arezoo orooji

Environmental exposures and genetic predisposition interactions may result in autoimmune rheumatic diseases. This study aimed to determine the effect of outdoor air pollutants on the activity of rheumatoid arthritis (RA) in a longitudinal follow-up.  

We longitudinally studied 50 patients with RA bimonthly over 6 months in Mashhad, one of the most polluted cities in Iran. Disease activity and health-related quality of life (HRQoL) were examined according to the disease activity score (DAS28ESR), health assessment questionnaires (HAQ), physical health component summary (PCS), and visual analogue scale (VAS) criteria. The outdoor air pollutant was measured by monitoring the average concentration of nitrogen oxide (NO), carbon monoxide (CO), O2 level, Sulfur dioxide (SO2), and some particles less than 10 and 2.5 micrometers in diameter (PM <10 µm, PM <2.5 µm). The temperature and humidity levels were also measured. The univariate and multivariate statistical analyses were used for data analysis and the role of confounding factors was determined using the generalized estimation equation method.  

Statistical analysis indicated a significant increase of the DAS28ESR (B = 0.04 [0.08]; P = 0.01) and VAS (B = 4.48 [1.73]; P = 0.01) by CO concentration. Moreover, a number of polluted days increased the VAS in patients. In addition, other air pollutants, temperature, and humidity were not affected significantly by the DAS28ESR and quality of life indexes by considering confounders such as medications, age, and job.  

Based on our findings, CO concentration was the only effective outdoor air pollutant that could increase RA disease activity. In addition, CO concentration and the number of polluted days make patients feel more ill. As the role of indoor air pollutants is highly important, further research on this critical topic is required to establish the role of air pollution on RA disease activity.

The obesity prevalence is growing worldwide. There is strong evidence indicating that a disturbance of zinc, copper and magnesium concentrations is associated with the development of obesity and its related diseases. Our aim was to determine the effect of curcumin supplementation on serum zinc, magnesium and copper in obese individuals.

In this randomized crossover trial study, thirty obese patients with an age range of 18 to 65 years were randomized to treatment with curcumin 1 g/day or placebo for 30 days. There was then a two-week wash-out period, after which, subjects crossed to the alternate regimen. Serum levels of zinc, copper and magnesium were determined at baseline and at the end of the study.

The study groups were similar to each other in base line characteristics. We did not observe significant impacts (p>0.05) of curcumin on Cu, Zn, Mg serum concentrations.

Curcumin administration at a dose of 1 g/day for 30 days did not affect serum Cu, Zn, Mg levels in obese subjects.

Food contamination with heavy metals is the main concern for human health that increases globally. Bread wheat is one of the most important grain products for human consumption. The aim of the study is to examine the effect of baking methods on residues of heavy metals in the different breads produced with wheat flour in Mashhad, Iran. A total of 180 samples of different breads produced in 90 bakery shops in Mashhad was analyzed for some heavy metals (Fe, Cr, Cu, Zn, Pb, Hg, Co, As, Al, V, Cd, and Ni) by inductively coupled plasma-optical emission spectrometry (ICP-OES). Results showed that the average concentration of Fe, Al, Zn, Cu, and Cd in some bread samples were significantly (p<0.05) different between traditional and industrial baking processes. The average concentrations of the entire test of Fe (46.35±39.78 mg.kg-1), Cr (0.28±0.33 mg.kg-1), Al (3.49±1.89 mg.kg-1), and As (0.479±0.229 mg.kg-1) were higher than the current corresponding safety limit in all type of bread. The results obtained indicated that the government requires implementing more remediation or intervention to control and mitigating the contamination burden of heavy metals in traditional bread in the study area to reduce its associated risks for human health.

Obesity is a common risk factor associated with cardiovascular disease (CVD) risk. Curcumin has been reported to exert beneficial effects on lipid metabolism, including HDL functionality. We have examined the effects of curcumin on HDL cholesterol uptake capacity in subjects with obesity.

