Prevalence and risk factors of latent tuberculosis infection in hemodialysis patients in southwest Iran.

INTRODUCTION: Tuberculosis (TB) is a significant global health concern, particularly in developing countries. Diagnosing latent tuberculosis infection (LTBI) in hemodialysis patients is crucial because of the risk of developing active tuberculosis in this population due to attenuated immune response. Herein, we assessed the prevalence of LTBI in hemodialysis patients. METHODS: In this cross-sectional study, we included all patients referred to hemodialysis centers in Kohgiluyeh and Boyer-Ahmad Province, southwest Iran, in 2018 through census sampling. Tuberculin skin test (TST) was utilized to screen the patients for LTBI. All steps were done by trained physicians. RESULTS: In total, 183 patients (mean age: 59.3, SD= 16.0) were included in the study of which 76 (41.5%) were females, and 107 (58.5%) were males. Neither the patients nor their family members had a history of tuberculosis. Assuming an above 5-millimeter enduration as a positive TST result, 22 patients (12%) had LTBI. None of the demographic or clinical features differed between TST -negative and -positive groups. CONCLUSION: Hemodialysis patients are prone to LTBI due to several immunological and environmental factors. Screening for LTBI may be beneficial to prevent active tuberculosis in this population.

An application of social marketing for promoting HIV testing in Iran.

BACKGROUND: It has been estimated that 60,000 Iranians have been infected with HIV/AIDS and only 36% of them are aware of their status. This study aimed to design, implement and evaluate a social marketing campaign to promote HIV testing in Boyer-Ahmad County, Kohgiluyeh, and Boyer-Ahmad Province, southwest of Iran. MATERIALS AND METHODS: This study was a quasi-experimental pretest-posttest without a control group, developed based on a social marketing assessment and response tool. To design the intervention formative research was conducted, comprised of four focus group discussion sessions with 42 participants of the target community along with seven in-depth semi-structured personal interviews with health care providers involved in the HIV/AIDS Program. Data analysis was done manually using content analysis and the main content was formulated for the campaign. Afterward, the slogan and messages of the campaign were developed. The campaign's materials including banners, posters, pamphlets, referral forms, and short messages were designed, pretested, and revised. Ultimately, the campaign was conducted for one month in October 2019. To determine the effectiveness of the campaign, the rate of referrals to the Center for Behavioral Health Counseling Services (CBHCS), for three months before and after the campaign, was compared. RESULTS: Qualitative findings identified that the majority of the interviewees mentioned that the main reasons for the low rate of referrals to get tested for HIV were lack of awareness and information about HIV/AIDS and its diagnosis as well as the free and confidential tests available from the CBHCS. Moreover, the stigma associated with HIV/AIDS was another important reason for low referrals for testing. The rate of referrals for HIV testing in the three months leading up to the campaign was 18, 32, and 23 people, and three months after the campaign was 64, 81, and 44 individuals; respectively. The results of the multivariate analysis demonstrated that the campaign had increased the rates of referrals for HIV testing through its significant influence on females, and individuals with academic degrees. CONCLUSION: It can be concluded that the social marketing campaign was successful in persuading people to get tested for HIV.

Physical and psychological workloads and their association with occupational fatigue among hospital service personnel.

BACKGROUND: Physical and psychological workloads are a vital issue in the workplace. This study aimed to investigate the association between physical and psychological workloads and occupational fatigue among Iranian hospital service personnel. In Iran, hospital service personnel refers to a group of healthcare workers who undertake a range of duties, such as moving and carrying the hospital waste, transporting patients by wheelchair or gurney to the operating room, x-ray department, other wards, or other locations around the facility, performing cleaning tasks such as changing linens, mopping floors, and sterilizing equipment, and following infection control procedures to reduce the risk of spreading germs within the hospital setting. METHODS: This cross-sectional study was conducted on 198 Iranian hospital service personnel. The response rate was 86%. The data were gathered using 1) The Persian version of the Job Content Questionnaire (P-JCQ) for assessing physical and psychosocial workloads and 2) The Persian version of the Swedish Occupational Fatigue Inventory (P-SOFI-20) for assessing fatigue dimensions. RESULTS: According to the P-JCQ, the physical and psychological workload intensities were high in 72.7% and 47% of the participants, respectively. Based on the P-SOFI, the participants' mean scores of "physical fatigue" (21.73 ± 6.2), "psychological fatigue" (13.61 ± 5.76), and "fatigue due to shift work" (18.17 ± 5.6) were moderate, while the mean score of "general fatigue" was high (27.3 ± 6.98). The findings revealed that various types of fatigue are associated with age, gender, marital status, daily working hours, and psychological workload. CONCLUSIONS: Psychological workload was a determinant of occupational fatigue among Iranian hospital service personnel. Hence, an interventional program, including job enrichment, job rotation, and work-rest cycle, is recommended.

