Concordance assessment between self-reports of substance use and urinalysis: A population-based study in Mashhad, Iran.

BACKGROUND: Few studies have addressed the validity of self-reports of substance use in Iran. This study was conducted to evaluate concordance between self-reported data on drug use and urinalysis results in an adult population in Mashhad as the second most populous city in Iran. METHODS: This population-based study recruited 2142 Mashhad residents aged over 16 years. The data were obtained from a study conducted in 2015 on the prevalence of chronic kidney disease (CKD) in an adult population in Mashhad. The participants were selected using multistage stratified cluster sampling. To evaluate the validity, the participants' responses to a single-question screening test of drug use were compared with their urinalysis results. The sensitivity, specificity, and positive and negative predictive values of the self-reports were also assessed. RESULTS: The prevalence of drug use was found to be 2.33% (95% CI: 1.75-3.09) based on the self-reported data and 17.74% (95% CI: 16.15-19.43) based on the urinalysis results. Opioids were the most prevalent form of drug used and the self-reports indicated low validity (sensitivity = 12.63%, 95% CI: 9.54-16.49). The women were found more predisposed than the men to misreporting their drug use. DISCUSSION: In line with other studies in Iran, the validity of the self-reports of drug use was found to be low. Policymakers should therefore avoid relying only on self-reported data to evaluate the effectiveness of interventions and preventive strategies.It is recommended that further in-depth studies be conducted to address the factors affecting the validity of self-reports in Iranian populations.

The burden of tuberculosis in Iran, A 12- year population-based study.

Background: Tuberculosis (TB) is a major global health problem, so for better planning in the health sector, it is necessary to know the real burden of tuberculosis in our country. The main aim of this study was to calculate the burden of TB for the Iranian population in 2001-2012. Methods: The Disability Adjusted Life Years (DALYs) index was calculated using a computer model (DisMod version II) in Iran between the years 2001 and 2012. DALYs are age-weighted (ß= 0.04) and are discounted for time preference (r= 0.03). Results: The trend was decreasing from 2001 till 2006, and after it, there is an increasing trend. The incidence was more in younger age groups and in female, and the YLL is higher in men (11744 in male vs 7897 in female in 2012); it showed that the life lost is higher in men. The YLD in men and women are very close. In comparison, the DALY of TB was higher in men than women. Conclusion: In the present investigation, it has been found that the overall tendency to get TB was higher in the female population. It shows that the incidence was higher in the younger age groups but the mortality was higher in the elderly groups. It that shows the significant success of the country in controlling the disease.

Perceived social support and compliance with stay-at-home orders during the COVID-19 outbreak: evidence from Iran.

BACKGROUND: Strong evidence demonstrates that social support plays a key role in facilitating preventive health behaviors. The aim of the current study was to assess the effects of perceived social support on compliance with stay-at-home orders in response to a COVID-19 outbreak during the Persian New Year (Nowruz) holydays, since Nowruz holidays of 2020 coincided with the peak of the coronavirus epidemic in Iran. METHODS: This cross-sectional survey was carried out based on phone interviews of 1073 adults aged over 18 years from 4 to 12 April 2020 in Mashhad, Khorasan-Razavi Province, as the second largest city of Iran. A systematic random sampling was carried out using fixed phone number lists provided by Telecommunication Company of Khorasan-Razavi Province. Phone interviews were carried out by trained interviewers from the Iranian Students Polling Agency (ISPA) at various times of the day. The survey included sociodemographic questions, perceived social support scale (MSPSS) and questions about self-isolation during the Nowruz holiday. Statistical analysis included Chi-square test, Mann-Whitney test and multivariate logistic regression. RESULTS: 20.5% of participants reported poor compliance with stay at home orders during the first 2 weeks of Nowruz. Clear social gradients were not found in stay-at-home compliance. When controlling socio-demographic factors, perceived social support, interestingly, both fostered and hindered people's compliance with stay at home orders, depending on the source of support from family members (OR = .874, 95% CI = .803, .950, p < .005), friends (OR = 1.147, 95% CI = 1.076, 1.222, p < .001) and a significant other person (OR = .926, 95% CI = .849, 1.010, p = .084). CONCLUSIONS: Public health messaging may need to emphasize the role that friends and families can play in helping to protect those in their friendship/family groups by promoting compliance with social distancing. Further in-depth studies are recommended to evaluate how this kind of messaging can most effectively encourage people to engage in social distancing practices.

