Prevalence of Molar-incisor hypomineralization in Iranian children - A systematic review and narrative synthesis.

INTRODUCTION: Molar-incisor hypomineralization is a developmental defect of enamel with clinical features vary from demarcated opacities to severe tissue breakdown which calls for considerable preventive and interceptive measures. The aim of this article was to systematically review the literature on the prevalence of MIH in Iran and highlight the condition in Iranian children. MATERIALS AND METHODS: A systematic search of literature was conducted in Scopus, Pubmed, Ovid, Embase, Web of Science, and Google-Scholar as well as national Iranian database and digital archives of dental schools from the beginning of 2000 to the end of 2021 for published and unpublished studies. Data from cross-sectional, cohort, and case-control studies on prevalence of molar-incisor hypomineralization among 6-13-year-old children was gathered, using the following MeSH terms and keywords and their Persian equivalents: Prevalence, Hypomineralisation, Hypomineralization, MIH, "molar incisor", "molar-incisor", "cheese molars", "Hypomineralised first permanent molars", "Hypomineralized first permanent molars", "developmental defects of enamel", "enamel developmental defects", Iran*. Methodological quality and the risk of bias of quantitative studies was assessed using a modified version of Newcastle-Ottawa Scale. Due to the considerable clinical and statistical heterogeneity of the included studies, pooling of data through meta-analysis was not possible. Therefore, a descriptive synthesis of data was performed. RESULTS: Fifteen cross-sectional studies with a total number of 12011 participants were included in the systematic review. The prevalence of MIH ranged from 5.1% to 25.6%. All of the included studies were at a moderate risk of bias (NOS of 4-6). The lowest prevalence of MIH was reported in Kerman (5.14%) and the highest in Tehran (25.6%). Substantial methodological, clinical and statistical heterogeneity was observed. CONCLUSION: This is the first study to systematically review the available literature on MIH prevalence in Iran. However, the present review has some limitations such as limited number of included studies, large heterogeneity of the research, and moderate quality of included studies. Further high-quality research is warranted.

Evaluation of serum alanine aminotransferase and aspartate aminotransferase enzyme levels in women patients with chronic periodontitis.

The authors' aim in this study was to investigate the relationship between chronic periodontitis and liver status using alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in women patients. The researchers conducted a case-control study on women patients referred to Dental School. The researchers collected 5 ml of peripheral venous blood from women for the laboratory process after performing periodontal examination. Participants were 124 women aged 25-50 years (62 cases and 62 control). The difference in serum levels of ALT and the difference in serum levels of AST between the two groups were not statistically significant. However, there was a significant correlation between liver enzymes and periodontitis parameters.

Effects of Melatonin on Salivary Levels of Cortisol and Sleep Quality of Hemodialysis Patients: A Randomized Clinical Trial.

Objective: The aim of this study was to investigate the effects of exogenous melatonin on the quality of sleep in patients undergoing dialysis and to investigate its mechanism for the regulation of total circadian rhythm and salivary levels of cortisol in hemodialysis patients admitted to Pange Azar hospital in Gorgan in winter of 2017. Method : This was a double-blind randomized clinical trial. Samples were transferred to the laboratory by maintaining the cold chain. Then, the patients were divided into two groups. In a double-blind trial, one group received three mg melatonin and another group received placebo for two weeks at 10 PM. At the end of two weeks, sampling was performed to investigate the salivary level of cortisol under the same conditions. The research instrument was Pittsburgh questionnaire. Data were analyzed before and after intervention using SPSS 16 software. Results: Salivary levels of cortisol decreased significantly after the intervention in the melatonin group (melatonin: 1.40 ± 1.82 and placebo: 4.94 ± 4.43; P = 0.008). Salivary levels of cortisol in the morning after intervention were also lower in the melatonin group, but were not statistically significant (melatonin 3.99 ± 3.45 and placebo: 5.35 ± 4.9; P = 0.93). Also, the difference in salivary levels of cortisol at night and before and after intervention significantly decreased in melatonin group. PSQI difference (interventional dimension) and PSQI (before intervention) were significantly decreased in melatonin group (P = 0.0001). The rate of change in the subscales of sleep latency, sleep efficiency, and sleep disorders in the melatonin group than in the placebo group was significantly higher. Conclusion: Melatonin can be used as a safe and cost-effective treatment to improve sleep quality and can also reduce salivary cortisol increased in hemodialysis patients at night.

