[Relationship between socio-economic factors and tuberculosis using negative binomial and Poisson regression models]

Tuberculosis [TB] is the most important cause of death worldwide. The main reason for the increasing global burden of TB are severe poverty and class distinctions between rich and poor population groups in various communities. This study was performed to determine the relationship between socio-economic factors and TB using negative binomial and Poisson regression models. This descriptive - analytic study was conducted on 11320 TB affected patients in Iran during 2010. Data was gathered from the Iranian Ministry of Health and Medical Education. The relationship between the numbers of cases with socio-economic indicators was determined using negative binomial and Poisson models. Fitting models were compared using AIC [Akaike Information Criterion] and BIC [Bayesian Information Criterion]. The Poisson regression model showed a significant relationship between the TB mortality rate and socio-economic factors [P<0.05]. Negative binomial regression model showed a significant relationship between TB and unemployment, illiterate, immigration and urban residency [P<0.05]. Negative binomial regression model showed no relationship between TB and family size, physicians' ratio to the number of population centers and annual average income. There is a significant impact of socio-economic factors with the number of TB cases. Negative binomial regression model is suitable for accountable data in comparision with Poisson regression model

Double-stranded RNA viral infection in Tehran trichomonas vaginalis isolates

Trichomonas vaginalis is a pathogenic protozoon and may be contaminated with dsRNA virus called Trichomonas vaginalis virus [TVV]. The viral infection is an important factor for its pathogenesis and sensitivity to metronidazole. The presence of TVV is associated with qualitative and quantitative expression of cysteine proteinases and surface immunogenic; P270. The purpose of this study was to determine TVV frequency in T. vaginalis clinical isolates in Tehran, Iran. The 46 T. vaginalis isolates were collected from Tehran Province and cultured in TYI-S-33 culture medium. Viral RNA was extracted and RT-PCR was done. Of 46 T. vaginalis isolates, 8 isolates [17.39%] were infected with TVV-1. There was not any association between patient age and TVV- infected T. vaginalis. There were 17.39% viral infection in T. vaginalis isolates which was lower than that reported by other researchers. This is the first report on T. vaginalis isolates infection by TVV-1 in Iran

[ prevalence of obesity and its relative factors among less than 5 years aged children, bandar turkmen district, Iran]

Child obesity is increasing in developing countries. This study assessed the prevalence of obesity and some related factors among less than 5-years children in Bandar Turkmen district, Iran. In this descriptive-analytical study, 616 children aged less than 5 years were selected with stratified random sampling. Obesity was defined as more than +2 standard deviation [SD] National Center for Health Statistics [NCHS] reference. Data were collected by interviewing mothers using a questionnaire and were analyzed with chi-square and Fisher's tests and multiple regression logistic models. 6 percent of children were obese. Prevalence of obesity did not differ significantly between boys and girls [6 and 6.1 percent respectively]. Less than 2500 g and more than 4000 g birth weight [P = 0.031], less than 18 months breast feeding duration [P = 0.017], more than 37 years mother's present age [P = 0.039], more than 30 years mother's delivery age [P = 0.043], and formula or cow's milk plus breast feeding up to 6 months of age [P = 0.018] had significant correlation with children's obesity. Exclusively breast feeding up to 6 months of age rather than formula or cow's milk plus breast feeding, reduced obesity risk about 2.45 times [P = 0.019]. This study suggests that exclusively breast feeding at first 6 months of age, longer breast feeding duration and pregnancy in lower than 30 years of age reduce risk of child obesity

Trend analysis of gastric cancer and colorectal cancer mortality in Iran, 1995-2003

Cancer is the third most common cause of death in Iran. Gastric cancer [GC] and colorectal cancer [CRC] are two important causes of mortality due to cancer. With regards to cancer mortality, data are important to monitor the effects of screening program, earlier diagnosis, demographic data and other prognostic factors. The aim of this study was to evaluate the mortality rates and trends from GC and CRC in Iranian population during a period of almost a decade, i.e. from 1995 to 2003. National death Statistic Reported by the Ministry of Health and Medical Education [MOH and ME] from 1995 to 2003, stratified by age group, sex, and cause of death are included in this study. CRC and GC were expressed as the annual mortality rates/100,000, general and/or per gender, and age group. The general mortality rate of CRC slightly increased during the years under study from 0.44 to 2.54 and CRC mortality was higher for older age and male. The general mortality rates of GC showed a sharp increasing from 1.68 to 9.67. In addition to this, GC mortality rate was higher for male than female. Our study indicated remarkable increasing trends in GC and CRC mortality. So developing for a gastric cancer for both primary prevention and early detection programs and manage the delays of diagnosis is recommended to decrease the trend of GC mortality. For CRC, since the rate of CRC screening is very low in Iran, it is recommended that in Iran screening be started as a public program in order to control the mortality and burden of CRC in the future

