The effect of educational intervention on efficacy of 1% permethrin shampoo and 4% dimeticone lotion to treat head lice infestation using propensity score matching (PSM).

BACKGROUND: Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. METHODS: This quasi-experimental study included 100 individuals with head lice infestation from comprehensive urban health centers in Ardabil as the intervention group, and 400 individuals from East Azerbaijan and West Azerbaijan provinces as the control group, from April to March 2019. The data collection tools included a demographic questionnaire and an examination recording sheet, which documented the presence of adult lice or nits. Due to the inability to perform random assignment and control for numerous observed covariates, propensity score matching (PSM) was used. RESULTS: The outcome of treatment included elimination of head lice infestation on is 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. The results showed that the educational intervention program had a significant positive effect on the efficacy of both treatments. The likelihood of improvement was approximately three times greater in the intervention group compared to the control group. CONCLUSION: Participants who received the training intervention (OR = 3.29; CI 95%: 2.21-4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

Hematological Parameters as Diagnostic Factors: Correlation with Severity of COVID-19.

Bachground and aim: Coronavirus disease 2019(COVID-19), which is the pandemic of 21st century, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Prognostic factors play an essential role in predicting the patients who need more care. Therefore, the current study aimed to investigate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) ratio as discriminated indexes in prognosis of patients with COVID-19. METHODS: Age, NLR, PLR, white blood cell (WBC), neutrophil count, lymphocyte count and platelet from 1007 hospitalized patients with COVID-19, who were admitted to two referring hospitals  in Ardabil, North Western Iran. All confirmed cases divided into non-severe and severe groups. RESULTS: 534 (53.4%) males and 473 (47.3 %) females with mean age of 52 years were enrolled in this study. Patients with severe COVID-19 have lower counts of lymphocyte, but have higher NLR, comparing to non-severe patients (P = 0.001). CONCLUSION: Elevated NLR can be assumed as an independent biomarker, which could provide a crucial indicator in the monitoring patients with COVID-19 on admission. Increased NLR was correlated with the severity of COVID-19. Assessment of NLR could be proposed to identify high risk individuals with COVID-19.

Reproductive health status of adolescent mothers in an Iranian setting: a cross-sectional study.

BACKGROUND: In low and middle-income countries (LMICs), where millions of women give birth before the age of 18, the reproductive health status of married adolescent mothers, including family planning, sexual, psychosocial, and maternal health, remains a significant and recurring phenomenon. As a result, the purpose of this study was to assess the reproductive health status of married adolescent mothers who sought treatment at Ardabil health care centers in 2019. METHODS: A cross-sectional study was carried out in five health centers in Ardabil, Iran. This research included 312 married adolescent mothers who were under 19 years old. Health workers who asked questions of each participant completed a demographic questionnaire and the Reproductive Health Assessment Scale for Married Adolescent Women, and all data were self-reported. Univariate and multivariate linear regressions were used to determine risk factors associated with reproductive health scores. The data was examined using statistical software (SPSS version 20). RESULTS: The mean age (years) of the respondents was 16.41 ± 0.85, the mean age of their husbands was 24.18 ± 2.29, and the mean age of their marriage was 15.06 ± 1.15. In this study, adolescent mothers had an average reproductive health score of 63.78 ± 11.06. There was a significant association between reproductive health status and age, education, husband's age and education, and contraceptive methods among married adolescent mothers (p < 0.05). CONCLUSION: The research findings indicated that adolescent mothers had an average level of reproductive health. Several socio-demographic characteristics, including age, education, gravida, and contraception, were linked to reproductive health scores. Programmers and policymakers should prioritize improving the reproductive health of adolescent mothers through education and increasing women's and spouses' knowledge and awareness.

In LMICs, the health status of adolescent mothers remains unstudied in a systematic way. This study aims to evaluate the reproductive health of married adolescent mothers. A cross-sectional study of adolescent mothers was conducted at five Ardabil health centers. A total of 312 adolescent mothers under the age of 19 were selected to complete a survey regarding their health and contraceptive awareness. The mothers' reproductive health status was rated as average. Age, education, husband's age and education, gravida, and contraceptive methods significantly impacted reproductive health. Increased education among women and their spouses, as well as pregnancy prevention, appear to be essential for safeguarding the health of adolescent mothers. This study recommends conducting qualitative research on reproductive health and contraception in the cultural context.