Using Anti-SARS-CoV-2 IgG and IgM Antibodies to Detect Outpatient Cases with Olfactory and Taste Disorders Suspected as Mild Form of COVID-19: a Retrospective Survey.

Many patients with olfactory disorders were referred during the COVID-19 pandemic in 2020. The aim of this study was to detect outpatient cases with olfactory and taste disorders suspected to mild form of COVID-19 disease in Gorgan city in the north of Iran retrospectively. This study was performed on patients who had the complaints of olfactory disorders during 03/01/2020 to 04/01/2020. They also had the mild symptoms of upper respiratory tract infection. The control group included patients who had similar symptoms during this period but did not report olfactory or taste disturbances. Due to the limitations of serologic kits, this study was performed 2-3 months after the onset of symptoms. The number of patients and controls was 72 and 36 respectively. The range and the mean ± SD of patient's age were 21-63 and 39.82 ± 9.82 years. In both groups, 44.44% were male and 55.56% were female. The time interval between the onset of symptoms and the serologic tests in both groups was 91.11 ± 16.20 days. In the cases and controls, the IgG titer was positive in 44.4% and 22.2% and the IgM titer was positive in 5.6% and 8.3% respectively. IgG antibody titers were higher in cases than in the control group (P = 0.024). There was no correlation among antibody titers and the severity of olfactory disturbances, the gender, and the age. The high COVID-19 IgG antibody titer in patients with olfactory disorder during the pandemic can probably be considered as a warning complaint of COVID-19 and may be used for isolation plans.

Periodontal Condition in Patients with Rheumatoid Arthritis: Effect of Anti-rheumatic Drugs.

STATEMENT OF THE PROBLEM: Rheumatoid arthritis and periodontitis are chronic inflammatory diseases with a possible bidirectional relationship. This link may be affected by many factors like drug consumption. PURPOSE: This study was designed to evaluate the periodontal condition in patients with rheumatoid arthritis, considering the effect of disease modifying anti-rheumatic drugs. MATERIALS AND METHOD: This case-control study included 25 newly diagnosed rheumatoid arthritis patients with negative history of taking anti-rheumatic drugs, 25 patients who received anti-rheumatic drugs for more than three years and 50 healthy individuals as a control group. Periodontal indices, including plaque index, gingival index, probing depth, clinical attachment loss, and rheumatologic indices were recorded and compared between these groups. RESULTS: Rheumatoid arthritis patients were significantly more affected by periodontitis compared with healthy subjects (p= 0.006). There was no significant difference in rheumatologic indices between patients with and without periodontitis. Clinical attachment loss in old rheumatoid arthritis patients and gingival index in newly diagnosed ones were significantly more compared to the control group (p= 0.003 and p< 0.001 respectively). We could not find a linear relationship between the severity of rheumatoid arthritis and chronic periodontitis (p= 0.1, r= -0.224). CONCLUSION: Periodontitis and clinical attachment loss were more in patients with rheumatoid arthritis than the healthy group, especially in drug consumers. Gingival index in patients without the history of consuming anti-rheumatic drugs was significantly higher than those who were drug consumers, indicating the effect of the medications on the signs of inflammation.

The effectiveness of narrative writing on the moral distress of intensive care nurses.

BACKGROUND: Nursing is a profession that has always been accompanied with common ethical concerns. There are some evidences which indicate that narrative writing on traumatic experiences may improve an individual's emotional health. OBJECTIVE: This study aimed to determine the effectiveness of narrative writing on moral distress of nurses working in intensive care unit. RESEARCH DESIGN: This study was a clinical trial with pre- and post-test design. The frequency and intensity of moral distress was measured by a valid and reliable questionnaire (Corely) at baseline and after 8 weeks. The intervention group was asked to write about their deepest emotions and stressful experiences in the intensive care unit for 8 weeks. PARTICIPANTS AND RESEARCH CONTEXT: Using consensus sampling, 120 nurses of intensive care unit and neonatal intensive care unit of the teaching hospitals (in Iran) were invited to and were randomly allocated into the intervention and control groups. ETHICAL CONSIDERATIONS: Participation was voluntary, data were anonymized, and the confidentiality of the participating nurses and their institutions maintained. The ethical approval was obtained from an IRB or research ethics committee. FINDINGS: In total, 106 nurses completed the trial consisting of 87.75% females. The mean work experience of nurses in the intervention and control groups was 7.21 ± 4.96 and 8.28 ± 5.45 years, respectively. Independent t-test showed no statistical difference neither in the intensity of moral distress (P = 0.8), nor in its frequency (P = 0.5) between the two groups. DISCUSSION: As nurses constantly face ethical tensions, moral distress is a phenomenon that results from the different situations of critical care units. Their concern about receiving negative feedback from the managerial level may have influenced the outcome of the intervention. CONCLUSION: Narratives writing by the nurses showed no effect on reducing the intensity and frequency of moral distress. It seems that due to the intensity of moral distress in clinical settings, we need to test variety solutions to reduce the problem.

