mehrab sayadi

Biliary atresia (BA) is the primary cause of neonatal jaundice with various pathological mechanisms. Many BA patients may experience progressive liver dysfunction and eventually need a liver transplant. Therefore, identifying potential non-invasive biomarkers for BA is crucial. miR-122, the most abundant microRNA in the liver, plays significant roles in different liver diseases. This study aimed to assess miR-122 levels in BA patients. Eighteen patients with biliary atresia were selected at random from the Shiraz Pediatric Liver Cirrhosis Cohort Study (SPLCCS), along with 18 healthy controls. Blood samples were collected, and biochemical parameters (such as liver function tests) were measured. Quantitative reverse-transcription PCR (RT-PCR) was conducted on serum samples from both the case and control groups to analyze miR-122 levels. The study results indicated that serum miR-122 expression in BA patients was elevated compared to the control group, although it did not reach statistical significance. Additionally, no correlation was found between miR-122 expression and serum levels of liver enzymes or other laboratory findings in BA cases. miR-122 could be a potential target for diagnosing BA; however, further research with a larger population is necessary to determine if miR-122 could serve as a useful biomarker for diagnosing BA.

 There are different types of drugs to shorten prolonged labor. Spasmolytic drugs are used frequently in the delivery section to overcome cervical spasms and reduce the duration of labor. The study's objective was to evaluate the therapeutic efficacy of hyoscine N-butyl bromide (HBB) and Promethazine on the duration of the active phase of labor.

We searched the Science Direct, PubMed Scopus, Google Scholar, MEDLINE, Web of Science, Cochrane Library, PsycINFO, and ProQuest databases, and reviewed the literature and reference lists of retrieved articles. We included reports of quantitative studies published in all Persian and English articles from 2000 to 2021 that focused on Promethazine or Hyoscine during. Two authors independently screened titles and abstracts and assessed articles in full text against the inclusion criteria. These criteria included vertex presentation, no previous uterine surgery, intact membranes, and spontaneous labor, with mothers having no contraindications for normal vaginal delivery.   

 Out of a total of 170 records initially screened, we included 44 articles in our review, and other studies were excluded. The results showed that 10, 20, 40 mg of HBB decreased the first stage of labor duration by 147.02 min, 58.95 min, and 71.60 min, respectively. Additionally, HBB decreased the first stage of labor duration by 100.61 min in multiparous women and 66.04 min in primipara women. To evaluate the Promethazine effect on labor duration, the results showed that the combined MD was not significant (p=0.67, 0.85, and 0.44 in the first, second, and third stages, respectively).

 HBB is more effective in multiparous women compared to primiparous women. On the other hand, Promethazine has no effect on reducing total labor duration and any stages of labor, so its use is not recommended.

Aim:

This review sought to evaluate the significance of a functional assessment for liver transplant candidates, i.e., frailty, in the pre-transplant setting and its association with mortality and morbidities.

Background:

 Liver transplantation (LT) remains the treatment of choice for patients with end-stage liver disease. Due to the shortage of organs for LT, a careful selection of suitable recipients is essential. Frailty, a measure of physiologic reserve and increased vulnerability to stressors, was initially used in geriatrics and then introduced to the field of transplantation for better patient selection.

Methods: 

PubMed, Scopus, and Web of Science databases were reviewed up until January 2023. The search terms included: “frail*”, “liver”, and “transplant*”. A Meta-analysis was conducted for the hazard ratios (HRs) obtained from the COX regression models. Fifty-four studies were included in this review; ten were included in the meta-analysis.

Results: 

The prevalence of frailty varied from 2.82% to 70.09% in the studies. Meta-analysis showed that overall frailty had a significant association with mortality ((pooled adjusted HR: 2.66 [1.96−3.63]). Subgroup analyses revealed that both the Liver Frailty Index and Fried Frailty Index were significantly associated with mortality. Furthermore, these studies have demonstrated that this population's frailty is associated with ascites, hepatic encephalopathy, and esophageal varices.

Conclusion: 

According to emerging evidence, frailty is associated with increased morbidity and mortality of the patients on the LT waiting list. Further randomized trials are required to determine the efficacy and safety of variable interventions in the frail population.

