Serum level of matrix metalloproteinase-3 in patients with oral Lichen planus

Oral Lichen planus [OLP] is a chronic lesion of the oral mucosa with unknown origin. Basement membrane changes are common in OLP and may be mediated by proteases such as matrix metalloproteinase [MMPs] and mast cell chymase. The aim of our study was to evaluate the level of serum MMP-3 in OLP compared to normal individuals and assess its clinical significance. Thirty four serum samples from patients diagnosed with OLP [12 males, 22 females, age: 42.2 +/- 10.8 years] and 34 serum samples from healthy control subjects [11 males, 23 females, age: 42.5 +/- 13.3 years] were collected and MMP-3 concentration was measured by ELISA. The serum MMP-3 level in OLP patients was higher [21.64 +/- 24.31 ng/ml] compared with healthy controls [16.52 +/- 23.63 ng/ml], but showed no statistically significant difference. A statistically significant difference was demonstrated between the two types of OLP, being more pronounced in the erosive/atrophic form 6]. The different clinical appearances of OLP are associated with significant differences in MMP-3 serum level

Prevalence of breast cancer in a defined population of Iran

Prevalence of breast cancer In Asian developing countries is much lower than western developed countries. The main aim of this study was to measure breast cancer prevalence in a defined population of Iran. A total of 25201 women who were under coverage of [Imam Khomeini Relief Foundation [IKRF]], which is an organization for delivering supportive social and cultural services to the deprived and poor subgroups of the society, were involved in the study. The study was conducted during years 2007 and 2008. All subjects were interviewed for their sociodemographic features and underwent precise clinical and paraclinical breast examination. Mean age was 47 years with standard deviation 10 ranging from 11 to 88 years. Subjects were from deprived subgroups of the community; were mainly illiterate or had primary school education [86%] and majority of them [93%] had their first full-term pregnancy at age less than 26 years and also were multiparous. With confirmed diagnosis by breast biopsy, breast cancer prevalence was 0.15% [95%CI; 0.10-0.20]. Compared with developed countries, Asian developing countries have been at a lower risk of breast cancer development. It is seen that more deprived subgroups are at much lower risk. The more industrialized life is accompanied with more hazards

Systolic and diastolic blood pressure among three groups of occupation

It is believed that occupation influences cardiovascular risk factors. To assess blood pressure [BP] and other cardiovascular risk factors in three occupation groups-teachers, military personnel and female housekeepers residing in Shiraz, southern Iran. We studied 2783 teachers, 366 military personnel, and 1896 female housekeepers who attended various medical education centers in Shiraz. BP, anthropometric parameters as well as fasted lipid profile and blood glucose level were measured determined for each participant. The mean values of all analyzed cardiovascular risk factors were higher among female housekeepers compared to female teachers. The mean systolic and diastolic BP was significantly [<0.001, and P=0.047, respectively] higher in female housekeepers than female teachers. Neither systolic nor diastolic BP had association with the type of occupation in men [military personnel vs. male teachers]. Housekeeping compared to teaching, may increase both systolic and diastolic BP in women

Correlation between cigarette smoking and blood pressure and pulse pressure among teachers residing in Shiraz, southern Iran

Hypertension [HTN] affects nearly 26% of the adult population worldwide. Assessment of factors which influence blood pressure is a major topic for public health. One of these preventable risk factors is smoking. This cross-sectional study was conducted on 3115 [1842 [59.1%] females] teachers from Shiraz. The participants aged between 21 and 73 years. A questionnaire was used to collect data on several cardiovascular disease risk factors including smoking and blood pressure. The prevalence of smoking in our study group was 5.85%; 1.52% of the studied participants were ex-smokers. The prevalence of pre-HTN and HTN [JNC VII] was 42.6% and 18.2%, respectively. HTN was more prevalent among men and elderly people. Pre-HTN was more prevalent in smokers but HTN was more frequent in non-smokers. The mean rang of systolic and diastolic HTN, and pulse pressure was greater in heavy smokers than those who smoked <20 packs year, although the difference was not statically significant. The relation between the smoking status and blood pressure is not yet obvious. However, it seems that cessation or at least reduction in the amount of smoking would significantly decrease blood pressure

Comparison of oral and intravenous proton pump inhibitor on patients with high risk bleeding peptic ulcers: a prospective, randomized, controlled clinical trial

