[Analysis of the factors affecting survival of the kidney transplant patients by means of penalized splines model]

Background and Aim: Various methods are used to analyze the data in survival studies. The aim of this study was to compare the analysis results of penalized splines in Cox model and Cox proportional hazards model in relation to the effects of prognostic factors related to the survival of renal transplant patients

Material and Methods: This retrospective study included data of 876 renal transplant patients in Kermanshah, in Iran, from 2001 to 2015. Cox proportional hazards model and penalized splines in cox model were used. We used R version 3.3.2 for data analysis. The significance level was set at 0.05 and Akaike information criterion was used to compare the efficacy rates of these models

Results: Using Cox proportional hazards model, one, three and five year survival rates of the patients were 94.9, 92.3 and 90.2 percent, respectively. But the corresponding figures for penalized spline model were 95.6, 93.3 and 91.4 percent. The recipient's age, postoperative creatinine, urea after surgery and underlying diabetes were significantly associated with the patients' survival rates [p < 0.05]. Akaike's criteria for Cox proportional hazards model and penalized spline model were 1016.3 and 984.1, respectively

Conclusion: Considering lower Akaike information criterion and suitability of penalized spline model for continuous variables affecting the survival of renal transplant patients, this model can be used instead of Cox proportional hazards model for more accurate estimate of survival rate of the renal transplant patients

What do we need to eradicate rubella in the Islamic Republic of Iran?

To evaluate the need for congenital rubella syndrome prevention in our national health programme we aimed to determine the rate of anti-rubella positivity in umbilical cord blood samples 8 years after measles–rubella mass vaccination in the Islamic Republic of Iran. In a cross-sectional study we tested umbilical cord blood samples for anti-rubella IgG and IgM by ELISA in 154 deliveries at a university hospital in Tehran. Overall 72.7% of umbilical cord blood samples were positive for anti-rubella IgG and 27.3% were negative. All of the samples were negative for anti-rubella IgM. In the samples with a history of mothers' rubella vaccination, only 87.5% were positive for anti-rubella IgG. The results suggest the need for another mass vaccination for rubella in women of child-bearing age and continuation of routine vaccination of infants, plus consideration of obligatory anti-rubella IgG testing before pregnancy in women who were not vaccinated and vaccination of women before marriage.

[Survival rate among children with acute lymphoblastic leukemia based on their relapse status in Shiraz Shahid Faghihi hospital during 2004-9]

Relapse in leukemic patients is considered as a major cause of treatment failure and a decrease in patient survival rate. This study was conducted to determine the survival rate of patients with acute lymphoblastic leukemia [ALL] and acute myeloid leukemia [AML] based on their relapse status. This retrospective cohort study was performed on a total of 243 cases of leukemia aged less than 15 years in Shiraz Shahid Faghihi hospital. Data were analyzed using Kaplan-Meier method, log-rank test and Cox regression model. The 1-and 5-year survival rates for patients without relapsed leukemia were 96.9 and 76.9% and for relapsed leukemia were 82.4 and 28.6%, respectively. Therefore, there was a significant relationship between the relapse occurrence and survival rate among the patients [P=0.001]. The relapse occurrence is one of the main effective factors in survival rate of leukemic patients; a five-year survival rate in the patients is less than 30 percent in this center

[Trend of incidence rate for female genital cancers based on cancer registry data in Fars province during 2003-2009]

Genital cancers are the second most common cancer among women [after breast cancer] in some countries. The aim of this study was to determine the trend of the age-standardized incidence rates for female genital cancers in Fars province during 2003-2009. In this descriptive study, using Fars province cancer registry data, the crude incidence rate per 100,000 people and the age-standardized incidence rates were calculated through direct standardization method and using the world standard population. In addition, to evaluate changes in incidence rate trend, the Cochran-Armitage linear trend test was used. Results showed that ovarian cancer was estimated as the most common cancer of female genital cancers. Age-standardized incidence rate of all female genital cancers during 2003-2009 were 3.7, 3.77, 5.52, 6.62, 9.75 and 12.4 cases per 100,000 people, respectively. It seems that the incidence rate of female genital cancers in Fars province is the same as the other regions in Iran which exhibits an ascending trend