More and more children are undergoing liver transplantation and reaching adolescence, even though they must take immunosuppressant drugs for their entire lives.

This study aimed to determine the non-adherence rate in liver transplant recipients and identify its potential etiologies.

A cross-sectional survey was performed to assay medication adherence among pediatric liver transplant recipients in Shiraz, Iran. The patients’ demographic, socioeconomic, and clinical characteristics were collected via interviews. Medication adherence was assessed using a validated Morisky 8-item Medication Adherence Questionnaire (MMAS-8).

A total of 157 patients with a mean age of 12.73 ± 4.02 participated in this study. Based on the Morisky adherence scores, 12.1% (n = 19), 25.5% (n = 40), and 62.4% (n = 98) were categorized as low, moderate, and high adherence groups, respectively. Among all studied variables, cost, forgetfulness, the number of drugs used, and follow-up time after transplant were significantly associated with adherence among children after liver transplantation in Iran.

The rate and reported causes of non-adherence are similar to those found in previous studies, which is quite remarkable. Proper instruction, financial aid, and recruitment of new technologies are among the strategies to overcome non-adherence.

Metabolic syndrome (MetS) is a set of conditions that occur together and increase the risk of cardiovascular disease. Previous studies have linked a gluten-free diet (GFD) to obesity and MetS in some populations. However, others have suggested that weight gain is usually regulated only in underweight individuals with celiac disease (CD). Owing to the lack of sufficient data and the importance of GFD in controlling cardiovascular disease, we surveyed the prevalence of MetS and its components before and after a year of GFD in patients referred to the main celiac clinic in southern Iran.

This was a repeated cross-sectional study conducted on 69 patients with a definite diagnosis of cardiovascular disease who were on follow-up and registered at the Shiraz Celiac Clinic. Demographic, anthropometric, and laboratory measurements at the time of diagnosis and one year after the GFD were extracted from their medical records.

The participants’ mean age was 35.53, and 68.1% were women. The prevalence of MetS increased from 5.8% to 11.6% after a year of the GFD; however, this increase was not statistically significant. Waist circumference (WC) and serum triglyceride levels were significantly elevated during the study period.

A GFD may contribute to the development of MetS in patients with cardiovascular disease; however, the rate of MetS is still lower than that in the general population. It is critical to educate patients about these potential risks and encourage them to have a healthy lifestyle that includes a balanced diet and physical activity.

Postpartum home visits have yielded conflicting results. One of the challenges in this field is the implementation of effective training to support mothers after giving birth to investigate the problems of exclusive breastfeeding. The present study was performed with aim to investigate the impact of home visits by midwives on the amount of breastfeeding problems after delivery.

This clinical trial study was conducted on 100 mothers who gave birth in Flowerjan Imam Khomeini Hospital in 2018. The subjects were randomly divided into two groups of intervention and control (n=50 in each group). The control group received routine postpartum care through health centers and the intervention group received training in 4 sessions (in the early postpartum period up to 42 days after birth) at home. The data collection tool was a demographic and breast problems questionnaire which was completed in mothers' homes. Data was analyzed by SPSS statistical software (version 22) and independent t-test and paired t-test. P<0.05 was considered statistically significant.

The frequency of engorgement on the third and seventh days was significantly lower in the intervention group than the control group (P<0.05), and there was no significant difference between the two groups on the fourteenth and forty-second days (P>0.05). The frequency of fissure on the third day was significantly lower in the intervention group than the control group (P<0.05), and there was no significant difference between the two groups on the seventh and fourteenth days (P>0.05). There was no fissure in any of the two groups on the forty-second day.

Practical advice and support on breastfeeding techniques by trained midwives may result in greater transfer of skills and reduced fissure and engorgement.

Despite the importance of a gluten-free diet (GFD) in the management of celiac disease (CD), non-adherence is quite common and varies in different societies. The aim of this study was to survey adherence to a GFD and identify the barriers in the adult celiac population in Shiraz.

