Haplotype diversity of 17 Y-STR in the Iranian population.

The current study aimed to evaluate Y chromosome haplotypes obtained from 1353 unrelated Iranian males using the AmpFlSTRTM YfilerTM kit; 1353 out of the 1353 identified haplotypes were unique. The haplotype diversity (HD) and discriminating capacity (DC) values were 1.00000 and 0.997, respectively. Analysis of genetic distance was performed using molecular variance (AMOVA) and multidimensional scaling plots (MDS), revealing a statistically significant difference between the study population and previous data reported for other Iranian populations and other neighboring countries. The present findings are likely to be useful for forensic casework analyses and kinship investigations.

Prevalence, treatment outcomes and determinants of TB/HIV coinfection: A 4-year retrospective review of national tuberculosis registry in a country in a MENA region.

Background: The co-occurrence of tuberculosis (TB) and AIDS (HIV) has emerged as a significant public health challenge. This study investigated the epidemiological factors and treatment outcomes of TB in individuals based on their HIV status in Iran. Methods: The current study was a descriptive-analytical cross-sectional study that focused on new patients diagnosed with TB in Iran between 2018 and 2021. Patients' data were sourced from the National Tuberculosis Registry database of Iran. A multiple logistic regression model was used to investigate the relationship between the most important influencing factors and TB/HIV coinfection. Results: Over a 4-year period, a study was conducted on 25,011 new TB patients out of 30,762 registered in the national database. TB and HIV were coinfected in 672 cases (2.68%). The highest number of coinfection cases were found in patients with smear-negative pulmonary tuberculosis (249 patients, 37.05%) and extrapulmonary tuberculosis (123 patients, 18.19%). TB patients with coinfection had a median TB treatment duration of three months longer than others. The success rate of TB treatment was lower in patients with coinfection (437 patients, 65.02%) than in non-coinfection patients (20,302 patients, 83.41%). Treatment success probability in smear-positive pulmonary tuberculosis patients with and without coinfection was lower than other types of TB. Logistic regression analysis showed that having a TB risk factor was the strongest predictor of coinfection, with an odds ratio of 29.73 (95% CI: 22.05-40.07), followed by having an HIV risk factor with an odds ratio of 17.52 (95% CI: 13.68-22.45). Conclusions: The findings of this research offer significant insights into the potential causes of HIV coinfection in individuals with TB, which could be used to inform the development of policies and strategies aimed at enhancing the identification and treatment of TB patients who are at risk of TB/HIV coinfection and to promote optimal health status for patients with TB.

Higher Serum Vitamin D Levels have a Positive Association with the Incidence of Recidivans Form of Cutaneous Leishmaniasis; A Cross-Sectional Study.

Background: Several manifestations of cutaneous leishmaniasis are related to the host's immune system and the species of parasite. Objective: There have been some studies on the relationship between vitamin D statuses in infectious diseases including cutaneous leishmaniasis. However, the results of these studies have been inconsistent. Materials and Methods: In this cross-sectional study, 147 patients with leishmaniasis were recruited and divided into the following categories: acute cutaneous leishmaniasis (<1 year) (n = 51), chronic cutaneous leishmaniasis (more than 1 year) (n = 26), and leishmaniasis recidivans (the appearance of new papular lesions around a previous scar) (n = 20), and a group of participants without leishmaniasis (n = 50), as a control group. Serum 25-hydroxyvitamin D [25(OH) D] level was analyzed. Result: There were significant differences in serum 25(OH) D between the groups with acute or chronic leishmaniasis and those with recidivans leishmaniasis (P = 0.013 and P = 0.022, respectively). The median serum level of vitamin D in the acute group was 13.7 ng/mL, in the chronic group was 16.05 ng/mL, in the recidivans group was 21.75 ng/mL, and in the control group was 17.97 ng/mL. Conclusion: Higher serum concentrations of 25(OH) vitamin D levels being associated with leishmaniasis recidivans.

A comparative study on the results of beating and arrested heart isolated tricuspid valve surgery: A cross-sectional study.

