Archives of Iranian Medicine
Volume:20 Issue: 4, Apr 2017

Prediabetic condition can lead to development of type 2 diabetes, especially in individuals who do not adhere to a healthy lifestyle. The aim of the present study was to investigate the socio-cognitive factors using the Theory of Planned Behavior (TPB) that may be associated with the choice of lifestyle in prediabetic patients.
A prospective study with one-month follow up was designed to collect data from 350 individuals with prediabetic conditions. A questionnaire was used to collect the information, including demographic variables, exercise behavior, food consumption, as well as the constructs of the TPB (attitude, subjective norms, perceived behavioral control, and behavioral intention) regarding physical activity and dietary choice. The correlations between TPB variables and the dependent variables (dietary choice, physical activity) were assessed using Spearman correlation and multiple regression models.
In total, 303 people participated. The mean age of the participants was 53.0 (SD 11.5) years and 42% were males. Significant correlations were found between all TPB constructs and both dependent variables (healthy eating and exercise behaviors) both at baseline and after one month (P The TPB may be a useful model to predict behaviors of physical activity and dietary choice among prediabetic people. Therefore, it may be used to monitor lifestyle modification to prevent development of diabetes among people with prediabetic conditions.

Opium is one of the most common substances used worldwide with variable epidemiologic features in different regions. This study was performed in southern Iran, to find the epidemiology of opium use and its association with different factors and diseases.
This cross-sectional study was performed on baseline data extracted from Pars Cohort Study performed in Valashahr, a rural area in southern Iran. For any subject, information was collected about demographic factors, some common diseases including heart disease, stroke and hypertension and the state of using opium, other substances and cigarettes.
There were 4276 males and 4988 females, with a mean age of 52.6 ± 9.7 years of whom 8.4% reported opium use (17.3% of males and 0.7% of females). In men, the history of stroke and heart disease were significantly more common in opium users (12.6% vs. 8.8%, P = 0.001 and 2.8% vs. 1.5%, P = 0.01, respectively) while the history of hypertension was significantly more common in non-opium users (7.8% vs. 10.3%, P = 0.04). Younger age, male gender, being non-married and positive history of joint pain, cigarette smoking and alcohol consumption were the factors associated with opium use.
Opium use is common in non-married men who have a positive history of cigarette smoking and alcohol consumption in the rural population of southern Iran. It is associated with increased risk of heart disease and stroke and decreased risk of hypertension in males. Global interventional and preventive measures are required to control this complicated social problem.

Recent data has proven that the WHO (world health organization) cut-off for obesity is not applicable to the Asian population. This study aims to estimate the prevalence of lean NAFLD (non-alcoholic fatty liver disease) in the capital of Iran and extract probable predictors for this growing health issue in this population.
This is a population-based cross-sectional study on apparently healthy subjects over 18 years of age. The participants were interviewed for baseline demographic and clinical information. They were subsequently referred for physical examination and blood sampling. NAFLD was diagnosed using abdominal ultrasonography by a single expert radiologist.
Of 927 eligible participants who entered the study, 314 were lean; BMI (body mass index) The prevalence of NAFLD in lean subjects in a sample of Iranian population is 17.52%. Hypertriglyceridemia, higher SBP, and higher BMI especially over 23.2 are independent factors associated with the presence of NAFLD in lean subjects.

Family dinner is a proxy of family connectedness that may affect mental health. The present study aimed to examine the associations of frequency of family dinner with mental disorders and obesity in a nationally-representative sample of Iranian adolescents.
A total of 5528 Iranians adolescents aged 10–18 years were enrolled in the third survey of a national surveillance program during 2009–2010, entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-III) study. The frequency of family dinner meal was assessed. Mental health assessments were done as part of the World Health Organization-Global School-based Student Health Survey. The odds of having mental disorders and obesity were assessed by logistic regression.
No significant difference was found in dietary intake between family dinner consumers (≥5 times (night)/wk) and skippers ( The current study showed an inverse relationship between the frequency of family dinner consuming and mental disorders and obesity in a nationally-representative sample of Iranian adolescents. Such simple recommendations for families may be feasible, sustainable, and effective for health promotion and disease prevention.