In this cross-sectional study, the patients diagnosed with CD were determined through serum levels of tissue transglutaminase IgA (tTg-IgA) and immunoglobulin A (IgA). In patients with positive anti-tTG, small bowel biopsies were taken. A gastroenterologist routinely assesses CD patients at Shiraz Celiac Clinic. Also, an expert general practitioner describes a list of forbidden food to patients. Adherence to a gluten-free diet was evaluated using interview and tTg-IgA level.

Adherence to a gluten-free diet was 58.2% among 170 participating patients aged 15 to 71 years. There was no significant difference in sex (P=0.730), current age, and age at the time of diagnosis (P>0.05) between the adherent and non-adherent groups. However, the adherence among the unemployed (P=0.036) and highly educated ones was significantly higher than others. More patients adhered to the gluten-free diet for 1-3 years (63.7%), so after three years, less adherence was seen (50%). The most reason for non-adherence was lack of proper access and labeling, cost, and feeling different from others.

Advances in the catering/food industry, increasing economic support and awareness about CD, GFD, and gluten-free products, as well as removing barriers such as inaccessibility and cost, can improve adherence to a GFD.

The coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide and becoming a pandemic. Since the diagnostic tests are relatively expensive, simple diagnostic tests are valuable for quarantining individuals suspicious of COVID- 19. This study is designed to predict the potential contributing factors of COVID-19 diagnosis. It was a referral-based historical cohort study. 363358 individuals referred to the health centers from February to November 2020 in Fars province were entered in the study. The collected data before the lab test were symptoms, underlying diseases, some conditions, risk factors, and demographic information. The Reverse transcriptase polymerase chain reaction test was performed to identify the COVID-19 virus. Chi-square and T-tests were used to compare the variables. A logistic regression test was used to identify predictor variables. Positive COVID-19 test was reported for 119,324 (% 34.9) participations. The positive group result was compared with that of the negative group (n=244,034). The studied symptoms were significant in positive patients. According to the odds ratio (OR), smell disorder (OR=3.80, P<0.001), taste disorder (OR=3.17, P<0.001), and fever (OR=2.65, P<0.001) were common. However, diarrhea, chest pain and dyspnea showed the lowest odds ratio. According to the results, DM (OR=1.46, P<0.001), HTN (OR=1.42, P<0.001), and CVD (OR=1.27, P<0.001) were common in patients with positive COVID-19 tests. Cases whose Body Mass Index (BMI) was more than 40 (excessive obesity) showed a higher odd (OR=1.45, P<0.001) for being positive. According to the results, the symptoms and underlying diseases are effective factors in predicting COVID- 19 disease. Identifying these factors for Covid-19 disease helps health policymakers to make quick decisions and take timely action.

Breast cancer is the most prevalent cancer and a major cause of mortality among women. Breast self‑examination (BSE) is a key technique for early diagnosis of breast cancer, which, along with lifestyle changes, can alleviate the risk of mortality. This study aimed to examine the effect of self‑care training programs on lifestyle change and BSE of immigrant Afghan women residing in Iran.

In this quasi‑experimental study, 140 immigrant Afghan women visiting health‑care centers in Shiraz (Iran) were selected via convenience sampling during 2019–2020. The data were collected using a lifestyle questionnaire, a demographic information checklist, and a BSE checklist. Following the pretest, the experimental group received three sessions of self‑care training and took the posttest 2 months after the intervention. The control group did not receive any intervention, but took the same posttest 2 months after the pretest. Data analysis was performed using paired and independent t‑test and Chi‑squared test in Statistical Package for the Social Sciences (SPSS) 22.

The post‑intervention level of knowledge and performance of the experimental group significantly increased in terms of a healthy lifestyle (P < 0.001) and performance of BSE (P < 0.001) compared to the control group. The intervention also had a significant positive effect (P < 0.000) on all dimensions of lifestyle.

Self‑care training for lifestyle and BSE can promote the prevention and early diagnosis of breast cancer in immigrant Afghan women who have limited access to health care.

This study aimed to investigate the possible relationship between different stent sizes and clinical outcomes after percutaneous coronary intervention (PCI) in patients with diabetes treated with drug-eluting stents (DESs) and dual antiplatelet therapy (DAPT).

