overview and mapping of malaria and its vectors in Iran

In spite of public health level improvement in Iran, Malaria is still an important health problem in the southeast corner of the country. Mapping distribution of endemic diseases with their relations to geographical factors has become important for public health experts. This study was carried out to provide the distribution maps of the geographical pathology of Malaria in Iran with emphasis on its vectors. A systematic literature review was performed and the data and/or metadata were used for evaluation of findings. All available articles and books were used for mapping vectors and parasites, data of Malaria cases were obtained from Iran Center for Diseases Control, Ministry of Health in 2010. Incidence or prevalence of the diseases and also scientific names of vectors with collection details were arranged and mapped as a shapefile in ArcGIS software. About 28 different Anopheles species are found in Iran. Seven maps provided for the main vectors in the country. Distribution maps generated for Plasmodium falciparum, P. vivax and co- infection cases. Distribution maps of transmission and endemic areas are provided. Out of 11668 indigenous and transmitted malaria from imported cases in three years leading to 2010, about 9400 cases occurred in south parts of the country where the weather is influenced by Afrotropical zoogeographic region, while 2200 cases occurred in the southeast corner of the country where the weather is influenced by Indo-malayan and only 25 cases were reported in the typical Palearctic area of Iran. Most malaria cases occurred in the southeast corner in Sistan Baluchistan, Hormozgan and south parts of Kerman. There are similarities between malaria transmission conditions in Iran and many tropical and subtropical countries. Such information on vectors, incidence of all cases and environmental factors can be used to set a Malaria Early Warning System and help to prevent and control of malaria

[ relationship between self-esteem and depression in nursing students of a selected medical university in Tehran]

Medical students, especially army university students are considered as being under high risk for mental disorders. This study investigated the relationship between self-esteem and depression in nursing students of a selected medical university in Tehran. In this descriptive-analytical survey, 130 nursing students of a selected medical university in Tehran were selected. Data collection tools were: A researcher-made demographic information questionnaire, the 21-item Beck Depression questionnaire, and 58-question Cooper Smith self Esteem Questionnaire. After entering the data into SPSS version 18 and using the Liker method for scoring options in the questionnaire, data analysis was made according to SPSS software and descriptive-analytical statistics [Chi-square]. The results showed that%24.3 of students had moderate to severe depression. Also%56.1 had a low self-esteem. Chi-square tests showed significant differences between depression and self-esteem in the assessed units [P<0.05]. Given that a significant difference existed between the level of self-esteem and depression and upon increasing self-esteem, the scores of depression decreases, it, therefore is possible to use methods of enhancing self-esteem to improve students' mental health

[Effect of chronic mild stress on the expression of hepcidin gene in hippocampus of male rats]

The first effect of stress on the immune system is usually a rapid increase in function which manifests itself by an increase in the number of inflammatory cytokines in blood. It is however, followed by a decrease of function in immunological response. During inflammation, the expression of hepcidin gene is increased in order to keep iron away from pathogens. This study was conducted to determine the effect of chronic mild stress on the expression of hepcidin gene in the hippocampus of the male adult rats. This experimental study was carried out on 30 adult male Wistar rats, weighing approximately 200-250 grams. They were randomly allocated into two groups of 15 rats: control and chronic mild stress group. Animals in intervention group were exposed to chronic mild stress for 3 weeks. At the end of the stress protocol, 2 ml blood sample was collected to measure the serum concentration of IL-6. Real time PCR method was used to investigate hepcidin expression in hippocampus. Data were analyzed using SPSS-16 and independent t-test. The mean level of IL-6 was significantly higher in the CMS exposure group [27.98 +/- 0.84 pg/ml] than control group [18.29 +/- 1.18 pg/ml] [P<0.05]. Hepcidin expression in the hippocampus of intervention group was significantly higher [2.69 +/- 0.226%] in compared to control group [1 +/- 0.105] [P<0.001]. This study showed that chronic mild stress increases the expression of hepcidingene and the serum level of IL-6 in adult rats

[Antibacterial effect of methanolic extract of camellia Sinensis L. on Pseudomonas aeruginosa strains producing beta-lactamases]