Human T-lymphotropic virus type 1 (HTLV-1) was the first retrovirus identified in human. The current evidence is quite scarce regarding the potential role of HTLV-1 in pathogenesis of hematologic disorders and non-hematologic malignancies.
The aim of this study is to evaluate the prevalence of HTLV-1 infection in patients with hematologic disorders and non-hematologic malignancies.
This cross-sectional study was conducted on 505 cases of definite diagnosis of hematologic disorders including malignancies as well as non-malignant disorders such as polycythemia and myelofibrosis and non-hematologic malignancies referred to the hematology and medical oncology ward at Army Hospital 501 from January 2015 to January 2016. A 3-mL blood specimen was collected from each patient and tested for the presence of anti-HTLV-1 antibodies using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using SPSS software package version 19 (IBM, New York, USA). Data are presented as mean ± SD if normally distributed and otherwise as median (range).
Totally, 242 (48%) males and 263 (52%) females with a mean ± SD age of 52.09 ± 16.24 were enrolled in this study. In total, there were 9 (1.78%) cases positive for HTLV-1 infection including 4 males and 5 females. Seven out of 287 (2.4%) patients with hematologic disorders were infected by HTLV-1. In non-hematologic malignancies, 2 out of 211 cases were positive (0.9%). There was no HTLV-1 positive case in 7 patients with both hematologic and non-hematologic disorders. The difference in HTLV-1 infection prevalence between patients with hematologic disorders and non-hematologic malignancies was not statistically significant different (P = 0.31). There was no association between sex and transfusion history with HTLV-1 infection in this population (P = 0.9 and 0.7, respectively).
Our study revealed that the prevalence of HTLV-1 in hematologic disorders is higher than the general population. Further larger prospective studies are recommended to corroborate the current evidence.

This study assessed the status of cigarette marketing in Iran as well as the attitude of smokers toward smoking and the policies and tobacco control programs in the country.
This cross-sectional study was conducted on 3480 volunteer smokers in six provinces, using a stratified cluster random sampling method. The study population consisted of smokers who used at least one cigarette per day. The data collection tool was an anonymous self-administered questionnaire including basic information and 20 five-choice questions related to participant's attitude toward smoking habits (Cronbach's alpha; 79.73%.).
The majority (66.9%) of participants started smoking at the age of 10 to 19 years and 61.1% used foreign cigarettes. Of 160 marketed brands, 38 (23.8%) were domestic and 122 (76.2%) were foreign, including 63 (39.3%) imported and 59 (36.9%) smuggled brands. Being tempted (25.0%), getting nervous (24.1%), and seeking euphoria (24.1%) were the most common reasons for restarting cigarette smoking after cessation. The majority of participants believed that smoking in public places was a violation of the rights of others and smoking should be avoided in such places.
Smoking prevention programs should focus on adolescents as the most vulnerable age group. Raising the retail price of tobacco products through increasing taxes can reduce consumption, particularly among first starters and youth. However, increasing taxes and prices of tobacco products may be effective when simultaneous effective measures are implemented to eliminate all kinds of illicit trade in all forms of tobacco products.

The circle of Willis, an anastomotic polygon at the base of the brain, forms an important collateral network to maintain cerebral blood perfusion. The aim of this study was to investigate different anatomic variations of the circle of Willis and their prevalence.
This cross-sectional study was conducted on 525 healthy participants including 205 men and 320 women. The mean age of the patients was 51.5 years. Three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) technique was used. Vascular variations in the anterior and posterior parts of the circle were evaluated.
The findings show that the complete circle of Willis was visible in a small number of patients. The circle of Willis had a complete vascular structure in 20.9% of the patients. The anterior part of the circle of Willis had a complete structure in 80.95% of the cases, while the posterior part had a complete structure in 20.95% of the cases.
We observed wide variations in the circle of Willis configuration in our study. Similar to other studies, most variations are related to the posterior part of the circle of Willis. Absence of bilateral posterior communicating artery variation is more common than other types of variations in this population.

