[Association between healthy lifestyle score and upper gastrointestinal disorders in Iranian adults]

Background and Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders [FGIDs], there is no epidemiologic data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia [FD], its symptoms and gastro-esophageal reflux disease [GERD] in a large group of Iranian adults

Methods: This descriptive -analytic study was conducted on 3363 Iranian adults [19-70 yr], whom were working in 50 health centers across Isfahan province in Iran during 2012. We used easy non-random sampling to select participants. The "healthy lifestyle score" for each participant was calculated by summing up the binary score given for five lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. A validated Persian version of ROME III questionnaire was used, to assess functional gastrointestinal disorders

Results: The prevalence of FD and GERD among study participants was 14.5 and 23.6%, respectively. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD [95% CI: 0.05-0.92, OR: 0.21, P=0.03] and GERD [95% CI: 0.09-0.69, OR: 0.26, P=0.01], respectively, compared with those with the lowest score. They were also less likely to have early satiation [95% CI: 0.11-0.73, OR: 0.28, P=0.001], postprandial fullness [95% CI: 0.09-0.50, OR: 0.22, P<0.001] and epigastric pain [95% CI: 0.21-0.92, OR: 0.44, P=0.03]. In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits and non-smoking were separately associated with FGIDs [P<0.05]

Conclusion: This study showed that adherence to a healthy lifestyle was associated with lower odds of GERD, FD and its symptoms in this group of Iranian adults. Individual lifestyle-related factors were also associated with these conditions

[ relationship between dietary diversity score and obesity in Tehranian adults: a case-control study]

Introduction: The aim of current study was to compare dietary diversity score [DDS] among obese, overweight and normal-weight Tehranian adults

Materials and Methods: This was a casecontrol study conducted on 200 cases [100 obese and 100 overweight] and 300 controls, all aged over 18 years with [normal-weight matched by socioeconomic status], in Tehran. The study was based on self-administered questionnaires, including a 168-item semi-quantitative food frequency questionnaire [FFQ], a simple self-report physical activity questionnaire and a sociodemographic questionnaire. DDS was computed based on the scoring of the five food groups of the United States Department of Agriculture [USDA] food guide pyramid according to the Kant et al method. Anthropometric measurements including height, weight, waist and hip circumferences were measured and body mass index [BMI] and waist-to-hip ratio [WHR] were calculated

Results: Mean DDS in obese [5.65 +/- 1.32] was higher than in overweight participants [5.23 +/- 1.23] and that of overweight participants was higher than normal-weight ones [4.97 +/- 1.42], [P<0.001]. The odds of obesity increased with increase of each one unit of DDS [OR,1.46; 95%CI,1.22-1.74] and slightly weakened after adjusting for age, sex, marital status, smoking, socioeconomic status, physical activity and energy intake [OR,1.34; 95%CI,1.07-1.68]

Conclusion: There was a significant positive association between DDS and obesity among Tehranian adults, emphasizing the need for more investigations to recommend increasing dietary diversity to improve health in adults

[Relation between pattern of nutrient intake and obesity in Isfahanian Adults: SEPAHAN study]

Background and Objective: The growing evidence suggest on the association between dietary patterns and obesity. This study was done to determine the relation between pattern of nutrient intake and obesity in Isfahanian adults

Methods: In this descriptive - analytical study, dietary data were collected using a semi-quantitative food frequency questionnaire in 8,691 subjects aged 18-55 years. Complete data of 6,724 and 5,203 adults were available for general and abdominal obesity, respectively. Daily intakes of 38 nutrients and bioactive compounds were calculated for each participant. Factor analysis was applied to derive major nutrient patterns

Results: Three major nutrient patterns were identified: 1] pattern high in fatty acids, cholesterol, vitamin B12, vitamin E, zinc, choline, protein, pyridoxine, phosphorus, and pantothenic acid; 2] high in thiamine, betaine, starch, folate, iron, selenium, niacin, calcium, and manganese; and 3] high in glucose, fructose, sucrose, vitamin C, potassium, dietary fiber, copper and vitamin K. Men in the highest quintile of the second pattern were less likely to be generally obese in the fully adjusted model [95% CI: 0.20-0.76, OR: 0.39, P<0.05]. After adjustment for potential confounders, a significant positive association was observed between the third pattern and general obesity among men [95% CI: 1.04-3.04, OR: 1.77, P<0.05], but it was not in women [95% CI: 0.74-1.88, OR: 1.18, P>0.05]