Pseudomonas aeruginosa is one of the important causes of nosocomial infections. Extended spectrum-beta Lactamases [ESBLs] and Metallo-beta Lactamase [MBL] producing strains have become resistant against a wide range of antibiotics. The aim of this study was to determine the effect of Methanol extract of Camellia Sinensis on Pseudomonas aeruginosa producing ESBL isolated from burnt wounds of patients. This descriptive study was done on burnt wounds of 245 hospitalaized patients in Shafa hospital, Kerman, Iran during 2006-07. ESBLs producing strains were detected by phenotypic confirmatory test and also E-test strips were used for MBL detection. P.aeruginosa MIC was determined for Cefotaxime, Ceftazidime, Azteronam, Imipenem, Meropenem and methanol extracts of plant Camellia Sinensis prepared by Maceration method. 120 of burnt wound infected with P.aeruginosa, out of them 41 isolates contained ESBL while lacked MBL. 60% of isolates were resistant to Cefotaxime, 66% to Ceftazidime, 42% to Azteronam, 3% to Imipenem and 5% to Meropenem. Among the extracts, green Tea had the highest antibacterial effect on standard strains and P.aeruginosa producing ESBLs in 1.25mg/ml concentration. This study showed that methanolic extract of green tea has higher antibacterial effect aginst beta-lactamase P.aeruginosa strains than Cefotaxime and Ceftazidime

Evaluation of an interferon-gamma release assay in young contacts of active tuberculosis cases

In a cross-sectional study in a hospital in Tehran in 2006-08 the QuantiFERON[Registered]-TB interferon-gamma release assay [QTB] was compared with the tuberculin skin test [TST] in 59 young people [aged<20 years] with close contact with immunocompetent cases of proven pulmonary tuberculosis. After 1 year follow-up 10 subjects had progressed to tuberculosis disease and received treatment; TST was positive in 30% and QTB in 100%. Of the 49 non-progressive subjects, TST was positive in 10.4% and QTB in 16.3%. The agreement between TST and QTB assay in non-progressive subjects was poor [Kappa=0.43]. False positive and false negative rates for TST were 40.0% and 9.3% respectively; positive and predictive values were 60.0% and 90.7%. We suggest adding the interferon assay to the skin test in the decision to perform chest X-ray or to start chemoprophylaxis at least in younger subjects [aged<20 years]

[ effect of nicorandil and glibenclamide on morphine-induced tolerance to the analgesic effect]

Long-term use of opiates induces tolerance to the analgesic effect. Despite significant investigations, the precise cellular mechanisms underlying opioid tolerance is not clear. Many studies have revealed the key role of nitric oxide in the morphin-induced tolerance. The aim of this study was to evaluate the effects of nicorandil [a nitric oxide donor and ATP sensitive potassium channel opener] and glibenclamide [an ATP sensitive potassium channel blocker] on morphine-induced tolerance. In this study male mice weighting [20-30g] were randomly placed into groups of 8, and received different therapeutic regimens for 5 days. Different groups received either morphine [50mg/kg, i.p]+normal saline [10ml/kg, i.p], or morphine [50mg/kg, i.p]+nicorandil [2.5, 5, 10mg/kg, i.p] or morphine [50mg/kg, i.p]+glibanclamide [5, 10, 15mg/kg, i.p] every day. Nociception was assessed using a hotplate apparatus on the 6th day. The nociceptive effect was recorded when the animal licked its hind paw or jumped due to the heat effect. Our results showed that tolerance to the analgesic effect of morphine significantly increased in the group which received morphine+nicorandil [5, 10mg/kg, i.p], [p<0.05], while in morphine+glibenclamide group, tolerance significantly reduced [p<0.05]. The results of this study indicated that intraperitoneal injection of nicorandil increased tolerance to the analgesic effects of morphine while glibenclamide decreased tolerance. The above effect seems to be related to the role of nitric oxide [NO] and ATPsensitive potassium channel in this phenomenon

[Pattern of empirical antibiotic administration in emergency department of an educational hospital in Tehran]

