International Journal of Preventive Medicine

Human papillomavirus (HPV) and p53 alterations are speculated to play a role in carcinogenesis. This study was carried out to find out the association of HPV and p53 with precancerous lesions of the oral cavity such as leukoplakia: The objective of this study was to find the association among human papilloma virus (HPV) 16 infections and p53 polymorphism in tobacco using the oral leukoplakia patients. A total of 91 oral leukoplakia patients and 100 controls were randomly selected from the out-patient department of a tertiary care dental hospital of North-east India. Blood samples were drawn incisional biopsy was performed from the lesion proper and the tissue was processed for histopathological grading. Cytological smears were taken from the lesional site of leukoplakia patients and buccal mucosa of controls. The rate of HPV infection and p53 polymorphism was detected with the help of polymerase chain reaction, gel electrophoresis and deoxyribonucleic acid sequencing. The rate of HPV 16 infection was found significantly high in the oral leukoplakia patients. No particular p53 genotype at exon 4 of codon 72 was found to be associated with oral leukoplakia, but "C" allele (proline) at exon 4 of codon 72 was significantly raised in these patients. Oral leukoplakia, a well-known pre-cancerous lesion, has been shown to be associated with tobacco, but certain other factors like HPV infection and p53 polymorphism may play an important role in its development.

Fatalities from road traffic crashes (RTCs) are a public health challenge for low- and middle-income countries, especially those experiencing epidemiological transition. This paper aims to describe demographics and trend analysis of fatalities of RTCs in Oman from 1995 to 2009. The RTC data from 1995 to 2009 were obtained from the published reports of the Royal Oman Police (ROP). Data were extracted on the distribution of deaths by age, sex, nationality, mode of travel (driver, passenger, pedestrians), and type of vehicle (four- vs. two-wheelers). Trend analyses were carried out using the Chi-square for the percentages of deaths and linear regression for rates. A total of 9,616 deaths from RTCs were reported from 1995 to 2009. Of 9,616 fatalities, 4,666 (48.5%) were aged 26-50 years, 7,927 (82.4%) were males, 7,215 (75.0%) were Omanis, and 2,278 (23.8%) were pedestrians. Overall, mortality increased by around 50% from 479 deaths during 1995 to 953 deaths during 2009. There was a significant increase in the proportion of deaths (P < 0.05) and death rates (P < 0.05) among individuals aged 26-50 years, males, Omani nationals, and drivers. The number and rate of RTC fatalities due to overspeeding was also increased (P < 0.05). Fatalities due to RTCs in Oman are increasing, especially among those aged 26-50 years, males, drivers, and Omani nationals with overspeeding as a major cause of road traffic fatalities. There is a need for more research in understanding the risk-taking behaviors of young drivers, and sociocultural factors, especially among Omani nationals to target interventions.

Fascioliasis is one of the most common zoonotic diseases in Iran and other parts of the world. Although the largest epidemic of this disease has occurred in northern provinces of Iran (Guilan) during the past two decades and a few cases have also been reported in Tehran and the other provinces, there has been no evidence of its' occurrence in western provinces of Iran such as Kermanshah before the outbreak which is being reported. The study was conducted by teamwork of infectious disease specialist, parasitologist, general practitioner, entomologist, and laboratory technician. It is an "epidemic investigation" and a cross sectional descriptive one. Clinical data and para-clinical changes are recorded considering all of the population of a village in Kangavar, one of the suburbs of Kermanshah (western Iran). The mean age was 21.65, (SD=12.44). Fifty three percent were female, and all of them were farmers. Eighty two percent had a history of watercress ingestion in a period of 1-2 months before the admission and 18% consumed other vegetables. The average of eosinophils was 32.35% (SD=26). The patients' Enzyme Linked Immunosorbent Assay (ELISA) and Counter Current Immuno-electrophoresis (CCIE) serological tests were reported positive by the department of parasitology, Pasteur Institute of Iran. Treatment response to triclabendazole was excellent. A ten-year clinical and laboratory follow-up revealed no evidence of abnormality in treated patients. It was the first case of human fascioliasis in west Iran and was a real epidemic and an emerging infectious disease for this area at that time. The clinical symptoms were less severe compared with other reports. Health education to inhabitants and health care workers can lead to rapid detection of such outbreaks.

The aim of this study was to show up-to-date estimates of incidence and prevalence in Isfahan for all cancers, except non-melanoma skin cancer over the period 2001-2010 to provide projections up to 2015, based on a statistical method that uses mortality and cancer patients' survival data. Mortality data in Isfahan province were collected from various sources such as hospitals, medical forensic, cemetery, and health centers. In addition, population data by sex, age, location, and calendar year in the period of 2001-2010 were acquired from the Statistical Center of Iran. Relative survival probabilities for all cancers combined and for selected specific cancers were estimated based on observed cancer death and expected mortality data. Incidence and prevalence estimates were computed with Mortality-incidence Analysis Model (MIAMOD) method. The estimated age-standardized cancer incidence rate had higher increase rate for urban females than for males. Also, the number of prevalent cancers was higher among females, which was mostly due to better cancer survival rates in women. Age-adjusted incidence was estimated to increase by 6.9 and 8.7 per 100000 annually, between 2001 and 2015, in males and females, respectively. The prevalence is to increase by 24 and 40 and mortality by 2.8 and 2.5 per 100000 between 2001 and 2015. The present study does not only show the incidence and prevalence estimates of all cancers combined, but also gives information about cancer burden, which can be used as a bases for planning healthcare management and allocating recourses in public health.

An article with a clear message can transfer research knowledge better. However, this is the case when the message suits the type of study methodology (research design) and its results. The objective of this study was to assess the presence of message articles and the type of study methodologies. Articles published between 2001 and 2006, on maternal care, diabetes, and tuberculosis, which were based on studies performed on the Iranian population were investigated. A systematic search was performed in foreign databases 'Pubmed, Medline, and Embase', and national databases 'Iranmedex, SID (Scientific Information Database), and Iranpsych'. Seven hundred and ninety-five articles were examined for the type of study methodology and presence of an actionable message (one that specifies what and how an action should be carried out). Among the 795 articles accessed, cross-sectional studies were the most frequent (50.9%) and systematic reviews were the least frequent (0.4%). Cohort cases were observed in 6.9% of the cases. Actionable messages were observed in 22.1% of all the cases and 24.7% of the cross-sectional studies. Cohort studies increased from 5% in 2001 to 6.9% in 2006, but the shortage of systematic reviews represented a major weakness in the country's knowledge production process. Studies with a higher level of evidence such as systematic reviews, and cohort and interventional studies should be among the priorities of knowledge production in the country.

