Iranian Registry of Crohn's and Colitis: study profile of first nation-wide inflammatory bowel disease registry in Middle East

BACKGROUND/AIMS: A recent study revealed increasing incidence and prevalence of inflammatory bowel disease (IBD) in Iran. The Iranian Registry of Crohn's and Colitis (IRCC) was designed recently to answer the needs. We reported the design, methods of data collection, and aims of IRCC in this paper. METHODS: IRCC is a multicenter prospective registry, which is established with collaboration of more than 100 gastroenterologists from different provinces of Iran. Minimum data set for IRCC was defined according to an international consensus on standard set of outcomes for IBD. A pilot feasibility study was performed on 553 IBD patients with a web-based questionnaire. The reliability of questionnaire evaluated by Cronbach's α. RESULTS: All sections of questionnaire had Cronbach's α of more than 0.6. In pilot study, 312 of participants (56.4%) were male and mean age was 38 years (standard deviation=12.8) and 378 patients (68.35%) had ulcerative colitis, 303 subjects (54,7%) had college education and 358 patients (64.74%) were of Fars ethnicity. We found that 68 (12.3%), 44 (7.9%), and 13 (2.3%) of participants were smokers, hookah and opium users, respectively. History of appendectomy was reported in 58 of patients (10.48%). The most common medication was 5-aminosalicylate (94.39%). CONCLUSIONS: To the best of our knowledge, IRCC is the first national IBD registry in the Middle East and could become a reliable infrastructure for national and international research on IBD. IRCC will improve the quality of care of IBD patients and provide national information for policy makers to better plan for controlling IBD in Iran.

[Effect of combination of Melatonin and All-Trans retinoic acid on maturation, fertilization and embryonic development of immature mouse oocytes]

Background and Objective: With respect to the antioxidant role of melatonin and retinoic acid, it seems to be effective both in the maturation and embryonic development. This study was done to investigate the effect of combination of melatonin and All-Trans retinoic acid [RA] on maturation, fertilization and embryonic development of immature mouse oocytes

Methods: In this experimental study, cumulus - oocyte complex [COCs] were recovered from 4-6 week old female mice NMRI and were divided into 6 maturation medium groups including control, sham, experiment 1[melatonin 100 nM, 1 and 2 microM], experiment 2 [retinoic acid 1, 2, 4, 6 microM], experiment 3 [melatonin 2 microM+RA 4 microM], experiment 4 [Mel 100nM + retinoic acid 4 microM]. The maturation rate was recorded after 24 hours of culture in a humidified atmosphere of 5% CO2 at 37°C. The matured oocytes were fertilized with sperm. Fertilization and embryonic development rates to the blastocyst stage were recorded

Results: Maturation rate in the control and sham groups were 50.6% and 49.4%, respectively. Maturation rate were 54.3%, 54.8%, 59.9% in melatonin group with concentrations of 100 nM, 1 and 2 microM, respectively. Maturation rate were 51.6%, 51%, 59% and 49.6% in t-RA group with concentrations of 1, 2, 4, 6 microM. Maturation rate were 60.4% and 54.2% in the experiment 3 and 4 groups, respectively. The maturation rates in the melatonin 2 microM, retinoic acid 4 microM and experiment 3 significantly increased in compare to control [P<0.05]. The embryonic development rate in the melatonin with 100nM concentration and 4 microM of retinoic acid increased significantly compared to controls [P<0.05]. Although, embryonic development rate in experiment 3 was higher than control, but lower in compare to melatonin 100 nM and the retinoic acid 4 microM. The embryonic development rate in experiment 4 significantly increased in compare to control [P<0.05]

Conclusion: Combination of melatonin and All-Trans retinoic acid in medium culture increase maturation rate and improved embryonic development in dose dependent manner

[Effect of aquatic exercises on the motor performance and the quality of life in patients with knee joint osteoarthritis]

