Enrolment Phase Results of the Tabari Cohort Study: Comparing Family History, Lipids and Anthropometric Profiles Among Diabetic Patients

OBJECTIVES: Different factors are responsible for the silent epidemic of diabetes mellitus in developing and developed countries. This study aimed to determine the role of demographic factors, lipid profile, family history (the estimation of genetic association) and anthropometric factors on diabetes onset. METHODS: Data from the enrolment phase of the Tabari Cohort study was applied for this study and included 10,255 participants aged between 35–70 years. Anthropometric variables were measured by trained staff using standard tools. Blood specimens were collected for lipid profile and blood glucose measurements. Data analyses were performed using SPSS version 24, with univariate and multivariate logistic regression. RESULTS: The prevalence of diabetes mellitus was estimated to be 17.2% in the cohort population, 15.6% in men, and 18.3% in women. The adjusted odds ratios (95% confidence intervals) for age groups 40–49, 50–59 and over 60 were 2.58 (2.20–3.69), 5.80 (4.51–7.48) and 8.72 (6.67–11.39), respectively. In addition, the odds ratios (95% confidence intervals) for 2 (or more), and 1 affected family member were 4.12 (3.55–4.90) and 2.34 (2.07–2.65), respectively. Triglyceride concentrations more than 500, and abnormal high-density lipoprotein levels increased the odds of diabetes mellitus by 3.29- and 1.18-fold, respectively. CONCLUSION: The current study showed that old age and a family history were strong predictors for diabetes mellitus.

[Prevalence of depression before, after, and during anti-viral therapy among patients with chronic hepatitis B and C]

Depression is a possible side effect associated with antiviral therapy for chronic hepatitis B [CHB] and chronic hepatitis C [CHC]. The objective of this study was to evaluate the prevalence of depression in patients receiving different anti-viral medications before, during and after treatment. This descriptive cross-sectional study was undertaken on 248 CHB or CHC patients referred to two clinics of Mazandaran University of Medical Sciences between March 2011 and April 2012. Those who received alpha interferon, another antivirus medication or combination of them were evaluated by Hospital Anxiety and Depression Scale [HADS] and clinical psychiatric interview before initiation of the medications, 12 and 24 weeks after the initiation of the treatment and 6 weeks after termination of antiviral therapy. The prevalence of depression in patients with either hepatitis B or C was higher than general population, but similar to each other. During the 12 and 24 week of the antiviral therapy, the prevalence of depression was increased especially in whom were receiving alpha-interferon. Six weeks after the termination of medical therapy, the prevalence of depression in whom received alpha interferon was decreased statistically. However, this event did not happen in the group that did not use interferon. It is suggested that patients receiving alpha-interferon should be psychologically assessed in the course of treatment. Displaying the symptoms of depression, doctors should apply the prophylactic and therapeutic measures as soon as possible

Outcome of vesicoureteral reflux in infants: impact of prenatal diagnosis

Vesicoureteral reflux [VUR] is an important disorder that could be diagnosed in antenatal or postnatal period. The natural history of VUR seems to be different between prenatal or postnatal forms of the disease. We compared the natural history and outcome of vesicoureteral reflux in infants less than one year old diagnosed prenatally or postnatally. All infants less than 12 months old with VUR were enrolled in two groups. Group 1 composed of patients with antenatal hydronephrosis and group2, infants with diagnosis of VUR because of UTI or other postnatal problems. We followed patients for an average of 33 months. Outcome was assessed by several factors: somatic growth, need for surgery, resolution, occurrence of UTI and scar formation. We studied 236 renal units in 152 patients [70 boys, 82girls], 67 patients in group 1 and 85 patients in group2. Occurrence of recurrent UTI was 10.6% with no significant difference between two groups. Reflux resolved in postnatal group more significantly than in the other group [73% vs 49%]. Scar developed similarly in both groups [15% vs 25% of renal units]. Surgery performed in 7 [8.2%] of postnatal and 4 [6%] of prenatal group with no significant differences between the two groups. VUR diagnosed prenatally has similar importance and outcome as postnatal diagnosed one. We suggest performing the same imaging and treatment procedures for prenatally and postnatally diagnosed VUR

