Rotavirus infection in children with acute gastroenteritis in Iran, a systematic review and meta-analysis

The recent studies show that Rotavirus is important cause of the acute gastroenteritis. The aim of this review is to estimate the number of Rotavirus infection among Iranian children by performing a systematic review and estimating a pooled data. We performed a systematic literature review in relevant databases including PUBMED, MEDLINE, OVID, SID, MAGIRAN, and IRANMEDEX. Search in databases was done in October 10, 2013. Meta-analysis was performed using the STATA statistical package version 11. We assessed heterogeneity by Q-test and used random model for pooling measures of proportion of Rotavirus infection among Iranian children with diarrhea [and 95% confidence intervals [CI]]. Sub group analysis between in-patient and outpatient group were done and publication bias was assessed by Egger and Begg tests. A total of 154 records were identified in our searching. There were 36 studies including a total of 15,368 children with diarrhea. Out of 15,368 children, 6,338 were positive for Rota virus gastroenteritis. Overall pooled estimate of infection with Rotavirus among cases of gastroenteritis was 0.35 [95% CI, 0.28-0.41]. Pooled estimates for hospitalized children and outpatient subgroups were 0.39 [95% CI, 0.30-0.48], and 0.31 [95% CI, 0.23-0.38], respectively. This study supports the importance of Rotavirus in the Iranian population such as common cause of diarrhea among children. Therefore, decision to adopt immunization programs to prevent Rotavirus infection might be helpful in Iran

Indoor smoke exposure and risk of anthracosis

The association between indoor smoke exposure due to traditional baking [baking homemade bread] and anthracosis has rarely been investigated. The aim of the present study is to quantify such association among the Iranian population. A hospital based case-control study was carried out on 83 anthracotic cases and 155 controls [83 individuals with non-anthracotic pulmonary disorders from the pulmonary ward and 72 persons from the surgical ward without any known pulmonary disorders]. The interview was performed using the "American Thoracic Society" questionnaire, comprising demographic information, occupational history, cigarette smoking, and indoor smoke exposure due to traditional baking. Multivariate analysis was performed by logistic regression. Comparison between cases and pulmonary ward controls showed that only the association between indoor smoke exposure due to traditional baking and anthracosis in women was statistically significant [OR: 4.30, 95% CI: 1.31 to 14.10]. This was concluded after adjusting for other risk factors such as occupational exposure to dust, age, and education. When surgical ward controls were considered as control, after controlling for the significant risk factors, we found a significant relationship between indoor smoke exposure due to traditional baking and anthracosis [OR: 3.35, 95% CI: 1.49 to 7.55]. Based on the findings from this study, it is concluded that there is an association between indoor smoke exposure and anthracosis. Women are significantly more susceptible to anthracosis than men are when exposed to smoke exposure

[Validity and reliability of a checklist for critical appraisal of the original research abstracts by student peer reviewers in medical student research congresses]

Background: Nowadays, it is of utmost importance to critically appraise the research evidences presented in scientific congresses by the audiences. In addition to improvement in scientific and practical skills of critical appraisal, it is important to use a standard framework as the major tool for peer reviewing. We aimed to assess the validity and reliability of one proposed checklist for critical appraisal of the original research abstracts by student peer reviewers.

Methods and Materials: This study was a part of an educational interventional project that was performed in a setting of a workshop where 40 medical students from the medical faculties of the universities in Tehran were recruited. Participants were selected using a non-probability purposive sampling method. Educational curriculum of the workshop included clarifying explanations on the 31-item checklist for peer reviewing of the abstracts as well as several tips about each item using lectures, simulations and group discussions during 10 hours. Medical students used the checklist twice, at beginning and the end of the workshop to score three sample abstracts. Data were collected and analyzed using Spearman correlation [internal consistency] and Cronbach's' alpha methods to calculate the reliability of different items and domains of the introduced peer reviewing checklist by SPSS software. Moreover, Delphi method was applied to confirm the validity of the instrument by experts' opinion.