Atherogenic Index of Plasma (AIP): A marker of cardiovascular disease.

BACKGROUND: Cardiovascular disease (CVD) is the cause of one third of deaths worldwide and this will progress because of increasing CVD's risk factors. The most basic task of dealing with the epidemic of CVD is primary prevention of risk factors. As Atherogenic Index of Plasma (AIP) is a strong marker to predict the risk of atherosclerosis and coronary heart disease, we assessed the correlation between AIP and other important factors. METHODS: This cross-sectional study was a part of national non-communicable risk factors surveillance system data that has been established since 2004 in Iran. This was done on 1000 people between 2008 and 2010. The study was approved by Ethics Committee of Mashhad University of Medical Science. Chi square, Mann-Whitney U, correlation tests were used in this study. Statistical analysis was performed using SPSS version 11. In all calculations, p <0.05 was considered as statistically significant level. RESULTS: The study population consisted of 500 men and 500 women with mean±SD age 41.9±14.2 years. According to the AIP category, 9.8% (98) were in low risk group, 12.7% (127) were in intermediate risk and 77.5% (775) were in increased risk of CVD. AIP was significantly correlated with waist circumference (r=0.35, p<0.001), BMI (r=0.33, p<0.001) and physical activity (r=-0.09, p<0.01). CONCLUSION: AIP can be used as a regular monitoring index of CVD in every day practice, especially in persons with other cardiovascular risk factors.

Effect of Crocus sativus L. (saffron) on coagulation and anticoagulation systems in healthy volunteers.

Saffron showed some effects on blood coagulation and platelet aggregation in in vitro and in vivo studies. In a clinical trial with a limited number volunteers, saffron tablets influenced on bleeding time. In this study, the effect of saffron on plasma level of fibrinogen, factor VII (as coagulant agent), C and S protein (as anti-coagulant agent), PT and PTT in a larger sample size was evaluated. The study was a double-blind, placebo-controlled study consisting of 1 week treatment with 200 mg and 400 mg saffron tablets. Sixty healthy volunteers (age range 20-50 years) were selected for the study. The volunteers were divided into three groups of 20 each. Group 1 received placebo; Groups 2 and 3 received 200 mg and 400 mg saffron tablets, respectively, for 7 days (1 tablet per day). Before and after 7 days treatment and also 1 month after that, blood samples were taken. The plasma levels of fibrinogen, factor VII, C and S protein, PT and PTT were evaluated. Statistical analysis showed no difference between groups for any of evaluated factors. This study rejected any effect of saffron with dose of 200 and 400 mg for 1 week on coagulant and anticoagulant system.

Early Hearing Detection and Intervention Results in Northeastern of Iran from 2005 to 2019: A Repeated Cross-Sectional Study.

Background: Hearing loss is one of the most common congenital disorders. The Early Diagnosis and Intervention Process is designed for the early diagnosis and intervention of hearing loss in infants. The present study aimed to examine the results of Early Hearing Detection and Intervention (EHDI) in northeastern Iran from 2005 to 2019. Setting: Northeastern Iran. Methods: In most cases, the two-stage protocol (otoacoustic emissions [OAE] and automated auditory brainstem response [AABR]) has been used. Infant assessment methods included the use of OAE, ABR, auditory steady-state response, high-frequency tympanometry, and behavioral audiometry. Interventions included medical interventions, hearing rehabilitation, hearing aids, and cochlear implants. Results: 1,162,821 infants were screened. The screening coverage increased from less than 1% in 2005 to about 99% in 2018. The referral rate has been about 1%. 2.17 out of every 1000 infants are hearing impaired, and the most common cases are bilateral hearing loss and mild to moderate hearing loss. Conclusions: During 2005 to 2019 the coverage rate reached to more than 95% of live births. To improve the EHDI process in this population, better follow-up of diagnosed neonates and expansion of diagnostic and intervention services are needed.