Teenage girls' experience of the determinants of physical activity promotion: A theory-based qualitative content analysis.

BACKGROUND: The progress of technology in developed countries has changed lifestyles to sedentary and has increased non-communicable diseases. Identifying factors affecting patterns of physical activity among adolescents is valuable and it is important to change these pattern. OBJECTIVE: This study aimed to explore teenage girls' experiences regarding the determinants of physical activity promotion based on Pender's Health Promotion Model. METHODS: This qualitative study is a content analysis research on the girls of three high schools in Minoodasht city for six months from September 2015 until the end of February 2016. The data were obtained by focused group discussions and semi-structured in-depth interviews from 48 girls ranging from 15 to 18 years old and six teachers. Data analysis was done using theory-driven qualitative content analysis. RESULTS: Data analysis resulted in a total number of 53 primary codes which were classified in the six predetermined classifications of Pender's Health Promotion Model (Perceived benefits, perceived barriers, perceived self-efficacy of physical activity behavior, feelings related to physical activity behavior, interpersonal and situational influencers). The results showed that two classifications (perceived barriers, and situational influencers) were considered more important than other classifications in reducing levels of physical activity in adolescent girls and also high self-efficacy for promoting physical activity in adolescents. CONCLUSION: The results obtained from this study specified the determinants affecting the promotion of physical activity among adolescent girls and can help the planners to choose the most appropriate methods and strategies in order to promote physical activity among adolescent girls and to prevent chronic non-communicable diseases in this age group and gender.

The effect of group counseling based on self-awareness skill on sexual risk-taking among girl students in Gorgan, Iran: a randomized trial.

Background Sexual puberty in adolescents occurs before their mental and emotional maturity and exposes them to high-risk sexual behaviors. Because sexual risk-taking occurs before adolescents become involved in a sexual relationship, this study was conducted to identify the effect of group counseling based on self-awareness skill on sexual risk-taking among female high school students in Gorgan in order to suggest some preventative measures. Methods The present parallel study is a randomized field trial conducted on 96 girl students who were studying in grades 10, 11 and 12 of high school with an age range of 14-18 years old. Sampling was done based on a multi-stage process. In the first stage, through the randomized clustering approach, four centers among six health centers were selected. In the second stage, 96 samples were collected through consecutive sampling. Finally, the samples were divided into two intervention and control groups (each one having 48 subjects) through the simple randomized approach. It has to be noted that no blinding was done in the present study. The data were collected using a demographic specifications form and the Iranian Adolescents Risk-Taking Scale (IARS). The consultation sessions based on self-awareness skill were explained to an intervention group through 60-min sessions over 7 weeks. The pretest was conducted for both groups and the posttest was completed 1 week and 1 month after the intervention by the intervention and control groups. Finally, after the loss of follow-up/drop out, a total of 80 subjects remained in the study; 42 subjects in the intervention group and 38 subjects in the control group. Data analyses were done using SPSS v.16 along with the Freidman non-parametric test and the Mann-Whitney and Wilcoxon tests. Results The results showed that the sexual risk-taking mean scores in the intervention group (10.54 ± 15.64) were reduced by applying 1-week (8.03 ± 12.82) and 1-month (4.91 ± 10.10) follow-ups after the intervention. This reduction was statistically significant (p = 14%). However, no statistically significant difference was observed in the control group. Conclusion Group counseling based on self-awareness skill decreased the sexual risk-taking in girl students of the high school. As prevention is prior to treatment, this method could be proposed as the prevention of high-risk sexual behavior to healthcare centers and educational environments and non-government organizations (NGOs) interacting with adolescents.

