Gender differences in modifiable dementia risk factors in monolingual and bilingual Australian adults.

ISSUE ADDRESSED: Gender and bilingualism are reported to influence the risk of dementia. This study examined the prevalence of self-reported modifiable dementia risk factors by gender in two samples: one that speaks at least one language other than English (LoE) and one that speaks only English. METHODS: A descriptive cross-sectional study was conducted on a sample of Australian residents aged 50 years or over (n = 4339). Participant characteristics and dementia risk behaviours were inspected using descriptive statistics in data collected via online surveys between October 2020 and November 2021. RESULTS: In both samples, men had a higher rate than women of being overweight and were classified more frequently as being at risk of dementia due to alcohol consumption, lower cognitive activity, and non-adherence to the Mediterranean-style diet. Men reported better management of their cardiometabolic health than women across both groups. Non-significant trends showed men were more often smokers but more physically active than women in the LoE group, and less often smokers but less physically active than women in the English-only group. CONCLUSION: This study found men and women reported similar patterns of dementia risk behaviours regardless of LoE or English-only status. SO WHAT?: Gender differences in risk behaviours prevail regardless of language-speaking status. The results can be used to guide future research aiming to understand and reduce modifiable dementia risk in Australia and beyond.

Modifiable Risk Factors for Dementia Among Migrants, Refugees and Asylum Seekers in Australia: A Systematic Review.

While the prevalence of non-communicable disease risk factors is understood to be higher among migrants than for people born in host nations, little is known about the dementia risk profile of migrants, refugees and asylum seekers. This systematic review examines published literature to understand what is currently reported about 12 identified modifiable risk factors for dementia among migrants, refugees, and asylum seekers residing in Australia. Three literature databases (PubMed/CINAHL/MEDLINE) were systematically searched to find articles reporting excessive alcohol consumption, traumatic brain injury, air pollution, lack of education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and limited social contact in Australia's migrant, refugee and asylum seeker population samples. Papers were systematically reviewed following PRISMA guidelines. A total of 763 studies were found, of which 676 articles were excluded, and 79 articles remained. Despite wide variability in study design, size and purpose, the prevalence and correlates of modifiable risk factors of dementia appears markedly different among the studied samples. Compared with Australian-born participants, migrant samples had a higher prevalence of depression, social isolation, physical inactivity and diabetes mellitus. Insufficient information or conflicting evidence prevented inference about prevalence and correlates for the remaining dementia risk factors. A better understanding of the prevalence and correlates of modifiable dementia risk factors is needed in Australia's migrant, refugee and asylum seeker populations. This information, together with a deeper understanding of the contextual and cultural contributing factors affecting people who arrive in Australia through differing pathways is needed before preventive interventions can be realistically targeted and sensitively implemented.

The Prevalence and Correlates of Fissured Tongue Among Outpatients in Andkhoy City, Afghanistan: A Cross-Sectional Study.

BACKGROUND: Fissured tongue is a common manifestation of the tongue, marked by the presence of multiple prominent grooves or fissures on the dorsal surface of the tongue. However, there is a lack of studies focusing on the prevalence and factors associated with fissured tongue among patients attending an outpatient clinic in Afghanistan. AIM: The purpose of the current study was to determine the prevalence and factors associated with fissured tongue and its effects on the general health of adult outpatients in Afghanistan. PATIENTS AND METHODS: The cross-sectional survey was conducted among outpatient populations in Andkhoy City, Afghanistan, between September 2019 and December 2019. A convenience technique was applied by including 1182 patient aged 18-80 years. Socio-economic status, smoking, nass use (smokeless tobacco use) and medical data were collected using face-to-face interviews. We used logistic regression analysis to identify factors associated with fissured tongue. A convenience technique was applied by including patient aged 18-80 years. RESULTS: The studied population consisted of 1182 participants, of whom 573 (48.5%) were males and 609 (51.5%) females. The prevalence of fissured tongue was 27.2% (95% CI: 24.7-29.9%) with males having significantly higher prevalence than females (47.5%, 95% CI: 43.3-51.6% versus 8.2%, 95% CI: 6.2-10.7%, p<0.001). Male participants (OR=7.1, 95% CI: 4.8-10.3), diabetes mellitus (OR=1.6, 95% CI: 1.1-2.3) and smokeless tobacco use (OR=12.0, 95% CI: 8.1-17.6) were the only variables independently associated with fissured tongue. CONCLUSION: This study suggested that there was a high rate of fissured tongue among an outpatient clinic in Andkhoy, Afghanistan. Male gender, diabetes mellitus, and nass consumption were associated with fissured tongue. Therefore, these factors might usefully be targeted in local health promotion, prevention and early intervention programs.