Background and Aims: The isolated tricuspid valve surgery is performed using beating or arrested heart surgery. The present study aimed to evaluate and compare the results of patients who underwent isolated tricuspid valve surgery using the beating and arrested heart techniques. Methods: In this retrospective observational study, all patients undergoing isolated tricuspid valve surgery between 2011 and 2018 were included. The patient's demographic information, echocardiographic, surgery, and hospitalization results were collected, and the EuroSCORE was calculated from the patient's medical records. Results: Fifty-three patients were included in the study of which 21 (39.63%) and 32 (60.37%) underwent a beating heart and arrested heart surgeries, respectively. There were no significant differences between the two studied groups in the echocardiographic results before and after the surgery, total hospitalization days (p = 0.56), and the mortality in the first 30 days after the surgery (p = 0.152). However, the duration of surgery (p < 0.001), EuroSCORE (p = 0.005), and patients who underwent lateral thoracotomy (p = 0.007) were notably lower in the arrested heart than in the beating heart group. In contrast, the duration of cardiopulmonary bypass and hospitalization in an intensive care unit after the surgery was remarkably lower in the beating heart than in the arrested heart group (p < 0.001 for both cases). Conclusion: Although there were some significant differences between the two kinds of surgery techniques, it seems superficial that made a particular decision to consider each method's superiority. Therefore, further studies with larger populations and meta-analyses are required to recommend the preferred method for the surgeons certainly.

Can levetiracetam improve clinical symptoms in schizophrenic patients? A randomized placebo-controlled clinical trial.

INTRODUCTION: Schizophrenia is associated with persistent cognitive deficits, which worsen treatment outcomes despite increasing antipsychotic doses. This study aimed to assess the effect of levetiracetam on the severity of schizophrenia symptoms and cognitive deficits in these patients. MATERIALS AND METHODS: In this randomized, controlled, three-blind randomized clinical trial approved by Mashhad University of Medical Sciences, Iran (IRCT20101130005280N31), forty chronic schizophrenic patients aged 18-60 years were randomly divided into two groups of levetiracetam and placebo. The levetiracetam group received levetiracetam for 8 weeks. The symptoms were evaluated by Positive and Negative Symptoms Scale (PANSS), Stroop test, Digit Span test and Wisconsin Test at baseline, 4th week, and 8th week. Data were analyzed through SPSS V. 23 software, descriptive tests and inferential statistics. RESULTS: At the end of the study, all subscales of the PANSS questionnaire reduced significantly (P < 0.05). Also, all subscales of the cognitive tests had significant changes. The trends of digit span tests, correct number of consonants and inconsonant were increasing. While the trends related to consonant errors, inconsistent errors, consistent reaction time and nonconsistent reaction time were decreasing. The changes in the number of classes were increased while changes in preservation error were decreased. CONCLUSION: The results showed that levetiracetam has significant effects on clinical symptoms, especially negative symptoms. Also, it impacts significantly on cognitive functions. It is recommended that it be added to the pharmacological regimen of these patients to improve their clinical symptoms, quality of life and treatment outcomes.

The Epidemiology of Gender Dysphoria in Iran: The First Nationwide Study.

Gender dysphoria (GD) is defined as a persistent and distressful incongruence between one's gender identity and one's at-birth-assigned sex. Sex reassignment has been religiously accepted for transgender individuals in postrevolutionary Iran since 1987; however, very little is known about how many individuals seek and receive such treatment annually. This study provides the first nationwide effort to assess the prevalence of GD in Iran as a function of diagnosis. The medical records of all transgender individuals referred to the Iranian Legal Medicine Organization between March 2012 and March 2017 were reviewed. All individuals diagnosed with GD were contacted. A total of 839 medical records meeting study criteria were received and evaluated. The prevalence of transgender individuals was estimated to be 1.46 per 100,000 Iranians with a transwoman (TW)/ transman (TM) ratio of 1:2. The mean age of individuals with GD at the time of referral was 25.22 (SD = 6.25) years for TW and 25.51 (SD = 5.66) years for TM. The findings are twofold. First, gender dysphoria is less prevalent in Iran than has been reported in Western countries. Second, the sex ratio is skewed toward at-birth-assigned females, which differs from what has been reported in Western countries. These findings have been interpreted in light of Iran's legal system, which is based on Islamic penal codes. These findings are of utmost importance for both health providers and legislators, as it can illustrate a more accurate picture of the transgender population in Iran.

Comparison of Serum Total IgA Levels in Severe and Mild COVID-19 Patients and Control Group.