Results: A group of experts finally confirmed the validity of this checklist by means of Delphi method. Moreover, internal consistency of the main domains of the checklist consisting of "Introduction", "Methods", "Results" and "Conclusion" were statistically significant [P<0.05]. The coefficient of Cronbach's alpha was calculated as excellent [0.926] in "Methods", and acceptable in two other domains of "Results" [0.650] and "Conclusion" [0.739] in pre-test data.

Conclusion: The introduced checklist was shown to be a structured, valid and reliable tool, which could be used in research congresses to improve the quality of peer reviewing.

[Evaluation of the risk factors of ectopic pregnancy and a comparison between two age groups: more and less than 20 years old]

Ectopic pregnancy [EP], is one of the most important complications of pregnancy and one of the most important factors of maternal mortality in developing countries. Evaluation of the risk factors might be helpful for patients in order to conduct a better management. The purpose of the present study, was to determine the risk factors of ectopic pregnancy and to compare them between the ago group of more and less than 20 years old. Also, these risk factors were compared between Iranian and Afghans. The study was conducted as a case- control study. In this evaluation 308 cases of EP [case group], were compared with 616 cases of normal pregnancy in Akbarabadi Teaching Hospital. All ectopic pregnancies have been confirmed by surgery and pathology. The evaluated factors were age, BMI, smoking, history of previous EP, history of STD, consanguinity, blood group and Rh, history of infertility and abortion, pelvic surgery, marital age, contraceptive methods, previous cesarean section, socioeconomic status, and nationality. Statistical analyses were performed using SPSS version 16. Chi- square test and logistic regression were used for analysis. Smoking p<0.001, AOR=5.7 [CI 95%= 2.8-11.6]], previous EP p=0.000, AOR= 11.4 [CI 95%= 3-42.4]], previous STD p<0.001, AOR= 3.2 [CI 95%= 2.1-4.9]], previous use of IUD p<0.001, AOR=4.1 [CI 95%= 2.1-8]], history of infertility p=0.01, AOR= 1.8 [CI 95%= 1.1-3]], previous cesarean delivery p=0.03, AOR= 1.5 [CI 95%=1.1-2.3]], consanguinity, p=0.002, AOR=2.2 [CI 95%= 1.3-3.6]], were considered as risk factors for EP. Age, BMI, previous abortion, socioeconomic status, blood group and Rh, did not show significant relationship with EP. Smoking, previous EP, history of STD, IUD, infertility, previous cesarean delivery, and consanguinity were, risk factors for EP

[Evaluation of short-term survival of patients with acute myocardial infarction and the differences between the sexes in Isfahan and Najaf Abad between [1378 - 1387]]

The purpose of this study is detecting short-term survival of all hospitalized patients with acute myocardial infarction in Isfahan and Najaf Abad based on sex. The data of all patients who were hospitalized with acute myocardial infarction between 1378 to 1387 in Isfahan and Najaf Abad were collected by trained nurses of the surveillance department in a research center. Using these information and Cox proportional hazard method, Kaplan-Meier method and log Rank test, the survival by sex in different subgroups of patients, was determined and compared between two sexes. Short-term 28 days survival following the occurrence of acute myocardial infarction is 90.9%. A significant difference was seen between overall women and men survival [Respectively, 86.7% vs. 92.5% p<0.001]. It decreases significantly with increasing age and increases with thrombolytic use. The survival rate of acute myocardial infarction in Iranian women is less than men. Physicians should pay more attention to the treatment and care of patients at higher risk of mortality, especially women and older patients