The prevalence and correlates of symptoms of post-traumatic stress disorder (PTSD) among resettled Afghan refugees in a regional area of Australia.

BACKGROUND: Post-traumatic stress disorder (PTSD) is common among resettled refugee populations and may be particularly problematic for refugees who have resettled in rural and regional areas. AIMS: The aim of this study was to examine the occurrence and correlates of PTSD among Afghan refugees resettled in a regional area of Australia, namely, Launceston, Tasmania. METHODS: A cross-sectional survey was conducted with 66 resettled Afghan refugees living in Launceston using the Post Migration Living Difficulties Scale (PMLD) and Impact of Event Scale-Revised (IES-R). Descriptive statistics and multivariable analysis of variables associated with a probable diagnosis of PTSD were conducted. RESULTS: Approximately half of participants 48.8% (95% CI: 36.0-61.1%) met an operational definition of probable PTSD diagnosis according to the IES-R. In multivariable logistic regression analysis, communication difficulties (OR = 14.6, 95% CI: 1.7-124.7), separation from family (OR = 9.9, 95% CI: 1.8-55.5), and self-recognition of a mental health problem (OR = 13.8, 95% CI: 2.4-80.0) were strongly and independently associated with probable PTSD diagnosis. While most participants (81.2%) with a probable PTSD diagnosis recognised that they had a mental health problem, less than half (46.9%) had sought professional help for such a problem. CONCLUSIONS: The findings suggest that there are high rates of PTSD, and relatively low uptake of mental health care by sufferers, among resettled Afghan refugees in the regional area of Launceston, Australia. Factors that might usefully be targeted in health promotion, prevention and early intervention program include communication difficulties, issues of family separation and isolation and aspects of "mental health literacy" likely to detract from help-seeking.

Occurrence and correlates of depressive symptoms among the resettled Afghan refugees in a regional area of Australia.

AIMS: Refugees and asylum seekers are at high risk of mental health problems such as post-traumatic stress disorder (PTSD) and depression. Elucidating the occurrence and correlates of these problems in specific resettled refugee populations may be helpful in informing tailored prevention and health promotion programs. We sought to elucidate the occurrence and correlates of depressive symptoms among Afghan refugees resettled in Launceston, a regional town of Australia. METHODS: We conducted a cross-sectional survey of 66 resettled Afghan refugees residing in Launceston in April 2019. We used the Hopkins symptoms checklist (HSCL-25) and the post migration living difficulties scale (PMLD) to measure depression symptoms and post-migration variables, respectively. Demographic characteristics and levels of physical activity were also assessed. Multivariate analysis was used to examine factors associated with depressive symptoms. RESULTS: High levels of depressive symptoms were reported by 21.2% of participants (95% CI: 12.1%-33.0%) and were more common among female participants (41.2%, 95% CI: 18.4%-67.1%) than male participants (14.3%, 95% CI: 5.9%-27.2%). Isolation (loneliness, being or feeling alone) (OR = 19.5, 95% CI: 1.9-203.5) and physical inactivity (OR = 9.2, 95% CI: 1.8-45.8) were the only variables independently associated with depressive symptoms. CONCLUSIONS: Depressive symptoms were common among Afghan refugees living in Launceston, particularly women, and were associated with isolation and physical inactivity. Hence these factors might usefully be targeted in local health promotion and prevention programs.