Early prediction of renal parenchymal injury with serum procalcitonin.

INTRODUCTION: Urinary tract infection (UTI) is one of the most common bacterial infections in children that can be associated with renal parenchymal injuries and late scars. Dimercaptosuccinic acid (DMSA) renal scan is known as golden standard for detecting acute pyelonephritis (APN) that has a lot of difficulties and limitations. OBJECTIVES: we designed this study the accuracy of one inflammatory marker, serum procalcitonin (PCT) to identify as an early predictor of renal injuries. PATIENTS AND METHODS: A prospective study was carried out in 95 patients who admitted in the hospital with the first febrile UTI. Serum PCT of all patients was measured; sensitivity, specificity, positive and negative predictive value (PPV and NPV) of this marker was analyzed compared to DMSA scan. P value <0.05 was taken as significant. RESULTS: In total, 79 females and 16 males were investigated. There are 42 cases in group 1 with normal DMSA scan and 53 patients in group two with renal parenchymal injuries in their scans. Mann-Whitney test showed a meaningful relation between the two groups regarding PCT level (P<0.0001). Sensitivity, specificity, PPV and NPV of PCT reported in optimum cut off were 70%, 88.1%, 88.1% and 70%, respectively. The positive likelihood ratio (PLR) of PCT test was 5.8. CONCLUSION: In the current survey, PCT was the eligible inflammatory marker to predict renal parenchymal injuries in children with proper sensitivity, specificity, PPV and NPV that play also a pivotal role in the children aged less than 24 months, although, more studies should be undertaken to confirm.

The effect of green tea extract supplementation on sputum smear conversion and weight changes in pulmonary TB patients: A randomized controlled trial.

BACKGROUND: Acceleration in sputum smear conversion helps faster improvement and decreased probability of the transfer of TB. In this study, we aimed to investigate the effect of green tea extract supplementation on sputum smear conversion and weight changes in smear positive pulmonary TB patients in Iran. METHODS: In this double blind clinical study, TB patients were divided into intervention, (n=43) receiving 500 mg green tea extract (GTE), and control groups (n=40) receiving placebo for two months, using balanced randomization. Random allocation and allocation concealment were observed. Height and weight were measured at the beginning, and two and six months post-treatment. Evaluations were performed on three slides, using the ZiehlNeelsen method. Independent and paired t test, McNemar's, Wilcoxon, Kaplan-Meier, Cox regression model and Log-Rank test were utilized. Statistical significance was set at p<0.05. This trial was registered under IRCT201212232602N11. RESULTS: The interventional changes and the interactive effect of intervention on weight were not significant (p>0.05). In terms of shortening the duration of conversion, the case to control proportion showed a significant difference (p=0.032). Based on the Cox regression model, the hazard ratio of the relative risk of delay in sputum smear conversion was 3.7 (p=0.002) in the higher microbial load group compared to the placebo group and 0.54 (95% CI: 0.31-0.94) in the intervention compared to the placebo group. CONCLUSION: GTE decreases the risk of delay in sputum smear conversion, but has no effect on weight gain. Moreover, it may be used as an adjuvant therapy for faster rehabilitation for pulmonary TB patients.

A sham-controlled trial of acupressure on the quality of sleep and life in haemodialysis patients.

BACKGROUND: Sleep disorder in haemodialysis patients can lead to disturbance in their psychosocial function and interpersonal relations, and reduced quality of life. The aim of the present study was to investigate the effect of acupressure on the quality of sleep of haemodialysis patients. METHODS: In a randomised controlled trial, 108 haemodialysis patients were randomly divided into three groups: true acupressure, placebo acupressure, and no treatment. The two acupressure groups received treatment three times a week for 4 weeks during dialysis. Routine care only was provided for the no treatment group. The main study outcome was sleep quality. RESULTS: The total Pittsburgh Sleep Quality Index score decreased significantly from 11.9±3.13 to 6.2±1.93 in the true acupressure group, from 11.3±3.69 to 10.6±3.82 in the sham acupressure group, and from 10.9±4.10 to 10.7±3.94 in the no treatment group. There was a significant difference between groups (p<0.001). CONCLUSIONS: Acupressure seems to have a positive effect on the sleep quality in haemodialysis patients. CLINICAL TRIAL REGISTRATION: IRCT201106145864N2.