BACKGROUND: The present study aimed to compare serum total IgA levels between severe and mild COVID-19 patients' groups and the control group. METHODS: In this cross-sectional study, 216 definite severe COVID-19 patients (as the inpatient group), 183 subjects with positive specific COVID-19 IgG with mild or no symptoms as the (outpatient group), and 203 healthy subjects with negative specific serology, as the control group were investigated. The cases' laboratory data were collected, and thereafter, statistical tests, including independent samples t test, ANOVA test, and post hoc test, were performed using SPSS software version 22. RESULT: The mean ± SD of IgA in all the included subjects was 2.23 ± 0.78 (g/L). According to the obtained results, there were statistically significant changes in IgA among the three study groups (P value < 0.05). This difference was significant between both outpatient and inpatient groups (P value < 0.05). The mean ± SD of serum IgG in all the subjects was calculated as 15.83 ± 5.73 (g/L). A strong statistically significant change was also seen in IgG among all three groups (P value < 0.001). Of note, there was a significant negative correlation between IgG and IgA total titers of the outpatient group (P value = 0.011*r = - 0.188). CONCLUSION: It was shown that the total serum IgA and IgG levels are significantly associated with the severity of COVID-19 infection. As well, we found that total serum IgA and IgG are associated with the severity of illness. Since a low level of IgA is asymptomatic and high frequent in Iran and other countries, we suggest the evaluation of serum IgA levels in high-risk people and strengthening immune system in subjects with a low level of IgA, in order to reduce the rate of death. In this regard, oral or nasal mucosal vaccines in combination with parenteral vaccination are recommended due to increasing immunity versus COVID-19 by further secretion of the IgA antibody and preventing virus transmission.

Efficacy of repetitive transcranial magnetic stimulation in patients with obsessive-compulsive disorder: a pilot study.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a common disabling psychiatric disorder. Considering the lack of an acceptable treatment response in many patients, several efforts have been made to increase the efficacy of therapy. We aimed to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on the supplementary motor area in the treatment of patients with drug-resistant OCD and examine changes in brain function. METHODS: This quasi-experimental study was performed on 12 patients who were referred to outpatient clinics of Ibn-e-Sina psychiatric hospital and were diagnosed with OCD according to the clinical and diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). All patients received 20 rTMS sessions in their right supplementary motor region. Main outcomes were assessed using quantitative electroencephalography (qEEG) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and after the intervention. In addition, Y­BOCS was completed after 10 rTMS sessions and after the 6­week follow-up. Data were analyzed with SPSS. RESULTS: Ten of 12 patients completed this study, of whom 7 (70%) were female. The mean age was 36.66 ± 10.28 years. Y­BOCS overall score significantly decreased over time during the course of study compared to baseline (P < 0.05). A significant decrease in beta wave activity of the parietal and occipital regions was seen in posttreatment qEEG, compared with baseline (P < 0.05). CONCLUSIONS: rTMS over the supplementary motor area at 20 sessions could effectively improve Y­BOCS score and decrease beta wave activity in parietal and occipital regions. Further studies are needed to approve these findings in a controlled design.

Self-harm prevalence and associated factors among street children in Mashhad, North East of Iran.

BACKGROUND: Self-harm is intentional harmful behavior in the context of emotional distress. Street children are boys and girls under eighteen who are forced to work or live on the streets. These children are exposed to violent situations and high-risk behaviors like self-harm. This study investigated the prevalence of self-harm in street children in Mashhad, the second Metropolis of Iran. METHODS: In this cross-sectional study, 98 children were assessed with a 22-item of self-harm Inventory (SHI) questionnaire. A trained social worker interviewed the participants who were referred to Mashhad Welfare Office, February-July 2020. RESULTS: The mean age of participants was 13.8 (2.3) years old, and 71.4 % of them were male. Of street children 59.2 % have had self-harming behavior, among them 8.6 % had one self-harming behavior, and others have more than one. The self-harmed people who had physical injuries, more frequent injuries were hitting (26.5 %), self-starvation (23.5 %), cutting (21.4 %), respectively. In comparison, common psychological injuries were God-distancing (29.6 %) and self-defeating thoughts (19.4 %). The most important risk factors were having a mental disorder (OR = 6.3, P = 0.002), losing parents (OR = 4.4, P = 0.01), self-harming or suicide history in relatives (OR = 3.2, P = 0.001, OR = 4.3, P = 0.03 respectively), low-educated parents (OR = 4.2, P = 002, OR = 2.8, P = 0.02 for father and mother respectively), and age-increasing (OR = 1.5, P = 0.001). CONCLUSIONS: The prevalence of self-harming in street children is significantly high. Some of these children are in more high-risk conditions that face them to suffer from self-harming at a younger age. Family factors are more important in predicting self-harming and community health decision-makers should provide educational interventions and psychological support for these children and their families.