The advantages of participating in physical activities are so well proved that many statements recommend them in preventing chronic diseases such as osteoarthritis. Training methods that are used to treat this condition is aquatic exercise. The purpose of this study was to examine the effects of aquatic exercises on the motor performance and quality of life in patients with knee joint osteoarthritis. 22 women with knee osteoarthritis with mean age 35-55 [years] were equally randomly assigned to one of two groups: experimental or control groups the world-known knee injuries and Osteoarthritis Outcome Score questionnaire was used for data collection. Aquatic exercises were carried out under the supervision of a aquatic expert three sessions a week for 8 weeks, each session lasting 60 minutes. Patients in the control group continued their normal daily living activities. Data were statistically analyzed via ANOVA. Results showed significant mean differences of performance comparing pre- [40.56 +/- 10.23] and post- [71.81 +/- 10.94] intervention conditions in the experimental group, while mean differences between pre- [46.20 +/- 15.04] and post- [45.71 +/- 15.41] tests was not significant in control group. The mean differences of quality of life regarding pre-[63.89 +/- 7.10] and post- [75 +/- 5.68] intervention evaluations was significant in experimental group [P<0.05], but there was no significant mean differences between pre- [65.97 +/- 6.6] and post- [64.81 +/- 6.69] tests in control group. The results showed that aquatic exercises, as a safe and effective exercise method, should be incorporated in rehabilitation programs to improve the motor functions and quality of life of elderly females with knee osteoarthritis

[Incidence of neural tube defects and its risk factors in Yasuj, Iran [2000-10]]

The incidence of neural tube defects [NTDs] is varied according to race, geographical situation and other predisposing factors. This study was carried out to determine the incidence rate of NTDs and its risk factors in Yasuj, Iran. This case - control study was done on live newborns in Imam Sajad hospital, Yasuj, Iran during 2000-10. 78 neonates with NTDs out of 36755 live newborns were considered as cases. The control group was also consisting of the same number of healthy neonates who born at the same period and in the same hospital. Data were collected by a check-list and analyzed using SPSS-19, Chi-Square, Logistic regression and odd's ratio. The incidence rate of NTDs was 2.12 per 1000 live births. Anencephaly and Spina Bifida was detected in 59 [75.6%] and 19 [24.3%] of affected newborns, respectively. The ratio of females to males was 1.5 times. 53.85% of mothers with affected newborns were grouped in 27-36 years age range. The mean number of pregnancies and abortion between two groups of mothers had no statistical significant differences. There is no significant relation between the mothers occupation and the incidence of NTDs. 10 [12.8%] of mothers from case group and 7 [8.97%] of mothers from control group have used tobacco. 52 [66.7%] of mothers of case group and 30 [38.5%] of controls did not consumed folic acid. The relation between non-user folic acid during pregnancy with NTDs was significant [95% CI: 1.4-6.15, OR=2.93, P<0.001]. This study showed relatively high incidence of NTDs in Yasuj. Non-consuming folic acid increased the risk of NTD by 2.93 times

Suicide in the Islamic Republic of Iran: an integrated analysis from 1981 to 2007

Although the rate of suicide is low in Muslim countries, there is evidence that it is increasing. An integrated analysis was made of data on suicide attempts [nonfatal and fatal] from studies carried out in the Islamic Republic of Iran from 1981 to 2007. Of 54 published studies concerning suicide, 48 [covering 26 768 cases of attempted suicide] satisfied the inclusion criteria. The weighted mean rate of suicide attempts was 26.5 per 100 000 and the average rate of death by suicide was 6.7 per 100 000. The mean age of suicide attempters was 25 years; on average 41.8% were male, 50.5% single and 70.0% from urban areas. Most suicide attempters were not working: 54.2% on average were housewives, 24.5% students and 21.0% unemployed men. Medical history showed that 16.2% of suicide attempters had a history of disability and 42.0% had a history of psychological disorders. The rates were compared with studies from other nations/religious groups