Assessing preventive health behaviors from COVID-19: a cross sectional study with health belief model in Golestan Province, Northern of Iran.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a new viral disease that has caused a pandemic in the world. Due to the lack of vaccines and definitive treatment, preventive behaviors are the only way to overcome the disease. Therefore, the present study aimed to determine the preventive behaviors from the disease based on constructs of the health belief model. METHODS: In the present cross-sectional study during March 11-16, 2020, 750 individuals in Golestan Province of Iran were included in the study using the convenience sampling and they completed the questionnaires through cyberspace. Factor scores were calculated using the confirmatory factor analysis. The effects of different factors were separately investigated using the univariate analyses, including students sample t-test, ANOVA, and simple linear regression. Finally, the effective factors were examined by the multiple regression analysis at a significant level of 0.05 and through Mplus 7 and SPSS 16. RESULTS: The participants' mean age was 33.9 ± 9.45 years; and 57.1% of them had associate and bachelor's degrees. Multiple regression indicated that the mean score of preventive behavior from COVID-19 was higher in females than males, and greater in urban dwellers than rural dwellers. Furthermore, one unit increase in the standard deviation of factor scores of self-efficacy and perceived benefits increased the scores of preventive behavior from COVID-19 by 0.22 and 0.17 units respectively. On the contrary, one unit increase in the standard deviation of factor score of perceived barriers and fatalistic beliefs decreased the scores of the preventive behavior from COVID-19 by 0.36 and 0.19 units respectively. CONCLUSIONS: Results of the present study indicated that female gender, perceived barriers, perceived self-efficacy, fatalistic beliefs, perceived interests, and living in city had the greatest preventive behaviors from COVID-19 respectively. Preventive interventions were necessary among males and villagers.

A qualitative exploration of the factors associated with initiation to methamphetamine use in Iran.

BACKGROUND: Crystal (methamphetamine) is a strong stimulant of addictive substances that affects the central nervous system. The consumption of this substance is increasing among teenagers and adult young people in the country. In this matter, one of the practical and important ways to its control is to identify the factors leading to its first use. Thus this paper, explores the factors related to the first crystal use in Golestan province, Iran. METHODS: In a qualitative study, 19 crystal users were recruited in the study conducted in Golestan province by snowball sampling from DIC (Drop-In Center) in addiction treatment centers. The interviews were mostly carried out individually with the participants; only one interview was conducted in an addiction treatment camp in the form of a group-focused discussion. Data analysis was implemented through content analysis in MAXQDA 10 software. RESULTS: The mean age of the participants was 35.05 ± 6.06 years with a range of 23-46 years. Meanwhile, the mean of crystal use period was 7.42 (SD: 3.61) and a range of 1-14 years. Based on the obtained data, the reasons for first crystal use could be categorized in six; 1: "crystal use to other drugs rehabilitation"; 2: "Lack of awareness of the addictive nature of crystal"; 3: "stimulating curiosity in public with crystal-use friends", 4: affordable and convenient use", 5: "anti-sleeping effects and increasing work efficiency", and 6: "therapeutic and other misconceptions"". CONCLUSIONS: The results indicated that crystal is mostly abused to opium rehabilitation. The lack of awareness and misconceptions about this substance can lead people to crystal use. Therefore, designing public health interventions to increase awareness about negative consequences of crystal use is fundamental to prevent people from abusing it. We suggest designing public health program to promote awareness about health risks of crystal and modifying related misconceptions. Finally, the government can establish policies to mandate sale tax for crystal producers and reduce easy access to crystal especially among youth.

The prevalence and associated factors of cigarette smoking and its association with opium use among outpatients in Afghanistan: A cross-sectional study in Andkhoy city.

