Low Levels of Extensively Drug-resistant Tuberculosis among Multidrug Resistant Tuberculosis Isolates and Their Relationship to Risk Factors: Surveillance in Tehran, Iran; 2006 to 2014

OBJECTIVES: Extensively drug-resistant tuberculosis (XDR-TB) is more expensive and difficult to treat than multidrug-resistant tuberculosis (MDR-TB), and outcomes for patients are much worse; therefore, it is important that clinicians understand the magnitude and distribution of XDR-TB. We conducted a retrospective study to compare the estimated incidence of and risk factors for M/XDR-TB with those of susceptible TB controls. METHODS: Sputum culture and drug susceptibility testing (DST) were performed in patients with known or suspected TB. Strains that were identified as MDR were subjected to DST for second-line drugs using the proportion method. RESULTS: Among 1,442 TB patients (mean age, 46.48 ± 21.24 years) who were culture-positive for Mycobacterium tuberculosis, 1,126 (78.1%) yielded isolates that were resistant to at least one first-line drug; there were 33 isolates (2.3%) of MDR-TB, of which three (0.2%) were classified as XDR-TB. Ofloxacin resistance was found in 10 (0.7%) isolates. Women were 15% more likely than men to yield M/XDR-TB isolates, but this difference was not significant. In a multivariate analysis comparing susceptible TB with X/MDR-TB, only one variable—the number of previous treatment regimens—was associated with MDR (odds ratio, 1.06; 95% confidence interval, 1.14–21.2). CONCLUSION: The burden of M/XDR-TB cases is not sizeable in Iran. Nonetheless, strategies must be implemented to identify and cure patients with pre-XDR-TB before they develop XDR-TB. Our results provide a greater understanding of the evolution and spread of M/XDR-TB in an environment where drug-resistant TB has a low incidence.

Protective Effect of Ozone against Hemiscorpius lepturus Envenomation in Mice / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Scorpion (Hemiscorpius lepturus) stings are a public health concern in Iran, particularly in south and southwestern regions of Iran. The gold standard for the treatment of a scorpion sting is anti-venom therapy. However, immunotherapy can have serious side effects, such as anaphylactic shock (which can sometimes even lead to death). The aim of the current study was to demonstrate the protective effect of ozone against toxicity induced by Hemiscorpius lepturus (H. lepturus) venom in mice.</p><p><b>METHODS</b>Eight hours after the injection of ozone to the experimental design groups, the male mice were decapitated and mitochondria were isolated from five different tissues (liver, kidney, heart, brain, and spinal cord) using differential ultracentrifugation. Then, assessment of mitochondrial parameters including mitochondrial reactive oxidative species (ROS) production, mitochondrial membrane potential (MMP), ATP level, and the release of cytochrome c from the mitochondria was performed.</p><p><b>RESULTS</b>Our results showed that H. lepturus venom-induced oxidative stress is related to ROS production and MMP collapse, which is correlated with cytochrome c release and ATP depletion, indicating the predisposition to the cell death signaling.</p><p><b>CONCLUSION</b>In general, ozone therapy in moderate dose can be considered as clinically effective for the treatment of H. lepturus sting as a protective and antioxidant agent.</p>

Adipose-derived mesenchymal stem cells for treatment of airway injuries in a patient after long-term exposure to sulfur mustard

Objective: Sulfur mustard [SM] is a potent mutagenic agent that targets several organs, particularly lung tissue. Changes in morphological structure of the airway system are associated with chronic obstructive pulmonary deficiency following exposure to SM. Although numerous studies have demonstrated pathological effects of SM on respiratory organs, unfortunately there is no effective treatment to inhibit further respiratory injuries or induce repair in these patients. Due to the extensive progress and achievements in stem cell therapy, we have aimed to evaluate safety and potential efficacy of systemic mesenchymal stem cell [MSC] administration on a SM-exposed patient with chronic lung injuries

Materials and Methods: In this clinical trial study, our patient received 100x106 cells every 20 days for 4 injections over a 2-month period. After each injection we evaluated the safety, pulmonary function tests [PFT], chronic obstructive pulmonary disease [COPD] Assessment Test [CAT], St. George's Respiratory Questionnaire [SGRQ], Borg Scale Dyspnea Assessment [BSDA], and 6 Minute Walk Test [6MWT]. One-way ANOVA test was used in this study which was not significant [P>0.05]

