Heavy metal contaminated soil, water, and vegetables in northeastern Iran: potential health risk factors.

Purpose: This study was designed to measure the concentrations of heavy (Pb, Cu, Fe, Ni, and Zn) metals in water, soil, and frequently edible leafy vegetables in the Iranian population and assessed the carcinogenic and non-carcinogenic health risk in consumers. Methods: The samples of soil, water, and vegetables were collected from forms near the Tehran-Mashhad highway in Neyshabur, Iran. The content of heavy metals in the samples was analyzed using Atomic Absorption Spectrophotometry. Results: The average concentrations of Pb, Cu, Fe, Ni, and Zn were 5.56, 3.35, 4.74, 2.95, and 5.27 mg/kg, respectively. Lead concentration in all of the vegetable samples was higher than the permissible value endorsed by the World Health Organization (WHO) / Food and Agriculture Organization (FAO). In contrast, the concentrations of all the other heavy metals in the samples were less than the maximum permissible levels recommended by WHO/FAO. Similarly, the water and soil samples were highly contaminated by Lead. The hazard quotient (HQ) of all the heavy metals was distinctively less than one, and it did not exceed 0.3 in any of the age groups. Furthermore, the carcinogenic risk for nickel was only higher than the recommended value, especially in women. Conclusion: While it seems that consuming vegetables has no acute health risk related to heavy metals, long-term and regular ingestion of the vegetables are likely to make cancer risk. Besides, due to the high concentration of Pb in soil and vegetables, regular and integrated assessment of heavy metals in soil, water, and food is necessary.

Colorectal Cancer in North-Eastern Iran: a retrospective, comparative study of early-onset and late-onset cases based on data from the Iranian hereditary colorectal cancer registry.

BACKGROUND: The incidence rate of colorectal cancer (CRC) is increasing among patients below 50 years of age. The reason for this is unclear, but could have to do with the fact that indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent mann er. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and clinicopathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran. METHODS: This retrospective study, carried out over a three-year follow-up period (2014-2017), included 562 consecutive CRCs diagnosed in three Mashhad city hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and hereditary features together with information on the presence of mismatch repair (MMR) gene deficiency with respect to recovery versus mortality. Patients with mutations resulting in absence of the MMR gene MLH1 protein product and normal BRAF status were considered to be at high risk of Lynch syndrome (LS). Analyses using R studio software were performed on early-onset CRC (n = 222) and late-onset CRC (n = 340), corresponding to patients ≤50 years of age and patients > 50 years. RESULTS: From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC than men (56% vs. 44%), while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, with 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal and proximal), the frequencies were 61, 28 and 11%, respectively, but the variation did not reach statistical significance. However, there was a dramatic difference with regard to the history of CRC in second-degree relatives between two age categories, with much higher numbers of family-related CRCs in the early-onset group. Expression of the MLH1 and PMS2 genes were significantly different between recovered and deceased, while this finding was not observed with regard to the MSH6 and the MSH2 genes. Mortality was significantly higher in those at high risk of LS. CONCLUSION: The variation of demographic, pathological and genetic characteristics between early-onset and late-onset CRC emphasizes the need for a well-defined algorithm to identify high-risk patients.

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective.

Background: The development of hospital information systems (HISs) has a significant effect on care processes. In this regard, the clinical staff's perspective is very important in evaluating the success of these systems. The present study aimed to evaluate the clinical staff's perspective at hospitals affiliated to Neyshabur University of Medical Sciences on the effectiveness of the HIS in improving their performance and strategies for increasing the system effectiveness. Materials and Methods: In the present cross-sectional study, 120 clinical staff who actively worked with the HIS were included. A two-part questionnaire was used for data gathering. Results: From the perspective of the research population, the effective score of HIS was %64.42 in improving their performance, and %81.85 in the case of developed HIS according to the suggested strategies. According to the research scale, the effectiveness of the system could be improved from good to excellent in the case of implementation of strategies, so that there was a statistically significant difference between the pre- and post-effectiveness (P<0.001). Conclusion: Positive population perspective on the effectiveness of HIS in-performance improvement of the clinical staff indicated that there was a good context for the development and utilization of information technology in the hospitals. The clinical staff's opinions and work needs as the primary group of patient care should be taken into consideration in order to increase the effectiveness of the HIS.

Epidemiological Study of Cutaneous Leishmaniasis in Neyshabur County, East of Iran (2011-2017).

BACKGROUND: Cutaneous Leishmaniasis (CL) isn't a lethal disease, but it has always been taken into consideration due to more involvement of patients with skin ulcers and its long-term treatment. Various factors can play an intervening role in increasing the rate of disease. The present study aimed to evaluate the prevalence and associated factors of disease from 2011-2017 and provide appropriate control strategies for reducing its incidence in Neyshabur county. METHODS: All patients with CL, who had medical records in the health centres of Neyshabur from 2011 to 2017, were examined for conducting this cross-sectional analytical study. Data were analyzed by descriptive statistics and chi-square test at a 0.05 using Statistical Package for the Social Sciences (SPSS V.22). RESULTS: Findings indicated that the highest annual incidence was in 2016 (229 patients), and the least incidence was in 2014 (100 patients). The majority of patients were under 10 years of age and 51.7% of patients were male. About 59.5% of patients were living in cities and 35% of them were living in North of Neyshabur city. Hands were the most affected part of the body (56.0%) followed by trunk (1.3%). Most patients (69.9%) were treated with topical regimens. CONCLUSION: This study showed that CL was hypo-endemic in Neyshabur. Also, the disease was more prevalent in urban areas. Therefore, appropriate health measures to improve environmental conditions, public health educations, and the public awareness of the positive impact of early diagnosis of disease in the success of treatment (especially for inhabitance suburbanite) are essential.