Inhibition of dipeptidyl peptidase IV by fexofenadine: Virtual screening study

Dipeptidyl peptidase IV (DPP IV) is relatively new anti-diabetic target. DPP IV inhibitors lower fasting andpostprandial glucose concentrations by preventing the degradation of the natural hypoglycemic incretin hormones:glucose-dependent insulinotropic peptide and glucagon-like peptide-1. In this work, the high throughput dockingsoftware FRED was used as a virtual screening tool against in house built drug database to discover new DPP IVinhibitors. One of the highest ranking hits, the antihistamine drug fexofenadine, was found to inhibit recombinanthuman DPP IV in vitro with IC50 = 4.6 (±1.0) µM. The anti-diabetic effect of fexofenadine was validated in vivo byoral glucose tolerance test. These results could be helpful in the development of novel DPP IV inhibitors based onfexofenadine scaffold for the treatment of type 2 diabetes.

Quality of the clinical laboratory department in a specialized hospital in Alexandria, Egypt

Assessment and improvement of turnaround times [TAT] as well as customer satisfaction is essential for laboratory quality management. This study in a specialized hospital in Alexandria, Egypt measured the current TAT for outpatient department bilirubin samples and evaluated the satisfaction of physicians with aspects of clinical laboratory services. While the mean TAT for 110 bilirubin tests [58.1 [SD 31.8] min] was within the College of American Pathologists' benchmark, the 90th percentile was long [96.7 min]; 62.7% of tests were reported within 60 min. The mean overall satisfaction score of physicians [range 1-5] was 3.46 [SD 0.49]. The highest satisfaction rating was for staff courtesy while the lowest ratings were for laboratory management responsiveness, outpatient stat TAT and critical value notification. Quality or reliability of results was judged by physicians as the most important factor [32.3%], followed by routine test TAT [18.5%]. Further analysis of the different steps of the TAT would be helpful and follow-up through examining outliers is recommended

Analysis of familial aggregation, co-aggregation and association within person of myopia and four phenotypes of astigmatism based on a conditional model: tehran eye study

Background: To determine the familial aggregation, Coaggregation and within person association of myopia and four phenotypes of astigmatism by a conditional model in Tehran Eye Study

Materials and Methods: Myopia, Total, ATR, WTR and oblique astigmatism were studied through a population based, cross sectional study in 1326 siblings older than 5 years from 531 families with 2-4 siblings using stratified cluster random sampling from August to December 2002 in Tehran Eye Study

Results: Based on the conditional model and via Proc GENMOD SAS 9.1, the conditional odds ratios [95% confidence interval], that indicates conditional familial aggregation, for the total, WTR, ATR and oblique astigmatism and myopia were 1.16 [1.01-1.33], 1.59 [1.17-2.16], 1.77 [1.39-2.26], 2.12 [1.41-3.19] and 1.96 [1.72-2.24], respectively .On the other hand, conditional odds ratios that indicates within person association of two disease, for myopia and WTR, myopia and ATR, myopia and Oblique and at last myopia and total astigmatism were 5.74 [3.99-8.17], 3.41 [2.01-5.82], 4.6 [2.15-9.86] and 6.10 [4.76-7.82], respectively. Although no significant familial co-aggregation has been identified

Conclusion: Based on conditional model and after controlling for the confounders, this analysis yielded, a significant aggregation of four phenotypes of astigmatism and myopia, a large within person association and moderate but non-significant coaggregation of these disorders

Multiple imputation to deal with missing clinical data in rheumatologic surveys: an application in the WHO-ILAR COPCORD study in Iran

