Estimation of influenza and severe acute respiratory illness incidence (burden) in three provinces of the Islamic Republic of Iran, 2012 and 2013.

There are few estimates of influenza burden in the WHO Region for the Eastern Mediterranean. In this study we estimated the burden of severe acute respiratory infection (SARI) and influenza-associated SARI (F-SARI) in selected provinces of Islamic Republic of Iran, the trends of SARI and confirmed cases of influenza (F-SARI) over 12 months (seasonality), and the age groups most at risk. Using the electronic Iranian influenza surveillance system and data of cases in sentinel hospitals of 3 selected provinces, we estimated the monthly trend (seasonality) of incidence for SARI and F-SARI, overall incidence of SARI and F-SARI and their disaggregation by age with the aid using the Monte Carlo technique. The age groups most at-risk were children aged under 2 years and adults older than 50 years.

Estimation of influenza and severe acute respiratory illness incidence [burden] in three provinces of the Islamic Republic of Iran, 2012 and 2013

There are few estimates of influenza burden in the WHO Region for the Eastern Mediterranean. In this study we estimated the burden of severe acute respiratory infection [SARI] and influenza-associated SARI [F-SARI] in selected provinces of Islamic Republic of Iran, the trends of SARI and confirmed cases of influenza [F-SARI] over 12 months [seasonality], and the age groups most at risk. Using the electronic Iranian influenza surveillance system and data of cases in sentinel hospitals of 3 selected provinces, we estimated the monthly trend [seasonality] of incidence for SARI and F-SARI, overall incidence of SARI and F-SARI and their disaggregation by age with the aid using the Monte Carlo technique. The age groups most at-risk were children aged under 2 years and adults older than 50 years

Peu d'estimations sont disponibles sur la charge de la grippe dans la Région OMS de la Méditerranée orientale. Dans la présente étude, nous avons estimé la charge de morbidité due aux infections respiratoires aiguës sévères [IRAS] et aux IRAS associés à la grippe dans certaines provinces de la République islamique d'Iran, ainsi que les tendances des IRAS et des cas de grippe confirmés sur 12 mois [saisonnalité], et les groupes d'âge les plus exposés. En utilisant le système électronique iranien de surveillance de la grippe et les données relatives aux cas des hôpitaux sentinelles de trois provinces sélectionnées, nous avons estimé la tendance mensuelle [saisonnalité] de l'incidence des IRAS et des IRAS dus à la grippe, l'incidence globale des IRAS et des IRAS dues à la grippe et leur ventilation par âge grâce à la méthode de Monte Carlo. Les groupes d'âge les plus exposés au risque étaient les enfants de moins de 2 ans et les adultes de plus de 50 ans

Dental Curriculum Revision in Iran: Dentists' Perspective on Achievement of Essential Competencies through National Curriculum.

BACKGROUND: Based on the current emphasis on competency-based education, as a part of need assessment phase of dental curriculum revision in Iran, in the present study the dental graduates' perspective concerning the minimum competency requirements for an Iranian general dentist has been investigated. METHODS: Based on the three available major competency documents in the literature a questionnaire was developed in which the participants were asked to indicate their opinion about the necessity of each of the 142 stated competencies for an Iranian general dentist (Yes/No), and to state the degree to which they believed the current curriculum covers each competency (Completely, Partially, Not at all). In an annual meeting in June 2008, the provincial chief dental managers were asked to distribute the questionnaires among general dentists in their province (10 questionnaires in each province). The managers posted back the completed questionnaires to the researchers. RESULTS: Of 300 questionnaires distributed in the 30 provinces of the country, 250 questionnaires (83%) were returned. While most of the participants considered the competencies as necessary for an Iranian dentist, less than 40% of the respondents believed that the graduates acquire the most required competencies of the profession during the current educational program. CONCLUSION: A necessity exists for curriculum revision. In addition to clinical skills, in this revision more emphasis also should be placed on the non-clinical part of the curriculum.

Mortality from Pandemic Influenza A (H1N1) in Iran.

