Mortality and morbidity due to exposure to ambient particulate matter.

The aim of this study was to investigate spatial variation and health risk of the exposure to PM2.5 (particulate matter with a diameter of 2.5 µm or less) and PM10 (particulate matter with a diameter of 10 µm or less) in Sabzevar, Iran. PM2.5 and PM10 were measured during three campaigns from April to November 2017, in 26 sampling points. Spatial analysis was performed using kriging and autocorrelations (Moran's index) model in Arc GIS software. Relationship between exposure to the PM2.5 and PM10 and their health impacts were investigated by AirQ 2.2.3 software. The mean concentrations (and standard deviation) of PM 2.5 and PM10 over the entire study period were 32.54 (37.28) and 42.61 (47.76) µg/m3, respectively, which were higher than the guideline of World Health Organization. According to the spatial analysis, the maximum concentrations of PM2.5 and PM10 were around the main highway (beltway) which placed all over the south of Sabzevar. According to the Moran's index, the emission patterns for PM2.5 (Z-score = 2.53; P-value = 0.011) and PM10 (Z-score = 2.82; P-value = 0.004) were clustered. The attributable percentage (AP) of total mortality related to PM2.5 and PM10 were 3.544% (95% confidence interval (CI): 2.623-4.447%) and 2.055% (95% CI: 1.379-2.721%) per increasing each 10 µg/m3 of these pollutants, respectively. According to observed results, it is suggested that the beltway and other pollution sources, such as industries, should be placed at a greater distance from the city, to reduce PM amounts in residential areas.

Application of novel Modified Biological Aerated Filter (MBAF) as a promising post-treatment for water reuse: Modification in configuration and backwashing process.

Biological Aerated Filter (BAF) reactors due to their plentiful biomass, high shockability, high efficiency, good filtration, availability and lack of need for large land areas, are enjoying from great importance in advanced wastewater treatment. Therefore, in this study, Polystyrene Coated by Sand (PCS) was produced as a novel media and its application in a modified down-flow BAF structure for advanced wastewater treatment was assessed in two steps. In step one, the backwash effluent did not return to the system, while in step two backwash effluent returned to increase the water reuse efficiency. The backwash process was also studied through three methods of Top Backwashing (TB), Bottom Backwashing (BB), as well as Top and Bottom Backwashing Simultaneously (TBBS). The results showed that return of backwash effluent had no significant effect on the BAF effluent quality. In the second step similar to the first one with slight differences, the residual average concentrations of TSS, BOD5, and COD at the effluent were about 2.5, 8.2, and 25.5 mg/L, respectively. Additionally, in step two, the mean volume of disposal sludge/volume of treated water (vds/vtw) decreased a large extent to about 0.088%. In other words, the water reuse has increased to more than 99.91%. The backwash time in methods of TB and BB were 65 and 35 min, respectively; however, it decreased in TBBS methods to 25 min. The concentrations of most effluent parameters in this system are in concordance with the 2012 EPA Agriculture Standards, even for irrigation of Non-processed agricultural crops and livestock water consumption.

Yazd Breast Cancer Project Profile; A Community Based Trial for the Evaluation of Self-Examination and Physical Examination of the Breast Cancer Disease.

There is some evidence to suggest that a benefit might be derived from a program that incorporated both annual physical examination of the breast (BPx) and the teaching of breast self-examination (BSE). Current investigation presents the profile of a multicenter community based intervention for evaluating the effect of BSE+BPx on the reduction of morbidity and mortality due to breast cancer amongst women residing in urban areas of Yazd (Iran) from 2008 to 2018. There were three distinctive phases in this trial with 10 years duration: pilot phase with the duration of 1 year, active intervention phase with 4 rounds of annual screening of BPx+BSE and follow up phase with 5 years duration. Tools of enquiry included a pre-tested questionnaire, repeated annual physical examination of the breast and more importantly mammography, sonography, and fine needle aspiration (FNA). Data were analyzed using descriptive statistics such as frequencies, percent, mean (SD), tests of chi-square and student t-test with 95% confidence level. Comparison of socio-demographic and socio-economic factors such as age, age at marriage, family size, number of live births, occupation, education level, total family income and marital status showed that no significant difference was seen between the groups (P>0.05). A response rate of 84.5% was seen by participants of the experiment group visiting the health centers for the first BPx. Our results showed that except for the education and marital status, the difference in other main demographic and socio-economic factors between the groups were not significant, and the response rate of individuals in the experiment group was at an acceptable level.