Diagnosis of dengue infection is easily and best accomplished by demonstration of specific IgM antibodies in blood. We analyzed retrospectively the dengue IgM seropositivity available for samples obtained over a period of 5 years (2006-2010) from patients with suspected dengue fever (DF)-like illness to investigate whether there was an overall increase in the dengue IgM prevalence over this period. Blood samples were collected from patients with DF-like febrile illnesses attending the Pediatric, Medicine, and Fever clinics of a Government hospital, Delhi. A total of 8138 individuals (suspected dengue cases) obtained over 5 years were tested for dengue specific IgM antibodies. Year wise, month wise, and age wise data on geographic distribution and clinical manifestations were analyzed. Of the 8138 samples, 1600 (19.66%) were positive for dengue specific IgM. The year 2006 had the highest number of reported cases, 761 (46.23%). In our study, the age group most commonly affected of all 5 years was 11-20 years. Out of the total 1600 cases admitted to the hospital between 2006 and 2010, 279 (58.9%) had DF, 178 (37.6%) had dengue hemorrhagic fever, and 16 (3.38%) had dengue shock syndrome. We found a high burden of dengue in young children and late adolescents in both rural and urban communities at a magnitude greater than previously described. We observed an increase in the dengue positive cases every alternate year, thereby indicating a possible role of herd immunity in northern India. We did not find a steady increase in the number of cases over 5 years. We found an increase in the number of positive cases in children and young adolescents.

Although intellectual disability (ID) is a common disability in Iran, there is no investigation on the spatial distribution pattern of these patients in national level and the spatial maps for recognition the areas with higher prevalence of IDs and local neighborhoods of these regions or effect of socio-demographic factor on this scattering is not still available. This proposition motivated us to assess the population with ID in our country. In a cross-sectional study, we applied Moran's Index (Moran's I) which includes information about the strength of the neighboring association between counties, as global univariate distribution assessment. A geographically weighted regression was used to explore relation between ID patient's prevalence and some socio-demographic factors (migration and illiteracy rate, physician number (PN)/10,000 people and health-care centers (HCCs)/10,000 people). We found that spatial clusters of ID patients exist among Iran counties (Moran's I = 0.36, P < 0.01) and in a rural area population groups (Moran's I = 0.20, P < 0.01). Further, we detected spatial associations between ID patients and all of our investigated socio-demographic factors in national scale. In rural areas, illiteracy has high association with ID especially in the south region of Iran. Urban area has random pattern of ID patients both within and between the Iran counties (Moran's I = 0.01, P > 0.3). According to the results, our Initial hypothesis about the existence of spatial clusters in distribution of people with ID in Iran was proven. Spatial autocorrelation between migration and illiteracy rate and prevalence of patients with ID was shown and was in agreement with our hypothesis. However, our supposition that the prevalence should have inverse relationship with PN and HCC was rejected.

High daily intake of fruit and vegetables promotes population health and is inversely associated with morbidity and mortality. Demographic and socioeconomic characteristics are among main predictors of fruit and vegetables consumption. The current study aimed to evaluate these associations using province-level data in Iran during the years 2007-2009. Data on the mean number of fruit and vegetables consumption per day in age and sex stratum at the province level from three consecutive stepwise non-communicable diseases risk factors surveys were obtained. Data about provinces' socioeconomic status (SES) were obtained from the Statistical Centre of Iran and published reports. One-way repeated measures ANOVA and random effect linear regression models were applied for non-stratified and stratified analyses, respectively. There were substantial variations in the fruit and vegetables consumption across the country. Consumption of vegetables was higher than fruit over the study period. There were no statistically significant differences in fruit (P = 0.52) and vegetables (P = 0.14) intake among men and women. Older age was associated with lower consumption of fruit. People in the provinces with better SES consumed higher amounts of combined fruit and vegetables and this association was more profound among females. The results suggest that policies and interventions to improve the intake of fruit and vegetables in the country may be significantly beneficial, especially for older people and women in low socioeconomic groups.

Cancer is the third cause of death in Iran, with an increasing incidence projected for the next decade. This study aimed to provide a disaggregated viewpoint on cancer incidence in all 22 districts of Tehran, using the Geographic Information System (GIS). Identifying clusters of cancers may assist in recognizing the cause of the disease, visualizing patterns of cancer distribution, the potential disparities, and help in the provision of early detection programs and equitable, curative, and palliative services. According to the 2007 - 2008 Cancer Registry Data published by the Ministry of Health, there were 7948 new cancer cases diagnosed in Tehran. Data were collected from all pathology centers and hospitals, either public or private facilities, in Tehran. These were classified into 31 main categories according to the expert panels and available resources. The population of the districts and neighborhoods were obtained from the Iran Statistical Center and the Municipally of Tehran, respectively. Home addresses and phones were extracted from the database and imported to GIS. The Age-Standardized Rate (ASR) was calculated using both the new world standard population (2000 - 2025) and the Iran population. Overall, the cancer incidence rate and ASR were 101.8 and 94.775 per 100,000 people, respectively. The maximum cancer incidence rates in both sexes were in districts 6, 3, 1, and 2, whereas, the maximum ASRs were in districts 6, 1, 2, and 3. District 6 accommodated the highest ASRs in both the sexes. Common cancers were breast, skin, colorectal, stomach, and prostate. The ASR in men and women were 129.954 and 114.546 per 100,000 population. This report provides an appropriate guide to estimate the cancer distribution within the districts of Tehran. Higher ASR in districts 6, 1, 2, and 3, warrant further research, to obtain robust population-based incidence data and also to investigate the background predisposing factors in the specified districts.

Evaluating the tuberculosis (TB) status of the Economic Cooperation Organization (ECO) member countries relation to goal 6-c of the third millennium, which includes that TB incidence, prevalence, and death rates should be halved by 2015, compared with their level in 1990. In 2009, we have critically reviewed the countries' Millennium Development Goals (MDGs) reports and extracted the data from the surveillance system and published and unpublished data. The main stakeholders, from both governmental and international organizations in the country have been visited and interviewed by the research team as part of the data validation process. The TB incidence is very heterogeneous among ECO countries, which differ from 21.7 in Iran to 230.7 per 100,000 in Tajikistan. TB incidence (per 100,000) is more than 100 in six countries and is from 50 to 100 in two countries and is less than 30 in two countries. Only in two countries the crude death rate (CDR) is higher than 70%. In seven countries the death rate is higher than 10 per 100,000. Two countries are among the 20 top world countries with the highest tuberculosis burden. THERE ARE SOME SIGNS AND SIGNALS INDICATING THE BAD CONDITION OF AN ECO MEMBER INCLUDING: incidence of more than 50 per 100000, CDR of less than 70%, death rate more than 10 per 100,000, and rating two member countries among 20 top countries with the highest burden in the world. Iran and Turkey could achieve MDGs by 2015, but if other countries do not prepare urgent intervention programs, they will not be able to fulfill the goals.