Risk factors for pre-eclampsia: a study in Tehran, Iran

This study evaluated some risk factors for pre-eclampsia, which is one of the most problematic complications of pregnancy. This was a retrospective case control study conducted on 318 pre-eclamptic women [case group] and 318 women who were normotensive at the time of delivery as the control group. Evaluated factors were: maternal age, gestational age, nuliparity, mother's educational status, maternal body mass index [BMI], maternal hemoglobin and blood Rh, familial history of pre-eclampsia, history of pre-eclampsia in a previous pregnancy, marital relations, urinary infection [UTI] during the present pregnancy, season of delivery, and method of contraception. Risk factors for pre-eclampsia were: UTI [P=0.04]; history of pre-eclampsia during previous pregnancy [P=0.003], and winter season [P=0.001]. Maternal age of more than 20 years, high educational status of mother, parity more than one, and oral contraceptive pills were protective for pre-eclampsia. After adjusting for all possible confounding factors using multiple logistic regression, only preexisting pre-eclampsia [P=0.004] was a risk factor, whereas parity more than three [P=0.007] and anemia [P=0.01] were protective for pre-eclampsia. The rate of cesarean delivery was more common in the pre-eclamptic group [245 cases, 77%] than the control group [85 cases, 26.7%]. The one minute Apgar scored neonates less than 8 was more common in the case group [28.6% vs. 47.4%, P<0.001]. Gestational age at the time of delivery was lower in the case group [36.48 +/- 3.4 weeks vs. 37.12 +/- 3.3 weeks, P<0.001]. Awareness of risk factors of pre-eclampsia can help to monitor patients, ensure earlier diagnosis and predict which patients are more likely to develop pre-eclampsia

Patellofemoral pain syndrome in Iranian female athletes

Patellofemoral pain syndrome [PFPS] is the most common overuse syndrome in athletes. It is one of the causes of anterior knee pain in athletic population who come to the sports medicine clinic. Patellofemoral pain is more common among female athletes especially adolescents and young adults. Symptoms include: persistent pain behind the patella or peripatella. Pain increases on ascending and descending stairs and squatting and prolonged sitting. The aim of this study was to evaluate the prevalence of PFPS in Iranian female athletes. 418 female athletes aged 15-35 years were examined in five sports: Soccer [190], volleyball [103], running [42], fencing [45] and rock climbing [38]. The athletes who had non- traumatic onset anterior knee pain of at least 3 months that increased in descending and ascending stairs and squatting, had no other causes of anterior knee pain such as ligament instability, bursitis, meniscal injury, tendonitis and arthritis and no history of knee surgery during the one past year were diagnosed as PFPS. 26/190 [13.68%] soccer players, 21/103 [20.38%] volleyball players, 7/42 [16.66%] runners, 6/45 [13.33%] fencers and 10/38 [26.31%] rock climbers had patellofemoral pain. Among the 418 female athletes who were evaluated 70 had PFPS. Rock climbers were the most common athletes with PFPS followed by volleyball players and runners

[Stress in medical students: a cross-sectional study]

There is little doubt that medical students are subject to considerable amounts of physical and mental stress, resulting in high rates of depression and anxiety as well as other health problems. The present study- conducted from June to August 2006- looks at the problem of stress among Iranian medical students. A total of 742 students in different stages of their general medical training filled in a questionnaire dealing with personal and demographic characteristics, physical and mental stress, social relations and perceived job perspectives as well as problems faced at home and the campus. For each participant, a total stress score computed and its association with putative risk factors examined using Mann-Whitney test, non-parametric correlations and logistic regression analysis. In logistic regression analysis, the following factors were found to have significant, independent associations with a high degree of stress: female gender [P=0.001], living in a large family [P=0.01], low income [P=0.05], training in clinical rotations [P<0.001] and internship [P<0.001] and separation from the family [P=0.01]. From a student's perspective, the most important problems [stressors] faced by the students included crowded campus and dormitories, poor learning facilities, work overload, humiliation and abuse from staff and faculty members. Addressing the financial needs of the students [e.g. easier access to student loans], developing better communication skills, education in various relaxation and stress reduction techniques, and measures to reduce workload are recommended to mitigate the effects of physical and mental stress in medical students. Key words: Stress, Medical students, Cause, Cross-sectional