Chronic urticaria: the necessity of laboratory examination

Urticaria is a common dermatologic disease. About 20 per cent of the population experiences it in a life-time period. The aim of this study was to compare the various laboratory examinations of chronic urticaria patients and healthy individuals and to determine the necessity of laboratory tests in such patients. In this study 78 patients suffering from chronic urticaria and 67 healthy individuals [2-50 year-old] with analogous demographic features underwent ALT, AST, S/E, ESR, CBC, TSH, T4, C4, C3, CH50, ANA, anti-thyroglobulin, anti-peroxidase, and anti H. pylori antibodies testing. Forty-one per cent of patients had increased IgE in comparison to 14.92% in normal subjects. Anti-thyroid antibodies were positive in 17.94% of cases while only 9% of normal individuals were positive [p<0.05]. Anti H. pylori antibodies were positive in 69.23% of patients [all above 18-year-old] and 61.19 per cent of normal population [p>0.05]. No significant difference found in other variables. Urticaria is often diagnosed based on clinical grounds and no routine laboratory examination is required

Frequency of nasal carriage of staphylococcus aureus and its antimicrobial resistance pattern in patients on hemodialysis

Staphylococcus aureus is currently the most common cause of infection in hospitalized patients. Patients on hemodialysis are at increased risk due to their immunocompromised state. The present study was designed to determine the frequency of S aureus nasal carriage in patients on hemodialysis. This study was undertaken in 2 dialysis centers to establish the frequency of S aureus nasal carriage at teaching hospitals of Mazandaran University of Medical Sciences, in the north of Iran. Standardized nose swabs were rotated into the anterior nares of the patients, and the samples were cultured on a blood-agar medium. Having grown the colony, gram stain, catalase, manitol, DNAase, and coagulase tests were all performed. Pattern of antibacterial sensitivity was determined by using the disc diffusion method. Also, agar dilution method was used to determine minimal inhibitory concentration of oxacillin and vancomycin. Of 84 patients on hemodialysis, 31 [36.9%] were nasal carriers of S aureus, of whom 23 [74.2%] were resistant to methicillin. Of the methicillin-resistant S aureus isolates, 3 [13.0%] were resistant to vancomycin and 7 [56.5%] had reduced susceptibility to vancomycin in agar dilution method. Resistance frequencies to clindamycin, ciprofloxacin, and trimethoprim-sulfamethoxsazole were 12.9%, 9.7%, and 19.3%, respectively. However, all microorganisms were sensitive to rifampicin. Patients on hemodialysis are at an increased risk of S aureus infections; thus, screening of these susceptible patients should be considered as a health priority. Meanwhile, microbial sensitivity tests should be ordered for all cases in order to optimize treatment options

Hypersensitivity to house dust mite and cockroach is the most common allergy in North of Iran

Asthma and allergic rhinitis are among the most common diseases in the world. The aim of this study was to detect, by skin prick test, aeroallergens in allergic patients in Sari, Mazandaran in north of Iran. This is a prospective study of skin prick test of aeroallergens in asthma, allergic rhinitis and their combination with clinical diagnosis. Three hundred and seventy five cases aged between 5 to 50 years, were referred to Tooba and Boo-Ali allergic centers of Mazandaran University of Medical Sciences between December 2006 and July 2009. The aeroallergens studied included house dust mites [Dermatophagoides farinae, Dermatophagoides pteronyssinus], cockroaches, feather, aspergillus, Alternaria, pigweed, nettle, oak and maple. Of the studied individuals, 175 cases were males [46.7%] and 200 were females [53.3%], of which 156 [n=41.5%] reacted to allergen extracts. In asthma, allergic rhinitis and their combination, the respective positive percentages were 26.6%, 22.9%, and 32.6% for Dermatophagoides farinae; 26.6%, 25.3%, and 23.3% for Dermatophagoides pteronyssinus; 12.7%, 17.4%, and 11.6% for cockroaches and 16.5%, 4.7%, and 7.0% for the feather. Other allergens were positive up to 5 percent. Total IgE levels were elevated in 56.4%, 53% and 60.5% of asthmatic, allergic rhinitis and the combination group, respectively. Eosinophils count was elevated in 40.5%, 33.2% and 37.2% of the same groups, respectively. The hypersensitivity to house dust mites is very common in north of Iran which may be attributed to the warm and humid weather of this area