Frequent pUL27 Variations in HIV-Infected Patients.

OBJECTIVE: Drug-resistant isolates of human cytomegalovirus (HCMV) have led to the development of new anti-HCMV drugs. Maribavir (MBV) is a novel inhibitor of the HCMV viral kinase. Resistance to MBV is mapped to gene UL27, a viral nuclear protein. In this study, we investigated UL27 polymorphisms in MBV-naive HIV-positive and HCMV congenitally infected clinical samples. METHODS: DNA was extracted from 20 CMV-positive HIV (9/20) and congenitally infected (11/20) patients and used for UL27 polymerase chain reaction amplification. Sanger sequencing and multiple sequence alignment of products was performed. RESULTS: K90 was the most prevalent polymorphism in both HIV-positive and congenitally infected patients. Polymorphisms Q54, D123, and R107 (10%) were seen in more than one sample. There were significantly more polymorphisms in the HIV-positive samples (p = 0.038). CONCLUSION: HCMV pUL27 is highly variable in adult immunocompromised HIV-positive patients.

Impact of creatinine clearance on Helicobacter pylori eradication rate in patients with peptic ulcer disease.

INTRODUCTION: Gastrointestinal complaints are common in patients with kidney failure. The aim of this study was to investigate the effect of creatinine clearance on Helicobacter pylori (HP) eradication rate in patients with peptic ulcer disease. MATERIALS AND METHODS: In this clinical trial, 132 patients with a range of kidney function (normal to end-stage renal disease) and peptic ulcer disease with HP infection were enrolled and divided into 5 groups by their creatinine clearance. For all patients, a 14-day standard regimen of triple therapy for peptic ulcer was started with omeprazole, 20 mg; clarithromycin, 500 mg; and amoxicillin, 1 g; twice per day. After 6 weeks, HP eradication rate were evaluated and compared between the groups with urea breath test. RESULTS: The mean age of the participants was 44.84 ± 12.20 years and 68 (51.5%) were women. The five groups were not significantly different in terms of age, sex distribution, or body mass index. The results of urea breath test at 6 weeks were positive in 23 patients (17.4%). There was no significant difference in HP eradication rate (negative urea breath test) between the five groups. CONCLUSIONS: This study showed no association between the success rate of eradication of HP infection and kidney function.

Effect of Motivational Interviewing on a Weight Loss Program Based on the Protection Motivation Theory.

BACKGROUND: The prevalence of overweight and obesity is on the increase the world over, which imposes an ever-increasing burden on societies and health care systems. OBJECTIVES: This study sought to investigate the effect of motivational interviewing (MI) on a weight-loss program based on the protection motivation theory (PMT). PATIENTS AND METHODS: This randomized clinical trial study, comprising pretest-posttest with a control group, was conducted on 150 overweight and obese women attending a private nutrition clinic for the first time. Samples were randomly selected using the clinic's records and then allocated to three groups (50 women in each group) receiving: 1) a standard weight-control program; 2) motivational interviewing; and 3) MI plus intention intervention. Data were collected using a researcher-made questionnaire through in-person interviews and were analyzed using SPSS (version 11) and statistical tests, including the Kruskal-Wallis test, one-way analysis of variance, paired t-test, and linear regression model. RESULTS: In the two intervention groups, the PMT construct scores, namely susceptibility (P = 0.001), severity (P = 0.001), rewards (P =0.004), self-efficacy (P = 0.001), response efficacy (P = 0.001), and costs (P = 0.014), were significantly increased compared to those in the control group. The anthropometric status was statistically significant in the MI group (P = 0.001) and the MI plus intention-intervention group (P = 0.001) at 2 months' follow-up, while in the control group, weight was meaningfully different after the intervention (P = 0.027). Weight was different between the groups after the intervention, with the Tukey test demonstrating that the differences were statistically significant between the control group and the MI group. CONCLUSIONS: Our results demonstrated that MI, combined with the implementation of intention intervention, increased weight loss and PMT construct scores in our study population.

Depression and Quality of Life in Patients With Type 2 Diabetes.