Examination of the Topical Effect of the Combination of Plantago ovata and Vinegar on the Improvement of Rural Cutaneous Leishmaniasis Lesions.

Background: The present study aimed at investigating the topical effect of the combination of Plantago ovata and vinegar on the improvement of rural cutaneous leishmaniasis lesions. Materials and Methods: The present randomized double-blind controlled clinical trial was performed on 42 patients with rural skin leishmaniasis. In the case group, in addition to injecting glucantime into the lesion according to the latest national instructions, a combination of P. ovata and vinegar was applied topically twice a day for 8 weeks. In the control group, only glucantime injection into the lesion was performed for 8 weeks according to the latest national guidelines. At the end of the 1st, 2nd, 3rd, 4th, 8th, and 12th weeks after the intervention, the lesion area and improvement were evaluated and recorded. Results: The results of the present study indicated the lesion area in the case group with the mean of 0.35 ± 0.39 cm and 0.18 ± 0.27 cm in the 8th and 12th weeks, respectively was significantly less than that of the control group with the mean of 0.64 ± 0.78 cm and 0.56 ± 0.44, respectively (P < 0.05). Twelve weeks after the intervention, 84.1% of the lesions in the case group and 65.9% of the lesions in the control group were completely improved (P < 0.05). Conclusion: According to the results of the present study, the improvement of leishmaniasis lesion with the topical application of the combination of P. ovata and vinegar was significantly more than that of the control group in the 8th and 12th weeks after the intervention.

COVID-19 vaccine in pregnant women and pregnancy outcomes: A historical cohort in center of Iran.

BACKGROUND: Starting vaccination in pregnant women; numerous theories have been proposed that the vaccine might affect the mother or the fetus. OBJECTIVE: The goal of this research was to see whether there was a link between the Sinopharm vaccination and certain pregnancy outcomes in COVID-19-vaccinated women. STUDY DESIGN: This is a retrospective cohort study. METHOD: This study was conducted on pregnant women who delivered from 1 August 2021 to 1 January 2022 in Yazd city. We have followed the STROBE Guidelines when preparing the manuscript. In this period time, all pregnant women were 5787 people in which 5666 were in the second and third trimester. Among these women, 1222 women were randomly selected. RESULTS: Among 1222 pregnant women, 558 (45.6%) women had received one dose vaccine, 162 (13.3%) people had received two doses, and 502 (41.1%) women had not been vaccinated. On crude analysis, there was no significant difference between vaccinated and non-vaccinated groups. After adjusting for maternal age, maternal body mass index, parity, stillbirth history, abortion history, and gestational diabetes in multivariate analysis, no differences were found between the groups in pregnancy as well. CONCLUSION: Vaccinations during pregnancy seem to have no negative effects on the mother or the baby. This finding may aid pregnant women in deciding whether or not to take the vaccination.

Adjustment for collider bias in the hospitalized Covid-19 setting.

Background: Causal directed acyclic graphs (cDAGs) are frequently used to identify confounding and collider bias. We demonstrate how to use causal directed acyclic graphs to adjust for collider bias in the hospitalized Covid-19 setting. Materials and methods: According to the cDAGs, three types of modeling have been performed. In model 1, only vaccination is entered as an independent variable. In model 2, in addition to vaccination, age is entered the model to adjust for collider bias due to the conditioning of hospitalization. In model 3, comorbidities are also included for adjustment of collider bias due to the conditioning of hospitalization in different biasing paths intercepting age and comorbidities. Results: There was no evidence of the effect of vaccination on preventing death due to Covid-19 in model 1. In the second model, where age was included as a covariate, a protective role for vaccination became evident. In model 3, after including chronic diseases as other covariates, the protective effect was slightly strengthened. Conclusion: Studying hospitalized patients is subject to collider-stratification bias. Like confounding, this type of selection bias can be adjusted for by inclusion of the risk factors of the outcome which also affect hospitalization in the regression model.

