Childhood recurrent abdominal pain and Helicobacter pylori infection, Islamic Republic of Iran

We examined the role of Helicobacter pylori infection as a cause of recurrent abdominal pain [RAP] among Iranian children in a population-based case-control study to determine the association between H. pylori infection and RAP among schoolchildren. A total of 1558 children aged 6-13 years were examined. Children with RAP confirmed by the Apley and Naish criteria were selected; 145 cases were selected for inclusion and were compared with 145 healthy children recruited from the same area. Both groups underwent stool antigen testing. The prevalence of RAP in the children tested was 9.3%. Children with RAP had a higher H. pylori infection rate than the control group [58.6% vs 44.8%] [OR = 1.744; 95% CI: 1.095-2.776]. There was no significant difference between the RAP symptoms in children with positive stool test, i.e. infected with H. pylori, and those whose tests were negative. We identified H. pylori infection in more than 55% of the case group. Therefore, H. pylori infection can be considered an important factor for RAP in children

Effectiveness of teaching anger management skills using cognitive-behavioral approach in the reduction of aggression among womensuffering from breast cancer

Cancer patients are facing with the problems such as anxiety, depression, hopelessness, and aggression, which affect the various aspects of their life. Therefore, this study aimed to investigate the effectiveness of teaching anger management skills using cognitive-behavioral approaches in the reduction of aggression. This quasi-experimental study with a pre-test/post-test design was performed on 30 female clients suffering from breast cancer referred to Imam Khomeini Hospital, Tehran, Iran, during 2014-2015. The participants were selected according to the inclusion and exclusion criteria and assigned to the experimental and control groups. Then, the participants in the experimental group answered the Buss and Fray's scale of aggression before and after the therapy sessions. After receiving the cognitive-behavioral therapy, results obtained from multivariate covariance analysis showed that the mean aggression score in the experimental group had a significantly meaningful reduction [P<0.05] compared to that of the control group. It seems that teaching the anger management skills, due to its cognitive improvement, has an effective role in the control of aggression among the women suffering from breast cancer

Instructional design, delivery, and evaluation of interactive case-based e-CME contents

Background and purpose: Studies have shown the advantages of e-CME programs. Developing case-based e-CME activities, which is a popular format of e-CME programs, is difficult and time-consuming. In this article, we have discussed our experience in designing instructional system for creating case-based e-CME contents

Methods: We designed the instructional system in five steps [i.e., system analysis, design, development, delivery, and evaluation] to create e-contents. We held several sessions with subject experts to analyze the system. Then, we determined the contents' framework and created a plan for faculty members' development and incentives. In the development phase, we held workshops for faculty members and trained e-learning advisors who were to help faculties create contents. Incentives were legitimized. Then, we delivered programs to the learners who would fill a program evaluation questionnaire after completing the study of each program

Results: A total of 20 e-CME programs were developed and delivered to the learners and a total of 3644 learner-programs were studied. The cases rated the programs as 4.56 [SD=0.65] on a 1-5 Likert-type scale

Conclusions: Results showed that the learners rated this learning activity highly. However, we faced some challenges in developing the contents. In future, designing a comprehensive instructional system would help overcome these barriers

[Trihalomethane formation potential in drinking water from minab steghlal dam to water distribution network in Bandar Abbas, Iran]

Organic matters enter to drinking water from a variety of sources, but one of the major sources of these compounds in aqueous solution can be decomposed plant and microbial residues. Chlorination is the most common method for water disinfection, the free chlorine in the water reacts with natural organic compounds and form disinfection byproducts. One of the dangerous byproducts is Trihalomethanes [THMs]. These compounds are suspected to be carcinogenic for humans. In this study, 96 samples were taken from 4 points [Mianb Steghlal dam, output Minab water treatment plant, input and output of water treatment plant in Bandar Abbas] within 6 months. Parameters such as TOC, pH, temperature and chlorine residual were measured and used for prediction of THM formation by a methematical model. Results showed that Bandar Abbas drinking water has high TOC and THM formation potential is high. Minimum and maximum of THM was measured 14.78 and 84.86 micro g/l, respectively. Positive correlation was seen between concentrations of organic carbon and pH with THM formation. Increasing pH and TOC concentration in water, leads to increase of THM formation potential. Bandar Abbas drinking water has high potential to form THM, therefore, it is necessary to consider measures in this field

