masoumeh noori
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Background
Various factors, including family associations, school culture, personality traits, and lifestyle play a fundamental role in the development of drug addiction. This study aimed to investigate how the association of family communication patterns and school culture affect addiction tendencies among high school students in Yazd, Iran.
MethodsThis cross-sectional study was conducted in January 2021. A total number of 420 people were selected using the random multi-stage sampling method. To collect data, addiction tendency scale, family communication pattern and school culture questionnaires were used. Data analysis was done using SPSS version 24, Pearson’s correlation coefficient, descriptive statistics, T-Tests and ANOVA.
ResultsThe mean±SD for addiction tendency, family communication patterns and school culture was 40.24±7.65, 65.84±5.34, and 45.69±9.24, respectively. This study showed a statistically significant association between the mean score for addiction tendency and gender (P=0.01) and economic status (P=0.02). Among the two components of communication patterns, alignment orientation (R=-0.31, P<0.001) showed a negative association and conformity orientation (R=0.25, P=0.01) showed a significant positive association with addiction tendency. Additionally, all of the three components of school culture, namely, student relations (R=-0.23, P=0.02), student and teacher associations (R=-0.29, P<0.001), and training opportunities (R=-0.20, P=0.03) revealed a significant negative association with addiction tendencies.
ConclusionAccording to the results of the study, it is recommended to implement family education programs in counseling centers, health centers and schools. These programs should emphasize the importance of creating a healthy communication pattern based on dialogue and active listening in the family. By promoting positive personality traits, young people can effectively combat their inclination towards drug use and decrease the chances of developing addiction.
Keywords: Family relations, School culture, addiction, Students -
Novel therapeutic options such as adoptive immunotherapy have been progressed drastically for treating hepatocellular carcinoma (HCC). Chimeric antigen receptor T cell (CAR-T) therapy is a kind of adoptive immunotherapy that has been associated with promising results in hematopoietic malignancies. However, its application is associated with some obstacles in solid tumors, including heterogeneity of tumor antigens, immunosuppressive microenvironment, and serious adverse complications. In recent years, some progress has been made in this regard, and several preclinical and phase I clinical trial studies have been conducted concerning the application of CAR T-cells in solid tumors. This study will review the possibilities of CAR T cell therapy in HCC, the most common primary liver cancer associated with high morbidities and mortality globally.
Keywords: Hepatocellular Carcinoma, Cancer Immunotherapy, Adoptive Cell Therapy, Chimeric Antigen Receptor (CAR) T-cells -
مقدمه
سندرم آشرمن (چسبندگی رحمی) به علت آسیب لایه آندومتر رحم ایجاد می شود که معمولا به دنبال اعمال جراحی رحمی مانند کورتاژ و میومکتومی ایجاد می شود و در بارداری بعدی ممکن است شانس برخی عوارض مامایی مانند سقط، پلاسنتا پرویا و آکرتا افزایش یابد.
معرفی بیماردر این مطالعه بیماری گزارش می شود که به دنبال یک بار سزارین بدون عارضه، دچار آمنوره گردید. بیمار پس از درمان با هیستروسکوپی در 3 نوبت، به طور خودبه خود باردار شد. در بارداری بعدی، دچار چسبندگی شدید جفت به میومتر گردید که منجر به خونریزی شدید و هیسترکتومی شد.
نتیجه گیریسندرم آشرمن ممکن است به دنبال یک سزارین بدون عارضه به وجود آید و شانس عوارض مامایی را در بارداری بعدی افزایش دهد.
کلید واژگان: جفت اکرتا, سزارین, سندرم آشرمن, هیستروسکوپیIntroductionAsherman syndrome (uterine adhesion) occurs due to injuries to the basal layer of endometrium that is usually caused following surgeries of uterine such as curettage and myomectomy. In the next pregnancy, obstetrical complications such as abortion, placenta pravia and acreta may be increased.
Case presentationIn this study, a case of amenorrhea after one uncomplicated caesarean section is reported. She had spontaneous pregnancy after treatment with three times histroscopy. In the next pregnancy, she developed severe adhesion to the myometrium, resulting in severe hemorrhage and hysterectomy.
