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Objectives@#The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran. @*Methods@#This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality. @*Results@#The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model. @*Conclusions@#The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran.
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Introduction: About one third of the world's population is infected with tuberculosis [TB] and each year, about 1.5 to 2 million people die from TB. Procalcitonin [PCT] is an inflammatory marker that its level has variable results. There are some discussions in the utilization of PCT as a diagnostic marker in active pulmonary TB. The aim of this study was to compare serum PCT before and after treatment in patients with pulmonary TB
Materials and Methods: This study was conducted on patients with pulmonary TB. Data were collected using a check list. The serum level of PCT was measured by ELISA test at the beginning and after six months of treatment. All data were analyzed using SPSS 16
Results: Forty-two patients with active pulmonary TB entered in this study. The mean age of the patients was 45.48 +/- 12.54 years and 54.8% of them were male. Most of the patients [59.5 %] were rural inhabitants. There was a family history of TB in 26% of patients. The most common symptom [45.2%] was cough. Mean PCT prior to treatment was 1.25 +/- 0.98 ng/ml. and 81% of the patients had PCT higher than 0.5 to 5. After treatment PCT level reduced significantly [P<0.001]. The mean erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP] before treatment were 45.88 +/- 21.87 and 7.16 +/- 3.98 respectively that were reduced significantly after treatment [P<0.001]. Neutrophil counts before treatment was 6221 +/- 3161 Cells per ml. and decreased statistically significant after treatment [P=0.01]
Conclusion: Our results showed that the PCT levels in pulmonary TB were high in active disease and reduced after treatment. PCT level may be used for follow-up as a discriminative marker between active and cured pulmonary TB and predict treatment response, although the PCT assay cannot be substituted for microbiological and pathological data
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Preterm birth is a leading cause of perinatal mortality and long-term morbidity as well as the long-term health consequences and cognitive outcomes. Present study was conducted to determine prevalence and risk factors associated with preterm birth in Ardabil, Iran. A case control study was conducted between Nov 2010 and July 2011 in all three maternal hospitals in Ardabil. All the live newborns during the study period were investigated. Of 6705 live births during the study period 346 births occurred in <37 weeks were taken as a case and 589 term neonates were taken as a control group. Data were obtained through review of prenatal and hospital delivery records. Univariate and multivariate logistic regression analysis were applied to obtain magnitude of association between independent variables and preterm birth. The prevalence rate of preterm birth was 5.1%. History of previous preterm birth [OR=12.7,CI: 3.9-40.4, p<0.001], hypertension [OR=7.3, CI:2.1-25.4, p=0.002], Oligohydramnios [OR=3.9, CI:1.6-9.5, p=0.002], spouse abuse [OR=3.7, CI:1.1-11.8, p=0.024], preeclampsia [OR=3.6, CI:1.3-10.3, p=0.014], premature rupture of membrane [OR=3.1, CI:1.9-4.9, p=0.000], bleeding or spotting during pregnancy [OR=2.0, CI:1.0-3.8, p=0.037], Hyperemesis Gravid arum [OR=2.0, CI: 1.1-3.8, p=0.015], urinary tract infection in 26-30 weeks, [OR=1. 8 CI:1.0-3.2, p=0.04], diastolic blood pressure
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Introduction: According to the latest statistical and epidemiological studies, chronic obstructive pulmonary disease [COPD] will become the fourth leading cause of death in 2030 worldwide. Scientists are studying on methods to diagnose COPD in the patients in early stages, because it is a curable and preventable disease in early stages. In this study, evidences of hyperinflation on chest X- ray [CXR] of COPD patients were compared with pulmonary function test [PFT] finding
Materials and Methods: This cross-sectional study was done on 100 patients who were referred to the pulmonary clinic with symptoms of chronic cough and dyspnea. After taking history and performing physical examination, demographic information, history of smoking and bakery and frequency of exacerbations were recorded. Standard spirometry was performed and the severity of COPD was determined by GOLD [Global initiative for chronic Obstructive Lung Disease] staging. Additionally, they underwent CXR examination [PA and lateral]. Collected data were analyzed in SPSS ver. 18