Results: There were no infusion toxicities or serious adverse events caused by MSC administration. Although there was no significant difference in PFTs, we found a significant improvement for 6MWT, as well as BSDA, SGRQ, and CAT scores after each injection

Conclusion: Systemic MSC administration appears to be safe in SM-exposed patients with moderate to severe injuries and provides a basis for subsequent cell therapy investigations in other patients with this disorder

Burden of obstructive lung disease study in Tehran: research design and lung spirometry protocol

Chronic obstructive pulmonary diseases [COPD] are planned to rank fifth in burden of disease and third with respect to mortality by 2020. Carrying out research regarding different aspects of COPD is mentioned as important health priorities by academic institutions and governments. The burden of lung disease [BOLD] Initiative was designed a decade ago to develop robust models that can be used to estimate the prevalence and current and future economic burden of COPD. The goal of the present project is to describe the prevalence and determining the causes and risk factors of COPD in the population of Tehran city. This cross sectional study follows a stratified cluster sampling strategy with proportional allocation within strata. The target population is all noninstitutionalized inhabitants, aged 18-40 in one group and over 40 in another, who inhabit in Tehran city. The stratification of the sample according to the 22 municipal districts of Tehran is incorporated in the sampling process. Proportional to the number of households in the 22 districts, the appropriate number of clusters is weighted according to each district. For each cluster, a team of three members approaches the index household, which is specified through the aforementioned random selection of clusters, and continues the enumeration in 10 neighbor households in a systematic manner. As a study protocol, there are no specific results to present; our purpose is to share our design with the scientific body. We expect that findings from the BOLD study in Tehran will show the status of COPD and its causes in the community

role of serum level of interleukin-6 in severity of pulmonary complications of sulfur mustard injuries

Diverse studies suggest that interleukin-6 [IL6], as a member of cytokines family, has a major role in inflammatory processes of airways and lungs. In this study, an attempt was made to determine the serum level of IL6 in sulfur mustard [SM] injured patients and its comparison with controls. The measured IL6 mean level in patients with chemical injuries [0.76 +/- 0.3 ng/ml] was significantly higher than the control group's mean level [0.34 +/- 0.12 ng/ml]. Furthermore, patients with moderate to severe symptoms had a serum level of [0.95 +/- 0.92 ng/ml] which was significantly higher than mild [0.47 +/- 0.54] and control [0.34 +/- 0.12] groups. The outcome of this research program demonstrates that an increase in serum level of IL6 can have a role in pulmonary complications of SM, similar to other well defined pulmonary diseases. However, further studies are required to clarify the role and mechanism of IL6 in such patients

Project monitoring and evaluation: an enhancing method for health research system management

Planning, organizing, staffing, leading and monitoring are the basic functional component of management. In present article, we aim to define the project monitoring and evaluation in health research system [HRS] considering its success and challenges based on our national experience. In this study based on the information of annual Medical Science Universities evaluation during the last decade the HRS indicators have been scored in three axes based on HRS functions: Stewardship, capacity building and knowledge production. In this article, we will focus on the results of HRS evaluation from 2002 to 2010, also on its success and challenges. In an overall view, the main results are the experiences of the designing and implantation of such process after pre-project preparation, all parts followed under the whole supervision of the aims of the HRS evaluation. Project management light the way of practical application of knowledge, skills, tools and techniques for better HRS evaluation and management. We concluded that; although monitoring and evaluation as an essential part of HRS Management light the improvement ahead way but we still need to advantage of the new project management advances

Long-term effects of mustard gas on respiratory system of Iranian veterans after Iraq-Iran war: a review / 中华创伤杂志(英文版)

