Global epidemic trend of tuberculosis during 1990-2010: using segmented regression model

Tuberculosis [TB] is a pandemic disease. It is the second leading cause of death from infectious diseases after human immunodeficiency virus [HIV] in the world. The main objective of this paper was to determine and compare the epidemiology of TB incidence rate and its trend changes during 1990-2010 in six WHO regions regarding age, gender and income levels. The Average Annual Percent Change [AAPC] and Annual Percent Change [APC] of TB incidence, mortality, treatment-successes, case detection rates, as well as change points of trend was estimated using segmented regression model. The number of change points was selected by the permutation procedure based on likelihood ratio test. Two change points for global TB incidence rate trend with AAPC[5years] equaling -1.4% was estimated, the maximum AAPC[5years] of six regions was attributed to the American region [-3.5%]. AACP of TB treatment-successes rate for Eastern Mediterranean [+2.2], the Americas [+1.6], south East Asia [+.8] and Global [+1.1] were significant [P<0.05]. Moreover AACP[5years] of TB case detection rate for South East Asia [+7.5], Eastern Mediterranean [+4.9], Africa [+2.8] and the Americas [+1.7] were significant [P<0.05]. Globally, all of income categories had descending trend of TB incidence and mortality rate, except the upper-middle income level that had ascending incidence trend [AAPC=+0.7%]. Globally, TB incidence and mortality rates have downturn trend and TB treatment successes and detection rates have upward trend, but their changes rate are insufficient to reach the goal of TB stop strategy. The economic levels have effect on trend, with no clear pattern, so it seems necessary that evaluation TB control programs based on characteristics of countries for reach TB control goals

impact of treatment on serum level of procalcitonin in patients with active pulmonary tuberculosis

Introduction: About one third of the world's population is infected with tuberculosis [TB] and each year, about 1.5 to 2 million people die from TB. Procalcitonin [PCT] is an inflammatory marker that its level has variable results. There are some discussions in the utilization of PCT as a diagnostic marker in active pulmonary TB. The aim of this study was to compare serum PCT before and after treatment in patients with pulmonary TB

Materials and Methods: This study was conducted on patients with pulmonary TB. Data were collected using a check list. The serum level of PCT was measured by ELISA test at the beginning and after six months of treatment. All data were analyzed using SPSS 16

Results: Forty-two patients with active pulmonary TB entered in this study. The mean age of the patients was 45.48 +/- 12.54 years and 54.8% of them were male. Most of the patients [59.5 %] were rural inhabitants. There was a family history of TB in 26% of patients. The most common symptom [45.2%] was cough. Mean PCT prior to treatment was 1.25 +/- 0.98 ng/ml. and 81% of the patients had PCT higher than 0.5 to 5. After treatment PCT level reduced significantly [P<0.001]. The mean erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP] before treatment were 45.88 +/- 21.87 and 7.16 +/- 3.98 respectively that were reduced significantly after treatment [P<0.001]. Neutrophil counts before treatment was 6221 +/- 3161 Cells per ml. and decreased statistically significant after treatment [P=0.01]

Conclusion: Our results showed that the PCT levels in pulmonary TB were high in active disease and reduced after treatment. PCT level may be used for follow-up as a discriminative marker between active and cured pulmonary TB and predict treatment response, although the PCT assay cannot be substituted for microbiological and pathological data

[ study of reliability and validity of the teacher evaluation form and factors affecting student's evaluation of teachers]

Background and Objective: Evaluation is an essential process for educational institutions, and one of the most common methods of evaluation of teachers is evaluation by students. Students are the real customers in the educational process; therefore, their judgments should be important variables in determining teaching status of teachers. According to customer-centric principles, the consumer's satisfaction must be met. This study assessed the validation of the current teacher evaluation form in theoretical courses

Methods: This was a cross-sectional study investigating the validity and reliability of the teacher evaluation form that is completed by students, and identifying some factors affecting student evaluations. To determine content validity of the teacher evaluation form, 20 expert teachers were selected proportional to the number of teachers of each school of the Hamadan University of Medical Sciences. To assess the reliability coefficient of the form, 189 students were selected from different schools by proportional random sampling

Results: According to the results, questions such as rate of adherence to the determined topics, providing practical application of teaching materials, and the efficacy of determined assignments did not have the necessary validity score. However, the results indicated that validity of the questionnaire was acceptable. In the present study, the Spearmen-Brown correlation coefficient indicated that the teacher evaluation form did not have an acceptable reliability [r = 0.456, P < 0.001]

Conclusion: The current teacher evaluation form has an acceptable content validity, but it does not seem reliable

[Comparison of hepatic enzymes level between operating room's staff and other wards' personnel]

Long exposure to inhalant anesthetic gases especially halothane, among the known hepatotoxic agents, is a serious health risk for the staff of operating room. Current study was performed to compare the level of hepatic enzymes between Operating's room staff and other therapeutic wards' personnel out of the operating room. A total of 100 personnel from educational hospitals were included and their demographic and occupational information were recorded. Hepatic function tests and bilirubin were analyzed. In cases with values more than normal, in order to rule out hepatitis B and C, Hbs-Ag, Hbs-Ab and HCV-Ab were tested. Demographic information and employment span were comparable in two groups. The average of ALT, AST were significantly higher among operating room's staff in comparison with the other group [P<0.05] and there was no significant difference between the average of GGT and ALP between two groups [P>0.05]. ALT, AST and GGT indicated significantly increase with the age of personnel [more than 40 years] and increase in employment period [more than 15 years]. The operating room's staff in educational hospitals of Ardabil may be exposed to hepatotoxic agents that caused significant rise in hepatic enzymes

[Assessment of angiogenesis in basal cell carcinoma using CD31 and CD34 markers and relation with tumor invasiveness in histology]

Tumor angiogenesis is essential for tumor growth and appears to play an importating role both in invasive growth and metastasis. Basal cell carcinomas [BCCs] and squamous cell carcinomas [SCCs] of the skin are derived from a similar cell type but differ in the invasive and metastatic potential. Basal cell carcinoma generally shows a relatively benign course in contrast to squamous cell carcinoma .This study investigates whether the behavior of these tumors could be explained by differences in their angiogenesis pattern. Vessel counts were made of blood vessels in stroma and the body of 50 variants of BCC of skin samples including: nodular, micronodular, sclerosing and superficial, both after H and E and immunohistochemical staining for CD31 and CD34 markers. The body vessel counts of invasive variants [sclerosing and micronodular] differed significantly from the counts of noninvasive variants [nodular and superficial] using both CD31 and CD34 markers. The stromal vessel counts compared between invasive and noninvasive variants showed no significantly difference using CD31 and CD34 markers, respectively. The invasive growth pattern of BCC variants correlated with the microvascular density and according to results, vessel counts of the body play a more important role