The prevalence and predictors of cardiovascular diseases in Kherameh cohort study: a population-based study on 10,663 people in southern Iran.

BACKGROUND: The prevalence of cardiovascular disease (CVD) is rapidly increasing in the world. The present study aimed to assess the prevalence and Predictors factors of CVD based on the data of Kherameh cohort study. METHODS: The present cross-sectional, analytical study was done based on the data of Kherameh cohort study, as a branch of the Prospective Epidemiological Studies in Iran (PERSIAN). The participants consisted of 10,663 people aged 40-70 years. CVD was defined as suffering from ischemic heart diseases including heart failure, angina, and myocardial infarction. Logistic regression was used to model and predict the factors related to CVD. Additionally, the age-standardized prevalence rate (ASPR) of CVD was determined using the standard Asian population. RESULTS: The ASPR of CVD was 10.39% in males (95% CI 10.2-10.6%) and 10.21% in females (95% CI 9.9-10.4%). The prevalence of CVD was higher among the individuals with high blood pressure (58.3%, p < 0.001) as well as among those who smoked (28.3%, p = 0.018), used opium (18.2%, p = 0.039), had high triglyceride levels (31.6%, p = 0.011), were overweight and obese (66.2%, p < 0.001), were unmarried (83.9%, p < 0.001), were illiterate (64.2%, p < 0.001), were unemployed (60.9%, p < 0.001), and suffered from diabetes mellitus (28.1%, p < 0.001). The results of multivariable logistic regression analysis showed that the odds of having CVD was 2.25 times higher among the individuals aged 50-60 years compared to those aged 40-50 years, 1.66 folds higher in opium users than in non-opium users, 1.37 times higher in smokers compared to non-smokers, 2.03 folds higher in regular users of sleeping pills than in non-consumers, and 4.02 times higher in hypertensive individuals than in normotensive ones. CONCLUSION: The prevalence of CVD was found to be relatively higher in Kherameh (southern Iran) compared to other places. Moreover, old age, obesity, taking sleeping pills, hypertension, drug use, and chronic obstructive pulmonary disease had the highest odds ratios of CVD.

The comparison of morbid obesity quality of life and body image between surgery and other treatments: A case-control study.

BACKGROUND: Morbid obesity is rising around the world. Surgery is a selective treatment intervention for it. Since most of the surgeons use weight loss for evaluating of the morbid obesity surgical outcomes and paying attention to the the quality of life (QOL) and body image evaluation are rare, this study aimed to assess the QOL and body image in pre- and postsurgery with other interventions. MATERIALS AND METHODS: This case-control study was done on 200 morbidly obese patients (n = 100 in each group) who referred to the obesity clinic in Shiraz. The data were collected by Body Image Concern Inventory and 12-item Short Form Survey. The data were analyzed by t-test, Pearson correlation coefficient test, analysis of variance, and regression analysis. P = 0.05 was considered as significant. RESULTS: The paired t-test showed a significant difference in mean scores of body image (P < 0.001) and all dimensions of the QOL (P < 0.001) in the case and control groups. In the case group, there was a significant difference between the mean scores of the QOL and the different categories of body mass index (BMI) in postsurgery (P < 0.05) and the different mean scores of body image and the different categories of BMI in pre- and postsurgery wasn't significant (P > 0.05). Age was a predictor variable for the QOL of morbidly obese persons after surgery (P < 0.001). After surgery, men showed better QOL than women (P < 0.001). CONCLUSION: Final results indicated that body image and QOL defects caused by obesity could be more improvement after surgery. This study can promote health-care team's knowledge about holistic supporting of all dimensions' QOL of obese individuals. It is suggested that supporting interventions should be done as effective methods of maintenance for effects of weight loss methods such as surgery.

Antibiotic therapy for prevention of fistula in-ano after incision and drainage of simple perianal abscess: A randomized single blind clinical trial.