To review long-term respiratory effects of mustard gas on Iranian veterans having undergone Iraq-Iran war. Electronic databases of Scopus, Medline, ISI, IranMedex, and Irandoc sites were searched. We accepted articles published in scientific journals as a quality criterion.The main pathogenic factors are free radical mediators. Prevalence of pulmonary involvement is approximately 42.5%. The most common complaints are cough and dyspnea. Major respiratory complications are chronic obstructive pulmonary disease, bronchiectasis, and asthma. Spirometry results can reveal restrictive and obstructive pulmonary disease. Plain chest X-ray does not help in about 50% of lung diseases. High-resolution CT of the lung is the best modality for diagnostic assessment of parenchymal lung and bronchi. There is no definite curative treatment for mustard lung. The effective treatment regimens consist of oxygen administration, use of vaporized moist air, respiratory physiotherapy, administration of mucolytic agents, bronchodilators, corticosteroids, and long-acting beta-2 agonists, antioxidants, surfactant, magnesium ions, therapeutic bronchoscopy, laser therapy, placement of respiratory stents, early tracheostomy in laryngospasm, and ultimately lung transplantation. High-resolution CT of the lung is the most accurate modality for the evaluation of the lung parenchyma and bronchi. The treatment efficacy of patients exposed to mustard gas depends on patient conditions (acute or chronic, upper or lower respiratory tract involvement). There are various treatment protocols, but unfortunately none of them is definitely curable.

Effect of mindfulness based stress reduction on quality of life [SF-36] and spirometry parameters, in chemically pulmonary injured veterans

Studies have shown that Mindfulness Based Stress Reuction [MBSR] has positive effect on physical and psychological dimensions of chronic illnesses. In this study for the first time we examine the effect of this new technique on quality of life and pulmonary function in chemically pulmonary injured veterans who have chronic pulmonary problem, psychological problems and low quality of life. Forty male pulmonary injured veterans were randomly replaced in two groups with 20 participants [MBSR and control Wait List [WL]]. Then MBSR group received 8-weekly session intervention. We evaluate quality of life [used SF-36 questionnaire] and Spirometry parameters two times; before and after intervention in two group. We used "mixed factorial analyses of variance" test for analyzing data in each dependent variables. Then if we have significant interactional effect, we used "paired - sample t-test" for comparing before and after intervention data of each group, and "Independent-Sample t-test" for comparing after intervention data of two groups. The MBSR compare to WL group improved SF-36 total score, [F[1,38] =12.09, P=0.001], "Role limitations due to physical problems" [F[1,38]= 6.92, P=0.01], "Role limitations due to emotional problems" [F[1,38]= 7.75, P=0.008], "Social functioning" [F[1,38]= 9.89, P=0.003], "Mental health" [F[1,38]= 15.93, P=0], "Vitality" [F[1,38]= 40.03, P

Improving trend of adhering to ethical measures in Iranian research in human genetics: a survey from 2005 to 2009; and the road ahead

The overwhelming rate of progress in biotechnological research especially in human genetics, as well as the high levels of power these researches provide us to intervene in human lives, brings serious concerns on the ethical problems that may rise from these research endeavors. To address this critical issue in Iran, we conducted a study issuing publishing authors of studies in human genetics from Iran, between years 2005 to 2011. We contacted 116 corresponding authors of articles issuing genetics research on human subjects, asking them that whether they have gotten either informed consent from their study subjects or ethical approval from their institutional ethics committee. Only 13% of the authors presented both documents; 52% had not gotten any of the documents; 19% of authors felt no need for getting the mentioned documents; 13% declared that they only gotten oral consent and 3% of authors did not remember whether they have gotten any documentation or not. The trend for informed consent taking was improving over time, from 5% in year 2006 to 24% in 2009. The result was not satisfactory but showed good trend towards improvement, recommending more serious follow up concerning ethical aspects of articles published in human genetics

Pepsin and bile acid concentrations in sputum of mustard gas exposed patients

Gastro-esophageal reflux has been suggested to be associated with several pulmonary complications such as asthma, and post-transplant bronchiolitis obliterans [BO]. Pepsin or bile salts in the sputum is shown to be an optimal molecular marker of gastric contents macro/micro aspiration. In this study, we investigated sputum pepsin as a marker of micro-aspiration in sulfur mustard [SM] exposed cases compared to healthy controls. In a case controlled study, 26 cases with BO and 12 matched healthy controls were recruited and all cases were symptomatic and their exposure to SM was previously documented during Iran-Iraq conflict. Pepsin levels in sputum and total bile acids were measured using enzymatic assay. The severity of respiratory disorder was categorized based upon the spirometric values. The average concentration of pepsin in sputum was higher in the case group [0.29 +/- 0.23] compared with healthy subjects [0.13 +/- 0.07; P +/- 0.003]. Moreover, the average concentration of bile acids in the sputum cases was not significantly different in comparison to the controls [P = 0.5]. Higher pepsin concentrations in sputum of SM exposed patients compared with healthy control subjects indicate the occurrence of significantly more gastric micro-aspiration in SM exposed patients