Proton pump inhibitors [PPIs] decrease the rate of rebleeding following endoscopic hemostatic therapy in patients with bleeding peptic ulcers. This study compares the efficacy of oral omeprazole vs intravenous pantoprazole in decrease of rebleeding of peptic ulcer patients. One hundred and six patients with high risk peptic ulcer were randomized to receive either oral omeprazole [80 mg BID for 3 days] or IV pantoprazole [80 mg bolus and 8 mg/hour infusion for 3 days] followed by omeprazole [20 mg each day for 30 days]. All patients underwent upper endoscopy and endoscopic therapy within 24 hours. Seventeen patients were excluded from the study. Forty four patients were randomly allocated into omeprazole group and 41 patients to IV pantoprazole group. Both groups were similar for factors affecting the outcome. Bleeding reoccurred in five patients of omeprazole group and four patients in pantoprazole group [11.4% vs 9.8%]. The mean hospital stay and blood transfusion were not different in both groups. Oral omeprazole and IV pantoprazole had equal effects on prevention of rebleeding after endoscopic therapy in patients with high risk bleeding peptic ulcers

Correlation between fasting blood sugar and resting blood pressure in teachers residing in Shiraz, Iran 2009

Coronary Artery Disease [CAD] is the major cause of morbidity and mortality. The knowledge about correlation between the different risk factors of CAD provides valuable information for prediction and prevention of the disease in a specific population.The aim of this study was to evaluate the correlation between fasting blood sugar [FBS] and resting blood pressure in teachers residing in Shiraz, Iran. A total of 3115 teachers from different educational centers of Shiraz, Iran were interviewed in this cross sectional study. The data obtained comprised demographic information including age, sex, and history of hypertension [HTN], diabetes mellitus [DM], and current use of medications. Other parameters measured were height, weight, fasting blood sugar [FBS] and resting blood pressure [BP] as well as calculating the body mass index [BMI]. Out of all the cases studied, undiagnosed and/or untreated cases of diabetes and hypertension were 1.5% and 15.2% respectively. FBS was higher in the elderly and in cases with higher BMI, but without any significant difference in relation to sex. The prevalence of HTN was higher in males, in older cases and in those with higher BMI. A significant relationship was observed between FBS and resting BP in hypertensive and prehypertensive groups [P < 0.001] as compared to normotensive subjects. There was a significant correlation between FBS and resting BP in hypertensive and prehypertensive teachers residing in Shiraz,Iran. But this correlation was not present in the vast majority of the population with normal resting blood pressure. The prevalence of neglected DM and HTN in this population was high enough to warrant regular screening

Correlation between HDL-C and smoking in teachers residing in Shiraz, Iran

It has been established that serum HDL-C is a main predictor for cardiovascular diseases. The aim of this study was to assess the relationship of HDL-C to smoking in teachers residing in Shiraz in order to improve the health status of the group under study and community as a whole. The present study comprised a total of 3115 teachers working in Shiraz recruited in a prospective cohort study. Of these, two groups of 235 smokers and 235 non-smokers were randomly selected for evaluation of cardiovascular risk factors, and to determine any association between serum HDL-C, LDL, triglyceride [TG], systolic and diastolic blood pressure with smoking, gender and BMI. One way ANOVA, Pearson correlation and independent sample t tests by SPSS version 16 were used for statistical analysis and all means were followed by SD. Mean age of subjects was 45.5+/-6.7 years. Of smokers 4.7% were females. Among smokers males had a significantly higher mean of HDL [P=0.002] compared to females [42 vs. 32.4 mg/dl]. HDL level was significantly lower [P<0.001] in heavy smokers compared to non-smokers and light smokers [36.5 vs 41.7 and 43.5]. However, light smokers had a higher mean of HDL than non-smokers, although the difference was not statistically significant [43.5 vs. 41.7 mg/dl, P=0.131]. Serum HDL was not affected by other factors. Smoking was associated with a low serum HDL in the subjects under study who were intellectual class of the population. It is thus warranted to take preventive measures to combat cardiovascular diseases in this sector of community

prevalence of labyrinthine fistula in chronic otitis media surgery in Shiraz, Southern Iran