The aim of the article is demonstrating an application of multiple imputation [MI] for handling missing clinical data in the setting of rheumatologic surveys using data derived from 10291 people participating in the first phase of the Community Oriented Program for Control of Rheumatic Disorders [COPCORD] in Iran. Five data subsets were produced from the original data set. Certain demographics were selected as complete variables. In each subset, we created a univariate pattern of missingness for knee osteoarthritis status as the outcome variable [disease] using different mechanisms and percentages. The crude disease proportion and its standard error were estimated sgscrately for each complete data set to be used as true [baseline] values for percent bias calculation. The parameters of interest were also estimated for each incomplete data subset using two approaches to deal with missing data including complete case analysis [CCA] and MI with various imputation numbers. The two approaches were compared using appropriate analysis of variance. With CCA, percent bias associated with missing data was 8.67 [95% CI: 7.81-9.53] for the proportion and 13.67 [95% CI: 12.60-14.74] for the standard error. However, they were 6.42 [95% CI: 5.56-7.29] and 10.04 [95% CI: 8.97-11.11], respectively using the MI method [M=15]. Percent bias in estimating disease proportion and its standard error was significantly lower in missing data analysis using MI compared with CCA [P< 0.05]. To estimate the prevalence of rheumatic disorders such as knee osteoarthritis, applying MI using available demographics is superior to CCA

[Factors affecting time to pregnancy, Kermanshah, Iran, 2011]

The time needed to achieve a wanted pregnancy is referred to as time to pregnancy [TTP]. Due to differences in lifestyles and geographical locations in different countries, factors affecting TTP may be different in various countries. This study was conducted in 2011 to determine factors affecting time to TTP in Kermanshah, Iran. In this case-control study 174 women with TTP>12 months [cases] and 587 women with TTP/= high school diploma; OR=0.854, CI 95%=0.741-0.984], frequency of intercourse in a week [OR=0.728, CI95%=0.631-0.839], blood group A compared to O [OR=0.639, CI95%=0.405-1.01], and non-exposure to smoking [OR=0.606, CI95%=0.380-0.965]. On the other hand, factors increasing TPP were a woman's irregular menstrual cycle [OR=3.701, CI95%=2.127-6.441], lack of physical activity [OR=1.920, CI95%=1.263-2.918] and a body mass index [BMI] higher than 25 [OR=2.221, CI 95%=1.489-3.312]. According to the results of this study, a high BMI and lack of exercise increase, while factors such as frequency of intercourse decrease the length of TTP. Couples seeking medical intervention for pregnancy often disregard factors associated with TTP. It is recommended that care-providers support these couples, promote their awareness, and give them suitable advice

familial aggregation of cigarette smoking in Kish, Iran

Based on WHO reports, smoking is an epidemic in developing countries. One of important issues about this behavior is its distribution pattern in family members. The main purpose of this study was to evaluate if cigarette smoking had a tendency to cluster or aggregate in the families and what the determinants were. Using a multi-stage random cluster sampling approach, a household survey was conducted in Kish Island in 2009. We used the Alternating Logistic Regressions algorithm to model to show the familial aggregation. The odds ratio for the aggregation of cigarette smoking between family members was 1.63 [1.29-2.06] which increased to 1.96 [1.50-2.55] after adjustment for demographic factors. There was no significant correlation between siblings' cigarette smoking nor was between spouses but the pairwise odds ratio for parents offspring was significant. In other words, cigarette smoking in at least one of the parents increased the odds of being a smoker in offspring significantly. The study showed that the smoking behavior aggregated in families significantly. The inter-parent offspring aggregation was the main component of the familial aggregation. Higher education and age-gender interaction were determinants of smoking in the families. The programs for prevention and cessation of this behavior in the community might be more successful if they were designed in a family-based rather than an individual- based approach

Comparison of logistic regression and artificial neural network in low back pain prediction: second national health survey

The purpose of this investigation was to compare empirically predictive ability of an artificial neural network with a logistic regression in prediction of low back pain. Data from the second national health survey were considered in this investigation. This data includes the information of low back pain and its associated risk factors among Iranian people aged 15 years and older. Artificial neural network and logistic regression models were developed using a set of 17294 data and they were validated in a test set of 17295 data. Hosmer and Lemeshow recommendation for model selection was used in fitting the logistic regression. A three-layer perceptron with 9 inputs, 3 hidden and 1 output neurons was employed. The efficiency of two models was compared by receiver operating characteristic analysis, root mean square and -2 Loglikelihood criteria. The area under the ROC curve [SE], root mean square and -2Loglikelihood of the logistic regression was 0.752 [0.004], 0.3832 and 14769.2, respectively. The area under the ROC curve [SE], root mean square and -2Loglikelihood of the artificial neural network was 0.754 [0.004], 0.3770 and 14757.6, respectively. Based on these three criteria, artificial neural network would give better performance than logistic regression. Although, the difference is statistically significant, it does not seem to be clinically significant