Prevention and treatment of respiratory consequences induced by sulfur mustard in Iranian casualties

About 100,000 Iranian have been exposed to chemical weapons during Iraq-Iran conflict [1980-88]. After being spent of more than two decades, still about 30,000 of them are under follow-up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long-acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes

Needs assessment in health research projects: a new approach to project management in Iran

The science and technology health plan has defined the outline of health research to the national vision of Iran by 2025. The aim of this study was to focus on the process of needs assessment of health research projects also health research priority setting in Iran. The project management life cycle has four phases: Initiation, Planning, Execution and Closure. Based on abovementioned points we conducted the study. Focusing on the needs assessment led to systematic implementation of needs assessment of health project in all of the medical sciences universities. Parallel with this achieved strategies health research priority setting was followed through specific process from empowerment to implementation. We should adopt with more systematic progressive methods of health project managements for both our national convenience as well as our international health research programs

Health research system evaluation in I.R. of Iran

Several systems have been proposed to rank academic institutions worldwide. We aimed to introduce a new method of Health Research System [HRS] evaluation in Iran. In this cross-sectional study, a specific questionnaire has been used to assess stewardship, capacity building, and knowledge production through annual evaluations of HRS in Iran. This article has explored the results of the 5-year evaluation [2003 - 2008] and aims to introduce this method to other developing countries. According to our study, in the stewardship axes, all medical science universities designed strategic plans by 2008 and 70% of the approved projects were based on priorities. In the domain of capacity building, the trend in the number of arranged workshops and held congresses is ascending. In the domain of knowledge production, the number of Iranian biomedical research articles increased from 2996 in 2003 to 8816 in 2008.The proportion of ISI Web of Science/Pub Med indexed articles per academic members also increased from 0.09 to 0.33. We conclude that HRS evaluation in Iran has supported knowledge production and has strengthened evidence-based policy making. The adapted ranking system for evaluation of medical research activities is an effective strategy for HRS promotion

Correlation between the degree of air trapping in chest HRCT and cardiopulmonary exercise test parameters: could HRCT be a predictor of disease severity?

The purpose of this study was to examine whether the degree of air trapping in high resolution computed tomography [HRCT] of patients with histories of sulfur mustard gas exposure during suspended full expiration correlated with various parameters of the cardiopulmonary exercise test as the gold standard for assessment of pulmonary function. In this analytic study 75 male patients, each with a history of sulfur mustard gas exposure, were investigated. Each participant underwent an incremental cardiopulmonary exercise test, pulmonary function test and arterial oxygen saturation for hemoglobin measurement. For HRCT examination, both lungs were divided into three parts [upper, middle, and lower] and in each part images were separately observed from the involved area point of view [<25% = 6/24; >/= 25%= >/= 6/24]. A total of 49.3% of the patients of >/= 25% or < 25% were 41.1 +/- 6.8 and 39.7 +/- 4.0 years, respectively [P=0.281]. In our study there was no significant difference in pulmonary function test findings [FEV1, FVC and FEV1/FVC] between the two groups. There was no significant correlation with air trapping of >/= 25% and any of the exercise test parameters. Also, no correlation was found between significant air trapping and exercise test finding in maximum exercise and anaerobic situations. No correlation was found between HRCT and cardiopulmonary exercise test findings. HRCT is neither pathognomic of the disease nor a good predictor of disease severity but it might be suggestive of mustard lung injuries

Vascular endothelial growth factor in bronchoalveolar lavage fluid in sulfur mustard exposed lung patients