Health beliefs and behaviors of livestock industry workers regarding Crimean-Congo hemorrhagic fever in Northwest of Iran.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is an acute, feverous disease that is caused by tick bites or humans' direct contact with the blood and tissues of infected livestock and humans. The transmission of the disease is also possible via human-to-human contacts and nosocomial transmission is well described. The majority of patients suffering from this disease are slaughterhouse workers (including butchers), farmers, veterinarians and hospital staff. Thus, this study aimed to investigate the health behaviors of butchers regarding CCHF and study factors affecting such behaviors based on the health belief model. METHODS: This is a descriptive cross-sectional study conducted on 500 butchers in Ardabil Province in 2020 by a multistage sampling method. The participants of the study completed the researcher-made questionnaire of health belief model and health behaviors model relevant to CCHF. The collected data were then analyzed by descriptive statistical tests and linear regression analysis. RESULTS: The mean (SD) age of the participants was 44.4 (10.5) years, and 96% were males. Only 11.1% of the participants displayed acceptable disease-preventive behaviors. The validity and reliability of the developed questionnaire were confirmed. The results of the exploratory factor analysis showed that the constructs of the model explained 84% of the total variance. The results of the study revealed that among the variables of the health belief model, perceived susceptibility (p-value = 0.006, ß = 0.152) and perceived barriers (p-value = 0.023, ß = 0.14) were the strongest factors predicting disease-preventive behaviors regarding CCHF. CONCLUSION: The results of the study showed that the health belief model can predict preventive behaviors for CCHF. Therefore, designing and executing interventions based on the results of this study may encourage such preventive behaviors in butchers.

Effect of Streptococcus mutans on the flexural strength of resin-based restorative materials.

BACKGROUND: There are a limited number of studies about the effects of microbial aging on the mechanical properties of restorative materials. Therefore, this study aimed to evaluate the effect of simulated aging with Streptococcus mutans on the flexural strength of different resin-based materials. MATERIALS AND METHODS: This experimental study was performed on the blocks of different types of restorative materials including composite resin, giomer, and a resin-modified glass ionomer (RMGI). Moreover, three types of aging, such as 30-day storage in distilled water, S. mutans, and germ-free culture medium, were used in this study. The three-point bending flexural strength of the specimens before and after aging was measured according to the International Organization for Standardization-4049 standard. Data were analyzed by two-way ANOVA and post hoc Tukey's tests. A P < 0.05 was considered statistically significant. RESULTS: Results showed that the 30-day aging with the S. mutans significantly reduced the flexural strength of all three types of materials (P = 0.00). In all restorative materials, storage in a bacteria-free culture medium acted the same as distilled water, and there was no significant difference between these two solutions in terms of the flexural strength of the material, compared to the before-aging strength (P > 0.05). Furthermore, no significant difference was observed between S. mutans-based aging and distilled water aging regarding RMGI (P = 0.75). CONCLUSION: It can be concluded that aging by S. mutans reduced the flexural strength in all three restorative materials.

Developing and Psychometric Evaluation of a Reproductive Health Assessment Scale for Married Adolescent Women: An Exploratory Mixed-Method Study.

BACKGROUND: Adolescent women's reproductive health is often neglected despite the high prevalence of early marriage. Since no appropriate scales were found to assess the health status of adolescent women, this study aimed to develop a reproductive health scale in married adolescent women in Iran and investigate its psychometric properties. MATERIALS AND METHODS: An exploratory mixed-methods study was conducted in Ardabil healthcare centers (Ardabil City, Iran) between May 2017 and December 2018. In the qualitative phase, 14 semi-structured in-depth interviews were conducted with married adolescent women, and two focus group discussions were held with 12 key informants. In the quantitative phase, the initial scales were validated using face, content, and construct validities. In a cross-sectional study among 300 women, Exploratory Factor Analysis (EFA) was used to assess the construct validity. Internal consistency and test-retest methods were used to review. The initial scale was designed with 45 items, but only 30 items reached the construct validity stage. EFA revealed five factors that explained 50.96% of the variance. Cronbach's alpha coefficient of 0.75 estimates the reliability of the scale. RESULTS: The qualitative study identified 76 items that reached 88 items through literature confirmed its reliability, and test-retest with a two-week interval confirmed its consistency (ICC = 0.99, p < 0.001). Finally, the scale was approved with 27 items and four domains: sexual, pregnancy and childbirth, psychosocial, and family planning. CONCLUSIONS: This valid and reliable scale with cultural sensitivity can be used to help health professionals to improve the reproductive health of married adolescent women.

