Risk factors in childhood lymphoblastic leukemia in Shiraz-Iran [2009]: an epidemilogical study

The etiology of childhood leukemia as the most common childhood malignancy remains largely unknown. This study was done to ascess the risk factors in childhood lymphoblastic leukemia in Shiraz-Iran. This case-control study was done on 141 children younger than 18 years suffering from acute lymphoblastic leukemia [ALL] whome resided at Fars Province of Iran during 2009. Patients were individually matched with 141 controls in respect to age, sex and residential area. Variables included: maternal age, parental education, father occupation, child birth weight and birth order, number of siblings, history of pet ownership including cat or dog, history of child day care attendance, history of leukemia in relatives, and history of mother diagnostic radiography during pregnancy. In order to evaluate the relationships between each variable and the risk of leukemia, odds ratio [OR] and 95% confidence interval [CI] were estimated using conditional logistic regression. Data were analyzed using SPSS-16 and Chi-Square test. The agricultural occupation fathers in case and control were 17% and 5.7%, respectively [P<0.01]. The association between risk of childhood lymphoblastic leukemia with birth order >/= 3 [OR=5.939, 95% CI: 2.646-13.331, P<0.01], pet ownership [dog or cat] [OR=2.582, 95% CI: 1.265-5.269, P<0.009] and history of leukemia in first and second degree relatives [OR=3.5, 95% CI: 1.252-10.633, P<0.027] was significant. No relationship was found between birth weight, day care attendance, history of miscarriage, number of siblings and history of mother diagnostic radiology tests with risk of acute lymphoblastic leukemia. This study showed that father occupation, birth order, pet and history of leukemia in relation are risk factors of childhood acute lymphoblastic leukemia

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

Maternal and prenatal risk factors for childhood leukemia in southern of Iran

The causes of childhood leukemia as the most common malignancy in children are vastly unknown. The aim of this study is to evaluate the relationship between maternal birth characteristics with environmental exposures in childhood leukemia. This is a case-control study which consists of children younger than 18 year old suffering from leukemia who reside at Fars Province of Iran. Patients were individually matched with variables such as age, sex and residence region. In order to evaluate the relationships between each variable and the risk of leukemia, odds ratio [OR] and 95% confidence interval [CI] were estimated using conditional logistic regression. Statistically, the association between risk of childhood leukemia with birth order [OR=6.177, 95% CI: 2.551-14.957], pet ownership [OR=2.565, 95% CI: 1.352-4.868] and history of leukemia in first and second degree relatives [OR=2.667, 95%CI: 1.043-6.815] was significant. However, there was no significant association between daycare attendance, history of miscarriage, number of siblings and history of mother's diagnostic radiology tests with risk of childhood leukemia. Although no definite etiologic factor for acute childhood leukemia has been clearly defined, the contribution of environmental risk factors in the context of genetic predisposition are strongly elucidated

Hearing impairment and hypertension associated with long term occupational exposure to noise

Noise induced hearing loss, a permanent bilateral hearing impairment due to long term exposure to high levels of noise, represents one of the most common occupational hazards. This historical cohort study was undertaken to evaluate the auditory effects of noise and to further examine the hypothesis that a link between noise exposure and hypertension exists. The study population consisted of 140 healthy male employees from a local petrochemical industry with a history of past and present exposure to noise and 140 matched healthy unexposed individuals from the same industry [reference group]. A questionnaire with 40 items concerning age, sex, weight, height, length of employment, workplace noise level, and history of hypertension was administered. Furthermore, the subjects were physically examined, their blood pressure was taken under normal resting position and all underwent audiometry testing. Similarly, sound pressure level and octave band analyzing in different stations of the workplace were carried out for every employee, and then Leq was calculated. The prevalence of hearing impairment in this study was 38.5% among the exposed and 7.8% among the unexposed group and the difference was statistically significant. Similarly, the prevalence of hypertension in the exposed group was significantly higher than that in the unexposed group. These findings provide corroborative evidence to further substantiate the notion that exposure to noise is associated with hearing impairment. They also support the proposition that long term occupational exposure to noise appears to be a risk factor for arterial hypertension

Survival models in breast cancer patients

Breast cancer is the most prevalent malignancy among Iranian women. Five and ten year survival is one of the indicators used for evaluation of the quality of care after surgery. In this study, we used several survival models to determine risk factors, survival times and life expectancies of different types of surgery. This study was performed on 310 patients who underwent surgery during a ten years period. Logistic regression and Cox regression models were used to analyze the factors leading to death. The Kaplan-Meier method [non-parametric] was used to estimate the survival rate. The log-rank test was used to compare survival in different groups. To compare life expectancy of different types of surgery, we used the actuarial life table method. Logistic regression showed that stage, grade, age and history of benign malignancy had significant relationship with death. Log-rank test showed that there was a significant difference between survival for patients with different stages, age and history of benign tumors. Cox regression model demonstrated that the variables of stage, grade, age and benign problems were the major risk factors. Actuarial life table model showed that the life expectancy for all patients was 10.03 years. This life expectancy in early stages of breast cancer for mastectomy and lumpectomy were 8.99 and 8.35 years, respectively, which was not significant. It can be concluded that the higher stage, grade, age and history of benign tumor were, the most important risk factors were correlated to mortality in breast cancer patients. This study showed that there was no significant difference between life expectancies of mastectomy and lumpectomy surgery

Estimation of survival and factors related to it in Esophageal Cancer using actuarial life-table mathod