Relation between coping ways with stress and lowdensity lipoprotein [LDL] in coronary heart disease patients

Background and objective: Due to the increasing incidence and prevalence of coronary heart disease and emphasis onresearchers of Health on Association Biological and psychological factors and cardiac biomarkers with incidence and persistence of cardiovascular disease are felt more than ever necessary to analyze the relationship between Coping Ways with Stress and Low-density lipoprotein [LDL], But until now researchers have not explored it empirically, So The aim of this study was to examine the relation between Coping Ways with Stress and Low-density lipoprotein [LDL] in Coronary Heart Disease patients

Materials and methods: This is a correlation study. Statistical community were All patients CHD Shahid Rajaie Heart Hospital in Tehran. 44 patients with CHD admitted to the women and men surgical department surgery, women and men local department and private sector hospitals that CHD confirmed by angiography had been chosen from among eligible patients.Condition.In this study was used of Coping Ways questionnaire- Lazarus and Folkman and Low-density lipoprotein [LDL] kit. For statistical analysis of research data was usedIndicators and descriptive statistics and Pearson correlation and multiple regression analysis with stepwise method. The computer software used in this study for data processing was SPSS/17

Results: The results showed there are Positive and significant correlation between Emotional Focused Coping Ways [Inefficient] and Low-density lipoprotein [LDL] and also Negative and significant correlation between Problem Focused Coping Ways [Efficient] and Low-density lipoprotein [LDL] and coefficient of positive re-evaluation coping way [=-0/737] according to the T test show that the variables with 99% confidence can be predicted to the changes related to Low-density lipoprotein [LDL] and also coefficients of positive re-evaluation and Responsibility coping ways_according to the T test show that the variables with 99% confidence can be predicted to the changes related to Lowdensity lipoprotein [LDL]

Conclusion: In sum, we conclude that the increased use of Emotional Focused Coping Ways lead to increases in levels of Low-density lipoprotein [LDL] and increased in the use of Problem Focused Coping Ways lead to decreased in levels of Low-density lipoprotein [LDL]

High prevalence of HCV coinfection in HIV-infected individuals in Shiraz, Islamic Republic of Iran

We carried out a cross-sectional survey in Shiraz to determine the prevalence of hepatitis C virus [HCV] in 1 444 individuals infected with human immunodeficiency virus [HIV]. We also determined the risk factors for this coinfection. Demographic and behavioural data were obtained using a standard questionnaire. The prevalence of HIV–HCV coinfection was 78.4% [95% CI: 76.3–80.5]. Intravenous drug use [OR = 7.2; 95% CI: 4.9–10.6], imprisonment [OR = 6.9; 95% CI: 4.6–10.4], tattooing in prison [OR = 2.61; 95% CI: 1.4–4.8], tattooing out of prison [OR = 2.0; 95% CI: 1.3–3.1] and age [OR = 1.02 with increasing each year of life; 95% CI: 1.0–1.04] were significantly associated with HCV–HIV coinfection. Prevalence of HCV–HIV coinfection is high in Shiraz. Intravenous drug use and imprisonment are the main risk factors for this coinfection. Therefore, serious implementation of HIV and HCV testing, education, prevention, care and treatment programmes and evaluation of harm reduction programmes in prisons are very important.