Introducing a quantitative method to calculate the rate of primary infertility

In the previous studies, the rate of primary infertility was reported differently. It seems the main reasons are related to the different methods of data collection and information analysis. Therefore, introducing a precise method to determine the infertile couples and the population exposed to the risk of infertility is an important issue to study primary infertility. The proposed methodology for assessing primary infertility rate has been designed and applied by Avicenna Research Institute in a national survey. Sampling was conducted based on probability proportional to size cluster method. In this survey, after reviewing the former studies, the reproductive history was used as a basis for data collection. Every reproductive event was recorded with a code and a date in the questionnaire. To introduce a precise method, all possible events were considered thoroughly and for each situation, it was determined whether these cases should be considered in numerator, denominator or it should be eliminated from the study. Also in some situations where the correct diagnosis of infertility was not possible, a sensitivity analysis was recommended to see the variability of results under different scenarios. The proposed methodology can precisely define the infertile women and the population exposed to the risk of infertility. So, this method is more accurate than other available data collection strategies. To avoid bias and make a consistent methodology, using this method is recommended in future prevalence studies

Evaluation of a binary carrier system for the dissolution enhancement of a high dose poorly soluble drug

The role of two surface active carriers, Gelucire[registered] 44/14 and Lutrol[registered] F127, for improvement of solubility and dissolution of the high-dose, poorly water-soluble drug, albendazole, using solid dispersion approach was evaluated. The solubility of albendazole in solutions of the studied carriers and binary mixtures showed improvement, with solutions containing higher percentages of Lutrol[registered] F127 as best solvents. Albendazole was then incorporated in matrices made of either carrier alone or mixtures of the two carriers at different ratios using a melting procedure. The resulting particles were compressed into tablets. In vitro dissolution of particles and tablets showed fast dissolution. Increased wettability of albendazole by the carriers and formation of partial solid solutions of it in the carrier system were shown to be the mechanisms of the improvement in its dissolution

Chemical and biological studies of Kalanchoe pinnata (Lam.) growing in Bangladesh

Objective: To isolate compounds from K. pinnata and elucidate their structures and to explore preliminary antioxidant, antimicrobial, cytotoxic and thombolytic activities of extractives of the plant. Methods: The methanol extract of whole plant of K. pinnata has been subjected to different chromatographic separation and purification processes to isolate the secondary metabolites. The structures of the isolated compounds have been elucidated by extensive NMR studies. The free radical scavenging activity of the crude extract and its different Kupchan fractions were determined on stable radical DPPH. In vitro antimicrobial activity was determined by the disk diffusion method. Cytotoxicity screening has been performed against Artemia salina. Total phenolics content, membrane stabilizing activity and thombolytic activities were assessed by following established protocol. Results: The isolated compounds were identified as glut-5(6)-en-3-one, taraxerone, 3β-friedelanol, β-amyrin-3-acetate, 3,5,7,3',5'-pentahydroxyflavone and β-sitosterol. The chloroform soluble fraction showed potent antioxidant activity of (IC50=80.0 μg/mL) and significant cytotoxicity, while the crude extract demonstrated noticeable total polyphenol content (149.24 mg of GAE/gm of extractive), moderate membrane stabilizing activity and inhibition of clot lysis of blood. Conclusions: The obtained results rationalize the folkloric use of the plant and can be further investigated to isolate the active compounds responsible for the biological activities.

Iranian Azeri's Y-chromosomal diversity in the context of turkish-speaking populations of the Middle East