Characteristics of flavored and non-flavored waterpipe tobacco users: a real-world setting study.

We aimed to compare sociodemographic characteristics, smoking patterns, beliefs and perceptions, nicotine dependence, and psychological indicators between flavored waterpipe (WP) tobacco (FWT) and non-flavored WP tobacco (non-FWT) smokers in Iran. A cross-sectional study was conducted in 94 WP-serving venues surrounding Tehran and Ardabil metropolitans in Iran. Convenience sampling was applied to select 900 current WP smokers [508 (56%) FWT-only and 392 (44%) non-FWT-only smokers] aged 18 years and older. Multivariable logistic regression was used to examine the independent characteristics of FWT and non-FWT smokers. Compared to non-FWT smokers, FWT smokers were younger (adjusted odds ratio [AOR]=0.88, 95% confidence interval [CI]: 0.87-0.90) and more likely to have ≥ 1 sibling who smoked WP (AOR=1.54, 95% CI: 1.06-2.24), share WP with others (AOR=2.52, 95% CI: 1.68-3.77), report current cigarette smoking (AOR=2.05, 95% CI: 1.23-3.42), and report confidence in quitting at any time (AOR=3.64, 95% CI: 2.45-5.39). FWT smokers were less likely to have seen (AOR=0.40, 95% CI: 0.27-0.60) or read (AOR=0.44, 95% CI: 0.24-0.80) warning messages on WP tobacco packages relative to non-FTW smokers. The most common self-reported reason for smoking WP was entertainment for both groups, followed by stress relief for non-FWT smokers and the escape from loneliness for FWT smokers. FWT-only smokers differ from non-FWT-only smokers in several aspects including being younger, having more positive beliefs and perceptions regarding WP use, and having higher cigarette smoking prevalence. These findings will help in developing more effective and targeted policies and cessation interventions for WP smokers according to flavor type they use, especially in the Middle East.

Exposure to BTEX concentration and the related health risk assessment in printing and copying centers.

This study was derived to investigation of BTEX (benzene, toluene, ethylbenzene, xylenes) concentrations in printing and copying centers (PCCs) in Ardabil city of Iran. Fifty-three PCCs were randomly selected from all the 136 number of PCCs and BTEX was sampled form their indoor air. The results showed that the concentration of BTEX in the indoor air PCCs is lower than the OELs (occupational exposure limit) in all cases. The obtained mean concentrations of benzene, toluene, ethylbenzene, and xylene were 93.6±63.2, 150.6±99.2, 34.3±16.8, and 29.5±15.2 µg/m3 respectively. Type of printer, number of printing and copying device, and type of ventilation system had significant influence on the BTEX concentration. The mean inhalation lifetime cancer risk (LTCR) value for benzene and ethylbenzene in the indoor air of the PCCs with LaserJet and inkjet printers was 44.4 × 10-6 and 153.3 × 10-6, and 23.4×10-6 and 54.2× 10-6, respectively, which were higher than EPA (Environmental Protection Agency) and World Health Organization (WHO) recommended limits. The hazard quotient (HQ) of benzene in the indoor air of the PCCs with inkjet printers was >1, which indicates that the non-carcinogenic risks associated with exposure to these compounds are considerable.