ConclusionAshman syndrome may be caused following an uncomplicated cesarean section and may increase the chance of obstetrical complications in next pregnancy.
Keywords: Asherman syndrome, Cesarean section, Hysteroscopy, placenta acreta -
IntroductionMany people do not have sufficient knowledge about cardiovascular risk factors in Iran. We used a school-based educational intervention program to promote the health knowledge in all participating families.IntroductionA total of 1100 fifth-grade school children and their parents were invited; 603 families were included in the study. The children attended a single session and were supplied with family information packages. Pre- and post-test questionnaires were completed by these families before and after the session.ResultsThere was a significant increase in the overall cardiovascular risk factor knowledge of families (P value <0.001). The parents of boys achieved a greater level of health knowledge in comparison to the parents of girls (P value <0.005).ConclusionsThis school-based educational intervention was effective in improving cardiovascular risk factor knowledge of families. Similar programs with more comprehensive methodology could be more effective in promoting healthy behaviors.
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مقدمهوجود همبستگی بین نمایه توده بدنی و افزایش فشار خون در افراد چاق اثبات شده است. از طرف دیگر به نظر می رسد که لپتین، هورمون نو یافته بافت چربی، دارای نقش مهمی در پاتوژنز چاقی باشد.در این مطالعه رابطه بین لپتین، چاقی و افزایش فشار خون در نمونه ای از کودکان چاق ایرانی بررسی شد.روش هادر این مطالعه تمامی کودکان 12-7 ساله دبستان های منطقه 6 تهران جهت چاقی غربالگری شدند. از تمامی کودکانی که دور کمر آنها بالاتر از صدک 90 سن و جنسشان بود جهت شرکت در مطالعه دعوت به عمل آمد. شاخص های آنتروپومتریک 563 دانش آموز وارد شده در مطالعه اندازه گیری شد و نمونه خون ناشتا جهت اندازه گیری لپتین به عمل آمد.برای ارزیابی ارتباط بین عوامل مختلف با چاقی، آنالیز رگرسیون خطی چند متغیره به عمل آمد.یافته هامیانگین هندسی سطح سرمی لپتین در این جامعه 2.18±8.65 نانوگرم بر میلی لیتر بود. سطوح سرمی لپتین در دختران بیشتر از پسران بود (009/0 P=). همبستگی معنی داری بین نمایه توده بدنی با سطوح سرمی لپتین، سن کودک، فشار خون سیستولیک و فشارخون دیاستولیک وجود داشت. در آنالیز رگرسیون چند متغیره پس از تطبیق برای متغیر های دیگر، فشار خون سیستولیک و فشار خون دیاستولیک همبستگی خود را با لپتین از دست دادند.نتیجه گیریدر کودکان چاق ایرانی نمایه توده بدنی با سطوح سرمی لپتین رابطه دارد. ارتباط مستقیم و قوی بین چاقی و سطوح سرمی لپتین، این فرضیه را که هورمون لپتین در پاتوژنز چاقی دارای نقش است، تقویت می کند. به نظر نمی رسد که لپتین به صورت واسطه ای اصلی بین چاقی و فشار خون عمل کند. هرچند که مقادیر زیاد آن به صورت عامل خطر برای افزایش فشار خون عمل کند.