Students, clergymen and teachers as role models can be very important in encouragement or prevention of cigarette smoking in young people. The aim of this study was to compare prevalence of smoking in 3 male groups of teachers, clergymen and university students. Also, study their knowledge and attitude towards it and the prediction of their future consumption. In a cross sectional study in 2009 in Tehran, Iran, 1,271 male students, 549 clergymen and 551 teachers were randomly enrolled. Each participant completed the global adult tobacco survey questionnaire. Knowledge, attitude and prediction of smoking for the next 5 years were questioned in these 3 groups. Chi-squared test and logistic regression were used for analysis. P < 0.05 was considered significant. Prevalence of cigarette smoking was 31.1%, 21.9% and 27.2% among students, clergymen and teachers, respectively. Smoking in students was not associated with poor knowledge but were in teachers and clergymen. The odds ratio of smoking in students, clergymen and teachers was higher among those with having inappropriate attitude towards it (OR = 1.6, 6.1 and 4.5). Those with poor knowledge had an inappropriate attitude and predicted higher chance of cigarette consumption in the next 5 years (P < 0.0001). Inappropriate attitude in all 3 groups resulted in higher prediction of future smoking (P = 0.008). This study revealed that the prevalence of smoking among male students and teachers was higher than general population and clergymen who equally smoked. Also, level of knowledge and attitude of students were lower than teachers and clergymen.

Intention to smoking is a strong predictor of future smoking behavior. The aim of this study is identifying the personal, environmental, and psychological factors relating to intention to smoking in adolescents of Tabriz city (Northwest of Iran). Four thousand nine hundred and three (4903) students were randomly selected and completed a self-administered questionnaire about cigarette smoking, intention to smoking, and the related risk factors through multi-stage sampling. The association of independent variables with intention to smoking was evaluated using the multi-variable logistic regression model. The mean age of student was 15.7 ± 0.73 years, and 42.9% of the samples were male. The results showed that 95.0% of students were in committer stage (students who had never smoked and were sure never start smoking). Having general risk-taking behavior (OR = 2.90; 95% confidence interval [CI]: 1.21-6.97), smoker in the family (OR = 2.60; 95% CI: 1.20-5.61), and positive attitude towards cigarette smoking (OR = 1.30; 95% CI: 1.18-1.43) had statistically significant association with intention to start smoking in future. Majority of non-smokers have firm decision to not start smoking in the future. Having general risk-taking behavior, smoker in the family, and positive attitude towards smoking are associated with intention to smoking in adolescents.

The aim of this study was to determine the prevalence of tobacco use and effect of lifestyle factors on cigarette and hookah use among adult residents of Shiraz, Iran. In 2010, 1,000 participants were recruited in a multistage, random sampling cross-sectional population-based survey. Response rate was 98%. Prevalence of cigarette smoking was 9.7%. Among cigarette users, 12.6% reported smoking <1 year; 13.4% smoked 1-2 years and 73.9% smoked>2 years. Almost half of those surveyed (48.9%) smoked <10 cigarettes per day (cpd); 28.4% smoked 10-15 cpd; 14.8% smoked 16-19 cpd, and 8%>20 cpd. Almost a quarter (20.4%) of the cigarette smokers tried to quit in the past year. Being male, married, aged 37-54, having higher perceived levels of stress, a non-manual occupation, and sedentary lifestyle were positively associated with cigarette smoking. Manual labor occupations, housewife/jobless status, and going frequently to restaurants were positive predictors of hookah smoking. Compared to cigarettes, hookah smoking was more prevalent among Iranian adults. Approximately, the prevalence of hookah smoking in women is the same as men, whereas cigarette use was 31 times more common in men. Cigarette and hookah smoking were associated with less healthy lifestyle habits in both men and women.

University entrance is accompanied by major changes in social relationship, rules, and expectations that lead to psychological disorders in susceptible students. The goal of this research is to study the anxiety rate in Iranian medical residents in 2010-2011. This study is a cross-sectional, descriptive study. It contains 370 medical residents from the 1(st) year to the 4(th) year of medical universities in Isfahan, Gilan, Zahedan, Sanandaj, and Kashan. The stratified sampling method proportionate to volume of participants is used in this study. The information is collected based on researchers' questioners and Zung self-rating anxiety scale and analyzed with the use of spss software version 16, addition to descriptive and analytic tests (Pearson, one-way analysis of variance, t-test). Meaningful level is regarded as P ≤ 0.05. The study showed that more than 92% of residents participated in the study did not demonstrate anxiety. Among 370 subjects 5.5% presented with mild symptoms of anxiety and no one had symptom of severe anxiety. A meaningful statistical relationship was observed between anxiety and sex, major of study and the city of study (P < 0.05). The results showed a positive meaningful relationship between the number of visits and the score of anxiety. On average the number of night floats were two in 1 week and the number of patient visit was 19 in the past 24 h. A meaningful statistical relationship between anxiety score and number of patient visits was observed. The anxiety rate in medical students in this study compared to the findings of previous studies reveled very low anxiety in medical residents. The low rate of anxiety could be attributed to the sense of job security and the hope for a better future among residents. The high percentage of anxiolytics abuse and absence of anxiety producing factors among residents in addition to inaccurate response to the questionnaire may all contribute to the low rate of anxiety in this study.

The average rural Indian women enter her reproductive life, particularly in pregnancy, suffer from nutritional anemia due to iron deficiency. National program of India had implemented a strategy for supplementation of iron folic acid by means of iron folic acid (IFA) tablets at least 3 months during antenatal period. The study had been conducted to assess the proportion of pregnant mothers consumes the IFA tablets and the factors determine compliance. A cross-sectional, community-based study was conducted in rural area of India on 50 antenatal mothers by multistage sampling technique. The data were analyzed by using SPSS 16 (Statistical Package for the Social Sciences, ver. 16), Chicago, considering the level of significance at 95%. The IFA tablet was adequately consumed by 62% mother among the study population. The consumption is more among the mother who were explained properly than those who were not explained by the health worker (χ(2)= 4.529, P < 0.05). The compliance of iron folic acid tablets was still far behind to reach the National Goal though the service component are quite strong by the front line workers and health providers. An effort should be given at the level of front line health workers by training and re-training them to improve the compliance of IFA consumption.