Mental health and well-being in different levels of perceived discrimination

To compare mental health and well- being in different levels of the perceived discrimination among Iranian people living in Tehran. Using multi- stage sampling, 1255 subjects with the average age of 45 years and 9 months [including 672 women and 583 men] were selected and they completed all items of the general health questionnaire [GHQ], the social well- being inventory [SWI], personal well- being inventory [PWI], and a question to assess the perceived discrimination. Data analysis by Kruskal- Wallis test revealed that there were significant differences between physical symptoms [X[2]=5.93, P<0.05] and depression [X[2]=15.70, P<0.05], the subscales of mental health in different levels of the perceived discrimination. Furthermore, comparing personal well- being scores and its subscales in different levels of the perceived discrimination showed significant differences in personal hygiene [X[2]=7.20, P<0.05], and security in future [X[2]=7.60, P<0.05]. Emotional well- being [X[2]=12.25, P<0.05], self-rule [X[2]=7.45, P<0.05], personal growth [X[2]=19.87, P<0.05], and psychological well- being [X[2]= 9.09, P<0.05] were significantly different in different levels of the perceived discrimination, too. Moreover, comparing social well- being in different levels of the perceived discrimination indicated significant differences between social acceptance [X[2]=14.91, P<0.05], and social participation [X[2]= 10.91, P<0.05]. Therefore, people are more active in society, increases the possibility of encountering with discrimination and consequently the perception of that

intermediary role of self-efficacy in relation with stress, glycosylated haemoglobin and health-related quality of life in patients with type2 diabetes

Stress is not always a direct result of stressful conditions, but rather the way they are perceived. Thus individual variables that may be associated with perceived stress should be examined in stress studies. This study investigates the intermediary role of self-efficacy in relation with stress, glycosylated haemoglobin and health-related quality of life in patients with type2 diabetes. All women with diabetes in Yazd Diabetes Research Centre, in 2012, were considered and 80 women were selected by random sampling. They completed Shirer's self-efficacy scale questionnaire, depression, anxiety and stress scale [DASS], and ADDQ0L19 questionnaire. Then they were introduced to the lab for blood test. Data were analysed by SPSS software and stepwise regression method. Pearson correlation test results showed that the hemoglobin A1c [r = 0.35] and Quality of Life [r = -0.22] are associated with stress [P <0.05]. As so hemoglobin A1c [r = 0.83] and Quality of Life [r = 0.37] with variable of self efficacy are associated positively and significantly [P <0.05]. Results of stepwise regression also showed that self efficacy and stress scales 0.697 of variance hemoglobin A1c and 0.140 of variance of Quality of life explaining to do. The impact of stress on blood sugar and patients' health-related quality of life can be influenced by their self-efficacy; therefore it is suggested that an educational intervention is done to increase patients' self-efficacy to better cope with stress in their life

[Comparison of transcutaneous and serum bilirubin level in term neonates with jaundice]

Transcutaneous bilirubin measurement is a noninvasive method which is associated with decreased pain, less skin injury and lower risk of infection. In addition there is no need to take blood sample .The aim of this study was to determine the clinical accuracy of transcutaneous bilirubinometry [TCB] in comparison to that of total serum bilirubin [TSB] measurements in term neonates. This descriptive- analytic study included 212 term neonates with indirect hyperbilirubinemia at neonatal intensive care unit of Imam Reza Hospital in Kermanshah from January 2009 to August 2010. Inclusion criteria were: birth weights between 2500-4000 grams and postnatal age between 2-28 days. Before starting phototherapy blood samples for measurement of serum bilirubin levels were obtained and measurement of transcutaneous bilirubin was carried out at the same time. Measurement of transcutaneous bilirubin from the forehead skin was performed by a trained person according to the manufacturer's recommendations. Data analysis was performed with Stata software. Mean values for total serum bilirubin before and after the onset of phototherapy were 18.43 and 15.21 mg/dl, and the respective values for transcutaneous bilirubin were 18.08 and 15.02mg/dl. There were no significant differences between transcutaneous and serum bilirubin levels before the onset of phototherapy [p=0.47], and the linear correlation coefficient was 0.50. Also no significant differences were detected between transcutaneous and serum bilirubin levels after phototherapy [p=0.27], and the correlation coefficient was 0.78. There was a good correlation between transcutaneous bilirubin and serum bilirubin levels especially in the male neonates with birth weights of less than 2600 grams after 12 hours of phototherapy. According to the results of this study, transcutaneous bilirubinometry can be recommended for the screening of neonatal jaundice

