Performance evaluation of Anaerobic-Aerobic Hybrid Baffled Reactor Coupled with an Anaerobic Filter treating Landfill Leachate.

The Anaerobic Baffled Reactor (ABR) is an effective solution for landfill leachate treatment using an anaerobic fermentation process, which helps to reduce operating costs and sludge volume. To better understand the biological, chemical, and physical processes involved, especially when combining the ABR with an aerobic component, the study aimed to investigate the performance of an Anaerobic-Aerobic Hybrid Baffled Reactor (AABR) that includes an Anaerobic Filter (AF) for treating landfill leachate. This research utilized two glass reactors. The first reactor, designated as AABR-AF, consisted of six independent rectangular glass chambers arranged side by side. The third and sixth chamber designed for aerobic treatment and AF, respectively. The second reactor was used as a control reactor and did not include any aerobic chamber. The highest Removal Efficiencies (REs) for turbidity, COD, BOD, TP, TKN, nitrate, TOC, and TSS in the AABR-AF and ABR-AF were found to be (65.4% and 56.3%), (98.3% and 94.1%), (98.1% and 93.2%), (86.4% and 65%), (89.2% and 76.7%), (81.2% and 64.4%), (88.2% and 79.4%), and (72.4% and 68.5%), respectively. These optimal REs were achieved at an HRT of 48 h and an OLR of 10 kg/m3.d. Also, the highest and the lowest REs in Heavy Metals (HMs) were 89.57% for manganese in AABR-AF and 6.59% for nickel in ABR-AF, in an OLR of 10 kg/m3.d, respectively. The effective removal of Organic Matters (OMs) from landfill leachate using the AABR-AF and ABR-AF was found to be strongly influenced by HRT and OLR. The AABR-AF configuration, featuring a single aerobic chamber in the reactor, exhibited a higher efficiency in removing OMs compared to the ABR-AF configuration.

C-Reactive Protein and D-dimer as Prognostic Markers for Clinical Outcomes in Patients with Mild Traumatic Brain Injury: A Cross-Sectional Study.

Objective: To investigate the use of prognostic markers such as C-reactive protein (CRP) and D-dimer for clinical outcomes in patients with mild traumatic brain injury (TBI). Methods: This cross-sectional study was conducted on patients with mild head trauma who were admitted to the Emergency Department of Imam Khomeini Hospital (Sari, Iran). Data were collected from 2018 to 2019. Age, sex, the time of injury hospitalization, length of hospitalization, length of unconsciousness, blood pressure, heart rate, respiratory rate, and concomitant symptoms were all recorded using a pre-designed checklist. The patient's Glasgow Coma Scale (GCS), CRP, and D-dimer were also measured. Moreover, all patients underwent CT scan. Results: This study included 74 patients with TBI. The mean age of the participants was 36.92±3.54. The mean CRP and D-dimer values were 5.69±0.77 and 0.58±0.11 in these patients, respectively. At the cut-off point of 11.50 for CRP, the sensitivity and specificity to detect the pathological lesions in CT scan were 75% and 95.50%, respectively (p<0.001). Additionally, with a D-dimer cut-off point of 0.90, the sensitivity and specificity for diagnosing pathological lesions in CT scan were 100% and 98.50%, respectively (p<0.001). Conclusion: In general, the CRP and D-dimer levels of patients with mild TBI (GCS≥13) can be assessed to protect against CT-induced radiation exposure and subsequent disorders; if they do not exhibit clinical signs to increase the risk of adverse brain damage, such as reduced level of consciousness, drowsiness, and prolonged periods of unconsciousness.

Evaluation of the Salivary Matrix Metalloproteinase-9 in Women With Polycystic Ovaries Syndrome and Gingival Inflammation: A Case-Control Study.