The incidence of fistulas found during the surgery for chronic otitis media with cholesteatoma has been reported in a wide range in different geographical areas. This study aims to find the prevalence of labyrinthine fistula in the south of Iran. A prospective cross sectional study of 787 [504 ears belong to 462 patients] consecutive tympanoplasty with or without mastoidectomy for chronic otitis media was performed. Data on preoperative clinical and preoperative and postoperative hearing status and intraoperative findings were analyzed. A labyrinthine fistula was found at surgery in 24 [4.7%] ears of the total 504 ears belonging to 462 patients undergoing surgery for chronic otitis media. Location of the fistula was the lateral semicircular canal in 23, posterior semicircular canal in 1 and promontory in 1 subject. There was a statistically significant difference in preoperative and postoperative AC threshold in 500-3000 Hz frequency and ABG 500-3000 Hz, but there was no statistically significant difference in the other variables. Regarding postoperative hearing outcome in the labyrinthine fistula surgery, it seems that there is no universal method of reporting of hearing results. Past hearing evaluation methods in the literature have been often poorly comparable, based on different methodology

Prevalence of dyspepsia and its correlation with demographic factors and lifestyle in Shiraz, Southern Iran

Dyspepsia is a common disorder that can present many clinical dilemmas in patient management. Although not life-threatening, the symptoms are long-lasting, interfere with daily activities and have a significant impact upon quality of life. The aim of this study was to determine prevalence of dyspepsia and its relationship with demographic and socioeconomic factors, and lifestyle in an apparently healthy population in Shiraz, southern Iran. In a population-based study, 1978 subjects aged 35 years or older were interviewed from April to September 2004. A questionnaire consisting of demographic factors, lifestyle data and gastrointestinal symptoms was completed for each participant. The validity and reliability of the questionnaire were determined. The prevalence of dyspepsia was 29.9%. The dyspeptic patients were classified as having ulcer-like [27.9%], dysmotility-like [26.2%] or unspecified dyspepsia [45.9%]. The prevalence was higher in females, water-pipe smokers, NSAIDs users, and in those with psychological distress, recurrent headache, anxiety, nightmares and past history of gastrointestinal disease. Dyspepsia had an inverse relationship with consumption of pickles, fruits and vegetables, and with duration of meal ingestion. Subjects with dyspepsia symptoms were more likely to restrict their diet, take herbal medicine, use over-the-counter drugs, consult with physicians and consume medication advised by their friends. This study reveals that dyspepsia has a high prevalence in Shiraz, southern Iran and is associated with several demographic factors, lifestyle and health-seeking behavior

relationship between body mass index and pre-diabetes in teachers residing in Shiraz-Iran 2009

Diabetes and cardiovascular diseases often go hand in hand and conversely, many patients with established coronary heart disease suffer from diabetes or its pre-states. Thus, it is high time that diabetologists and cardiologists join their forces to improve the quality management in diagnosis and care for the millions of patients who have both cardiovascular and metabolic diseases in common. The cardio-diabetological approach not only is of utmost importance for the sake of those patients, but also instrumental for further progress in the fields of cardiology and diabetology and prevention. This descriptive cross- sectional study was conducted February to December 2009. A total of 3115 teachers residing in Shiraz aged 21- 73 years, were enrolled. Questionnaires were applied to collect information including demographic data, physical activity, history of CAD, hypertension, dyslipidemia,and smoking. In addition, waist circumference, height, weight, body mass index [BMI], and hip circumference [HC] were measured and serum biochemistry profiles were determined on venous blood samples. The prevalence of diabetes, hypercholesterolemia,hypertriglyceridemia, hypertension, overweight, obesity, central obesity, and smoking were identified based on the above mentioned data. Total prevalence of impaired fasting glucose and diabetes were 47.2% and 6.2% and the prevalence of impaired fasting glucose and diabetes were 44.3% and 5.3% among men and 49.2% and 6.6% among women respectively. Thus the association of sex with prevalent impaired fasting glucose and diabetes was signi?cant and greater among women. Diabetes and prediabetes are more prevalent in men and women who are considered as obese in regard to waist circumference and waist/hip ratio scales. This study showed a relationship between higher range of BMI and prevalence of diabetes and prediabetes. Obesity is a preventable risk factor for diabetes mellitus and preventive measures taken to control obesity are effective means of reducing the risk of diabetes mellitus and also cardiovascular disease