Conclusion: Nutrient patterns were significantly associated with general, but not abdominal obesity in the male Iranians participating in SEPAHAN study

[Effect of diagnostic and treatment factors on growth development of children with congenital hypothyroidism: a prospective longitudinal study]

Introduction: no study has yet been conducted evaluate the factors influencing the growth of patients with congenital hypothyroidism [CH], in Iran. The high prevalence of this disease in Iran, particularly in Isfahan, made it necessary to investigate biomedical diagnostic and early treatment factors potentially affecting growth status among patients with CH

Materials and Methods: in this prospective cohort study, 760 CH neonates [born 2002-2010], diagnosed and followed up [minimum 1, maximum 5 years] during the CH screening program in Isfahan were enrolled. Height, weight and head circumferences of the patients, during follow up and in subsequent periods, were measured. Diagnostic and therapeutic factors included serum T4 and TSH concentration at diagnosis and after treatment initiation, age at onset of therapy, initial dosage of levothyroxine and age at first normalization of T4 and TSH. Quantile regression for longitudinal data was used for investigating the effects of main factors determining growth development. R free software was used for analyzing data

Results: longitudinal growth in height and weight was significantly correlated with age at onset of therapy and initial dosage of treatment [p<0.01], while head circumference was associated only with initial dosage [P<0.05]. Increase in weight and head circumference were affected by serum TSH concentration at diagnosis [p<0.05], and age of T4 normalization also had significant impact, on some of the proposed quantiles, i.e. weight [p<0.05], height [p<0.01] and head circumference [p<0.001]

Conclusion: among the factors studied, initial dosage of treatment and age at onset of therapy seem to be more important factors for growth development, suggesting that more optimal outcomes are possible through earlier treatment and appropriate levothyroxine dosage

[ effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy]

The goal of this study was to determine the effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy. This study was a randomized clinical trial performed as a pre-post, double blind study. It was performed on 25 children with hemiplegia and diplegia [2-8 years] in Tehran city, who were referred to valiasr rehabilitation foundation. Participants were chosen by simple randomized sampling and were matched for age, Gross Motor Function Classification System [GMFCS] and type. They were randomly divided into two groups. The first group [n=13] underwent BTX-A injection alone and the second group [n=12] had BTX-A injection and foot serial casting after the injection. Clinical assessments were done using the GMFCS and Modified Ashworth Scale before and at 1, 3, 6 and 12 months after the interventions. Data were analyzed by Wilcoxon signed rank test and mann-whitney U. Comparison of two groups in regard to the right and left knee spasticity at, 1, 3, 6 and 12 months after injection showed no significant difference in comparison to those before interventions. Furthermore, comparison of right and left ankle spasticity before injection with that at 1, and 3 months follow ups did not show statistically significant difference, but significant differences were found when compared with 6 and 12 month follow-ups [P<0.05] It seems, one of the proper approaches to reduce spasticity in children with cerebral palsy is foot serial casting along with botulinum toxin type-A injection and it can decrease the muscle tone when applied more than six months

[Parents' worries about life problems of adolescent girls with diabetes: a qualitative study]

Parents participation in management of diabetes has been recognized to be beneficent. Recognizing parents' worries should be addressed to plan effective health promoting programs. This study aimed to explore parents' worries about life problems of adolescent girls with diabetes. In this qualitative study, 26 parents [16 mothers and 10 fathers] of adolescent girls with type 1 diabetes were recruited using purposive sampling from the Diabetes Society in west Azerbaijan. Data were collected using in-depth and semi-structured interviews. Analysis of the transcripts was guided by qualitative content analysis. Qualitative content analysis demonstrated three original categories from parents' worries: 1] worries about the future; 2] worries about the treatments; and 3] worries about the society. Better perception of parents' concerns may promote effective communication between health professionals and parents. Modification of parents' personal control and perceived threat through appropriate educational programs that acknowledge and address their concerns may be a means of empowering parents

[Effect of Echinacea purpurea dried extract effect on producing antibody from newcastle disease vaccine in broilers by HI test]