[ efficiency comparison of conventional activated sludge and stabilization pond systems in removal of cysts and parasitic eggs [a case study: Kermanshah and gilangharb wastewater treatment plants]]

Microbial quality, particularly parasitic characteristics in terms of effluent reuse in agriculture is one of themost important indices. The aim of this study is determination of removal efficiency of Kermanshah wastewater treatment [conventional activated sludge] and Gilangharb wastewater treatment plants [stabilization ponds] for cyst and parasitic eggs. In this study research samples were taken once in five days from both inlet and outlet of wastewater Plants within a period of five months. The identification and counting of cyst and parasitic eggs were carried out by Mac master slide according to Bailenger method. The findings shows that mean of parasitic eggs and protozoan cysts in effluent of Kermanshah wastewater treatment plant were 0.99 +/- 0.42 and 0.90 +/- 0.25 per liter respectively, indeed removal efficiency for parasitic eggs and cysts are%98.42 +/- 3 and%97.5 +/- 4.5 respectively, but, any parasitic eggs and protozoan cysts in Gilangharb wastewater treatment plant was not observed and removal efficiency of these tow parameters was%100. Ascaris lumbricoides eggs had most number in influent and effluent of both plants. As results show, removal efficiency for cysts and parasitic eggs in both abovementioned are desirable, and the quality of effluent treatment plant of both the rate of nematode eggs Anglbrg index [number of nematode eggs: 1 >/- number per liter] is consistent

[Economic comparison of standard method with E.Jurdo simplified method to measure linear alkyl benzene sulfonates in municipal wastewater]

Linear alkyl benzene sulfonates are widely used as surfactants in formulated detergent products. Because of their use in household and industrial detergents, LAS is discharged into wastewater collection systems and subsequently entered to wastewater treatment plants. Therefore, it is important to determine the concentration of LAS with accuracy. They are usually determined by standard method which is time-consuming, tedious and requires great quantities of chloroform. IN 2006 E.Jurado et al proposed a simplified method for measurement of LAS. In the present work the standard method and E.Jurado simplified method was compared economically. In this work NPV method was used for accounting the cost of initial investment, consumable material, non-consumable equipment and annual cost of staff and finally Net Present Value was calculated for them separately. The rate of interest was considered 15%. calculation showed initial investment, annual cost of staff and materials for standard method 13351981, 499968 and 1710981 RLS, respectively. And these costs for simplified method were 12048202, 83328 and 58202 RLS, respectively. Finally NPV for standard method and simplified method were equal to 30360709 and 14681848 RLS. The method proposed by E.Jurdo et al is simple, time consuming and more economical than standard method .This technique can be suggested applying to the routine measurement of LAS in wastewater treatment plants

Graft survival rate of renal transplantation: a single center experience, [1999- 2009]

Renal transplantation is the best option for treatment of the end-stage renal diseases and has more advantages than dialysis. The objective of this study is to determine the ten-year graft survival rate of renal transplantation and its associated factors in patients who have been transplanted from March 1999 to March 2009 in Nemazee Hospital Transplantation Center. This is a historical cohort study of 1356 renal transplantation carried out during 1999 to 2009. Kaplan-Meier method was used to determine the survival rate, log rank test to compare survival curves, and Cox regression model to determine hazard ratios and for modeling of variables affecting survival. The 1, 3, 5, 7 and 10 years graft survival rates were 96.6, 93.7, 88.9, 87.1 and 85.5 percent, respectively. Cox regression model revealed that the donor source and creatinine level at discharge were effective factors in graft survival rate in renal transplantation. Our study showed that 10 year graft survival rate for renal transplantation in Nemazee Hospital Transplantation Center was 85.5% and graft survival rate was significantly related to recipients and donor's age, donor source and creatinine level at discharge. Our experience in renal transplantation survival rate indicates a success rate comparable to those noted in other reports

[Estimation of aerobic capacity [VO[2]-max] and study of its associated factors among male workers of industrial factories in Sepidan/Fars province, 2009]