Background Polycystic ovary syndrome (PCOS) is an endocrine disease of women of reproductive age that impacts their oral and systemic well-being. This study aimed to compare the gingival inflammation indices and matrix metalloproteinase-9 (MMP-9) of non-obese women with PCOS. Materials and methods This is a case-control study in which 78 women were referred to the Babol Clinic Hospital in Northern Iran between 2018 and 2019. They were divided into three groups: 26 women with PCOS and gingivitis, 26 women with PCOS with no gingivitis, and 26 women with no PCOS and no gingivitis as a control group. After recording the anthropometric and demographic variables, fasting saliva samples were taken from all participants before any periodontal intervention. These samples were transferred to Babol Molecular Cell Research Center under highly guaranteed cold-chain conditions to measure the serum levels of MMP-9. Periodontal status was evaluated for Gingival Index (GI), Plaque Index (PI), and Bleeding on Probing (BOP). Analysis of variance was used to compare the mean results for these indices. The significance level was considered when p ≤ 0.05. Results All the gingival indices were significantly higher for women with PCOS with gingivitis compared to the results for women from the other two groups. Similarly, women with PCOS showed high salivary MMP-9 levels but were within the normal reference ranges. Conclusion The gingival indices (GI, PI, and BOP) and salivary MMP-9 are higher in women with PCOS, regardless of the gingival status.

Evaluation of Clinical, Laboratory, and Radiologic Findings of Pulmonary and Extrapulmonary Involvement in Sarcoidosis.

Background: Sarcoidosis is a systemic disease with unknown etiology that is characterized by the presence of granuloma in various organs with diverse pulmonary and extrapulmonary manifestations. Regarding differences in the presentation of sarcoidosis in different geographical areas, the present study aimed to determine clinical, laboratory, and radiologic findings of patients with sarcoidosis in the north of Iran. Materials and Methods: In a cross-sectional study, patients with sarcoidosis were enrolled, and demographic data in addition to disease manifestations including clinical, laboratory, and imaging findings were recorded. Results: A total of 58 patients with sarcoidosis were enrolled in the study. The mean age and disease duration were 51.10±10.2 and 3.07±2.7 years, respectively. 62.1% of patients were female. Clinical manifestations were: cough and dyspnea (55.2%), fever and weight loss (11%), arthritis (15.5%), dermatologic presentation (15.5%), and ophthalmic involvement (17.2 %). Abnormalities in liver, renal, and calcium levels are found in approximately 1-8% of cases. The ACE level was increased in 56.9 % of patients, especially in those who presented in summer and autumn. Chest CT abnormalities were found in 94.8 % of patients, more predominantly hilar and paratracheal lymphadenopathy in 84.5% and 74.1%, respectively. Conclusion: Although sarcoidosis presents with varying clinical, radiological, and laboratory features, knowledge of its epidemiology and the incidence of these features in different populations can aid in its diagnosis in a particular geographic area.

Polarization-sensitive optical coherence tomography monitoring of percutaneous radiofrequency ablation in left atrium of living swine.

Radiofrequency ablation (RFA) is commonly used to treat atrial fibrillation (AF). However, the outcome is often compromised due to the lack of direct real-time feedback to assess lesion transmurality. In this work, we evaluated the ability of polarization-sensitive optical coherence tomography (PSOCT) to measure cardiac wall thickness and assess RF lesion transmurality during left atrium (LA) RFA procedures. Quantitative transmural lesion criteria using PSOCT images were determined ex vivo using an integrated PSOCT-RFA catheter and fresh swine hearts. LA wall thickness of living swine was measured with PSOCT and validated with a micrometer after harvesting the heart. A total of 38 point lesions were created in the LA of 5 living swine with the integrated PSOCT-RFA catheter using standard clinical RFA procedures. For all lesions with analyzable PSOCT images, lesion transmurality was assessed with a sensitivity of 89% (17 of 19 tested positive) and a specificity of 100% (5 of 5 tested negative) using the quantitative transmural criteria. This is the first report of using PSOCT to assess LA RFA lesion transmurality in vivo. The results indicate that PSOCT may potentially provide direct real-time feedback for LA wall thickness and lesion transmurality.

Contraceptive Prevalence and Consulting Service in Women with Systemic Lupus Erythematosus: A Cross-Sectional Study.

