Seroprevalence of Fasciola sp. and Toxoplasma gondii Infections in Rural and Urban Inhabitants of Jolfa County, Northwest Iran.

Fascioliasis and toxoplasmosis are the two important zoonotic diseases that are endemic in Iran and share some common transmission routes. The present study is aimed at determining the seroprevalence of human fascioliasis and toxoplasmosis in rural and urban areas of Jolfa County, Northwest Iran. In a cross-sectional study, 600 human sera were collected randomly from humans living in Jolfa County including three cities and 13 villages from 2017 to 2018. Anti-Toxoplasma IgG and anti-Fasciola sp. IgG tests have been performed using the enzyme-linked immunosorbent assay. Four (0.7%) out of 600 human sera showed positive levels of anti-Fasciola IgG. Three out of four seropositive humans were from an urban area, and one (25%) was from rural inhabitants. Considering T. gondii infection, 45% of studied human sera were seropositive for anti-T. gondii IgG. In conclusion, this is the first study reporting Fasciola seropositivity in the area. Based on the findings, human fascioliasis is present in the studied area, Northwest Iran, granted in low prevalence. Considering T. gondii seropositivity, the prevalence is high, yet close to the reports from other regions in the province.

Smartphone-based educational and counseling interventions for women with high body mass index at Urmia's health centers.

BACKGROUND AND PURPOSE: Overweight and obesity in women of reproductive age not only contribute to chronic diseases but also lead to fertility issues, adverse pregnancy outcomes, and psychological challenges. Among the detrimental behaviors associated with obesity, the consumption of fast foods and sedentary lifestyles have the most significant impact on weight gain and require effective interventions. This study aims to examine the effectiveness of an educational and counseling smartphone intervention in raising awareness and modifying behaviors related to sedentary behavior and fast food consumption in women with high body mass index. MATERIALS AND METHODS: This randomized controlled trial was conducted with two parallel groups comprising 106 women of reproductive age who sought assistance at Urmia health centers in 2022. Participants with diverse social and economic backgrounds were included. They were randomly assigned to either a control group or an intervention group. Valid and reliable questionnaires were administered to assess awareness regarding sedentary behaviors and fast foods consumption, as well as engagement in sedentary behaviors and consumption of fast foods. In addition to standard care, the intervention group received educational and counseling sessions through a dedicated smartphone application. Data analysis was performed using SPSS 20 software at a significance level of P < 0.05. FINDINGS: The results of a statistical t-test indicated a noteworthy disparity between the control and intervention groups concerning the average awareness scores related to fast foods consumption (P < 0.001) and sedentary behaviors (P < 0.001) before and 3 months after the intervention. Additionally, a substantial statistical difference was observed in the mean consumption of fast foods (P < 0.001) and hours of sedentary behaviors (P < 0.001) before and 3 months after the intervention when comparing the two groups. CONCLUSION: Educational and counseling programs, when applied effectively, can serve the dual purpose of enhancing awareness concerning sedentary behaviors and fast foods consumption while concurrently fostering a reduction in the prevalence of these behaviors. The study was registered in the Iranian Registry of Clinical Trials (IRCT Id: IRCT20210722051953N1) at 04/08/2021.

Sero-epidemiology of Hydatidosis Among General Population of Jolfa County, Northwestern Iran Using IHA, ELISA and Western Blot (2017-2018).

BACKGROUND: Human hydatidosis is mostly a latent and neglected disease with known endemicity in Iran. AIMS: Due to the importance of this infection in the country and its latent nature, we aimed to evaluate the serological status of hydatid cyst in northwestern Iran. OBJECTIVES: Herein, we evaluated the serological status of hydatid cyst in urban and rural inhabitants of Jolfa county, northwestern Iran during 2017-2018. METHODS: In total, 1296 blood samples were obtained from human individuals and the presence of anti-E. granulosus antibodies was investigated using IHA, ELISA and WB. RESULTS: Based on results, 25 IHA positive person were detected in the examined population, however ELISA test showed 14 of 25 IHA positive patients as negative. Also, 269 IHA negative fellows were shown as negative by ELISA. WB analysis of sera from 25 IHA positive subjects revealed consistent results with the ELISA test, and the most reactive SHCF Ag was a 37 KDa protein. The age-standardized seroprevalence of hydatidosis among Jolfa's general population was 1.12% with 95%CI: 1.02-1.20. Moreover, there existed a significant association between keeping/- contact with dogs (P = 0.022) as well as vegetable consumption (P < 0.001) with ELISA positive test results. CONCLUSION: Along with such serological evidence in this region, we highly suggest physical examination and applying imaging techniques for suspected cases in the area for a better understanding of CE.

Implementation evaluation of an iron supplementation programme in high-school students: the crosswise model.