Patients with stable coronary artery disease undergoing elective PCI with the DES were entered into a retrospective cohort between 2003 and 2019. Major adverse cardiac events (MACE), defined as the combined endpoint of revascularization, myocardial infarction, and cardiovascular death, were recorded. The participants were categorized according to the stent size: 27 mm for length and 3 mm for diameter. DAPT (aspirin and clopidogrel) was used for at least 2 years for diabetics and 1 year for nondiabetics. The median duration of follow-up was 74.7 months.

Out of 1630 participants, 29.0% had diabetes. The diabetics constituted 37.8% of those with MACE. The mean diameter of the stents in the diabetics and nondiabetics was 2.81±0.29 mm and 2.90±0.35 mm, respectively (P>0.05). The mean stent length was 19.48±7.58 mm and 18.92±6.64 mm in the diabetics and nondiabetics, respectively (P>0.05). After adjustments for confounding variables, MACE was not significantly different between the patients with and without diabetes. Although MACE incidence was not affected by stent dimensions in the patients with diabetes, the nondiabetic patients implanted with a stent length exceeding 27 mm experienced MACE less frequently. 

Diabetes did not influence MACE in our population. Additionally, stents of different sizes were not associated with MACE in patients with diabetes. We propose that using the DES supplemented by long-term DAPT and tight control of glycemic status after PCI could decrease the adverse consequences of diabetes.

Hypothyroidism is the most common hormonal deficiency worldwide; however, there is limited data about its prevalence in the children and adolescents of the Middle East.

The prevalence of hypothyroidism were calculated by dividing the number of patients purchasing levothyroxine in 1397 Solar-Hijri year (Correlate with March 2018-February 2019) by the population at risk (per 10000 persons). Data were collected from the Iran health insurance organization registration records and family physician databases of health vice-chancellor of Shiraz University of Medical Sciences.

The present study shows that the prevalence of levothyroxine treated population aged under 18 years is 13 in 10000 in the Fars province and it is more common in females (17 in 10000 in females versus 9 in 10000 in males). This study also revealed that the prevalence of hypothyroidism was different in various age groups and increased in older children and adolescents after pubertal ages. Also, an increase in the female: male ratio of prevalence was more obvious during and after puberty.

Our study showed that the prevalence of congenital hypothyroidism was 3/10000 in southern Iran. Also, the prevalence of hypothyroidism in children and adolescents was totally 13/10000 population, and this prevalence increased in older age and female gender. This prevalence was close to the data from iodine sufficient areas in Europe and the United States.

The beneficial effects of oral turmeric extract on proteinuria levels have been investigated in several human and animal studies. We conducted a systematic review and meta-analysis to evaluate the significance of this new treatment in CKD patients for the first time. We searched ISI Web of Science, PubMed/Medline, Google Scholar, Scopus, SID, and Magiran until March 2021 to identify human-controlled trials that evaluated the effect of turmeric on proteinuria in chronic kidney disease patients. A total of six trials met the selection criteria and were reviewed in our study and four of them were included in the meta-analysis. In these studies, the results showed not only a significant decrease in the level of proteinuria of the trial groups, who had received curcumin but also a significant change in the level of proteinuria between the trial and control groups (SMD = -0.72, 95% CI: -1.10 to 0.35). The results of this meta-analysis demonstrates that turmeric/curcumin oral supplementation significantly improves urinary protein excretion in patients who suffer from chronic kidney diseases with proteinuria; thus, it can be considered as a potential treatment modality in this population.

Celiac disease (CD) is a common autoimmune disorder that presents intestinal and extra-intestinal symptoms. It is also associated with cardiovascular diseases and malignancies, and mortality risk. The only way to control the disease is to follow a strict gluten-free diet (GFD) for the rest of life.

This survey aimed to investigate GFD non-adherence and causes in the pediatric setting.

In this study, 187 children aged between 2.5 to 14 years old with a confirmed diagnosis of CD at least for a year were studied using a questionnaire-based interview in a census study between 2018 to 2019 in a referral center in southern Iran.

About 40% of children adhered to a GFD poorly. This group significantly complained of more symptoms than the group with high adherence. Improper access was the most important cause of non-adherence to a GFD. The mean current weight and at the time of diagnosis as well as the mean current BMI and at the time of diagnosis in the non-adherent group were significantly lower than the adherent group. However, IgA anti-transglutaminase antibodies and histopathologic examination did not change remarkably. Furthermore, no significant relationship was found between following a GFD and age, age at the time of diagnosis, gender, and parental educational status.

According to our results, inaccessibility, high costs, and lack of food labeling were the primary reasons for non-adherence to GDF. Therefore, to increase compliance, easy access to GFD with proper food labeling and suitable price should be implemented.

COVID-19 rapidly spread globally. Until now, no effective treatment has been provided. Thus, preventive activities such as mask-wearing and social distancing are a priority. This study aimed to measure mask wearing and physical distance adherence after thesecond wave of COVID-19. In this Web-based survey, 1100 staff members participated. We used an online platforms called Porsline for data collection. Online data included demographic characteristics and staff member’s viewpoints about mask wearing and physical distance in their communities. Data were analyzed using descriptive statistics and Pearson’s correlation test. Finally, 1100 participants (584 men) aged 23-66 years filled out the questionnaire. Most of them believed that mask wearing was increased in the community, but with a variety in different places. The lowest percentage of increasing mask wearing was in the park (67.1%) and the highest percentage was among people referring to government offices (86.1%). The lowest percentage in increasing adherence to physical distance was among users of private cars (56.3%) and the highest percentage was among civil servants (74.8%). Physical distance was also increased, although less than wearing a mask. Although mask wearing and adherence to physical distance in community have increased, they have not been developed. On the other hand, it seems that the heath system should pay more attention to physical distance.

Infertility, as an individual and social problem, affects couples’ quality of life and family functioning, job relationships, sexual skills, and marital satisfaction.

The present study aimed to investigate the relationship between infertility and the quality of life in fertile and infertile women.

In this cross-sectional study with a convenience purposive sampling method, 220 eligible women (110 fertile and 110 infertile) admitted to Shiraz’s healthcare centers were selected. Data collection was conducted using a demographic information questionnaire and the World Health Organization Quality of Life questionnaire.

In this study, a total of 220 fertile and infertile women were studied. Our findings showed that the quality of life WHOQOLBREF score was higher in the fertile group (72.21±12.74) than in the infertile group (69.86±12.58), although not significant. However, the physical area of the quality of life was significantly higher in the fertile group (17.55 ± 3.62) than in the infertile group (16.57 ± 3.55) (P = 0.04). There was no statistically significant difference between the groups concerning other quality of life areas (P > 0.05).

The results showed that infertility could reduce the quality of life of infertile women in all areas, and this reduction was significant in the physical area. It appears that infertility diagnostic and therapeutic interventions can affect the quality of life of women in the physical area. Further research is recommended in this field.

Human health has been challenged drastically by the emergence of COVID-19. This pandemic has imposed a serious burden on different aspects of life. Apart from the high rates of morbidity and mortality, reporting of newly formed variants with enhanced contagious capacity has made the future vague. Existence of different comorbidities is a prominent factor towards poor prognosis and fatal outcomes.

The present study aimed to identify the most important comorbidities in the COVID-19 patients who passed away during the first wave in Fars province, Iran.

Trained general physicians obtained data from medical files in the referral hospitals of COVID-19 throughout the province. These included demographic data, past medical history, and existence of comorbidities. The data were analyzed using chi-square test, independent sample t-test, and Mann-Whitney test. P-values less than 0.05 were considered statistically significant.

Out of the 3700 confirmed cases, 87 patients died from February to May 2020. Among these patients, 81.1% had comorbidities, with hypertension, diabetes, and cardiovascular disease being the most prevalent ones. The results revealed no significant differences between the individuals with and without comorbidities regarding age, gender, and duration of ICU hospitalization. Oxygen saturation was also poor in both groups. However, the patients with comorbidities had significantly higher blood urea nitrogen and creatinine levels compared to their comorbidity-free peers.