Survival of breast cancer in Southern Iran

Breast cancer is the most frequent cancer in women in the western world. With breast cancer now affecting one in ten women, it is important to know how this disease burden is shared among women. This study was undertaken to determine the survival rate of breast cancer in southern Iran. From December 2001 to December 2006, among 8000 hospital-based registered cancer cases in southern Iran, 863 individuals with breast cancer entered our study. One, 5, 10 and 15 year-survival rates were estimated by Kaplan Meier function. Mean age at the time of diagnosis of breast cancer was 46.3 years [SD=11.5]. About 25.4% had a previous family history of cancer in their first and 13.8% in their second degree relatives. About 92.5%, 71.3% and 41.4% of breast cancer cases underwent surgery, radiotherapy and chemotherapy, respectively. Nearly 11.7% of patients had a history of exposure to chemical materials. About 32.3% were passive and 19.2% were active smokers. Totally, one, 5, 10 and 15 year-survival rates were 97%, 67%, 45% and 25%, respectively. The survival rate had a significant negative correlation with age at the time of diagnosis. The survival rate of women with breast cancer in southern Iran seems to be identical to other parts of the country and stands between western and eastern European countries

Echocardiographic features of cardiac fatigue

Little information is available regarding the effects of strenuous exercise on cardiac function. We evaluated the effect of severe prolong exercise on ventricular performance. Army rangers were invited to participate in this study. All patients underwent transthoracic echocardiography using tissue Doppler imaging. A total of 45 consecutive male rangers who completed ranger training program were included in this study. Peak systolic myocardial velocity [S] decreased significantly after training [12.46 +/- 0.54 vs. 9.93 +/- 0.45 cm/s; P< 0.001]. In the right ventricle, tissue Doppler measures of systolic and early diastolic function decreased significantly after training. In conclusion, strenuous prolonged exercise may result in depressed left ventricular contractile function

Outcome and characteristics of patients on the liver transplant waiting list: Shiraz experience

The only curative therapy for end-stage liver disease is transplantation but due to a shortage of available donor livers the waiting list mortality is high. This study aimed to evaluate the outcome and characteristics of patients on the waiting list for liver transplantation in Shiraz, southern Iran during the period from April 2004 to March 2007. Medical records of all chronic liver disease patients >/= 14 years that were on the waiting list for liver transplantation at the Nemazee Hospital Organ Transplant Center during April 2004 to March 2007 were reviewed. Hospital records were used to retrieve demographic, clinical and laboratory data. Records of the referring gastroenterologists provided information about the etiology and complications of liver disease. The patients were followed at the end of the study period by clinic visits or telephone contact. There were 646 patients on the waiting list for liver transplant during April 2004 to March 2007. Hepatitis B was the most common etiology of liver disease [31.2%]. Of those on the waiting list, 144 patients 22.3%] underwent liver transplant and 166 [25.7%] died while waiting for a transplant. The mean waiting period for transplant was 6.6 months. Receiving a transplant was correlated with the etiology of liver disease and Rh blood group [p<0.05] but had no significant association with gender or ABO blood type. Among non-transplanted patients, survival was lower in those who had a history of encephalopathy, SBP or uncontrolled ascites and in patients with a Child-Turcotte-Puph [CTP] class C and/or a Model of End-stage Liver Disease [MELD] score >/= 15. Hepatitis B virus is the most common cause of end-stage chronic liver disease amongst patients on the waiting list for liver transplant in Shiraz, southern Iran. Patients with a MELD score >/= 15 particularly those with a history of SBP, hepatic encephalopathy or uncontrolled ascites are recommended for waiting list enrollment

Risk of seizure recurrence following a first unprovoked seizure in childhood

There is still a question whether first seizure leads to epilepsy. Several risk factors have been reported in this relation. This study was undertaken to determine the risk of recurrence after a first unprovoked seizure in children In a prospective study between December 2003 and December 2005, 156 children who presented with a first unprovoked seizure were enrolled and followed for at least 18 months. Potential predictors of recurrence were compared, using the Cox Proportional Hazard model in a univariable and multivariate analysis. Survival analysis was performed, using the Kaplan-Meire curves. Seventy two children [46.2%] experienced subsequent seizures. The cumulative risk of seizure recurrence was 28.8%, 41.7% and 46.2% at 6, 12, and 24 months following the first seizure, respectively. The median time for repeated seizure was 4 months while 62.5% of the recurrence occurred within 6 months, 88.9% within 1 year and 100% till the end of the second year. On multiple analysis, risk factors for resumption of seizure consisted of abnormal electroencephalography [EEG], seizure during sleep, abnormal brain imaging and history of perinatal problems. On univariable analysis, abnormal EEG, abnormal imaging [remote etiology of seizure], history of neonatal problems, previous febrile seizure, and family history of afebrile seizure increased the risk of recurrence. The study revealed that the risk of seizure recurrence in our patients was relatively high. Those who had abnormal electroencephalography, past history of prenatal problems, remote etiology for seizure, abnormal brain imaging, and seizure during sleep were at greater risk for recurrence of seizure