Effect of colloid versus crystalloid administration of cardiopulmonary bypass prime solution on tissue and organ perfusion

We evaluated the effects of tissue and organ perfusion during and after coronary artery bypass graft surgery with either colloid [Voluven] or crystalloid [Lactated ringer's] as prime solution. In this prospective randomized-controlled trial study, 70 patients undergoing on-pump coronary artery bypass graft surgery were randomly assigned to receive either colloid [Voluven] or crystalloid [Lactated ringer's] as prime solution, for initiation of cardiopulmonary bypass machine procedure. Tissue and organ perfusion markers including lactate, troponin I, liver and renal function tests and electrolytes were measured sequentially, before induction [T1] to second days after surgery [T5]. With exception of chloride and potassium levels no significant differences detected in other measurements, and the laboratory results were entirely identical in both procedures. There was no significant difference between Voluven[registered] [ hydroxyethyl starch, HES 130/0.4] and crystalloid [Lactated ringer's] as priming solution on the basis of organ and tissue perfusion tests assessment

[Clinical comparison of root length measurements with electronic apex locator and conventional radiography in mandibular deciduous teeth]

Statement of Problem: Success in pulpectomy of deciduous teeth greatly depends on the accuracy of root length measurements which have mostly been done radiographically. However, X-ray risks and patient cooperation have usually been a challenge for the clinicians

Purpose: The clinical comparison of root length measurements with electronic apex locator and conventional radiography in 4-6 year old children's mandibular deciduous teeth was the aim of the present study

Materials and Method: In the current clinical trial, 15 mandibular molars with 60 canals in 4-6 year old patients who had the treatment plan of pulpectomy were chosen. The measured root lengths with apex locator and parallel technique radiography were evaluated with the same reference point. Data were analyzed using simple linear regression, coefficient of correlation, coefficient of variability and also graphic Bland Altman Plot

Results: The accuracy of electronic apex locator measurements in +/-0/5 from apical foramen was 85%. In all cases without considering pulp situation, the difference between the two techniques was not significant

Conclusion: The electronic apex locators are recommended for root length measurements of the deciduous mandibular molars without apical resorption, disregarding the pulp status, especially when initial radiographic films are available

Toxoplasma infection in schizophrenia patients: a comparative study with control group

Schizophrenia is a serious, chronic, and often debilitating neuropsychiatric disorder. Its causes are still poorly understood. Besides genetic and non-genetic [environmental] factors are thought to be important as the cause of the structural and functional deficits that characterize schizophrenia. This study aimed to compare Toxoplasma gondii infection between schizophrenia patients and non-schizophrenia individuals as control group. A case-control study was designed in Tehran, Iran during 2009-2010. Sixty-two patients with schizophrenia and 62 non-schizophrenia volunteers were selected. To ascertain a possible relationship between T. gondii infection and schizophrenia, anti-Toxoplasma IgG antibodies were detected by indirect-ELISA. Data were statistically analyzed by chi- square at a confidence level of 99%. The sero-positivity rate among patients with schizophrenia [67.7%] was significantly higher than control group [37.1] [P <0. 01]. A significant correlation between Toxoplasma infection and schizophrenia might be expected

[Specular microscopy evaluation of corneal endothelial cells after intravitreal and subconjuctival injection of avastin]