A double-blind placebo-controlled randomized trial of oral saffron in the treatment of rheumatoid arthritis.

OBJECTIVE: Recently, saffron (Crocus sativus L. from the Iridaceae family) has been characterized by its antioxidant, anti-inflammatory and analgesic effects. This study aimed to evaluate the effect of saffron on disease activity in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: This is a double-blind, placebo-controlled, randomized clinical trial (RCT) performed on 55 newly- diagnosed RA patients without previous treatment, who were randomly divided into intervention (included 28 cases) and control groups (consisted of 27 individuals). Standard therapy including prednisolone, oral methotrexate, folic acid, vitamin D, calcium, and alendronate, was administered similarly in both groups. Patients received a 100 mg saffron pill/day (pure saffron powder) or placebo besides the standard protocol. The placebo had the same shape as the saffron pills. Follow up of DAS28ESR disease activity score was done on the 30th, 45th and 90th day of the study. RESULTS: There was no difference between the intervention and control groups regarding to the DAS28ESR at the end of the study. However, a significant decrease in DAS28-ESR was observed in each group compared to the first visit (p=0.001). The results also showed no significant difference in the incidence of side effects in both groups. CONCLUSION: In summary, patients who received pure saffron pills (100 mg/day) in addition to standard therapy did not have a significant difference in improvement of disease activity from the patients on standard therapy.

The burden of tuberculosis in Iran, A 12- year population-based study.

Background: Tuberculosis (TB) is a major global health problem, so for better planning in the health sector, it is necessary to know the real burden of tuberculosis in our country. The main aim of this study was to calculate the burden of TB for the Iranian population in 2001-2012. Methods: The Disability Adjusted Life Years (DALYs) index was calculated using a computer model (DisMod version II) in Iran between the years 2001 and 2012. DALYs are age-weighted (ß= 0.04) and are discounted for time preference (r= 0.03). Results: The trend was decreasing from 2001 till 2006, and after it, there is an increasing trend. The incidence was more in younger age groups and in female, and the YLL is higher in men (11744 in male vs 7897 in female in 2012); it showed that the life lost is higher in men. The YLD in men and women are very close. In comparison, the DALY of TB was higher in men than women. Conclusion: In the present investigation, it has been found that the overall tendency to get TB was higher in the female population. It shows that the incidence was higher in the younger age groups but the mortality was higher in the elderly groups. It that shows the significant success of the country in controlling the disease.

Opioid Dependency and Myocardial Infarction: A Systematic Review and Meta-Analysis.

BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality worldwide. A major health concern in the developing countries is opioid addiction, which has controversial cardiovascular side effects. We aimed to investigate whether Myocardial Infarction (MI) and its risk factors are associated with morphine dependency in the Iranian population. METHODS: Electronic databases, including PubMed, Medline, Scopus, SID, Element, and Magiran were searched to find published articles including the keywords morphine, coronary artery disease, hypertension, hyperlipidemia, and diabetes mellitus. RESULTS: Twelve studies involving 25,800 people were included in this systematic review and metaanalysis. Morphine dependency was significantly associated with MI with an adjusted odds ratio (AOR) of 2.28 (95%CI=1.26-4.11). It neither has significant associations with hypertension (AOR=0.952; 95%CI=0.696-1.301) nor diabetes (AOR=0.895; 95%CI=0.644-1.246). Morphine dependency also had no significant association with hyperlipidemia with a Crude Odds Ratio (COR) of 0.906 (95%CI=0.786-1.045). CONCLUSION: Morphine dependency was significantly related to MI, but its risk factors were not significantly associated with morphine dependency. The increasing prevalence of opioid abuse in developing countries may be a reason for the growing incidence of MI in younger ages and individuals with no risk factors. Besides, physicians should consider the presence of impurities in morphine-based opioids and their possible effects on health.

The risk of cardiovascular events based on the Framingham criteria in Adults Living in Mashhad (Iran).