Cardiovascular disease and the related risk factors contributed greatly to the deadly fate in COVID-19 patients. Hence, early prophylactic and therapeutic interventions should be considered in COVID-19 patients harboring such comorbidities. This can play a pivotal role in reducing the rate of mortality and the consequent financial and social harms.

Male infertility may originate from a wide spectrum of conditions while in 30-40 percent of cases, no significantreason can be identified. Thereby, it is recognized as male idiopathic infertility. This study was undertaken to investigatethe effect of daily intake of selenium, vitamin E and folic acid on sperm parameters in males with idiopathic infertility.

Seventy infertile men were selected to participate in this single-blind, randomized controlledclinical trial using convenience sampling. They were equally divided into two groups via permuted blockrandomization method. The intervention group received selenium tablet (200 μg per day, oral), vitamin E capsule(400 IU per day, oral) and folic acid tablet (5 mg per day, oral).The placebo group received matching placebo forthree months. Semen volume, total sperm motility, sperm concentration, progressive sperm motility, normal spermmorphology, sperm motility index (SMI) and functional sperm concentration (FSC) were assessed by sperm qualityanalyzer-v (SQAV) before and after the intervention. Paired t test, and independent t test were used to compare theresults within and between the groups, respectively. The IBM SPSS V.16.005 was used for data analysis. A p <0.05was considered statistically significant.

After three months, according to within-group analysis, a significant difference was found in mean SMI(P=0.007) and FSC (P=0.001) in the intervention group. According to between-group analysis, no significant differencewas found in mean semen volume (P=0.610), sperm concentration (P=0.126), total sperm motility (P=0.765), progressivesperm motility (P=0.767), normal sperm morph (P=0.403), SMI (P=0.556) or FSC (P=0.706) between the groups.

Consumption of selenium, vitamin E and folic acid in infertile men with asthenozoospermia was not effective(Registration number: IRCT2017012432153N1).

Human papillomavirus (HPV) is one of the most common sexually transmitted infections, with the highest prevalence among young adults. We investigated the risk factors of this infection among men. A total of 224 men referred to a dermatology clinic in Shiraz to treat anogenital warts from June 2015 till Feb 2016 were enrolled. Data collection form included demographic characteristics and risk factors. The participants’ mean age was 28.84 ± 8 years, and half of them (54.5%) were in the second decade of their life. Nearly half of them were single, 110 (49.1%), and 103 had high education (48.4%). Among our participants, the mean age of sexual relationship onset was 20.31 ± 3.71; 69 (60.5%) of the married participants had experienced sexual intercourse before marriage, and 58 (61.05%) had extramarital sexual relationships. The mean number of sex partners was 2.8. More than half of the participants (n = 146, 66.4%) were not aware of STI symptoms. Our participants were young, and more than half of the married ones had extramarital relationships. Altogether, low awareness of STI symptoms was seen. HPV could be a public health challenge in our young male adults because of their risk factors and lack of knowledge.Human papillomavirus (HPV) is one of the most common sexually transmitted infections, with the highest prevalence among young adults. We investigated the risk factors of this infection among men. A total of 224 men referred to a dermatology clinic in Shiraz to treat anogenital warts from June 2015 till Feb 2016 were enrolled. Data collection form included demographic characteristics and risk factors. The participants’ mean age was 28.84 ± 8 years, and half of them (54.5%) were in the second decade of their life. Nearly half of them were single, 110 (49.1%), and 103 had high education (48.4%). Among our participants, the mean age of sexual relationship onset was 20.31 ± 3.71; 69 (60.5%) of the married participants had experienced sexual intercourse before marriage, and 58 (61.05%) had extramarital sexual relationships. The mean number of sex partners was 2.8. More than half of the participants (n = 146, 66.4%) were not aware of STI symptoms. Our participants were young, and more than half of the married ones had extramarital relationships. Altogether, low awareness of STI symptoms was seen. HPV could be a public health challenge in our young male adults because of their risk factors and lack of knowledge.