This study aimed to investigate the impact of internet addiction on some psychiatric symptoms among university students. This cross-sectional study was conducted among 250 students selected via quota sampling from universities in Isfahan, Iran. Participants completed demographic questionnaire, Young Diagnostic Questionnaire, Internet Addiction Test and Symptom Checklist-90-Revision (SCL-90-R). Finally, the means of psychiatric symptoms of internet addicted and non-addicted subjects were compared. Also, t-test and multivariate analysis of covariance were used through SPSS(16) software for data analysis. The mean±standard deviation (SD) of psychiatric symptoms such as somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, aggression (hostility), phobic anxiety, paranoid ideation and psychoticism in the addicted group were 11.27 ± 6.66, 14.05 ± 7.91, 10.5 ± 6.20, 15.61 ± 8.88, 10.77 ± 5.52, 6.77 ± 4.88, 6.05 ± 4.47, 7.61 ± 4.28, and 9.66 ± 6.87, respectively, and in the non-addicted group were 6.99 ± 6.42, 7.49 ± 5.23, 5.46 ± 4.95, 9.27 ± 7.92, 6.35 ± 6.69, 3.57 ± 3.35, 2.41 ± 2.79, 5.47 ± 4.1, and 5.29 ± 4.95, respectively. There were significant differences between the means of psychiatric symptoms in all SCL-90-R subscales and Global Severity Index, Positive Symptom Distress Index, Positive Symptom Total in the addicted and non-addicted individuals (P<0.05). Also, internet addiction (with controlling sex variable) seemed to affect psychiatric symptoms. Psychiatrists and psychologists involved in the field of mental health need to be well informed about mental problems due to internet addiction, such as anxiety, depression, aggression, and job and educational dissatisfaction.

This study assesses self-reported tobacco use prevalence (cigarette, water-pipe, and medwakh) among applicants to Abu Dhabi's Premarital Screening program during 2011. Premarital Screening data reported to the Health Authority - Abu Dhabi from April to December 2011 were utilized to estimate tobacco use prevalence among applicants. Smoking prevalence was examined by nationality, age group and gender. Overall, 24.7% of Premarital Screening Program applicants were current smokers; 11.5% smoked cigarettes, 5.9% smoked medwakh (hand-held pipe), 4.8% smoked water-pipe and 2.5% smoked a combination (more than one type). Men (19.2%) were more likely than women (3.5%) to be current cigarette smokers. Women were much less likely to smoke medwakh (0.1%) than men (11.5%), with male UAE Nationals having the highest medwakh smoking prevalence (16.1%). The overall prevalence of water-pipe smoking was 6.8% among men and 2.8% for women with the highest water-pipe smoking prevalence (10.2%) among Arab expatriate men. Variations in tobacco use prevalence among Premarital Screening Program applicants reflect preferences for different modes of tobacco consumption by nationality, age group and gender. Enforcement of tobacco control laws, including implementation of clean indoor air laws and tobacco tax increases, and targeted health education programs are required to reduce tobacco consumption and concomitant tobacco-related morbidity and mortality.

Electroconvulsive therapy (ECT) is one of the most efficacious treatment for major depressive disorder (MDD), it is also used as a rapid and efficacious treatment for other psychiatric disorders, especially treatment resistant ones. The cognitive impairment is one of the most important side effects of ECT. This study examined the Memoral herbal efficacy in prevention of ECT-induced memory impairment. In a randomized clinical trial, 70 patients with mood disorders who were candidates for ECT enrolled in either Memoral or Control group, and received either Memoral or placebo. The memory was assessed by Addenbrook Cognitive Examination (ACE), and the findings were analyzed by ANOVA under SPSS18. The Memoral group patients showed significantly higher total ACE scores than placebo group (P < 0.001). The scores of attention and orientation, verbal fluency and memory subscales not only never decreased during the study in Memoral group, but also increased. There was no significant difference between these scores of Memoral and placebo groups for the subscales of language and visuospacial ability. The Memoral herbal is an efficacious and safe choice in prevention of ECT- induced cognitive impairment.

To compare the level of knowledge, the attitudes, and practices with regards to tobacco use between Iranian students at a public (PBU) and Islamic Azad (IAU) university. A cross-sectional design was used in this study. As the number of students at the IAU were three times greater than that of the PBU, we selected 150 students from the PBU and 450 students from the IAU using simple random sampling. A 57-item survey instrument was utilized for this study. The collected data were recorded by SPSS version 15 software and then it underwent statistical analysis using descriptive statistics and ANOVA to compare the difference between means of knowledge, attitude and practice scores. Logistic regression analysis was conducted to identify variables that have an independent association with students smoking and to describe possible variations in these relationships. The P value level for statistical significance was set at 0.05. From participants, 46.8% were females, 10% of 327 students reported being daily smokers; of these, 84% were from the IAU. Totally, among the 107 smokers, 61 (57%) and 29 (27.1%) were water pipe and cigarettes smokers, respectively. Ninety-three IAU students (21.7%) and 30 PBU students (20.7%) reported smoking during the past 30 days. The mean of the knowledge items between the students of IAU was lower than PBU students. Female gender, smoking in the home, and allowing visitors to smoke in the home were significant predictors of smoking in the past 30 days in PBU, respectively. In IAU, female gender, smoking by friends, and health status were predictors for smoking in the past 30 days. Future studies should assess the factors affecting smoking initiation, as well as effective techniques for the prevention of smoking initiation and substance abuse in Iranian adolescents and young adults.

Scenes depicting smoking are among the causes of smoking initiation in youth. The present study was the first in Iran to collect some primary information regarding the presence of smoking scenes in movies and propagation of tobacco use. This cross-sectional study was conducted by polling audience about smoking scenes in Persian movies on theaters in 2011. Data were collected using a questionnaire. A total of 2000 subjects were selected for questioning. The questioning for all movies was carried out 2 weeks after the movie premiered at 4 different times including twice during the week and twice at weekends. A total of 39 movies were selected for further assessment. In general, 2,129 viewers participated in the study. General opinion of 676 subjects (31.8%) was that these movies can lead to initiation or continuation of smoking in viewers. Women significantly thought that these movies can lead to initiation of smoking (37.4% vs. 29%). This belief was stronger among non-smokers as well (33.7% vs. 26%). Despite the prohibition of cigarette advertisements in the mass media and movies, we still witness scenes depicting smoking by the good or bad characters of the movies so more observation in this field is needed.

Background: Tobacco smoking is the leading cause of preventable mortality. The prevalence of smoking in adolescents in high schools ranges from 23.5% to 41%, respectively. In Colombia, these figures are similar and students entering the University are exposed to initiate smoking. The purpose of this study was to establish the determinants associated with the initiation of tobacco smoking among university students. Methods: A case–control paired by sex and age study design was used. The study population was the students of a private university of Bucaramanga, Santander, Colombia. The final sample consisted of 167 cases and 314 controls randomly select undergraduate university students. Data analysis was performed using a Logistic regression model adjusted by gender and age; using the initiation of tobacco smoking as the dependent variable, and as independent variables relationship with parents, history of parental smoking, university social environment, being away from hometown, steady girlfriend/boyfriend who smokes, alcohol consumption, physical activity, and Francis Score. Results: The social environment (odds ratio [OR]: 32.70, 7.40-144.55), being away from hometown (OR: 3.06, 1.55-6.07), history of steady girlfriend/boyfriend who smoke (OR: 2.87, 1.43-5.76), a bad relationship with the father (OR: 8.01, 2.01-31.83), history of tobacco consumption of the mother (OR: 2.66, 1.37-5.17) and alcohol consumption (OR: 4.79, 1.91-12.00) appeared as determinants of initiation of tobacco smoking. As protector factors we found media advertisement (OR: 0.19, 0.05-0.71), light physical activity 2-3 times a week (OR: 0.33, 0.12-0.88), and a high result in Francis score (OR: 0.95, 0.919-0.99). Conclusions: University efforts for tobacco-free policies should focus on preventive advertisement, promoting physical activity and awareness among young students of social environmental factors that could influence their decision to start smoking tobacco.

