Third study on WHO MPOWER tobacco control scores in eastern mediterranean countries 2011-2015

This study was conducted to quantify the implementation of the MPOWER policies and to assess any possible changes across Eastern Mediterranean Region [EMR] countries. In this comparative cross-sectional study based on 10 categories mentioned in MPOWER report 2015 a checklist was designed. Seven questions were scored from 0-4 and three from 0-3. The 22 EMR countries were ranked and compared by their total score on a scale of 0-37. The highest scores were achieved by Egypt and the Islamic Republic of Iran. Pakistan, Sudan and Yemen showed progress, while Bahrain, Jordan, Kuwait, Oman, and the Syrian Arab Republic had decreased scores. The total score of the EMR countries had decreased compared to 2013. Thus, there remains a need for greater focus on tobacco taxation and smoke-free policies to address this retrograde step

comparative study on tobacco cessation a quantitative systematic review

During recent years, there have been many advances in different types of pharmacological and non-pharmacological tobacco control treatments. In this study, we aimed to identify the most effective smoking cessation methods used in quit based upon a review of the literature. We did a search of PubMed, limited to English publications from 2000 to 2012. Two trained reviewers independently assessed titles, abstracts and full texts of articles after a pilot inter-rater reliability assessment which was conducted by the author [GH]. The total number of papers and their conclusions including recommendation of that method [positive] or not supporting [negative] was computed for each method. The number of negative papers was subtracted from the number of positive ones for each method. In cases of inconsistency between the two reviewers, these were adjudicated by author. Of the 932 articles that were critically assessed, 780 studies supported quit smoking methods. In 90 studies, the methods were not supported or rejected and in 62 cases the methods were not supported. Nicotine replacement therapy [NRT], Champix and Zyban with 352, 117 and 71 studies respectively were the most supported methods and e-cigarettes and non-Nicotine medications with one case were the least supported methods. Finally, NRT with 39 and Champix and education with 36 scores were the most supported methods. Results of this review indicate that the scientific papers in the most recent decade recommend the use of NRT and Champix in combination with educational interventions. Additional research is needed to compare qualitative and quantitative studies for smoking cessation

effect of Garcin[registered sign] in preventing antiTB-induced hepatitis in newly diagnosed tuberculosis patients

Adverse effects of antituberculosis agents such as hepatotoxicity may reduce treatment effectiveness, because they significantly contribute to nonadherence and eventually result in treatment failure, relapse or the emergence of drug resistance. Garlic is an ancient herbal substance, which its effectiveness on isoniazid and rifampicin-induced hepatic injury in animal models has been demonstrated [1]. In the present study a randomized, double blind, placebo-controlled, parallel group clinical trial was designed to assess the effect[s] of garlic tablets [1000 mg daily] administered for two weeks orally. Fifty eight newly diagnosed, smear positive pulmonary tuberculosis patients, with age ranges between 18-65 years old, were randomly allocated into two groups. Each patient received either garlic or placebo tablets for the first two weeks of tuberculosis treatment. Of total 58 patients, 31 received garlic tablets while 27 received placebo. No significant difference was found between the two groups regarding age, sex, nationality, smoking, underlying diseases and opium usage. During 8 weeks of anti-TB [antituberculosis] treatment, 8 [13.0%] patients developed drug-induced hepatotoxicity [DIH]. Of them, 6 [75%] occurred in the first two weeks of treatment. Fifty percent of the patients who developed DIH were in garlic group. Results indicated no significant difference between groups in developing DIH [p=1.000]. We could not show a significant role in preventing DIH by 1000 mg daily garlic administration

Behavior and knowledge of Iranian professional athletes towards smoking

This study aimed to assess the rate of tobacco consumption among professional athletes in Iran and assessing their knowledge and attitude in this regard. A total of 738 athletes from 10 different types of sports were evaluated. Athletes were all members of the priority leagues. After obtaining consent from the Physical Education Organization and coordination with the related federations, athletes were asked to fill out the standard questionnaire. All understudy subjects were males. The mean age was 28.4 +/- 2.7 yrs. The mean age of initiation of sport in these subjects was reported to be 12.3 +/- 4.01 yrs. A total of 178 [24.6%] subjects had experienced cigarette smoking and 308 [42.3%] had experienced hookah smoking. Sixty four subjects [9%] were current smokers. The mean score of knowledge about hazards of smoking was 5.6 +/- 0.9 among those who had experienced smoking. This score was 7.9 +/- 0.5 among those with no smoking experience [P=0.04]. Rate of smoking among professional athletes is lower than general population average. So participation in organized sports may be a protective factor against tobacco use in people

Clinical and demographic characteristics of confirmed cases in H1N1 [2009] influenza

Presentation of pandemic H1N1 influenza [H1N1] is widely evolving as it continues to involve different geographic locations and populations. This study was conducted to improve the precision of clinical diagnosis of H1N1 [2009] influenza infection in an outpatient setting. A prospective cross-sectional study was conducted among adult patients [age >15 years] with influenza-like illnesses [ILI] from November 2009 to February 2010. Clinical, laboratory and epidemiological findings in the first week of illness were collected using a standardized datasheet. Influenza testing was performed by real-time reverse-transcriptase polymerase chain reaction [rRT-PCR]. Thirty nine [24%] patients were positive for H1N1 and 123 [76%] were negative for any subtype of influenza A virus. Whilst otalgia [14% vs. 0 p= 0.01] was more prevalent in non-influenza A cases, cough [90% vs. 72% p = 0.03] and shortness of breath [67% vs. 47% p = 0.02] were more often associated with H1N1-infection. Comparative analysis of coexisting conditions and demographic factors of patients revealed no other significant differences between the two groups. The clinical presentation of H1N1 [2009] infection is largely indistinguishable from other acute respiratory diseases. Although previous studies suggested significant differences in demographic and co-existing conditions of H1N1 infected patients, our study shows that as the pandemic spreads worldwide and affects the majority of the population, H1N1 diagnosis based on clinical presentation and demographic characteristics has become less practical and much more difficult in tertiary care centers

