Journal of Inflammatory Diseases
Volume:21 Issue: 4, 2017

In 1930's first whole cell pertussis vaccines became available to the public heralding a dramatic success in overcoming the global burden of the disease. To date only a handful of B. pertussis strains have been used by international/local pertussis vaccine manufacturers. Inevitable well-documented genetic changes in the world population of this pathogen have prompted serious questions on suitability of traditional vaccine strains protect human against currently circulating wild isolates of Bordetella pertussis.
Analyzing the genetic diversity within the most frequently-used vaccine strains of B. pertussis in the world
A recently developed multi locus variable number of tandem repeats analysis (MLVA) genotyping system along with a bioinforamtic piece of analysis was conducted on 11 strain/sub-strains of B137, B203 (10536), C393, Cs, E476, Tohama I, J445 (134), B202 and J446 (509) plus 2 sub-strains of 134 and 509 that are used at Razi institute for preparation of pertussis vaccine. In this study have used 6 individual loci of VNTR1, VNTR3a, VNTR3b, VNTR4, VNTR5 and VNTR6.
Findings: Six distinct genotypes were recognized among the examined strains by comparing our data with the Dutch MLVA databank. These were all new and not reported before in the database.
This observation reiterates on necessity for detection of predominant native strains to include in vaccine preparations suitable for different countries.

Indiscriminate or no indication prescribed blood products can increase health care costs, transmission of infection, infusion-related complications and improper disposal of blood products and inappropriate distribution of blood products can reduce blood bank reserves.
This study was performed to determine the index of platelet concentrate transfusion in an emergency department.
A cross-sectional study was done on 28 patients admitted in the emergency department, Rasool Akram hospital, Tehran for one year (October, 2014-2015). Infusion index include crossmatch / transfusion ratio (C/T Ratio), transfusion ratio (T%) and transfusion index (TI), separately were identified. Also, the non-infusion or incomplete injection units were recorded. For data analysis student T-Test and analysis of variance and chi-square were used.
Findings: 17 (60.7%) cases were men and 11 (39.3%) were female with mean age 47.36±21.30 years. The most requests for platelet concentrate were pre-operation preparation (16 cases). In 15 cases, 10 units of platelet concentrate was request for the each patient. A total of 249 units of platelet concentrate were requested for 28 patients, which 141 units were used (56.62%). Transfusion ratio, C/T ratio and TI were 71.42%, 1.76 and 5.03, respectively.
Based on the findings, the platelet concentrate transfusion indexes in the emergency department were acceptable and can be used as a suitable approach in the management of blood products in emergency departments of the hospital.

Cleft lip and palate is one of the most common congenital anomalies. The etiology of non syndromic orofacial clefts is multifactorial.
The aim of this study was to evaluate the related risk factors of cleft lip and palate in a group of infants born in Tehran during the years between 2012-2015.
In this case-control study the files of 105 newborns with oral clefts, and 218 normal newborns as control group with their mothers were evaluated in Mofid Hospital in Tehran. Data were analyzed by Chi-square test.
Findings: Among 105 cases, 40 cases (38%) were females and 65 cases (62%) were males. The frequency of cleft lip and palate, cleft palate and cleft lip were 58%, 27.6% and 14.2% respectively. A significant relationship was found between parents with familial marriage (P=0.001). The highest number of clefts belonged to 25-35 year-old mothers (51.4%), 41% of mothers reported smoking during pregnancy thus maternal smoking would be an effective predisposing factor to have a child with oral clefts (P=0.001).
The results of this study indicate that history of familial matrimony, mother’s age above 35 years and maternal smoking during pregnancy can enhance the risk of orofacial clefts 18, 17 and 14 times respectively. These findings emphasize the importance of preconception counseling of mothers-to-be on amendable lifestyle factors in order to reduce the birth prevalence of cleft lip/ palate in future generations.

Overweight and obesity is a worrying issue in the present age and the cause of many chronic non-communicable diseases. Nutritional and non-nutritional factors involved in the development of this health crisis. One of the most important nutritional factors is dietary diversity.
The present study was conducted to report the relationship among dietary diversity score (DDS), obesity and abdominal adiposity among Tehranian young students.
This study was cross-sectional in which, 246 young men, according to the inclusion criteria, were selected. The study was conducted in April 2016. Demographic data were collected by questionnaire and anthropometric measurements were conducted according to international standards. For each participant recorded 24-hour recall food and calculated the DDS. Finally, nine food groups were measured for each person. The analysis was adjusted for confounding factors.
Findings: The means of BMI and waist circumference were 23.9±3.8 and 88.7±10.6. The probability of obesity decreased with quartiles of DDS (1.00, 0.53, 0.08 and 0.19; P=0.01).
The inverse relationship between the DDS and odds ratio of obesity and abdominal obesity was observed in young men. So that by increasing dietary diversity score, the odds ratio of obesity was lower. Further prospective investigations are needed to confirm this finding.