Higher Serum Vitamin D Levels have a Positive Association with the Incidence of Recidivans Form of Cutaneous Leishmaniasis; A Cross-Sectional Study.

Background: Several manifestations of cutaneous leishmaniasis are related to the host's immune system and the species of parasite. Objective: There have been some studies on the relationship between vitamin D statuses in infectious diseases including cutaneous leishmaniasis. However, the results of these studies have been inconsistent. Materials and Methods: In this cross-sectional study, 147 patients with leishmaniasis were recruited and divided into the following categories: acute cutaneous leishmaniasis (<1 year) (n = 51), chronic cutaneous leishmaniasis (more than 1 year) (n = 26), and leishmaniasis recidivans (the appearance of new papular lesions around a previous scar) (n = 20), and a group of participants without leishmaniasis (n = 50), as a control group. Serum 25-hydroxyvitamin D [25(OH) D] level was analyzed. Result: There were significant differences in serum 25(OH) D between the groups with acute or chronic leishmaniasis and those with recidivans leishmaniasis (P = 0.013 and P = 0.022, respectively). The median serum level of vitamin D in the acute group was 13.7 ng/mL, in the chronic group was 16.05 ng/mL, in the recidivans group was 21.75 ng/mL, and in the control group was 17.97 ng/mL. Conclusion: Higher serum concentrations of 25(OH) vitamin D levels being associated with leishmaniasis recidivans.

Socioeconomic Disparities in Iranians' Preferences toward Dental Care Services: A Population-Based Survey.

Background and Aims: Patients' perspectives and preferences are considered an essential influencing factor for healthcare utilization. This study is one of the first to investigate patient preference for dental services across socioeconomic and demographic indicators in Iran. Materials and Methods: This cross-sectional study was conducted through telephone interviews with adult residents in Mashhad and Kerman cities. A representative sample was selected by stratified random sampling. A valid structured questionnaire was used for data collection, including people's preference toward dental care services in terms of dental settings, choosing a general or specialist dentist, prevention or treatment, and the preferable gender of the dentist. Factors potentially associated with preferences included gender, age, educational level, job, monthly income, house size, family number, insurance coverage, dental insurance, type of insurance, and social class in the city were investigated. Results: 1475 individuals participated in the study [response rate 63%]. Our findings showed higher preferences for private offices (50.6%), specialist dentists (76.2%), treatment services (40.8%), and no specific gender preference for the dentist (60.6%). Their preferences were significantly influenced by age range, social class, insurance status, dental insurance, and type of insurance. Income, household size, level of education, and job were not statistically significant with none of the preferences. Conclusions: Socioeconomic and demographic factors' correlation with people's preferences was observed. Efforts are needed to promote preventive care demand in deprived regions. Moreover, increasing financial resources allocated to preventive care and covering preventive dental services in insurance plans are recommended.

Inequalities in Unmet Oral Health Care Need Among Adults in East Iran, a Cross Sectional Population-Based Study.