Clinical courses of 24,563 hospitalized COVID-19 patients during the first 12 months of the pandemic in the Central City of Iran.

This study was designed and implemented to analyze and establish documents related to the above cases in the first to third COVID-19 epidemic waves for the use of researchers and doctors during and after the epidemic. The current case series study was conducted on 24,563 thousand hospitalized COVID-19 patients by examining their clinical characteristics within a one-year period from the beginning of the pandemic on 02.22.2020 to 02.14.2021, which included the first to the third waves, based on gender and severity of COVID-19. The mean age of the participants was 56 ± 20.71, and 51.8% were male. Out of a total of 24,563 thousand hospitalized COVID-19 patients until February 2021, there were 2185 mortalities (9.8%) and 2559 cases of severe COVID-19 (13.1%). The median length of hospitalization from the time of admission to discharge or death in the hospital (IQR: 13-41) was estimated to be 21 days. The rate of hospital mortality was higher in severe (37.8%) than in non-severe (4.8%) cases of COVID-19, While the risk of severe cases increased significantly in the third (HR = 1.65, 95% CI: 1.46-1.87, P < 0.001) and early fourth waves (HR = 2.145, 95% CI: 1.7-2.71, P < 0.001). Also, the risk of contracting severe COVID-19 increased significantly in patients aged ≥ 65 years old (HR = 2.1, 95% CI 1.1.93-2.72, P < 0.001). As shown by the results, the rates of hospital mortality (9.3% vs. 8.5%) and severe cases of COVID-19 (13.6% vs. 12.5%) were higher among men than women (P < 0.01). In our study, the mortality rate and severity of COVID-19 were within the scope of global studies. Men experienced higher severity and mortality than women. The was a significantly higher prevalence of old age and underlying diseases in individuals with severe COVID-19. Our data also showed that patients with a previous history of COVID-19 had a more severe experience of COVID-19, while most of these patients were also significantly older and had an underlying disease.

Comparison of FEV(3), FEV(6), FEV(1)/FEV(3) and FEV(1)/FEV(6) with usual spirometric indices.

BACKGROUND AND OBJECTIVE: Pulmonary function tests play an important role in the management of pulmonary diseases. One of the tests that are widely used is spirometry. Performing an acceptable spirometry manoeuvre according to the standards set by the American Thoracic Society/European Respiratory Society is difficult. The aim of this study was to compare forced expiratory volume in 3 s (FEV(3)) and forced expiratory volume in 6 s (FEV(6)) with forced vital capacity (FVC), and forced expiratory volume in 1 s FEV(1)/FEV(3) and FEV(1)/FEV(6) with FEV(1)/FVC, in order to substitute the usual spirometric manoeuvres with manoeuvres that are easier to perform. METHODS: In a cross-sectional study, spirometry was performed for 588 subjects who were referred for occupational health evaluations. The accuracy of FEV(3), FEV(6), FEV(1)/FEV(3) and FEV(1)/FEV(6) was compared with that of FVC and FEV(1)/FVC. Chi-square tests and kappa tests were used to analyse the data. RESULTS: Individuals with normal (n = 297) and abnormal spirometry (n = 291) were evaluated. The sensitivity, specificity, positive predictive value and negative predictive value of FEV(1) /FEV(6) , as compared with that of FEV(1)/FVC for detecting obstruction, were 93.56, 99.32, 98.95 and 96.09, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of FEV(6), as compared with that of FVC for detecting restriction, were 96.68, 98.65, 96.68 and 98.65, respectively. CONCLUSIONS: FEV(6) and FEV(1)/FEV(6) can be used as surrogates for FVC and FEV(1)/FVC, respectively, and these parameters showed acceptable sensitivity, specificity, positive predictive value and negative predictive value for occupational health evaluations.

Risk Factors of Osteoporosis in Females: A Hospital-Based Case-Control Study, Yazd, Iran.