[Effects of high-fat diets based on butter or soybean, olive or fish oil on insulin resistance and plasma desacyl-ghrelin in rats

There is evidence on reciprocal effects of insulin and desacylghrelin [DAG], but associations between secretions of hormones [insulin and DAG] and saturated and unsaturated proportions of edible oils in high-fat diets have not been studied. The aim of this study was to investigate the impact of different sources of dietary fat and the extent of fatty acid saturation on plasma insulin and DAG levels and determine the association between DAG and insulin action in rats. Weaning male Wistar rats were randomly divided into four groups to be fed on one of 4 high-fat diets containing, as the source of fat, butter [HF-b], soybean oil [HB-S], olive oil [HF-O], or fish oil [HF-F]. A fifth group was put on a standard diet [SD]. Blood samples were collected after 8 weeks at non-fasting state and after a 24h fast. Body weight, food intake, and plasma parameters - glucose, insulin, DAG, and HOMA-IR, as an insulin resistance index - were measured. Body weight and food intake in the HF-S and HF-B groups were higher than in the other groups [p<0.05]. In the HF-B group the fasting insulin level and HOMA-IR were both higher as compared to the ST, HF-O or HF-F group [p<0.05]. In addition, the fasting DAG level in the HF-B group was lower than in HF-F, HF-O or ST group [p<0.05]. Finally, the HF-F group had a significantly higher DAG level than the HF-S group [P<0.05]. Diets containing polyunsaturated omega -3 and monounsaturated fatty acids cause lower weight gains and energy intakes. It is likely that these dietary fats could bring about a decrease in appetite through increasing the DAG level, thereby causing weight reduction. It is concluded, then, that they may have a role in lowering HOMA-IR or insulin level

[Folic acid and vitamin B12 status in healthy preschool children in Tehran, Iran, 2010]

A deficiency of folate or vitamin B12, particularly in tissues with a high cell replication rate, could inhibit RNA and DNA synthesis, DNA methylation, as well as cell maturation. Therefore, a sufficient intake of these vitamins in childhood is of vital importance. Since there are no published reports on the status of folic acid and vitamin B12 in Iranian children, the present study was conducted to assess serum and red blood cells concentrations and some related factors in healthy 3-6 year old children in Tehran, Iran, 2010. This was a cross-sectional, descriptive-analytical study, in which 228 children, 3-6 year old [105 girls and 123 boys], were selected by random systematic cluster sampling from 20 [out of 270] day-care centers in Tehran. A 2-ml non-fasting blood sample was drawn from each child and analyzed for serum and red blood cell folate and vitaminB12 by the RIA method. SPSS.16 was used for data analysis, the statistical tests being t-test, Chi-square and ANOVA. There were no significant differences between the 2 sexes with regard to age, weight, height, BMI, RBC folate, or serum folate and vitamin B12 levels. Based on the serum folate level, 9.6% and 37.8% of the children suffered from severe and mild deficiency, respectively; 52.6% had normal folate serum levels. The data also showed that 97.4% of the children had a normal serum vitamin B12 level, only 2.6% being mildly deficient. As judged by the RBC folate level, of 105 children [60 boys and 45 girls], 1% and 37% had severe and mild deficiency, respectively, an absolute majority [62%] having normal levels. The distributions of serum folate, serum vitaminB12, and RBC folate levels were not statistically different between boys and girls. Similarly, no associations were observed between the RBC folate level, serum folate level, or serum vitamin B12 level and age, weight, height, family size, birth order, or head of the family. There were positive significant correlations between serum folate on the one hand and RBC folate [r=0.4, p<0.001] and serum vitamin B12 [r=0.8, p<0.001] on the other hand. Furthermore, folate, RBC folate, and serum vitamin B12 were all positively related to father's education [p=0.01], mother's education [p=0.008] and father's job status [p<0.027]. In addition, the vitamin levels were higher in children of the working mothers, as compared to those of non-working mothers [p<0.036]. There were no differences between the 2 groups with regard to other variables. Folate deficiency is highly prevalent, while the deficiency of vitamin B12 is low, among Tehrani preschoolers. It is recommended to design and implement suitable intervention programs. Major components of such programs should be mothers' nutrition education and improving family food consumption patterns with particular emphasis on optimum utilization of folate sources, particularly vegetables