STATEMENT OF THE PROBLEM: Need assessment is considered as a key element of health care planning. Subjective measures can be useful tools in epidemiologic surveillances. PURPOSE: The aim of study was to evaluate inequality in perceived unmet oral health need (PUOHN) in adults in east of Iran. MATERIALS AND METHOD: In this cross-sectional population-based study, the target population included adult residents in the Mashhad and Kerman city. Data was collected through telephone interviews using a validated structured questionnaire. Phone numbers were obtained from telecommunication company. Participants were selected by stratified random sampling. Predisposing and enabling variables associated with PUOHN were included gender, age, educational level, job, insurance coverage, dental insurance, type of insurance, residential location, household size, and family economic indicators. Logistic regression was used to examine association of PUOHN and predisposing and enabling factors. RESULTS: 1475 individuals participated in the study (response rate of 63%). 52% of participants stated that their dental needs have not been met during the past year. The mean ages of respondents were 39 years old and 69.8% were female. Logistic regression analyses indicated living in rental house [OR=2 (95% CI 1.25-3.21), p Value=0.004] and higher household size [OR=1.19(95% CI 1.003-1.43), p= 0.04] significantly associated with PUOHN. CONCLUSION: The results of this study indicated high PUOHN in the adult population of East Iran. Effective strategies must be implemented to provide accessible dental services regardless of socioeconomic status.

Autoantibody profile in systemic sclerosis.

Systemic sclerosis is a generalized disorder of connective tissue clinically characterized by thickening and fibrosis of the skin and by distinctive forms of involvement of internal organs. One of the hallmarks of systemic sclerosis is the presence of serum autoantibodies against a variety of nuclear and cytoplasmic antigens. The primary purpose of this study was to identify the autoantibodies profile in the scleroderma sera and the secondary goal was to determine the correlation and discrepancy of autoantibody profile. Autoantibody profile was determined in 118 samples stored in the Advanced Diagnostic Laboratory at the University of Calgary. 78 sera were provided from Canadian and 40 sera were provided from Ukraine. We used the following techniques to identify autoantibodies profile in scleroderma patients: 1. Antinuclear antibody (ANA) by indirect immunofluorescence on human epithelial cell substrate 2. Detection and identification of specific autoantibodies by Innolia strip assay 3. Detection and identification of specific autoantibodies against extractable nuclear antigens. 111 out of 118 patients showed positive ANA results by indirect immunofluorescence and 7 patients had negative ANA results. Anti-ENA analyses by Inolia were positive in 84 patients, while by western blotting 81 patients showed positive results. In this study, we compared the results of anti-ENA antibody by Innolia with SLR technique. A significant correlation was found between anti-SC1-70 antibodies (P=0.000) and anti- RNP antibodies (P=0.001) and JO-1 antibodies (P=0.014). Thus, we may propose that SLR and Innolia techniques could be used for the detection of autoantibody in systemic sclerosis.

The risk of cardiovascular events based on the Framingham criteria in Adults Living in Mashhad (Iran).

BACKGROUND AND AIM: Cardiovascular diseases are a problem in low- and middle-income countries, such as Iran. The present research was performed to identify risk factors contributing to cardiovascular diseases and their distributions among the adult population of Mashhad (Iran) using the Framingham criteria. METHODS: This cross-sectional population-based study performed in 2015 on 2,976 adults living in Mashhad (Iran) using Stratified cluster-random sampling method. Demographic information was acquired by surveyors in the research team using a checklist and referring to a medical laboratory for laboratory assessments. The 10-year risk of cardiovascular diseases for the participants was calculated using the Framingham criteria and was classified into three classes: low risk (<10%), intermediate risk (10-20%), and high risk (>20%). The analysis was done by SPSS Version 11.5 by using the Independent-samples t-test, Kruskal-Wallis, and analysis of variance (ANOVA). RESULTS: A total of 2,978 participants aged 16-90 participated in our cross-sectional study with an average age of 43.5±14.7 years. Total risk scores among men and women were 7.29±6.3 and 5.8±6.03, respectively. Compared to women, men exhibited a significantly higher risk of cardiovascular diseases (p<0.001). Average heart age among men and women was estimated at 50.37±18.7 and 48.8±17.0 respectively, i.e. significantly older heart age was obtained for men compared to women (p<0.001). CONCLUSION: According to this study, men are at a great risk of cardiovascular events, so we should develop our screening and educational program especially for this population.