The main goal of this study was to conduct a comparative population genetic study of Turkish speaking Iranian Azeries as being the biggest ethno-linguistic community, based on the polymorph markers on Y chromosome. One hundred Turkish-speaking Azeri males from north-west Iran [Tabriz, 2008-2009] were selected based on living 3 generations paternally in the same region and not having any relationship with each other. Samples were collected by mouth swabs, DNA extracted and multiplex PCR done, then 12 Single Nucleotide Polymorphisms [SNPs] and 6 Microsatellites [MS] were sequenced. Obtained data were statistically analyzed by Arlequin software. SNPs and Microsatellites typing were compared with neighboring Turkish-speaking populations [from Turkey and Azerbaijan] and Turkmens representing a possible source group who imposed the Turkish language during 11-15[th] centuries AD. Azeris demonstrated high level of gene diversity compatible with patterns registered in the neighboring Turkish-speaking populations, whereas the Turkmens displayed significantly lower level of genetic variation. This rate of genetic affiliation depends primarily on the geographic proximity. The imposition of Turkish language to this region was realized predominantly by the process of elite dominance, i.e. by the limited number of invaders who left only weak patrilineal genetic trace in modern populations of the region

Survival of male breast cancer in Fars, south of Iran

Although breast cancer in men is uncommon, its incidence rates has an increasing trend. Due to its low incidence, there are few studies in this subject and limited information is available. The purpose of this study was to investigate clinicopathological characteristics and survival of male breast cancer [MBC] in Fars Province, south of Iran. The data for this study were obtained from the population based cancer registry of Vice-Chancellor for Health Affairs of Shiraz University of Medical Sciences and Shiraz hospitals between January 1, 1989 and January 1, 2008, including 64 patients with MBC. Demographic, clinical and pathological aspects were investigated. The Kaplan-Meler method was used for the determination of survival rate and Log Rank test for the comparison. The Cox proportional hazards model was used for the multiple analysis. The patients' mean age at the time of diagnosis was 60,3 years [SD=12.7]. The most frequent age group [26.6%] was 51-60 years. The most common symptom [96.8%] was a palpable mass. The majority of patients [44.4%] had a symptom duration of less than or equal to 6 months. 56.3% of the patients had a tumor size of 2-4.9 cm. Forty six percent of the cases had axillary lymph node involvement. The median survival time was 10.0 years [95% confidence interval [CI]: 6.0-14.0]. The 5 year overall survival rate was 66.0% [95% CI=51.08-81.0%]. The median survival time of patients with axillary lymph node involvement was 8.2 years [95% CI=6.7-9.6] and for the cases without involvement was 12.0 years [95% CI=8.4-15.2]. In addition to axillary lymph node involvement, positive family history in contrast to negative family history and left tumors in comparison with right tumors were poorer prognostic factors in univariate analysis respectively [p=0.006, p=0.031]. In multiple analysis, axillary lymph node involvement was an independent predictor of poorer survival [Hazard ratio=1.6, 95% CI=1.1-6.4, p=0.030] and the other variables did not have a significant effect. The mean age of MBC in this series is lower than that in western countries. It is compatible to the mean age of female breast cancer which is approximately one decade less than that in developed countries. The survival rate of MBC is relatively lower than that in western countries. Axillary lymph node involvement is an important prognostic factor in the survival of MBC. Multicenter population based studies with greater number of patients are required for better estimation of different aspects of MBC in Iran

In vitro xanthine oxidase inhibition by selected Jordanian medicinal plants

In the present study, 18 Jordanian medicinal plants were evaluated for their Xanthine Oxidase [XO] inhibitory potential. Their aqueous extracts, prepared from used parts, were tested in vitro, at 200 micro g/mL concentration, for their inhibition potencies expressed as% inhibition of XO activity. Five of the tested plants were found most active [% inhibition more than 35%] and their inhibition profiles [dose-dependent] were further evaluated by estimating the IC[50] values of their corresponding extracts. These plants were Hyoscyamus reticulates L. [IC[50] = 12.8 micro g/mL], Achillea fragrantissima [Forssk.] Sch. Bip. [197.6 micro g/mL], Pimpinella anism L., [300.4 micro g/mL]. Origanum syriacum L. [317.0 micro g/mL], and Origanum vulgare L. [403.9 micro g/mL]. Moreover, five more plants showed XO inhibitory activity in the range of 14-30%. Namely: Daphne linearifolia L. [29.5% inhibition], Hibiscus sabdoriffa L. [19.44], Aristolochia maurorum L. [15.6%], Citrullus colocynthis [L.] Schr. [14.4%], and Laurus nobilis L. [13.97%]. Considering the results of the present screening study, many of the investigated plants species can be used as potential sources of natural XO inhibitors that can be elaborated as successful herbal remedies for gout, arthritis and other XO-related disorders