Newcastle disease is one of the most important causes of economic losses in the poultry production and can he resulted in high mortality. Antibody detection is also an important tool for assessment of the immunity against the disease. In the present study a trial was conducted to evaluate the effect of an immune stimulator[Echinacea purpurea] on antibody production against Newcastle disease vaccine. 450 one day old broiler chicks were divide into five groups of three repeat each. For three weeks from day one various doses of Echinacea purpurea extract was prescribed to four treatment groups and to the fifth group placebo in water was prescribed. All groups were vaccinated on days:11, 19, 38. Subsequently. serum samples were collected at days 10. 25, 34.52 of post vaccination from 21 chicks of each group [4 samples of each repeat] and were tested for Newcastle antibody titers by HI test. This experiment showed that the use of Echinacea purpurea extract with the rate of 29, 75Mg per kilo body weight per day had better effects on antibody titers and significantly increased between control group arid treatment groups [p<0.01]. It is also revealed that the use of Echinacea purpurea induces FCR improvement and mortality rate was decreased significantly [p<0.01]

[Incidence rate of acute reactions in transfusion of blood and its products prepared by Urumia Blood Refinery Center]

"Blood transfusion is one of essential and important but dangerous parts of today's medicine in which if appropriate measures have not been done, fatal reactions may occur. Acute hemolytic reactions, febrile reactions, and allergic reactions are among the most important and most prevalent transfusion reactions that happen shortly after its beginning and can lead to considerable mortality and morbidity. The aim of this descriptive study was to investigate the prevalence of acute reactions of blood and its products prepared by Urumia Blood Refinery Center. 3880 blood product units transfused to 1261 patients were studied by convenience sampling method. Various instruments and methods such as sphygmomanometer, thermometer, urine analysis, interview and observation were used for data gathering. Collected data were documented in special forms designed for this purpose. Descriptive statistics were used for data analysis. Among the blood recipients, 604 were female and 657 were male. The most frequent complaints of patients were coldness [22.5%], pruritus [20.1%] and chills [18.1%]. The prevalence of acute hemolytic reaction, febrile reaction and allergic reactions were 0.52, 6.2 and 11.1 per 1000 transfusions respectively. In spite of improved blood refinement techniques, acute transfusion reactions can lead to significant morbidity and mortality. Therefore, physicians', nurses' and midwives' meticulous attention to early symptoms and signs of acute reactions to transfusion of blood and its products have an important role in preventing adverse outcomes of this life-saving remedy

Epidemiology of burn injuries in west Azerbaijan province, western Iran

Burn injuries are in many respects the most of all tragedies an individual can experience. So there was an attempt to quantify the frequency of burn injuries, identify the risk and predisposing factors, determine the health outcomes at Imam Khomeini Hospital in Urmia, westen Iran. From March 2005 to March 2006, all demographic and epidemiological information of 639 patients [48.36% female and 51.64% male] about the burns and the complications were provided from the records of patients at Imam Khomeini Hospital in Urmia, Western Azarbaijan Province, westen Iran. The incidence rate of burn hospitalization was 21.6 per 100.000. Almost 31.8% of admissions were in the 16-25 years age group. Pediatric [<5 years] and geriatric [> 65 Years] burns were [21.6%] and [3.2%], respectively. Burning with flame, the most common cause of burning, accounted for 36.4% of admissions in males and for 43.6% in females. The mortality rate was 25.9%. The percentage of patients who had more than 40% body surface area [BSA] burn was 30.9%. Patients with >40% BSA burn had a mortality of 76.7%. The mean BSA burn was 33.8% in males and 25.2% in females. Admissions from Urmia were the most among the cities of the province. The mean duration of hospitalization was 7.76 days. The most cases occurred from October 22 to November 22; 10.95%] and from Jun 21 to July 21; 9.54%]. The results of this study help to guide health care efforts towards the prevention of burn injuries and provide a valuable baseline for assessing future efforts directed toward the prevention of burn injuries

Fators responsible for compliance of medical treatment among compliant and non-compliant tuberculosis patients in Urmia, Iran

