis have been reported as an important and common non-albicans Candida species with high drug resistance pattern, the inhibitory effect of farnesol on biofilm formation by Candida tropicalis was evaluated. Five Candida tropicalis strains were treated with different concentration of farnesol [0, 30 and 300 micro M] after 0, 1 and 4 hrs of adherence and then they were maintained under biofilm formation condition in polystyrene, 96-well microtiter plates at 37°C for 48 hrs. Biofilm formation was measured by a semiquantitative colorimetric technique based on reduction assay of 2,3- bis -2H-tetrazolium- 5- carboxanilide [XTT]. The results indicated that the initial adherence time had no effect on biofilm formation and low concentration of farnesol [30 micro M] could not inhibit biofilm formation. However the presence of non-adherent cells increased biofilm formation significantly and the high concentration of farnesol [300 micro M] could inhibit biofilm formation. Results of this study showed that the high concentration of farnesol could inhibit biofilm formation and may be used as an adjuvant in prevention and in therapeutic strategies with antifungal drugs
Subject(s)
/drug effects , Candida tropicalis , Azoles , Candidiasis , Antifungal AgentsABSTRACT
Immunization against diphtheria, tetanus and pertussis [DTP] has long been applied in Iran using whole cell vaccine. Despite the role of whole cell DTP [DTwP] vaccine in reduction of mortality as a result of disastrous diseases such as diphtheria, tetanus, and pertussis, serious local and systemic complications have been attributed to these vaccines. This study was performed to determine the complications of DTwP vaccine in infants attending some of the health centers of Tehran in 2006-2007. In this prospective study, 330 infants were injected with DTwP vaccine manufactured by Razi Institute of Iran. All subjects received DTwP vaccine at 2, 4, and 6 months of age following the national vaccination schedule of Iran. Reactogenicity was assessed by the parents for 7 days post-vaccination using diary cards. Of the 279 infants who completed the vaccination study, pain was the most frequent local reaction after the primary vaccination [68.1-75.3%]. The mean diameters of the redness and swelling at first day post-vaccination were 2.81 +/- 6.91 and 2.60 +/- 7.93 mm in the first dose, 2.40 +/- 6.25 and 1.94 +/- 5.74 mm in the second dose and 2.24 +/- 5.66 and 2.16 +/- 6.03 in the third dose, respectively. Fever [axillary temperature > 37.5°C] was the most frequently reported systemic reaction during the primary vaccination [53.8-58.8%]. All systemic reactions observed after each dose were either reduced or completely disappeared during a week. The high incident of complications observed following vaccination with this cellular triple vaccine may be related to the formulation or the bacterial cell fragments used in vaccine production
Subject(s)
Humans , Male , Female , Infant , Prospective Studies , VaccinationABSTRACT
Disability Weights [DWs] are main components for computing summary measure of population health [SMPH] and economic studies. They are specific for each community, but there are no previous studies in Iran. In this study, we investigated the feasibility of health state valuation [HSV] in Iranian population. Twelve cardiologists in 3 sessions of expert panels, defined 25 states, related to cardiovascular diseases [3 major and 22 specific diseases]. From January to March 2008, 80 persons in 4 groups including: physicians, patients, patients' families and general publics [each group 20], were interviewed and valuated the states, using visual analogue scale [VAS] method. SPSS[Registered] 15 for window[Registered] [SPSS Corporation, Chicago, Illinois] was used for statistical analysis. Data showed that the defined health states had various severities. All the 4 groups ranked the "3 major-diseases" and "very-mild" and "very-severe" states, similarly. Non-physicians were not able to differentiate among "valvular-diseases" and "pacemakers" properly. The reliability of responses was acceptable. VAS is an appropriate and reliable method for HSV in Iranian population. Non-physicians' opinions can be consider in major cardiac diseases. Valuation of more specific situations must perform by physicians
Subject(s)
Humans , Pain Measurement , Cost of Illness , Cardiovascular Diseases/diagnosis , Pain MeasurementABSTRACT
We evaluated the measles-rubella mass vaccination campaign in the Islamic Republic of Iran in December 2003. Vaccination coverage, community awareness of the campaign and the quality of vaccination services were assessed in the population covered by Tehran University of Medical Sciences. At the end of the campaign 96.4% [95% CI: 94.6%-98.2%] of the population sample [n = 390] had been vaccinated. Awareness of the campaign was 80.59% of the sample [n = 190] at the start, rising to 96.8% during and 100.0% at the end of the campaign. None of the 24 vaccination teams sampled were over the threshold for unacceptable performance. The mass media and vaccination teams demonstrated good performance and have achieved their goals
Subject(s)
Female , Humans , Male , Mass Vaccination , Awareness , Quality of Health Care , National Health ProgramsABSTRACT
Background and Purpose: Epidemiologists have always been sought to discover factors influencing populations so that they can control population growth. This study was conducted to investigate the relationship of socioeconomic and demographic factors with fertility