کلید واژگان: لپتین, فشار خون افزایش یافته, چاقی دوران کودکی, شاخص های اندازه گیری بدنی, ایرانBackgroundIt is well recognized that an increased body weight is often associated with increased blood pressure. Moreover, leptin an adipocyte-derived hormone is strongly suggested to have an important role in pathogenesis of the obesity. We aimed to evaluate the levels of serum leptin in association with obesity and hypertension in a sample of Iranian obese children.MethodsChildren from all the primary schools of a distinct of Tehran were screened for obesity. Children with a waist circumference equal to or above 90th percentile for their age and height were invited for the study. Anthropometric measurements were done and blood samples for fasting serum leptin levels were collected from 563 enrolled obese children. Multivariate linear regression analysis was used to evaluate relationship of various factors with obesity.ResultsMean Serum leptin levels were 8.65 ±2.18 (ng/ml). Serum Leptin levels were higher in girls than boys (P=0.009). There were significant correlations between body mass index (BMI) and serum Leptin levels, child age, systolic and diastolic blood pressure. Systolic blood pressure and diastolic blood pressure lost their association with serum Leptin level in multivariate linear regression analysis.ConclusionBMI is independently associated with Leptin levels among obese children. This may affirm a role for this hormone in the pathogenesis of childhood obesity. It seems unlikely that plasma Leptin be a major mediator of association between obesity and hypertension. However, severe hyperleptinemia may act as a risk factor for increased blood pressure.Keywords: Leptin, Hypertension, Childhood obesity, Anthropometric measurement, Iran -
مقدمههموسیستیین یکی از عوامل خطرزای نسبتا جدید مطرح در بیماری های قلبی- عروقی است. می دانیم که اغلب عوامل خطرزای بیماری های قلبی- عروقی و دیابت مشابه می باشند. با توجه به شیوع بالای دیابت در کشور ما و مشخص نبودن تاثیر این عامل در بیماری دیابت، بر آن شدیم تا مطالعه ای در این زمینه انجام دهیم.روش هااین مطالعه در ساکنین 64-25 ساله منطقه 17 شهری تهران و طبق پروتکل MONICA سازمان جهانی بهداشت (WHO) انجام شد. هوموسیستیین بالاتر از 15 میکرومول در لیتر، غیرطبیعی در نظر گرفته شد. طبق معیار انجمن دیابت امریکا (ADA 2004)، گلوکز ناشتای سرم 100 تا 125 میلی گرم در دسی لیتر به عنوان عدم تحمل گلوکز مساوی یا بیشتر از 126 به عنوان دیابت در نظر گرفته شد.یافته ها5/54% کل جمعیت دچار افزایش هموسیستیین بودند. شیوع عدم تحمل گلوکز 5/3% و شیوع دیابت 1/10% بود. شیوع عدم تحمل گلوکز و دیابت در واجدین هموسیستیین طبیعی و غیر طبیعی تفاوت معنی داری نداشت (p=0.365). این تفاوت در هیچ یک از دو جنس نیز معنی دار نبوده است؛ ولی میانگین گلوکز در مبتلایان به اختلال هموسیستیین به طور معنی داری پایین تر بود (p=0.003).نتیجه گیریدر مجموع یافته ها حاکی از ارتباط معکوس سطح گلوکز خون با سطح هوموسیستیین سرم بوده است. از آنجایی که در مورد اثر هموسیستیین به عنوان یک عامل موثر در ابتلا به دیابت همچنان اختلاف نظر وجود دارد؛ نیاز به تحقیقات بیشتری جهت مشخص شدن نقش واقعی هموسیستیین در این بیماری وجود دارد.
کلید واژگان: هموسیستیین, عدم تحمل گلوکز, گلوکز, دیابتBackgroundHomocysteine is one of the novel cardiovascular risk factors. We know most of the cardiovascular and diabetes risk factors are accompanied. The aim of this study was to determine the role of homocysteine in diabetes.MethodsThe study was performed in 25-64 year old individuals of the 17th district of Tehran according to WHO MONICA project. Homocysteine levels higher than 15 µmol/l was considered as abnormal. According to ADA 2004 criteria, fasting glucose levels of 100 to 125 mg/dl were considered as impaired glucose tolerance (IGT), while levels higher than 125 mg/dl included diabetes.ResultsPrevalence of hyperhomocysteinemia was 54.5% in the whole population. Prevalence of IGT and diabetes were 3.5% and 10.1%, respectively. There was no difference between prevalence of IGT and diabetes in both hyperhomocysteinemic and normal group (P= 0.365). The difference was also not significant in each genders, but mean glucose levels were significantly lower in people with hyperhomocysteinemia (P= 0.003).ConclusionThis study emphasizes that an inverse relation between glucose and homocysteine levels. Some studies indicate an opposite result and there is controversy on it. More researches may determine the exact role of homocysteine in diabetes.Keywords: Homocysteine, IGT, Glucose, Diabetes -