Measurement of Maximum aerobic capacity [VO[2]-max] is important in physiologically fitting the job to the worker. This study was conducted to estimate VO[2]max of industrial workers and to determine its demographic associated factors. In this cross-sectional study, 184 randomly selected male workers of industrial sector of Sepidan/Fars province participated. A questionnaire consisted of two parts was used as data collecting tool. The first part was related to workers' demographic characteristics which was completed by interview. In the second part of the questionnaire, the value of the measured variables including height, weight, BMI and pulse rate were entered. VO[2]-max was measured by Tuxworth and Shahnavaz method. To investigate association between demographic variables and VO[2]-max, linear regression analysis was applied. T-test was used to compare mean value of VO[2]-max in different groups [based on the variables studied]. Workers' aerobic capacity was estimated to be 2.66 +/- 0.35 Lit/M. The results showed that there was no association between VO[2]-max and age while associations were found between VO[2]-max and weight as well as height and BMI. Statistical analysis revealed association between VO[2]-max and smoking. The results also demonstrated that VO[2]-max was higher among those workers who exercised as compared with other workers with no exercise [p=0.019]. Shift working, job satisfaction, and fatigue had no association with aerobic capacity. Aerobic capacity had association with weight, height, BMI, exercise and smoking

[10-year graft survival analysis of renal transplantation and factors affecting it in patients transplanted from live donor in Shiraz transplant research center during 1999-2009]

Background and Aims: Renal transplantation is the best therapeutic option for End Stage Renal Disease [ESRD]. The aim of this study was to determine the graft survival rate of renal transplantation in patients who have been transplanted from live donor in Shiraz Transplant Research Center, Shiraz, Iran

Methods: In a survival analysis study, organ survival rate after kidney transplantation from live donor was determined in 843 patients being transplanted in Shiraz Transplant Research Center, Iran during a period of 10 years [March 1999 to March 2009]. Kaplan-Meier method was used to determine the survival rate, Logrank test was used to compare survival curves and Cox proportional hazard model was used for multivariate analysis

Results: Mean follow-up period [+/- Standard deviation] was 53.07+/-34.6 months. Allograft survival rates at 1, 3, 5, 7 and 10 years after kidney transplantation were found to be 98.3%, 96.4%, 92.5%, 90.8% and 89.2%, respectively. Using Cox proportional hazard model, age of donor and creatinine level at discharge showed significant relationships with survival rate of renal allograft

Conclusion: The 10- year graft survival rate of renal transplantation from live donor in this center is 89.2% which in comparison with reports from large centers of transplantation it is satisfactory

[ special health education course effects on knowledge, attitude and practice of preparation, distribution and sale centers food staff in Kermanshah]

The food handling employee education program improves food safety. Determining knowledge, attitude and practice [KAP] level of workers who prepare, distribute and sale the food products make easy to control food safety. This study aimed to evaluate effects of intensive food safety education course on KAP of food handlers. in Kermanshah. Knowledge, attitude and practice of 370 workers of variety of food handling fields were studied before and after educational intervention course. A validated questionnaire about knowledge, attitude based on instruction from Ministry of Health and Medical Sciences for food handling was used for data collection. Paired t-test and chi[2] were applied for statistical analysis. The results showed positive effects of education program on KAP of food handlers. There was significant increase in knowledge marks before and after intervention, 20.5+ 4.03 vs. 23.73 +/- 3.75 [p<0.001].Attitude and practice of participants were increased significantly before 107.2 +/- 14.6; 43.93 +/- 7.6 compared to after 112.23 +/- 14.5; 46.11 +/- 8 intervention respectively [p<0.001]. The most increased mark of KAP was belonged to 21-30 years age group. Our findings confirm that educational intervention improved KAP of food handlers. To increase food safety, running periodical educational courses for the same filed workers with final exam and providing certificate highly recommended

[Graft survival rate of renal transplantation in diabetic patients, Namazi hospital transplant center, Shiraz, Iran [1999-2009]]