BACKGROUND: Due to worldwide spread of influenza A (H1N1) virus, the World Health Organization declared the first pandemic of influenza in four decades. This study aims to report the mortality from pandemic influenza A (H1N1) in Iran population and its epidemiologic and clinical characteristics up to December 21, 2009. METHODS: The data were obtained from all provinces and reported to center for disease control of Ministry of Health and Medical Education (MOHME) of Iran through nationwide surveillance system for influenza A (H1N1) was implemented by MOHME since April 2009. RESULTS: Of 3672 confirmed cases of influenza A (H1N1) in Iran between 22 May and 21 December 2009, 140 (3.8%) deaths were reported, mostly in 15-65 year old (yo) age group (67%). The highest admission mortality rate was in > 65 yo group (107 deaths/1000 hospitalized cases). Of decedent patients, 54% had no long term condition or risk factor, 34% had one, 11% had two, and 1% had three. Diabetes mellitus, pregnancy, chronic respiratory diseases and hypertension were the most common underlying conditions. The most common clinical pictures of death were acute respiratory distress syndrome and viral pneumonia. Although 66% of decedent patients received oseltamivir, enough information was not available about time of onset of antiviral therapy. CONCLUSION: As death due to influenza A (H1N1) occurs in all age groups and in those with and without any predisposing factors, we recommend health policy makers to provide influenza vaccination for people with underlying conditions and respiratory hygiene for all people.

Detection of atypical cultivable canine gastric Helicobacter strain and its biochemical and morphological characters in naturally infected dogs.

Helicobacter-like organisms are frequently found in canine stomachs, but the relationship between such organisms and gastric pathology has not been established. However, some such organisms have zoonotic importance. The aims of this study were to evaluate the morphological and biochemical characteristics of cultivable canine gastric Helicobacter-like organisms (GHLOs) in pets and stray dogs and their prevalence in these two groups of dogs. Specimens were taken by gastroscopy from 30 clinically healthy stray dogs and 30 pet dogs. Cultures were positive from biopsies of 11/30 of stray and 6/30 of pet dogs. The isolated Helicobacters were observed by light microscopy and studied by biochemical, physiological and PCR analysis. Some of the isolated GHLO's displayed atypical shapes that were similar to Helicobacter pylori or Helicobacter acinonychis in stray dogs' cytological examinations. They had 2-3 helices and were smaller than other canine GHLOs. One of these atypical Helicobacter strains was cultured. It was not possible to distinguish such strains by routine PCR and biochemical evaluations. Electron microscopy showed a smaller Helicobacter (2 microm in length) with 2 or 3 helixes. This study demonstrates that not all canine gastric Helicobacters are 5-15 microm in length, as has been previously proposed, and portrays the need for further investigation of canine GHLOs.

Cardiovascular risk factors among males with war-related bilateral lower limb amputation.

This study was conducted to determine the cardiovascular risk factors among 327 Iranian males with bilateral lower limb amputation.The average age at the time of amputation and at the time of the study was 20.6 (SD = 5.4) and 42 years (SD = 6.3), respectively. Below both knees was the most common level of amputation (37.6%). About 95.4% had at least one modifiable risk factor. Prevalence of risk factors included: hyperglycemia 13.1%, systolic hypertension 18.9%, diastolic hypertension 25.6%, abdominal obesity 82.5%, high total cholesterol 36.7%, low HDL 25.9%, high LDL 24.7%, high triglycerides 32.1%, and smoking 31.8%. The most common risk factor was abdominal obesity. Prevalence of coronary artery disease was similar to the general Iranian population but prevalence of risk factors was higher significantly. The majority of the cases seem to be susceptible to cardiovascular disease in near future. Some strategies are needed as a primary prevention to reduce the risk of cardiovascular disease.

Interaction of bladder glycoprotein GP51 with uropathogenic bacteria.