Pattern of Crimean-Congo hemorrhagic fever related high risk behaviors among Iranian butchers and its relation to perceived self-efficacy.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is highly fatal to humans and an acute viral disease. The CCHF disease has been reported in occupations such as butchers, slaughterhouse butchers and workers. The aim of this study was to investigate the pattern of CCHF related high risk behaviors among butchers and determine the effects of perceived self-efficacy of the participants on their membership in latent classes. METHODS: The participants of this cross-sectional study were recruited from all the meat distribution centers in Ardabil Province in 2019-2020. The LCA approach was used to observe the CCFH related high risk behaviors patterns. RESULTS: The statistical significance level was assigned at P-value < 0.05 in all the analyses. Three latent classes were identified; namely, 1) low risk (16.1%), 2) high risk (53.6%), and 3) very high risk (30.2%). After adjusting for other possible confounders higher score of perceived self-efficacy significantly decrease the odds of membership in high risk class (OR = 0.74) and very high risk class (OR = 0.62) compared to the low risk class. Also, age (OR = 1.07) and experience (OR = 0.91) associate with very high risk class. CONCLUSIONS: This study revealed the co-occurrence of CCHF related high risk behaviors in the majority of workers in the livestock and meat industry. It is necessary to provide butchers and slaughterhouse workers with general education, force them to use protective equipment and investigate the rate of tick bites in risky occupations.

Assessment of types of bacterial bio-aerosols and concentrations in the indoor air of gyms.

The presence of airborne microorganisms in indoor air (home and work) is a serious public health concern. Bio-aerosols have a significant role in indoor air pollution as they can be pathogenic or cause an allergic reaction following inhalation, ingestion or skin absorption. This study aimed to assess bacterial bio-aerosols in the indoor air concentration of gyms, and its relationship with gym area per person, temperature, and relative humidity. Sampling was performed by the National Institute for Occupational Safety and Health (NIOSH) method 0800-0999 and using an Anderson single-step sampler. Fifty-five gyms were selected with simple random sampling method and 165 samples collected for evaluation of bacterial bio-aerosols. The concentrations of airborne bacteria were measured as colony-forming units per cubic meter of air (CFU/m3) collected by impaction on to tryptic soy agar plates. The maximum and minimum densities of bacteria in the air of gyms were 877 and 117 CFU/m3, respectively. Pseudomonas, Staphylococcus and Escherichia Coli had an order of the highest to lowest frequency among the microorganisms, respectively. Generally, with increasing temperature and humidity, the density of bacteria was increased. The higher amount of the microorganisms was observed in the air of gyms in the lower available area per person. Athletes are at risk of high exposure to the bacterial bio-aerosol that can affect their health.

The Relationship between Quality of Life and Physical Activity, Worry, Depression, and Insomnia in Pregnant Women.

Objective: Physical activity (PA), insomnia, depression, and worry were the key factors affecting pregnant women's quality of life (QoL). The present study aimed to determine quality of life and its relationship with physical activity, insomnia, depression, and worry in pregnant women. Method : This was an observational cross sectional study, conducted among 256 healthy pregnant women using 5 questionnaires: WHOQOL-brief (WHO Quality of Life Questionnaire, brief version, ISI (Insomnia Severity Index), PSWQ (Penn State Worry Questionnaire), ZSRDS (Zung Self-Rating depression Scale), and Pregnancy Physical Activity Questionnaire (PPAQ). Results: There was a significant relationship between general QoL, insomnia, and worry with educational background, number of children, and occupation (P < 0.05). Depression had a significant relationship with occupation (P < 0.05). PA did not have a significant relationship with demographic information. However, insomnia had a significantly negative relationship with general QoL, general health, and psychological health (P < 0.05). The worry variable had also a significant negative relationship with general QoL, general health, and physiological health (P < 0.05). Depression had a significant negative relationship with general health, physical health, and psychological health (P < 0.05). There was no significant relationship between physical activities in pregnancy with QoL, depression, worry, and insomnia. Conclusion: Women need to be informed about the necessity of controlling and reducing insomnia, worry, and depression to have a higher QoL. PA declined during the second and third trimester of pregnancy. However, PA in pregnancy can positively impact general QoL.

Forecasting head lice (Pediculidae: Pediculus humanus capitis) infestation incidence hotspots based on spatial correlation analysis in Northwest Iran.

