association between oral hygiene and gastric pathology in patients with dyspepsia: a cross-sectional study in Southeast Iran

Many studies have reported an association between periodontal infections and some systemic diseases such as respiratory and cardiovascular diseases. Some studies found a direct association between chronic gastritis caused by Helicobacter pylori [HP] infection and poor periodontal health

Methods: In a cross-sectional study from November 2014 to December 2015 in Kerman, the largest province in southeast Iran, patients with dyspepsia who were candidate for diagnostic upper gastrointestinal [GI] endoscopy were included in our study. Decayed, Missing, and Filled Teeth [DMFT] index and Loe plaque index that are two popular indexes in dental epidemiology were used to assess the oral health by a dentist before the upper GI endoscopy. According to the Loe plaque index, score: 0= no plaque, score: 1= a film of plaque attaching to the free gingival border and near area of the tooth, score: 2= moderate reposition of deposits within the gingival pocket, score :3= plenty of soft matter within the gingival pocket +/- on the tooth and gingival border. Scores

Results: According to Sidney's classification 77 [89.5%] patients had superficial gastritis, 3 [3.5%] had atrophic gastritis, and 6 [7%] had intestinal metaplasia. HP was found in 80.2% of the gastric mucosal biopsy samples. There were not statistically significant relationship between Sidney's classification, presence of HP in gastric mucosal biopsies, and hygiene indicators [p>0.05]. No relation was found between the DMFT index and superficial gastritis, atrophic gastritis, and intestinal metaplasia [p>0.05]. Gastric infection with HP was found in 70%, 75%, and 100% of patients with mild, moderate, and sever DMFT index, respectively

Conclusion: Our study showed that there might be a relation between poor oral hygiene and gastric precancerous lesions. In addition, HP infection in gastric histopathology might be associated with periodontal disease

[ effect of ice massage of the LI4 point on severity of labor pain in primigravidas]

Labor pain is one of the severe pains women experience during their life. Today various pharmacological and non-pharmacological interventions are used to relieve the labor pain; one of the non-pharmacological relief methods is acupressure. This study was fulfilled to evaluate the effect of ice massage in LI4 point on severity of labor pain in primigravidas. This quasi-experimental study was carried out on 60 primigravidas admitted for delivery in Valiasr Hospital, Zanjan. The cases were primigravidas with single fetus, in the age range of 20-35 years with cervical dilatation of 3-4 centimeters and gestational age of 38-42 weeks. At first, they were selected by simple sampling and then randomly divided into two groups: Case and control. Severity of pain was measured in visual analogue scale [VAS] before and after massage of the left and right hand. The data were analyzed by T test, paired t-test, Chi-square at a significance level of alpha=0.05. There were no significant statistical differences in age, education, occupation, and severity of pain before intervention between two groups. Intensity of pain decreased significantly after intervention in case group compared to control group [p<0.0001]. Ice massage of left hand was more effective than right hand [p<0.001]. The results of this study suggested that ice massage could be considered as a safe, effective and noninvasive method of reducing labor pain

Gastroesophageal reflux disease and overall and cause-specific mortality: a prospective study of 50000 individuals

BACKGROUND Only a few studies in Western countries have investigated the association between gastroesophageal reflux disease [GERD] and mortality at the general population level and they have shown mixed results

This study investigated the association between GERD symptoms and overall and cause-specific mortality in a large prospective population-based study in Golestan Province, Iran

METHODS: Baseline data on frequency, onset time, and patient-perceived severity of GERD symptoms were available for 50001 participants in the Golestan Cohort Study [GCS]

We identified 3107 deaths [including 1146 circulatory and 470 cancer-related] with an average follow-up of 6.4 years and calculated hazard ratios [HR] and 95% confidence intervals [CI] adjusted for multiple potential confounders

RESULTS: Severe daily symptoms [defined as symptoms interfering with daily work or causing nighttime awakenings on a daily bases, reported by 4.3% of participants] were associated with cancer mortality [HR 1.48, 95% CI: 1.04-2.05]

This increase was too small to noticeably affect overall mortality

Mortality was not associated with onset time or frequency of GERD and was not increased with mild to moderate symptoms

CONCLUSION: We have observed an association with GERD and increased cancer mortality in a small group of individuals that had severe symptoms. Most patients with mild to moderate GERD can be re-assured that their symptoms are not associated with increased mortality