Background: Nowadays, there has been a growing trend of caesarean sections in Iran. One reason would be the mother's desire. Increased maternal self-efficacy can be an important step to reduce percentage of cesarean. This study aimed to determine the effectiveness of training-based strategies to increase the self-efficacy for choosing delivery method among pregnant women in Shahrekord city. Methods: This quasi-experimental study was conducted on 130 pregnant women who attended urban health centers in Shahrekord city in 2013. Intervention was applied in the experimental group in three sessions in about 60-90 min while control group did not receive any intervention. Fear of childbirth and self-efficacy questionnaire was completed before and after training. Results: While mean scores of the fear of childbirth, expectations and childbirth self-efficacy before the intervention between the two groups were not significantly different (P > 0.05), mean scores of childbirth in intervention group was reduced and expectation and childbirth self-efficacy had a significant increase after intervention (P < 0.05). In this study, 71.4% of mothers in intervention group and 53.8% of control mothers naturally delivered their children. Most of intervention group mothers desired to deliver through cesarean and had more fear (P < 0.001) but lower childbirth expectation (P > 0.05) and self-efficacy (P < 0.001) than those who chose normal method. Conclusions: Our findings showed that training-based self-efficacy procedure has been effective in encouraging mothers to choose natural childbirth. Therefore, the design and implementation of curriculum-based strategies for increasing self-efficacy is suggested for pregnant women.

Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenitis is a benign disorder characterized histologically by necrotic foci surrounded by histiocytic aggregates, and with the absence of neutrophils. The patient was a 21-year-old man with chills, fever and cervical lymphadenopathy. He had swelling and tenderness of cervical area. Multiple enlarged lymph nodes were palpable. Cervical lymph node excisional biopsy was performed. Microscopic examination showed reactive follicular hyperplasia with vast areas of necrosis without neutrophilic infiltration. No sign of malignancy was seen. Final diagnosis was Kikuchi-Fujimoto necrotizing lymphadenitis. Kikuchi-Fujimoto disease should be considered as one of the differential diagnoses in patients with prolonged fever and cervical lymphadenopathy. It should be differentiated from tuberculous lymphadenitis in regions where tuberculosis is prevalent.

The first step in diagnosis of diabetic nephropathy is measurement of albumin in a spot urine sample. The aim of this study was assessment of the accuracy of urinary albumin to creatinine ratio (UACR) in random urine specimens (RUS) for microalbuminuria and macroalbuminuria screening in Iranian diabetic patients. A total of 200 diabetic patients participated to our study. 24 h timed urine specimens followed by RUS were collected. 24-h urine albumin excretion (24-h urinary albumin excretion (UAE)) and UACR in RUS were measured. Data were analyzed by Pearson's correlation, receiver operating characteristic (ROC) curve and McNemar test. A total of 165 patients finalized the study. Pearson's correlation of coefficient for 24-h UAE versus UACR was 0.64. The area under ROC curve for UACR was 0.83 in microalbuminuria and 0.91 in macroalbuminuria. The cutoff point of 30 mg/g in UACR method had 86% sensitivity and 60% specificity for microalbuminuria screening and cut-off point of 300 mg/g had 75% sensitivity and 99% specificity for macroalbuminuria screening respectively. UACR in RUS showed acceptable performance as a screening test for diagnosis of both micro and macroalbuminuria in Iranian diabetic patients.

Background: Icter is the most prevalent disease in newborns. Although most of the newborns affiliated with this seem healthy in other aspects, there is always a fear for toxic complication of indirect hyperbilirobinemia in the central nervous system. Nowadays phototherapy is the method of decreasing (or avoidance of increase) of total serum bilirobin (TSB) and it is also used widely in neonatal health care centers according to the availably of equipment, but without any defined standard. In this study, two light sources, quarts halogen incandescent filament lamp (QHIFL) and fluorescent lamp (FL) are compared with each other to find out which method is more useful and efficient. Methods: This study is a randomized controlled trial done on 25 newborns with gestational age of 35 weeks or more, with newborn's icter in the 1st week after birth, at Isfahan Behesti Hospital, February 2012 to March 2013. A group of these newborns was treated with FL and the other with QHIFL and they all were controlled and tested according to their level of TSB at the beginning of phototherapy, at 8th, 12th, and 24th h of treatment and at discharge. The data from the study was analyzed by IBM SPSS Statistics Version 21. Results: According to the findings, the level of TSB before and 8 h after the intervention had no significant difference among the groups. However, at 16th and 24th h of treatment, the TSB level was lower in the FL group and this difference was meaningful (P = 0.002 and P = 0.013 respectively). Furthermore the duration of the treatment was significantly shorter in FL group meaningfully (P = 0.047). Conclusions: According to the findings of this study, the technology used in QHIFL cannot show the capabilities of the FLs. However, more studies are needed to confirm the findings of this study are universal.

Background: Quality of life (QOL) is increasingly recognized as an important outcome measure in dermatology. Psoriasis has a great impact on QOL of patients, and has a strong effect on social relations, psychological status, and daily activities. This study describe and compare the impact of different grades of severity of psoriasis on QOL of patients in north of Iran. Methods: This cross-sectional study was performed on 55 patients diagnosed with psoriasis and 55 healthy controls. The patients were selected by consecutive sampling from April to December 2006. The controls were recruited by simple random sampling among patient escorts. After obtaining written informed consent, all the members were included into the study. The Psoriasis Area and Severity Index (PASI) standard questionnaire was used to determine the severity of the disease. In addition, the short-form-36 questionnaire, which is validated for use in Iran, was employed. The gathered data were analyzed using the Stata (V 8.0, SE) (Copyright 1984-2003, Stata Corporation, 4905 Lakeway Drive Special Edition, College Station, Texas 77845 USA) and analyses of covariance (ANCOVA) test. Results: Overall, The mean PASI scores was 5.4 ± 6.7, total QOL scores had a significant difference between patients and controls (61.1 ± 17.0 vs. 71.9 ± 22.4) (P < 0.05), especially in three domains: Role-physical (58.5 ± 23.3 vs. 70.8 ± 26.2), general health (43.8 ± 21.6 vs. 61.5 ± 27.3), and social functioning (62.7 ± 26.7 vs. 79.5 ± 27.5) (P < 0.01). Physical activities were affected in >50% of the cases. This figure significantly increased with the increasing severity of psoriasis. In addition, social relationships were disrupted in more than half of the patients, but with no significant difference between different grades of severity (P > 0.05). There is no significant difference between adjusted score of multiple domains of QOL in psoriatic patients according to PASI levels (ANCOVA, P > 0.05). Conclusions: The physicians’ awareness of the importance of patients’ QOL in both physical and emotional aspects could improve and enhance the psychological evaluation of the psoriatic patient, which will promote his/her positive outcome. And, PASI score can’t to predict the QOL really.