In-situ hydrothermal synthesis of CNT decorated by nano ZnS/CuO for simultaneous removal of acid food dyes from binary water samples.

The zinc sulfide/copper oxide-carbon nanotube nanocomposite (ZnS/CuO-CNT) was fabricated by using an in-situ hydrothermal synthesis method and was used for simultaneous ultrasound-assisted adsorptive removal of a binary mixture of ponceau 4R (P4R) and tartrazine (TA) acid food dyes from contaminated water. The as-synthesized ZnS/CuO-CNT was described by FESEM, XRD, FTIR, BET, and zeta potential analysis. The results included nested network morphology, high purity with the crystalline structure, oxygen-containing functional groups, mesoporous/micropores texture with cumulate interspace, specific surface area of 106.54 m2 g-1, and zero-point charge (pHzpc) of 5.3. In adsorption experiments, the simultaneous effect of main independent variables, including solution pH, adsorbent dosage, concentration of each dye, temperature, and sonication time on the removal efficiency of dyes was studied systematically using the central composite design (CCD) method based on response surface methodology (RSM). Also, the second-order multivariate equation was presented to determine the relationship between the removal efficiencies of P4R and AT dyes and six independent effective variables. The high correlation coefficient (R2 ≥ 0.99), significant p-value (P < 0.0001), and non-significant lack-of-fit (P > 0.05) showed the high accuracy, and validity of the proposed model to predict the removal efficiency of P4R and TA acid food dyes. The experimental removal efficiency for P4R and TA dyes was found to be 98.45 ± 2.54, and 99.21 ± 2.23, respectively. Also, the Langmuir maximum adsorption capacity for P4R and TA dyes was determined to be 190.1 mg g-1 and 183.5 mg g-1, respectively. Finally, the adsorbent's reusability was tested for six periods and could be reused repeatedly without significant reduction in adsorption performance.

In vitrostatic and dynamic cell culture study of novel bone scaffolds based on 3D-printed PLA and cell-laden alginate hydrogel.

The aim of this paper was to design and fabricate a novel composite scaffold based on the combination of 3D-printed polylactic acid-based triply periodic minimal surfaces (TPMSs) and cell-laden alginate hydrogel. This novel scaffold improves the low mechanical properties of alginate hydrogel and can also provide a scaffold with a suitable pore size, which can be used in bone regeneration applications. In this regard, an implicit function was used to generate some gyroid TPMS scaffolds. Then the fused deposition modeling process was employed to print the scaffolds. Moreover, the micro computed tomography technique was employed to assess the microstructure of 3D-printed TPMS scaffolds and obtain the real geometries of printed scaffolds. The mechanical properties of composite scaffolds were investigated under compression tests experimentally. It was shown that different mechanical behaviors could be obtained for different implicit function parameters. In this research, to assess the mechanical behavior of printed scaffolds in terms of the strain-stress curves on, two approaches were presented: equivalent volume and finite element-based volume. Results of strain-stress curves showed that the finite-element based approach predicts a higher level of stress. Moreover, the biological response of composite scaffolds in terms of cell viability, cell proliferation, and cell attachment was investigated. In this vein, a dynamic cell culture system was designed and fabricated, which improves mass transport through the composite scaffolds and applies mechanical loading to the cells, which helps cell proliferation. Moreover, the results of the novel composite scaffolds were compared to those without alginate, and it was shown that the composite scaffold could create more viability and cell proliferation in both dynamic and static cultures. Also, it was shown that scaffolds in dynamic cell culture have a better biological response than in static culture. In addition, scanning electron microscopy was employed to study the cell adhesion on the composite scaffolds, which showed excellent attachment between the scaffolds and cells.

Seroprevalence of Toxoplasma gondii infection among HIV-positive patients in Southwest Iran and associated risk factors: a case-control study.