To determine the levels of vascular endothelial growth factor isoform consisting of 165 amino acids [VEGF165] in Bronchoalveolar Lavage fluid from Mustard Exposed Patients. Bronchoscopy with Bronchoalveolar Lavage was performed on sulphur mustard exposed patients. A total of 39 patients with documented exposure to Sulfur Mustard during the Iran-Iraq war participated in this study, of which 38 patients were males and one patient was female. The mean +/- SD age of patients was 41 +/- 6.6 years. The mean time after exposure to sulfure mustard was 19 +/- 1.7 years. Eighteen patients had concomitant war injuries but they were not related to the respiratory system. While twenty-two patients had a history of submassive persistent hemoptysis. There was no case with massive hemoptysis. Most of the patients had small airway obstruction [FEV1/FVC% = 78.14 +/- 9.76 and FEV% = 82.79 +/- 18.23]. Twenty-three patients had significant air trapping in the chest. High Resolution Computed Tomography was compatible with BOS. VEGF 165 concentrations in BALF were 36.87 +/- 34.68 pg/ml. When corrected to total protein of Bronchoalveolar Lavage Fluid [BALF] it was 0.76 +/- 0.70 pg/mg. BALF of VEGF did not correlate with hemoptysis or air trapping in chest HRCT. Thus, there was also no correlation between level of VEGF165 in BALF and any of PFT indexes [FVC, FEV1, MMEF or PEF]. Although VEGF is one of the cytokines which has an important role in chronic pulmonary disorders, it seems that it has no essential role in the severity of Mustard Lung Disease

Hepatitis C and pulmonary fibrosis

Hepatitis C virus [HCV] is a hepatotropic and lymphotropic virus that causes hepatic and extrahepatic disease. Emerging clinical data suggest that chronic HCV infection can lead to many direct and indirect effects on the lung. This article discusses evidence on the relationship between HCV infection and pulmonary fibrosis to increase knowledge on this topic among clinicians and scientists and highlights the need for further study. We searched the MEDLINE, ISI WEB OF KNOWLEDGE, OVID, ELSEVIER, and MDCONSULT databases and top respiratory journals, such as the American Journal of Respiratory and Critical Care, Chest, and Thorax for articles in English using the following keywords: hepatitis C, HCV infection, IPF, pulmonary fibrosis, and interstitial pneumonitis. We reviewed the reference lists of all identified studies. The evidence for a pathogenetic link between pulmonary fibrosis and HCV is: the higher frequency of HCV markers in IPF patients, an increase in lymphocyte and neutrophil numbers in bronchoalveolar lavage of chronic HCV infection patients, and the development of IPF in HCV-related chronic hepatitis that is treated with interferon. There is a discrepancy between studies on the frequency of HCV in IPF patients, which might be attributed to geographical differences of in the prevalence of HCV infection, selection bias in choosing the control group, and the HCV genome. BAL studies in HCV infection are associated with increased counts of lymphocytes and neutrophils in BAL fluid. These studies show that HCV infection is associated with nonspecific pulmonary inflammatory reactions that are not compatible with IPF but that it can lead to pulmonary fibrosis. The other factor is interferon therapy. Interstitial pneumonia and sarcoidosis are well-documented complications of IFN therapy. More extensive cohort studies should be conducted to confirm an actual causal relationship between HCV infection and pulmonary fibrosis

Bronchial anthracosis: a potent clue for diagnosis of pulmonary tuberculosis

Occupational exposure to carbon, silica, and quartz particles are predisposing factors for bronchial anthracosis. In some cases anthracosis may be associated with mycobacterium tuberculosis. This study aims to investigate the clinical, radiographic, and bacteriologic findings in bronchial anthracosis patients and its association with tuberculosis, This is a prospective study conducted between 1998 and 2001, A total of 919 patients underwent diagnostic bronchoscopy for pulmonary diseases. Of these, 71 patients showed evidence of bronchial anthracosis, 32 [45.8%] males and 39 [54.2%] females, age range, 30-92 years. The distinctive clinical features, nature of bronchoscopic lesions, and radiologic findings were analyzed prospectively and summarized, Bacteriologic studies and results of laboratory examinations were also assessed, Forty-one [57,8%] patients had positive smears or cultures for mycobacterium tuberculosis. Of 71 patients with bronchoscopic evidence of pulmonary diseases, 30 had previous occupational exposure, and 41 stated no previous exposure, Cavitary lesions on chest radiography, positive purified protein derivative tests and high ESR were more prevalent in tuberculous patients than the others. Bronchial anthracosis was caused by active or previous tuberculous infection. Detailed examinations for the presence of active tuberculosis should be performed in patients with such bronchoscopic findings in order to prevent the spread of tuberculosis and to avoid unnecessary invasive procedures

Smad molecules expression pattern in human bronchial airway induced by sulfur mustard