Results: In this study, there were 79 male and 21 female. The patients, 64% of whom were urban and 36% were rural dwellers. There was significant correlation between forced expiratory flow [FEF] 50% predict with sterno-diaphragmatic angle and retro-sternal lucency [p=0.01, r=-0.26 and p=0.01, r=-0.25 respectively]. Also there were significant correlations between the forced expiratory volume/forced vital capacity [FEV1/FVC] with retro-sternal lucency [p=0.006, r=-0.27] and FEV1% predict with sterno-diaphragmatic angle [p=0.002, r=-0.31]
Conclusion: The study showed some evidences of lung hyperinflation on CXR which significantly associated with PFT parameters. Sternodiaphragmatic angle and retro-sternal lucency can be used to predict the severity of airway obstruction in patients with COPD, although the CXR finding cannot be substituted for PFT and CT data
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Brucellosis is one of the most common zoonotic diseases in Iran and human brucellosis is endemic in all parts of the country. Because of the difficulty in the diagnosis of brucellosis, particularly in endemic areas, the use of new and feasible diagnostic tests seem to be of great importance for resolving the diagnostic obstacles. We evaluated the usefulness of a new serological test based on an immunocapture-agglutination technique in comparison with ELISA test for serological diagnosis of brucellosis. A total of 11 patients with brucellosis, who had positive blood cultures for BruceIla species, and 47 suspected patients were included in this study. Serum samples collected from these patients were tested by brucellacapt and ELISA and the results were, consequently, compared. In patients with positive blood culture, all the samples gave positive results with brucellacapt test while IgM ELISA, IgG ELISA and [IgG + IgM] ELISA tests were positive in 8, 9 and 11 patients, respectively. Out of the 46 suspected patients, [IgG + IgM] ELISA, Brucellacapt, IgG ELISA and IgM ELISA were positive in 37, 15, 34 and 37 patients, respectively. The best cut-off point ofELISA-IgG was 10.78 IU/ml which produced the maximal sensitivity and specificity for the diagnosis of human brucellosis. Both the [IgG + IgM] ELISA and Brucellacapt tests demonstrate a high specificity in this study. According to the results of the current study, it is found that both tests are valuable tools for diagnosis of brucellosis in Iran as an endemic area of brucellosis. It is strongly suggested that a combination of both tests to be used for the diagnosis of brucellosis
Subject(s)
Humans , Enzyme-Linked Immunosorbent Assay , Agglutination Tests , Immunoglobulin G , Immunoglobulin MABSTRACT
Peptic ulcer disease is a multifactorial health problem affecting almost all populations worldwide. Large scale population-based studies are crucial to understanding its scope and specifications in various nations. We aimed to explore environmental risk factors of peptic ulcer disease in the first population based study in Ardabil, Northwest Iran. This study was a part of a larger survey on upper gastrointestinal tract health conducted in Ardabil and Meshkinshahr with a total catchment area population of 600,000 persons during 2000-01. Using a random sampling proportional to place of residence, 1122 persons aged 40 or elder were selected. 1011 [90.1%] accepted participation and underwent a comprehensive medical examination and a systematic upper gastrointestinal endoscopy. Point prevalence of peptic ulcers was correlated to various life style risk factors. Gastric and duodenal ulcers were identified in 33 [3.26%] and 50 [4.94%] participants, making an overall prevalence of 8.20%. Based on multivariable logistic regression analyses, H.pylori infection [OR 3.1, 95% CI: 2.1-4.7], Smoking [OR 1.8, 95% CI: 1.1-6.8], and chronic intake of NSAIDs [OR 2.8, 95% CI: 1.3-4.4] were main risk factors of gastric ulcer. For duodenal ulcer, in addition to H.pylori infection [OR 5.6, 95% CI: 1.9-8.8] and Smoking [OR 2.3, 95% CI: 1.4-6.5], male gender [OR 3.6, 95% CI: 1.2-5.8] and living in an urban area [OR 1.9, 95% CI: 1.1-5.2] were among significant risk factors. This is the first population-based endoscopic study in North West of Iran reporting accurate point prevalence of peptic ulcer disease. The rate of 3.3% for gastric ulcer and 4.9% for duodenal ulcers are substantially lower than the estimates reported in Asian population-based endoscopic studies but higher than European reports