BACKGROUND: Frequency of mood disorders in patients with chronic diseases, especially diabetes and its effects on life quality are dramatically increasing. OBJECTIVES: This study aimed to investigate the relation between depression and quality of life in patients with diabetes. PATIENTS AND METHODS: This is a cross sectional survey. Subjects were selected from 330 eligible people referred to the only diabetes clinic in Gorgan City during 6 months, using systematic random sampling. Beak Depression questionnaire and the brief questioner with 26 questions recommended by the World Health Organization (WHOQOL-BREF) were used to measure depression and quality of life, respectively. Data were analyzed through descriptive methods, Chi-square, Independent t test and linear regression model using SPSS16; moreover, P value < 0.05 was considered as significant. RESULTS: In total, 330 patients with diabetes (35.5 % male and 64.5% women) were studied. The mean and standard deviation of their age and years involved with diabetes were 50.6 ± 9.0 and 5.4 ± 4.5 years, respectively. Range of age was 25 - 75 years, as well. The prevalence of depression in all patients with diabetes was 58.2% (124 mild, 56 medium, and 12 with severe depression). Hypertension was 13.9% more in diabetic patients with depression (P value < 0.001) and physical activity in 24.7% of the cases was less with a meaningful difference (P value = 0.01). The mean and standard deviation of quality of life in diabetic patients with and without depression was 50.7 ± 14 and 60.5 ± 13.3, respectively that was significant in two groups (P < 0.0001). CONCLUSIONS: The prevalence of depression is high in patients with diabetes and has a considerable impact on the consequences of diabetes and quality of life too.

Effect of vitamin d3 supplement in glycemic control of pediatrics with type 1 diabetes mellitus and vitamin d deficiency.

BACKGROUND: Glycemic control prevents microvascular complications in patients with type I diabetes mellitus such as retinopathy, nephropathy and neuropathy that influences quality of life. Some studies show the immunomodulatory effect of vitamin D in synthesis and secretion of insulin. AIMS: In this study we evaluate glycemic changes after vitamin D3 supplement in children with type I diabetes mellitus and vitamin D deficiency. MATERIALS AND METHODS: In children with type I diabetes mellitus, level of vitamin D and HbA1C was measured. Patients with type I diabetes mellitus who had vitamin D deficiency (25OHD < 50 nmol/lit) treated with 300,000 units of vitamin D3. Calcium supplement (40mg/kg/day) divided in two doses in order to avoid hungry bone was also used. After three months, 25OHD and HbA1C were measured again. Differences, in mean ± SD HbA1C and 25OHD were evaluated before and after the study. RESULTS: Mean ± SD HbA1C was 9.73±1.85 before the study which was diminished to 8.55±1.91 after vitamin D3 supplement treatment. This decline has a significant difference (p-value < 0.0001). Mean ± SD 25OHD was 17.33±8.97 nmol/lit before the study which is increased to 39.31±14.38 nmol/lit after treatment with vitamin D3 supplement. This increase also has a significant difference (p-value < 0.0001). Vitamin D3 supplement causes the improvement of HbA1C in all groups of glycemic control including HbA1C <7.8, 7.8-9.9, and >9.9. This supplement transfer patients toward better glycemic control for the entire group (p-value < 0.0001). CONCLUSION: Vitamin D3 supplement improves HbA1C in pediatrics with type I diabetes mellitus and vitamin D deficiency.

Relationship between 25-Hydroxy Vitamin-D and Obesity in 2-7 years old Children Referred to a Paediatric Hospital in Iran.