Esophageal cancer is the 6th common cancer in Iran. Affected patients have a relatively short lifetime, as this cancer is usually diagnosed in advanced stages. This study was conducted to estimate survival and factors related to it in patients with esophageal cancer. All patients definitely diagnosed as esophageal cancer, registered in Fars Cancer Registry Center, were investigated. Required information was gathered from cancer registry forms and other resources. 1- to 5-year survival rates were estimated using life-table method. Wilcoxon test was used to compare survival rates between subgroups. All data were analyzed by SPSS software. Of 161cases, 61.5% were male. Mean age of patients was 64.6 +/- 13.10 years and 57.6 +/- 11.9 years in male and female, respectively. Overall survival rates at 1- to 5-years after diagnosis were: 58, 33, 18, 15 and 9 percent, respectively. Factors such as age at time of diagnosis, Presence of metastasis, histologic grade, type of first treatment, occupation in males, ethnicity and number of household showed to have a significant effect on prognosis. According to this study and similar studies carried out, screening and early detection of patients [in lower ages, and lower stages] is emphasized

[ effect of cool dialysate on intradiaytic hypotension among end stage renal disease patients]

Hypotension is the most frequent adverse event during hemodialysis. Cool dialysate is a simple and cost effective measure in treating intradialytic hypotension by stabilization of core body temperature. This study was designed to find out the effects of cool dialysate on the frequency of intradialytic hypotension, presenting symptoms and intervention measures used for patients undergoing hemodialysis In this randomized cross-over clinical trial, patients with intradialytic hypotension were detected based on the pre-defined inclusion criteria. Then, they were randomly assigned to treatment [cool dialysate] and control [conventional dialysis] groups. After 1 month, they crossed over as control and treatment groups. Data analysis [paired t-test] revealed that cool dialysate was associated with decrease in frequency of hypotension and number of interventions while improving symptoms and an increment in systolic and diastolic blood pressure. Cool dialysate is an effective tool in maintaining intradilaytic hemodynamic stability, alleviating symptoms of hypotension and the interventions applied for intradialysate hypotension. Therefore, cool dialysate is recommended in hemodialysis patient

[Comparison of post extubation complications in 3 different states of filling endotracheal tube cuff with lidocaine 4% in elective surgery patients]

Endotracheal intubation during general anesthesia is necessary to control the ventilation of patients during surgery. Nevertheless, the endotracheal tube as an external object can stimulate the patient's airway during the emergence from general anesthesia and create different reactions and complications. To prevent these reactions, a wide variety of interventions have been examined. In this study, post-extubation endotracheal tube complications are investigated in 3 different states of lidocaine 4% for filling endotracheal tube cuffs. In this quasi-experimental clinical trial study executed in one of Shiraz hospitals during 2005-2006, 200 candidates of elective surgery being in class1 and 2 ASA were randomly divided into 4 groups [N=50]. The endotracheal tube cuffs of each group members were filled with [5-10mI] distilled water, lidocaine 4%, alkalized lidocaine 4% and warmed alkalized lidocaine 4%, respectively. The patients were observed for complications such as cough [for 6 hrs], sore throat, hoarseness [for 24 hrs] and laryngospasm [immediately] after extubation. The data were analyzed by chi square and logistic regression using SPSS. The findings revealed that the frequency of cough, sore throat and hoarseness was more in the control [distilled water] group as compared to the 2 groups of the study [alkalized lidocaine 4% and warmed alkalized lidocaine 4%]. Distilled water and lidocaine 4% groups differed significantly in only the frequency of sore throat. The odds ratio of cough, sore throat and hoarseness was just significant for the distilled water group in comparison to warmed alkalized lidocaine 4%. Furthermore the odds ratio of the above-mentioned complications was significant for the distilled water and lidocaine 4% groups in comparison to the warmed alkalized lidocaine 4% group. Among all the considered variables, the duration of tube existence in trachea was significantly effective in the frequency of complications. Filling endotracheal tube cuffs with alkalized lidocaine 4% and warmed alkalized lidocaine 4% decreases the frequency of the post-extubation complications [cough, sore throat and hoarseness]. The odds ratio for the observed complications is less in the warmed alkalized lidocaine 4% group as compared to other groups

[Effect of lecithin on blood lipid profiles in hypercholesterolemic patients]

Hypercholesterolemia is a risk factor for atherosclerosis that responded variably to dietary modification of fat and cholesterol. Previous studies in humans have shown that ingestion of lecithin can alter plasma cholesterol and triglyceride but results were different. The current study was designed to investigate the hypocholesterolemic properties of lecithin on patient with hypocholesterolemia. Sixty one subjects [27 Male, 34 Female] with mean ages 44 +/- 14 years old with hypercholesterolemia, was admitted to Mottahari Health Center[Shiraz], randomly assigned to the case [n=31] and control [n=30] groups. Case group received three lecithin capsules [1200 mg] which contain 420 mg Phosphatidylecoline, daily for six weeks. Subject's weight, Body Mass Index [BMI] and serum lipid concentration were measured at the beginning and the end of six weeks. No significant difference were found in mean weight in case group when compared to control group. Also no significant difference were found in mean BMI in case group when compared to control group. Significantly lower mean serum Total Cholesterol, LDL cholesterol, and triglyceride and significantly higher HDL cholesterol were found in case group. In addition mean serum total cholesterol [P<0.05], LDL cholesterol [P<0.05] and TG [P<0.05] decreased and mean serum HDL-Cholesterol [P<0.05] increases significantly in case group vs. control group. This study showed that lecithin could be considered as effective nutrient useful in dietary treatment of hypercholesterolemia