[Correlation between obesity, exclusively breast feeding and breast feeding duration among infants, Bandar Turkmen district Northern, Iran]

Child obesity is increased in developing countries. This study assessed the prevalence of obesity on children which are exclusively on breast feeding and its duration among children aged 24-59 months in Bandar Turkmen district Northern, Iran. In this descriptive- analytical study, 343 in children aged 24-59 months were selected with stratified random sampling. Obesity was defined as >+2SD NCHS [National Center for Health Surveys] reference. Data were collected by questionnaire, interview with mothers and were analyzed with Chi-Square and Fisher tests and multiple regression logistic models. In this study, 6.4% of children were obese. Prevalence of obesity was not significantly different between boys and girls [5.4% and 7.4% respectively]. Breast feeding duration<18 months [P<0.005] and formula or cow's milk plus breast feeding up to 6 months old [P<0.01] was significantly correlated with children's obesity. Breast feeding duration more than 18 months reduced the obesity risk factor with 64%.This study demonstrated that exclusively breast feeding in the first 6 months of life and breast feeding duration more than 18 months reduce the child obesity

[Comparison of the effects of a fish oil-containing diet, a diet containing an oil mixture based on the Iranian fat consumption pattern, and a standard diet on the serum glucose level and insulin sensitivity in rats]

Information on the effects of different types of fat on insulin sensitivity is limited. The present study was designed to compare the effects of feeding a fish oil-containing diet, a diet containing an oil mixture based on the Iranian fat consumption pattern, and a standard diet from the fetal period till puberty on the serum glucose and insulin sensitivity in Wistar rats. Thirty female Wistar rats were randomly allocated to three dietary groups: a standard diet [containing soy bean-oil], a diet containing fish oil, and a diet containing an oil mixture based on the Iranian population fatty acid intake. Dams in each group were fed one of the diets during pregnancy and lactation, and in each case the pups born were weaned onto the same diet. Fasting serum glucose level [by photometry] and insulin [by ELISA] were measured in the pups and insulin sensitivity was calculated at puberty. Data were analyzed using SPSS software and the one-way ANOVA and Tukey tests. The fasting serum insulin level and insulin sensitivity in the fish oil-fed group were significantly lower [P=0.018] and higher [P=0.002], respectively, than in the other two groups. It seems a diet containing fish oil [rich in long chain omega-3 fatty acids] causes a higher insulin sensitivity, as compared to diets containing either soy bean oil [rich in omega-6 fatty acids] or mixed oil based on the Iranian dietary fatty acid pattern [rich in saturated fatty acids]

[Comparison of the effects of a fish-oil containing diet, a diet with a fat composition based on the Iranian fat consumption pattern, and a standard diet on pathologic changes in the wistar rat liver]

Information of the effects of different types of fat on liver pathology is limited. The present study was designed to compare the effects of a fish-oil containing diet, a diet with a fat composition based on the Iranian fat consumption pattern, and a standard diet on pathologic changes in the Wistar rat liver. Thirty female Wistar rats were randomly allocated to one of three diets: a standard diet [containing soy bean-oil], a diet containing fish oil, and one containing mixed oil based on the Iranian population fatty acid intake. Dams in each group were fed one of the diets during pregnancy and lactation, and the pups were weaned onto the same diet. Hepato-cellular pathology in pups was assessed on days 21 and 70 postnatal. Data were analyzed using the SPSS software and Kruskal-Wallis test. Fish oil-fed and Iranian mixed oil-fed pups showed more ductular cell hyperplasia on day 70 postnatal, as compared to the soy bean oil-fed pups [p=0.005]. The pathologic changes increased from day 21 to day 70 in all the 3 groups [p=0.002]. The magnitude of the increase was significant in the fish oil-fed rats [p=0.007]. A diet containing fish oil as the only fat source and a diet with the Iranian population fatty acid intake pattern may lead to pathologic changes in the rat liver. It seems this adverse effect increases by age of the animal