Prevalence of oseltamivir-resistant 2009 H1N1 influenza virus among patients with pandemic 2009 H1N1 influenza infection in NRITLD, Tehran, Iran

Oseltamivir-resistant cases were reported during the 2009 pandemic influenza outbreak and therefore, widespread emergence of oseltamivir-resistant 2009 H1N1 virus is imaginable. Underlying medical conditions like immunosuppression increase the chance of oseltamivir resistance. In a retrospective cross-sectional study, respiratory tract specimens of confirmed cases of 2009 H1N1 influenza referred to the Masih Daneshvari Hospital were analyzed for presence of H275Y mutation. From November 2009 through March 2010, oseltamivir-resistant 2009 H1N1 infection was observed and confirmed in 4 patients [including 2 immunocompromised patients] by performing H275Y mutation molecular testing. Close monitoring of resistance to neuraminidase inhibitors is essential in tertiary care centers. The H275Y mutation [oseltamivir-resistant genotype] could appear in the absence or presence of selective drug pressure

Foreign body removal using bronchoscopy and argon plasma coagulation

Foreign Body Aspiration can be a life threatening event especially for young children with smaller diameters of airway size. The foreign body can result in body response and granulation tissue formation around the object which makes the foreign body removal difficult. In such situations surgical intervention is usually needed but with interventional pulmonology modalities we can restrict the need of surgery

[Evaluation of the smoking habit among male students of all faculties of the Shahid Beheshti University and Shahid Beheshti Medical Science University during 2008]

Cigarette smoking and consuming other tobacco products are the behaviors that generally start in adolescence. This study was done to evaluate the prevalence of smoking in male students of Shahid Beheshti University in 2008. This is a questionnaire-based cross-sectional study. The questionnaires were designed in accordance with the WHO and IUATLD questionnaires; validity and reliability of questionnaires were assessed in previous samples. Smoking prevalence and its determinants were evaluated using SPSS software. 1271 students including 765 [60.2%] medical students and 506 [39.8%] non-medical students were included in the study. In this population, 782 [61.5%] students had had smoking experience, among which 395 [31.1% of whole population and 50.5% of experienced smokers] smoked 100 cigarettes or the same amount of nicotine from other tobacco products. This figure increased significantly with an increase in the number of terms the students had attended the university i.e. senior students, [p=0.000]. There was no significant difference between smoking 100 cigarettes in medical and non-medical students, [p=0.08]. Figures for smoking experience and smoking 100 cigarettes were respectively 63.7% and 54.2% among medical students and they were 58.3% and 44.4% among non-medical students. Considering the high rate of smoking experience in this population, it is essential to implement prevention programs before entrance to the universities and the increasing rate of smoking in senior years calls for educational interventions in universities

[Evaluation of knowledge, attitude and practice about smoking among male teachers in Tehran, Iran]

To assess knowledge, attitude and practice about smoking should be evaluated as their cigarette smoking may lead to smoking among teachers in Tehran, Iran. This was a cross sectional study carried out in Tehran, Iran. A random sample of teachers from 50 schools were selected. Data on knowledge, attitude and practice about smoking were recorded using a WHO based questionnaire. In all 551 male teachers were took part in the study. 150 teachers reported that they smoke more then 100 cigarettes of these 80 teachers [14.5%] reported to smoke daily, 40 teachers [7.3%] smoked occasionally and 30 teachers [4.5%] have quit smoking. So their cigarette smoking prevalence was stimated to be 27.2% [CI 95%:23.5%-31.1%]. The prevalence of smoking among teachers was not different in different educational districts [P=0.13]. Also, there was no statistical difference between the prevalence of smoker born in Tehran and elsewhere [P=0.18]. In addition, type of employment and smoking status were not associated [P=0.25]. However, the association between knowledge, attitude and practice and smoking status of teachers were found statistically significant [P<0.0001]. Since, smoking habits among teachers was similar to general population and because the students imitate their teachers, therefore, educational tobacco control programs for teachers should be designed and implemented in order to reduce tobacco smoking in this group and finally among the students

[Does smoking cessation result depend on smoking reason?]

Since the smoking reason for different smokers needs different treatment methods and special advices, it is necessary to specify these reasons. This study designed to know the main smoking causes in Iran, in order to design proper treatment methods and behavioral therapies for smoking cessation. In addition the study thought to evaluate the effects of these reasons on the quit results and the probable circumstances of these effects. This was a cross-sectional study carried out in Tehran, Iran. All people attending to smoking cessation clinics [affillated to Research Institute for Tuberclosis and Lung Diseases, Shahid Beheshti University of Medical Sciences] were invited to take part in the study in year 2006-2008. Volunteers answered 13 items of the Iranian version of the Modified Reasons for Smoking Scale [MRSS], Fagerstrom test and demographic characteristics. All participants have been assessed by a physician and they participated in a four-session per week program including nicotine replacement and non-nicotinic therapies and behavioral therapy. All participants were followed-up for 6 and 12 months after quiting smoking. In all 822 participants including 590 men [68.7%] with mean age of 43.8 +/- 13.2 years were studied. All analyses were adjusted for sex and Fagerstrom test score. Pleasure to smoke was found as the principle reason for failure to smoking cessation in the end of clinical trial [P=0.004]. In 6 and 12 months follow-up, failed quitting was predicted by pleasure to smoke and hand-mouth activity score [P<0.05]. The study findings suggest that reason for smoking is associated with its quiting