BACKGROUND AND AIM: Pediculus humanus capitis has been prevalent throughout the world, especially in developing countries among elementary students and societies with a weak socio-economic status. This study aimed to forecast head lice (Pediculidae: P. capitis) infestation incidence hotspots based on spatial correlation analysis in Ardabil Province, Northwest Iran. MATERIALS AND METHODS: In this retrospective analytical study, all cases of head lice infestations who were confirmed by Centers for Disease Control office have been studied from 2016 to 2018. Head lice infestation incidence hotspots in the province should be detected based on general G statistics in ArcMap GIS10.4.1. Furthermore, MaxEnt.3.3.3 model was used for modeling the high-risk areas. RESULTS: The prevalence rate of pediculosis was 14.90/100,000 populations. The general G statistics revealed that the head lice infestation in this study area has a high cluster pattern. The analysis showed that the Parsabad and Germi counties were identified as a head lice infestation incidence hotspots. Statistical and spatial analyses of head lice infestation incidence showed a significant positive correlation with head lice infestation incidence hotspots and the altitudes (15-500 m), annual temperature range (14-16.5°C), and slope and average diurnal temperature (12-18°C). CONCLUSION: The results of this study showed that the most ecologically suitable areas of head lice occurrence were identified in two hotspots (Parsabad and Germi) in the Northern areas of Ardabil Province (Parsabad and Germi counties); in the borderline of Iran and the Republic of Azerbaijan.

Insecticide Susceptibility Status of Wild Population of Phlebotomus kandelakii and Phlebotomus perfiliewi transcaucasicus Collected from Visceral Leishmaniasis Endemic Foci in Northwestern Iran.

BACKGROUND: Phlebotomus kandelakii and Phlebotomus perfiliewi transcaucasicus sand flies are the vectors of visceral leishmaniasis in Iran. The aim of this study was to evaluate the susceptibility of Ph. kandelakii and Ph. perfiliewi transcaucasicus, collected from an endemic focus of visceral leishmaniasis (VL) in the northwest of Iran, to different selected insecticides. METHODS: Sand flies were collected from the villages of Meshkinshahr and Germi Counties using light traps and aspirators from May to October 2019. The sand flies were identified as Ph. kandelakii and Ph. perfiliewi transcaucasicus using standard identification keys. Susceptibility test was carried out against DDT (4%), Malathion (5%), Propoxur (0.1%) and Lambda-cyhalothrin (0.05%) according to the WHO standard method. MedCalc statistical software was employed to calculate LT50 and LT90 and to compare the chances of sand flies surviving the exposure to the studied insecticides. RESULTS: A total of 1,278 female specimens were used for the susceptibility tests. Out of which 1,063 samples were used for the test and 215 for the control group. The estimated LT50 values for DDT (4%), Malathion (5%), Propoxur (0.1%), and Lambda-cyhalothrin (0.05%) for Ph. kandelakii were 15.1, 13.4, 15.4 and 5.8 minutes respectively, and for Ph. perfiliewi transcaucasicus were 11.9, 15.6, 15.9 and 5.8 minutes respectively. CONCLUSION: This susceptibility studies revealed different LT50 values for different insecticides efficient against Ph. kandelakii and Ph. perfiliewi transcaucasicus. The regular monitoring for the resistance of Ph. kandelakii and Ph. perfiliewi transcaucasicus sand flies seems necessary in diseases control programs in this area.

Evaluation of the apical microleakage of MTA Fillapex, AH26, and Endofill sealers / Avaliação da microinfiltração apical de cimentos MTA Fillapex, AH26 e Endofill

Objective: Proper apical seal plays an important role in the success of root canal treatment. The most common cause of failure of root canal therapy is known as the lack of adequate apical seal. The aim of this in vitro study was to compare the apical microleakage of MTA Fillapex, AH26, and Endofill sealers using dye penetration method. Material and Methods: In this in vitro study, 72 single-rooted extracted human teeth were selected. The teeth were randomly divided into three experimental groups of 20 and two positive and negative control groups of 6. The canals were prepared by step-back technique and then filled with gutta-percha and one of the sealers mentioned. In the positive control group, the canals were filled with gutta-percha without sealer, and in the negative control group, the canals were prepared but not filled. The teeth were immersed in 2% methylene blue dye for 72 hours. The teeth were then cut longitudinally and the level of dye penetration was measured under a stereomicroscope. Data were analyzed by SPSS ver. 19 software, ANOVA and Bonferroni post-hoc tests. Results: The mean level of dye penetration in the Endofill test group was significantly higher than that in the AH26 and MTA Fillapex test groups. While, the observed difference between AH26 and MTA Fillapex groups was not statistically significant (p<0.05). Conclusion: The results of this study showed that AH26 and MTA Fillapex sealers did not show any significant difference in apical seal properties. However, their sealing strength was significantly greater than Endofill sealer. (AU)