Background: The aim of this study was to evaluate the predictors of osteoporosis in women in Yazd, Iran. Methods: This hospital-based case-control study was performed on 270 women 35-65 yr old (135 case and 135 control) from Mar 2016 to Mar 2017. Case and control were matched in terms of age ± 2 (year) as a group matching. Osteoporosis is defined as a T-score of bone mineral density (BMD) below -2.5 SD. Data were analyzed using SPSS 20 software. Statistical tests included chi-square, student t test and Mann Whitney test .Multiple logistic regression (MLR) which forward method was used for modeling. Results: Odds ratio (OR) of osteoprosis were menarche age>12 yr (OR=3.37, CI:2.29-15.89), history of hysterectomy (OR=13, CI:3.81-44.82), rheumatoid arthritis (RA) (OR=6.58, CI:2.29-18.91) calcium supplements (OR=0.14, CI:0.04-0.41), menopause age <40 (OR=11.84, CI:1.54-90), second smoking (OR=3.38, CI:1.16-9.81) and increase of weight (OR=0.86, CI:0.80-0.94). Conclusion: Predictors of osteoporosis was menarche age >12 yr (3 times), history of hysterectomy (13 times), RA (6.5 times), menopause age <40 (12 times), second smoking (more than 3 times), calcium supplements and weight (protective).

Burden of severe COVID-19 in center of Iran: results of disability-adjusted life years (DALYs).

The outbreak of COVID-19 disease is an international public health concern. Therefore, the analysis of information related to mortality and disability due to COVID-19 is considered important, so the present study was designed and conducted with the aim of assessing COVID-19 Disability-Adjusted Life Years (DALYs) in Yazd. In Yazd province, all suspected cases of COVID-19 that would be referred to central hospitals in order to get confirmed through PCR or CT scan test, were recruited to our study. The fatality data of COVID-19 was gathered from the forensic medicine organization. The Disability-Adjusted Life Years (DALYs) combines in one measure years of life lost (YLL), the loss of healthy life due to premature mortality and years of life lived with disability (YLD), the loss of healthy life because of disease and disability. The total burden of COVID-19 was 23,472 years. The number of years lost due to premature death was 23385 and the number of years of life with disability due to COVID-19 was estimated to be 87 years. The disease burden was 12992 years for men and 10480 years for women. The overall incidence of COVID-19 was 1411 per 100,000, of which 1419 in men and 1402 in women per 100,000. The outbreak of COVID-19 pandemic affected a large population and the residents of Yazd Province lost many years of their lives due to this disease.

Monitoring of Essential and Toxic Elements in Leaves, Branches, and Stem of Prosopis cineraria (as Anti-Inflammatory) Growing in Iran.

Prosopis cineraria is locally grown which scientific literature present evidence for its anti-inflammatory effect. Monitoring the content of toxic elements is one of the most important aspects to consider medicinal plants' safety before evaluating the pharmaceutical use. The aim of present study was to investigate the level of essential and toxic elements in the leaves, branches, and stem of Prosopis cineraria to assess its health risk. Samples were collected around Bandar Abbas, washed several times, and dried in air for 2 weeks. The dried samples were chopped with stainless steel knife to small pieces and powdered by electrical mortar. Some physical and chemical properties of samples were investigated by chemical methods. Samples were ashed by a programmable electric furnace at 650 °C for 6 h. Then samples were dissolved in 30% HNO3, and the content elements of each sample were determined by inductive coupled plasma optical emission spectrometer (ICP-OES). The tests quality control and the measurement uncertainty were checked through the analysis of certified reference materials of SRM 1515 from NIST and solution standards. Correlation analysis of the obtained results showed a significant difference between leaves, branches, and stem of Prosopis cineraria so that the stem had the high essential and low toxic elements ones in comparison to other parts. The results revealed that the Prosopis cineraria stem is meeting health standards regarding the studied toxic metals.

Isolation and Molecular Identification of Leishmania spp. Agents in Patients with Cutaneous Leishmaniasis in Yazd Province, Endemic Region of Central Iran.