In many countries around the world, diabetic nephropathy is the most common causes of renal transplantation and dialysis. One third of diabetic patients suffer from kidney diseases which, in turn, considerably increase mortality rates and treatment costs. The aim of this study was to compare graft survival rate in diabetic and non-diabetic patients in the Shiraz Namazi Hospital Transplant Center, during the years 1999 to 2009. This study was a retrospective cohort study that investigated graft survival rate among diabetic patients who had undergone kidney transplant and compared it with that of non-diabetic patients, in the Transplant Center of Shirza Namazi Hospital. The Kaplan-Meier method was used to calculate the survival rate and Log-rank test was applied to compare survival curves. Furthermore, to model the factors affecting survival rate, Cox proportional hazard model was implemented. The results of the study revealed that the average follow-up period of patients was 48.15 +/- 31.05 [range: 3.07- 118.03] months. The estimated 9-year graft survival rates among diabetic and non-diabetic patients were 84.2% and 85.7%, respectively. Moreover, using Cox proportional hazard model, it was found that the age of a donor <40 years, is an effective factor for higher graft survival rate in diabetic patients. Based on the results of this study, we observed that there was no significant difference between kidney transplant survival rate in diabetic and non diabetic patients. This treatment method can hence be a good option for patients with diabetic nephropathy

[ estimation of water consumption, waste water generation and its biodegradability per capita based on social income and meteorological temperature in Kermanshah]

The aim of this study is to investigate water consumption, domestic wastewater generation and organic matter concentration, based on both, economical income and meteorological temperature. The method of this study is descriptive and analytical. A checklist was used to collect data on economical income. Water consumption was obtained based on water bills. Wastewater generation and organic matter such as biochemical oxygen demand [BOD] per capita/ day were measured every four hours, during a day in three regions of Kermanshah city: Kasra, Ellaheiah and Taavon. Comparing water consumption in winter and summer showed significant difference in three regions, mentioned above. The water consumption was [398 +/- 75, 291 +/- 48 and 188 +/- 50] for warm climate and [200 +/- 25, 188 +/- 35 and 140 +/- 41] for three regions respectively in cold weather. In spite of an apparent difference in BOD in three regions, it was not significant statistically. Water consumption has strongly considerable relationship with economical income [r=0.988, P-value<0.001], while the generated wastewater in these regions were not different, statistically for warm climate [220 +/- 60, 204 +/- 15 and 170 +/- 34], and in cold weather [170 +/- 21, 158 +/- 31 and 112 +/- 29], also the generated wastewater did not have considerable difference in cold climate. This study confirms that, the effects of these two parameters, i.e.monthly economical income and environmental temperature on water consumption, generated wastewater and biodegradable organic loading per capita/day is considerable. It was concluded that water consumption and wastewater generations were much more in warm climate than in cold weather. Finally through this study the estimation of water consumption, wastewater generation and BOD concentration becomes possible, which is beneficial for establishment of water consumption

Pb and Co removal from paint industries effluent using wood ash

The release of heavy metals into the environment is a worldwide major concern. Different studies have demonstrated that natural agents have a high removal capacity for divalent heavy metal ions. Wood ash is a natural adsorbent and, in comparison with others, has a very low price. In this study, the removal of heavy metals [Pb and Co] from Binalood paint industry [Kerman, Iran] effluent was investigated in batch condition. Pb and Co measurement in samples were done with atomic absorption equipment and test methods were adapted from standard methods for the examination of water and wastewater. The effect of pH and the amount of adsorbent was determined and different adsorption isotherms were also obtained. This study shows that the adsorption process follows the adsorption Langmuir isotherm. The amount of wood ash has a great role in the adsorption rate and adsorption rate increased as wood ash increased. In the study, the reactions reached equilibrium in 3 h contact time. The maximum Pb removal efficiency was 96.1% at pH 2 with a contact time of 3 h and 100 g/L wood ash and the maximum Co removal efficiency was 99% at pH 2 with a contact time of 3 h and 100 g/L wood ash. According to the results, wood ash is recommended as a low cost and available adsorbent to remove Pb and Co from municipal and industrial wastewaters