BACKGROUND AND AIM: Cardiovascular diseases are a problem in low- and middle-income countries, such as Iran. The present research was performed to identify risk factors contributing to cardiovascular diseases and their distributions among the adult population of Mashhad (Iran) using the Framingham criteria. METHODS: This cross-sectional population-based study performed in 2015 on 2,976 adults living in Mashhad (Iran) using Stratified cluster-random sampling method. Demographic information was acquired by surveyors in the research team using a checklist and referring to a medical laboratory for laboratory assessments. The 10-year risk of cardiovascular diseases for the participants was calculated using the Framingham criteria and was classified into three classes: low risk (<10%), intermediate risk (10-20%), and high risk (>20%). The analysis was done by SPSS Version 11.5 by using the Independent-samples t-test, Kruskal-Wallis, and analysis of variance (ANOVA). RESULTS: A total of 2,978 participants aged 16-90 participated in our cross-sectional study with an average age of 43.5±14.7 years. Total risk scores among men and women were 7.29±6.3 and 5.8±6.03, respectively. Compared to women, men exhibited a significantly higher risk of cardiovascular diseases (p<0.001). Average heart age among men and women was estimated at 50.37±18.7 and 48.8±17.0 respectively, i.e. significantly older heart age was obtained for men compared to women (p<0.001). CONCLUSION: According to this study, men are at a great risk of cardiovascular events, so we should develop our screening and educational program especially for this population.

Effect of oral ginger on prevention of nausea and vomiting after laparoscopic cholecystectomy: a double-blind, randomized, placebo-controlled trial.

BACKGROUND: Postoperative nausea and vomiting (PONV) are among the most frequent complications following laparoscopic cholecystectomy. Recently, some studies have shown ginger, as an herbal medicine, to be effective and safe in PONV prevention; however, there is no evidence of its efficacy in the Iranian population. OBJECTIVE: The aim of this study was to determine the effect of oral ginger on PONV prevention after laparoscopic cholecystectomy. METHODS: This double-blind, randomized, placebo-controlled clinical trial was performed on women who were undergoing laparoscopic cholecystectomy in Imam Raza Hospital, Mashhad, Iran between April and November, 2016. Patients were divided randomly into two groups of G) intervention group (n=75, received 2 capsules containing 250 mg ginger) and P) placebo group (n=75, received 2 placebo capsules) one hour before surgery. Nausea severity and vomiting frequency were evaluated at 2, 4, 6, and 12 hours after the operation. Data analysis was done by SPSS version 16.0 software with Chi-square test, Independent-sample-t-test, repeated measure ANOVA and Mann-Whitney U test. RESULTS: The two groups were homogenous in terms of age, gender and surgery duration. The severity of nausea was lower in the ginger group at the 2, 4, 6, and 12 hours after the operation; however, these differences were statically significant only at 2 (p=0.034) and 12 hours (p=0.043). Although the incidence of vomiting was higher in the placebo group in the 2nd and 12th hours after surgery, the number of vomiting episodes in 2, 4, 6 and 12 hours after surgery was statistically similar in the two groups (p>0.05). The nausea severity was significantly changed during 12 hours of study in both groups (p=0.001), however the nausea severity was always lower in the ginger group (p=0.078). CONCLUSION: This study demonstrated that 500mg oral ginger one hour before surgery in women who were undergoing laparoscopic cholecystectomy is effective in decreasing severity of PONV. TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016122222218N2. FUNDING: The study was financially supported by Deputy of Research of Mashhad University of Medical Sciences.

Assessment of life skills of medical students in Mashhad, Iran, in 2015.

BACKGROUND: Developing social skills and mental health is a crucial part of the psychosocial health status of medical students. OBJECTIVE: The aim of this study was to assess the life skills of medical students in Mashhad University of Medical Sciences (MUMS). METHODS: This cross-sectional study was performed in Mashhad University of Medical Sciences, Iran in 2015. By census method, 146 interns were entered into the study. The life skill questionnaire, consisting of 144 questions, was used as the measurement tool. Over 3 months, all the medical students in internship period were asked to complete the questionnaire. Data were analyzed by independent-samples t-test, one-way ANOVA, and Mann-Whitney with SPSS version 11.5 software. RESULTS: Women were shown to have higher decision-making ability than men (p=0.046). It was also shown in the study that social behavior (p=0.018), participation in activities that improve benefits (p=0.006), critical thinking (p=0.007), observing and using safety points (p=0.005), and mental health status (p=0.034) were significantly lower in men than in women. The data also suggests that men (13.97±4.7249) are more likely to become global citizens than women (12.15±3.6298) (p=0.010). Furthermore, there was a significant difference when comparing smoking and non-smoking in freedom and justice (p=0.003) and becoming a global citizen (p=0.012). CONCLUSION: Our study provides helpful information about medical students' life skills for policy makers and university authorities. We suggest that gender differences should be considered during life skill training.