Antibiotic misuse is an important cause of antibiotic resistance. The aim of this study was to determine the pattern of empirical antibiotic administration in emergency department of an educational hospital. In this cross-sectional study we evaluated the pattern of antibiotic administration [indication, drug appropriateness, dose, and method of administration] in 190 patients who had been received antibiotic in emergency department of an educational hospital of Tehran Medical University in 2009. Data were collected from medical records and statistical analysis was performed by SPSSv.15 software. 55.8% of patients were male and 44.2% were female. Mean age of them was 56.61 +/- 23.66. 26.3% of patients received one antibiotic and 73.7% received two antibiotics or more. The most common prescribed drug was ceftriaxone [72.1%]. 63.7% of prescribed antibiotics were appropriate choice and 36.3% were inappropriate. Unnecessary antibiotic was prescribed in 15.8% of patients. Inappropriate dose and method of administration were 6.8% and 2.1%, respectively. Total mistakes in determination of indication of antibiotic, selection of appropriate drug, dose and administration method were 40.5%.Antibiotic misuse was more than what expected in a university hospital. It seems logical to conduct educational courses about antibiotic administration guidelines

survey physical activity status of employed women in Hamadan university of medical sciences: the relationship between the benefits, barriers, self-efficacy and stages of change

From the health perspective one of the most important problems in contemporary society is decreasing appropriate physical activity among individuals. Moderate physical activity reduces the risk of mortality and morbidity from heart disease and has a great impact on high blood pressure, diabetes ii, osteoporosis, colon cancer, and obesity. Physical activity can also have positive psychological effects, with lower levels of anxiety and depression thus enhancing self-confidence. In addition, epidemiological studies have shown that physically in active lifestyle increases mortality. Unfortunately, despite much physical and mental health benefits, many people do not exercise adequately. The purpose of this study is to determine the status of physical activity in employed women. This is a cross-sectional study conducted on 230 women employed at Hamedan University of Medical Sciences with stratified sampling among various departments of the university. The data collection tool used in this study was a standardized questionnaire. Finally, using SPSS software version 13 the data were analyzed with Spearman correlation test. The results showed that over 65% of the subjects did not have enough mobility; 25.7% of them had irregular exercise and only 8.7% did daily and regular exercise. Statistically a significant relationship was found between the benefits, barriers, self-efficacy and stages of change [p<0.05]. Due to a high prevalence of inactivity among women, educational classes for women seems to be necessary. Also adequate provision of sports facilities can promote physical activity in women

[Uterine septum dimensions in patients with infertility and recurrent abortion and the outcomes of hystroscopic metroplasty]

It is believed that uterine septum, because of its effect on infertility and recurrent abortion is very important and pregnancy outcome is obviously improved by hysteroscopic metroplasty [HM]. In this study, the probable relationship of uterine septum dimensions [length and width] with infertility and recurrent abortion has been investigated. This clinical trial was carried out from Jan. 2004 to Feb. 2007 on all patients referred to Ahwaz educational hospitals for evaluation of infertility and recurrent abortion and underwent hysterosalpingography [HSG]. Patients with suspected uterine septum were referred to Imam Khomeyni Hospital and underwent simultaneous hysteroscopy and laparoscopy. After that hysteroscopic metroplasy was done. The participants were checked by new HSG after one month and were evaluated for pregnancy outcome after one year. In whole, 50 patients [28 cases with infertility and 22 cases with recurrent abortion] were studied. In 62.5% septum width was equal or less than 3cm and in 48% length of septum occupied two thirds of uterine cavity and there was no significant difference between the two groups in regard to septum's width and length. Rate of pregnancy occurrence was 71.4% in patients with infertility and 76.5% in patients with recurrent abortion and no significant difference was found between the two groups in this regard. According to the findings, it seems that septum dimensions [width and length] have no role in infertility and abortion. Therefore, resection of uterine septum regardless of its size is recommended. In patients with uterine septum who suffer from infertility and recurrent abortion, HM is an appropriate approach