BACKGROUND: Much controversy exists regarding the role of antibiotics in the development of fistula in-ano after incision and drainage. We evaluated the role of postoperative antibiotics in the prevention of fistula in-ano after incision and drainage of perianal abscess. METHODS: In a randomized single blind clinical trial study, 307 patients were randomly selected from those referring for incision and drainage of perianal abscess at Shahid Faghihi Hospital, Shiraz, Iran, during September 2013 to September 2014. Patients were allocated randomly either to receive 7 days of oral metronidazole and ciprofloxacin in addition to their standard care or to only receive standard care without any antibiotics after they were discharged from the hospital. Patients were followed for 3 months and final results were evaluated. The study was registered at the clinical trial registry (www.irct.ir; Irct201311049936n7). RESULTS: Seven patients were lost to follow-up. Those who used prophylactic antibiotics (n = 155) had significantly lower rates of fistula formation compared with those who did not use any medication (n = 144; P < .001). Men had higher rates of fistula formation (P = .002). Patients who used more cigarettes had higher rates of fistula development (P = .001). In the univariate analysis, only postoperative antibiotic use showed a protective role against fistula formation (odds ratio = 0.426; confidence interval, 0.206-0.881). In the regression analysis postoperative antibiotic use remained protective against fistula development (odds ratio = 0.371; confidence interval, 0.196-0.703), furthermore male sex presented as a risk factor for developing fistula in-ano (odds ratio = 3.11; confidence interval, 1.31-7.38). CONCLUSION: Postoperative prophylactic antibiotic therapy including ciprofloxacin and metronidazole play an important role in preventing fistula in-ano formation. Considering the complications of fistula in-ano formation and the minor side effects of antibiotic therapy, based on our results, a 7-10 course of postoperative antibiotics is advised after incision and drainage of perianal abscess.

The Healing Effect of Teucrium polium in Acetic Acid-Induced Ulcerative Colitis in the Dog as an Animal Model.

BACKGROUND Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD), are debilitating and chronic disorders with unpredictable courses and complicated treatment measures. Therefore, an efficient treatment protocol seems necessary as therapeutic prophylaxis for these disorders.This study aims to determine the healing effect of Teucrium polium (T. polium) in acetic acid-induced UC in an experimental dog model. METHODS From September to December 2010, eight male (20-25 kg) crossbred dogs were used for induction of UC by 6% acetic acid, transrectally. After one week, three biopsies (10, 20 and 30 cm proximal to the anal verge) were taken from the colon of each animal for histological studies. In the presence of UC, 400 mg/kg/day of T. polium extract was administered orally and transrectally (via enema) for 30 days in six of the dogs. The remaining two dogs were used as controls and did not receive T. polium. Multiple biopsies were taken 7, 14, and 30 days after discontinuation of T. polium in the same manner as before treatment. RESULTS After administration of acetic acid, we noted the presence of multiple ulcers, diffuse inflammation, PMN infiltration in the lamina propria, glandular destruction and goblet cell depletion. Treatment with T. polium restored the colonic architecture with an increased number of healthy cells and a reduction in inflammatory cells. Damage of the surface epithelial cells and mucosal layer of the lumen were reversed, which lead to faster ulcer healing. CONCLUSION T. polium may be a treatment choice for UC and can broaden the current therapy options for UC.

Evaluation of different chemical agents on the germinative layer of sheep hydatid cyst after implantation to peritoneal cavity of BALB/c.

In spite of the use of protoscolocidal agents during hydatid cyst surgery, a notable rate of disease recurrence in postoperation patients is still observed. The question remains whether living protoscolices lead to recurrence or the recurrence is due to the remainder of the germinative layer in the peritoneal cavity. The aim of this study was in vivo evaluation of different chemical (protoscolicidal) solutions on the germinative layer of the hydatid cyst. The germinative layer of sheep hydatid cyst was separated under sterile condition, divided into 0.25-cm(2) parts, and exposed to 0.5% cetrimide, 0.5% silver nitrate, 20% hypertonic saline, 15% dextrose and 25% dextrose, and normal saline as negative control for 2 min. The exposed germinative layers were implanted into the peritoneal cavity of 90 Balb/C mice (15 mice in each group). After nine months, the peritoneum was evaluated macroscopically as well as microscopically for the presence of any hydatid cyst. No hydatid cyst was observed in the peritoneal cavity of the exposed mice. The role of the germinative layer for inducing hydatid cysts in mice is questionable. However, the present study showed that the germinative layer had no role in the induction of hydatid cyst in these laboratory animals.

