Prevalence of celiac disease in patients with irritable bowel syndrome in Ardabil-Iran [2009-10]

Irritable bowel syndrome [IBS] is the most prevalent gastrointestinal disorder and is one the common conditions seen by gastroenterologists in their daily practice. This study was done to determine the prevalence of celiac disease in patients with irritable bowel syndrome in Ardabil-Iran. This descriptive study was conducted on 105 patients with IBS whome referred to the gastroenterology unit in Ardabil-Iran during 2009-10. Serum IgA anti tTG were measured all patients with positive for antibodies against tTG were candidated for upper endoscopy and biopsy. Data were analyzed using SPSS-16, t-test, Chi-Square and Fisher's exact tests. The average age of IBS subjects were 31.4 +/- 10.14 years [range 16-63 years]. Celiac disease was diagnosed in 14 subjects [13.5%]. The celiac patient age were 22-55 years with mean of 34.93_9.47. Among celiac afflicted patients IBS type D and M observed among 10 and 4 patients, respectivley. Celiac affected female constituted 12 [85.7%] of all patients [P<0.05]. 10 of these patients were IBS-D and 4 with IBS-M. From 14 celiac patient 4 [28.57%] were family related, but this rate among IBS patient was 3.3%, this difference was significant [P<0.05]. This study showed that the prevalence of celiac in patients with IBS is found to be 13.5% which seem is more than ther studies in other parts of Iran

[Applying segmented regression model to analysis the trend of tuberculosis incidence rate in Iran between 1964 -2008]

Study trend of observed rates changes provide valuable information for need assessment, plan, reload programs and develop indicators of each country. The main objective of this paper is to determine the changes in tuberculosis incidence rate trend in Iran by applying segmented regression model. In this study, segmented Linear Regression employed to analyze the trend of changes in pattern of Tuberculosis incidence rate during past 44 years [1964-2008] in Iran. We used least square method and permutation test and Bayesian Information Criteria to decide which of the two segment regression model and poison regression would be better. Data analyzed by Joinpoint 3.4 and SAS 9.1 software. According the permutation test, it was detected that there were two breakpoints over 1977 and 1993 years [p=0.0108]. Incidence rate of tuberculosis during the first 11 years of review had declined with annual percentage change = -10.1%, for second segment it rose upward with 4.3% increase in per year and for end segment TB incidence rate again declined with annually 4.5%. The average annual change of Tuberculosis incidence rate in Iran for at least 10 years has been estimated -4.5 percentages. The findings of this study have shown that the incidence rate of Tuberculosis decreased after 1992 that interestingly this decline seems faster than estimated by international TB control program. This indicates that preventive and treatment of Tuberculosis programs have been successful in Iran

[Epidemiology of tuberculosis in Iran [2001-08]]

The characterization of any disease have important role for the evaluation and control strategy and programming of diseases. This study was done to determine the epidemiology of Tuberculosis in Iran during 2001-08. In this descriptive cross sectional study, Annual percentage change [APC], average annual percentage change [AAPC] of Tuberculosis incidence rate, mortality of Tuberculosis, case detection rate, success percentage in Tuberculosis treatment and relapses cases during 2001-08 have been studied in Iran. Linear segmented regression model was used for analysis trend of Tuberculosis and estimate parameters. The trend of Tuberculosis smear positive [SP] incidence rate was reduced in Iran during 2001-08. Anually, 4.1% and 3.6% reduction took place in incidence rate and relapses cases, respectively. Tuberculosis mortality decreased annually by 6.8% and success in case detection increased by 2.5%. The Tuberculosis treatment though AAPC is decreasing by 0.5%. The trend of Tuberculosis are higher among women and in both sexes over 65 years of age. This study showed that trend of SP pulmonary tuberculosis and treatment success rate is decreased, but case detection was increased

[ status of filled consent form of hospitalized patients in Ardabil - Northwest of Iran [2010]]

Patients consent for medical care is a legal requirement. Consent is a document that patient must be necessary aware about all risks of surgery, treatment strategy, Substitution and the risks involved by physician. This study was done to evaluate status of filled consent form of hospitalized patients in Ardabil - Northwest of Iran. This descriptive cross sectional study was done by interview with patients and accompained patients in hospitals of Ardabil - Northwest of Iran during 2010. Patient demographics and other variables gathered by a questionnaire. Data was analyzed by Chi-Square test. 86 [57%] of patients were female and 64 [43%] male. 35 [23%] were illiterate and 92 [61%] under diploma. 45% of patients get information about their illness from doctors. According to patient ideas, 13% of reception personals did not complete consent form. 65 [43.3%] of patients stated that the context of consent form was unreadable and long. Rate of completing form for patients were 87%. 40% of completed forms was not signed by witnesses. The patients and relatives were not satisfied with the form itself, and this observation statistically was significant [P<0.001]. This study showed that validity of completed consent forms are low and it is necessary to design programs for improvement the quality of filling the consent forms