Esophageal squamous cell carcinoma (ESCC) accounts for 80% of all esophageal cancers worldwide. It is the most common histological type of esophageal carcinoma in low-resource countries. ESCC is prevalent in Asian countries, accounting for more than 95% of esophageal cancers. The epidermal growth factor receptor (EGFR) is involved in cancer development, as its gene is often mutated and/or amplified in cancer cells. According to recent statistics, esophageal cancer is the eighth most common cancer in Iran.
In this retrospective study, we assessed EGFR overexpression, using immunohistochemistry (IHC) in 68 patients with ESCC, undergoing neoadjuvant chemoradiotherapy and esophagectomy in 2011-2014. The treatment protocol included external beam radiotherapy (40 Gy), concomitant with cisplatin 20mg/m2 and 5- fluorouracil (5-FU) 1000 mg/m2 for 4 consecutive days during the first and fourth weeks of treatment. To compare the two groups (EGFR positive and negative) in terms of complete pathologic response, Chi-square test was performed using SPSS version 16.
The median age of the patients was 59 years (range: 27–70 years), with a female-to-male ratio of 1.06. Overall, 70% of the subjects showed EGFR overexpression. Complete pathologic response to neoadjuvant treatment was significantly higher in EGFR-positive patients (40% vs. 15.8%, P = 0.05). In all cases, 1- and 3-year overall survival rates were 86.6% ± 4.1 and 48% ± 6.9, respectively. The 1- and 3-year disease free survival rates were calculated as 71.8% ± 5.4 and 44.3% ± 6.5, respectively. The overall survival rate was relatively higher in cases with EGFR overexpression, although the difference was not statistically significant (5-year survival rate: 47.9 ± 8.2 vs. 30.9 ± 13, P = 0.23).
EGFR overexpression was reported in the majority of patients with ESCC in northeastern Iran. Moreover, EGFR overexpression was significantly associated with complete pathologic response.

EBOV outbreaks continue to threaten the world due to the absence of effective vaccines and therapeutics. Easy-to-use and rapid diagnostic tests for EBOV are highly desired for prevention and control of the EVD epidemic.
Escherichia coli expression system was used to express VP40 protein of Zaire Ebola virus (ZEBOV) as water-soluble protein upon optimization of temperature, time, and IPTG concentration. VP40 protein was purified through Ni-NTA affinity chromatography and applied to immunize rabbits for immunogenicity analysis. Rabbit polyclonal antibodies against VP40 protein was produced and antibody response was analyzed using Western blot, enzyme-linked immunosorbent assay (ELISA), and immunoperoxidase monolayer assay (IPMA).
Recombinant full-length VP40 protein of ZEBOV was expressed in E. coli Rosetta (DE3) cells as water-soluble protein. Analysis of antibody responses showed that rabbit polyclonal antibodies against VP40 protein could react specifically with this E. coli-expressed protein in Western blot and ELISA, and antibody titers in ELISA reached 1:125600. Besides, the produced rabbit polyclonal antibodies bound to VP40 proteins eukaryotically expressed by transfecting pcDNA-eGFP-VP40 into BHK-21 cells in IPMA.
These results show that the prokaryotically expressed VP40 protein has high immunogenicity and can be used as diagnostic antigen in ELISA and other immunoassays. The strategy used in this study might be a potential way for preparing diagnostic agents for prevention and control of exotic diseases.

In recent years, in European academic circles, there has been a trend to dismiss Gondeshapur as a myth perpetrated by the Bokhtishu family in early Islamic era, despite many historiographical attestations. The writings of Islamic historians such as Al-Qifti and Ibn Abi Usaibia have been discounted as exaggerations by non-contemporary historians, and the lack of primary Pahlavi sources blamed for historical hyperbole.
In this essay, I have attempted to show through primary Syriac Christian texts, that there was both a medical school and a bimarestan in Gondeshapur in pre-Islamic Sassanid era, and that Galenic medical texts had been translated and taught in that institution.