[Skill, attitude and use of computer and internet in scholarly works and educational affairs by faculty members of Mazandaran universities of medical sciences]

Use of the internet to retrieve health information is increasingly common .The present study aimed to determine the ratio of attitude, skill and performance of faculty members in using computer and internet in research and educational affairs at Mazandaran University of Medical Sciences. In this cross-sectional study, an expert-reviewed and pilot-tested questionnaire, in 3 dimensions of attitude, skill, and usage, was used to collect data from 124 faculty members coming from five faculties of Mazandaran University of Medical Sciences .Data were analyzed by SPSS software using Spearman correlation test, central and scattered indices. Most of study population 38.7% was in good skill level, 15.3%in average, 11.3% in weak, and 29%in excellent skill level .58.9%of faculty members had excellent attitude and 26.6%good attitude about using internet and computer in medical education .About performance, 41.9%used computer 10-15 hours per week and in average, 33.9%used internet more than 60 hours per month. According to positive attitude of the faculty members to computer and internet in medical education and lack of enough knowledge and skill, it is necessary to think about promoting their skills and performances for optimal use of computer and internet in research and educational affairs .It is recommended to provide educational workshops based on needs due to knowledge, skill and science for faculty members of Mazandaran University of Medical Sciences, so they can gain from computer an internet facilities and electronic databases

Polyethylene glycol versus paraffin for the treatment of childhood functional constipation

Chronic constipation is a common elimination dysfunction in children. It can be treated with several drugs of different efficacy in different age groups. This study assessed the efficacy of Polyethylene glycol [PEG] and oral liquid paraffin in treatment of childhood chronic functional constipation. A total of 126 functional constipated children aged 1 to 15 years were divided into two therapeutic groups using systematic and random sampling technique. In addition, children were divided into three age groups of 12 to 23 months, 24 to 59 months and over 60 months old. They were scored based on five main criteria as follow: stool frequency per week, painful defecation, blood-stained stools, stool consistency and number of encopresis incidents per month. At the end of one therapeutic month, the scores obtained by drugs were compared with each other. Data were analyzed by using SPSS software, McNamara test, sign test, independent t test, and paired t-test. The scoring in PEG group was increased from 13.13 [ +/- 2.18] to 17.20 [ +/- 2.07] while in paraffin group, it increased from 13.48 [ +/- 1.90] to 16.78 [ +/- 2.51]. Comparison of the mean scores showed a significant difference of the two groups after one month [P=0.02]. Our results have shown that PEG is more effective than oral liquid paraffin for treatment of childhood functional constipation. Therapeutic response to the drugs varied among the different age groups

[Frequency of blood transfusion and its products in Emam hospital of Sari]

Blood is a life saving product and has no equivalent. Limitation time for storing and cost of typing and cross matched in respect of lab equipment and personnel, may lead to importance of proper request and use of them. In a cross sectional descriptive study, 500 patients with elective surgery were participated. Variable and data collection were done with check list. Data analyzed with SPSS soft ware. The standard ratio of cross matched per transfused was less than 1/5 pack. Results shown that of 500 patients, the blood transfused only for 80[16%] of them. The mean of hemoglobin for patients who have transfused were 12/4. The mean of hemorrhage for patients who have transfused were 822 milliliters and for the rest were 424. The whole products which used were, 325 packs and 15 units were platelet and the rest were whole blood and packed cell. In this study the ratio of cross matched blood with transfused was 4 packs higher than standard. Because of costs for storing, reservation, transport to hospitals, and costs of cross matched in respect of lab costs and staffs, the request of blood must be by real indication and exact needs