Physicians' knowledge and attitude towards fecal microbiota transplant in Iran

Fecal microbiota transplant [FMT] is employed to replace the 'unhealthy' microbiota of the patient with the 'healthy' microbiota of a pre-screened healthy donor. Given the growing importance of gut microbiota dysbiosis in the pathogenesis of intestinal or extraintestinal diseases; it is conceivable that FMT becomes integrated in the routine clinical practice. Our objective was to assess the knowledge and attitude of the Iranian physicians towards FMT. We surveyed the participants of Iranian gastroenterology and hepatology 2014 conference. Overall, 146 [68.5%] were familiar with FMT; of whom 132 [94.28%] were willing to accept FMT if scientifically and ethically approved and 115 [88.46%] were willing to refer their patients for FMT if indicated. In total, 42 [30.7%] had identified stool preparation as the most unappealing aspect of FMT, while 17 [11.6%] reported the therapeutic use of fecal material as the most unappealing and 39 [28.5%] indicated that both are equally unappealing. The doctors who had an overall positive opinion toward FMT reported less negative feelings towards FMT. Iranian physicians are willing to accept FMT as a therapeutic option if it is scientifically justified and ethically approved. Nevertheless, physicians prefer to skip the stool preparation phase; as they are more in favour of synthetic microbiota as opposed to fecal microbiota

Mean polyp per patient is an accurate and readily obtainable surrogate for adenoma detection rate: results from an opportunistic screening colonoscopy program

The incidence of colorectal cancer is rising in several developing countries. In the absence of integrated endoscopy and pathology databases, adenoma detection rate [ADR], as a validated quality indicator of screening colonoscopy, is generally difficult to obtain in practice. We aimed to measure the correlation of polyp-related indicators with ADR in order to identify the most accurate surrogate [s] of ADR in routine practice. We retrospectively reviewed the endoscopic and histopathological findings of patients who underwent colonoscopy at a tertiary gastrointestinal clinic. The overall ADR and advanced-ADR were calculated using patient-level data. The Pearson's correlation coefficient [r] was applied to measure the strength of the correlation between the quality metrics obtained by endoscopists. A total of 713 asymptomatic adults aged 50 and older who underwent their first-time screening colonoscopy were included in this study. The ADR and advanced-ADR were 33.00% [95% CI: 29.52-36.54] and 13.18% [95% CI: 10.79-15.90], respectively. We observed good correlations between polyp detection rate [PDR] and ADR [r=0.93], and mean number of polyp per patient [MPP] and ADR [r=0.88] throughout the colon. There was a positive, yet insignificant correlation between advanced ADRs and non-advanced ADRs [r=0.42,p=0.35]. MPP is strongly correlated with ADR, and can be considered as a reliable and readily obtainable proxy for ADR in opportunistic screening colonoscopy programs

Psychosocial determinants of colorectal cancer screening in Iran

Colorectal cancer [CRC] is the third most prevalent cancer among Iranians, and threatens them at younger ages. This study was guided by the theoretical concepts of the preventive health model [PHM] to assess the attitudes and beliefs of Iranians towards CRC screening. This cross-sectional study was conducted with participation of 200 individuals aged 50 years or older in a Teaching Hospital in Tehran, Iran. Background characteristics [e.g., age, gender, marital status] were assessed and a validated instrument drawn from the PHM was applied to measure cognitive and psychosocial variables [i.e., self-efficacy, intention to screening, perceived susceptibility, cancer worries, response efficacy, and social support]. Data were collected via face-to-face interviews and analyzed using the SPSS version 13.00 for Windows. The age of the participants ranged from 50 years to 83 years [mean 60.13]. Most respondents were married [62.5%], unemployed [42%], and had secondary or higher education [44.5%]. Overall, 11% of respondents reported prior screening. Individuals obtained relatively poor scores on self-efficacy, intention to screening, perceived susceptibility, cancer worries, response efficacy, and social support. In this study, individuals mostly reported poor attitude in regard to CRC screening. The results of the present study could guide policy makers in designing tailored interventions to increase the participation of individuals in screening programs

Characteristics of colorectal polyps and cancer; a retrospective review of colonoscopy data in Iran