30 obese individuals received curcumin and placebo 1 g per day for a period of 30 days. The subjects were crossed over to the alternative regimen after a 2-week washout period. A modified cholesterol uptake capacity (CUC) assay was used to determine serum HDL functionality.

The study groups had similar base line characteristics. We did not find significant effects (p>0.05) of curcumin on serum HDL CUC levels.

Curcumin administration at a dose of 1 g per day for 30 days did not affect HDL CUC in subjects with obesity.

Aging is a major challenge not only for high-income countries but also for middle- and low-income countries. The length of stay (LOS) in hospitals is one of the major concerns of elderly patients, which should be taken into consideration. We aimed to investigate the factors affecting LOS of elderly patients admitted to a referral hospital of northeast of Iran.

A relatively large population of 7130 hospitalized elderly patients (over 65 years old) who referred to Ghaem hospital (Mashhad, Iran) from March 20, 2016 to March 19, 2017 were selected. The demographic and medical records data of patients were extracted from the hospital database. Univariate analyses as well as count regression models, including poisson regression and negative binomial regression, were conducted to assess the influential factors on the LOS and the number of admissions considered for potential confounders using SAS software. In this study α =0.05 was considered as statistically significant.

The mean age of participants was 76.57±7.29 years, and 54.8% were male and 45.2% were female. The mean LOS was 8.11±13.97 days and the mean number of admissions 1.5±1.73 times. The negative binomial regression model had better fitness than Poissonchr('39')s model. Findings indicated that emergency hospitalization (RR: 0.21), admission to the CCU (RR: 0.33), and male gender (RR: 0.92) were statistically reducing factors for LOS among elderly patients, respectively. Discharge status (deceased, RR: 1.50), patients with diagnosis of injuries and poisoning (RR: 1.34), and native residence (RR: 1.10) were factors that statistically increased the length of stay among hospitalized elderly patients.

LOS in hospitals is affected by multiple factors and the negative binomial regression model is a better statistical method for estimating the influencing factors.

Inadequate health literacy (HL) is associated with poorer health outcomes and worse health care. Up to one-half of Iranian women have difficulty in interpreting medical information, and national HL assessment has been limited in Iran. We have undertaken a systematic review of the literature and used a meta-analysis to examine the situation of HL status in Iranian women, and determine the relationship between HL and self-efficacy, and self-care behaviors.

Six databases (PubMed, Web of Science, Scopus, Google Scholar, Scientific Information Database) and other non-indexed citations were searched using a variety of keywords regarding HL and Iranian women. The bias risk was decreased by the involvement of two independent reviewers assessing study quality and eligibility of included articles.

The average HL scores were in the range of marginal or limited (63.08; 95% CI, 59.83–66.32) in the Iranian women. The HL score was significantly higher among pregnant women (67.55; 95% CI, 32.54– 82.57) and was lower in women with chronic disease (57.79; CI, 48.34-67.24). There was a significant association between HL and self-efficacy and self-care behaviors.

The average level of HL in the period of the review was marginal among Iranian women. The relationship of HL with self-efficacy and self-care behaviors was statistically significant but moderate.

Numerous studies have shown that prolonged duty shifts reduces the quality of rest, decreases the quality of responsiveness, decrease the response time and dramatically increases the rate of medical errors. The purpose of this study was to investigate the changes in internal medicine intern duty hours through a 3-month period and to examine its effects on different individual, behavioral, and educational aspects of medical interns.

 This was a Quasi-Experimental Study. Two groups of medical interns were selected as control and intervention groups. The control group will normally run their ward. The case group will pass their period by having the regular working hours but the shifts were separated into 2 (for example, a 24-hour shift split into two 12-hour shifts). At the end of the course, they fill in a questionnaire form containing several questions about different educational, behavioral, and other parameters.