To evaluate corneal endothelial cell changes after intravitreal and subconjunctival injection of avastin [bevacizumab] based on specular microscopic findings. This prospective interventional study was performed on 82 eyes of 82 patients. Forty-two cases with ptrygia received a subconjunctival injection of bevacizumab [2.5mg/0.2ml] and 40 diabetic subjects with retinal neovascularization or macular edema received an intravitreal injection of bevacizumab [1.25mg/0.1ml]. Specular microscopy, including corneal endothelial cell count, size and shape, was performed in all patients for the injected eye before, and one and three month after injection and the results were compared and analyzed. There was no change in the corneal endothelial cells count after one month but there was mild reduction of endothelial cells after 3 months which was not statistically significant.[P=0.75 and 0.29, respectively]. Subconjunctival and intravitreal injection of bevacizumab [up to 1.25 mg/0.1 ml and 2.5 mg/0.2 ml, respectively] entails no harmful effect on human corneal endothelial cells up to three months following the injection

effect of low-dose of ketamine infusion on stressresponses in coronary artery bypass graft surgery

Open heart surgery is associated with acute perioperative changes in plasma levels of neurohormonal stress factors, cortisol, interleukin-6 and C-reactive protein. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate the markers of inflammation without adverse effects. The aim of this study was to investigate whether, low dose infusion of ketamine when administered during 48 hours after induction, have anti-inflammatory effect and attenuate stress factors, in on-pump coronary artery bypass graft surgery. In this prospective randomized-controlled trial, 50 patients undergoing on-pump coronary artery bypass graft were randomly assigned to receive either 1.25mcg/kg/min of ketamine [Ketamine group, n=25] or normal saline [Control group, n=25] infusion during and for 48 hours after surgery. Inflammatory and stress response markers including C-reactive protein, cortisol, White blood cell count and differential, glucose and lactate level were measured ,before induction [T1], 4 hours after surgery [T2], and on the first and the second days after surgery [T3 and T4]. The level of lactate were higher in ketamine compared with control group four hours after operation [P< 0.05] without any significant differences detected in other measurements. Low dose ketamine did not cause any change in C-reactive protein, cortisol, White blood cell count and glucose level, however lactate level was higher compared to control group

[ effect of low-dose ketamine infusion on hemodynamic change in coronary artery bypass graft surgery]

Cardiopulmonary bypass often causes a stress hormonal response with subsequent changes in hemodynamic and organ perfusion. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate inflammatory and stress markers, without adverse effects. The aim of this study was to investigate whether low dose infusion of ketamine have hemodynamic stability effect in coronary artery bypass surgery. In this double blind-controlled trial, 50 patients undergoing on-pump CABG were randomly assigned to receive either 1.25mcg/kg/min of ketamine infusion [Ketamine group, n=25] or normal saline infusion [Control group, n=25] during 48 hours after induction of anesthesia. hemodynamic measurement including blood pressure, heart rate, central venous pressure, cardiac output, cardiac index, systemic venous resistance, arterial blood gas and lactate were measured previous to induction [T1], 4 h, 24h, and48h after the surgery [T2,T3 and T4]. The data were evaluated with using of variance analyzing test and repeated measurement. There were significant interaction effect between time [pre operation, 4, 24 and 48 hours after operation] and group of study [ketamine and placebo] in assessment of systolic blood pressure [p=0.0001], diastolic blood pressure[p=0.0001], heart rate [p=0.004], central venous pressure [p=0.0001] and lactate [p=0.035]. These indicate that ketamine caused decrement in tissue perfusion. Those interactions were not statistically significant for other parameters [p>0.05]. low dose ketamine during and 48 hours after operation not only didn't show hemodynamic stability effect but also decreased tissue perfusion slightly