BACKGROUND: Systemic lupus erythematosus (SLE), often affects women of childbearing age. Family planning consultation is a major aspect of medical care in these patients because of the risk of disease activation and poor pregnancy and fetal outcomes. The aim of the present study was to evaluate contraceptive prevalence and consulting service in women with SLE. METHODS: In a cross-sectional study, a total of 144 female patients with SLE, ages 15-50, who were presented to rheumatology clinics in Sari, north of Iran, were evaluated. The study was conducted between March 2019 and May 2020. Patients' clinico-demographic profile and fertility information were obtained. Disease activity and damage were assessed by the systemic lupus erythematosus disease activity (SLEDAI) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI). RESULTS: One hundred and forty-four SLE patients of childbearing age participated in this study. From 102 patients with the possibility of pregnancy, 36(35.2%) received contraceptive consultations in last year. Withdrawal was the most prevalent contraceptive method (41.7%), followed by permanent (11.8%), and barrier methods (9%). There were no significant differences in age, disease duration, marriage duration, SDI or SLEDAI scores between the women who received or not received contraceptive counseling (P>0.05). CONCLUSION: Many SLE patients did not receive adequate information about contraception, and it may be associated with many adverse effects on disease activity and pregnancy outcomes. Therefore, contraceptive consultation as an important aspect of patient's management is strongly suggested.

Is gastric mapping needed in the endoscopy of dyspeptic patients?

AIM: Our study aimed to determine the prevalence of intestinal metaplasia in dyspeptic patients who underwent upper GI endoscopy. BACKGROUND: Intestinal metaplasia, which is defined as the replacement of normal gastric mucosa by metaplastic intestinal epithelium, has been described as a premalignant gastric lesion. METHODS: Six hundred two consecutive patients with dyspeptic symptoms who had undergone upper GI endoscopy were included in the study. For all patients, gastric mapping was performed to determine the presence of intestinal metaplasia. All histologic samples were reported according to the updated Sydney classification. RESULTS: Total of 61.3% of the patients were female. The mean age of the patients was 46±15 years. The overall prevalence of intestinal metaplasia was 22%. The distribution of intestinal metaplasia in the stomach was 15.1% in the antrum, 4.3% in the body, and 2.6% in the antrum and body together. Also, the prevalence of intestinal metaplasia in the age group of under 40 years was 9.5% and in patients over 40 years it was 29.5%.. CONCLUSION: The results of this study have shown that more than one-fifth of the patients with dyspepsia have intestinal metaplasia. This indicates that gastric mapping in patients with dyspepsia may lead to the detection of precancerous lesions especially after the age of 40.

Application of soft computing to predict water quality in wetland.

Prediction of water quality is a critical issue because of its significant impact on human and ecosystem health. This research aims to predict water quality index (WQI) for the free surface wetland using three soft computing techniques namely, adaptive neuro-fuzzy system (ANFIS), artificial neural networks (ANNs), and group method of data handling (GMDH). Seventeen wetland points for a period of 14 months were considered for monitoring water quality parameters including conductivity, suspended solid (SS), biochemical oxygen demand (BOD), ammoniacal nitrogen (AN), chemical oxygen demand (COD), dissolved oxygen (DO), temperature, pH, phosphate nitrite, and nitrate. The sensitivity analysis performed by ANFIS indicates that the significant parameters to predict WQI are pH, COD, AN, and SS. The results indicated that ANFIS with Nash-Sutcliffe Efficiency (NSE = 0.9634) and mean absolute error (MAE = 0.0219) has better performance to predict the WQI comparing with ANNs (NSE = 0.9617 and MAE = 0.0222) and GMDH (NSE = 0.9594 and MAE = 0.0245) models. However, ANNs provided a comparable prediction and the GMDH can be considered as a technique with an acceptable prediction for practical purposes. The findings of this study could be used as an effective reference for policy makers in the field of water resource management. Decreasing variables, reduction of running time, and high speed of these approaches are the most important reasons to employ them in any aquatic environment worldwide.

Association between prostate-specific antigen change over time and prostate cancer recurrence risk: A joint model.

BACKGROUND: Prostate specific antigen (PSA) is an important biomarker to monitor patients after treated with radiation therapy (RT). The aim of this study is to evaluate the relationship between the PSA data and prostate cancer recurrence using the joint modeling. METHODS: This historical cohort study was performed on 422 prostate cancer patients. Inclusion criteria included: patients with localized prostate cancer referring to Cancer Institute in Tehran (Iran) from 2007 to 2012, and under radiation therapy. Joint model has two components or sub-models. We showed the results by parameter estimating the longitudinal sub-model and survival sub-model. EM algorithm, Newton-Gauss and Gauss-Hermit law were used for final model parameters. R software version 3.2 was used for statistical analysis. RESULTS: In this study, considering the inclusion and exclusion criteria, out of 422 patients, the data on 314 cases were selected for analysis and the main result of joint model was obtained. PSA directly and significantly was associated with recurrence risk, therefore increasing 2.6 ml/lit PSA (one unit in transformed PSA) increases 39% recurrence risk (95% CI for RR: 1.09-1.77). Also, slope of PSA trend has significant association with prostate cancer recurrence risk (95% CI for RR: 1.05-1.41). CONCLUSION: This study showed a significant relationship between PSA, and its slope with the recurrence risk by joint model, with regard to the pathological, demographic and clinical features in the Iranian population.

Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women.

INTRODUCTION: A person's sexual satisfaction reflects their judgment and analysis of their own sexual behavior. Factors that affect sexual satisfaction vary in different societies and cultures. AIM: This study investigated the determinants of sexual satisfaction in women referred to health centers in Sari, north of Iran, in 2016. METHODS: This cross-sectional study investigated 490 women who had been referred to health centers in 2016 and who were qualified for the study; the population was selected using convenient sampling method. MAIN OUTCOME MEASURE: The main outcome of this study was sexual satisfaction that assessed by the Larson's sexual satisfaction questionnaire. Other Data were 2 questionnaires: the general health questionnaire-28 and a researcher-made questionnaire developed on factors related to sexual satisfaction. Data were analyzed with IBM SPSS software using the one-way analysis of variance, Pearson correlation coefficient, and t-test. To determine the predictors of sexual satisfaction, all the significant independent variables were incorporated into a linear regression model. RESULTS: The average age of the women in this study was 33.6 years, and average sexual satisfaction score was 99.26. The results of the linear regression model showed that the spouse's job as a laborer (P = .003), a low income (P < .002), insufficient income of the spouse (P < .001), and dissatisfaction with being a woman (P < .001) were the main social determinants of sexual satisfaction (r2 = 0.54). CONCLUSION: It can be concluded from the findings of this study that several factors influence women's sexual satisfaction. The main social determinants of women's sexual satisfaction were dissatisfaction with their gender, the spouse's job as a laborer, low income, and insufficient income. Sexual healthcare providers can play a prominent role in increasing women's sexual satisfaction, thereby, improving the quality of their sexual life by identifying and discussing ways to control them. Afzali M, Khani S, Hamzehgardeshi Z, et al. Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women. Sex Med 2020;8:290-296.

Serum levels of interleukin-23 and 35 in patients with and without type 2 diabetes mellitus and chronic periodontitis.

BACKGROUND: Type 2 diabetes mellitus (DM) and chronic periodontitis (CP) show common pathophysiological features. We investigated the serum levels of IL-23 and IL-35 in people with type 2 DM and CP. METHODS: In a cross-sectional study, 72 patients were divided into four equal groups: group A, participants without type 2 DM and CP; group B, patients with type 2 DM without CP; group C, patients with CP and without type 2 DM; and group D, patients with type 2 DM and CP. Demographic data were obtained and periodontal conditions including clinical attachment loss, bleeding on probing, plaque index, gingival index, and probing depth was evaluated on all existing teeth. Fasting blood sugar (FBS) levels, hemoglobin (Hb) A1c, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. In addition, serum levels of IL-23 and 35 were measured using enzyme-linked immunosorbent assay. RESULTS: The serum levels of IL-23 and 35 showed no significant differences between all groups (P>0.05). A significant positive correlation between the serum concentration of IL-23 and clinical attachment loss in the control group (r: 0.548, P=0.019) was detected. A significant negative correlation between IL-35 and the plaque index in group B (r: -0.578, P=0.012), plus significant negative correlations between IL-23 with ESR (r: -0.487, P=0.040) and CRP (r: -0.498, P=0.035) in groups C and D were also detected. CONCLUSION: Despite significant associations of serum concentration of IL-23 and 35 with certain periodontal and inflammatory indices, neither type 2 DM nor CP differentially affects serum levels of these two cytokines.

Effects of Minocycline on Neurological Outcomes In Patients With Acute Traumatic Brain Injury: A Pilot Study.