RELATION BETWEEN LEPTIN AND BMI AND HYPERTENSION IN OBESE CHILDRENBackgroundIt is well recognized that an increased body weight is often associated with increased blood pressure. Moreover, leptin an adipocyte-derivedhormone is strongly suggested to have an important role in pathogenesis of the obesity. We aimed to evaluate the levels of serum leptin in association with obesity and hypertension in a sample of Iranian obese children.MethodsChildren from all the primary schools of a distinct of Tehran were screened for obesity. Children with a waist circumference equal to or above 90th percentile for their age and height were invited for the study. Anthropometric measurements were done and blood samples for fasting serum leptin levels were collected from 563 enrolled obese children. Multivariate linear regression analysis was used to evaluate relationship of various factors with obesity.ResultsMean Serum leptin levels were 8.65 ±2.18 (ng/ml). Serum Leptin levels were higher in girls than boys (P=0.009). There were significant correlations between body mass index (BMI) and serum Leptin levels, child age, systolic and diastolic blood pressure. Systolic blood pressure and diastolic blood pressure lost their association with serum Leptin level in multivariate linear regression analysis.ConclusionBMI is independently associated with Leptin levels among obese children. This may affirm a role for this hormone in the pathogenesis of childhood obesity. It seems unlikely that plasma Leptin be a major mediator of association between obesity and hypertension. However, severe hyperleptinemia may act as a risk factor for increased blood pressure.Keywords: Leptin, Hypertension, Childhood obesity, Anthropometric measurement, Iran
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THE RELATION OF HYPERHOMOCYSTEINEMIA WITH IMPAIRED GLUCOSE TOLERANCE AND DIABETES (TEHRAN HOMOCYSTEINE SURVEY)BackgroundHomocysteine is one of the novel cardiovascular risk factors. We know most of the cardiovascular and diabetes risk factors are accompanied. The aim of this study was to determine the role of homocysteine in diabetes.MethodsThe study was performed in 25-64 year old individuals of the 17th district of Tehran according to WHO MONICA project. Homocysteine levels higher than 15 µmol/l was considered as abnormal. According to ADA 2004 criteria, fasting glucose levels of 100 to 125 mg/dl were considered as impaired glucose tolerance (IGT), while levels higher than 125 mg/dl included diabetes.ResultsPrevalence of hyperhomocysteinemia was 54.5% in the whole population. Prevalence of IGT and diabetes were 3.5% and 10.1%, respectively. There was no difference between prevalence of IGT and diabetes in both hyperhomocysteinemic and normal group (P= 0.365). The difference was also not significant in each genders, but mean glucose levels were significantly lower in people with hyperhomocysteinemia (P= 0.003).ConclusionThis study emphasizes that an inverse relation between glucose and homocysteine levels. Some studies indicate an opposite result and there is controversy on it. More researches may determine the exact role of homocysteine in diabetes.Keywords: Homocysteine, IGT, Glucose, Diabetes
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غربالگری قلب و عروق خانواده های در معرض خطر بالا / یک مطالعه بر اساس مدل مشارکت دانش آموزانمقدمهبیماری های قلب و عروق شایع ترین علل مرگ در ایران هستند. وجود سابقه بیماری قلبی- عروقی در والدین در ارتباط قوی با تجمع عوامل خطرساز در فرزندان دارد. تشخیص و درمان عوامل خطر ساز از هنگام کودکی به منظور کاهش میزان بروز بیماری های قلب و عروق در دوران بزرگسالی امری ضروری است. این مطالعه به منظور تعیین عوامل خطر ساز قلب و عروق در دانش آموزان مدارس راهنمایی و والدین آنها در دو گروه پر خطر و کم خطر انجام گرفته است.روش هامدارس راهنمایی منطقه شش تهران به طور تصادفی به دو گروه تقسیم شدند. در گروه اول خانواده های پرخطر و در گروه دوم خانواده های کم خطر مورد ارزیابی قرار گرفتند. در مجموع 169 دانش آموز از گروه اول و 105دانش آموز از گروه دوم همراه با خانواده هایشان در این مطالعه شرکت کردند. شاخص های تن سنجی و متابولیک در همه این افراد اندازه گیری شد.یافته هامیانگین محیط دور کمر و WHR در پدران گروه پر خطر به طور معنی داری بیشتر بود. میانگین مقادیر کلسترول تام وکلسترول LDL به طور معنی داری هم در والدین و هم در فرزندان گروه پر خطر بیشتر بود. میانگین مقادیر قند خون ناشتا به طور معنی داری در پدران و فرزندان گروه پر خطر بیشتر بود. مصرف سیگار در پدران خانواده های پر خطر شایع تر بود. شیوع هیپرگلیسمی، هیپرکلسترولمی تام و هیپرکلسترولمی LDL در والدین و فرزندان در خانواده های در معرض خطر بیشتر بود. شیوع اضافه وزن و چاقی در پدران و فرزندان خانواده های پرخطر بیشتر بود.نتیجه گیریعوامل خطر ساز قلب و عروق در خانواده های در معرض خطر شایع تر است. غربالگری خانواده های پر خطر از دوران کودکی برای پیشگیری از پیشرفت آترواسکلروز و کاستن از وقوع حوادث قلب و عروق در هنگام بزرگسالی یک اقدام ضروری است. برای این منظور می توان از دانش آموزان برای انتقال پیام های مربوط به سلامت و ترغیب خانواده ها به شرکت در برنامه غربالگری استفاده نمود.
