Coronary artery disease risk factors in an urban and peri-urban setting, Kerman, Southeastern Iran [KERCADR study]: methodology and preliminary report

This article was to present the sampling and measurements methods and the main preliminary findings of the KERCADR cohort study [first round] in an urban and peri-urban setting, Kerman, southeastern Iran2009-11. 5900 [3238 female] people aged between 15 to 75 years were recruited in the household survey by non-proportional to size one-stage cluster sampling. Trained internal specialists, general practitioners, clinical psychologists and dentists have assessed the study subjects by person-assisted questionnaires regarding different NCD risk factors including cigarette and opium smoking, physical activity, nutrition habits, anxiety, depression, obesity, hypertension and oral health. Blood samples were also collected for determining FBS, HbA1c, cholesterol and triglyceride. Weighted standardized prevalence estimates were calculated by STATA 10 survey analysis package. The participation rate was more than 95% in all subgroups. Cigarette smoking [18.4% vs. 1.2%], opium use [17.8% vs. 3.0%] and triglyceridemia [16.1% vs. 12.0%] were significantly higher among men than women. In contrast, women were presented with higher level of sever anxiety [29.1% vs. 16.7%], obesity [16.8% vs. 9.2%], low-physical activity [45.1% vs. 39.2%] and uncontrolled diabetes [60.2% vs. 31.0%]. More than 68% of all subjects have presented with moderate to severe gingival index scores. The first round of the KERCADR cohort with sufficient sample size and response rate provided precise estimates for the main clinical and para-clinical NCD risk factors. These evidences need to be translated into public health interventions and monitored in the next rounds of the cohort

[Opium dependency with histopathologic changes of brain in rats]

Central nervous system is one of the primary targets of the detrimental effects of narcotics. Although opiates are among the most drugs of abuse, little is known about their side effects on the brain structures. Most investigations in this field are about their biochemical or psychological side effects. In this study pathologic changes in morphine dependent rats have been investigated. In this experimental study, 48 male wistar rats were divided into 6 groups. The dependent groups received 0.4mg/ml morphine in drinking water for 7, 28 and 56 days. The control groups received a solution of saccharose in drinking water for the same periods and then the histological studies of the brain samples were done. Significant neuronal loss in frontal and parietal lobes and hippocampus was observed. Results also showed a significant relationship between the duration of morphine intake and neuronal loss. The results of this study, in line with the other studies in this field indicate that opiate drugs might induce neuronal damage after long term exposure. These changes could be more significant in chronic addiction. Since brain atrophy is the most common pathology in dementia, further investigations for finding probable relations between dementia and opiate dependency is suggested

Systemic effects of experimental spinal cord injury on bone healing in rabbit

loss after spinal cord injury leads to increased fragility of bone and subsequent risk for low-trauma fractures in the sublesional parts of the body. Although in such injuries upper limbs are normally innervated, bone loss may occur in the upper extremities. The present study was designed to de-termine the systemic effects of spinal cord injury on the fracture healing of upper limbs in rabbits. Twenty nine skeletally mature New Zealand white rabbits received a transverse mid-humeral open osteotomy in the left upper limb with the use of a standardized technique and spinal cord injury was done using forceps model at T8 level. The animals were divided into three groups: experimental [laminectomy, spinal cord injury, and osteotomy], sham [laminectomy and osteotomy], and control [osteotomy alone]. The bone healing score was calculated using modified Sandhu system by two independent pathologists. The mean ['SD] of healing scores in experimental, control, and sham groups were 7.22 [ +/- 3.6], 8.6 [ +/- 3.3], and 8.5 [ +/- 4.3] respectively [P = 0.68]. The percentage of mesenchymal [20%] and cartilaginous tissue [35%] showed a slightly higher value in the experimental group compared with the sham group [15% and 20% respectively]. A reverse pattern was seen concerning the percentage of trabecular bone, though as a whole there was no significant difference regarding the percentage of selected components of bone healing between the three trial groups. Fracture healing in innervated upper limbs is not influenced by the systemic effects of spinal cord injury

[Knowledge of patients with cancer towards their disease status]

Ethical issues arise in oncology more frequently than before. Informing patient of his/her disease status and prognosis is of utmost importance. The present study was designed to assess knowledge of patients with cancer towards their disease status in Kerman. For this study, 150 patients with cancer referring to the radiotherapy-oncology ward of Shafa hospital in Kerman were interviewed. We attempted to find out the following issues: Patients' knowledge towards their diagnosis, prognosis, etiology, duration and probable side effects of treatment. Then, the association between patients' knowledge and studied factors was determined. Of 150 patients, 53 [35.3%] were completely informed of their disease while 11 patients [7.3%] were aware of the prognosis. Totally, 63[42%], 16[10.7%] and 106[70.7%] of patients were aware of the disease complications, etiology and the treatment duration, respectively. 58 patients [38.7%] were involved in decision making about their treatment protocol. Patients' knowledge was associated with level of education, place and type of treatment [p < 0.05]. Iranian patients with cancer were not sufficiently informed of their disease status

[Evaluation of pathologist blinding in medical research proposals of Kerman university of medical sciences]

Human behavior is influenced by what we know or believe. In research projects, when the researcher expected a particular finding then explaining the results would be biased. Thus, blinding is a fundamental aspect of all research projects. A retrospective descriptive study was performed. During a 4-year period [2001- 2004] all approved research projects in deputy of research affaires of Kerman University of Medical Sciences that had been referred to pathology laboratories were evaluated. The mechanism used for blinding is questioned by interview with researchers or reviewing the proposals. Only 31% of research proposals had observed blinding policies correctly. Mistakes occurred most often in blinding process were as follow: single pathologist who was aware of research design, inappropriate group labeling by alphabetic abbreviations rather than case labeling by randomized numbers, remaining of interventions such as orthopedic devices in the test group, step by step remittance of specimens to pathology laboratory in multiphase studies, etc. Our results revealed that the pathologist should be blinded to group assignment. The blinding process and evaluating techniques should be supervised by statisticians and the monitoring committee [research center]

[Concordance standards of breast cancer pathology reporting: with international a 4-year study in Kerman]

Accurate pathology reporting is important for treatment of malignancies including breast cancer. The aim of this study was to determine the concordance of the current reporting system with international cancer reporting guidelines. Pathology reports of 112 consecutive cases of invasive breast cancer who were treated by modified radical mastectomy and axillary lymph node dissection in different hospitals of Kerman city during 2001 to 2004 were studied. Adherence to the international guidelines for macroscopic and microscopic items were determined. Pathology reports were collected from pathology centers of Kerman University of Medical Sciences, social security organization and private laboratories. Rosai check list was considered as our standard reporting proforma. One hundred twelve cases met the inclusion criteria. The results of reporting of the prognostic criteria were as follow: Histologic type [100%], lymph node status [96.4%], tumor size [93.7%], tumor location [91.2%], histologic grade [87.5%], vascular invasion [85.7%], perineural invasion [83.9%], status of surgical margins [82.3%], calcification [75%], necrosis [74.1%], presence of insitu component [39.3%], tumor multicentricity [38.4%], extent of lymph node involvement [33%], extent of insitu component [23.2%] and level of lymph node involvement [0.8%]. In most reports the presence and extent of carcinoma insitu, level and extent of lymph node metastasis and tumor multicentricity have been ignored. Considering the pivotal role of these factors using a standard reporting protocol is suggested