The Effect of Oral Levamisole Co-administration on the Level of Immune Response to Hepatitis B Vaccine in Healthy Individuals: A Randomized Clinical Trial.

Despite its proven efficacy, the hepatitis B vaccine requires improvements in immune enhancement and durability, especially in the elderly. Levamisole, an immune modulator, has been tested as an adjuvant to hepatitis B vaccine in several studies in immune-compromised populations. However, we aimed to evaluate the effect of levamisole on the immune response to hepatitis B vaccine in healthy subjects. In this randomized clinical trial, healthy family members of chronic hepatitis B patients were given twenty-microgram intramuscular injections of hepatitis B vaccine at 0, 1, and 6 months and 50 miligrams of oral  levamisole twice a day for two weeks with every vaccination dose. Serum hepatitis B surface antibody (HBsAb) levels of ultimately 98 individuals were measured one month after the final vaccination dose and compared to those of 119 subjects that received placebo and vaccine with an identical regimen. HBsAb levels >10 mIU/mL were considered protective. The Student's t-test, Mann-Whitney test, Kruskal-Wallis analysis (quantitative comparison in age groups), Chi-square test, and the Pearson correlation were used to analyze data. p<0.05 was considered significant. Serum HBsAb levels were significantly higher in the test group (p<0.001). All test subjects had levels above 50 mIU/mL (86.7% exceeding 100 mIU/mL). The quantitative response according to age groups was remarkable (p=0.01 and p<0.001 for placebo and levamisole, respectively), while that of gender was insignificant (p=0.9). Unlike HBsAb titers amongst controls, levels in the levamisole group were affected by smoking (p=0.79 and p=0.006, respectively). We conclude that oral levamisole as an adjuvant to the hepatitis B vaccine enhances the anti-HBs antibody in healthy vaccinees.

Research Misconduct: A Report from a Developing Country.

BACKGROUND: Cheating rate is rising and engages newer methods. This study performed to estimate the rate of research misconduct in the thesis of undergraduate and postgraduate medical students in 2015. METHODS: In this cross sectional study, all undergraduate and postgraduate medical students graduated during the study period in 2015, from the School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran were asked to fill a small checklist anonymously. It consisted of two demographic questions and two other ones for estimation of research misconduct. All three major types of research misconduct were explained in the checklist. We used the Randomized Response Technique for sensitive question in this survey. We asked the respondent to choose one question randomly and answer to it. The probability of selection of each question was equal. RESULTS: There were 149 filled questionnaires out of which 44 (31%) were graduated for General Practitioner, 63 (44%) for Residency, 31(21%) for Master Degree and 6 (4%) for Ph.D. Fifty-two percent (75) were male. More than half of participants were graduated between 2011 and 2012. The majority of participants were native (104, 81%). Undergraduate students had an estimation of 19% research misconduct in performing the thesis while this was 26% of postgraduate students. Males were nearly two times comparing to females in this issue (30% vs. 16%). CONCLUSION: This high estimation must be considered in future policy making about observing strictly on researches.

Cardiovascular Disease Risk Factors Profile in Individuals With Diabetes Compared With Non-Diabetic Subjects in North-East of Iran.