Cancer occurrence in Fars Province, Southern Iran

Cancer is a significant health problem in the developing countries, and one that is likely to increase in future. Due to unavailability of data concerning cancer during the last 15 years in our area and young age structure of our country, this active hospital-based study was undertaken to determine the occurrence of cancer in Fars Province, southern Iran. Data including face-to-face interview with patients and a survey of their medical and demographic records in relation to all invasive cancers were actively collected from 1990 to 2005 from four university hospitals. Among 2993 cases of registered malignant neoplasms presented by site and sex, the crude incidence [CRs], and age-specific incidence and age-standardized incidence rates [ASRs] per 100,000 were determined, using the world standard population. Over a 5-year period, 1495 and 1620 cancer cases were registered in males and females, respectively, while breast cancer was at the top of 10 cancers in both sexes. With regard to the top 10 types of cancer, there was a remarkable difference between the results of our study and the estimated cancer incidence for Iran by Globocan 2000. Ethnic, racial and environmental factors may explain these differences but more studies in a longer time span are needed to clarify the causes

Clinical characteristics of colorectal cancer in Southern Iran, 2005

Colorectal cancer is the second leading cause of cancer-related mortality and represents a major public health problem in developed countries. The objective of present investigation was to determine the epidemiologic aspects and clinical characteristics of colorectal cancer in Shiraz, southern Iran. This was a retrospective study carried out during 2000-2005, and comprised 491 subjects with pathologically documented colorectal cancer. They were registered in Fars Cancer Registry, affiliated to Shiraz University of Medical Sciences, southern Iran. A questionnaire including data on demographic information, histological types of cancer, site of primary cancer and metastasis were completed by trained interviewers. Among 491 subjects, 57.2% were male and the most common age was 65-75 years. Patients under 45 years of age represented 22.8% of all colorectal cancer cases while 32% were over 65 years old. Those with a history of cancer in their first-degree relatives included 26.9% of the patients. Adenocarcinoma was the most common reported histological type of cancer [96.1%]. Among all subjects, 60.7% suffered from abdominal pain, 28.4% abdominal distention and 28.0% rectal bleeding. Other symptoms included diarrhea/constipation, nausea/vomiting, urogenital problems and mass sensation. The most common sites of metastasis were lung, brain and ovary

Growth of infants in relation to type of feeding in Jahrom, Islamic Republic of Iran

We evaluated the growth of 597 infants < 24 months attending health centres in Jahrom according to type of infant feeding. We also compared our growth curves with those of the National Center for Health Statistics [NCHS]. The infants were divided to 3 groups: exclusively breastfed, exclusively bottle-fed and both breast- and bottle-fed and were assessed monthly for the first year and every 2 months in the second year. There were no significant differences between the groups in height and weight in the first few months of birth; later, breastfed infants were significantly heavier and taller. The mean heights and weights of our infants were lower that those for NCHS

Obesity indices among infants and their parents, Shiraz, Iran

Infantile obesity is becoming increasingly recognized as one of the public health problems in Iran. Obesity charts of a cohort of 317 healthy infants and their parents living in Shiraz [Southern Iran] are presented and the familial pattern of infants' obesity with that of its parents explored. An adjusted weight-for-height index was used to develop power type obesity indices, Ip=W/Hp. Polynomial modelling was used by applying the Healy-Rasbash-Yang [HRY] nonparametric method to estimate age-related smoothed centiles of obesity and dynamic obesity charts for infants and their parents are presented. Principal component analysis [PCA] was applied to the data as continuous variables to analyse familial pattern of parent-infant obesity structurally. The optimal value of p was found to be 2.5 for infants and 1 for their parents. Infants' obesity increases from birth to six months of age and decreases thereafter until the age of 21 months when it became stable. Obesity indices and circumferences sizes were reduced to two principal components interpreting infants as well as family obesity. The first principal component evaluates infants' obesity as a combination of obesity index as well as their arm, chest and head circumferences. Also the second principal component combines mothers' obesity and her arm circumference, while father obesity did not influence familial obesity structure significantly. Obesity is an age related phenomenon and dynamic charts presented herein are appropriate practical tools to assess obesity in both infants less than two years of age and their parents