Comparison of electrotherapy of hemorrhoids and Ferguson hemorrhoidectomy in a randomized prospective study.

BACKGROUND: Ferguson hemorrhoidectomy has been shown to be associated with significant amount of post-operative (post op) pain and complications. However, electrotherapy in which hemorrhoidal tissue is not excised might not be associated with severe complications. OBJECTIVE: Our aim was to compare the results of Ferguson hemorrhoidectomy with electrotherapy methods using 16 and 30 mA (milliampers) direct current (DC). METHODS: Four hundred and eight patients with symptomatic hemorrhoids, grades 1, 2 and 3, were randomly assigned into 3 groups. Group A (136 patients) underwent Ferguson hemorrhoidectomy, group B1 (136 patients) and group B2 (136 patients) were subjected to electrotherapy using 16 and 30 mA, respectively. The groups were compared in terms of duration of procedures, duration of hospital stay, post op pain severity and post op complications including recurrence, infection and non-healing ulcers. RESULTS: All patients in group A had severe pain for 7-14 days of post op. However, in group B1, 88(65%) patients had mild pain during the treatment and 1st post op day; 28(21%) of them could not tolerate the operation; 20(15%) of them had mild pain and 10(7.5%) of them had moderate pain up to day 7. In group B2, 47(35%) of patients had sever pain for 6 h and 20(15%) of them experienced mild pain for 2-7 days post op. The one day hospital stay in group A and group B2 were 82 and 97%, respectively, while patients in group B1 were treated as out patients. Mean procedure time for one hemorrhoidectomy in group A was 23 min, in electrotherapy using 16 and 30 mA was 9.7 and 6.1 min, respectively. The overall success rate with the first application in group B1 was 57% and in group B2 was 93%. CONCLUSION: Electrotherapy method using 30 mA DC could significantly decrease post op pain, operation time and hospital stay. This method had good success rate and very low post op complications compared to Ferguson hemorrhoidectomy and using 16 mA method. Therefore, due to its effectiveness, less pain, rapidity and safeness, we recommend it.

Assessment of electrotherapy in treatment of hemorrhoids in Southern Iran.

OBJECTIVE: In this study, we have developed an electrotherapy device in order to improve the outcome and decrease the number of referrals and duration of treatment of internal hemorrhoid. METHODS: We treated 2015 hemorrhoids among 931 patients (382 males and 549 females); 319 hemorrhoids were grade 1, 1158 grade 2 and 538 grade 3, from May 1995 to October 2002, at Nemazee and Faghihee Hospitals in Shiraz University of Medical Sciences, Shiraz, Iran. All patients were referred due to fresh rectal bleeding or reducible prolapsed hemorrhoid with no response to medical treatment. After introduction of anesthesia, 27-30 mAmp direct current was applied to each hemorrhoid with durations of 4.5 minutes for grade 1, 5.5 minutes for grade 2 and 7 minutes for grade 3. RESULTS: Our results showed that 97.1% of patients responded well to the treatment and 27 patients returned with fresh rectal bleeding or prolapsed hemorrhoid in 2 weeks to 2 months postoperatively. Ninety-six percent of the patients were discharged on the same operating day. After 24 hours postoperation, 92% of the patients had no any pain and no need any analgesic. Among those patients who had not responded to the treatment; 24 cases underwent electrotherapy for a 2nd time and 3 patients were treated excising their prolapsed hemorrhoids. No other complications were detected. CONCLUSION: Postoperative pain was mild and tolerable and 93.2% of patients returned to normal activity after 2 days. Electrotherapy with the above mentioned method is considered safe and effective without any major complications and with acceptable patient's satisfaction. This method can be used for treatment of grades 1, 2 and 3 hemorrhoids.