Assessing health system responsiveness: a household survey in 17[th] district of Tehran

Responsiveness is an indicator by WHO to evaluate the performance of health systems on non-medical expectations of consumers. This study measures the health system responsiveness and the factors affecting responsiveness in Iran health system. World Health Survey [WHS] questionnaire was used to collect data on a two-stage cluster sampling in 17[th] District of Tehran in 2003. Of a sample of 773, 677 and 299 individuals who respectively had outpatient or inpatient services utilization responded to the responsiveness module of WHS questionnaire. More than 90% of respondents believed that responsiveness issues were very important. Performance of outpatient services was better than hospital services in terms of responsiveness. [Prompt attention] and [quality of basic amenities] received low score for outpatient services. Service user variables had no significant effect on responsiveness, while type of centers was significantly related to responsiveness. Principal component analysis found three factors for both outpatient and inpatient services that explained 62% and 61% of total variances respectfully. Iran health system should pay more attention to responding non-medical expectations of service users. It sounds that health system interventions are main determinant of responsiveness score compared to demographic or user variables. Training health staff, allocating more resources and reengineering some processes may play a role in improving responsiveness. Responsiveness domains seems to be tailored based on each society's cultural factors

[To determine the prognostic factors in esophageal cancer using log-logistic regression model in Iran]

Each year almost 400,000 people are diagnosed with oesophageal cancer worldwide. Wide variation in incidence has been reported both between countries and in different ethnic groups and populations within a country. The area with the highest reported incidence for oesophageal cancer is the so-called Asian 'oesophageal cancer belt', which stretches from eastern Turkey through north-eastern Iran, northern Afghanistan and southern Russia to northern China. In the high risk area of Gonbad in Iran, world age-standardised rates are more than 200 per 100,000 and the male/female ratio is reported as 0.8:1.0.This study aimed to assess the risk factors and demographic factors influencing survival of patients with esophageal cancer in north of Iran using weibull and log-logistic regression models. Demographic and clinical data of 359 patients with confirmed diagnosis of esophageal cancer from Babol Cancer registry utilized for our model. parametric and weibull models were employed to analyze the data. The Akaike information criterion [AIC] was also considered as a criterion to select the best model[s]. All p values as 0.05 were considered as statistically significant. The sample study consisted of 62.7% men and 37.3% women. Estimated survival rates in 1, 3, and 5 years following diagnosis were 23%, 15%, and 13% respectively. According to AIC criterion, the hazard rate of non-monotonic and rejection proportional hazards assumption [p<0.05], log-logistic model was more efficient than weibull model. Family history of having cancer in patients showed a significant difference in both models. It is concluded that early detection of people with a family history of cancer can be effective as an important factor in reducing the risk of death in patients with esophageal cancer

Expected survival using models of life table compared with survival of gastrointestinal tract cancer patients in north of Iran

Northern regions of Iran have been encountered to dominate malignancies of gastrointestinal [GI] tract. We came to examine the total excess mortality due to the GI cancer in Mazandaran province. Socio-demographic and clinical data of 484 patients with GI cancer collected during the years 1990-1991were available from Babol Cancer Registry. Patients were followed up for 15 years by the year 2006. Using the West Coale-Demeny life table model, a number of five life tables for men and four for women, corresponding to each birth cohort, were constructed. Observed survival was obtained using the Kaplan-Meier method and compared with the Expected survival calculated using the direct adjusted method represented by STEIN et al. The sample of subjects encompassed 66.3% men and 33.7% women with mean age 58.26 +/- 10.90, and endoscopy was the general method for cancer detection. Esophagus accounted for 74.2%, and stomach and colorectal accounted for 22.7% and 3.1% of GI cancers, respectively. Survival rate in 15 years following diagnosis was nearly 6%. Comparing patient and expected survival curves showed a significantly reduced survival for patients of each GI cancer over the whole period and especially during the first two years after diagnosis. Patients experienced reduced survival associated with the development of GI cancers. Considering individuals in a population come from different cohorts, adjustment by constructing distinct life tables for different birth cohorts is recommended. The West model is recommended as a first choice to represent mortality in countries whose registration systems are exposed to various errors

Does group prenatal care affect satisfaction and prenatal care utilization in Iranian pregnant women?