Early diagnosis and endoscopic resection of adenomatous polyps is the main approach for screening and prevention of colorectal cancer [CRC]. We aimed to assess polyp detection rate [PDR] and to characterize demographic, clinical, and pathological features of colorectal polyps in an Iranian population. We retrospectively analyzed the data from 5427 colonoscopies performed during 2007-2012 at Masoud Clinic, the main endoscopy center associated with Sasan Alborz Biomedical Research Center, in Tehran, Iran. Our sample included 2928 [54%] women and 2499 [46%] men, with the mean age of 48.3 years [SD=16.1]. The most common reasons for colonoscopy included screening in 25.0%, and gastrointestinal bleeding in 15.2%. Cecal intubation was successful in 86% of patients. The quality of bowel preparation was fair to excellent in 78.1% [n=4235] of colonoscopies. Overall PDR was 42.0% [95% CI: 40.6-43.3]. The PDR in men [51.1%, 95% CI: 49.1-53.1] was significantly higher than women [34.2%, 95% CI: 32.4-35.9, p<0.001]. Polyps were more frequently observed in patients after the 6th decade of life [F=3.2; p=0.004]. CRC was detected in 2.9% [73/2499] of men and 1.9% [57/2928] of women [p=0.02]. The mean age for patients with cancer was significantly higher than that for individuals with polyps, 60.9 [SD=13.4] year vs. 56.9 [SD=13.7] year, respectively [p=0.001]. Almost 82.8% of the lesions were precancerous with tubular type predominance [62.3%] followed by tubulo-villous [10.3%], villous [6.6%], and serrated [3.6%]. Hyperplastic/inflammatory polyps comprised 17.2% of lesions. Distal colon was more prone to develop polyps and cancer than proximal colon in our series. These findings provide a great infrastructure for next preventive programs and have implications for colorectal cancer screening at population-level

Trends of obesity in Iranian adults from 1990s to late 2000s; a systematic review and meta-analysis

Obesity is currently emerging as a global epidemic, affecting 10% of adult population worldwide. The primary objective of the current systematic review is to describe the trend of overall prevalence of obesity in Iranian women and men through a meta-analysis. We searched the medical literature published from 1990 to 2007 in Medline [PubMed], EMBASE database, and the Iranian digital library. All published reports of research projects, papers in relevant congresses, unpublished crude data analysis, proceedings, books and dissertations were reviewed. Data from eligible papers that fulfilled the qualification criteria entered meta-analysis [Random Model]. Data from 209,166 individuals were analyzed. The overall prevalence of obesity in adults was 18.5% [95%CI: 15.1-21.8], respectively. The prevalence of obesity in men and women was 12.9% [95%CI: 10.9-14.9] and 26.2% [95%CI: 21.3-30.5], respectively. The trend of obesity was similar in both genders; women had almost a constantly higher risk of obesity than men during the recent two decades. Data from 209,166 individuals were analyzed. The overall prevalence of obesity in adults was 18.5% [95%CI: 15.1-21.8], respectively. The prevalence of obesity in men and women was 12.9% [95%CI: 10.9-14.9] and 26.2% [95%CI: 21.3-30.5], respectively. The trend of obesity was similar in both genders; women had almost a constantly higher risk of obesity than men during the recent two decades

Knowledge and practice of Iranians toward colorectal cancer, and barriers to screening

Colorectal cancer [CRC] is the third most common malignancy in Iran. Limited data are available on knowledge and barriers in regard to CRC and screening tests in Iran. The aim of the study was to characterize knowledge, practice, and barriers toward CRC and its screening tests among an Iranian at risk population. This cross sectional study was conducted with participation of 200 individuals of both genders aged 50 years or older in a teaching hospital in Tehran, Iran. Data were collected via face-to-face interviews. A questionnaire containing demographics; knowledge about CRC and screening tests; screening practice; and reasons for not being screened was administered. The reliability alpha for knowledge items was 0.52. The age of the participants ranged from 50 to 83 years [mean 60.13]. Overall, 11% of the respondents reported prior screening by either fecal occult blood test [6.5%] or colonoscopy [4.5%]. The majority of individuals had poor knowledge although respondents with prior screening obtained slightly higher score in comparison with nonparticipants in screening [26.74 vs. 23.24; P<0.05]. Four commonly cited reasons for not having CRC tests were "doctor did not recommend the test," "did not think it was needed," "never think of the test," and "no symptoms/problems" which were reported by 29%, 26%, 20%, and 17% of the participants, respectively. It is necessary to design appropriate educational interventions to increase the general population's knowledge about CRC and screening before implementing preventive programs in Iran

School-based physical activity intervention improves the physical fitness of the adolescent girls and their mothers