PURPOSE: The objectives of this study were to estimate the prevalence and associated factors of cigarette smoking and the association between cigarette smoking and opium use among patients visiting an outpatient clinic in Afghanistan. METHODS: A cross-sectional study was conducted on consecutive patients aged 18 years and older from January 2018 to April 2018. Data on patients' sociodemographic characteristics and clinical variables were collected using an interview-based survey. RESULTS: Six hundred and twenty-two patients (391males vs. 231 females) were interviewed for this study. The overall prevalence of current smoking was 50.2% (95% confidence interval [CI]: 46.2-54.2). Males were (odds ratio [OR] = 9.5; 95% CI: 5.3-17.1) more likely to smoke cigarettes than females. The odds of current cigarette smoking increased with having a family member smoker or a friend smoker (OR =3.3; 95% CI: 2.0-5.3). Cigarette smoking was significantly associated with the level of education (illiterate OR = 8.9; 95% CI: 4.0-19.8), primary/private education (OR = 7.8; 95% CI: 3.9-15.6), and secondary education (OR = 4.4; 95% CI: 2.3-8.4), with high school or higher education as the reference group. Rural residents were 3.7 times (95% CI: 2.3-6.2) more likely to smoke cigarette than urban residents. Opium users were 23.0 times (95% CI: 12.5-42.3) more likely to smoke cigarettes than non-opium users. CONCLUSIONS: The prevalence of cigarette smoking among patients visiting an outpatient clinic in Afghanistan was high, and there was an association between cigarette smoking and male gender, a family history of smoking or a friend history of smoking, level of education, rural residency, and opium consumption.

Anxiety and Depression among Hypertensive Outpatients in Afghanistan: A Cross-Sectional Study in Andkhoy City.

There is a relationship between mental and physical health. Depression and anxiety are linked with the development of several chronic diseases. The purpose of the present study was to determine the prevalence and factors associated with anxiety and depression among adult hypertensive outpatients in Afghanistan. Methods. Two hundred thirty-four consecutive hypertensive patients from December 2015 to August 2016 were recruited to complete the Hospital Anxiety and Depression Scale (HADS) questionnaire, which has scores for classifying the participants having anxiety and depression symptoms. Results. Of the total 234 patients, 81 (34.6%) were males and 153 (65.4%) were females. The mean age was 54.6 ± 12.7 for the hypertensive patients with anxiety and 63.8 ± 15.0 for the hypertensive patients with depression while this figure was 49.5 ± 10.2 for the adult participants in general population in Kabul city (Saeed, 2013). The prevalence of anxiety and depression (42.3% vs. 58.1%) among hypertensive persons is compared with the same mental disorders among Afghan refugees (39.3% vs. 22.1%) in Dalakee Refugee Camp (in Iran) (Hosseini Divkolaye and Burkle, 2017). Of the total participants, 99 had anxiety (42.3%), 136 had depression (58.1%), and 66 had (28.2%) comorbid anxiety-depression. Multivariate analysis was used. For anxiety age, female gender, smoking, diabetes mellitus, and 2 or more chronic diseases had a significant association. For depression, age and diabetes mellitus had a significant association, and for comorbid anxiety, depression, age, diabetes mellitus, and 2 or more chronic diseases had a significant association. Conclusion. This study shows that anxiety and depression are highly prevalent among hypertensive patients in an outpatient clinic in Afghanistan. There was an association between some sociodemographic and clinical characteristics and anxiety and depression. More studies are needed on a national level to inform the development of strategies for the prevention and control of psychological distress among patients with chronic diseases in Afghanistan.

Association between Helicobacter pylori Infection and Cardiovascular Risk Factors among Patients in the Northern Part of Afghanistan: a Cross-Sectional Study in Andkhoy City