Malignant giant cell tumor of soft parts in lumbosacral region

Giant cell tumor of soft parts is a rare neoplasm that mainly affects adulst and the elderly and is usually located in the extremities. Here we report a child with giant cell tumor of soft tissue, which is a very rare condition in childhood Clinical presentation: A 5 year old girl presented with a 5 month history of left lower extremity pain. She had developed paraplegia before admission. On examination, mild left lumbosacral swelling and tenderness was found. Abdominal and pelvic CT-Scan revealed an expansile lytic lesion of the left side of sacrum with significant soft tissue component extending toward the left iliac bone. Lumbar MRI revealed a space occupying lesion originating from posterior L5 elements, projecting toward the L1.Intervention: The patient underwent surgery. A firm epidural hemorrhagic tumor of L5, S1, and S2 with no spinal cord involvement was found. Partial tumor resection [measuring 3*1*0.5 cm in maximal diameter] and laminectomy was done. Primary giant cell tumors of soft tissue are distinctive, rare neoplasms that exhibit a wide clinicopathologic spectrum similar to osseous GCTs and need to be differentiated from other giant cell rich soft tissue tumors. Recognition of this tumor is important due to its behavior as a low grade malignancy, but this cannot be predicted and metastasis does occur rarely

10 year survey on childhood CNS tumors

Tumors of the central nervous system constitute the largest group of solid neoplasms in children and are second only to leukemia in their overall frequency during childhood. The main purpose of the present study is to determine the incidence, age, sex, location and histological diagnosis of CNS tumors in children, less than 15 years of age, in the Mofid Children's Hospital, in the past 10 years. In this descriptive retrospective study we reviewed the medical records of 143 children with diagnosis of CNS tumors admitted during the past 10 years in neurology and surgery departments of Mofid Children's Hospital between the years 1996 and 2006. During the 10 year study period, CNS tumor was diagnosed in 143 patients; of these tumors, 119 were intracranial and 58 were intraspinal; 51.3% of brain tumors were located in the supratentorial and 48.7% in the infratentorial regions. The most common intracranial neoplasms were astrocytic tumors [36.8%], embryonal tumors [31.1%] and ependymal tumors [13.4%]. Of the intraspinal neoplasms the most frequently noted were embryonal tumors [37.5%], mesenchymal meningothelial tumors [20.8%], followed by astrocytic tumors [16.7%]. The median age at diagnosis was 8.9 +/- 4.1 years with a male to female ratio of 1.4:1 [P<0.5]. The most common intracranial astrocytic and embryonal neoplasms were pilocytic astrocytoma and medulloblastoma/ PNET respectively. Brain tumors in children constitute a diverse group in terms of incidence, distribution and histopathological diagnosis

Multidetector CT evaluation of congenital heart disease: a pictorial essay

Multidetector computed tomography [MDCT] with or without ECG-synchronized images can successfully evaluate cardiac morphology and congenital heart diseases which mainly involve great vessels. In this pictorial essay, we present the great capability of MDCT for the evaluation of complex congenital heart disease

investigation on Pathogenic vibrios distribution in domestic wastewater

Municipal wastewater is one of the most important pollution sources for water supply resources. Iden-tification and enumeration of pathogenic agents particularly pathogenic Vibrios are beneficial for con-trolling and prevention planning of the infectious diseases. This research was carried out to identify the distribution of the recognized pathogenic Vibrios with emphasizing on identification of Vibrio cholera in the wastewater of Kermanshah city western Iran in 2002. The method of study was cross sectional descriptive. There were 8 discharge outlet domestic wastewaters, which had been chosen as sampling sites. Samples were collected weekly in randomized manner in daytime. Three hundred and thirty nine samples were collected and analyzed. The results indicated site 7 with 5 positives, sites 4 and 8 each with 3, site 5 with 2, sites 2, 3 and 6 each with one positive, whereas, there was not any Vibrio detected in site 1. The most positive samples were seen in spring, late summer and early autumn. The positive results were detected on May, June, September, and October. Among positive samples, Vibrio parahemolyticus, could be regarded based on differentiation tests. Vibrio cholera was not seen. It seems that the presence of Vibrio parahemolyticus was due to some food store deal with distribution of seafood. Hence it is suggested that this relationship could be considered through analytical study using PCR for detection of Vibrios