OBJECTIVE: To evaluate the implementation of the national health promotion programme (through nutritional education and Fe supplementation) among female high-school students in Iran and to assess the application of the crosswise model (CM) for evaluating the programme's implementation. DESIGN: Two cross-sectional surveys in female high-school students, one using the direct questioning (DQ) method and the other using the CM, were conducted. Two survey questionnaires used to collect the data contained questions about three aspects of the programme: delivering the Fe supplements, consuming them and holding nutritional training sessions. SETTING: Female high schools, West Azerbaijan Province, Iran. PARTICIPANTS: A sample of 2180 students, of whom 1740 were surveyed by the CM and 440 were interviewed by DQ. RESULTS: The CM resulted in estimates that were consistently lower than the estimates of the DQ. The proportion of students in the DQ and CM who reported receiving the pills weekly and on a regular basis was 73·2 and 22·5 %, respectively. About 43 and 31 % of students in the DQ and CM surveys reported consuming all pills delivered to them. In the DQ method, only 12 % of students who reported the number of pills consumed had taken the complete dose (sixteen pills). CONCLUSIONS: Implementation of the Fe supplementation programme in female high schools was poor and insufficient, so that it seems unsuccessful in reducing Fe-deficiency anaemia in adolescent girls. The CM might be considered for evaluating the health programme's implementation at high schools.

Oral health status, knowledge, attitude and practice of patients with heart disease.

BACKGROUND: The aim of this study was to investigate knowledge, attitude and practice (KAP) of cardiovascular disease (CVD) patients about their oral health status. METHODS: In this cross-sectional study, we analyzed the data of 150 CVD patients that collected by a self-administered questionnaire consists of demographic characteristics and KAP. Oral health indicators calculated based on the results of oral examination by an expert dentist. RESULTS: CVD patients had an overall moderate level of knowledge and attitude, but their practice was lower than moderate. There were important associations between knowledge scores with gender, education, residential area and financial status, between attitude scores with education and residential area, and between practice scores with education and financial status. There were no associations between KAP and age, marital status or job. Significant positive correlations were found between KAP components. Significant negative correlations were found between oral hygiene index with knowledge and practice. CONCLUSION: The practice of heart disease patients about their oral health was poor, and declares that increasing awareness and attitude may not promote practice. Efficient programs are needed to promote oral health practice of adult populations in special groups.

Underestimating the Effect of Lipids on Cardiovascular Events: Regression Dilution Bias in the Population-Based Cohort of Tehran Lipid and Glucose Study.

BACKGROUND: Random errors in the measurement of risk factors lead to bias in the exposure-disease association. OBJECTIVES: This study aimed to examine the extent of underestimation in the association of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG) with cardiovascular disease (CVDs) in the Tehran Lipid and Glucose Study. PATIENTS AND METHODS: Of 6327 eligible people in the original cohort followed for about 10 years to detect CVD events, 3063 (1224 men and 1839 women) had replicate measurements for blood lipids. Two regression dilution ratios were calculated by nonparametric and parametric methods, using replicate data from reexaminations three and six years after baseline. Adjusted and unadjusted hazard ratios (HR) were corrected for regression dilution bias. RESULTS: By parametric method, based on reexamination three years after baseline, the strength of real association of usual levels of TC, TG and HDL-C with cardiovascular disease, considering ß coefficients of related models, were underestimated about 42%, 51% and 81% in men and 40%, 43% and 62% in women, respectively. Underestimations were relatively independent of age, sex and body mass index. Correction for regression dilution bias led to more than 60% increase in estimated HR for TC adjusted for confounders. CONCLUSIONS: Using baseline measurements of lipids led to considerable underestimation in the association of these factors with CVD outcome in TLGS. The underestimation increased with time interval between baseline and follow-up measurements for TC and TG. TC had more attenuation on estimated HR due to stronger relation with CVD risk.

Regression dilution bias in blood pressure and body mass index in a longitudinal population-based cohort study.

BACKGROUND: Use of single measurement of risk factors can distort their estimated effects, due to random error in measurements. The aim of this study was to examine the extent of underestimation in the estimated effect of common variables in physical exam i.e. systolic and diastolic blood pressure (SBP, DBP) and body mass index (BMI) on cardiovascular diseases in Tehran Lipid and Glucose Study (TLGS). METHODS: A subsample (1167 men and 1786 women) of the original cohort, who had replicate measures of the variables in triennial interval, was used to calculate the regression dilution ratios (RDRs) in men and women. RDRs were determined by parametric and nonparametric methods. Hazard ratios (HR) of risk factors, per one standard deviation change, were corrected for regression dilution bias. RESULTS: The estimated RDRs by parametric method in men and women were 45% and 35% for SBP and 54% and 64% for DBP respectively. There were 26% and 25% underestimation in HR of SBP and 23% and 33% in HR of DBP in men and women. The corresponding underestimation for BMI was about 8%. RDRs of men and women and in age groups by both methods were fairly similar. They were relatively constant during the 10-year follow-up for SBP and BMI. CONCLUSIONS: Using baseline measurements of blood pressure underestimate its real association with CVD events and the estimated HRs. The underestimations are independent of age and sex, and it can be fairly constant in short to moderate time intervals.

Seroprevalence of hepatitis E among Iranian renal transplant recipients.