کلید واژگان: غربالگری, بیماری های قلب و عروق, عوامل خطر, دانش آموزان و مشارکتCARDIOVASCULAR SCREENING OF CHILDREN AND PARENTS IN HIGH-RISK FAMILIESBackgroundCardiovascular disease is one of the major leading cause of death in Iran. There is a strong association between parental history of cardiovascular disease clustering of risk factors in the offspring. Detection and treatment of cardiovascular risk factors since childhood is essential to reduce the incidence of disease in adulthood. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in high risk compared to control families.MethodsThe middle schools of the 6th of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group while 105 control children with their families were recruited from the second group of schools. Coronary risk factor survey was performed in the participants.ResultsPrevalence of increased total- and LDL-cholesterol and high FBS were higher in high-risk parents and children. Prevalence of increased BMI was higher in fathers and children of high-risk families. More fathers in high-risk families were smoker. The means of waist circumference and WHR were significantly higher in high-risk fathers. The means of total- and LDL- cholesterol were significantly higher both in parents and children of high-risk group. The means of FBS were significantly higher in fathers and offspring of high-risk families.ConclusionCardiovascular risk factors are more prevalent and clustered in high-risk families. Screening of these families is essential to prevent progression of cardiovascular disease since childhood and reduce its burden in adulthood.Keywords: Cardiovascular Disease, Risk Factor, Cholesterol, Screening -
EVALUATION OF DYSLIPIDEMIA IN POLYCYSTIC OVARY SYNDROMEBackgroundPolycystic ovary syndrome(PCOS) is the most endocrinopathy in women and the most common causes of anovulatory infertility. Women with this disorder moreover the common manifestations such as,irregular menses, hirsutism and infertility, are susceptible to serious consequences like increase risk of endometrial carcinoma, dyslipidemia, hypertention, glocose intolerance, diabetes, cardiovascular problems and probably breast cancer. This study was conducted to demostrate the demographic, clinical,metabolic and hormonal conditions of the PCOS patients.MethodsA case-control study was performed on females with PCOS age group 15-40 years referring to endocrine and gynecology clinics. A control healthy woman was selected for each patient. The diagnosis of PCOS was made based upon the prescence of chronic anovolation and hyperandrogenemia .Other causes of hyperandrogenism were excluded by appropriate clinical and laboratory evalution .In all patients with PCOS and control women, appropriate medical history was taken and physical examination was done.Blood pressure ,body weight, height ,BMI,waist/hip ratio,score of hirsotism,acne, and other signs of androgen excess were determined.A venous blood sample were obtained at morning after 12_14hours fasting for measuring FBS, TG, Chol., LDL, HDL and hormonal profile,souch as:PROL,17_OH Progestrone,Te,DHEA-S and TSH.Case of late onset adrenal hyperplasia ,hypotyroidism and pituitary prolactinoma were excluded.The diagnosis of dyslipidemia was made upon the base of NCEP guidelines.Data was analyzed with Mann_Whitney U,T tests and Fisher's and Chi_Square Tests with SPSS-11.ResultsMean age were similar in both patients and controls.Mean of BMI and diastolic pressure were significantly higher in PCOS women in comparison with controls . Hirsutism and oligomenorrhea were the most frequent clinical features(72.7% and 69.1% respectively). SerumTG level was significantly higher in PCOS women in comparison with controls.There were no significant difference in FBS,Chol,LDL and HDL between patients and controls. The prevalence of high triglyceride ,high cholesterol and high LDL levels were significantly higher in PCOS women in comparison with controls,but there were no significant difference in the prevalence of IFG and low HDL levels. The prevalence of high TG and high Chol level were significantly higher in obese PCOS women in comparison with non obese patients.There was no significant difference in the prevalence of high LDL and low HDL levels between obese