Regarding risk of bacterial meningitis (BM) after Cochlear implantation (CI), it was suggested to receive polyvalent conjugate vaccine. We aimed to estimate the prevalence of BM post CI in child recipients who do not receive polyvalent vaccine. We enrolled 371 children who had received cochlear implants from 2007 to 2010. None of them received pre or post implantation polyvalent conjugate vaccine for BM. We followed all of them for BM for 2 years after implantation. We detected only one female case of BM (0.3% of patients) with the age of 24 months. The mean age of noninfected children was 36.7 ± 23.2 months. The education level of parents was "college level or higher" in less than half of them, and about 65% of patients were products of consanguineous marriage. Our findings indicated that the incidence of BM was not higher in our cochlear implanted children who did not receive immunization than patients from countries in which routine vaccination is done. We suggest that although proper immunization is recommended before surgery, this procedure could be performed without vaccination, especially in developing countries that face financial problems for preparing vaccines.

Increased central adiposity is associated with increased risk of cardiovascular disease (CVD) in youths. Since simple and inex-pensive but accurate diagnostic tools are required for general use in clinical practice, we examined body mass index (BMI), waist circumfe-rence (WC), waist-to-height ratio (WHtR) and skin-fold thickness (SFT) for their utility in predicting CVD risk factors in children. A representative sample of 3850 children (1981 males) aged, 3-11years, participated in this cross-sectional study. The association of CVD risk factors with BMI > 85(th), WC > 90(th), WHtR > 90(th) and SFT > 90(th) percentile was examined by multivariate logistic regression models. SPSS(17)was used for statistical analyses; P < 0.05 was considered statistically significant. In studied children the prevalence of increased general adi-posity (BMI 4.1%) was considerably lower than the prevalence of high central adiposity (WC 11.8%, WHtR 9.5% and SFT sum 9.8%). Girls had more adverse lipid profiles and CVD risk factors than boys. Age-and gender- adjusted hypertension was significantly associated with adiposity (OR: 2.8) and increased skin-fold thickness (OR: 1.7). Among the four fat patterning variables WHtR > 90(th) percentile had the strongest association with increased LDL-C (OR: 2.0), Non HDL-C (OR: 2.1), LDL-C/HDL-C ratio (OR: 3.3), TG/HDL-C ratio (OR: 2.0) and risk factor clustering (OR: 1.7). Among the children studied, increased (WtHR) was the strongest predictor of traditional CDV risk factors, followed by in-creased skin-fold thickness and BMI.

To evaluate the reliability, validity and feasibility of the Persian version of the Pediatric Quality of Life inventory (PedsQL™ 4.0™ 4.0) Generic Core Scales in Iranian healthy students ages 7-15 and chronically ill children ages 2-18. We followed the translation methodology proposed by developer to validate Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales for children. Six hundred and sixty children and adolescents and their parents were enrolled. Sample of 160 healthy students were chosen by random cluster method between 4 regions of Isfahan education offices and 60 chronically ill children were recruited from St. Alzahra hospital private clinics. The questionnaires were fulfilled by the participants. The Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales discriminated between healthy and chronically ill children (healthy students mean score was 12.3 better than chronically ill children, P<0.001). Cronbachs' alpha internal consistency values exceeded 0.7 for children self reports and proxy reports of children 5-7 years old and 13-18 years old. Reliability of proxy reports for 2-4 years old was much lower than 0.7. Although, proxy reports for chronically ill children 8-12 years old was more than 0.7, these reports for healthy children with same age group was slightly lower than 0.7. Constructive, criterion face and content validity were acceptable. In addition, the Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales was feasible and easy to complete. Results showed that Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales is valid and acceptable for pediatric health researches. It is necessary to alternate scoring for 2-4 years old questionnaire and to find a way to increase reliability for healthy children aged 8-12 years especially, according to Iranian culture.

Acinetobacter baumannii is an omnipresent pathogen known as a major agent in healthcare and nosocomoal-associated infections. Its ability to develop resistant pattern to the major and broad spectrum antibiotics is an important issue to be studied. In this study, 101 strains of Acinetobacter baumannii were isolated from the hospitalized patients during July 2007 to June 2009 in one teaching hospital in the southern Tehran. The identification of Acinetobacter baumannii and resistant pattern was performed by using conventional bacteriological methods and Clinical Laboratory and Standards Institute (CLSI). Respiratory tract specimens were the most common place of Acinetobacter isolation. The organism was resistant to ceftazidime (96%), ceftizoxime (95%), ceftriaxone (93%), amikacin (58%), gentamicin (68%), co-terimoxazole (85%), and ciprofloxacin (85%). This pattern also pointed that imipenem had the lowest resistance rate (9%). Susceptibility rates of Acinetobacter baumannii isolates to third-generation cephalosporins, fluoroquinolones, amikacin, gentamicin, and trimethoprim/sulfamethoxazole (SXT) were very low and the rate of resistant Acinetobacter baumannii to imipenem was significant. It would be a good idea to consider surveillance of antibiotic usage and restriction of using broad spectrum antibiotics before development of resistance to these agents.

To determine inequality in mortality in 1-59 months children across Iranian provinces focusing on referring system and determinants of death. After designing and examining a national questionnaire for mortality data collection of children 1-59 months, 40 medical universities have been asked to fill in the questionnaires and return to the main researcher in the health ministry in 2009. Mortality in 1-59 months children was unequally distributed across provinces (universities). The recommended refer was 3466 but only 1620 patients were referred. The first five important determinants of death were congenital (671 children or 20.9%), accident (547 children or 17.1%), pulmonary diseases (370 children or 11.5%), cardiovascular (266 children or less than 8.3%), central nervous system (263 children or 8.2%), and infectious and parasitic diseases (245 children or 7.6%), respectively. Our results suggest that inequality in 1-59 months mortality based on the hospital records, and specially referring system, needs more attention in Iran. In addition, it is advisable to conduct provincially representative surveys to provide recent estimates of hospital access inequalities and to allow monitoring over time.

Physicians constitute a considerable professional influential group; they may be most suited for tobacco use prevention and smoking cessation intervention among the growing tobacco using population. We assessed tobacco cessation knowledge and practice done by 91 physicians in two blocks of Khurda district by using modified version of survey instrument developed by Francisco G. Soto Mas. Statistical Package for Social Sciences (SPSS) 16 statistical software was used for the analysis. The response rate was 75.83%, of which 77 (84.6%) were male. Study participants were in the age group 36-45 years. Nearly 13.2% of the respondents were active tobacco user. In tobacco-related practices, around 58 (62%) of participant physicians ask patients about tobacco use status always-frequently. More than (67) 70% of participant physicians advise their patients to quit tobacco but only 10-20% of study physicians assist them in referring to cessation programs. Seventy one (78%) of physicians felt providing counseling to patients using tobacco as their responsibility. The results indicate that physicians participating in this study do not meet the level of intervention recommended by National Tobacco Control Program.

In some studies, the involvement of dangerous psychological and behavioral factors in etiology and physiotherapy of vascular disturbances have been shown. In other studies, the relationship between the personality type and increase in cardiovascular disease has been demonstrated. The type D personality is defined as having two characteristics of negative affect and social inhibition. It is thought that individuals with type D personality are at increased risk of carotid artery intima-media thickening which predisposes them to vascular disease that is one of the most important factors for the stroke. In this study, we try to determine whether type D personality is a contributing factor to an increase in the intima-media of the carotid artery. This study was done in 2012 in the teaching hospital of Alzahra in Isfahan Iran. This is a case/control study which is done at Alzahra hospital in Isfahan in 2011-12. The statistical population in this study is composed of individuals who do not have any risk factors for stroke and are randomly selected among the hospital staff or the patient's family members who accompanied the patient at the hospital. They filled out a questioner that would assist in detecting type D personality. A carotid Doppler ultrasound that measures the intima-media thickness in the selected individuals was performed. The information obtained from the study was evaluated by Statistical Product and Service Solutions (SPSS) software and the intima-media thicknesses were compared in two groups of patients. The average thickness of intima media in two groups, consist of placebo and patients, was 0.739 ± 0.12 and 0.759 ± 0.14 millimeter, respectively. There was no meaningful difference between the two groups based on t-test values (P = 0.19). It is important to note that based on the results, 22.9% of placebos and 48.6% of individuals with type D personality presented with abnormal thickness. The difference between the two groups were meaningful based on Chi-Squared test (P = 0.001). We conclude that type D personality increases the risk of cardiovascular diseases specially the stroke and myocardial infarction due to the higher prevalence of hormonal imbalances leading to arterial vasospasm and atherosclerotic disease. As a result, it is necessary to evaluate and treat these patients due to increased risk of atherosclerotic diseases, stoke, and myocardial infarction.

Cigarette Smoking is a recognized cause of systemic disorders such as bronchogenic, carcinoma, and cardiovascular diseases and hence prompt and effective interventions are required for its elimination. Thus, This Meta-analysis was carried out for an adult population of west of Iran in order to estimate of prevalence smoking in this area. We examined related to documentation by searching in published and non-electronic databases. Data were extracted based on variables such as the year of the study, sex, age group, and the prevalence of smoking. Based on the results of heterogeneity, we used fixed or random effects model to assessment the overall prevalence of cigarette smoking. All analyses were accomplished via STATA 11 software. Totally, 25,990 subjects (13005 males) were investigated. Meta-analysis in men and women indicated prevalence of 22.9 (20.6-25.2) and 0.6 (0.3-0.9) respectively. It was found that more than one-fifth of men from 15 year to 64-year-old of west of Iran smoked cigarette. Providing an education on harmful effects of smoking to the adult population would be a valuable means for reducing destructive consequences of smoking.

Background: Oligodendrocytes, the myelinating glial cells of central nervous system, are highly vulnerable to ischemic-induced excitotoxic insult, a phenomenon in which calcium overload triggers cell death. Berberine is an alkaloid extracted from medicinal herbs as Coptidis Rhizoma with several pharmacological effects like inhibition of neuronal apoptosis in cerebral ischemia. Methods: We examined the effects of berberine (0.5-4 μM) and glutamate receptors antagonists (MK-801 [10 μM] and NBQX [30 μM]) on OLN-93 cell line (a permanent immature rat oligodendrocyte) during (30, 60, 240 min) oxygen-glucose deprivation (OGD)/24 h reperfusion. The cells were cultured in 12-well plates. The cells were exposed to glucose-free medium and hypoxia in a small anaerobic chamber. Cell viability was evaluated by MTT (3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide) assay. The intracellular calcium levels also were evaluated by Ca2+-sensitive indicator Fura-2/AM in presence or absence of berberine (2 μM) during 30 min chemical OGD by NaN3 (20 mM). Student's t-test and ANOVA were used for statistical analysis. Results: Berberine, MK-801and NBQX significantly increased oligodendrocyte viability in all 3 time-scheduled oxygen-glucose deprivation/reperfusion. Berberine at 2 μM produced peak of protection, and increased cell viability to 83%, 77%, and 79% during 30, 60, 240 min ischemic experiments, respectively (P < 0.001). Berberine significantly attenuated intracellular Ca2+ rise induced by chemical ischemia, and this effect of berberine was significantly stronger than MK-801 and NBQX (P < 0.001). Conclusions: We concluded that berberine protected OLN-93 oligodendrocyte against ischemic induced excitotoxic injury. Attenuation of intracellular Ca2+ overload by berberine may be the key mechanism that saved OLN-93 from excitotoxicity damage.

Background: There are some evidences that control the blood sugar decreasing the risk of diabetes complications, and even fatal. There are so many studies, but they are mostly cross-sectional and ignore the trend and hence it is necessary to implement a longitudinal study. The aim of this prospective study is to find the trend of glycosylated hemoglobin (HbA1c) over time and the associative factors on it. Methods: Participants of this longitudinal study were 3440 eligible diabetes patients referred to Isfahan Endocrine and Metabolism Research Center during 2000-2012 who are measured 2-40 times. A linear mixed model was applied to determine the association between HbA1c and variables, including lipids, systolic, diastolic blood pressure and complications such as nephropathy, and retinopathy. Furthermore, the effect of mentioned variables on trend of HbA1c was determined. Results: The fitted model showed total cholesterol, retinopathy, and the method of therapy including oral antidiabetic drugs (OADs) plus insulin and insulin therapy decreased the trend of HbA1c and high-density lipoprotein, weight, hyperlipidemia and the method of therapy including diet, and OADs increased the trend of HbA1c. Conclusions: The present study shows that regular visits of diabetic patients as well as controlling blood pressure, lipid profile, and weight loss can improve the trend of HbA1c levels during the time.

A rare case of ascaris coming out through the anterior abdominal wall is reported here. A 40-year-old female had undergone dilatation and curettage by a quack. On the second day she presented with presented with features of peritonitis. She was explored. Resection anastomosis of the ileum was done for multiple perforations of the ileum. Patient developed a fistula in the anterior abdominal wall which was draining bile-colored fluid. On the 12(th) postoperative day a 10-cm-long worm was seen coming out through the fistulous tract which was found to be Ascaris lumbricoids. Ascaris lumbricoids can lead to many complications ranging from worm colic to intestinal obstruction, volvulus, peritonitis, pancreatitis, cholangiohepatitis, liver abscess and many more. Worm has been reported to come out through mouth, nostrils, abdominal drains, T-tubes etc. But ascaris coming out through the anterior abdominal wall is very rare hence reported here.

Obesity is a common health problem around the world. Studies have shown inverse relationship between serum vitamin D levels with obesity among patients and healthy population. The aim of this present study is to examine the relationship between serum vitamin D levels with general and abdominal obesity among migraine patients. The present study is a cross-sectional and 66 migraine patients aged 19-61 years were included for analysis. Partial correlation was performed to assess association between serum 25-OH-D with general and abdominal obesity. Adjustments were performed for age, sex, and education. No relationship was found between serum levels of vitamin D with general and abdominal obesity. However, a significant association was shown between waist circumferences (WC) with body mass index (BMI). Serum levels of 25-OH-D were not associated with WC and BMI. Furthermore, after adjustment for confounder variables, no association was observed.

Increased intra-abdominal pressure (IAP) results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. In a cohort study, a total of 60 patients aged 20-70 years who were admitted to the ICU and underwent mechanical ventilation were recruited. Mechanical ventilation included one of the three modes: Biphasic positive airway pressure (BIPAP) group, synchronize intermittent mandatory ventilation (SIMV) group, or continuous positive airway pressure (CPAP) group. For each patient, mechanical ventilation mode and its parameters, blood pressure, SpO2, and status of tube feeding and IAP were recorded. Our findings indicate that the study groups were not significantly different in terms of anthropometric characteristics including age (64.5 ± 4, P = 0.1), gender (male/female 31/29, P = 0.63), and body mass index (24 ± 1.2, P = 0.11). Increase IAP was related to the type of respiratory mode with the more increased IAP observed in SIMV mode, followed by BIPAP and CPAP modes (P = 0.01). There were significant correlations between increased IAP and respiratory variables including respiratory rate, pressure support ventilation, and inspiratory pressure (P < 0.05). Tube feeding tolerance through NG-tube was lower in SIMV group, followed by BIPAP and CPAP groups (P < 0.05). There is a significant relationship between respiratory modes and IAP; therefore, it is better to utilize those types of mechanical ventilation like CPAP and BIPAP mode in patients who are prone to Intra-abdominal hypertension.

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Celiac disease (CD) has been found in up to 10% of the patients presenting with unexplained abnormal liver function tests (LFT). As there is no precise data from our country in this regard, we investigated the prevalence of CD in patients presenting with abnormal LFT. From 2003 to 2008, we measured IgA anti-tissue transglutaminase (t-TG) antibody (with ELISA technique) within the first-level screening steps for all patients presenting with abnormal LFT to three outpatient gastroenterology clinics in Isfahan, IRAN. All subjects with an IgA anti-tTG antibody value of >10 μ/ml (seropositive) were undergone upper gastrointestinal endoscopy and duodenal biopsy. Histopathological changes were assessed according to the Marsh classification. CD was defined as being seropositive with Marsh I or above in histopathology and having a good response to gluten free diet (GFD). During the study, 224 patients were evaluated, out of which, 10 patients (4.4%) were seropositive for CD. Duodenal biopsies were performed in eight patients and revealed six (2.7%) cases of Marsh I or above (four Marsh IIIA, two Marsh I), all of them had good response to GFD. The overall prevalence of CD among patients with hypertransaminasemia, autoimmune hepatitis, and cryptogenic cirrhosis was determined as 10.7% (3/28), 3.4% (2/59), and 5.3% (1/19), respectively. Serological screening with IgA anti-tTG antibody test should be routinely performed in patients presenting with abnormal LFT and especially those with chronic liver diseases including hypertransaminasemia, autoimmune hepatitis, and cryptogenic cirrhosis.

Evidence shows that in Iran alcohol abuse rate may be of concern, especially among the youth. The mental and social health and addiction Department of the Ministry of Health and Medical Education has designed a plan to prevent, treat, and rehabilitate the patients abusing alcohol in a time period of 2011-2015. In a 6-month period, three guiding committees of experts in the field of alcohol abuse reviewed the literature. The meetings of the steering committee were held in order to collect the comments of the policy-makers in recognition of the problem, orientation, and administration procedures for the suggested strategies. The first input was discussed in the committee meeting. In the orientation phase, intervention strategies were suggested whose base was the evaluation of the previous international guidelines. In the final phase, the suggested strategies and challenges and their possible solutions were criticized. Finally, using these strategies, appropriate interventions were defined. Preventing alcohol supply, school- and community-based prevention efforts, monitoring and vigilance were defined as primary prevention. While secondary and tertiary prevention are defined to be the treating and rehabilitating services for the alcohol abusers. We hope by using this strategy we will be able to control alcohol abuse in our country. The first step to reach this aim is done by breaking the taboo of giving alcohol-related information and news using media and educational programs especially to the young population.

We assessed associations between educational achievement and alcohol consumption. We employed five alcohol consumption measures (length of time of and amount consumed during most recent drinking occasion, frequency of alcohol consumption, heavy episodic drinking, problem drinking); and three educational achievement indicators (students' subjective importance of achieving good grades, students' appraisal of their academic performance in comparison with peers, students' actual module mark). Males were positively associated with all five alcohol consumption measures. Age was negatively associated with three alcohol consumption measures. While students´ importance of good grades was negatively associated with three alcohol consumption measures, academic performance in comparison with peers was negatively associated with heavy episodic drinking. Actual module mark was not associated with any alcohol consumption measure. Alcohol consumption showed negative associations with motivation for and subjectively achieved academic performance. University alcohol prevention activities might have positive impact on students' academic success.

The goal of this study is to extend the applications of parametric survival models so that they include cases in which accelerated failure time (AFT) assumption is not satisfied, and examine parametric and semiparametric models under different proportional hazards (PH) and AFT assumptions. The data for 12,531 women diagnosed with breast cancer in British Columbia, Canada, during 1990-1999 were divided into eight groups according to patients' ages and stage of disease, and each group was assumed to have different AFT and PH assumptions. For parametric models, we fitted the saturated generalized gamma (GG) distribution, and compared this with the conventional AFT model. Using a likelihood ratio statistic, both models were compared to the simpler forms including the Weibull and lognormal. For semiparametric models, either Cox's PH model or stratified Cox model was fitted according to the PH assumption and tested using Schoenfeld residuals. The GG family was compared to the log-logistic model using Akaike information criterion (AIC) and Baysian information criterion (BIC). When PH and AFT assumptions were satisfied, semiparametric and parametric models both provided valid descriptions of breast cancer patient survival. When PH assumption was not satisfied but AFT condition held, the parametric models performed better than the stratified Cox model. When neither the PH nor the AFT assumptions were met, the log normal distribution provided a reasonable fit. When both the PH and AFT assumptions are satisfied, the parametric and semiparametric models provide complementary information. When PH assumption is not satisfied, the parametric models should be considered, whether the AFT assumption is met or not.