Seroprevalence of Leishmania infection among the healthy blood donors in kala-azar endemic areas of Iran.

Visceral leishmaniasis (VL) is a serious health problem in Iran. The disease is mainly transmitted by sand fly bites, but its transmission through transfusion in endemic areas may also occur. The current study aimed to determine the prevalence of Leishmania infection among blood donors in VL-endemic areas in south of Iran. A total of 2003 healthy blood donors from blood service centers in five VL-endemic districts in Fars province, southern Iran, were enrolled in the study. The blood samples were assessed for antibodies against Leishmania infantum by direct agglutination test (DAT). Seropositive subjects were tested for the presence of L. infantum DNA in their buffy coat by the molecular method. Socio-demographic features of the subjects were also documented during sample collecting. The mean age of participants was 36.3 (SD = 10.7 years). Male constituted 94.7 % of the subjects while only 5.3 % of donors were female. Twenty-eight blood donors (1.4 %) were positive for Leishmania infection by DAT. Only one of these seropositive donors was positive for Leishmania infection by polymerase chain reaction. A significant correlation was found between age, the place of residence and seropositivity to Leishmania (P < 0.05). Findings of this study revealed that the prevalence of Leishmania infection among blood donors in transfusion centers in the VL-endemic areas in Iran is relatively high. These asymptomatic blood donors may constitute a risk of transmitting of VL to susceptible recipients.

CoolClot, a novel hemostatic agent for controlling life-threatening arterial bleeding.

BACKGROUND: Uncontrolled bleeding is the first leading cause of preventable death in the battlefield and the 2nd cause of mortality in civil accidents. Incompressible hemorrhage control is among the interventions that drastically increase the survival rate in wound individuals. We have previously shown that a certain mixture of bentonite and zeolite minerals can significantly decrease the bleeding in rats. METHODS: In this study, nine healthy hybrid dogs were selected and after induction of anesthesia with ether, either arterial puncture by a needle or arteriotomy was performed on both groin regions of the dogs. For control arteries (either the right or left femoral artery), only pressure by sterilized gauze was performed, while for the femoral arteries of the opposite side, our invented hemostatic agent, namely CoolClot, was topically used before applying the pressure. In the second stage of the study, to assess the coagulation time, blood samples were collected from 10 volunteer students. RESULTS: CoolClot significantly decreased the bleeding time in animals whose femoral arteries were cut or punctured. In the human phase of the study, the mean coagulation time in control blood samples was 253.4±44.1 seconds, whereas it was 149.5±50.0, 162.3±74.6 and 143.4±114.6 seconds, respectively in blood samples treated with bentonite, zeolite and CoolClot (P<0.05). CONCLUSIONS: As controlling bleeding after a life-threatening arterial damage is critical for increasing the chance of survival, the results obtained in this study indicate the significant efficacy of CoolClot in shortening the bleeding time. Our experiments also indicate that CoolClot can significantly reduce the clotting time in human blood samples.

CoolClot, a novel hemostatic agent for controlling life-threatening arterial bleeding / 世界急诊医学杂志（英文）

@#BACKGROUND: Uncontrolled bleeding is the first leading cause of preventable death in the battlefield and the 2nd cause of mortality in civil accidents. Incompressible hemorrhage control is among the interventions that drastically increase the survival rate in wound individuals. We have previously shown that a certain mixture of bentonite and zeolite minerals can significantly decrease the bleeding in rats. METHODS: In this study, nine healthy hybrid dogs were selected and after induction of anesthesia with ether, either arterial puncture by a needle or arteriotomy was performed on both groin regions of the dogs. For control arteries (either the right or left femoral artery), only pressure by sterilized gauze was performed, while for the femoral arteries of the opposite side, our invented hemostatic agent, namely CoolClot, was topically used before applying the pressure. In the second stage of the study, to assess the coagulation time, blood samples were collected from 10 volunteer students. RESULTS: CoolClot significantly decreased the bleeding time in animals whose femoral arteries were cut or punctured. In the human phase of the study, the mean coagulation time in control blood samples was 253.4±44.1 seconds, whereas it was 149.5±50.0, 162.3±74.6 and 143.4±114.6 seconds, respectively in blood samples treated with bentonite, zeolite and CoolClot (P<0.05). CONCLUSIONS: As controlling bleeding after a life-threatening arterial damage is critical for increasing the chance of survival, the results obtained in this study indicate the significant efficacy of CoolClot in shortening the bleeding time. Our experiments also indicate that CoolClot can significantly reduce the clotting time in human blood samples.

The Isfahan cohort study: rationale, methods and main findings.