A Data Model for Teleconsultation in Managing High-Risk Pregnancies: Design and Preliminary Evaluation.

BACKGROUND: Teleconsultation is a guarantor for virtual supervision of clinical professors on clinical decisions made by medical residents in teaching hospitals. Type, format, volume, and quality of exchanged information have a great influence on the quality of remote clinical decisions or tele-decisions. Thus, it is necessary to develop a reliable and standard model for these clinical relationships. OBJECTIVE: The goal of this study was to design and evaluate a data model for teleconsultation in the management of high-risk pregnancies. METHODS: This study was implemented in three phases. In the first phase, a systematic review, a qualitative study, and a Delphi approach were done in selected teaching hospitals. Systematic extraction and localization of diagnostic items to develop the tele-decision clinical archetypes were performed as the second phase. Finally, the developed model was evaluated using predefined consultation scenarios. RESULTS: Our review study has shown that present medical consultations have no specific structure or template for patient information exchange. Furthermore, there are many challenges in the remote medical decision-making process, and some of them are related to the lack of the mentioned structure. The evaluation phase of our research has shown that data quality (P<.001), adequacy (P<.001), organization (P<.001), confidence (P<.001), and convenience (P<.001) had more scores in archetype-based consultation scenarios compared with routine-based ones. CONCLUSIONS: Our archetype-based model could acquire better and higher scores in the data quality, adequacy, organization, confidence, and convenience dimensions than ones with routine scenarios. It is probable that the suggested archetype-based teleconsultation model may improve the quality of physician-physician remote medical consultations.

Relationship Between Systemic Lupus Erythematosus Disease Activity Index Scores and Subclinical Cardiac Problems.

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune connective-tissue disease involving multiple organs and systems. Some evidence has demonstrated that disease activity could be associated with increased risk of organ damage. OBJECTIVES: The aim of this study was to determine the association between systemic lupus erythematosus Disease Activity Index (SLEDAI) scores and subclinical cardiac involvement. METHODS: This cross-sectional study was conducted on 45 SLE patients (88% female; mean age: 31.2 ± 8.2 years) from 2011 to 2013 in Mashhad, Iran. The patients had no clinical signs and symptoms of cardiac problems or risk factors for cardiovascular disease and were selected consecutively. All patients underwent complete echocardiographic examinations (using two dimensional (2D) tissue Doppler and 2D speckle tracking). Disease activity was evaluated by using the SLEDAI. RESULTS: Patients with higher SLEDAI scores had higher pulmonary artery pressure rates (r = 0.34; P = 0.024; 95% CI (0.086 to 0.595)) and SLE durations (r = 0.43; P = 0.004; 95% CI (0.165 to 0.664). The correlation between disease duration and left ventricular mass was also significant (r = 0.43; P = 0.009; 95% CI (0.172 to 0.681)), even after adjusting for age (r = 0.405; P = 0.016). There was no correlation between SLEDAI scores or disease duration and the left/right ventricle systolic function parameters. This was true while assessing the right ventricle's diastolic function. A statistically significant correlation was found between mitral E/E' as an index of left ventricle diastolic impairment and the SLEDAI scores (r = 0.33; P = 0.037; 95% CI (0.074 to 0.574)) along with disease duration (r = 0.45; P = 0.004; 95% CI (0.130 to 0.662); adjusted for age: r = 0.478; P = 0.002). CONCLUSIONS: Echocardiography is a useful noninvasive technique for screening subclinical heart problems in SLE patients. Although disease activity in general should suggest a closer follow-up, regular scanning would enable earlier detection of cardiovascular involvement and should not be confined to cases with higher SLEDAI indices or longer disease durations.

The prevalence of hypertension and its relationship with demographic factors, biochemical, and anthropometric indicators: A population-based study.