BACKGROUND: Diabetes mellitus is assumed to be a strong risk factor for cardiovascular diseases (CVD) and is frequently associated with other CVD risk factors. OBJECTIVES: The aims of this study were to assess the prevalence of different patterns of dyslipidemia in individuals with diabetes compared with non-diabetic subjects and evaluate other accompanied CVD risk factors between the two groups. PATIENTS AND METHODS: This was an analytical cross-sectional study on 230 participants, aged 28 - 66 years old, who were referred to different urban health centers of Khorasan Razavi province (north-east of Iran). Data from the participants were collected during their first visit by primary care physicians. Statistical package for social science (version 11.5) was used to analyze the data. The chi-square or Fisher's exact, student's t or the Mann-Whitney U and correlation tests were used in the analysis. RESULTS: The age and gender of the participants were not different between the two groups (P = 0.1 and P = 0.4, respectively). The most common patterns of dyslipidemia in both groups were isolated dyslipidemia followed by combined dyslipidemia. Prevalence of dyslipidemia as a whole (one, two or three lipid profile abnormalities) in patients with diabetes and non-diabetic participants was 89.3% and 82.6%, respectively and the difference between the two groups was not statistically significant (P = 0.1). Subjects with diabetes had higher systolic blood pressure (P < 0.001), higher diastolic blood pressure (P = 0.002) and higher body mass index (P = 0.09) compared to non-diabetics. Moreover, they were more likely to have higher levels of total cholesterol (P = 0.01), triglycerides (P = 0.001) and low density lipoprotein cholesterol (P = 0.009) and lower levels of high density lipoprotein cholesterol (P = 0.2). CONCLUSIONS: Cardiovascular diseases risk factors are more common in patients with diabetes; however, non-diabetic individuals also had a high prevalence of risk factors in our region, predisposing them to diabetes. Therefore, further attention by the medical community is necessary to choose effective strategies for a more a aggressive approach to prevent and manage these risk factors.

Effect of changing journal clubs from traditional method to evidence-based method on psychiatry residents.

INTRODUCTION: Journal club is a valuable educational tool in the medical field. This method follows different goals. This study aims to investigate the effect on psychiatry residents of changing journal clubs from the traditional method to the evidence-based method. METHOD: This study was conducted using a before-after design. First- and second-year residents of psychiatry were included in the study. First, the status quo was evaluated by standardized questionnaire regarding the effect of journal club. Then, ten sessions were held to familiarize the residents with the concept of journal club. After that, evidence-based journal club sessions were held. The questionnaire was given to the residents again after the final session. Data were analyzed through descriptive statistics (frequency and percentage frequency, mean and standard deviation), and analytic statistics (paired t-test) using SPSS 22. RESULTS: Of a total of 20 first- and second-year residents of psychiatry, the data of 18 residents were finally analyzed. Most of the subjects (17 [93.7%]) were females. The mean overall score before and after the intervention was 1.83±0.45 and 2.85±0.57, respectively, which showed a significant increase (P<0.001). CONCLUSION: Moving toward evidence-based journal clubs seems like an appropriate measure to reach the goals set by this educational tool.

Prophylactic Effect of Rectal Indomethacin Administration, with and without Intravenous Hydration, on Development of Endoscopic Retrograde Cholangiopancreatography Pancreatitis Episodes: A Randomized Clinical Trial.

BACKGROUND: Acute Post ERCP Pancreatitis (PEP) is the most common major complication of Endoscopic retrograde cholangiopancreatography (ERCP). The aim of the current study was to assess the utility of single dose rectal indomethacin with and without  intravenous perfusion of normal saline to prevent acute pancreatitis. METHODS: In this randomized clinical trial, 406 patients with choledocolithiasis underwent ERCP. Based on computer-generated  numbers, the patients were allocated into 4 groups, each group receiving a different intervention prior to the ERCP procedure. The interventions included rectal indomethacin (100mg) in the first group, intravenous (IV) saline perfusion in the second, both rectal indomethacin and IV saline in the third, and the fourth (control) group receiving rectal glycerin. Serum amylase levels were measured and clinical pancreatitis episodes were quantified and classified according to APACHE II prognostic criteria. Statistical inference was performed using the chi-square or Fisher's exact test for qualitative variables, while Student's zxA-test was used for quantitative variables. RESULTS: A diagnosis of mild pancreatitis was present in 38 (9.4%) cases. The numbers of events in the four study groups were 11, 10, 0, and 17, respectively, corresponding to an absolute risk reduction of 5.2% , 6.2%, 16.2% (number needed to prevent one episode of PEP) and a relative risk reduction of 32%, 38% and 100% in the three study groups, respectively. The frequency of PEP was only significant in the third group (P ˂ 0.001). CONCLUSIONS: The combination of rectal indomethacin and intravenous normal saline before ERCP significantly prevents post-ERCP pancreatitis.