BACKGROUND: The current study aimed to determine the seroprevalence of Toxoplasma gondii infection among HIV-positive patients and healthy subjects. METHODS: This study was carried out on HIV-positive patients and healthy individuals in Southwest Iran. Five millilitres of venous blood samples were collected aseptically from each individual. Sera and buffy coats were isolated from each sample and evaluated for anti-Toxoplasma antibodies and T. gondii DNA using ELISA kit and real-time PCR, respectively. Statistical analysis was performed using SPSS 18 software. RESULTS: Of 64 AIDS/HIV-positive patients, six (9.3%, 95% CI 7.2 to 11.3%) were seropositive for only IgG and five (7.8%, 95% CI 6.0 to 9.5%) were seropositive for both IgG and IgM. Moreover, among 64 healthy controls, 10 (15.6%, 95% CI 12.1 to 19.0%) were seropositive for only IgG and 2 (3.1%, 95% CI 2.4 to 3.7%) were seropositive for both IgG and IgM. Toxoplasma gondii DNA was detected in six samples (9.3%, 95% CI 7.2 to 11.3%) in the AIDS/HIV-positive patients group and eight samples (5.95%, 95% CI 4.6 to 7.2%) in the control group using real-time PCR. Consumption of undercooked meat was documented as an associated risk factor for T. gondii seropositivity in AIDS patients (OR 4.06, 95% CI 0.966 to 17.09; p=0.045). CONCLUSIONS: Our findings showed a lower prevalence of Toxoplasma infection in AIDS/HIV-positive patients vs healthy controls; however, a considerable number of AIDS/HIV-positive patients were also seen to be at risk of toxoplasmosis. Based on the findings, screening and prophylaxis for toxoplasmosis should be implemented for all AIDS/HIV-positive patients in Southwest Iran.

Prevalence and determinants of anemia among Iranian population aged ≥35 years: A PERSIAN cohort-based cross-sectional study.

BACKGROUND: So far, no comprehensive studies have been performed to assess burden and determinants of anemia in Iran. In the present study, we aimed to answer this query using the data obtained from the Prospective Epidemiological Research Studies in IrAN (PERSIAN). METHODS: In this cross-sectional study, we included 161,686 adult participants (aged 35 years and older) from 16 provinces of Iran. Anemia was defined as a hemoglobin concentration of <13 g/dL in males and <12 g/dL in females. To evaluate the association between anemia and different factors, we used the multivariable Poisson regression analysis with robust variance by applying adjusted prevalence ratio (PR) with 95% confidence interval (CI). RESULTS: Of the total number of subjects, 72,387 (44.77%) were male and others were female. Mean age was 49.39±9.15 years old. The overall age- and sex-standardized prevalence of anemia was 8.83% (95% CI: 8.70-8.96%) in the included population. The highest and the lowest age- and sex-standardized prevalence of anemia pertained to Hormozgan (37.41%, 95% CI: 35.97-38.85%) and Kurdistan (4.57%, 95% CI: 3.87-5.27%) provinces, respectively. Being female (PR = 2.97), rural residence (PR = 1.24), being retired (PR = 1.53) and housewife (PR = 1.11), third and fourth wealth status quartiles (PR = 1.09 and PR = 1.11, respectively), being underweight (PR = 1.49), drug user (PR = 1.35), inadequate sleep (PR = 1.16), poor physical activity (PR = 1.15), diabetes (PR = 1.09), renal failure (PR = 2.24), and cancer (PR = 1.35) were associated with increased risk of anemia. On the other hand, illiteracy (PR = 0.79) and abdominal obesity (PR = 0.77) decreased the risk of anemia. CONCLUSIONS: According to the results, a variable prevalence of anemia was observed across the included provinces. We tried to provide an informative report on anemia prevalence for health professionals and authorities to take measures for identification and management of the cases of anemia in high-prevalence areas.

The Relationship between Salivary and Serum IgA and IgG Levels and Dental Caries in Adults.