[Change-point in poisson distribution with application in Iranian mortality data]

Changing the pattern of mortality gives important perspective of health determinants. The aim of this study is to detect location and time of mortality pattern change in country using statistical change point method during 1971-2009 Years. We assume for years before and after K0, Y1 has a Poisson distribution with meansand lamda[0] and lamda[1] respectively. We used several methods for estimation change point in real data by assume Poisson model. Using two simulated and real data analysis showed that the change point has been occurred in year 1993 and this confirmed by all methods. Our findings have shown that the change pattern of mortality trend in Iran is related to improvement of health indicators and decreasing mortality rate in Iran

[Survival analysis of the patients with acute myocardial infarction by use of penalized splines]

Cardiovascular diseases are one of the most common causes of death and also major health problems in the world. The classical methods such as Cox regression are used in most medical studies on survival distribution, while this model assumes a linear relationship between log hazard ratio and risk factors which is not useful in many cases. The present study was performed to use the method of penalized splines to analyze the survival rate of the patients who had acute myocardial infraction. This research was a prospective descriptive-analytical study of longitudinal type which included 650 patients with acute myocardial infarction. Patients were followed for one year from the moment of diagnosis of MI, for survival analysis. The collected data were recorded in a check-list for every patient. Two different multivariate methods, proportional hazard regression and Cox model with penalized splines were used. Data analysis was carried out using R version 2.12 software and significant levels were considered 0.05. The mortality rate of the patients in a period of one year was 10.3% [67patients]. History of smoking, hypertension, diabetes, hyperlipidemia, arrhythmia and heart block were detected in 48%, 33.4%, 17.7%, 15.3%, 30% and 10.3% of the patient respectively. Based on Cox model with penalized splines the factors affecting survival rate were age, ejection fraction and use of streptokinase. Knowledge of the survival rate and factors affecting survival in the patients with acute MI can be used to provide the patients with valuable services, and to take measures to control and reduce mortality rate which can lead to increased life expectancy of these patients

[Frequency of colorectal tumors among patients who underwent colonoscopy in Imam Khomeini hospital, Ardabil, Iran from November 2008 to September 2010]

Colorectal cancer is the most common cancer and the second leading cause of cancer deaths. Annually it is the cause of more than 500000 deaths worldwide. Therefore, detection and treatment of these tumors could potentially enhance recovery and improve prognosis. This study determines the frequency of colorectal tumors among patients who underwent colonoscopies in Imam Khomeini Hospital, Ardabil, Iran. This retrospective cross-sectional study was performed on 853 patients who underwent colonoscopies in Imam Khomeini Hospital from November 2008 to September 2010. All patients were evaluated for demographic variables, location and size of tumors by a checklist. The collected data were statistically analyzed by tables, graphs and student's t-test with SPSS v. 16 software. Among 853 patients who were studied, 432 [50.87%] were females and 419 [49.13[y0] were males. Of these, 45.4% were less than 50 years of age. The most common cause for patient visits were rectal bleeding [34.5%] and abdominal pain [20.2%]. The most common complaint among patients with colorectal lesions seen in colonoscopies were rectal bleeding [54.2%], abdominal pain [18.75%], anemia [10.4%], diarrhea [8.3%], and constipation [8.3%]. Of all colonoscopies performed, 37.2% were normal. Lesions of the right colon were seen in 27.08% and 72.9% were in the left colon. According to results of this study and the frequency in detecting colorectal tumors, the performance of retrospective studies based on disease risk factors could be effective in decreasing future disease cases

[Survival rate in MI patients]

Today, heart diseases are the most common mortality causes in many of the world countries. According to current statistics, mortality rate from MI have been increased in Iran. The aim of this study was to determine survival rate and its effective cause in MI patients. This analytical-descriptive study was performed on 800 MI patients in Ardabil Bouali hospital. One year follow-up was carried out for all patients and data collected through a questionnaire. The reliability and validity of questionnaire had been earlier evaluated using Cronbach's alpha in 30 samples pilot study. Data analysis was carried out by statistical methods such as: Kaplan-Maier for survival rate and log-rank test for comparison survival mean in two groups using SPSS software. Cox regression model and survival graph was used for predictive effective causes on survival rate. Age mean of patients was. For one-year follow-up, mortality rate was 10.5% for all patients. 72.8% of patients were male and 27.2% female. 47.4% of patient was smoker, 33.4% have a HTN history, 18.1% were diabetic and 15.3% had high lipid. Survival rate in first ten days, first month and a year following MI was 0.95, 0.93 and 0.91, respectively. Effective causes in patient's survival rate were DM, HTN, SK and EF. Knowing survival rate and effective causes in MI patients, we can provide a better service as well as spatially works to control MI and decrease mortality rate from MI and also increase survival time in patients

Comparison of alfentanil and remifentanil infusion during anesthesia on recovery time and nausea and vomiting incidence after ophtalmic surgery in elderly patients