Traumatic brain injury (TBI) is a public health problem worldwide. Secondary damage of brain injury begins within a few minutes after the trauma and can last a long time. It can be reversible, unlike primary injury. Therefore, therapeutic intervention can be used. The aims of this study were to assess the effects of minocycline on neurological function and serum S100B protein and neuron-specific enolase (NSE) levels in patients with moderate to severe TBI. Patients with acute onset of TBI and surgical evacuation of hematoma were randomized to receive either minocycline 100 mg orally twice daily or placebo for 7 days. The primary outcomes included changes in level of S100B and NSE at different time points during the trial. Additionally, changes in Glasgow coma scale (GCS) score were evaluated. The Glasgow Outcome Scale-Extended (GOS-E) score at 6 months after injury was assessed in discharge patients. Thirty four patients were randomized into the placebo (n = 20) and treatment (n = 14) groups. There was a marginal statistically significant differences in the normalized value of S100B between groups (p < 0.1). The reduction in serum NSE level from baseline to day 5 was statistically significant (p = 0.01) in minocycline group while it was not significantly decrease in placebo group (p = 0.2). Also, GCS improvement over time within the minocycline group was significant (p = 0.04) while was not significant in placebo group (p = 0.11). The GOS-E scores were not significantly different between minocycline and placebo group. Based on this study, it seems that the use of minocycline may be effective in acute TBI.

Radiation dose-response (a Bayesian model) in the radiotherapy of the localized prostatic adenocarcinoma: the reliability of PSA slope changes as a response surrogate endpoint.

PURPOSE: One of the characteristics of Prostate-Specific Antigen (PSA) is PSA slope. It is the rate of diminishing PSA marker over time after radiotherapy (RT) in prostate cancer (PC) patients. The purpose of this study was to evaluate the relationship between increasing RT doses and PSA slope as a potential surrogate for PC recurrence. PATIENTS AND METHODS: This retrospective study was conducted on PC patients who were treated by radiotherapy in the Cancer Institute of Iran during 2007-2012. By reviewing the records of these patients, the baseline PSA measurement before treatment (iPSA), Gleason score (GS), clinical T stage (T. stage), and periodic PSA measurements after RT and the total radiation dose received were extracted for each patient separately. We used a Bayesian dose-response model, analysis of variance, Kruskal-Wallis test, Kaplan-Meier product-limit method for analysis. Probability values less 0.05 were considered statistically significant. RESULTS: Based on the D'Amico risk assessment system, 13.34% of patients were classified as "Low Risk", 51.79% were "Intermediate Risk", and 34.87% were "High Risk". In terms of radiation doses, 12.31% of the patients received fewer than 50 Gy, 15.38% received 50 to 69 Gy, 61.03% received 70 Gy, and 11.28% received more than 70 Gy. The PSA values decreased after RT for all dose levels. The slope of PSA changes was negative for 176 of 195 patients. By increasing the dosage of radiation, the PSA decreased but these changes were not statistically significant (p = 0.701) and PSA slope as a surrogate end point cannot met the Prentice's criteria for PC recurrence. CONCLUSION: Significant changes in the dose-response relationship were not observed when the PSA slope was considered as the response criterion. Therefore, although the absolute value of the PSA decreased with increasing doses of RT, the relationship between PSA slope changes and increasing doses was not clear and cannot be used as a reliable response surrogate endpoint.

Relation between Periodontitis and Prediabetic Condition.

STATEMENT OF THE PROBLEM: Prediabetic condition, which is characterized by impaired glucose tolerance, impaired fasting blood glucose, and hemoglobin A1c (HbA1c) higher than normal might be associated with periodontitis. Early diagnosis of this condition might decrease consequent tissue damage caused by periodontitis. PURPOSE: The present study aimed to evaluate the association between prediabetes and periodontitis. MATERIALS AND METHOD: This cross-sectional study was conducted on 108 prediabetic patients screened by primary fasting blood sugar (FBS) test (100-125 mg/dL). Three subsequent blood tests including FBS, HbA1C, and oral glucose tolerance test (GTT) were performed for ultimate diagnosis of these patients. The periodontal health was evaluated by employing bleeding on probing (BOP), clinical attachment loss (CAL), and plaque index (PI), Lِe-Silness gingival index (GI), and pocket depth (PD). Data were analyzed by SPSS version 16, using t-test, ANOVA, and chi-square tests. RESULTS: The sample included 20 (19%) male and 88 (81%) female individuals with mean age of 49 years and mean BMI of 27.5. The mean FBS, GTT, and HbA1C were 107 MG/DL, 137MG/DL, and 5.9%, respectively. Clinical evaluation showed 33% of patients involved with periodontitis. The mean CAL, BOP, PI, PD, GI was 3.7, 0.62, 1.9, 2.1, 1.5, respectively (p< 0.05). A significant difference in periodontal index was found among patients with prediabetes. Moreover, in the patients with periodontitis, a statistically significant relationship between FBS and BMI, BOP and GTT, and finally between CAL and HbA1C was detected. CONCLUSION: Periodontitis is associated with prediabetic condition. While diabetes is an important risk factor for periodontitis, the risk of periodontitis would be greater if glycemic control is poor. Glycemic control in prediabetic patients can reduce the severity of periodontal disease. Early diagnosis and prevention is crucial to avoid the largely irreversible tissue damage that occurs in periodontitis.