BACKGROUND: Dental caries is one of the most common microbial infectious diseases. The important method for as-sessment of oral health status is DMFT (Decayed, Missing, and Filled Teeth). Recent studies have shown conflicting results regarding the relationship of antibodies with dental caries. This study aimed to investigate the salivary and serum IgA and IgG levels in adult caries. METHODS: This cross-sectional study was conducted on 96 patients with dental caries who were referred to the specialized dental clinic in Yasuj. Based on the DMFT index, patients were divided into three groups. DMFT index in group 1, 2, and 3 were 0, 1 - 3, and more than 3, respectively. Salivary and serum levels of IgA and IgG were measured by nephelometric method. Data were analyzed using SPSS software, chisquared, and paired t-test. RESULTS: The mean salivary IgA level in group 1, 2, and 3 were 0.259 ± 0.118, 0.264 ± 0.175, and 0.169 ± 0.106 mg%, respectively (p = 0.001). Also, the mean salivary IgG level in group 1, 2, and 3 were 1.360 ± 316, 1.320 ± 0.350 and 1.320 ± 0.370 mg% (p = 0.929). The mean serum IgA level were 1.443 ± 0.433, 1.805 ± 0.518 and 1.790 ± 0.700 gr% in group 1, 2 and 3, respectively (p = 0.363). Also, the mean serum IgG level in group 1, 2, and 3 were 9.275 ± 1.899, 10.257 ± 1.658 and 10.589 ± 3.113 gr% (p = 0.451). CONCLUSIONS: This study showed that by decreasing the level of salivary IgA, the rate of dental caries and DMFT index increase and this indicates the protection mechanism against dental caries by IgA.

Using Social Marketing to Reduce Intention of Cesarean Section in Iranian Women.

INTRODUCTION: In Iran, the rate of cesarean section is three times more than the acceptable rate considered by the World Health Organization. This study aimed at reducing the selection of cesarean section by primigravida through an intervention based on social marketing in Boyer-Ahmad County, Iran, 2015. METHODS: In this field trial, 39 of primigravida women were identified and selected as a target group. Formative research (a quantitative survey and a qualitative study) was done to achieve the social marketing mix. The tailored intervention was developed based on the findings of formative research. The intervention was implemented for one month for pregnant women who had cesarean section intention. Their intention for the cesarean section was studied again one month after the implementation of the intervention. The effectiveness of the intervention was evaluated by the proportion test. RESULTS: The average age of the women was 25.82. All of the women 38.5 percent had a diploma degree and lower than and 61.5 percent had a university degree. Before the intervention, 39 women intended to do Cesarean. The intention of 30 pregnant women was changed significantly one month after the intervention. CONCLUSION: The study showed the effectiveness of an intervention based on consumer-oriented social marketing theory and could be used to reduce Cesarean intention. More studies about related factors of vaginal delivery selection especially from behavioral intention up to behavior are suggested.

Intercalation of curcumin into liposomal chemotherapeutic agent augments apoptosis in breast cancer cells.

Resistance to common chemotherapeutic agents is a frequent phenomenon in late-stage breast cancers. An ideal system capable of the co-delivery of hydrophobic and hydrophilic chemotherapeutic agents can regulate the dosage and co-localization of pharmaceutical compounds and thereby improve the anticancer efficacy. Here, for the first time, we have intercalated curcumin (Cur) into a double-layered membrane of cisplatin (Cis) liposomes to obtain a dosage controlled co-delivery formulation, capable of inducing apoptosis in breast cancer cells. The concentrations of Cur and Cis in nanoliposome (Cur-Cis@NLP) were optimized by response surface methodology (RSM); RSM optimization showed 99.81 and 23.86% entrapment efficiency for Cur and Cis, respectively. TEM analysis demonstrated the fabrication of nanoparticles with average diameter of 100 nm. The anticancer and apoptotic effects of Cur-Cis@NLPs were also evaluated using MTT assay, fluorescent staining and flow cytometry assays. Cytotoxicity assessments of various Cur-Cis@NLPs concentrations demonstrated a concentration-dependent manner. In comparison to free and liposomal Cis, Cur-Cis@NLP reduced breast cancer cells' viability (82.5%) in a significant manner at a final concentration of 32 µg.mL-1 and 20 µg.mL-1 of Cur and Cis, respectively. Combination index values calculation of Cur-Cis@NLP showed an overall CI value <1, indicating synergetic effect of the designed co-delivery system. Additionally, flow cytometry assay demonstrated Cur-Cis@NLPs triggered apoptosis about 10-folds higher than liposomal Cis. This co-drug delivery system has a potential for the encapsulation and release of both hydrophobic and hydrophilic drugs, while taking the advantages of the reduced cytotoxic effect along with achieving high potency.