 The total number of interns participating in this study was 83. Independent t-test results indicated that the subscales of individual, educational, and behavioral response scales increased after shifts (P <0.001), with a significant difference (P<0.001), with satisfaction From the changed status, it was significantly decreased (P <0.001).

The results of this study have shown that despite the positive effect of changing and correcting the working hours, interns do not have personal satisfaction with it. The reason for this can be attributed to the freshness and incompleteness of this change, the resistance to the change, as well as the commuting problems (for both resident and dorm interns).

Foot function index (FFI) is a worthy subjective patient reported outcome measures (PROM) tool forevaluation of the outcomes of medical interventions on foot and ankle. This study was conducted to assess the validityof the Persian version of the foot function index (FFI). After translating the original FFI into Persian, back-translation was performed on the agreed Persian versionand the final version was established. A total of 113 Persian-speaking patients with foot and ankle problems wereenrolled in this study and were asked to fill in the FFI. The Cronbach’s alpha for subsections of FFI and MOXFQ was above 0.8 and 0.7, respectively, while it was0.95 and 0.93 for total FFI and MOXFQ, respectively. The ICC for all subsections of MOXFQ and FFI was above 0.7.The Pearson’s correlation coefficient for all subsections of FFI and MOXFQ was significant (P<0.01). The Persian version of FFI is valid and reproducible in Persian speaking population.Level of evidence: IV

Assessment of students' academic achievement is one of the research priorities in education and identifying effective factors in them and paying attention to them is a step towards sustainable development. The purpose of this study was to determine the academic achievement status of students in Neishabour Medical School and its related factors in the academic year of 2016-2017. This cross-sectional descriptive study was conducted on 223 students. The data collection tool was a questionnaire that assessed demographic data Field and Grade of Study, university and diploma score, number of failed courses, the number of semesters. Data were analyzed using SPSS (version 16) software and Mann-Whitney, Kruskal-Wallis, Spearman correlation coefficient test. The total number of participants was 223 average age of participants is 21.82 ± 3.73 years and The average total of the score was 16±1.47. The results showed the University average of women higher than men and that this difference is significant (p<0.001). Also, there is a significant relationship between marital status and employment status, the distance between the acceptable in the university and get a diploma and university residence status with University Score (p<0.05). Spearman test results showed that the relationship between Diploma Score and the Total score is significance (p<0/001). The results generally showed that gender, marital status, employment status, the distance between university acceptable and get a diploma and residence status can a significant role to play in determining students progress.

The identification and management of unmet needs is an essential component of health care for the growing cancer patient population. Information about the prevalence of unmet need can help medical service planning/redesigning. Therefore, this study aimed to identify unmet needs in Iranian patients suffering from cancer.

This cross-sectional correlational study was conducted on 650 cancer patients admitted to the major medical centers in Mashhad and Neyshabur by census sampling. The data was gathered by the Survivor Unmet Needs Survey (SUNS). Data were analyzed using ANOVA, t-test and Pearson correlation.

Most of participants were female (56%, n=263) and Mashhad resident (67.1%, n=436). The most common cancers were colorectal (17.8 %, n=116), stomach (13.6%, n=88) and lung (9.4%, n=62), respectively. The highest unmet needs score belonged to work and financial needs (2.46 ± 0.91), and the least was the emotional domain (1.92±0.90). Among demographic factors, a significant relationship was found between resident places (p This is the first study addressing the unmet needs of cancer patients in Iran. It reveals that cancer patients had a relative high number of unmet needs; this shows the necessity of including these factors in the routine assessment of all cancer patients and planning treatment interventions based on their individual’s need.