BACKGROUND: Cutaneous Leishmaniasis (CL) is a major health problem in many parts of Iran. Many methods have been introduced for detection and identification of Cutaneous Leishmaniasis. The purpose of this study was isolation and molecular identification of Leishmania spp. agents in patients with CL from endemic region of central Iran. In this study, one of the main loci of central Iran named Yazd will be assessed CL identification using PCR-RFLP. METHODS: For this cross-sectional study, sampling was done from 372 suspicious patients with CL who referred to Health Centers of Yazd Province from 2016 to 2017. After collection samples of patients, DNA extraction was done from samples on slides. Genus detection was done using specific primers by PCR. RFLP analysis was done for species identification. RESULTS: Out of 372 samples, 159 samples were positive using PCR based method. Out of 159 samples, 87 (54.7%) L. major and 72 (45.3%) L. tropica were identified using RFLP analysis. The number of lesions in each patient was different but 119 (74.8%) patients showed the number of 1-3 lesions, and more lesions (more than 10 lesions) was showed in 4 (2.5%) person. CONCLUSION: The CL found in Yazd province resulted from L. major and L. tropica as the agents of rural and urban types, respectively. The prevalence of L. major and L. tropica was almost the same. This indicated that control programs could be designed for treatment and vector and reservoir control.

Population attributable risk of risk factors for type 2 diabetes; Bayesian methods.

OBJECTIVE: Demonstrating the risk factors of diabetes can help to plan for prevention of this disease. This study aimed at quantification of the impact of physical activity, hypertension, general obesity, central obesity, high cholesterol, HDL, LDL, triglyceride, smoking, hookah, drug use, alcohol consumption on the incidence of type 2 diabetes at a population level in Yazd, Iran. And this study calculated population attributable risk (PAR) of them. METHODS: For this study, data from the first phase of the cohort study of chronic diseases in the adults of Yazd city were used, which began in 2016. Data was recorded through a cohort trained team. To calculate PAR and its the Bayesian confidence interval were performed using software R (version 3.4.3). RESULTS: Of the 9967 subjects studied, age ≥30, 14.67% (n = 1432) has type 2 diabetes. The most common risk factors for diabetes were Inadequate physical activity and central obesity (WHR). The PAR for Inadequate physical activity of diabetes in women was 17.92%, in men 18.53, And PAR for WHR in women was 57.62%, in men 43.03. CONCLUSIONS: In this study, age was the strongest determinant of diabetes. And then type 2 diabetes is mainly attributable to WHR, significantly more so in women than men. Therefore, central obesity probably should be considered as a major strategy for reducing incidence of type 2 diabetes.

Environmental and behavioral determinants affecting the association of airway macrophages carbon load with distance to major roads and traffic density.

Biomarkers are promising indicators to evaluate human exposure to air pollutants and to predict the health outcomes. Area of Airway macrophages that is occupied by Black Carbon could be used as a biomarker of personal long term exposure to traffic related air pollution. Association of airway macrophages carbon load with weighted average distance and environmental and subject-specific behavior are considered in this study. Sputum samples were taken from 160 healthy adult women and airway macrophages carbon load (AMCL) were determined in 93 subjects, which represent a success rate of 62% in sputum induction. Nearest distance of the subjects to major roads and average weighted distance were calculated for each subject. A questionnaire was field according to general and behavioral characteristics of the participants. There was not any significant difference (P-value >0.05) between induced and non-induced subjects. Subjects with indoor kitchen without separation wall, passive smokers and those with longer presence time in high traffic streets showed higher carbon area. Weighted average distance had a better association (ß = -0.186, 95%CI: -0.139, -0.230, P-value = 0.00) with AMCL than nearest distance to major roads (ß = -0.155, 95%CI: -0.109, -0.201, P-value = 0.19). Association of Weighted average distance with AMCL was interrupted in subjects with a garage connected to house environment, those with IK kitchen, those with a hood above the stove and passive smokers. The findings indicated that more generation and distribution of indoor air pollutants can completely enhance the internal exposure and indoor pollution has the same importance as outdoor pollution.

Air pollution and telomere length in adults: A systematic review and meta-analysis of observational studies.