Quality of life one year after coronary artery bypass graft surgery

Coronary artery bypass graft [CABG] is a treatment strategy to relieve the symptoms of coronary artery disease [CAD]. Based on determining the long term outcome of CABG using SF-36 Health Related Quality Of Life [HRQOL] questionnaire, the present study was conducted in our center to determine the CABG results one-year after the operation. Between March 2005 and August 2009, 112 patients with coronary heart disease [CHD] who underwent coronary artery bypass graft [CABG] were enrolled. Patients completed SF-36 HRQOL general health status questionnaire. Stepwise multiple linear regression models were used to detect independent variables predicting changes in each eight subscales of SF-35 questionnaire. The mean age of patients was 61.4 +/- 0.9 years and most of them were male with three vessel diseases that were on pump CABG. The mean physical and mental component summary scores were 59.5 +/- 0.9 and 60.2 +/- 0.9, respectively. Physical functioning [PF] and role physical [RP] improved in males. Regression models showed that there were some statistical models with low R-square to predict role emotional [RE], general health [GH], PF and RP according to ejection fraction after surgery, diabetes, pump type of CABG and male gender. CABG has led to higher and more satisfactory outcomes for PF, RP and RE but lower in other scales comparing with normative data of the society and one-year post-operative scores of other studies. It could mostly be attributed to unmodified risk factors and progression of existing comorbidities

effects of capparis spinosa hydroalcoholic extract on blood glucose and lipids serum in diabetic and normal male rats

Diabetes mellitus is one of the most common endocrine disorders in the world which affects glucose metabolism in the body. Diabetes mellitus is due to lack of insulin secretion and/or failure in insulin action. Researches conducted in the last few decades on plants have reported anti-diabetic properties for some herbs and their traditional use for diabetes treatment. Capparis spinosa is one of these herbs which are used as an anti-diabetic treatment in tribal medicine. The objective of the present study was to examine the anti-diabetic effects of Capparis spinosa on blood glucose and serum lipids in streptozotocin induced diabetes in male rats. In this experimental study conducted at Yasouj University of Medical Sciences in 2010, five groups of animals were selected. Three groups out of five were administered with intraperitoneal injection of streptozotocin to become diabetic. Group I were fed normal diet. Group II of animals received 20 mg/kg/day Capparis spinosa extract. Group III received no treatment [diabetic control] and animals of groups IV and V were treated with capparis spinosa fruit extract 20 and 30 mg/kg body weight respectively for three weeks. Blood glucose, triglycerides, total cholesterol, LDL, HDL and body weight were measured in all animals. The collected data was analyzed by the SPSS software using one-way ANOVA. Treatment with the 30 mg/kg/body weight of capparis spinosa fruit extract showed a significant decrease in blood glucose, triglycerides, total cholesterol and LDL, and a significant increase in HDL level. In addition, administration of 20 mg/kg/body weight of capparis spinosa extract decreased blood glucose and lipid levels in diabetic rats. It can be concluded that the oral administration of capparis spinosa extract at the dose of 30 mg/kg/body weight has glucose and lipids lowering activity in diabetic rats

[Determination of the effect of cognitive behavioral therapy on stress among nurses at Yasuj Shahid Beheshti hospital in 2009]

Stress is one of the most important phenomena in this century that has had a great impact on people's mental and physical health and has become one of the main topics of organizational management. Primarily, nursing and taking care of patients is stressful itself. Therefore, in the working environment, any menace to organizational goals and reduction in the quality of nursing cares are due to stress. There are different therapeutic ways to deal with stress which cognitive behavioral therapy is one of them. The goal of this study was to examine the effects of cognitive behavior therapy on stress among nurses who worked at Yasuj Shahid Beheshti hospital in 2009. This was an experimental research that was carried out among 100 nurses working at Yasuj Shahid Beheshti hospital in 2009. The sampling type was available samples. After filling the DASS-42 questionnaire, we chose 30 cases that had the worst status from point of stress and were randomly divided into two groups: case and control groups. Each group consisted of 15 nurses. The cases were trained in 8 weeks, an hour a week, by a single clinical psychologist specialized in cognitive behavioral therapy. After the therapy, questionnaires were filled again by the two groups. Finally, two groups were compared together in view point of stress scores. For analysis of data we used the SPSS software and descriptive statistics, t-test and ANOVA. The mean and standard deviations of stress in case group on the pre-test were7.96 +/- 18.73 and on the post test were 6.295 +/- 12.266 respectively, the mean and standard deviations of stress in the control group for pre-test were 8.413 +/- 21.066 and for post test were 9.019 +/- 20.733 respectively. There weren't any significant differences between two groups before the intervention, but there were significant differences between case groups after the intervention. [p<0.05]. According to the findings of the study, cognitive behavioral techniques' training significantly reduces stress in nurses. Therefore, it is recommended to reduce nurses' stress and increase the level of nursing services and promoting patients' satisfaction by establishing a psychology consulting unit in hospitals