The Lived Experience of Nurses Caring for Patients with COVID-19 in Iran: A Phenomenological Study.

OBJECTIVE: This study aimed to explore the lived experiences of nurses caring for patients with COVID-19 in Iran. METHODS: This study was a descriptive phenomenology. Sampling was purposefully performed, and participants were selected in terms of the inclusion criteria. Data were collected through semi-structured interviews using the WhatsApp mobile messaging application. Colaizzi's method was used to analyse the data. The criteria introduced by Lincoln and Guba were used for the study rigour. RESULTS: The data were obtained from 12 nurses caring for patients with COVID-19. The mean age of the participants was 29.41 years (SD = 2.72) with a mean work experience of 6.75 years (SD = 2.52). Three main themes and six subthemes were identified: mental condition (subthemes included "anxiety and stress" and "fear"), emotional condition (subthemes included "suffering and affliction" and "waiting for death"), and care context (subthemes included "turmoil" and "lack of support and equipment"). CONCLUSION: The results of this study show that nurses working in the wards and care centres designated for patients with COVID-19 are experiencing mental and emotional distress and are working in inadequate professional conditions.

Facile preparation of a novel biogenic silver-loaded Nanofilm with intrinsic anti-bacterial and oxidant scavenging activities for wound healing.

To eliminate the microbial infection from an injury site, various modalities have been developed such as dressings and human skin substitutes. However, the high amount of reactive oxygen species, microbial infection, and damaging extracellular matrix remain as the main challenges for the wound healing process. In this study, for the first time, green synthesized silver nanoparticles (AgNPs) using Teucrium polium extract were embedded in poly lactic acid/poly ethylene glycol (PLA/PEG) film to provide absorbable wound dressing, with antioxidant and antibacterial features. The physicochemical analysis demonstrated, production of AgNPs with size approximately 32.2 nm and confirmed the presence of phytoconstituents on their surface. The antibacterial assessments exhibited a concentration-dependent sensitivity of Staphylococcus aureus and Pseudomonas aeruginosa toward biosynthesized AgNPs, which showed a suitable safety profile in human macrophage cells. Furthermore, oxidant scavenging assays demonstrated exploitation of plant extract as a reducing agent, endows antioxidant activity to biogenic AgNPs. The formation of PLA/PEG nanofilm and entrapment of AgNPs into their matrix were clearly confirmed by scanning electron microscopy. More importantly, antibacterial examination demonstrated that the introduction of biogenic AgNPs into PLA/PEG nanofibers led to complete growth inhibition of P. aeruginosa and S. aureus. In summary, the simultaneous antioxidant activity and antimicrobial activity of the novel biogenic AgNPs/PLA/PEG nanofilm showed its potential for application as wound dressing.

The Effect of Using Olive Oil and Fish Oil Prophylactic Dressings on Heel Pressure Injury Development in Critically Ill Patients.

INTRODUCTION AND AIM: Prevention of pressure injuries in patients hospitalized in intensive care units is significantly important. Therefore, in the present study, the effect of using olive oil and fish oil prophylactic dressings on the development of heel pressure injuries was investigated. METHODS: The present study was a clinical trial conducted in the intensive care unit of Shahid Beheshti Hospital, in Yasuj. Fifty patients, who were at moderate to high risk of pressure injuries development, were randomly divided into two groups based on the mean score of the Braden scale. In one group, patients' heels were dressed using olive oil prophylactic dressing, and in the other group, patients' heels were dressed using fish oil prophylactic dressing. The dressings were changed 3 times a day. Collected data were then analyzed using SPSS v16. RESULTS: No significant difference was determined in demographic variables among the two groups (p<0.05). In terms of the development of heel pressure injuries, none of the patients in the olive oil and fish oil groups had pressure injuries. CONCLUSION: There were no statistically significant differences in either treatment group related to heel pressure injuries outcomes during the 7 days observed in the study. Additionally, both dressings had the same effects. Further studies are recommended in this regard.

Women's Views About Domestic Violence: A Qualitative Study in Iran.