PURPOSE: A major component of bladder surface mucin is a glycoprotein GP51 (molecular weight 51 kD.). GP51, which has previously been isolated from rabbit mucosa, appears to function as part of the defense mechanism in an in vivo infection model. GP51 coats the epithelium and is secreted into the urine, as detected by immunohistochemical testing and enzyme-linked immunosorbent assay (ELISA). Increased urinary GP51 occurs during urinary tract infection. To elucidate the role of GP51 as a component of the primary defense mechanism we studied interactions with uropathogenic bacterial isolates and urine from symptomatic patients with urinary tract infection. MATERIALS AND METHODS: ELISA was performed to demonstrate the binding of GP51 and various uropathogens. Immunochemical studies were done using monoclonal antibodies to GP51 to determine the interaction of GP51 with certain uropathogenic isolates, including Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, S. epidermidis and Streptococcus faecalis. Infected urinary sediments and uropathogenic bacterial cultures were examined by immunocytochemical testing to localize GP51. Antigen inhibition ELISA was done to quantitate urinary GP51 in the urine of 17 normal controls and 19 patients with urinary tract infection. RESULTS: ELISA revealed that GP51 binds to a wide spectrum of gram-positive and gram-negative uropathogens in semiquantitative fashion. Immunochemical methods confirmed that purified GP51 binds to bacteria, encapsulating and aggregating the bacteria. Clinical specimens showed GP51 localized to bacteria and uroepithelial cells. We observed a significant increase in urinary GP51 in urinary tract infection compared to uninfected urine (p = 0.0003). CONCLUSIONS: These studies suggest that GP51, a component of bladder mucin, may be a strategic factor in the primary defense mechanism of the bladder.

Multicomponent penile prosthesis implantation under regional anesthesia.

Fourteen consecutive patients underwent placement of a multicomponent penile prosthesis under regional anesthesia using a pudendal nerve block. Results demonstrated the need for minimal administration of intraoperative narcotics, no major fluctuations in the blood pressure or pulse rate during intraoperative monitoring, and only 1 of 14 patients was converted to general anesthesia. Postoperatively, our results show that there was no urinary retention or cardiac side effects, adequate postoperative analgesia was obtained, and 13 of the 14 patients were discharged within 24 hours. This method was safe, effective, easily performed, and does not carry the associated morbidity of general or spinal anesthesia.

Multi-rate nonlinear state and parameter estimation in a bioreactor.

This paper concerns real-time, multi-rate, nonlinear state and parameter estimation in a pilot-scale biochemical reactor in which cultivation of mouse-mouse hybridoma cells takes place. A multi-rate estimator is designed and implemented to estimate specific growth rate and concentrations of viable cells, total cells, glucose, glutamine, and monoclonal antibodies (MAb) in the reactor. These are estimated from frequent measurement (inferred values) of oxygen uptake rate (OUR) and infrequent and delayed measurements of the concentrations of viable cells, total cells, glucose, glutamine, and MAb. The infrequent measurements are available every 2 to 17 h with a time delay of 0.08 to 2.00 h, and OUR is inferred from dissolved oxygen concentration measurements that are available very 0.17 h. For each of the process variables, its infrequent measurement data and the profile of its estimate are presented to show the performance of the multi-rate estimator.

Ureteroscopic retrograde endopyelotomy.

With improvements in technology, we continue to seek new surgical techniques to approach old surgical issues. Antegrade percutaneous endopyelotomy has become the most common first-line approach to treatment of ureteropelvic junction obstruction, however, it is now possible to treat this condition successfully through a retrograde ureteroscopic approach. By combining the latest small ureteroscopes with the technology of endoluminal ultrasound, it is possible to treat this disease in a single setting without the complications of ureteral strictures or significant postoperative hemorrhage, thereby eliminating the need for a nephrostomy tube and dramatically reducing the morbidity of the procedure.

Cytoskeletal agents inhibit motility and adherence of human tumor cells.

Cytoskeletal agents have been demonstrated to inhibit stimulated motility and substrate adherence by the human tumor cell line, A2058. cis-tubulozole, taxol, and cytochalasin D were tested for their effects on chemotaxis in response to a tumor cytokine, autocrine motility factor, and on adherence to several substrata: laminin- and gelatin-coated dishes as well as tissue culture plastic. Cytochalasin D, which inhibits microfilament polymerization, abolished stimulated motility. Taxol, which stabilizes microtubules, decreased stimulated motility to a greater degree than cis-tubulozole, which inhibits microtubular polymerization. In contrast, cis-tubulozole had the greatest inhibitory effect on adherence with a gelatin substratum more affected (100% inhibition) than tissue culture plastic (90%) or laminin substratum (52%). Taxol affected adherence in the same order but less than cis-tubulozole. Cytochalasin D had no significant effect on adherence to laminin with moderate inhibition of adherence to tissue culture plastic or gelatin. These data suggest that, in these tumor cells, microfilaments are more crucial for motility than adherence, but the dynamic polymerization and depolymerization of microtubules are required for both types of cellular activities.