Respiratory health following long term occupational exposure to fiberglass dust

Despite the wide application of fiberglass, its respiratory effects have not been extensively studied. The purpose of this study was to further examine this issue among a group of workers occupationally exposed to this compound. This is a historical-cohort study in which the respiratory health of 49 workers exposed to fiberglass as well as 42 unexposed employees as the referent group from a local fiberglass industry was evaluated. A standardized respiratory questionnaire was used. The subjects underwent chest x-ray and were examined by a physician for any possible respiratory abnormalities. Furthermore, pulmonary function tests were performed just before the work shift. Moreover, to assess the extent to which subjects had been exposed to fiberglass dust, respirable dust concentrations were measured in different dusty work sites, using standard methods. The average age of the exposed subjects and the duration of exposure were 39.6 +/- 7.34 and 11.2 +/- 5.59 years, respectively. Atmospheric concentrations of respirable fraction of fiberglass dust in dusty work sites, namely Line and Tissue units, were found to be 44.5 and 6.27 mg/m[3], respectively. The prevalence of respiratory symptoms and abnormalities in the chest x-ray of the exposed and unexposed subjects was not significantly different. Lung function parameters, i.e., vital capacity [VC], forced vital capacity [FVC], forced expiratory volume in the first second [FEVi], and percentage ratio of FEV1 to FVC in the exposed workers were comparable with those of the control subjects. Significant associations between the length of exposure to fiberglass and age with FEV/FVC ratio were noted. The results support that exposure to fiberglass dust is unlikely to be associated with respiratory symptoms, abnormal radiographic changes or functional impairments of the lungs

[Frequency of oral mucosal disease in referral patients to dental faculty of Tabriz in 2007]

Oral disease is a significant burden to all countries of the world. Since there is little know about this in Iran we decided to identify of oral mucosal disease in patients referred to Oral Medicine Center affiliated to Tabriz Dental School. A consecutive sample of admitted patients to OMC between April to June 2007 were included in this study. We employed a standard questionnaire in order to. Eight hundred two patients were completed the requested questionnaire. Seventy percent was female. The mean age of the study sample was 32.68 [SD=12.25] years. Approximately 70% of subjects had oral lesion,%19.2 had normal mucosa and%21.60 of patients had oral mucosal lesions that need to follow and control. The most common lesions were ankiloglossia [%29.7] then fissural tongue [%25.7] and coated tongue [%23.7]. Many patients attending the center were unaware of oral lesions in their soft oral tissue which needed to follow up. This emphasizes that examination of soft oral tissue should be considered by health policy makers in oral health agenda at national level

[Relationship between spirometry results and respiratory complaints to flour dust in flour mill workers]

Exposure to flour dust and related allergens is one of the most common causes of occupational airway disease [OAD] and occupational asthma [OA]. The main purpose of this study was to investigate the respiratory effects of exposure to high atmospheric concentrations of flour dust. This study was carried out in a local flour producing factory in Shiraz, in 1384. Sixty seven subjects [35 exposed and 32 non-exposed] were investigated. The prevalence of respiratory symptom as well as lung function capacities was evaluated. Additionally, atmospheric concentrations of flour dust were measured. The data were analyzed by Independent sample t-test, Chi-square or fisher's exact test and multiple linear regression. Atmospheric concentrations of dust exceeded current permissible levels. Additionally, exposed workers had higher prevalence rates of regular cough, productive cough, wheezing, phlegm and shortness of breath. Likewise, significant [p<0.05] decrements in the parameters of pulmonary function were noted. The findings of this study provide additional corroborative evidence in favour of the notion that after adjusting for age, smoking habits and other confounders, a strong association exists between exposure to flour dust and the prevalence of respiratory symptoms and functional impairments of the lungs

[Evaluation the impact of family physician care program on family planning in Sari from 2003 to 2007]

Iranian family physician care program as a new program has begun since 2005 to deliver a better service particularly in primary health care. The objective this survey was to evaluate the impact of this program on family planning in Sari city between 2003-2007. This survey was conducted among all women 15-49 years who married. Required data were collected from health files. The pattern of time trend evaluated and relevant indices compared before and after the family physician program. The application of condom, hormone injection, vasectomy and total modern contraceptives increased but employing the methods of tubectomy, IUD, OCR, Norplant and traditional method were descending. This variability for condom, tubectomy and traditional methods were statistically significant [p<0.05]. However for other methods were not statistically significant [p>0.05]. Difference of contraceptive using rates in pre and post of the application of program for condom, hormone injection, tubectomy and OCR were statistically significant [p<0.05] and for others were not statistically significant [p>0.05]. It seems relatively success of family physician program on family planning in Mazandaran province however more human resource should be allocated to family planning