Violence against women is an urgent health priority in Iran. Designing effective programs for preventing and controlling the problem necessitates a thorough understanding of Iranian women and their perspectives regarding domestic violence. This study was aimed at exploring the domestic violence-related views of married women who were referred to health care facilities in Ahvaz, Iran. In this qualitative research, data were collected through four focus group discussions with 30 married women. All the discussions were recorded and transcribed, after which the data were classified separately. The main themes and subthemes were then manually derived from the data and analyzed. The five main themes identified were domestic violence against women in Ahvaz, behavioral influencing factors, nonbehavioral influencing factors, the necessity to empower women to prevent domestic violence, and recommendations for developing special training programs for Ahvazi women. Most of the participants were aware that domestic violence against women is a common occurrence in Iran. They were well aware of the definition of violence and expressed a belief that behavioral factors exert an important effect on the occurrence of the problem. They recommended the development of appropriate training programs that empower women to prevent the problem, the use of mass media to educate citizens about domestic violence, and the involvement of opinion leaders in eliminating the taboo against considering such violence a crime against Iranian women. Considering the views and ideas of women as consumers of educational services is a principle used to develop effective programs for preventing and controlling domestic violence. As indicated by the findings, the participants believe that empowering women must be treated as a priority in the Iranian health care system. However, they recommended differing approaches and methods of empowerment on the basis of their individual views and concerns.

Cell targeting peptides as smart ligands for targeting of therapeutic or diagnostic agents: a systematic review.

Cell targeting peptides (CTP) are small peptides which have high affinity and specificity to a cell or tissue targets. They are typically identified by using phage display and chemical synthetic peptide library methods. CTPs have attracted considerable attention as a new class of ligands to delivery specifically therapeutic and diagnostic agents, because of the fact they have several advantages including easy synthesis, smaller physical sizes, lower immunogenicity and cytotoxicity and their simple and better conjugation to nano-carriers and therapeutic or diagnostic agents compared to conventional antibodies. In this systematic review, we will focus on the basic concepts concerning the use of cell-targeting peptides (CTPs), following the approaches of selecting them from peptide libraries. We discuss several developed strategies for cell-specific delivery of different cargos by CTPs, which are designed for drug delivery and diagnostic applications.

Mothers' views about sexual health education for their adolescent daughters: a qualitative study.

BACKGROUND: Given that mothers play a role in the sexual education of their daughters, it is important to understand their views of sexual health and related programs. This study was aimed at exploring mothers' perspectives regarding sexual health education for their adolescent daughters in Mahshahr, Iran. METHODS: In this qualitative study, in-depth interviews with ten key informants and five focus group discussions involving 28 mothers with daughters aged 12-18 were conducted. All the discussions were audio-recorded and later transcribed. The data were classified, after which the main themes and sub-themes were manually extracted and analyzed. RESULTS: The five main themes determined were: the necessity of sexual health education for adolescent girls, the sources of information that mothers use, barriers to sexual health education, the need to empower mothers to provide sexual education to their daughters, and recommendations for developing special training programs for mothers. Most participants believed in limiting sexual health education for adolescent girls; nevertheless, they stated that trained mothers were best equipped to educate their daughters. The major barriers identified by the mothers were their own insufficient knowledge about sexual issues, embarrassment surrounding discussions of this issue with their daughters, fear of the arrogance and curiosity of girls, and a lack of skills for effective communication. CONCLUSION: The results showed that empowering mothers to provide sexual health education is important. Tailored educational programs, based on mothers' views, should be developed and implemented.

Retrospective study of factors related to preterm labor in Yasuj, Iran.

INTRODUCTION: Premature labor is a serious worldwide problem that can cause neonatal death and other serious disorders. This study aimed to determine the most important factors related to preterm labor in Yasuj, Iran. METHOD: This case-control study was conducted in the maternity ward of Imam Sajjad Hospital, the obstetrics and gynecology center of Yasuj, in 2010. Among eligible samples, mothers with preterm labor were selected as the case group, and for each sample in the case group, one mother with full-term labor was selected by using clipper-matched sampling to make up the control group. Data were collected by a researcher-made questionnaire and the 28-item General Health Questionnaire. Finally, after deleting imperfect questionnaires, collected data of 52 subjects of case group and the same amount in control group were analyzed. RESULTS: Among the 5400 live birth infants in Yasuj in 2010, 130 infants were premature (2.4%). The preterm labor risk in women with two or more pregnancies was 5.5 times more than women with less than two pregnancies, its risk in women with low general health status was 2.9 times more than in women with normal general health status, and the preterm labor risk in women with a history of diabetes mellitus/thyroid dysfunction/cardiac disease was 2.3 times more than healthy mothers (P < 0.01). CONCLUSION: With respect to the above and due to the role and importance of mother-infant health in community health, it is necessary that the health-care system improve health education with regard to the appropriate number of pregnancies, diagnose and cure disease during pregnancy, especially diabetes and cardiovascular disease (hypertension and/or eclampsia), and recognize pregnant mothers with mental pressure or lack of sufficient support and help them.