BACKGROUND: Hypertension (HTN) is an important public health challenge worldwide. The prevalence of HTN varies across countries. It is necessary to obtain valid information about the prevalence of chronic condition like HTN and its predictors in different societies. Hence, this study was conducted to assess the prevalence of HTN and associated factors in Mashhad, Iran, 2015. METHODS: This cross-sectional study was performed on 2974 adults residing in Mashhad in 2015. Multistage random sampling was used. A checklist was fulfilled for each subject, and a blood sample was taken for measuring fasting blood sugar, total cholesterol, triglycerides, hemoglobin, serum creatinine, high-density lipoproteins, and low-density lipoproteins. The height and weight of participants and their blood pressure were measured according to protocols. RESULTS: The prevalence of HTN in this population was 22% (25.9% in male and 20% in female). Most interestingly, smoking and drug abuse were more prevalent in men (14.9% and 3.8%), but the sedentary behavior was more prevalent in women (51%). Interestingly, by increasing the age, the frequency of optimum, normal and high normal type was decreased and the frequency of HTN, specially sever form were increased. In binary logistic regression model, age [odds ratio (OR): 1.07, 95% confidence interval (CI): 1.06-1.09], gender (Ref:Female) (OR: 1.39, 95% CI: 1.05-1.83), and obesity (OR: 1.09, 95% CI: 1.06-1.12) were the predictors of HTN. CONCLUSION: The prevalence of HTN among this population was found to be high; which indicates the need for HTN-screening programs, especially for the elderly, male and obese population. Given the close relationship between obesity and various diseases, including HTN, practical solutions, including lifestyle interventions, need to be developed.

Insulin resistance and endocrine-metabolic abnormalities in polycystic ovarian syndrome: Comparison between obese and non-obese PCOS patients.

BACKGROUND: Insulin resistance has an important role in pathophysiology of polycystic ovarian syndrome (PCOS). Yet there are certain controversies regarding the presence of insulin resistance in non-obese patients. OBJECTIVE: The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women. MATERIALS AND METHODS: In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese (BMI ≥25) and 45 patients were non-obese (BMI <25). Presence of insulin resistance and endocrine-metabolic abnormalities were compared between two groups. Collected data were analyzed with SPSS version 16.0 and p<0.05 was considered as statistically significant. RESULTS: There was no significant difference in presence of insulin resistance (HOMA-IR >2.3) between two groups (p=0.357). Waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic (p<0.001) and diastolic (p<0.001) blood pressures, fasting blood sugar (p=0.003) and insulin (p=0.011), HOMA-IR (p=0.004), total cholesterol (p=0.001) and triglyceride (p<0.001) were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone (p=0.634) and androstenedione (p=0.736) between groups whereas Dehydroepiandrotendione sulfate (DHEAS) was significantly higher in non-obese PCOS women (p=0.018). There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively. CONCLUSION: Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients.

Cardiovascular Disease Risk Factors Profile in Individuals With Diabetes Compared With Non-Diabetic Subjects in North-East of Iran.