Methods and Materials: This descriptive analytical study was conducted in two stages in 2003 on 1300 families in the Northwester province of Azarbaijan-Gharbi in Iran. The study data were collected through questionnaires and interview. The relationship between woman's age, marital age, marital duration, sexual preference, number of wanted children, stillbirth, child death, education and employment, couples age difference and fertility was determined using Pearson's correlation coefficient, stepwise multiple linear regression and ANCOVA in SPSS
Results: Mean age of the participants was 32.61 +/- 7.97, and mean live birth was 2.39 +/- 1.82. In the regression model, child death, number of wanted children, sexual preference marital duration with positive coefficients, and couples education with negative coefficients emerged. Fertility in marriages under 15 years [4.20 +/- 2.43] was significantly higher than other marital age groups. Fertility was higher in illiterate or low-education women. Mean wanted child in women of younger than 20 years old and women of 40-49 years of age were 2.9 +/- 0.56 and 3.37 +/- 0.84 respectively
Conclusion: As the results suggest, child death, sexual preference, desire to bear more infants and marriage before the age of 15 are associated with higher fertility rates . Illiterate or Low-education women are more fertile than other educational groups. Mean wanted children in women of under 20 years of age is higher than the current fertility rate
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To assess the effect of supplementation with vitamins A, E and C and omega-3 fatty acids on lipid peroxidation in Streptozotocin [STZ] induced diabetic rats. Sixty four male wistar rats weighting 250g were divided into four groups as normal control, diabetic control, diabetic with vitamin A, E as well as C supplementation and diabetic with omega-3 fatty acids supplementation. After four weeks of treatment the rats were anesthetized and malondialdehyde [MDA] levels were investigated in blood samples, liver and heart homogenate. In diabetic rats MDA level in plasma, liver and heart was significantly more elevated than normal control rats [P< 0.05]. Vitamin A, E and C supplementation caused significant decrease in plasma, liver and heart MDA [P< 0.05]. A significant decrease in heart MDA [P< 0.05] was observed in diabetic rats with omega-3 fatty acids supplementation. Supplementation of vitamin A, E and C and co-3 fatty acids was found to decrease lipid peroxidation to some extent in diabetic rats and they can be valuable candidates in the treatment of the complications of diabetes
Subject(s)
Male , Animals, Laboratory , Vitamin A , Vitamin E , Fatty Acids, Omega-3 , Ascorbic Acid , Lipid Peroxidation , Rats, Wistar , Malondialdehyde , Diabetes Mellitus, Experimental , Streptozocin , Free Radical ScavengersABSTRACT
Prior investigators have demonstrated the positive effects of exercise on pain relief and extended range of motion in rheumatoid arthritis [RA] patients. The present study was designed to determine the effects of these exercises in water [hydrotherapy]. In a clinical trial, a total of 32 adult females were equally assigned in experimental and control groups. At baseline, demographic data, patients' pain and range of motion were determined. Then, the experimental group was advised associated hydrotherapy activities, finally, 6 weeks later, they were reassessed. The mean pain severity was reduced in both experimental and control groups [p<0.0007, p<0.03, respectively], however, pain severity reduction was more significant in hydrotherapy group. Range of motion was also significantly increased in hydrotherapy group, when compared with controls [p<0.05]. Hydrotherapy could effectively reduce pain severity and increase range of motion in RA patients
Subject(s)
Humans , Female , Range of Motion, Articular , Arthritis, Rheumatoid/therapy , Exercise , Pain/therapyABSTRACT
Pneumonia during pregnancy can induce serious consequences to the mother and the fetus, therefore its diagnosis and therapy is very important. There are few published articles on Legionella infection prevalence during pregnancy. In patients with Legionellosis, bacterial LPS and DNA are excreted into urine for extended periods, so combination of PCR and ELISA methods would be a good diagnostic tool. This research was done to determine the prevalence of L. pneumophila in pregnant women with respiratory infections. This is a cross-sectional study on 95 pregnant women with respiratory infection carried out during winter to summer 2006. Presence of Legionella infection was con-firmed by nested PCR-RFLP and antigen detection in urine specimens by ELISA method. The data were analyzed by SPSS, version 13, by using independent t tests, Fisher's exact test, ?2, a logistic model and McNemar's test, while considering p<0.05 as significant. The prevalence of infection using PCR was 22.1% [CI=14.1%-30.1%] and by ELISA it was 4.2% [CI=2%-8.2%]; this difference was statistically significant [p<0.005]. The most pre-valent clinical features were Cough [56.8%], headache [54.7%], abdominal pain [38.9%], chills [35.8%], fever [22.1%] and diarrhea [8.4%]. There were significant statistical relationships bet-ween cases with a positive CRP and fever, chills and abdominal pain and previous liver or renal problems [p<0.05, p<0.001]. There were significant relationships between fever and chills with ELISA results [p<0.05] but no relationships with other variables. There was a considerable prevalence of this infection in the studied population [22.1%]. It seems that performing PCR and ELISA tests on urine sample is suitable in detecting Legionella species and it can provide results in a less than a day_ a great help in the diagnosis and treatment of pneumonia especially during pregnancy