Asthma prevalence in Iranian guidance school children, a descriptive meta-analysis.

BACKGROUND: The morbidity and mortality of asthma have risen among children, especially those under 18, during the past 3 to 4 decades. There are various single studies in different target populations of Iran, which have reported different estimations. The present study designed in order to estimate a pooled prevalence among Iranian guidance school children. MATERIALS AND METHODS: After searching for relevant articles in international and local databases from 1997 to 2009, we found 16 relevant articles and studies having the inclusion criteria. The outcome measure was the prevalence of asthma, and forest plot was used for presenting the findings of the meta-analysis. Heterogeneity between the studies was evaluated by the Cochran test. Moreover, the random effects model was used for estimation of pooled measures in Stata software (version 10). RESULTS: From all the entered studies, 10 articles were published in English and the rest in Persian language. The pooled estimates for females, males and both genders were calculated as 3.9% (95% CI: 3.2% - 4.6%), 5% (95% CI: 4.2% - 5.8%), and 4.4% (95% CI: 3.7% - 5.1%), respectively. CONCLUSION: The prevalence of asthma among Iranian children varied from 1.26% to 11.6%, which is possibly due to the difference in sex, ethnicity race, and socio-economic level of Iranian population. Also, the prevalence of asthma among Iranian guidance school children was lower in comparison to the other neighborhood countries.

Titering of 2009 pandemic H1N1 influenza virus hemagglutinin inhibition antibody in nonvaccinated pregnant women in Shiraz, Southern Iran.

Influenza may cause severe complications for pregnant women. In this study antibody response against 2009 H1N1 influenza virus in pregnant women was investigated. This seroprevalance cross sectional and questionnaire based study was conducted using a convenient sampling method. Blood samples of pregnant women were checked for antibodies against 2009 H1N1 influenza virus using hemagglutination inhibition assay. An antibody titer level of ≥ 1:40 dilution was considered as the protective level. 167 (43.60%) of 383 pregnant women who participated in this study had protective antibody levels against this virus. 62 (35.63%) of 3rd trimester, 79 (46.74%) of 2nd trimester, and 21(52.50%) of 1st trimester pregnant women were immune respectively (χ2(for trend) = 8.20, p < 0.004). Lack of protective antibody level was significantly seen more in pregnant women of 3rd trimester of pregnancy (OR = 2.37, CI = 1.09-5.18). Pregnant women with higher education (OR = 1.67, CI = 1.02-2.73) and those with history of anemia (OR = 2.09, CI = 1.18-3.68) had more immunity. Older women (OR = 0.95, CI = 0.91-0.99) and those with history of psychological diseases (OR = 0.19, CI = 0.05-0.70) had less immunity. Vaccination of pregnant women, especially those who are in the higher trimesters of pregnancy, older, or less educated, against the 2009 H1N1 influenza virus should be continued.

Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer.

INTRODUCTION: Identification of simple and measurable prognostic factors is an important issue in treatment evaluation of breast cancer. The present study was conducted to evaluate the prognostic role of vascular invasion in lymph node negative breast cancer patients. METHODS: in a retrospective design, we analyzed the recorded profiles of the 1,640 patients treated in the breast cancer department of Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from January 1999 to December 2012. Overall and adjusted survivals were evaluated by the Cox proportional hazard model. All the hypotheses were considered two-sided and a p-value of 0.05 or less was considered as statistically significant. RESULTS: Mean age in lymph node negative and positive patients was 50.0 and 49.8 respectively. In lymph node negative patients, the number of nodes, tumor size, lymphatic invasion, vascular invasion, progesterone receptor, and nuclear grade were significant predictors. In lymph node and lymphatic negative patients, vascular invasion also played a significant prognostic role in the survival which was not evident in lymph node negative patients with lymphatic invasion. DISCUSSION: The results of our large cohort study, with long term follow up and using multivariate Cox proportional model and comparative design showed a significant prognostic role of vascular invasion in early breast cancer patients. Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer.