فهرست مطالب

Archives of Iranian Medicine - Volume:22 Issue: 2, Feb 2019

Archives of Iranian Medicine
Volume:22 Issue: 2, Feb 2019

  • تاریخ انتشار: 1398/01/19
  • تعداد عناوین: 13
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  • Mohammad Baniasadi , Parisa Divsalar *, Ahmad Ali Noorbala , Mahin Eslami Shahrbabaki , Behnaz Aflatoonian , Ahad Ashrafi Asgarabad Pages 59-64
    Background
    Mental health is one of the characteristic benchmarks of public health. This research aimed to evaluate mental health of survivors of the Bam earthquake which occurred in 2003 twelve years after the earthquake in fall of 2015.
    Methods
    The statistical population of this cross-sectional study were people over 16 years of age who were present at the time of the earthquake in the city of Bam. The sample of the study consisted of 1500 people selected from the survivors by multistage sampling. The general health questionnaire-28 was used as a screening tool for mental disorders. The independent sample test, ANOVA test, Welch test, one-sample t test and the multiple logistic regression test were used to analyze the data. The analysis of data in the current study was carried out using the SPSS-18 software.
    Results
    Using the GHQ Likert scoring method, the results showed 52% of the people surveyed were suspected of having mental disorders (49.93% of men and 54.27% of women). Somatization and anxiety is more frequent than severe depression in respondents. The obtained statistics revealed that the prevalence of mental disorders amplified with loss of close relatives and age (odds ratio [OR] =1.457 and 1.828 respectively). The results also indicated that widows and divorcees (66.66%), illiterates and drop-outs (57.48%) and the elderly (77.12%) had the highest average in terms of having mental disorders.
    Conclusion
    The results of this study showed more than half of the Bam earthquake survivors are suspected to be suffering from mental disorders. Since natural disaster-related mental illness effects can last for many years, comprehensive screening programs at regular intervals are required. Mental health services should be available to the elderly and people at risk in order to ensure restoration of mental health after a catastrophe.
    Keywords: Bam, Earthquake, Epidemiology, General health questionnaire (GHQ-28), Mental health
  • Rahmatollah Moradzadeh , Mohammad Ali Mansournia , Reza Ghiasvand , Taban Baghfalaki , Haidar Nadrian , Kourosh Holakouie, Naieni * Pages 65-70
    Background
    Our aim was to determine the association between age at menarche (AAM) and breast cancer adjusted for recall bias (misclassification) in AAM.
    Methods
    We have used data provided from a case-control study conducted in Iran from 2005 to 2009. The cases and controls were frequency matched based on 5-year age groups and region of residence. First, logistic regression was conducted to estimate the odds ratio (OR) and second, Bayesian analysis was applied to estimate the ORs adjusted for misclassification.
    Results
    The study was conducted on 880 cases and 998 controls. In the assumption of no correction for recall bias on self-reported AAM, the OR was 1.36 (95% Credible Interval (0.98, 1.90). Based on a sensitivity value = 71% and a specificity value = 81% (the indices about the ratio of true recall of AAM) for the case and control groups (as the first scenario), the AAM ≤ 12 years of age was associated with a lower OR for breast cancer by 1.23 (95% Credible Interval: 0.50, 3.13). In the other scenario, with consideration of 100% sensitivity and specificity of self- reported AAM in the case group, and 71% and 81% sensitivity and specificity of the item in the control group, the related OR between breast cancer and AAM was found increased to 2.96 (95% Credible Interval: 0.75, 7.66).
    Conclusion
    After adjustment for misclassification related to recall bias, this study provides evidence that the self-reported mode of AAM has a moderate impact on calculation of the OR.
    Keywords: Bias, Breast cancer, Menarche, Misclassification
  • Sara Naeimi , Meisam Akhlaghdoust *, Shahla Chaichian , Yousef Moradi , Fatemeh jesmi , Nesa Zarbati , Mina Jafarabadi Pages 71-75
    Background
    Gender identity disorder (GID) is associated with various adverse health outcomes as well as psychiatric problems. Quality of life (QOL) in patients after surgery is an important issue, as some cases report dissatisfaction and regret after surgery. The present study compared QOL in female-to-male (FTM) GID patients before and after gender reassignment surgery (GRS) in an Iranian population. In the present study, 42 natal female patients with Gender Disorder diagnosis, who were referred to the Fertility Research Center of Tehran University of Medical Sciences for GRS from December 2014 to December 2015, were prospectively recruited.
    Methods
    The demographic characteristics, including age, body mass index (BMI), occupational and marital status, educational level, and family support were recorded. Then, participants were asked to complete the Persian version of the 36-Item Short Form Health Survey (SF-36) questionnaire under supervision of the researcher, once at baseline and once 6 months after surgery.
    Results
    The changes in SF-36 scores and association with the demographic variables were then evaluated using SPSS 16 at significance level of 0.05. Mean age of patients was 34.17 ± 5.58 years with a mean BMI of 43.14 ± 6.91 kg/m2 . Most were single (54.8%), had primary school education (50.5%), and acceptable family support (59.5%). Total mean score of QOL significantly improved from 26.43±6.81 to 37.52 ± 8.67 (P < 0.001), 6 months after surgery and also in all domains (P < 0.001), although the increase in emotional problem was not statistically significant (P = 0.05).
    Conclusion
    In conclusion, as the results of the present study highlight, FTM GD patients have a low QOL before surgery that is significantly improved after surgery.
    Keywords: Gender identity, Quality of Life, Sex reassignment surgery, Transgender persons
  • Fahimeh Ranjbar Kermani , Kamran Mousavi Hosseini *, Sedigheh Amini Kafi, Abad , Mohammad Ali Mansournia , Zohreh Sharifi , Mahtab Maghsudlu Pages 76-79
    Background
    Hepatitis C virus (HCV) viremia is described as persistent HCV RNA among HCV exposed individuals. HCV viremic rate is defined as the proportion of anti-HCV positive and HCV RNA positive individuals to total anti-HCV positive individuals. Knowledge about HCV viremic rate increases understanding HCV epidemiology and provides the likelihood of HCV viremia infection in a given population. The aim of this study was to evaluate HCV viremic rate and demographic parameter correlations among HCV confirmed Iranian blood donors.
    Methods
    In this analytical, cross-sectional study, serologically confirmed HCV positive blood donors, who were referred to the Iranian blood transfusion centers around the country from November 2015 to September 2017, were included. HCV RNA RT-PCR was carried out by an in-house qualitative assay. Penalized logistic regression was performed for data analysis. STATA software version 13 was used for statistical analysis.
    Results
    Out of 239 subjects, HCV RNA was amplified in 161 (67.36%, 95% CI 61.21% -73.51%). No statistical associations were found between age, gender, education and marriage status with HCV viremic rate. First time donation was found to be associated with HCV viremia status (adjusted odds ratio [AOR]: 3.26; 95% CI 1.07–9.87).
    Conclusion
    The results of this study show the likelihood of active HCV infection occurrence among HCV confirmed Iranian blood donors, as the majority are in the active phase of HCV infection. The viremic rate was associated with first time donation. More effective donor selection process and paying special attention to maintenance of non-infected first time donors as a resource of regular donations are needed to improve blood safety. Follow-up studies on viremic first time blood donors are recommended to clarify impact of factors on the occurrence of HCV viremia.
    Keywords: Blood donors, Hepaitis C, Viremia
  • Kasm Turgut *, Ali Gür , Taner Güven , Hakan Ouztürk Pages 80-84
    Background
    Firearm related injuries continue to increase throughout the world and they become the first or second cause of mortality in worldwide. The present study aimed to determine the factors that affect mortality in firearm injuries.
    Methods
    The patients which were admitted to emergency service between January 2011 and December 2015 due to firearm injuries, were reviewed from hospital records. The patients were evaluated in terms of their age, sex, event time, admission time, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), the reason of event, type of weapon, the region of the body that injured, department in which they were hospitalized, hospitalization duration and the relation between these parameters and mortality.
    Results
    A total of 174 patients (86.8% male, 13.2% female) were identified. The mean age of patients was 35.2 years and 30 patients (17.2%) died. Among the cases, 137 were attempted homicide (78.7%), 23 were accidents and the remaining 14 were suicides. The suicidal cases had significantly higher mortality rate than other causes (P=0.003). The most frequently used weapon was pistols (73.6%) and the events took place between 18.00 and 24.00 (36.2%) hours mainly. The injuries were mostly on extremities, however many of deaths were seen after head- neck injuries and the mortality rate of head and neck injuries was significantly higher than other regions (P<0.001). The mean of hospitalization duration was 9.1 days and it was 10.2 ± 11.7 days for survivors, 4 ± 7.3 days for died subjects. The hospitalization duration of died patients was significantly shorter than survivors (P=0.042). The GCS of died patients (4.4 ± 1.7) was significantly lower than those of survivors (13.3 ± 2.8) (P<0.001). The ISS score of died patients (49.7 ± 24.1) was significantly higher than those of survivors (13.6 ± 10.6) (P<0.001).
    Conclusion
    It was determined that GCS, ISS, length of hospitalization, injuries due to suicide attempt, the department of hospitalization, injuries to head-neck regions affected mortality significantly.
    Keywords: Firearm, Homicide, Mortality, Suicide
  • Soghra Bahmanpour *, Tahereh Talaei Khozani , Fatemeh Rezaei Tazangi Pages 85-90
    Background
    The ability of stem cells to differentiate into different cell types makes them a key component of healing damage in regenerative medicine. As human umbilical cord Wharton’s jelly (HUCWJ) is available non-invasively, HUCWJ does not raise any ethical issues with higher differentiation potential compared to adult stem cells. With the ability to express embryonic stem cell markers, HUCWJ can be considered as a good candidate in regenerative medicine applications. The objective of this study was to find if these cells form cell aggregates with the same features as that formed by embryonic stem cells (embryoid body) and could form three germ layers.
    Methods
    Eighteen umbilical cords were of healthy infants with parent permission. The umbilical cords were cut into small pieces and the explants were cultured. At the third passage, 1000, 5000 and 10000 cells/ 20 µL were cultured in hanging drops for 3 days. Then, they were incubated for additional 3 days in non-adhesive dishes. As the center of cell aggregates formed from 5000 and 10000 cells were darker than those formed from 1000 cells, this study focused on the aggregates formed by 1000 cells for further assessments. The immunocytochemistry and flowcytometry were performed using 3 color antibodies to detect the markers for three germ cell lineages.
    Results
    The immunohistochemistry data showed that the embryoid-body-like aggregates expressed a low amount of ectodermal and endodermal markers and most of the cells expressed mesodermal markers. The flowcytometry percentage of the cells in each aggregate that expressed ectodermal marker Otx2 was17.1% and endodermal marker, Sox 17 was 5.49%. The frequency of cells expressing mesodermal marker Brachyury was high (75.0%). Flowcytometry also showed the percentages by mathematical evaluation and we did this three times for our result accuracy.
    Conclusion
    These aggregates mainly kept their mesenchymal state and showed a poor differentiation potential toward ectoderm and endoderm identity.
    Keywords: Brachyury, Cell aggregates, Embryoid-body, GATA4, HAND1, Wharton’s jelly
  • Pegah Khaloo _Hamid Alemi _Mohammad Ali Mansournia _Soghra Rabizadeh _Salome Sadat Salehi _Michael J Blaha _Mohammad Hassan Mirbolouk _Hossein Mirmiranpour _Alireza Esteghamati _Manouchehr Nakhjavani * Pages 91-98
    Background
    We investigated the association of estimated glomerular filtration rate (eGFR) with Framingham risk score (FRS), and actual cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM). We also assessed improvement in FRS for prediction of CVD after inclusion of eGFR and albuminuria.
    Methods
    A total of 571 patients with T2DM and mean age 55 were divided into 2 groups based on the presence of CVD. Participants without CVD were then divided into three groups according to FRS. CVD is defined as an episode of CCU admission, Myocardial infarction, history of coronary artery bypass graft surgery or percutaneous intervention. FRS is calculated using the Wilson 1998 Circulation equation, which includes age, sex, high blood pressure, smoking, high-density lipoprotein (HDL), total cholesterol and diabetes as components to assess CVD risk in 10 years.
    Results
    An inverse adjusted association between eGFR and prevalent CVD was confirmed by multiple logistic regression analysis (OR = 0.84, 95% CI: 0.74, 0.94, P = 0.03). We observed every 10 mL/min/1.73 m2 decrease in eGFR is related to 3% increase in FRS in patients without chronic kidney disease (CKD) (coefficient = -0.03, P < 0.001). The association between FRS and GFR and also CVD and eGFR were not significant in patients with CKD (P = 0.12; P = 0.17, respectively). Predictive values for FRS components with and without considering eGFR and albuminuria were calculated (0.74 and 0.75, respectively).
    Conclusion
    Inclusion of eGFR and albuminuria in the FRS formula did not improve the predictive value of the model. We showed an inverse association between eGFR and FRS in early stages of diabetic kidney disease, which was lost in patients with CKD.
    Keywords: Cardiovascular disease_Diabetic nephropathy_eGFR_Framingham risk score_Type 2 diabetes
  • Omer Burcak Binicier *, Sevil Ozer Sari Pages 99-101
    Cytomegalovirus (CMV) is an agent which exists asymptomatically in most individuals and may cause latent life-time infection following contamination. Symptomatic CMV infection develops most commonly in organ transplant recipients and in individuals who receive immunosuppressive drugs, undergo haemodialysis or have acquired immunodeficiency syndrome. The link between ulcerative colitis and CMV infection and the efficacy of antiviral therapy in these individuals have been demonstrated. Due to the fact that synchronous onset of CMV and ulcerative colitis is a very rare clinical condition, we present here a synchronous-onset fulminant CMV and ulcerative colitis in a 58-year-old man without any other co-morbidities.
    Keywords: Cytomegalovirus, Ulcerative Colitis, Fulminant Colitis
  • Moeinadin Safavi *, Shahriar Dabiri Pages 102-103
  • Vitorino Modesto dos Santos * Pages 104-105
  • Mohamed Zouari *, Riadh Mhiri Page 106
  • Beuy Joob *, Viroj Wiwanitkit Page 107
  • Amin Talebi Bezmin Abadi *, Negin Kamali Page 108