Avicenna's View on the Etiologies of Intestinal Obstruction.

CONTEXT: Bowel obstruction is one of the most common causes of acute abdomen. Because of heterogeneity of patients' population and variety of causes, therapeutic strategies are not standardized, so treatment of intestinal obstruction is a surgical challenge in many cases. A traditional medicine approach could help detect some issues that were ignored by modern medicine. One of the major schools of medicine, with a history of several thousand years, is Iranian traditional medicine. In this regard, Avicenna, who lived in the medieval period, has had a great influence on the medical knowledge of the world by writing an encyclopedia of medicine entitled "Qanun of Medicine." EVIDENCE ACQUISITION: The aim of this study was to investigate Avicenna's views on the causes of intestinal obstruction and comparing them to modern medicine views. This is a review study on an Iranian traditional textbook of medicine by Avicenna, entitled "Qanun of Medicine" (in short "Qanun"). We used Qanun in its original language (Arabic) along with its Persian translation. It consists of 5 books. Part 16 of the third book talks about intestinal anatomy and introduces some intestinal diseases such as "qoolinj" and "ilavos." Intestinal obstruction can be a kind of "qoolinj" or "ilavos" disease. All intestinal obstruction etiologies in Qanun are searched in international and Iranian databases (Scopus, ISI, SID, and Iranmedex) and similar causes in modern medicine will be discussed in this article. RESULTS: According to Qanun, 16 causes are involved in intestinal etiologies of bowel obstruction such as "reeh," mucoid phlegm, abdominal hot and dry distemperament, decreased bile secretion, job, and so on while modern medicine considers some of them, for instance, volvulus, intestinal herniation, worm, intestinal pseudo-obstruction, and opiate. CONCLUSIONS: Attention to the similar causes of intestinal obstruction in modern medicine and traditional medicine is the starting point for investigation of noninvasive diagnostic and therapeutic methods that have been mentioned in Qanun. In addition, etiologies which are missed in modern medicine can open new doors to the researchers and gastroenterologists for the study, diagnosis, and prevention of the disease.

The cost effectiveness of rotavirus vaccination in Iran.

Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. Effective vaccines have recently been approved and successful vaccination program implemented. The aim of this study was to evaluate the cost effectiveness of mass rotavirus vaccination program in Iran. We developed a Markov model that reflects key features of rotavirus natural history. Parameters of the model were assessed by field study or developed through literature search and published data. We applied the model to the 2009 Iranian birth cohort and evaluated the cost-effectiveness of including the rotavirus vaccine (Rotarix®) into Iranian expanded immunization program (EPI). With an estimated hospitalization rate of 0.05 and outpatient rate of 0.23 cases per person-year, vaccinating cohort of 1231735 infants in Iran with 2 doses of (Rotarix®), would prevent 32092 hospitalizations, 158750 outpatient visits, and 1591 deaths during 5 y of follow-up. Under base-case assumption of $10 cost per course of vaccine, the vaccination would incur an extra cost of $1,019,192 from health care perspective and would avert 54680 DALYs. From societal perspective, there would be $15,192,568 saving for the society with the same averted DALYs. The incremental cost effectiveness ratio showed a cost of $19 US dollars per averted DALY from health care perspective and a saving of $278 US dollars for each averted DALY from societal perspective. Introducing rotavirus vaccine into EPI program would be highly cost-effective public health intervention in Iran.

Temperament determination for melatonin: a bridge from Iranian traditional to modern sleep medicine.

History acknowledged Ibn Sina, or Avicenna, the author of the highly skilled textbook of medicine "Al-Qanun Fi Al-Tibb" or "The Canon of Medicine", as one of the greatest physicians in medicine. According to this medical textbook, the explanation of the existence of a cold temperament for sleep was that during sleep hours, people tended to have a movement of the nature of the body toward the inside, which caused the body to become cold during sleep. Temperament determination for molecules, including drugs, has proved several applications. The present study tried to demonstrate that the multitasking melatonin molecule, as a sleep related hormone, had a cold temperament. The consideration of this temperament for melatonin had the potential to connect and integrate Iranian traditional medicine to current medicine, and also opened new frontiers for the physiopathology of modern sleep medicine, based on traditional medicine.

Tuberculin Skin Test among 1,424 Healthy Employees in Chaharmahal Province, Iran.

BACKGROUND: Tuberculosis is still an important problem in developing countries. The tuberculin skin test (TST) is used for the identification of latent tuberculosis (TB) infection. This study aimed to evaluate the TST results of healthy employees of different departments in chaharmahal province, Iran. MATERIALS AND METHODS: This study was done on 1,424 healthy employees from 49 different departments in Chaharmahal Province. The tuberculin skin test was done with Purified Protein Derivative (PPD) solution. The induration was evaluated 48-72 hours later. RESULTS: Negative PPD test was observed in 346 subjects. A 5-10 mm induration was seen in 276, a 10-15 mm in 292, a 15-20 mm in 212, a 20-25 mm in 72, and a 25-30 mm induration was observed in 14 cases. A total of 212 subjects were absent when reading the induration. CONCLUSION: Tuberculin skin test can be used for the identification of TB infection. Prevalence of latent TB infection was low in our study. There were no significant differences in PPD test results between medical and non-medical departments.