Telomere length (TL) has been suggested to be a surrogate for cellular ageing, and a record of cumulative inflammation and oxidative stress over life. An emerging body of evidence has associated exposure to air pollution to changes in TL. To date there is no available systematic review of literature on this association. We aimed to systematically review and conduct meta-analysis of published studies on the relationship between air pollution and TL in adults. Electronic databases were systematically searched for available English language studies on the association between air pollution and TL published up to 1 July 2018. Meta-analyses were conducted following MOOSE guidelines. The heterogeneity in the reported associations was assessed using Cochran's Q test and quantified as I2 index. Publication bias was assessed using Egger's regression. Our search identified 19 eligible studies including 11 retrospective and eight prospective studies of which, four had excellent quality, ten had good quality and five had fair quality. Meta-analysis result of two studies on long-term exposure to PM2.5 showed an inverse association between these exposures and TL (for 5 µg/m3 PM2.5-0.03 95% CI; -0.05, -0.01). Meta-analysis of short-term exposure to PM2.5 with three studies and Polychlorinated Biphenyls (PCBs) with two studies revealed a direct association between these exposures and TL (0.03 95% CI; 0.02, 0.04 and 0.10 95% CI; 0.06, 0.15 respectively). No statistically significant relationship between exposure to PM10 and polycyclic aromatic hydrocarbons (PAHs) exposure and TL were observed. We observed suggestive evidence for associations between air pollution and TL with potentially different direction of associations for short- and long-term exposures.

The Association between Adverse Events in the Last 5 Years and the Rate of Breast Cancer.

BACKGROUND: This study was conducted in Yazd Province, Central Iran aimed to investigate the relationship between adverse events and breast cancer during 2012-2014. METHODS: Hospital-based case-control study of 150 women with breast cancer and 150 healthy women (did not have breast cancer) was conducted. Sampling was performed in the form of accessibility. Data collection was conducted using questionnaire through interview. The collected data were entered into SPSS for statistical analysis. RESULTS: The mean age of participants was 51.58 yr. Eight percent of cases and 1.3% of the controls had experienced the sister's death over the past 5 yr, this difference was statistically significant (P=0.03). Factors such as disability due to illness, divorce, unemployment, the second marriage, addiction, ill spouse, child's problems (such as conflict, unemployment, addiction, legal troubles, illness), taking care of their own parents or their husband's parents, migration, change of habitat, loss of home, communication problems, job-relevant factors were not significantly different between the two groups (P>0.05). Mean of severity of adverse events in both groups was significantly different (8.92±8.29 in the case group, 5.72±5.6 in the control group) (P=0.000). CONCLUSION: There was no significant relationship between adverse events in the last 5 yr and the risk of breast cancer. Factors such as personality and ability to cope with problems may positively influence this relationship.

Environmental determinants of polycyclic aromatic hydrocarbons exposure at home, at kindergartens and during a commute.

The aim of this study was to assess the potential health risk of exposure to polycyclic aromatic hydrocarbons (PAHs) at home and kindergarten for pre-school children. The urine samples were taken from 200 pre-school children aged 5-7 years and analyzed for 1-OHP as a biomarker of PAHs. Mixed effect models were applied to investigate the association between effective environmental parameters (mode of transport, distance to major roads, traffic density, greenness, tobacco exposure, home ventilation, and grill foods) and urinary 1-OHP levels. A Monte-Carlo simulation technique was applied to calculate the risk of exposure to PAHs and to check the uncertainty of input variables and the sensitivity of the estimated risk. The median and inter quartile range (IQR) of 1-OHP was 257 (188.5) ng L-1. There was a positive significant association between distance from the kindergartens to the green space with surface area ≥5000 m2 and 1-OHP concentration (ß = 0.844, 95% CI: 0.223, 1.46, P-value = 0.009). Also, urinary 1-OHP was found to be inversely associated with the time the window was open at the home (ß = -12.56, 95% CI: -23.52, -1.596, P-value = 0.025) and normalized difference vegetation index (NDVI) in a 100 m buffer around the homes. The mean (9.76 E-3) and 95th percentile (3.28 E-2) of the hazard quotient (HQ) indicated that the concentration of urinary 1-OHP is at a safe level for the target population (HQ < 1). According to the sensitivity analysis results, the concentration of 1-OHP is the most influential variable in the estimated risk. Our findings indicated that the proximity of homes and kindergartens to green space areas and their remoteness from the main streets and heavy traffic areas are associated with reduced exposure to PAHs.

Occupations and the Risk of Bladder Cancer in Yazd Province: A Case-Control Study.