Background: The association between Helicobacter pylori infection and cardiovascular risk factors remains controversial. The high prevalence of H. pylori infection among Afghan patients warranted the investigation of this association. The aim of the present study was to determine the association between H. pylori infection and cardiovascular risk factors among patients visiting an outpatient clinic in Andkhoy, Afghanistan. Methods: We performed a cross-sectional study of 271 consecutive patients in an outpatient clinic in Andkhoy, Afghanistan from April 2017 to June 2017. The diagnosis of H. pylori infection was achieved using an enzyme-linked immunosorbent assay test. The patients were divided into H. pylori positive (n=189) and H. pylori negative (n=82) groups. The association between H. pylori infection and cardiovascular risk factors was analyzed. Results: Of the total 271 study participants, 102 (37.6%) were male and 169 (62.4%) female. The mean age ± standard deviation of the patients who were H. pylori-positive and H. pylori-negative was 51.0 ± 17.6 years and 51.6 ± 17.6 years, respectively. In multivariate logistic regression analyses, H. pylori infection was significantly associated with diabetes mellitus (DM) (odds ratio [OR] 3.16, 95% confidence interval [CI] 1.31-7.62, P = 0.011), and body mass index (BMI) levels (OR 1.17, 95% CI 108-1.26, P < 0.001). Conclusions: Our study indicated that H. pylori infection was significantly associated with DM and elevated BMI levels in patients from an outpatient clinic in Andkhoy, Afghanistan. More aggressive measures, including DM, obesity control, and H. pylori eradication are needed.

Nass use and associated factors among outpatients in northern Afghanistan: A cross-sectional study in Andkhoy City.

INTRODUCTION: Tobacco use is one of the main risk factors for a number of chronic diseases, including cancer, lung diseases, and cardiovascular diseases. Nass is a form of smokeless tobacco. It is used most commonly in Central Asia, Afghanistan, Pakistan, and Iran, and is significantly associated with oral and oesophageal cancers. The aim of this study was to determine the prevalence of nass use and its associated factors among patients attending an outpatient clinic in Afghanistan. METHODS: This cross-sectional study was performed in an outpatient clinic in Andkhoy, Afghanistan, from April to July 2017. The study included 387 consecutive patients. The data collection tool was a questionnaire, which includes three main items: demographic, physical, and biomedical measurements. We performed binary logistic regression to identify independent risk factors of nass use. RESULTS: The study included 387 participants, of whom 225 were males (58.1%) and 162 were females (41.9%). The overall prevalence of nass use was 48.8% (95% CI: 43.8-53.9%), with the Turkmen ethnic group having significantly higher prevalence than other ethnic groups (58.2%, 95% CI: 50.8-65.3% vs 41.8%, 95% CI: 34.7-49.2%). The mean and standard deviation of the age was 63.9 (17.2) years for nass users and 42.3 (17.4) years for non-users.Based on a multivariate analysis, family history of nass use (OR=31.4, 95% CI: 12.5-78.5), illiteracy (OR=8.9, 95% CI: 2.5-31.2), rural residence (OR=2.0, 95% CI: 1.0-3.9), and unemployment (OR=5.4, 95% CI: 1.4-21.4) were associated with nass use. CONCLUSIONS: Our results indicate that about half of the participants were nass users, and nass use associated factors were family history of nass use, illiteracy, unemployment, and rural residency in outpatient clinics in Afghanistan. More surveillance data are needed on a national level to inform the development of strategies for the prevention and control of nass consumption in Afghanistan.

Prevalence of Helicobacter Pylori Infection in Dyspeptic Patients in Andkhoy Afghanistan

Background: The prevalence of Helicobacter pylori (H. pylori) infection is reported to be more than 50% worldwide. It has been associated with peptic ulcer disease, gastric carcinoma, and mucosal-associated lymphoid tissue lymphoma. The seroprevalence of H. pylori varies greatly among societies and geographical locations. The objective of this study was to determine the seroprevalence and factors associated with H. pylori infection among dyspeptic patients in Afghanistan. Materials and Methods: This cross-sectional study was designed to determine the seroprevalence of H. pylori among dyspeptic patients in an outpatient clinic in Andkhoy, Afghanistan from January 2017 to April 2017. Data were obtained from patients using a questionnaire, including socio-demographic data and history of smoking and dyspeptic symptoms. Serum samples were also collected from the patients and tested for H. pylori antibodies using the enzyme-linked immunosorbent assay. Results: A total of 152 patients with dyspepsia were included in the analysis; 59 were men (40.0%), and 93 were women (60.0%). The overall seroprevalence of H. pylori was 75.6%. The predictor of seroprevalence of H. pylori was found to be illiteracy (odds ratio [OR] 4.99, 95% confidence interval [CI] 1.03¬24.17), epigastric pain (OR 12.01, 95% CI 3.56- 40.52), and rural population (OR 9.66, 95% CI 3.36- 27.82). There was an inverse association between employed status and seroprevalence of H. pylori (OR 0.08, 95% CI 0.01- 0.52). Conclusions: The seroprevalence of H. pylori was high among patient with dyspepsia in an outpatient clinic in Afghanistan. Illiteracy, unemployment and rural populations, and epigastric pain were significantly associated with H. pylori infection.