[Association of homocysteine, vitamin and blood factors with preeclampsia in pregnant women]

Preeclampsia is a disease with worldwide importance to mothers and infants, where it accounts for 20-80% of the strikingly increased maternal mortality. The lack of enzymes added to the homocysteine metabolism or the cofactors necessary for its metabolism [folate, B6 vitamin, B12 vitamin] cause hyperhomocysteinemia. Abnormal serum lipid profiles such as cholesterol, LDL, HDL and triglyceride are associated with endothelial dysfunction. Recently high levels of B-HCG have been identified as a potential marker for developing preeclampsia. The purpose of this study was to identify the possible association of homocysteine, vitamin and some serum factors levels with preeclampsia in pregnant women. A case control study was performed prospectively on normotensive healthy pregnant women [80] and pregnant women diagnosed with preeclampsia [80] referring to Imam Sadjad hospital in Yasuj, between September 2004 to August 2005. in addition to the obstetric evaluation and laboratory examination in the 3rd trimester of gestation, blood samples were taken from all cases for homocysteine and vitamin B12, folic acid, triglyceride, cholesterol, LDL, HDL, B-HCG analysis. The samples were evaluated by Immunoassay [ELISA]. Univariant and logistic regression analyses were used to identify predictors of outcomes. The mean plasma level of total homocysteine was significantly higher in preeclamptic women compared with normal pregnancy [p<0/05]. No significant differences were observed in B12 concentrations and plasma folic acid [P>0.05]. Triglyceride and cholesterol levels were significantly higher in preeclamptic women compared with normal pregnant women [p<0/05]. LDL and HDL levels were not correlated with preeclampsia. There was no significant association between preeclampsia and B-HCG levels. Homocysteine, triglyceride and cholesterol concentrations increase in preeclampsia but decrease of vitamin B12 and folic acid levels was not observed in preeclampsia. LDL, HDL and B-HCG levels were not different preeclamptic women and women with normal pregnancy

[Solid wastes management of Yasuj hospitals, Iran 2006]

Unhygienic methods of colleting, storage, transportation and disposal of the hospital wastes results in serious hazards that can endanger the health and environment. These materials are classified as dangerous, and have to be collected and disposed based on special rules. In the present study we aimed to evaluate the quality of management of hospital wastes and to estimate the waste constituents in Yasuj hospitals. Density, constituents, methods of collecting, transportation and disposal of hospital wastes were evaluated in 3 consecutive days of every months of the year 2006. Study showed that the daily production of solid wastes was 5.5 Kg per hospital bed and infected solid wastes were estimated to be 1.5 Kg per hospital bed. The total solid waste production was 1350 Kg per day which included 27.2 percent as infected solid wastes. Solid waste density was 160.7 Kg per cubic meter and its constituents were food wastes [19.753%], rubber [47.02%], paper [12.05%], glass [5.211%], metals [3.41%] and bandages, gases, clothes, etc [12.556%].The findings suggest that the solid waste management of the studied hospitals is not satisfying and more attention must be paid to the critical issues, such as plans for reducing solid wastes, isolating infected solid wastes at the production site and using safe and updated methods of disposal of solid wastes