BACKGROUND: Bladder cancer is the most common cancer of the urinary tract, with known occupational causes. The most effective way to prevent occupational cancers of the urinary tract is to prevent exposure to known carcinogens. OBJECTIVE: To examine the relationship between occupation and the risk of bladder cancer. METHODS: This case-control study was performed on 200 patients with bladder cancer and 200 healthy individuals in Yazd. Data were collected using a researcher-made questionnaire and based on interviews with patients and controls. RESULTS: The mean age of cases and controls were 61.5 (SD 13.6) and 61.5 (13.3) years, respectively. Level of education, type of occupation, family history of bladder cancer in the first-degree relatives, and history of chronic and recurrent urinary tract infection, kidney and bladder stones, and using hair dye, were considered the main predictors for bladder cancer. CONCLUSION: There was a significant difference between cases and controls in terms of type of occupation. The risk of bladder cancer was higher among those working in high-risk occupations-metal working, textile, driving, farming, and construction.

Effects of rhubarb (Rheum ribes L.) syrup on dysenteric diarrhea in children: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Rheum ribes L. is a plant native to China, Iran, Turkey, India, and a few other countries. Antidiarrheal activity is considered to be one of its important properties according to various systems of traditional medicine. An increasing rate of bacterial resistance to antibiotics has led to treatment failure in some cases of shigellosis in children, and underlines a need for safe, efficient and valid options. OBJECTIVE: The purpose of this study is to evaluate the efficacy of R. ribes syrup as a complementary medicine for treatment of shigellosis in children. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This randomized, double-blind, placebo-controlled trial started with a group of 150 children aged between 12-72 months with suspected Shigella dysentery. R. ribes syrup or placebo syrup was administered to the intervention and control groups, respectively for 5 days. In addition, the standard antibiotic treatment (ceftriaxone for the first 3 days and cefixime syrup for 2 further days) was administered to both groups. MAIN OUTCOME MEASURES: Body temperature, abdominal pain, need for antipyretics, defecation frequency, stool volume and consistency and microscopic stool examination were recorded as outcome measures. Any observed adverse effects were also recorded. RESULTS: Mean duration of fever and diarrhea in the R. ribes group was significantly lower than that in the placebo group (P = 0.016 and 0.001, respectively). In addition, patients in the R. ribes group showed shorter duration of need for antipyretics and shorter duration of abdominal pain (P = 0.012 and 0.001, respectively). However, there were no significant differences between the two groups regarding the microscopic stool analyses. Furthermore, no adverse effect was reported. CONCLUSION: R. ribes syrup can be recommended as a complementary treatment for children with Shigella dysentery. TRIAL REGISTRATION: Iranian Registry of Clinical Trial: IRCT2014070518356N1.

PREVALENCE OF OCCULT HEPATITIS B INFECTION IN IRANIAN CANCER PATIENTS BEFORE CHEMOTHERAPY TREATMENT.

BACKGROUND: Occult hepatitis B infection is characterized by negative hepatitis B surface antigen (HBsAg) and also detectable hepatitis B virus (HBV) -DNA, with or without hepatitis B core antibody (anti-HBc). HBV reactivation in individuals under immunosuppressive therapy is critical, occurring in occult HBV. OBJECTIVE: In this study, we aimed to determine the prevalence of occult HBV infection among hepatitis B surface antigen negative in cancer patients before receiving chemotherapy. METHODS: Sera from 204 cancer patients who were negative for HBsAg, were tested for anti-HBc antibodies. The samples that were negative for HBsAg but positive for anti-HBc also examined for HBV-DNA by polymerase chain reaction (PCR). RESULTS: Of the 204 HBsAg negative blood samples, 11 (5.4%) samples were positive for anti-HBc antibodies. HBV-DNA was detected in 9/11 (81%) of anti-HBc positive samples. Occult HBV infection in hematological cancers was more than solid cancers, 4.8% and 4.3% respectively. There was no significant difference in HBc antibody positivity based on vaccination, previous blood transfusions, history of familial hepatitis or biochemical parameters (ALT, AST, total and direct bilirubin levels) (P>0.05). CONCLUSION: Screening of occult HBV infection by HBsAg, HBV DNA and anti HB core antibody should be suggested as a routine investigation in cancer patients before receiving chemotherapy.