Esophageal Cancer and associated Factors among Uzbek-Turkmen and Other Ethnic Groups in the Northern Part of Afghanistan

Background: A high incidence rate of esophageal cancer has been observed in the Northern part of Afghanistan, particularly among those of Uzbek-Turkmen ethnicity. However, there is a paucity of published data from which to compare the prevalence of environmental risk factors for esophageal cancer between Uzbek-Turkmen and other ethnic groups. Thus, we investigated the prevalence of environmental risk factors associated with esophageal cancer in the Northern part of Afghanistan, focusing on ethnicity differences. Methods: This retrospective study covered 168 patients diagnosed with esophageal cancer based on endoscopic findings when attending an outpatient clinic from October 2013 to April 2016. Demographic data and burden of relevant environmental risk factors were compared between Uzbek-Turkmen and other ethnic groups. Results: In the total of 168 patients (108 Uzbek-Turkmen and 60 other ethnicities), males had significantly higher rates of opium use, chewing nass (a mixture of tobacco, ash and lime), and smoking than female patients. The mean age of the Uzbek-Turkmen group was 62.9 years, while that of the other ethnic group cases was 59.1. The prevalence of opium use, chewing nass and hot tea consumption was significantly higher in the Uzbek-Turkmen group. Conclusions: This study showed that there were significant differences in prevalence of opium, nass, and hot tea consumption between Uzbek-Turkmen and the other ethnic group patients with esophageal cancer in the northern part of Afghanistan.

Impact of airflow limitation on carotid atherosclerosis in coronary artery disease patients.

BACKGROUND: Both airflow limitation and smoking are established cardiovascular risk factors. However, their interaction as risk factors for the development of atherosclerosis in coronary artery disease patients remains unclear. OBJECTIVES: To evaluate the effect of the interaction between airflow limitation and smoking status on the severity of carotid atherosclerosis. METHODS: We categorized the 234 enrolled patients with coronary artery disease into four groups: never-smokers with normal pulmonary function (group A), never-smokers with airflow limitation (group B), ever-smokers with normal pulmonary function (group C), and ever-smokers with airflow limitation (group D). RESULTS: The prevalence of airflow limitation in the enrolled patients was 23.1% (ever-smokers: 15.8%, never-smokers: 7.3%). The prevalence of severe carotid atherosclerosis was 28.2, 29.4, 41.3, and 45.9%, respectively, in the four groups (group D vs. group A, p = 0.035). Even after multivariate adjusting for confounding factors, ever-smokers with airflow limitation were independently associated with severe carotid atherosclerosis (odds ratio 2.89, 95% confidence interval, 1.19-7.00, p = 0.019). CONCLUSIONS: Ever-smokers with airflow limitation were significantly associated with severe carotid atherosclerosis among patients with coronary artery disease. These findings also provide additional insight into the correlation between airflow limitation and poor cardiovascular clinical outcomes.

Renin inhibition reduces atherosclerotic plaque neovessel formation and regresses advanced atherosclerotic plaques.