Antileishmanial activity of Artemisia aucheri, Ferula asa-foetid and Gossypium hirsutum extracts on Leishmania major promastigotes in vitro

Leishmaniasis is a complex disease with a broad spectrum of clinical features, usually divided into cutaneous leishmaniasis [CL], muco-cutaneous leishmaniasis [MCL], and visceral leishmaniasis [VL]. Plant extracts or plant-derived compounds are likely to provide a valuable source of new medicinal agents. In endemic countries, a number of traditional plants are commonly used to treat infectious conditions. Advances in the research of natural products for the treatment of leishmaniasis have been recently reviewed. To evaluate, anti-Leishmanial activity of three plant extracts on Leishmania major promastigotes as compared to a trivalent antimonial compound [tartar emetic], in vitro. promastigote stages of L.major [MRHO/IR/75/ER] were transferred to RPMI-1640 medium, supplemented with 10% fetal calf serum [PCS] and antibiotics then grown at 25 +/- 2°C. The biological activity of plant extracts in comparison to potassium antimonyl tartrate [Sb[lll]] on L.major promastigotes were assessed by using a MTT assay. The optical density [OD] due to cleavage of the tetrazolium salt MTT [3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide] into a colored product formazan by the parasite was measured by ELISA reader. The IC50 values [50% inhibitory concentrations] were determined, accordingly. All experiments were repeated in duplicate plant extracts and tartar emetic inhibited the growth of promastigote forms of L.major in vitro after 72 hour of incubation and drug control had a 50% inhibitory concentration [IC50] of 4.7 pg/ml, and microC50 values of plant extracts Artemisia aucheri, Ferula asa-foetida and Gossypium hirsutum were 7.5, 5.9 and 3.6 microg/ml, respectively. Although Gossypium hirsutum was more effective than others, but all extracts had profound effect on promastigotes of L.major. Plant extracts including Artemisia aucheri, Ferula asa-foetida and Gossypium hirsutum have anti-leishmanial effects in vitro. Further works are required to evaluate the exact effect of these extracts on Leishmania species in animal models

Location, size and clinical symptoms of uterine polyps

In this study we tried to find relationship between location, size and clinical symptoms of uterine polyps. Our cross sectional study was performed during the year 2008 in Ahwaz Imam Khomayni Hospital. Patients who underwent office hysteroscopy were evaluated and those with hysteroscopic diagnosis of polyp were entered in the study. Hysteroscopic findings of location and size of polyps and clinical presentations of Abnormal Uterine Bleeding [AUB] dysmenorrhea, infertility, discharge, spotting plus discharge were evaluated. One hundred and twenty four patients were evaluated. The most common location of polyp and clinical presentation were cervical canal and AUB, respectively. Polyp sizes of equal or less than 1 cm are commonly seen in cervical canal and cornea and more than 1 cm polyps are commonly found in uterine cavity and near internal os. In this study we showed that location of polyp is important in clinical presentation. Patients presented with AUB had polyps more common in uterine cavity, patients with spotting plus discharge had polyps more in cervical canal

[Comparison of sensitivity and specificity of transvaginal sonography, saline infusion sonohysterography and hysteroscopy in evaluation of women with abnormal uterine bleeding]

Bleeding disorders are a common problem in daily practice, especially in premenopausal women. In our investigation, we compared the sensitivity and specificity of three different diagnostic methods; Trans-vaginal sonography [TVS], saline infusion sonohystrography [SIS] and Hysteroscopy. It was a cross-sectional study with a study population of ninety-nine women suffering from AUB attending the outpatient clinic of Imam and Razi hospital in Ahvaz-Iran. They were evaluated by three different diagnostic methods and the results were compared. This study started from March 2008 to December 2008. The sensitivity, specificity, positive predictive and negative predictive values were measured in TVS, SIS, and finally these two methods were compared with hysteroscopy [as a gold standard]. The sensitivity and specificity of TVS was 74.2% and 49.7%, respectively, while that of SIS was 91.6% and 86%, respectively. The positive predictive value and negative predictive value of TVS was 71.9% and 54.3%, respectively, while that of SIS was 85.9% and 85.75%, respectively. The sensitivity, specificity, the positive predictive and negative predictive values of SIS was more than TVS, and it was similar to hysteroscopy. The findings obtained in the present study indicate that in AUB, sensitivity, specificity, positive and negative predictive value of SIS is more than TVS and therefore can be considered as a first step for diagnosis of AUB