Necessity for rapid and safe recovery of patients for coming back to daily life with consideration the daily - increased development of outpatient surgeries is the main point. This study is comparing recovery time post operative nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in anesthesia of elderly patients. In this double-blind clinical trial 40 elderly patient scheduled to cataract surgery with general anesthesia were sthdied. The patients were selected randomly into two groups and in each group alfentanil or remifentanil was injected one minute before induction of anesthesia during 30 seconds. Both two groups were under general anesthesia with same method and during the anesthesia alfentanil and remifentanil infused for each group respectively. The time intervals between end of anesthesia and spontaneous respiration, eyes opening with simulation, verbal response, nausea and vomiting incidence in recovery and the time of discharge from recovery room were recorded. The time of spontaneous respiration in alfentanil group 1.3 minute was shorter than remifentanil group, But statistically, the difference was not significant [P=0.08]. The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different in two groups. During recovery, nausea and vomiting in remifentanil group [30% of patients] was significantly more than alfentanil group [5% of patients] [P=0.045]. With consideration that faster return of spontaneous respiration after infusion of alfentanil than remifentanil group and especially the significantly lower incidence of postoperative nausea and vomiting in alfentanil group, the infusion of alfentanil as opioid supplement in anesthesia of elderly patients especially in out patient surgery is suggested

effect of music therapy on patients' blood pressure in endoscopy unit in Bou-Ali Hospital, Ardebil

Today, endoscopic evaluation of digestive system is an important diagnostic approach in gastrointestinal diseases. As it is an invasive method, it causes fear and anxiety in patients. The current study was fulfilled to evaluate the effect of music therapy during endoscopy on the anxiety of patients by measuring blood pressure. This is an experimental study of single blind clinical trial type. The participants were patients in the endoscopy unit in the age range of 30 to 60, undergoing endoscopy or colonoscopy for the first time with negative history of cardiovascular diseases or hypertension. Cases were randomly placed in two groups: the experiment group who listened to music during the procedure and the control group who did not listen to music during the procedure. The patients' blood pressures, arterial blood oxygen saturation during the procedure as well as their demographic information were recorded. Finally, the data was analyzed using t- test and analysis of variance by SPSS software. Our results demonstrated that patients of the experiment group had lower systolic and diastolic blood pressure and higher arterial blood oxygen saturation comparing to control group, but the difference was not statistically significant. Also it was showed that the blood pressure altered more in the patients underwent colonoscopy comparing those underwent endoscopy. The difference was statistically significant. [p= 0.034] Mean duration of endoscopy procedure in control group was higher than that of the experiment group. Light music has useful effects on cooperation and tolerance of patients during the procedure by regulating blood pressure and oxygen saturation of blood and reducing the duration of the procedure

Application of SIR epidemiological model in determination of measles epidemics

In the nineteenth century recurrent epidemics of cholera and influenza and decreasing cases of diseases in later years produced the question why communicable disease would suddenly produce epidemics and then disappear. Designing one model bases mathematically such as SIR model has been done for the question response. The aim of research survey model has been done on the measles in Iran and determination of outbreaks of measles at 1996 to determine the least vaccine covering for prediction of measles epidemics in the future.With collection, of data from disease control centers, the number of suffering with measles, age mean of measles and life expanse was calculated and the amount of R [Basic Reproduction Rate] resulted. Calculating R amount at range 5.5 to 7.49 for the reason R0 resulted in amounts greater than the measles epidemic that occurred in our country and least effective vaccine was 81.8-86.65%.Calculating R and the least vaccine predicted for measles epidemics determined that epidemic control vaccine must be more than 82.65% to decrease herd immunity and increase measles age mean under conditions due to another epidemic in the 2005

effect of music on Bp of patients in endoscopy unit as a criterion for anxiety in Bouali hospital, Ardabil, 2004

Today endoscopy is veray efficient but invasive gastrointestinal diagnostic method that can be frightening and painful. Common physiologic reaction to this is anxiety resulting in an increase in blood pressure. Previous studies have indicated that patients may benefit by music through reducing pain and anxiety. The purpose of this study was to determine the effect of music on patients' anxiety by checking their blood pressure. Statistical analysis using ANOVA and T-test were used to compare differences in SPSS soft ware. This study was an experimental clinical trial. Subjects were eligible for the study as they had undergone endoscopic and colonoscopic examinations for the first time, they were 30-60 years old, did not have any cardiac dieases and hypertension and had been randomly assigned into two groups. One group listened to music and the other one did not. Study results indicated that patients who listened to music had lower systolic and diastolic blood pressure and higher O[2] saturation than control group but it was not statistically significant. The findings also showed that patients who had colonoscopy had higher blood pressure compared to the patients who had endoscopy. Slow music had a positive effect on blood pressure decrease, O[2] saturation increase, patients' tolerance of procedure, cooperation and reduction of procedure time in the experimental group