OBJECTIVE: The interaction between the renin-angiotensin system and toll-like receptors (TLRs) in the pathogenesis of advanced atherosclerotic plaques is not well understood. We studied the effects of the renin inhibitor aliskiren on the progression of advanced atherosclerotic plaque in apolipoprotein E-deficient (ApoE(-/-)) mice with a special focus on plaque neovessel formation. METHODS AND RESULTS: Four-wk-old ApoE(-/-) mice were fed a high-fat diet for 8 wks, and the mice were randomly assigned to one of three groups and administered a vehicle, hydralazine, or aliskiren for an additional 12 wks. Aliskiren reduced the atherosclerotic plaque area and plaque neovessel density. It increased the plaque collagen and elastin contents, and reduced plasma angiotensin II levels and plaque macrophage infiltration and cathepsin S (CatS) protein. Aliskiren also decreased the levels of AT1R, gp91phox, TLR2, monocyte chemotactic protein-1, and CatS mRNAs in the aortic roots. Hydralazine had no beneficial vascular effects, although its administration resulted in the same degree of blood pressure reduction as aliskiren. CatS deficiency mimicked the aliskiren-mediated vasculoprotective effect in the ApoE(-/-) mice, but aliskiren showed no further benefits in ApoE(-/-) CatS(-/-) mice. In vitro, TLR2 silencing reduced CatS expression induced by angiotensin II. Moreover, aliskiren or the inhibition of CatS impaired the endothelial cell angiogenic action in vitro or/and ex vivo. CONCLUSION: Renin inhibition appears to inhibit advanced plaque neovessel formation in ApoE(-/-) mice and to decrease the vascular inflammatory action and extracellular matrix degradation, partly by reducing AT1R/TLR2-mediated CatS activation and activity, thus regressing advanced atherosclerosis.

Prevalence of esophageal cancer in the Northern part of Afghanistan.

BACKGROUND: Esophagogastroduodenoscopy (EGD) is the standard technique for diagnosis of patients presenting with upper gastrointestinal symptoms. Some reports have shown high prevalence of esophageal cancer in the northern part of Afghanistan. The aim of this study was to investigate epidemiological profile of esophageal cancer among patients in this region. MATERIALS AND METHODS: We identified 364 consecutive patients that received EGD examinations to examine upper gastrointestinal tract at the endoscopy unit of Balkh regional Hospital from March 2012 to March 2013. The case subjects included both in-patients and out-patients aged 16 years or more. We evaluated the results retrospectively. RESULTS: The cases consisted of 184 (51%) males and 180 (49%) females. The mean age was 47.3±17.8 and the age range 17-88 years. Ninety two cases had esophageal cancer, out of which 58 (63.0%) were male. The mean age at time of diagnosis was 57.8±13.2 years. Uzbek-Turkmen peoples were more common among patients with esophageal cancer (52.2%). Dysphagia was the most frequent symptom among patients with esophageal cancer at the time of presentation, seen in 77 (84.8%) of cases. CONCLUSIONS: Our results showed high incidence of esophageal cancer in the northern part of Afghanistan, especially in the Uzbek-Turkmen ethnic group.

Smoking and associated factors among the population aged 40-64 in Shahroud, Iran.

BACKGROUND: Smoking is known as a major risk factor for different types of cancer, as well as cardiovascular disease. Its prevalence is increasing in developing countries. The aims of this study were to determine the prevalence of smoking and its associated factors among the population aged 40-64 years in the city of Shahroud which is a representative urban population in Iran. MATERIALS AND METHODS: A cross-sectional population-based study with stratified random cluster sampling was conducted in 2009 as the first phase of Shahroud Eye Cohort Study. Of 6,311 people, 5,190 participated (82.2%). Information about smoking habit was obtained by face-to- face interview. RESULTS: The overall prevalence of current tobacco smoking was 11.3% (95%CI: 10.5-12.3). It was significantly higher among males than females (25.7% and 0.71%, P<0.001). The prevalence of current cigarette smoking was 10.8% and 1.75% were past smokers. The smoking rate of water-pipe was 0.67%. Unemployed people smoked more than employed (OR=2.66, 95%CI: 1.38-5.14). CONCLUSIONS: The prevalence of smoking is low in Shahroud compared with other parts of Iran and other countries. Age, sex, job and marital status were associated with smoking. The low smoking rate among women may be attributed to cultural and social reasons.