BACKGROUND: Obesity is increasing in children and it can cause many complications in adulthood, such as Diabetes mellitus (DM) and metabolic syndrome. In observational studies, vitamin-D was one of the factors which were found to be associated with obesity. AIMS: To determine the association between body mass index (BMI) and serum level of vitamin-D in children who were outpatients at Taleghani Paediatric Hospital, Iran. SETTINGS AND DESIGN: This was a cross-sectional observational study done on 215 children who were 2 to 7 y old, who were referred to Taleghani Hospital in winter (1391 solar calendar) 2013. MATERIALS AND METHODS: In this cross-sectional study, anthropometric indices: weight, height and waist circumference were measured by using identical instruments. BMI was also determined as per CDC 2000 criteria. Vitamin-D levels were estimated by ELISA. STATISTICAL ANALYSIS: Vitamin-D levels which were less than 20 nmol/L were considered as a deficiency, levels which were 20-30 nmol\L were considered as inadequate and those which were equal to or greater than 30 nmol\L were considered as sufficient. t-test, ANOVA and Pearson's correlation coefficient at a significant level of 0.05 were applied and data were analysed by using SPSS (version 16). RESULTS: One hundred and twenty five children (47.4%) were males and the rest were females. One hundred eighty four children (85.6%) had vitamin-D deficiency and only 31 had adequate levels of vitamin-D. The prevalence of obesity and overweight were 27%, but considering the vitamin-D status, it was found to be insignificant. However, there was a linear relationship between waist circumference and serum vitamin-D (p<0.01). The means and standard deviations of serum vitamin-D levels in girls and boys were 22.76 ±11.62 and 23.46 ± 9.30 nmol/L and this difference was not significant. Vitamin-D levels found in the three ethnic groups of Fars, Turkmen and Sistani showed significant differences (p<0.002). CONCLUSIONS: There was a high prevalence of vitamin-D deficiency in 2 to 7 year olds. There was no significant relationship between BMI and vitamin-D, but it was recorded in ethnic groups, and there was a correlation between waist circumference and vitamin-D levels. More exposure to sunlight and prescription of vitamin supplements were recommended.

The efficacy of a first aid training course for drivers: an experience from northern Iran.

OBJECTIVE: To evaluate the efficacy of a first aid training course for a group of drivers. METHODS: This study comprised 500 drivers, randomly selected from the road transport companies. They underwent a course of first aid training and the results were evaluated at 0-3 and 4-6 months after training. RESULTS: Both quantitative and qualitative improvements were observed in the drivers'efficacy in giving first aid. Also the rate of correct interventions was higher at 4-6 months than at 0-3 months. The exception was airway management which was not favorably improved after training. CONCLUSION: The first aid training course for drivers is beneficial and helpful for prehospital care system in road traffic accidents.

Reduction in non syndromic oral clefts following mandatory flour fortification with folic acid in Northern Iran.

UNLABELLED: Background Several studies have examined the effects of folic acid fortification on the occurrence of orofacial clefts. This study was carried out to evaluate the impact of flour fortification with folic acid on oral clefts in Northern Iran. METHODS: In this hospital based study from March 2006 to September 2009, we screened the total number of live births at all hospitals in Golestan province in North of Iran, as well as the number of pregnancies affected by non syndromic oral clefts, per 100000 births during the periods before (March 2006 -June 2007), during (July2007- March 2008) and after (May 2008- September 2009) folic acid fortification of flour was implemented. Non syndromic Oral clefts were defined in accordance with the International Classification of Diseases, 10th revision (ICD-10). RESULTS: The prevalence of oral clefting reduced from 64.2 per 100000 births before fortification to 32.2 per 100000 after flour fortification with folic acid. The preventive fraction rate of oral clefting after fortification period in comparison with before period was 49.8% (OR=0.502 95% CI 0.26-0.97, p=0.036). CONCLUSION: This study showed that flour fortification with folic acid is associated with a significant reduction in the rate of oral clefting in Golestan province in Northern Iran.

Enhanced cell immune responses to hepatitis C virus core by novel heterologous DNA prime/lambda nanoparticles boost in mice.

Hepatitis C virus (HCV) is a worldwide problem which does not have an effective vaccine and more than 170 million people worldwide are chronically infected by HCV. T cell responses are associated with spontaneous clearance of HCV infection. We report here the development of recombinant Lambda bacteriophage nanoparticles encoding HCV Core antigen. The aim of this study was to investigate the antigen-specific immune responses triggered in mice by different prime-boost combinations of DNA and Lambda phage nanoparticles encoding the HCV Core. The homologous prime/boost with recombinant Lambda nanoparticles induced higher levels of cellular and humoral immune response than the DNA vaccines. However, a heterologous prime/boost of HCV Core protein, using DNA vaccine priming followed by Lambda boost, induced highest level of lymphocyte proliferation, CD8 lymphocytes with cytotoxic function, and shifting the immune response toward a T helper (Th1) pattern and in overall improved immunity. Our study provides a new, safe, and effective vaccine for the prime-boost regimen which augments robust immunity and highlights novel promising strategies in HCV vaccine development.