BACKGROUND: Diabetes mellitus is assumed to be a strong risk factor for cardiovascular diseases (CVD) and is frequently associated with other CVD risk factors. OBJECTIVES: The aims of this study were to assess the prevalence of different patterns of dyslipidemia in individuals with diabetes compared with non-diabetic subjects and evaluate other accompanied CVD risk factors between the two groups. PATIENTS AND METHODS: This was an analytical cross-sectional study on 230 participants, aged 28 - 66 years old, who were referred to different urban health centers of Khorasan Razavi province (north-east of Iran). Data from the participants were collected during their first visit by primary care physicians. Statistical package for social science (version 11.5) was used to analyze the data. The chi-square or Fisher's exact, student's t or the Mann-Whitney U and correlation tests were used in the analysis. RESULTS: The age and gender of the participants were not different between the two groups (P = 0.1 and P = 0.4, respectively). The most common patterns of dyslipidemia in both groups were isolated dyslipidemia followed by combined dyslipidemia. Prevalence of dyslipidemia as a whole (one, two or three lipid profile abnormalities) in patients with diabetes and non-diabetic participants was 89.3% and 82.6%, respectively and the difference between the two groups was not statistically significant (P = 0.1). Subjects with diabetes had higher systolic blood pressure (P < 0.001), higher diastolic blood pressure (P = 0.002) and higher body mass index (P = 0.09) compared to non-diabetics. Moreover, they were more likely to have higher levels of total cholesterol (P = 0.01), triglycerides (P = 0.001) and low density lipoprotein cholesterol (P = 0.009) and lower levels of high density lipoprotein cholesterol (P = 0.2). CONCLUSIONS: Cardiovascular diseases risk factors are more common in patients with diabetes; however, non-diabetic individuals also had a high prevalence of risk factors in our region, predisposing them to diabetes. Therefore, further attention by the medical community is necessary to choose effective strategies for a more a aggressive approach to prevent and manage these risk factors.

Sero-Prevalence of Bloodborne Tumor Viruses (HCV, HBV, HTLV-I and KSHV Infections) and Related Risk Factors among Prisoners in Razavi Khorasan Province, Iran, in 2008.

BACKGROUND: Prisoners are at high risk of blood borne and sexually transmitted infections due to their high involvement in risky behaviors. In this descriptive/cross-sectional study, the prevalence, sero-prevalence, and risk factors for bloodborne tumor viruses including HTLV-I, HBV, HCV, and KSHV were evaluated among inmates of two central prisons in the northeast of Iran. METHODS: Blood samples of 1114 inmates were analyzed for the presence of anti HTLV-I, KSHV, and HCV antibodies and HBsAg by ELISA. PCR tests were performed to confirm the presence of these viruses in plasma and identify the current infections. RESULTS: The sero-prevalence of HCV, HBV, HTLV-I, and KSHV was 24.5%, 4.2%, 3.4%, and 3.2% and the prevalence of HCV, HBV, HTLV-I, and KSHV was 19.1%, 2.1%, 2%, and 3%, respectively. HCV infection was significantly associated with history of imprisonment, tobacco consumption, alcohol consumption, intravenous drug use, length of imprisonment, and type of crime committed. Thirty one (2.8%) prisoners had HCV-KSHV co-infection, 16 (1.5%) had HCV-HTLV-I co-infection, and 14 (1.3%) had HBV-HCV co-infection. Triple co-infection was observed in seven cases and one case had four infections concomitantly. CONCLUSIONS: This epidemiological study indicated different rates and transmission risks for these viruses. HCV was the most contagious viral infection and HTLV-I was the weakest in the prisoners. Apart from KSHV infection which its prevalence was as twice as in the general population, the prevalence of HBV and HTLV-I in prisoners was nearly in ranges of the general population.

Women, drug dependency and consequences: a study from a developing country.

Introduction. Addiction in women can expose them to malnutrition, high blood pressure, cancer, and some other dangerous diseases like hepatitis, AIDS, or other sexual transmitted diseases. The aim of this study was to assess illegal sexual relations in three groups of women. Methods. This is a cross-sectional study that was done on 236 girls and young women aged 16-25 years in 2012 in three groups: vulnerable women who have substance dependency (crimes that had made women incarcerated were considered as vulnerability in this study), invulnerable women who have substance dependency (substance dependent women without a history of incarceration), and a control group (women with no history of substance dependency or being in prison). Results. 43.8% of vulnerable women who have substance dependency had extramarital sexual relations; this percentage was 55.8% in invulnerable women who have substance dependency and 1.4% in the control group. Crystal and methamphetamine abuse was higher in addicts who had extramarital sexual relations and alcohol abuse was correlated with unsafe sexual intercourse (r = 0.36, P = 0.001). There was a statistically significant difference in extramarital sexual relation based on marital status (P < 0.001). Conclusions. Poverty, drug dependency, divorce, and alcohol consumption make women prone to other high risk behaviors that need more attention.