A 10-year longitudinal population-based study, entitled the Isfahan Cohort Study (ICS) is being conducted. The ICS commenced in 2001, recruiting individuals aged 35+ living in urban and rural areas of three counties in central Iran, to determine the individual and combined impact of various risk factors on the incidence of cardiovascular events. After 24379 person-years of follow-up with a median follow-up of 4.8 years, we documented 219 incident cases of ischemic heart disease (IHD) (125 in men and 94 in women) and 57 incident cases of stroke (28 in men and 29 in women). The absolute risk of IHD was 8.9 (7.8-10.2) per 1000 person-years for all participants, 10.6 (8.8-12.5) per 1000 person-years for men and 7.4 (6.0-9.0) per 1000 person-years for women. The respective risk of ischemic stroke was 2.3 (1.7-3.0), 2.3 (1.6-3.3) and 2.3 (1.5-3.2) per 1000 person-years. The risk of IHD was approximately 3.5-fold higher in the presence of hypertension, followed by diabetes mellitus and hypercholesterolemia with near 2.5- and twofold higher risk, respectively. This cohort provides confirmatory evidence of the ethnic differences in the magnitude of the impact of various risk factors on cardiovascular events. The differences may be due to varying absolute risk levels among populations and the existing ethnic disparities for using western risk equations to local requirements.

Cardiovascular disease risk factors, metabolic syndrome and obesity in an Iranian population.

As part of the Isfahan Healthy Heart Program, we evaluated the prevalence of cardiovascular disease risk factors in Iranians with generalized and abdominal obesity. We carried out a cross-sectional study on 3694 > or = 19 years. Overall, 36.6% of men and 35.9% of women were overweight; 11.2% of men and 28.l% of women were obese. Mean body mass index (BMI), waist circumference (WC) and waist/hip ratio (WHR) increased with age up to 65 years. Total serum cholesterol, triglycerides and 2-hour post-load plasma glucose increased with BMI, WC and WHR in both sexes. Prevalence of metabolic syndrome was 19.8% in females with normal BMI, 48.1% in overweight females and 63.2% in obese females. In males, corresponding values were 3.7%, 18.0% and 40.1%.

Cardiovascular disease risk factors, metabolic syndrome and obesity in an Iranian population

As part of the Isfahan Healthy Heart Program, we evaluated the prevalence of cardiovascular disease risk factors in Iranians with generalized and abdominal obesity. We carried out a crosssectional study on 3694 participants aged >/= 19 years. Overall, 36.6% of men and 35.9% of women were overweight; 11.2% of men and 28.1% of women were obese. Mean body mass index [BMI], waist circumference [WC] and waist/hip ratio [WHR] increased with age up to 65 years. Total serum cholesterol, triglycerides and 2-hour post-load plasma glucose increased with BMI, WC and WHR in both sexes. Prevalence of metabolic syndrome was 19.8% in females with normal BMI, 48.1% in overweight females and 63.2% in obese females. In males, corresponding values were 3.7%, 18.0% and 40.1%

The metabolic syndrome in hypertensive and normotensive subjects: the Isfahan Healthy Heart Programme.

INTRODUCTION: There are numerous correlations between hypertension and the metabolic syndrome, although this is not always the case. The objective of this study was to compare the prevalence of the metabolic syndrome and its different phenotypes among hypertensive and normotensive subjects. MATERIALS AND METHODS: This cross-sectional study was performed on a representative sample of adults living in 3 cities in Iran. Among the 12,514 subjects selected by multi-stage random sampling, 1736 (13.9%) were hypertensive. The prevalence of the metabolic syndrome [according to the Adult Treatment Panel (ATP) III criteria] was significantly higher in hypertensive than normotensive subjects (51.6% versus 12.9%, respectively; OR, 7.15; 95% CI, 6.4 to 7.9). The metabolic syndrome was more prevalent in normotensive and hypertensive subjects living in urban areas than those living in rural areas (14.2% and 53.9% versus 9.5% and 45.6%, respectively, P < 0.05). The mean age of hypertensive subjects, with or without the metabolic syndrome, was not significantly different (55.7 +/- 12 years versus 55.4 +/- 15.5 years, P = 0.6). Hypertension with the metabolic syndrome was more prevalent in women than men (72% versus 28% respectively, P < 0.000), and in subjects living in urban areas than those in rural areas (75.1% versus 24.9%, respectively, P = 0.002). CONCLUSION: The findings of this study indicate the need for metabolic screening in all hypertensive patients, and emphasise the importance of promoting primary and secondary prevention of high blood pressure and associated modifiable risk factors in order to counter the upcoming epidemic of non-communicable disease in developing countries.