Myoedothelial connection, a relationship between spiral arrangement of smooth muscle cells and endothelium in resistance muscular arteries

Conventionally, the architecture of the artery wall is based upon the close-packed smooth muscle cells, endothelial and adventitial cells in both sides of internal elastic lamina [IEL]. However, the adventitia and endothelium are now viewed as key players in vascular growth and repair. Recent work raises fundamental questions about the cellular heterogeneity of arteries, time course, triggering of normal and pathological re-modeling. Twelve wild type mice were employed. After killing with CO2 inhalation, dissected mesenteric arteries were removed and cleaned with adipose tissue. Arteries were mounted in the perfusion pressure myograph under normal pressure [70mmHg] in Kreb's solution, which bubbled with 95% O2 and 5% CO2 to pH 7.4, at 37 C. After staining with fluorescent ligands [Syto 13] for nuclei and [DIO 1mM] for cytoplasm, arteries were scanned with the Laser Scanning Co focal Microscopy [LSCM] under [488nm/515nm], [484nm/501nm] and [543nm/580nm] Argon-Helium ion laser wavelength. Three dimensional images of computer observation suggest that there may be a close relationship between the helical organization of smooth muscle cells and the underlying pattern of endothelial cells [myoendothelial connection]. Tight junctions between cells must be broken and remade during the remodeling process. This suggests a carefully controlled defensive structure for intra-cellular connections, that is capable of withstanding the acute stresses of normal function, but which must be capable of modification to adapt to a new state, when the bio-physical conditions dictate. Endothelial mosaicism related to spiral arrangements of underlying smooth muscle cells, are associated with the functional cell connections. Taken together, these issues provide an exciting new phase in understanding the physiological modeling of the vascular wall, producing a new view of the dynamic nature of vascular structure

[Effects of dietary calcium on body weight, carcass fat content and adipocyte size in male rats]

Calcium is a micronutrient and now receiving much attention for its doubtful effects on weight and body fatness. A few mechanisms has been suggested for calcium effects on body fatness and the most emphasized one is the reducing of lipolysis and increasing lipogenesis via reducing parathyroid hormone levels. The present study is designed to evaluate the effects of nondairy dietary calcium on adipogenes is and adipocyte size in male Sprague dawley rats. This experimental study was done from November to September of 2005 at Tehran school of health; nutritiondepartment.48 male Spragu-Dawley rats from Damgostar Company were used in three randomly selected groups. The rats were fed low [0.2% W/W], usual [0.5% W/W] and high [1.2% W/W] dietary calcium based on AIN-93M purified diet. Rats were housed in 12 hours light-dark cycle, 22-25°C room temperature with free access to their respective diets. At the end of the experiment, rats were decapitated and carcass fat content, carcass ash content and mean adipocyte size in testis, peritoneal and subcutaneous fat pads were compared in three groups. The SPSS 11.5 was used as statistical software, running analysis of variance for comparing the effects. weight gain, carcass fat content and adipocyte size, in groups were not significantly different, while serum parathyroid hormone concentrations in high calcium group was significantly lower than low calcium group [p<0.05] and insignificantly lower than usual calcium group [12.36, 23.57 and 42.2 pg/dl respectively]. Serum concentrations of 25-hydroxy cholecalciferol were also insignificantly lower in high calcium group. Our findings suggested that physiological concentration of dietary calcium is not effective on weight gain, body fatness and adipocyte size. Relatively equal fat content; beside significant difference in serum parathyroid hormone levels is against the parathyroid theory of calcium effects on body fatness. Finally we do not suggest any effect for calcium on body fatness and adipocyte size

[Comparison of the general health, self-esteem and social support in self-inflicted burn patients and non self-inflicted burn patients of the choromy accidental and burning hospital of Ganaveh]