Prevalence of Helicobacter pylori infection in Sari Northern Iran; a population based study.

AIM: In this study prevalence rate of Helicobacter pylori and its associated factors have been investigated in urban and rural areas of Sari. BACKGROUND: Helicobacter pylori has an important role in gastrointestinal diseases including peptic ulcer and gastric cancer. It is the most common infection in human population worldwide. Hence, the epidemiology of this infection in all parts of the world is of utmost importance. METHODS: We conducted a cross-sectional study on 497 individuals ranging 15-65 years of age in Sari city and its surrounding rural residents. The sampling method was a cluster random sampling multi staged in stratified population by urban and rural areas. Questionnaires for personal and socio-economic data were filled. Blood samples were drawn and kept for analysis (IgG antibody ELISA for Helicobacter pylori). The data was analyzed by SPSS statistical software and Chi-square test and logistic regression were used. RESULTS: The prevalence of helicobacter infection was 44.5% in the studied population. This prevalence was 41.3% and 47.8% in urban and rural areas, respectively. Just a significant association between the infection and the age of subjects was observed in multiple regression analysis (p=0.001). However, in univariate analysis the level of education was also significantly associated with Helicobacter pylori infection (p=0.015). No other variable was associated with the infection. CONCLUSION: The prevalence of helicobacter infection has dropped significantly in the region in comparison with the previous studies during the last 15 years.

Waist Circumference to Height Ratio: Better Correlation with Fat Mass Than Other Anthropometric Indices During Dietary Weight Loss in Different Rates.

BACKGROUND: The first-line strategy for the treatment of obesity is weight loss (WL) through decreasing calorie intake. However, a diet that is capable of attenuating fat free mass decline following WL is preferred. Furthermore, it is required to choose proper measurements and appropriate obesity-assessment indices to monitor weight and body composition during WL program. METHODS: A total of 68 adults with overweight and/or obesity underwent a WL program (rapid and slow WL). Dependent variables include: weight, resting metabolic rate (RMR), body composition, and related measurements such as waist circumference (WC), waist to height ratio (WHtR), body adiposity index (BAI), a body shape index (ABSI), fat mass to lean body mass (FM/LBM), and percentage body fat (PBF). RESULTS: Obesity measurements decreased in both groups (all P < 0.05) while LBM and RMR decreased more in the rapid WL group (P < 0.05). After age and sex adjustment, a robust correlation was observed between FM/LBM and PBF (r = 0.918), LBM% and PBF (r = -0.949), LBM% and FM/LBM (r = -0.904), WHtR and WC (r = 0.986), and BAI% and HC (r = 0.986) (P < 0.001 for all correlations). FM has the highest correlation with WHtR among other indices (r = 0.706). CONCLUSIONS: Compared to fast WL, our data support that slow and gradual WL is more effective to improve body composition and obesity-assessment indices. The robust relationship was observed between FM and WHtR, among other indices such as BMI or ABSI. Therefore, in order to evaluate FM, where the FM is not measurable, the WHtR might be the reasonable index.

The Polycystic Ovary Syndrome Health-Related Quality-of-Life Questionnaire: Confirmatory Factor Analysis.