[Comparison of vaginal with vaginal plus oral prostaglandine E[1] in medical treatment of missed abortion in first trimester]

Missed abortion, due to its severe complications, has both medical and surgical treatments. Because of surgical complications, medical treatment has recently more commonly used. As misoprostol [a prostaglandin E[1] analogue] has oral route formulation, low expense, ease of administration and quick effect, has been widely prescribed. The aim of this study was to compare the effectiveness of misoprostol when given by vaginal with that given both vaginal plus oral misoprostol in the treatment of missed abortion in the first trimester. In this clinical trial, which was performed during 2007, 98 patients with missed abortion who were referred to Ahvaz Imam Khomeini and Razi hospitals were enrolled and divided into two groups with 49 patients in each. Group I was prescribed 800 micro g of vaginal misoprostol and every 12-24 hours, an additional 800 micro g was administered. Group n was prescribed 400 micro g of oral and 400 micro g of vaginal misoprostol simultaneously with additional 400 micro g of vaginal misoprostol every 8 hours. For analysis of the data ANOVA and Chi squared tests and SPSS 13 software were used. Vaginal bleeding started significantly sooner in group I than group n 4 hour and 23 minute in contrast to 7 hour and 2 minute [P< 0.05]. Group I expelled gestational products more than group 39[76/5%] in contrast to 12[23/5%] [P< 0.05]. Patients in group I had less complications including nausea, vomiting, diarrhea, fever than the patients in group II [P<0.01]. The overall results of this study confirms the previous studies that misoprostol is an effective drug in controlling complications of first trimesters missed abortions. Furthermore vaginal route of administration is preferable method to vaginal plus oral route for treatment of missed abortion

[Mean duration of pregnancy in spontaneous deliveries in Ahwaz university affiliated hospital in 2007]

Accurate knowledge about gestational age is very important in taking decision for pregnancy management and termination. According to Naegele's rule the length of pregnancy is 280 days after LMP and according to studies performed in Harvard University, duration of pregnancy in nullipare and multipare women has been respectively 288 and 283 days and according to a study performed in Oxford University it is influenced by factors such as age, parity, some illnesses and personal habits. In this retrospective study, all laboring women admitted in Ahwaz Medical University Hospitals in 2007 including 689 nulliparas and 774 multiparas with true labor pain and reliable LMP were studied for pregnancy duration. Data were analyzed by SPSS software. Mean duration of pregnancy was 273.17, 274.31 and 273.77 days in nulliparas, multiparas and overall respectively. Parity has no significant association with pregnancy duration. According to the sonography below 26 weeks duration of pregnancy is calculated 270.07 days which had no significant relationship with LMP. According to this study parity has no effect on pregnancy duration. Mean pregnancy duration was shorter comapared to Naegele's rule and Harvard University studies

Comparison between cephalothin and ampicillin + gentamicin in treatment of pyelonephritis in pregnancy

Urinary tract infection is a common problem in pregnancy and its complications affect both pregnant woman and her fetus. Different treatment strategies have been suggested and some of them are less safe. This study compared the effectiveness of cephalothin treatment with ampicillin + gentamycin protocol. Sixty pregnant patients with pylonephritis in Imam Khomeini and Razi hospitals in Ahwaz were randomized in two groups of 30 patients, one with cephalothin only treatment and the other with ampicillin+gentamycin. Both groups were compared in term of duration of fever, CVA tenderness, symptoms and length of stay in hospital. Cephalothin only group had less duration of fever, approximately eleven hours, which was statisticaly significant. Length of stay and symptoms' relief were also less in cephalothin only group but it had no statistical significance. Cephalothin is a safe and effective remedy in the treatment of pyelonephritis in pregnancy and may be used as the first choice treatment even in severely ill patients