BACKGROUND: Renal transplant recipients are known to be susceptible to viral infections, with more severe clinical presentations compared to healthy persons. Hepatitis E is generally a self-limited disease, which is caused by hepatitis E virus. Recently, hepatitis E has become more important in organ transplant recipients, because of new findings regarding the potential for chronic infections in this patient group. OBJECTIVES: This study aimed to evaluate the seroprevalence of anti-HEV IgG among kidney transplant recipients in Urmia, in the north-western region of Iran. PATIENTS AND METHODS: 91 patients were selected randomly from amongst patients who had undergone kidney transplantation in Urmia, Iran. Each patient was tested for the presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay (ELISA, Dia.Pro; Diagnostic Bioprobes, Italy). RESULTS: 28 subjects (30.8%) were seropositive for anti-HEV IgG. Seropositive patients were generally older than seronegative patients (P = 0.009). There was no correlation between HEV infection and the level of education (P = 0.206), the history of blood transfusion (P = 0.164), or history of pre-transplantation hemodialysis (P = 0.228). There was no significant difference in the serum alanine aminotransferase (ALT) levels of the anti-HEV seropositive and seronegative patients. Multinomial logistic regression analysis indicated no significant relationship between HEV infection and increase in ALT levels, even after controlling for treatment with azathioprine (P = 0.79, OR = 1.12; 95% CI: 0.45-2.76). CONCLUSION: The anti-HEV IgG antibody has a high prevalence in Iranian kidney transplant recipients, and it is significantly higher in comparison with previous studies in the general population or in hemodialysis patients.

Varicocele and nutcracker syndrome: sonographic findings.

OBJECTIVE: Varicocele is a vascular lesion commonly associated with infertility. Its etiology is only partly understood; hence, the purpose of the study was to establish its correlation with intrinsic anatomic differences and nutcracker syndrome. METHODS: A total of 93 patients with varicocele and 76 patients without varicocele were enrolled. The diagnosis of varicocele was based on physical examination, followed by sonographic evaluation of the hilar portion and aortomesenteric portion (AMP) of the left renal vein (LRV). The anteroposterior diameter in millimeters and peak flow in centimeters per second in each region were measured. RESULTS: A total of 28 patients with the nutcracker syndrome were identified in the study group (30.10%), and 2 were identified in the control group (2.63%). The mean diameters of the hilar portion and AMP of the LRV were significantly different in varicocele-affected patients compared with the control group (P < .0001 for both). The mean peak velocities in the hilar portion and AMP were significantly different in patients with varicocele (P < .0001). Patients with varicocele and nutcracker syndrome did not have a significant difference in either the hilar or AMP diameter compared with patients with varicocele without nutcracker syndrome. They had a significant difference in both the hilar and AMP peak flow velocity (P = .0001 for both). CONCLUSIONS: Our findings indicate that nutcracker syndrome is a frequent finding in varicocele-affected patients and should be routinely excluded as a possible cause of varicocele. In addition, intrinsic anatomic differences in the AMP and hilar portion of the LRV could be directly responsible for the onset of varicocele.

Seroprevalence of HTLV-1 among kidney graft recipients: a single-center study.

BACKGROUND: Renal transplant recipients are susceptible to viral infections because of their immunocompromised background. HTLV-1 is a retrovirus that leads to adult T-cell leukemia/lymphoma or myelopathies. This study aimed to evaluate HTLV-1 antibodies among renal transplant recipients in Urmia, Iran. MATERIALS AND METHODS: Serum samples of 91 renal transplant recipients from Urmia, Iran, were examined serologically for antibodies against HTLV type 1 using an enzyme-linked immunosorbent assay. RESULTS: Mean age was 37.26 +/- 14.22 years old. Only 1 patient had a positive anti-HTLV-1 enzyme-linked immunosorbent assay test, which was confirmed by Western blot. The HTLV-1-positive case did not have HTLV-associated clinical manifestation. This patient was a 45-year-old man, with no history of blood transfusion, but he did have a history of hemodialysis before transplant. CONCLUSIONS: The frequency of HTLV-1 among renal transplant recipients of our region in the northwest of Iran was not so high, and it is similar to the HTLV- 1 seroprevalence among hemodialysis patients. Still, it is more frequent among healthy blood donors as representative of the general population in our region.

Seroprevalence of herpes simplex virus-2 in kidney transplant recipients: a single-center experience.

INTRODUCTION: Viral infections are a real threat in kidney transplant recipients because of their immunocompromised condition. This study aimed to evaluate herpes simplex virus-2 (HSV-2) seropositivity among kidney transplant recipients. MATERIALS AND METHODS: Serum samples of 91 kidney transplant recipients from Urmia, Iran, were examined serologically for antibodies against HSV-2 using an enzyme-linked immunosorbent assay. RESULTS: The mean time from transplantation at HSV-2 testing was 5.04 +/- 4.45 years. The anti-HSV-2 immunoglobulin G antibody was positive in 5.4% of the kidney transplant recipients. Seropositive patients did not present any clinical manifestations of genital herpes infection. There was no association between HSV-2 seropositivity and age, gender, history of hemodialysis and transplantation, blood transfusion, or immunosuppressive regimen. CONCLUSIONS: Seroprevalence of HSV-2 is not high among our kidney transplant recipients. However, it remains a source of concern, considering the compromised immune system in this specific population.