We studied factors responsible for compliance of medical treatment among compliant and non-compliant Tuberculosis [TB] patients referred to Urmia health centers in West Azarbaijan, Iran. This descriptive study included 82 Pulmonary TB patients [50 female and 32 male] aged between 15-65 years. The Integrated Model of Health Behaviors was used to elicit information related to factors responsible for compliance of medical treatment among these patients. The questionnaire included 8 parts and consisted of 53 questions. It evaluated socio-demographics and 5 components [Knowledge, cues, health beliefs, self- efficacy and social support] in TB patients. The data was analyzed by SPSS software. Sixty-three percent complied with treatment. There was a significant differences between compliance and health beliefs and self- efficacy [p < 0.001]. On the contrary, there were no significant differences between knowledge and socio-demographic characteristics and compliance of treatment The compliant patients had a good self-efficacy and health beliefs as compared to non compliant TB patients

Detection of N-RAS gene mutations in codons 12, 13 and 61 in patients with acute myeloid leukemia

Acute myeloid leukemia [AML] comprises a heterogenic group of malignant disorders involving cell maturation arrest at an undifferentiated stage in bone marrow. Activation of N-RAS proto-oncogene due to point mutations plays a major role in AML malignancy. Since there was no report on the frequency of N-RAS gene mutations in Iranian AML patients, therefore, we decided to determine its frequency and compare the results with age, sex and FAB subtypes. In this descriptive study, 60 de novo AML patients from Tehran Shariati hospital, hematology-oncology and bone marrow transplantation center were screened for the mutations of N-RAS gene at codons 12, 13 and 61. DNA was extracted from peripheral blood samples before the start of chemotherapy. The above mentioned codons were amplified by PCR and analyzed by restriction endnuclease enzymes. We were able to detect mutations in 12 out of 60 [20%] patients. Most of the mutations were detected in men with an age over 40 years old. The frequency of mutations for codons 12, 13 and 61 were 15%, 11.6% and 5% respectively. Most of the mutations [33.3%] were found to happen in AML-M4 FAB subtype. We could not detect any mutation in AML-MO, M6 and M7. We detected mutations in 20% of our AML patients. In general, the frequency of the mutations we found was in agreement with the results of other studies. However, a study with more patients and a wider range of age using a combination of PCR-RFLP and direct gene sequencing is highly recommended

[Contamination of drinking water with arsenic and its various health effect in the village of Ghopuz]

Arsenicosis is a serious environmental disease caused by chronic exposure to arsenic- usually from drinking water. Signs and symptoms of chronic arsenic poisoning include hyperkeratosis, hyper- or hypopigmentation, and ulcers. Also, the incidence of cancer is increased in the exposed population. There is some evidence of high arsenic levels in drinking water in the village of Ghopuz, located in Hashtrud District, East Azerbaijan province. We evaluated the genetic and health effects of chronic arsenic exposure in the residents of Ghopuz. In this cross-sectional study we determined the prevalence of hyperkeratosis, hyperpigmentation and hypertension in Ghopuz village. The study involved 101 individuals in Ghopuz and 107 in the adjacent village of Mayan, who were all visited by a trained physician. A total of 46 blood samples were collected for kariotyping. The level of heavy metals in water was determined by the Inductively Coupled Plasma [ICP] method. We detected high arsenic levels in the drinking water at Ghopuz [mean concentration in water = 1.03 mg/L]. There were chromosomal defects in the exposed group. Mean systolic blood pressure at Ghopuz [137mmHg, 95% CI: 132-142] was significantly higher than in Mayan [107, 95% CI: 99.9-114]. Also, mean diastolic blood pressure at Ghopuz [82, 95% CI: 79-85] was significantly higher than in Mayan [71, 95% CI: 66-75]. Hyperkeratosis was 34 times more frequent in the exposed population [OR = 34, P< 0.001]. Also, hyperpigmentation was significantly more frequent in the exposed population [OR = 2.4, P < 0.007]. Water arsenic and nitrate levels at Ghopuz were higher than the maximum permissible levels. The prevalence of skin lesions and hypertension is increased at Ghopuz village due to arsenic exposure. There is also some evidence of chromosomal defects in the exposed group. Affected people need appropriate medical care, and safe drinking water should be provided to reduce arsenic exposure

[Congenital obstructive anomalies of anterior urethra; diagnostic methods]

Radiological findings of ten patients with congenital obstructive anomalies of anterior urethra [eight cases with saccular diverticula, one case with globular dilatation of entire urethra, and one case with globular dilatation of distal urethra] showed that the VCUG and retrograde urethrography were diagnostic in all of patients