[Epidemiological and clinical aspects of Kala-azar in hospitalized children of Kerman province, during 1991-2006]

Leishmaniasis is a complex parasitic disease with various epidemiological and clinical features. Visceral leishmaniasis [VL] can be extremely fatal in untreated cases. The objective of this study was to assess the epidemiological and clinical aspects of the disease in children with VL in Kerman province during 1991-2006. In a descriptive-analytical survey, medical files of 68 VL cases hospitalized in Hospital No. 1 and Afzalipour Medical Center, Kerman University of Medical Sciences during 1991-2006 were studied. Data analysis was done by SPSS software and using descriptive and analytical statistics. Of 68 cases of Kala-azar, 45 ones were boys and 23 ones were girls with mean age of 52.3 +/- 46.2 months. Most of the cases were in the age group of 1-4 years. The majority of cases [41.2%] belonged to Ball, followed by Jiroft [22.0%], Kahnouj [14.7%] and Sirjan [10.3%]. Most patients were referred to hospitals in winter and mainly during February. Mean duration of clinical symptoms before referring was 31.8 days and mean duration of hospitalization was 12 days. Overall, 65 cases cured completely, while 3 cases died. The mean sedimentation rate was 58 mm/hour and the most common clinical symptoms were fever, and hepato-splenomegaly, respectively. Further studies on reservoirs and vector ecology, particularily in Ball district are required for planning control programs, in the affected areas

[Stress in senior managers of kohgilouyeh and boyrahmad province]

Stress is a collection of reactions against incompatible and unexpected internal and external factors. Since the manager of any organization is exposed to stress more than other personnel. The present study was performed to determine the rate of stress in senior managers and their assistants in Kohgilouyeh and Boyrahmad province. In this descriptive, cross-sectional study, all the 134 senior managers and their assistants were recruited through a stress questionnaire. The questionnaire included six physical, individual, cultural, occupational, familial domains, and physical conditions of job environment. It was revealed that the avarage rate of stress was 54.88, and 34.3% of the subjects appeared to experience high stress. Occupational stress [58.73] appeared to be the most stressful domain and physical stress [41 .43] was the least stressful one, respectively. Violation from regulations, success of the opportunists, and showing discrimination toward the referrals turned out to be the most stressful options. Since in this study the occupational dimension had created the highest degree of stress in the managers, it appears that the greatest and most effective step in decreasing the managers' stress is perhaps accurate supervision, appropriate encouragement and finally due punishment proportionate the managers' performance

invitro study of micro10 solution's capability of endodontic hand instruments sterilization

Microorganisms have an essential role in pulpo-periapical pathosis, therefore obtaining a successful treatment has a direct relationship with their elimination. According to previous studies, the most reliable method of sterilization is autoclave,but in some instances there are limitations for using this method, and we need an alternative.One of the most popular and wide-spread materials in this field is Micro10 solution. The aim of this research is to determine the sterilization effect of Micro10 solution on endodontic hand instruments. 1200 endodontic hand files were selected for this study, [15 groups of 80 files]. Each bacterial group was prepared in 0.5 Mc Farland standard concentration [1.5 x 10 [8]]. Every 5 groups of files were contaminated with one of bacterial samples. Then each group of contaminated files, underwent sterilization process, using one of the following methods: a] Application of autoclave, b] Application of 2% Micro10 solution, in 15 minutes, c] Application of 2% Micro10 solution, in 60 minutes, d] Application of 10% Micro10 solution, in 15 minutes, and e] Application of 10% Micro10 solution, in 60 minutes. The results of this study indicated that only in group 1 [autoclave] all of samples were sterile, but in other groups sterility diminished to 82.1% [group2], 83.3% [group 3], 90.8% [group 4], and 93.3% [group 5]. Only autoclave is a reliable method for obtaining a sterile condition and Micro10 solution at the most is just a good disinfectant, especially in 10% concentration. Also we concluded that the concentration of Micro10 solution has a direct effect on its killing ability of bacteria, while duration of process [60 minutes versus 15 minutes] has no effect