Objetivo: O selamento apical adequado desempenha um papel importante no sucesso do tratamento do canal radicular. A causa mais comum de falha da terapia endodôntica é conhecida como falta de selamento apical adequado. O objetivo deste estudo in vitro foi comparar a microinfiltração apical dos cimentos MTA Fillapex, AH26 e Endofill usando o método de penetração de corantes. Materiais e métodos: Neste estudo in vitro, 72 dentes humanos unirradiculares extraídos foram selecionados. Os dentes foram divididos aleatoriamente em três grupos experimentais de 20 e dois grupos controle, positivo e negative, de 6. Os canais foram preparados pela técnica escalonada e preenchidos com guta-percha e um dos cimentos mencionados. No grupo controle positivo, os canais foram preenchidos com guta-percha sem cimento, e no grupo controle negativo, os canais foram preparados, mas não preenchidos. Os dentes foram imersos em corante azul de metileno a 2% por 72 horas. Os dentes foram então cortados longitudinalmente e o nível de penetração do corante foi medido sob um estereomicroscópio. Os dados foram analisados pelo software SPSS ver. 19 e pelos testes ANOVA e post-hoc de Bonferroni. Resultados: O nível médio de penetração do corante no grupo de teste Endofill foi significativamente maior do que nos grupos de teste AH26 e MTA Fillapex. Enquanto, a diferença observada entre os grupos AH26 e MTA Fillapex não foi estatisticamente significante (p <0,05). Conclusão: Os resultados deste estudo mostraram que os cimentos AH26 e MTA Fillapex não apresentaram diferença significativa nas propriedades do selamento apical. No entanto, suas forças de vedação foram significativamente maiores que a do cimento Endofill. (AU)

Detecting Important Risk Factors of Survival Time of Lung Cancer Patients Using Censored Quintile Regression.

Objective: Lung cancer is the most frequently diagnosed cancer and the most leading cause of death due to cancer worldwide. This study aimed to use censored quintile regression model to estimate the effect of potential risk factors on survival of lung cancer patients. Methods: In this study we used a dataset of a retrospective cohort study conducted in West Azerbaijan (during 2007 and 2014). Demographic variables included age, and gender and biological variables included Eastern Cooperative Oncology Group, smoking, tumor type, stage, metastasis, and treatment were investigated as risk factors of survival of lung cancer patients by using censored quintile regression. Result: The mean (± standard deviation) age of the 347 lung cancer patients was 63.48 (± 13.55) years. The survival time ranges from 11 to 91. A total of 240 (67.6%) experienced death by the end of the study. The impact of Eastern Cooperative Oncology Group (IV), smoking and treatment were significant for most of quintiles (p<0.05). Stage of cancer and metastasis are the other affective risk factors on the survival of lung cancer patients(p<0.05). It was shown that Eastern Cooperative Oncology, smoking habit and treatment were significantly associated with a shorter time-to-death progression. Conclusion: As censored quintile regression could consider time-varying effects and the interpretation of its regression coefficients are easy it could be an adequate choice for analyzing survival data.

Detection of plasmid-mediated quinolone resistance in clinical isolates of Enterobacteriaceae strains in Hamadan, West of Iran.