Airway remodelling is characterized by the thickening and reorganization of the airways seen in mustard lung patients. Mustard lung is the general description for the chronic obstructive pulmonary disease induced by sulfur mustard[SM]. Pulmonary disease was diagnosed as the most important disorder in individuals that had been exposed to sulfur mustard. Sulfur mustard is a chemical warfare agent developed during Wars. Iraqi forces frequently used it against Iranian during Iran -Iraq in the 1980-1988. Peribronchial fibrosis result from airway remodeling that include excess of collagen of extracellular matrix deposition in the airway wall. Some of Smads families in association with TGF-are involved in airway remodeling due to lung fibrosis. In the present study we compared the mRNA expression of Smad2, Smad3, and Smad4 and Smad7 genes in airway wall biopsies of chemical-injured patients with non-injured patients as control. We used airway wall biopsies of ten unexposed patients and fifteen SM-induced patients. Smads expression was evaluated by RT-PCR followed by bands densitometry. Expression levels of Smad3 and Smad4 in SM exposed patients were upregulated but Smad2 and Smad7 was not significantly altered. Our results revealed that Smad3, and 4 may be involved in airway remodeling process in SM induced patients by activation of TGF-. Smad pathway is the most represented signaling mechanism for airway remodeling and peribronchial fibrosis. The complex of Smads in the nucleus affects a series of genes that results in peribronchial fibrosis in SM-induced patients

Urogenital history in veterans exposed to high-dose sulfur mustard a preliminary study of self-reported data

To date, little information exists regarding urogenital disease in those who have been exposed to sulfur mustard [SM]. We report the self-reported history of urologic conditions and findings on physical examination in a group of male veterans 19 to 26 years after exposed to high-dose sulfur mustard. Data on urologic health conditions of a nationwide health survey were used in this study. This survey included all 289 Iranian male veterans who had been exposed to high doses of SM between 1983 and 1989. Demographic data, exposure-related data, health status, and also self-reported lifetime history of urologic tract infections, pyelonephritis, urinary calculi, kidney failure, and urogenital neoplasms were specifically concerned. The mean age of the veterans was 45.0 +/- 7.5 years [range, 30 to 75 years]. An interval of 19 to 26 years had passed from exposure to SM. Fifty veterans [17.3%] had a positive history of urinary calculi, 25 [8.7%] had recurrent urinary tract infections, 5 [1.7%] had BPH, and 2 [0.7%] had kidney failure. None of them had experienced urogenital malignancies. Neither recurrent urinary tract infections nor urinary calculi were significantly associated with age, medications and their doses, or SM-reduced late complications in other organs. This study adds the prevalence of self-reported urologic conditions to our limited knowledge on SM-exposed veterans' health condition, without finding any link neither to demographic, nor to the severity of health complications related to SM exposure

socioeconomic status and quality of life in patients with chronic obstructive pulmonary disease

The quality of life in patients with chronic obstructive pulmonary disease [COPD] is associated with poor pulmonary function, respiratory symptoms, incapacity to perform daily activities, as well as mental and cognitive disorders. Although there exists some evidence regarding the effect of socioeconomic status on the quality of life in the general population and those with chronic diseases, research is scarce on this issue in COPD patients. This study aimed to investigate the association between income and quality of life in COPD patients. In a case-control study, 131 subjects were selected through systematic sampling from all COPD patients admitted to the pulmonology Clinic of the Baqiyatallah Hospital during the year 2006. Subjects were then divided into three groups based on their household monthly income as follows: group I [n=52], income < 2,000,000 Rials; group II [n=62], income between 2,000,000 and 3,000,000 Rials; and group III [n=17], income > 3,000,000 Rials. The groups were matched with regard to gender, age, educational background, marital status, comorbidity burden, and insurance coverage. Spirometric measures and quality of life [SF-36] were compared between the groups. The overall quality of life and physical health subscale were significantly different between the groups [p < 0.05]. Other parameters of SF-36 including physical functioning, role limitation due to physical problems, bodily pain, social functioning, general mental health, role limitation due to emotional problems, vitality, and mental health exhibited no significant difference between the groups [p > 0.05]. Quality of life and physical function of COPD patients are significantly correlated with their socioeconomic status. Future prospective studies are needed to find potential causative associations between the level of income and life quality in these patients