Association between cigarette smoking and suicide in psychiatric inpatients.

INTRODUCTION: Cigarette smoking is the single largest preventable cause of death and disability in the industrialized world and it causes at least 85% of lung cancers, chronic bronchitis and emphysema. In addition smokers are at a higher risk from psychiatric co-morbid illness such as depression and completed suicide. METHODS: We conducted a cross-sectional survey in which we targeted all patients with serious mental illness (SMI) who were admitted in Razi mental health Hospital in Tehran, Iran. We recruited 984 participants, who were receiving services from Razi mental health Hospital and hospitalized for at least two days between 21 July to 21 September, 2010. Nine hundred and fifty patients out of this figure were able to participate in our study. RESULTS: The final study sample (n = 950) consisted of 73.2% males and 26.8% females. The mean age was 45.31 (SD=13.7). A majority of participants (70%) was smoker. A history of never smoking was present for 25.2% of the study sample; while 4.8% qualified as former smokers and 70.0% as occasional or current smokers. Two hundred and nineteen participants had attempted suicide amongst them 102 (46.6%) once, 37 (16.9%) twice, and 80 (36.5%) attempted more than two times in their life time. In regression model, gender, age, and cigarette consumption were associated with previous suicide attempts and entered the model in this order as significant predictors. CONCLUSION: There is an association of cigarette smoking and suicide attempt in psychiatric inpatients. Current smoking, a simple clinical assessment, should trigger greater attention by clinicians to potential suicidality and become part of a comprehensive assessment of suicide risk.

The determinants of high school students smoking habits with special focus on teachers smoking in Iran: a population based study.

INTRODUCTION: Approval of smoking by friends and teachers is likely to increase the probability of smoking by the students. This study aims to determine whether adolescent smoking is associated with teachers or other students smoking, after controlling for confounders. MATERIALS & METHODS: In a cross sectional study, a representative sample of 4599 students in the third grade were selected from high schools in Tehran. A 21 item questionnaire was administered consisting of demographic and tobacco smoking habit questions. Pattern of adolescent tobacco smoking was compared between two sexes. Association between smoking behavior and perceived exposure to teachers smoking were assessed using bivariate and multivariate analyses, adjusting for parental, best friends and sibling smoking and sex. A multivariate logistic regression model was constructed and adjusted Odds Ratios were estimated. RESULTS: In total, 4591 students, aged 17 to 19 years, consisting of 2092 (45.6%) boys and 2499 (54.4%) girls, with the overall mean age of 17.53 +/- 0.59 years, were recruited. Of the students studied, 250 (12.1%) of boys and 131 (5.3%) of girls reported being current smokers (p = 0.001). The proportion of smoker and non-smoker students reporting to have been exposed to teachers smoking inside the school building was 209 (55.7%) and 1191 (29.3%), respectively (p = 0.001). Of those reporting being exposed to teachers smoking outdoors on school premises, 220 (58.7%) were smokers and 1205 (29.2%) were non-smokers (p = 0.001). After adjusting for sex, smoking habit of father, mother, brothers, sisters and best friends, adolescent perceived exposure to teachers smoking on school premises, but not inside school, was significantly associated with current smoking (OR = 2.1, 95 % CI:1. 7-2. 7). Adolescent exposure to best friend smoking was strongly associated with current smoking after adjusting for above variables (OR=6. 7, 95 % CI:5-9). CONCLUSION: Teachers smoking during school hours and best friend smoking are the two important determinants to be considered in any project aiming to establish tobacco-free schools.

The most prevalent Mycobacterium tuberculosis superfamilies among Iranian and Afghan TB cases.

This survey identified the spoligopatterns of Mycobacterium tuberculosis strains with an international designation responsible for transmission and prevalence of TB (2000 to 2005) among native and immigrant populations of Tehran. The spacer oligonucleotides typing was performed on 1742 Mycobacterium tuberculosis strains isolated from verified cases of TB. Clinical and demographic data of patients were collected using traditional methods. A total of 133 distinct spoligopatterns was observed. 1679 clinical isolates were clustered in 70 clusters (52.5%) and 63 isolates were defined as orphans pattern (47.3%). Based on an international spoligotype database, the east African-Indian (EAI, 24%), central Asian (CAS, 20.8%), T clade (20.7%), Haarlem I (4.4%), Beijing (3.2%) and shared type 253 (3.1%) were the major identified M. tuberculosis superfamilies. Our results showed that the intra-community TB transmission was 13.7%, whereas the inter-community transmission was 39.3% for Afghanis and 20.3% for Iranians. The study highlighted the epidemic potential of specific genotypes (EAI, CAS, T clades) among tuberculosis cases in the Tehran territory. We also confirmed that the impact of transmission through immigration is low.

Bacteriological follow-up of pulmonary tuberculosis treatment: a study with a simple colorimetric assay.

The viability of Mycobacterium tuberculosis (MTB) in serial sputum specimens from persistently smear positive patients was evaluated. The assay was based on oxidation-reduction of Alamar Blue and Malachite Green dyes that change their color in response to MTB growth. A total of 280 sputum specimens from 40 persistently smear positive TB patients and 40 sputa from non-tuberculosis patients were digested, decontaminated and examined microscopically. To check the MTB viability, the sediments from decontaminated samples were inoculated into three culture media: Lowenstein-Jensen (LJ) slants, Alamar Blue and Malachite Green culture tubes. We found that out of 280 smear positive specimens, the LJ culture was positive in 124 (44%). The numbers of correctly identified S+/C+ cases by Alamar Blue and Malachite Green were 118 (95%) and 116 (93%), respectively. The mean time required for reporting the positive signal in Alamar Blue culture tubes was 9 versus 11 days by Malachite Green culture tubes. In the standard LJ culture media the average detection time was 27 days (P < 0.05). The sensitivity of LJ was 99%, Alamar Blue 95% and Malachite Green 93%. The specificity was 100%, 92% and 93%, respectively. The oxidation-reduction method is rapid, sensitive and inexpensive in monitoring the treatment response of patients with pulmonary TB. Thus, using this method can be of paramount importance, particularly in resource-constrained areas.