To evaluate the effectiveness of a school-based exercise program on the body composition and physical fitness of girls and their mothers. In a semi-experimental study we included 70 subjects [35 high-school girl students as well as their mothers] in 2007. All the students, whose mothers volunteered to take part in the study, were in first to third grades of high school and randomly selected from five high schools in the city. The study was run at Neda high school in Sanandaj-Iran. Eligible subjects participated in an exercise program for 12 weeks, ninety minutes per session, two times per week. The subjects followed the same exercise programme, at the same time in the same place. Measurements included cardiovascular endurance, muscle strength, flexibility, height, weight, body-mass index [BMI], waist and hip circumference. Age mean [standard deviation] for girls and mothers was 15.00[1.60] and 40.00[3.80] respectively. In girls, the intervention had significant effect on weight, BMI, waist and hip circumference [p<0.05]. Physical fitness tests including muscle strength, flexibility and cardiovascular endurance were significantly different between the pre-test and post-test measurements [p<0.05]. In mothers body weight, BMI, waist and hip circumference declined significantly [p<0.05]. Flexibility test was not significantly affected over time, despite an increase in muscle strength and cardiovascular endurance [p<0.05]. The highest correlations were found between the mother's participation index and the girl's participation index [r: 0.48, p< 0.001]. The exercise program was effective in improving physical fitness

study of disability status of live leprosy patients in Kurdistan province of Iran

Leprosy is an infectious disease which may lead to disability before, during or after treatment. There have been different reports about the prevalence of disabilities in leprosy patients. This study is about the status of disabilities in live leprosy patients in Kurdistan province. This was a descriptive-analytic study. The live patients who were accessible and had been registered in the health care department of Kurdistan University were imcluded. The patients whose files were incomplete, were examined and their disabilities were assessed on the basis of the WHO protocol about grading of disabilities in leprosy. One hundred eighty patients were included in this study_ 116 [64.4%] were male and 64 [35.6%] were female. One hundred twenty six [70%] patients had multibacillary and 54 [30%] of them had paucibacillary leprosy. In our study 152 [84.4%] patients had developed disabilities of variable degrees. There was a significant relation between disabilities and type of leprosy [p<0.05], but no relation was observed between disabilities and sex or residential areas. Today, the main objective of therapeutic plans for leprosy is prevention of disabilities in the patients. Prevalence rate of disabilities in the leprosy patients of Kurdistan province, was higher than those of other parts of the world which might have been due to delay in referring to healthcare centers, incomplete treatment course and having no access to medical centers in the past

Brucellosis in Kurdistan province from 1997 to 2003

Brucellosis, one of the zoonotic, with regard to public health and its impact on socio-economical status of society is very significant in all over the world and especially in developing countries. This survey analyzes the epidemiological status of brucellosis in Kurdistan province. This was a descriptive-analytical Study in which 3880 cases of brucellosis from 1997 up to 2003 evaluated. Titer 1:80 or greater using standard tube agglutination method was estimated as a positive result. These data collected from province's laboratories weekly. Patient's data was analysed and described by using SPSS software. Three thousand and eighty cases of brucellosis infection have been studied. In this study 2020 [52.1%] were male and 1860 [47.9%] female, 707 [18.2%] citified, and 3173 [81.8%] rural. The highest level of incidence, with 89 cases of infection per 100000, has been appeared in 2003 and the lowest with 17 cases per 100000 in 2000. Housewife with 39.4% had the highest level of occurrence. There was a relationship between sex with age [p<0.001] and with place of living [p<0.05]. According to this study, males in villages and bricklayer in cities are the most affected groups. People training, especially villager and women in cities, about transition paths, prevention methods, food supply and delivery supervising could decrease disease prevalence

Physical activity and body weight status in relation to ischemic heart diseases [IHD]

Cardiovascular diseases [CVD] especially Ischemic Heart Diseases [IHD] are responsible for more than 40% of mortalities in the Islamic Republic of Iran: As is the case in the Western hemisphere. physica1lllactivity is the most prevalent CVDs risk factor. The aim of this research was to determine the association of the physical activity indices [work, sport and leisure, time indices], and body weight measures with the risk of developing IHD in Tehran, Islamic Republic of Iran, This case - control study was conducted during 2003 and 2004 in Tehran Heart Center and Tehran Shahid Rajaii hospital. A sample of 100 IHD patients [cases] and 100 healthy individuals served as control The controls we.re matched to the IHD patients by age [ +/- 5 years], sex, Information about Physical activity was recorded by means of the Beacke questionnaire. Some important risk factors including hypertension. hyperlipidemia. diabetes and Body Mass Index [BMI] were also recorded. All the data were statistically analyzed with the SPSS for Windows. All reported P values are based on two-sided and compared to a significance level of 5%. The patients had significantly lower indices for work sports and Leisure time Physical Activity [P <0,001]. Analysis of BMI showed that there was a significant association between obesity and the ask of developing IHD [P = 0.01]. There was a significant negative correlation between BMI and Leisure Time Physical Activity index: the higher the BMI, the lower the likelihood of participation in Leisure Time Physical Activity activities. After multivariate analysis. the Leisure Tune Physical Activity [LTPA] independently had a protective effect against developing IHD risk. also in the cases group. Obesity increased the risk of IHD nearly 4 times more 10 comparison with normal subjects. Physical activity has a beneficial effect on IHD risk developing and IHD related predisposing risk factors