The family's lifestyle is a valuable factor for improving the quality of life and it has an impact on children's habits.
The aim of this study is to evaluate the relationship between family's lifestyle and sleep habits and body mass index in children.
This descriptive-analytical study was conducted in 2014 in primary school children of Qazvin (6-11 years old children) and those children were randomly selected. The data was collected by using standard questionnaires and children's sleep status.
Findings: The total score for the studied lifestyles in families, physical and nutrition was moderate, the lowest and the highest respectively. Maximum average of sleep problems in children were related to the sleep behavior. The body mass index of children was moderate. There was a statistically significant relation between family's responsibility, diet, spiritual improvement and total score of the studied lifestyles with children waking up time (P According to a normal BMI and the presence of children in this study correlated variables lifestyle and sleep habits, improving sleep habits and lifestyle can be concluded as a strategy to prevent abnormal body mass index in children considered.

Quantum leadership approach causes efficient and effective procedures among health care organizations, specially clinical laboratories.
This research was aimed to determine the status of quantum leadership dimensions among all management levels of clinical laboratories of teaching hospitals of medical sciences universities in Tehran.
This descriptive, analytical and cross-sectional study was induced among 180 managers of 35 clinical laboratories of Iran, Shahid Beheshti and Tehran Universities of Medical Sciences 2016. The research tool was researcher - constructed questionnaire of quantum skills, demographic details that its content and face validity and reliability were confirmed. For analysis of data, T-test and ANOVA techniques were used.
Findings: Most of the studied clinical laboratories managers were male, married, with 15-20 years work experiences, 1-5 years managerial services, and minimally one training courses in clinical laboratory management. The managers had relatively desired and desired score of quantum skills and leadership respectively. Also, there was significant correlation between quantum leadership with age (P=0.01), and with management training courses (P=0.02).
It is expected this paradigm may change the clinical laboratory management in the near future with regards to desirability of quantum leadership dimensions among clinical laboratories.

Job stress is a major factor in the creation burn out, reduction patient satisfaction, leave the nursing profession. Nurses job stress can have a major effect on the quality of patient care.
This study was performed with the aim of investigation the job stress and determining factors among nurses.
This cross-sectional study was conducted stratified random sampling method on 123 nurses. The instruments includes demographic information and nurse job stress questionnaire that had seven domains (patient's suffering and death, conflict with physicians, lack of adequate preparation, lack of supportive resources, conflicts with other nurses, working pressure and uncertainty of treatment). Analysis methods of descriptive and inferential statistics (Pearson, t-test, chi-square, Tukey, Kruskal Wallis test, Anova, linear regression) was performed.
Findings: The majority had moderate stress 84 persons (68.3%) and 26 persons (21.1%) low stress, 13 persons (10.6%) a lot of stress. Nurses with Bachelor and higher education (P=0.045), the employment contract (P=0.042) had higher levels of stress and who with at least one child had lower levels of stress that was statistically significant (P=0.02). Work pressure and conflict with physicians were the most and least important factors respectively.
Workshop in the relation to the management and control of stress depending on the amount of stress, work pressure, can reduce job stress by the nurse's educational needs assessment.

Pancreatic cancer is one the most malignant cancers in human. A great percentage of patients die annually due to lack of early detection as well as efficient treatment strategies. Only five-year survival rate is still only seen in 5% of patients. Major problem of this deadly disease is the intrinsic and acquired resistance to current chemotherapeutic agents such as gemcitabine. So far, different molecular mechanisms are attributed to gemcitabine resistance. For instance, genetic mechanisms, aberrant gene expression in cellular signaling pathways, cancer stem cells, impaired apoptosis related genes, epigenetic changes and potential role of microRNAs have been identified in gemcitabine resistance of pancreatic cancer. Improving the drug efficacy and overcoming to drug resistance is the current goal in treatment of pancreatic cancer. Understanding the cellular and molecular mechanisms of resistance can help us to develop novel therapeutic approaches leading to increased effectiveness of current treatments. In this review, we summarized the molecular mechanisms involved in gemcitabine resistance in pancreatic cancer.

Heterotopic pregnancy is a rare form of pregnancy and could accompany with maternal mortality and morbidity. Most of the cases have a history of assisted reproductive technology or other risk factors like history of ectopic pregnancy and pelvic inflammatory disease. In this article we report a case of heterotopic pregnancy in a 39 year old woman with spontaneous pregnancy and without any risk factor whose heterotopic pregnancy diagnosed before rupture of ectopic pregnancy and surgery.

Work-related musculoskeletal disorders, is the cause of most disability and absences created to work.
This study was done in order to survey of effective occupation risk factors on absence from work and going to the doctor caused by musculoskeletal disorders.
This cross-sectional study was done among 114 subjects from rescue groups employees in the city of Qazvin in 2016. Data were collected by Nordic questionnaire and demographic characteristic. Data analyzed by using descript statistic and logistic regression test.
Findings: As the results, eighteen (15.7%), and forty-two (37%) rescue work employees were absent from work and gone to the doctor respectively due to pain in the one of body regions during the past year. Occupation group of Red Crescent was absent from work and going to doctor than firefighter due to musculoskeletal disorders in univariate, and multivariate analysis (5.2, 13.09 times) respectively.
Risk factors including work history and kind of job can influence on the consequence of musculoskeletal disorders.