The need to provide high quality prenatal care services, which take account of women's views and specifically address their need for information, support and communication, has been advocated and group prenatal care, had been suggested as one of the ways to achieve this objective. The purpose of this study was to examine the impact of group versus individual prenatal care on satisfaction and prenatal care use. This was a cluster-randomized controlled trial with the health center as the randomization unit that conducted in 2007. Satisfaction was measured through a standardized questionnaire, and the Kotelchuck Adequacy of Prenatal Care Utilization Index was used to measure prenatal care utilization. We recruited 678 women [group prenatal care, [N=344] and individal prenatal care, [N=334] in the study. Women in group prenatal care model were more satisfied than women in individual prenatal care model in all areas evaluated, including information, communication, co-ordination and quality of care. Group care women were significantly more likely to have adequate prenatal care than individual care women were [OR=1.35 95% CI=1.26-1.44]. Group prenatal care was associated with a significant improvement in client satisfaction and prenatal care utilization. This model of care has implications for the planning and provision of prenatal services within public health system, which is moving toward a better quality health care, and increasing use of services

effects of health education through face to face teaching and educational movies, on suburban women in childbearing age

The aim of the study was to compare the effects of 'face-to-face education' and 'educational movies' on 'knowledge' and 'practice' of women of child-bearing-age, in terms of health-care during pregnancy and during infancy in a suburban region near Tehran City, Iran. In this quasi-experimental study, the sample included 873 married women. Questionnaires for knowledge and practice assessment were designed. The women were assigned to three groups: control [group I], face-to-face education [group II], and educational movie [group III]. Knowledge questionnaires were completed before and immediately after intervention. Practice questionnaires were completed before and three months after intervention. Both questionnaires consisted of two types of questions: type A [concerning infant care issues] and type B [concerning prenatal health care]. There was a significant difference in post-test knowledge between groups I and II and between groups I and III, but not between groups II and III. In terms of post-test practice, the changes were determined for every individual question, and significantly, better results were seen in group II, especially concerning type B questions. Face to face education lead to better practice than educational movies. In addition, significantly better practice occurred regarding child health care issues rather than prenatal issues in both groups. Realistic and tangible issues, those easy to practice, and with little or no economical burden imposed on the family, progressed from the knowledge state to the practice state more successfully in both groups

simple and rapid HPLC-UV method for the determination of umckalin, as an herbal marker, in the cough syrup of pelargonium extract

A rapid and simple high performance liquid chromatography [HPLC] method with UV detection for the quantitation of umckalin, as an herbal marker, in Pelargonium extract cough syrup has been developed and validated. Chromatographic separation was achieved on a reverse phase Phenomenex-C[18] column [5 microm, 25 cm x 0.5 mm i.d.] using a mixture of acetonitrile and phosphoric acid [pH 2.5], in 25:75 [v/v] ratio, as a mobile phase at a flow rate of 1 mL/min under ambient conditions and with UV detection at 310 nm. The method, applied for umckalin quantitation, showed good linearity over the concentration range of 0.334 -1.667 microg/mL, with a correlation coefficient [r[2]] of 0.9996. The limit of detection [LOD] and limit of quantitation [LOQ] of umckalin were found to be 0.0344 and 0.1031 microg/mL, respectively. In addition, the developed HPLC method showed acceptable values of repeatability and intermediate precision and indicated high levels of method accuracy. Simplicity and validity of the method make it highly reliable and especially suitable for routine quality control analysis

Effect of breastfeeding on cognitive performance in a British birth cohort

This cohort study investigated the effect of early life nutrition on later performance in developmental milestones and cognitive tests. Structural equation modelling was carried out on follow-up data from a national birth cohort of 5362 children born in 1 week of 1946 in Britain. Children who were breastfed longer showed earlier developmental milestones. After adjusting for sex, social group and milestones, those children scored higher in verbal tests. Path analysis showed that breastfeeding may have an effect even into adult life. The chain of path coefficients from breastfeeding to developmental milestones at early ages, to cognitive scores at ages 8-15 years, to reading tests at age 26 years and to memory and visual tests at age 43 years were significant in females but not in males