Plasmid mediated quinolone resistance (PMQR) determinants have arisen as a significant concern in recent years. The aim of this study was screening of resistant-clinical isolates to fluoroquinolone antibiotics and detection of qnr and aac(6')-Ib-cr genes. For this purpose we collected 100 fluoroquinolone-resistant Enterobacteriaceae which were from 3 hospitals in Hamadan, west provinces of Iran, between October 2012 and June 2013. The all samples were identified by biochemical tests and confirmed by PCR method. Antimicrobial susceptibility to 14 antimicrobial agents including levofloxacin and ciprofloxacin were determined by disk diffusion methods and ciprofloxacin MIC was obtained by broth microdilution method as Clinical Laboratory Standards Institute (CLSI) recommendations. The isolates were screened for the presence of qnrA, qnrB, qnrS and aac(6')-Ib-cr genes using PCR assay. Among the screened isolates, 64 strains (64%) of Escherichia coli, 23 strains (23%) of Klebsiella pneumoniae, 13 strains (13%) of Proteus mirabilis were collected as quinolone-resistant isolates. out of 100 isolates, two (2%) were positive for qnrS, seventeen (17%) isolates were positive for qnrB and we did not find qnrA gene in any of the isolates. There were also 32 positive isolates for aac(6')-Ib-cr determinant. We described the prevalence of qnr and aac(6')-Ib-cr genes in fluoroquinolone-resistant Enterobacteriaceae in Hamadan city. The carriage rate of multidrug-resistant Enterobacteriaceae in healthy people in Hamadan City is extremely high. Moreover, genes encoding transferable quinolones, in particular aac(6')-Ib-cr, are highly prevalent in these strains.

Prognostic Factors for Survival in Patients with Gastric Cancer using a Random Survival Forest

Background: Gastric cancer is the fifth most common cancer and the third top cause of cancer related death with about 1 million new cases and 700,000 deaths in 2012. The aim of this investigation was to identify important factors for outcome using a random survival forest (RSF) approach. Materials and Methods: Data were collected from 128 gastric cancer patients through a historical cohort study in Hamedan-Iran from 2007 to 2013. The event under consideration was death due to gastric cancer. The random survival forest model in R software was applied to determine the key factors affecting survival. Four split criteria were used to determine importance of the variables in the model including log-rank, conversation?? of events, log-rank score, and randomization. Efficiency of the model was confirmed in terms of Harrell's concordance index. Results: The mean age of diagnosis was 63 ±12.57 and mean and median survival times were 15.2 (95%CI: 13.3, 17.0) and 12.3 (95%CI: 11.0, 13.4) months, respectively. The one-year, two-year, and three-year rates for survival were 51%, 13%, and 5%, respectively. Each RSF approach showed a slightly different ranking order. Very important covariates in nearly all the 4 RSF approaches were metastatic status, age at diagnosis and tumor size. The performance of each RSF approach was in the range of 0.29-0.32 and the best error rate was obtained by the log-rank splitting rule; second, third, and fourth ranks were log-rank score, conservation of events, and the random splitting rule, respectively. Conclusion: Low survival rate of gastric cancer patients is an indication of absence of a screening program for early diagnosis of the disease. Timely diagnosis in early phases increases survival and decreases mortality.

Association between overuse of mobile phones on quality of sleep and general health among occupational health and safety students.

Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance.

Estimation of survival rates in patients with lung cancer in west Azerbaijan, the northwest of Iran.

BACKGROUND: Lung cancer is a fatal malignancy with high mortality and short survival time. The aim of this study was to estimate survival rates of Iranian patients with lung cancer and its associate predictive factors. MATERIALS AND METHODS: The study was conducted on 355 patients admitted to hospitals of West Azerbaijan in the year 2007. The patients were followed up by phone calls until the end of June 2014. The survival rate was estimated using the Kaplan-Meier method and log-rank test for comparison. The Cox's proportional hazard model was used to investigate the effect of various variables on patient survival time, including age, sex, Eastern Cooperative Oncology Group (ECOG) performance, smoking status, tumor type, tumor stage, treatment, metastasis, and blood hemoglobin concentration. RESULTS: Of the 355 patients under study, 240 died and 115 were censored. The mean and median survival time of patients was 13 and 4.8 months, respectively. According to the results of Kaplan-Meier method, 1, 2, and 3 years survival rates were 39%, 18%, and 0.07%, respectively. Based on Cox regression analysis, the risk of death was associated with ECOG group V (1.83, 95% CI: 1 CONCLUSIONS: The survival time of the patients with lung cancer is very short. While early diagnosis may improve the life expectancy effective treatment is not available.