BACKGROUND: The health related quality-of-life (HRQoL) among females with polycystic ovary syndrome (PCOS) is reduced due to emotional, psychosocial, infertility, marital, and hirsutism problems. OBJECTIVES: The current study aimed at analyzing exploratory and confirmatory factor structures of HRQoL questionnaire for polycystic ovary syndrome (PCOSQ-50) in females with PCOS in order to verify the validity of the developed instrument. METHODS: The current cross validation study was conducted on females with PCOS using the PCOSQ-50. The PCOSQ-50 was developed based on a qualitative study. The exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) were conducted to examine the factor structure of PCOSQ-50. After the CFA, the reliability of the new instrument was also evaluated using Cronbach's alpha coefficient. RESULTS: Totally, 350 females with PCOS were entered into the study. The mean age of the subjects was 26.9 ± 5.1 years. Based on the results of CFA, data were fit to the 43-item model: the comparative fit index (CFI) = 0.91; the normal fit index (NFI) = 0.90; the goodness of fit index (GFI) = 0.60; incremental fit index (IFI) = 0.91; the root mean square error of approximation (RMSEA) = 0.09; standardized root mean square residual (SRMR) = 0.09 and the relative chi-square (x2/df) = 2.20, P < 0.05. The intraclass correlation coefficient ranged 0.91 to 0.94 indicating a satisfactory finding. CONCLUSION: The 43-item PCOSQ showed appropriate validity and reliability and its psychometric quality was superior to that of the original version. However, further longitudinal studies should be conducted to evaluate its predictive efficacy.

Metabolic syndrome in patients with systemic lupus erythematosus: Association with disease activity, disease damage and age.

AIM: Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular involvement. Metabolic syndrome (MetS) includes a group of classic cardiovascular risk factors with probably proinflammatory conditions. The aim of the present study was to evaluate the frequency of MetS in SLE patients. METHODS: Demographic, clinical and laboratory features of 73 SLE patients were compared with 73 age-sex matched controls using SLE Disease Activity Index (SLEDAI), Systemic Lupus Damage Index (SDI) and Health Assessment Questionnaire (HAQ). MetS was diagnosed according to the definitions of the 2005 National Cholesterol Education Program (NCEP/ATP III) and International Diabetes Federation (IDF). The frequency of MetS was compared in SLE patients and controls, and then patients were investigated for MetS and major organ involvement. Statistical analysis was performed in SPSS version 19, and results were considered significant at P < 0.05. RESULTS: The mean age of SLE patients was 40.97 ± 12.2 years, and 95.8% were female. MetS according to NCEP/ATP III and IDF criteria was present in 33 (45.2%) and 34 (46.6%) SLE patients versus 27 (37%) and 29 (39.7%) controls (P > 0.05). Lupus patients were more likely to have hypertension (P = 0.038). SLE patients with MetS had higher HAQ scores (P = 0.029). In patients with major organ involvement, age and disease duration were significantly higher in the MetS subgroup (P < 0.05). CONCLUSION: The frequency of MetS was not significantly different from that of the control group, but almost half of the patients were found with this syndrome. This calls for further follow up and appropriate treatment of patients with MetS.

Pyrethroid resistance in Iranian field populations of Rhipicephalus (Boophilus) annulatus.

Resistance to acaricides in ticks is becoming increasingly widespread throughout the world; therefore, tick control requires resistance monitoring for each tick species. The aims of this study were to monitor the susceptibility status of the cattle tick, Rhipicephalus (Boophilus) annulatus (Acari: Ixodidae), against pyrethroid acaricides from Mazandaran Province, northern Iran, and where resistance was evident, and establish the possible underlying mechanisms. Fully engorged adult R. (B.) annulatus females collected on cattle from Mazandaran Province. Twenty-nine tick populations produced 10-18days old larvae and bioassayed with cypermethrin and λ-cyhalothrin by larval packet test and the levels of detoxification enzymes were measured. Population AM-29 had a maximum resistance ratio (RR99) of 20.21 to cypermethrin and 53.57% of the tick populations were resistant at LC99 level. With λ-cyhalothrin, 17.86% of the tick populations were resistant and AM-29 was the most resistant population with RR99=4.54. AM-29 also showed significant elevation of cytochrome P450 monooxygenase (P450) and glutathione S-transferase (GST) (2.76- and 2.39-fold, respectively) (P<0.001). Rhipicephalus (Boophilus) annulatus showed resistance to pyrethroid insecticides with elevated levels of P450, GST and para-nitrophenyl acetate (p-NPA) in resistant populations. Operational failure was noted in controlling R. (B.) annulatus by pyrethroid insecticides, therefore alternative pest management measures should be adopted in Iran. For the first time, a new estimate of insecticide resistance based on effective dose recommended by the pesticide manufacturer termed Operational Dose Ratio (ODR) is defined and discussed.