Study of clinical competence in nursing helps determine the quality of health care delivered to patients. Given the priority of observance of principles over caretaking and necessity of spirituality existence at the core of health care provision, this study was conducted to investigate clinical competence and its relationship with professional ethics and spiritual health in nurses.
In this cross-sectional, descriptive, and correlational study, 281 nurses were enrolled by consensus sampling. Sampling was conducted from February, 2016 till June, 2016. The data were gathered by a demographics questionnaire, a self-assessment scale of clinical competence, a nursing ethics questionnaire, and a spiritual health questionnaire, and analyzed by descriptive statistics and t-test, Pearson's correlation coefficient, ANOVA, and linear regression analysis in SPSS 21.
The total scores for self-assessment scale of nurse's clinical competence, professional ethics, and spiritual health were moderate. In the light of the results of Spearman's correlation coefficient, there was a significant and positive correlation between clinical competence and spiritual health. Moreover, a significant positive correlation was observed between professional ethics and spiritual health but there was no correlation between professional ethics and clinical competence.
Manager's and personnel's Knowledge about the level of nurses clinical competence, professional ethics, and spiritual health in teaching health care centers provides valuable information to develop in-service and efficacious education programs and ultimately to improve the quality of nursing services.

Many studies have shown that electromagnetic field (EMFs) decrease anxiety. In this study we studied the effect of low frequency electromagnet fields on decreasing the induced anxiety by histamine in mice.
32 male albino mice at the weight of 30gr were classified in 4 groups (n=8), and were injected histamine (5mg/kg) 3 group of them were exposed to electromagnetic field with 25, 50, 75HZ & frequency with intense 250µT for 10min before injection. After 5 minutes, anxiety signs in the 3 exposed groups were compared with control group.
Analysis showed a significant increase in OAT (open arm times, p EMEs in low frequency can effect on induced anxiety by histamine

Survival models are statistical technique to estimate or predict the overall time up to specific events. Prediction is important in medical science and the accuracy of prediction is determined by a measurement, generally based on loss functions, called prediction error. The aim of this study is using parametric models to determine the factors influencing predicted survival time for patients with colorectal cancer (CRC) and select the best model by predicting error’s technique. 600 colorectal cancer patients whom admitted to the Cancer Registry Center of Gastroenterology and Liver Disease Research Center, Taleghani Hospital, Tehran, who were followed at least for 5 years and have completed information selected for this study. Body Mass Index (BMI), Sex, family history of CRC, tumor site, stage of disease and histology of tumor included in the analysis. The survival time was compared by the Log-rank test and multivariate analysis was carried out using parametric. For selecting the best model, the prediction error by apparent loss was used. Log rank test showed better survival for females, BMI more than 25, patients with early stage at diagnosis and patients with colon tumor site. Prediction error by apparent loss was estimated indicated that Weibull model was the best one for multivariate analysis. BMI and Stage were independent prognostic factors according to Weibull model. In this study, Weibull regression showed a better fit according to prediction error. Prediction error would be a criterion to select the best model with ability to make prediction of prognostic factors in survival analysis.

Colorectal cancer is the most common gastrointestinal cancer. Investigating the factors that predict survival time for these patients is important. The purpose of this study was comparison of parametric models by estimating the prediction error and also identifying the effective factors on predicted survival time of patients with colorectal cancer. This cohort study was conducted with 600 patients who were suffered from colorectal cancer in Taleghani Hospital of Tehran between 2001 to 2005 and they were followed up for at least 5 years. For identifying the effective factors on survival time، of the patients we analyzed the data by some parametric models such as Weibull، Exponential and Log logistic and compared these models with the estimation of prediction error by apparent loss method. Among 600 patients there was 344 men (57. 3%) and 256 wemon (47. 7%). Of total، 151 patients were died that 62. 3% of them were men. Univariate analysis showed that the effect of BMI، sex، staging of tumor، tumor site were significant but in multivariate model staging of tumor and BMI were significant. By the estimation of prediction error، the best model was Log logistic. With respect to the importance of survival time prediction، we found that we can use the prediction error to compare the parametric models. In addition، because of effectiveness of tumor stages and BMI in the patients’ survival time، survival time could be increased by an on-time diagnosis and an appropriate controled diet.