and nonobese patients. Serum level of total Testostrone was significantly higher in PCOS women in comparison with controls.There were no significant difference in serum levels of DHEA-S,17-OH Progestrone, Prolactine and TSH between patients and controls.ConclusionThe prevalence of obesity and dyslipidemia were higher in PCOS women in comparison with healthy women. For obese women with PCOS ,behevioral weight management is the main component of overall treatment strategy and these patients counseling about the importance of life style management ,diet and exercise shoud be emphasized. The patients should screened for dyslipidemia, diabetes and hypertension. In this study there was no significant difference in FBS between two groups and IGT and DM may be better detected by OGTT. In all PCOS women for detecting dyslipidemia a fasting lipid profile is indicated.Keywords: Polycystic ovary syndrome, Dyslipidemia, Obesity
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CARDIOVASCULAR SCREENING OF CHILDREN AND PARENTS IN HIGH-RISK FAMILIESBackgroundCardiovascular disease is one of the major leading cause of death in Iran. There is a strong association between parental history of cardiovascular disease clustering of risk factors in the offspring. Detection and treatment of cardiovascular risk factors since childhood is essential to reduce the incidence of disease in adulthood. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in high risk compared to control families.MethodsThe middle schools of the 6th of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group while 105 control children with their families were recruited from the second group of schools. Coronary risk factor survey was performed in the participants.ResultsPrevalence of increased total- and LDL-cholesterol and high FBS were higher in high-risk parents and children. Prevalence of increased BMI was higher in fathers and children of high-risk families. More fathers in high-risk families were smoker. The means of waist circumference and WHR were significantly higher in high-risk fathers. The means of total- and LDL- cholesterol were significantly higher both in parents and children of high-risk group. The means of FBS were significantly higher in fathers and offspring of high-risk families.ConclusionCardiovascular risk factors are more prevalent and clustered in high-risk families. Screening of these families is essential to prevent progression of cardiovascular disease since childhood and reduce its burden in adulthood.Keywords: Cardiovascular Disease, Risk Factor, Cholesterol, Screening
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OBESITY AND ASSOCIATED CARDIOVASCULAR RISK FACTORS IN IRANIAN CHILDRENBackgroundObesity is a serious public health problem in developing countries due to its association with the cardiovascular risk factors. Childhood obesity is responsible for a number of different complications both during childhood and adulthood. The aim of the present study was to determine the cardiovascular risk factors in overweight and obese Iranian children.MethodsWe screened 13086 children aged 7-12 years by measuring waist circumference. Those with a waist circumference ≥61 cm were selected for further evaluation. Anthropometric measurements were done and blood samples were taken from 563 enrolled overweight/obese children (284 boys and 279 girls). We determined cardiovascular risk factors (including fasting total cholesterol, LDL-C, HDL-C, triglycerides, blood pressure). In addition we measured the fasting blood sugar, insulin, apo-A , apo-B and leptin levels.ResultsOnly 2.7% of overweight or obese children had no risk factors. While, 20.6% had one and 70.85% had two or more risk factors. The prevalence of high total Cholestrol levels was 42.6%. HDL-C showed an acceptable level in 92.4%of children .There were strong correlations between BMI and serum apoB and leptin levels (pConclusionThe high prevalence of cardiovascular risk factors in overweight and obese Iranian children emphasizes the need for prevention and control of childhood obesity from early childhood in our country.Keywords: Children obesity, Cardiovascular Body, Body Mass Index, Waist circumference, Risk Factors
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