Street children are a hard-to-reach population. Since the direct method is not feasible and has some limitations, we utilized the network scale-up (NSU) as an indirect method. This study was conducted in Shiraz municipalities. Our target population was Iranian boys between 10 to 18 years of age during the years 2014 to 2016. Three trained psychologists conducted face to face interviews with 86 street children (boys) on the streets, through the convenience sampling technique. The social network size of street boys in Shiraz was estimated at 17 persons (ranging from zero to 92 people, mean = 17 ± 17, median = 13). Overall, the network size of the hidden population might be smaller than the general population, due to the stigmatized nature of their behavior and place of work.

The microbial quality of water plays a key role in community health. The present study aimed to determine the microbial quality of the drinking water distribution networks in the urban and rural areas of Dasht-e Azadegan County, Iran and assess the influential factors in the quality of drinking water.In this descriptive-analytical study, 907 drinking water samples were collected from the urban and rural regions in Dasht-e Azadegan County in 2017. Turbidity, free residual chlorine, pH, total coliforms, and fecal coliforms were measured using the Standard Methods for the Examination of Water and Wastewater, and the results were analyzed using the logistic regression model. The free residual chlorine was within the range of 0-3 mg/L (mean: 0.72 mg/L). The free chlorine residual in 58% of the samples was within the recommended range of the World Health Organization (WHO) for drinking water, and 29% of the samples had higher turbidity than the accepted limit of the WHO (5NTU). In addition, 7.7% and 16% of the samples were infected with fecal and total coliforms, respectively. According to the results of the logistic regression analysis, coliform contamination was most significantly associated with free chlorine residual and turbidity, and reduced free chlorine residual was most effective in coliform contamination.

Street children around the world are accompanying a wide range of risky behaviors. The most common ones include risky sexual behavior, substance and alcohol abuse, and violence. This study aimed to assess risk behaviors and HIV knowledge of street children in Shiraz.

A total of 329 street children (7-18 years of age who spend days or nights on streets with or without their family for earning money) were interviewed through 2014-2016 in Shiraz. Data were collected through a structured interview about high-risk behaviors and HIV/AIDS Knowledge based on a form and questionnaire. Street children were asked to identify HIV/AIDS mode of transmission. All correct answers were scored as one (1), and incorrect, “don’t know” responses and no responses scored as zero. The data were analyzed by SPSS software 16 (SPSS, Inc. Chicago, USA) using the Independent t-test and chi-square test, and Pearsonchr('39')s correlation test. P value< 0.05 was considered as statistically significant

The mean ± SD age was 13.46±3.09. A total of 86.6% of them were boys. A total of 97.6% of them reported staying with their parents. Street children reported sleeping place as follow: with their parents (n=312, 94.8%), sharing accommodation with other kids (n=13, %4), sleeping in parks (n=2, 7%), and one with relatives. The frequency of smoking, alcohol drinking, and drug abuse were 35 (10.6%), 47 (14. 3%), and 6 (1.8%) respectively. A total of 43 (13.1%) street children reported sexual activity, among them 30 (9.1%) had sexual activity without a condom. Mean ± SD HIV/AIDS knowledge scoring of street children was, 4.1±3.9.

Special programs should be implemented in order to reduce high-risk behavior among street children. Intervention should include increasing awareness about alcohol and drug abuse, HIV/AIDS knowledge, sexual and verbal abuse through an organized system with the help of peer education.

 Currently, conflicting evidence exists among community-based studies as to whether chronic kidney disease (CKD) is a cardiovascular (CVD) risk equivalent. We aimed to evaluate the effect of CKD on CVD based on a large trial results.

To perform a secondary analysis, we obtained the data of SPRINT trial from NHLBI data repository center. 2646 subjects with baseline CKD and 6715 without CKD were enrolled. A composite of myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes was considered as primary outcome.

Throughout the 3.21 years of follow-up, presence of CKD, compared to those without CKD, negatively affected the primary outcome (incidence rate, 2.84% per year vs. 1.55% per year in patients with and without CKD, respectively; Hazard ratio, 1.83; 95% CI, 1.49 to 2.11; P < .001). This finding was consistent across all the secondary outcomes. However, the risk was not as great as those with clinical cardiovascular disease (incidence rate, 4.13% per year). Presence of CKD was the strongest predictor of developing AKI with intensive blood pressure reduction, increasing its chance by 215%.