Colorectal cancer prevalence according to survival data in Iran 2007

Colorectal cancer is a common [5000 new cases per year in Iran] and lethal disease. Regarding the high incidence [7 cases per 100000] and survival rate of colorectal cancer and the priority of prevalence index in cancer management, in this study, 1, 2-3 and 4-5 year point prevalence were determined according to survival data. In this study, survival and incidence data were used for the determination of cancer prevalence. Incidence data were extracted from cancer registry in Iran and survival data were determined during a descriptive study through the follow up of 2342 colorectal cancer patients. 1, 2-3 and 4-5 year point prevalence were estimated from incidence rates in different years and the proportion of patients surviving 0.5, 1.5, 2.5, 3.5 and 4.5 year[s] from diagnosis. Proportion of cases surviving 0.5, 1.5, 2.5, 3.5 and 4.5 year[s] from diagnosis were 79.2%, 65.08%, 57.36%, 51.76% and 48.87%, respectively. Estimates of 1, 2-3 and 4-5 year prevalence were 4156, 5715 and 4283, respectively. The cumulative 5 year prevalence was 13954 cases. These estimates of 1, 2-3 and 4-5 year prevalence are applicable to the evaluation of initial treatment, clinical follow-up and point of cure, respectively. Therefore, 1, 2-3 and 4-5 year point prevalence estimates are necessary in health service planning for cancer management

Association of plasma folate, vitamin B12 and homocysteine levels with hypermethylation status of Eralphagene in primary breast carcinoma

The translation of estrogen receptor- a [ERa] is vital in therapeutic regimens in breast cancer. The repression of its expression could be attributed to regional CpG island methylation in exon1. We aimed to explore the association of plasma levels of folate, vitamin B12 and total homocysteine [tHcy] with the hypermethylation status of ERa genes in breast cancer patients. The hypermethylation status was determined in dissected tissues from 137 primary breast cancer patients aged 28-85 years, using methylation-specific PCR. In addition, the plasma levels of folate and vitamin B12 of the patients were assessed by automated chemiluminescence, and their total plasma homocysteine was determined by HPLC. The logistic regression analysis was used for analyzing the data after adjusting for potential confounding factors. Hypermethylation at ERa was observed in 51.1% of the participants. It was related positively to smoking history and duration of exposure to estradiol, and inversely with ER translation. After adjustments for confounding factors, an inverse association was also found between the hypermethylation status of ERa gene and the plasma levels of folate [OR=0.187; 95%CI, 0.052-0.668] and vitamin B12 [OR=0.185; 95%CI, 0.036-0.953]. The data also showed that the risk of hypermethylation at ERa gene increased with the high plasma levels of tHcy [OR=9.61; 95%CI, 1.26-73.2]. It may be concluded that a high plasma tHcy level can potentially increase the risk of hypermethylation of the ERa gene, while plasma folate and vitamin B12 levels may reduce the risk, in cancer patients

Study of the effect of baked lentil on glycemic control and lipid profiles in type II diabetics

Background and purpose: Researchers have Recently Recommended high-fiber and low glycemic-index foods for glycemic control in diabetics and reduction of Lipid Profiles. This Study intended to investigate the effect of baked lentils [as a highly consumed, and low glycemic index] on FBS and Lipid Profiles in type II diabetics

Methods and materials: This cross-over clinical trial was conducted on 30 type II diabetic patients of 45- 60 years [divided randomly into two groups of 15] with FBS of 126-180 mg/dl. The control group was given the usual diet but the experimental group received 50 gr baked lentild, 6gr canola oil instead of [30 gr] bread, and 20 gr cheese [in the form of an isocaloric breakfast with similar amounts of macronutrients]. For 6 weeks, after a 3- week rest, subjects in the two groups were interchanged. Diets were switched between the two groups and continued for another 6-week Period. At the beginning and end of each phase of the study, biochemical and anthropometric measurements were recorded. Calculations of dietary components were done using Food Processor II, and the data were analyzed using t-test in SPSS