Self-inflicted burn is a violent method of suicide. Since our society faces lots of psychological, social, personal and economical problems due to self-inflicted burn, more survey for this event can assist us to know its causes and prevent from its occurrence. This research was carried out to compare general health, self- esteem and social support in patient's self- inflicted burn and non-self-inflicted burn of the Choromy accidental and burning hospital in Ganaveh. This is a descriptive - analytic study. The sample consisted of 60 inpatients burnt [males and females] of the Choromy accidental and burning hospital [Ganaveh]. The method of sampling was simple random. Participants completed the General Health Questionnaire [G.H.Q- 28] of Goldberg, Cooper Smith's questionnaire of self-esteem and Philip's social support scale. Multivariate analysis of variance [MANOVA] and T-test were the major statistical analysis in this research. The mean and standard deviation of the general health were 44.57 +/- 14.65 for self-inflicted burn persons and for non - self inflicted burn they were 10.83 +/- 6.27. In the self-esteem variable, the mean and the standard deviation were 57.90 +/- 4.94 for self- inflicted burn persons and 55.47 +/- 6.04 for non-self inflicted burn ones. Mean and standard deviation of whole social supporting were 20.40 +/- 4.94 for self-inflicted burn persons and 23.73 +/- 1.17 for non-self inflicted burn group. The findings showed significant differences between the two groups from viewpoint of general health and social supporting while there were no significant differences between two groups in case of self-esteem. There are a significant relationship between general health, social supporting and self-inflicted burn. There fore, in order to prevent self inflicted burn it is suggested that we make a relationship between persons and societies, families, groups and different institutes

[ knowledge level and attitude of pre-university students of Yasuj city towards AIDS in 2003]

AIDS is not only a health problem but also a socio-cultural intricacy followed by economical consequences. Since a definite treatment has not been found so far and considering the importance of adolescence of status of school in health education, this research has been carried out with the aim to determine the knowledge level and attitude of pre- university students towards Aids. This is a descriptive, cross-sectional study which was performed on 400 pre university students at the high-schools of the Yasuj city in 1382. The subjects were selected through regular and random sampling. The data collections device was a questionnaire including demographic information and questions about knowledge and attitude toward AIDS. The data were then analyzed by SPSS software and descriptive and inferential statistical tests. Findings showed that most of the cases [98.2%] have heard about the disease. The source of getting information for most of students [63%] was mass media such as radio, TV, Newspapers and magazine. The knowledge level of most of the cases [77.5%] were good and their attitude were desirable [77%]. The study also showed a significant difference between the knowledge level of samples with sex, educational field, parent's occupation and mother's education and their attitude with their sex and mother's occupation and education [p<0.05]. There was also a significant difference between knowledge level and attitude of sample with their sex and mother's occupation and educatine. Findings revealed that most of the subjects had got their information from the mass media and the level of knowledge of most of them was good and their attitude was desirable. Thus extensive use of health education programs through mass media is recommended

Anthropometric survey on preschool children in yasuj 1380

Growth and development are basic subjects in pediatric health.Deviation in growth patterns are nonspecific but important indicators of serious medical disorders. Anthropometric survey in any region and for any child group is essential for the evaluation of growth pattern and factors that affect it. In this descriptive, cross-sectional study, 1822 children aged 64-82 months in Yasuj, Iran were evaluated for body weight, height, sex, birth grade, parents' education and job and number of sibling. Analysis of data showed wasting in 6.5% [118 children], stunting in 6% [106 children] and underweight in 10.3% [187 children]. Boys had lower anthropometric measures than girls when compared with NCHS' standard particularly for weight for age [p= 0.0001] and height for age [p=0.0003]. Results also showed that a few factors were more important for stunting including fathers education [p=0.0001], mothers education [p=0.0001], birth grade [p=0,02] and numbers of sibling [p=0.0009]. Also factors which affected underweight were fathers education [p=0.005], mothers education [p=0.013] and birth grade [p=0.04]. This factors did not have any meaningful effect on wasting. In general, weight for age, height for age and weight for height in 64-82 month children in Yasuj are below 50% of NCHS standards. Further study is needed to detect other factors that might deteriorate child growth pattern. Accordingly, those factors need to be changed actively