SPRINT is the first trial revealing that CKD is an independent risk factor for CVD. However, CKD could not be considered as a CVD risk equivalent. In the presence of CKD, with intensive blood pressure reduction the chance of AKI is dramatically increased.

Heart failure is a life-threatening event that could lead to sudden cardiac death. It is primarily prevented by the use of implantable cardioverter defibrillators. Applying this therapy is mainly determined by left ventricular ejection fraction. However, this criterion results in considerable pitfalls. Improving the discrimination strategies in order to select eligible patients can help avoid unnecessary insertions. This study aimed to compare global longitudinal myocardial strain and left ventricular ejection fraction in predicting sustained ventricular tachyarrhythmia in heart failure patients. This study was performed on 70 ischemic or dilated cardiomyopathic patients randomly selected from Imam Reza clinic. Patients with left ventricular ejection fraction ≤ 40% who had undergone implantable cardioverter defibrillator implantation were recruited into the research. Left ventricular ejection fraction and global longitudinal strain were measured by 3D echocardiography. Independent sample t-test was used for analysis and statistical significance was set at < 0.05. The data were expressed as mean ± SD. The study subjects in the ischemic and dilated cardiomyopathic groups were categorized according to the occurrence of ventricular tachyarrhythmia. The results showed a significant difference between arrhythmic and non-arrhythmic cases only in the ischemic group regarding the amount of left ventricular ejection fraction. Meanwhile, a significant difference was observed between arrhythmic subjects and their counterparts in both ischemic and dilated cardiomyopathic groups concerning global longitudinal strain parameters. Global longitudinal strain could be considered as a valuable predictor of ventricular tachyarrhythmia occurrence beside left ventricular ejection fraction. This helps selection of appropriate patients for implantable cardioverter defibrillator therapy.

Because of many health benefits, production and cosumption of probiotic products was incresead worldwide. Viability of probiotic bacteria and sensory propperties are important factors in quality of probiotic yoghurt. Many factor can affect the sensory property and survival of probiotic bacteric in yoghurt. Thus, the aim of this study was to assess the the viability of probiotic bacteria and sensory properties of two kind probiotic yoghurt. Two kind of probiotic yoghurt named as MY 1821 and ABY3 were made using commercial starter culures according to manufacturer instruction. Viability of probiotic bacteria (lactobacillus acidophilus, bifidibacteria and lactobacillis casei) and sensory properties (flavour, mouthfeel, appearance and texture) of yoghut were assessed during 21-days at 7 days interval. statistical analysis was carreid out using T-test and ANOVA (repeated measure) in SPSS software. P value less than 0.05 was considered as significant. At the end of experiments the number of lactobacillus acidophilus and bifidobacteria were 7.42± 0.04 and 6.90 ± 0.06 log cfu/gr in MY1821 and 6.45 ± 0.11 and 6.16 in ABY3 and the number of lactobacillis casei was 7.55± 0.04 log cfu/gr in MY 1821. population of lactobacillus acidophilus and bifidobacteria decreased by 1.1 and 0.48 log cfu/gr in MY 1821 And 0.89 and 1.38 cfu/gr in ABY3 yoghurts.viability of L. casei also reduced and by 0.55 Log cfu/gr in MY 1821 yoghurt. At the end of experiments the mean score for flavour, mouthfeel, appearance and texture were 21.2± 3.09 , 12.36 ± 1.80, 7.2± 1.1.01, 3.86± 0.35 in MY 1821 yoghurt and 17.6±4.22, 10.73±2.46, 6.66± 0.97 and 3.33± 0.49 in ABY3 yoghurt respectively. The number of probiotic bacteria at the end of storage were above the criteria determined by Iran national standard. The result of sensory evaluation showed that the prepared yoghurt had good to excellent acceptance. Thus using these starter cultures by diary industry is recommended. Because of helth benefits of probiotics, consomption of these products for their high population of probiotic bacteria can improve the public health.