Oral Health Related Quality of Life in a Group of Geriatrics.

BACKGROUND: A good quality of life in elderly population is related to different aspects of health including oral health. The aim of this study was to determine oral health-related quality of life (OHR-QoL) in elderly patients referred for dental or oro-maxillo-facial complaints to Mashhad dental school (MDS) and compare them with a group of normal population. MATERIALS AND METHODS: A total of 99 patients from MDS (as case group) and 114 elderly people as control were enrolled in this cross-sectional study. Control group were chosen among the pilgrims who had come to the holy shrine of Imam Reza (Haram). Persian version of OIDP (Oral Impact of Daily Performance) index was used. Data were entered to SPSS 11.5 and Statistical analysis was performed. RESULTS: A total of 213 (case =99, control=114) cases were enrolled. Mean Performance score (MPS) was 6.27±10.47 (7.96±11.95 in case group, and 4.80±8.77 in control group) and the difference was significant (p=0.015). Age was conversely correlated with MPS (r=0.0125, p=0.24) although this correlation was not significant. We found, in oro-maxillofacial functions, ill-fit dentures, oral ulcers, pain and tooth mobility were major determinants of OHR-QoL. Number of impaired functions was directly and significantly correlated with MPS (r=0.92, p<0.001). CONCLUSION: Some daily functions like speaking, emotional status, cleaning teeth, physical activity were impaired in case group. Oral and maxillofacial diseases were more prevalent in case group and can be an important impairing issue in OHR-QoL.

Demographic and Socioeconomic Factors of Patients With Coronary Artery Diseases Undertreatment of Coronary Artery Bypass Grafting, Percutaneous Coronary Intervention and Drug Therapy in Mashhad, Iran.

BACKGROUND: Considering the importance of preventing cardiovascular diseases, determining the contributing risk factors for ischemic heart disease which leads to atherosclerotic plaque, could be effective in selecting the required interventions. OBJECTIVES: This study aimed to evaluate socioeconomic factors in patients with Coronary Artery Diseases (CAD) in three treatment groups: Coronary Artery Bypass Grafting (CABG), Percutaneous Coronary Intervention (PCI) and drug therapy. By identifying and comparing the underlying factors in treatment groups, we can gather useful information for future planning and policy making in order to reduce and eliminate the contributing factors. PATIENTS AND METHODS: This cross-sectional study was conducted on 760 patients with CAD referred to cardiovascular health centers in Mashhad, Iran, including Javad-Al-Aeme Heart Hospital, Qaem, Imam Reza and Dr. Shariati educational Hospital. Samples were collected through purposive sampling from January to March 2014. Based on the experts' opinion, the subjects were categorized into three treatment groups: CABG, PCI, and drug therapy. RESULTS: The mean age of total patients was 58.3 ± 11.5 years (P = 0.09). The proportion of rural patients in the PCI (26.7%) and drug therapy (27.5%) groups was twice as high as the CABG group (11.7%) (P < 0.001). The proportion of patients with higher educational level (higher than high school diploma) in the CABG group (35.9%) was higher than PCI and drug therapy groups (26.7%, 24.3%) (P = 0.006). Smoking, drinking and drug abuse were more common in the drug therapy group (P = 0.03, P = 0.02, and P < 0.001, respectively). One-vessel and three-vessel coronary artery diseases were more common in the drug and CABG groups, respectively (P < 0.001). CONCLUSIONS: In total, application of therapeutic approaches in patients with CAD depends on many factors. In our study not only risk factors such as gender, lifestyle, smoking, alcohol abuse, diabetes and hypertension were associated with the incidence of CAD, but also they were highly correlated with the severity of the disease.