Obtaining informed consent in an illiterate population

Esophageal cancer is highly prevalent among the Turkman people in Northeastern Iran. In order to evaluate its etiology, there is an on-going prospective cohort study in this area involving approximately 50000 subjects over the age of 40 years. The majority of these subjects are illiterate, thus obtaining informed consent is very important and difficult. Initially, we explained the aim and study method to religious leaders and health-sanitary officials. One week prior to obtaining informed consent, potential participants were given adequate information about the research process by trained health personnel at their own home. Thus, participants had sufficient time to consider the research and consult with local health personnel, religious authorities, family, neighbors, friends and those who previously participated in the study. Potential participants could observe the research process directly and then be included in the study if they agreed. A total of 50045 individuals agreed to participate in the study, of which 70% were illiterate. There were no refusals due to the medical ethical aspects of this study. The method of awareness in this study can be a useful pattern for research on elderly and illiterate individuals who are participants in research studies in Iran and other countries

Cardiovascular disease prevention using fixed dose pharmaco-therapy in Iran: updated meta-analyses and mortality estimation

Short term randomized trials have shown the effectiveness of a fixed dose combination therapy [known as Polypill] on reducing blood pressure and serum cholesterol but the impact of Polypill on cardiovascular disease risk or mortality has not yet been directly investigated. Previous studies combined the effects of each component assuming a multiplicative joint risk assumption that may have led to overestimating the combined effects. We conducted an updated meta-analysis of randomized trials of anti-hypertensives, statins and aspirin. We used the estimated effect sizes applying a more conservative assumption to estimate the number of ischemic heart disease [lHD] and stroke deaths that could have been averted by Polypill in Iranians aged 55 years or older in 2006. We searched Medline and reviewed previous meta-analyses to select randomized trials on Angiotensin Converting Enzyme- inhibitors, thiazides, aspirin, and statins. We used a random-effects model to pool relative risks for each component and estimated the joint relative risks using multiplicative and additive assumptions for 4 combinations of Polypill components. We used age- and cause-specific mortality, separately by gender, and estimated the number of preventable deaths from IHD and stroke. Under the additive joint RR assumption, the standard Polypill formulation was estimated to prevent 28500 [95% Cl: 21700, 34100] IHD deaths and 12700 [95% Cl: 8800, 15900] stroke deaths. Removing aspirin from the combination decreased preventable IHD deaths by 15% under the additive assumption [5600 deaths] and by 21% under the multiplicative assumption [6800 deaths] and reduced preventable stroke deaths under both additive and multiplicative assumptions by 3% [300 deaths]. There was no significant difference between Polypill combinations with anti-hypertensive agents in full-dose or half-dose. Polypill can prevent a large number of IHID and stroke deaths in Iran. The cost-effectiveness, feasibility, and acceptability of this prevention strategy remain to be investigated

Synthesis of some new quinazolinone derivatives and evaluation of their antimicrobial activities

Wide range of quinazolinone biological properties including: antibacterial, anticancer, and anti-inflammatory activities encouraged us to synthesis some fused quinazolinone derivatives. Anthranilic acid was condensed with chloro acylchloride followed by dehydration to form the benzoxazinone intermediate; subsequent addition of an amine provided the fused quinazolinones. Deoxyvasicinone which was previously synthesized by a multi step complex reactions was prepared in three steps using the following procedure: Log P values of the compounds were measured using the shake flask method in octanol/ water solvent system. The synthesized compounds were evaluated against six strains of bacteria [three Gram-positive and three Gram-negative] and three strains of fungi. Overall results of antimicrobial tests showed that the compounds had better bacteriostatic activity against Gram-negative bacteria. The obtained results of MBC revealed that these compounds had more significant bacteriostatic than bactericidal activities. Almost all of the screened compounds showed good activity against C. albicans and A. niger. The obtained results of MFC indicated that these compounds had more significant fungistatic than fungicidal activities

Body mass index and ABO blood groups among different ethnicities of the Golestan cohort study subjects

ABO blood groups are associated with some important chronic diseases. Obesity as a major risk factor of chronic non-communicable diseases is rising rapidly in Iran as well as in developing countries. Understanding the risks for obesity is important for its control. This study seeks to determine if there is any association between ABO blood groups and body mass index [BMI]. Weight, height and blood groups were determined for participants of the Golestan Cohort Study in order to find any association between ABO blood groups and BMI. Prevalences of overweight and obesity in participants [mean age: 52.1 +/- 8.0 years] were 33.9 and 25.4, respectively. Mean weight and BMI were significantly higher in blood group A, females and those of Turkman ethnicity. After adjustments for age, sex and ethnicity, there was no association noted between VMI and ABO blood group. The prevalence of obesity and overweight in Iran is high, as seen in developing countries. There is no association between BMI and ABO blood groups in the Golestan cohort population, but Turkman ethnicity and female gender are associated with higher BMI