Results: Fasting blood glucose of the patients decreased significantly from 152.6 +/- 11.4 mg/dl to 148.4 +/- 11.8 mg/dl [p<0.05]. Except for total cholesterol, other lipid profiles were not affected by the treatment but Total cholesterole reduced significantly from 228.07 +/- 14.7 mg/dl to 222.4 +/- 12.6 mg/dl [p<0.05]. No significant changes were observed in the concentration of other lipid profiles [including LDL-C, HDL-C and serum triglyceride] and serum fructozamine

Conclusion: Consumption of baked lentils as a low glycemicindex breakfast can reduce levels of serum glucose and total glucose, and improve the glycemic control of type II diabetics

Colorectal cancer prevalence according to survival data in Iran in 2007

Colorectal cancer is a common and lethal disease with 5000 new cases reported each year in Iran. This study was done to estimate the 1, 2-3 and 4-5 year point prevalence of colorectal cancer in Iran. In this descriptive study we studied the follow-up of 2342 patients with colorectal cancer documented in the cancer registry in Iran during a time period of 4 years from March 2001 to March 2005. One-year, 2-3 year and 4-5 year point prevalence were estimated from incidence rates in different years and proportion of patients surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years after diagnosis. Proportion of cases surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years from diagnosis were 79.2%, 65.08%, 57.36%, 51.76% and 48.87% respectively. Estimation of prevalence at 1, 2-3 and 4-5 years were 4156, 5715 and 4283 cases, respectively. Cumulative 5 year prevalence was 13954 cases. Estimates of prevalence at 1, 2-3 and 4-5 years are necessary for the evaluation of initial treatment, clinical follow-up and point of cure, and also for identification of patients who need further social support or health care. Therefore 1, 2-3 and 4-5 year point prevalence estimation are necessary in health service planning for cancer management. Colorectal cancer is a common and lethal disease with 5000 new cases reported each year in Iran. This study was done to estimate the 1, 2-3 and 4-5 year point prevalence of colorectal cancer in Iran. In this descriptive study we studied the follow-up of 2342 patients with colorectal cancer documented in the cancer registry in Iran during a time period of 4 years from March 2001 to March 2005. One-year, 2-3 year and 4-5 year point prevalence were estimated from incidence rates in different years and proportion of patients surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years after diagnosis. Proportion of cases surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years from diagnosis were 79.2%, 65.08%, 57.36%, 51.76% and 48.87% respectively. Estimation of prevalence at 1, 2-3 and 4-5 years were 4156, 5715 and 4283 cases, respectively. Cumulative 5 year prevalence was 13954 cases. Estimates of prevalence at 1, 2-3 and 4-5 years are necessary for the evaluation of initial treatment, clinical follow-up and point of cure, and also for identification of patients who need further social support or health care. Therefore 1, 2-3 and 4-5 year point prevalence estimation are necessary in health service planning for cancer management

[Maximum likelihood analysis in logistic regression with missing covariate data and auxiliary information: Application to factors associated with selection of the delivery method in pregnant women]

Missing data exist in many studies, e.g. in regression models, and they decrease the model's efficacy. Many methods have been suggested for handling incomplete data: they have generally focused on missing outcome values. But covariate values can also be missing. In this paper we study the missing imputation by the EM algorithm and auxiliary variable and compare the result with case-complete analysis in a logistic regression model dealing with factors that influence the choice of the delivery method. Our data came from a cross-sectional study of factors associated with the choice of the delivery method in pregnant women. The sample size in this cross-sectional study was 365 and the data were collected through interviews, using questionnaires covering several demographic variables, delivery history, attitude, and some social factors. We used standard deviations to compare the efficiency of the two methods. The results show that maximum likelihood analysis by EM algorithm is more effective than case-complete analysis. The problem of missing data is common in surveys and it causes bias and decreased model efficacy. Here we show that the EM algorithm for imputation in logistic regression with missing values for a discrete covariate is more effective than case-complete analysis. On the other hand if missing values occur for a continuous covariate then we have to use other methods or change the variable into a discrete one