Atypical pityriasis rosea with unilateral presentation

Pityriasis Rosea (PR) is a common skin disease and characterized by generalized scaly eruptions typically on the trunk and proximal extremities. Atypical presentations of PR are common and can be a diagnostic challenge for clinicians. Here we present a case of a 26-year-old female who presented with a sudden onset of several asymptomatic, erythematous and scaly plaques on her trunk. Plaques sized 0.5-1cm in diameter that were distributed unilaterally (right side) on her chest, back and axilla. Atypical cases of PR are fairly common and less readily recognized. Careful history, clinical evaluation and follow-up are important to avoid misdiagnosis of PR and physicians should be aware of PR variants so that appropriate management and reassurance can be offered. For atypical eruptions without a definite diagnosis, it is safer to consider lesional skin biopsy. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved

Prehypertension; patient awareness and associated cardiovascular risk factors in an urban population in Iran

Background: This study was to estimate the frequency of prehypertension and to characterize patient awareness and associated cardiovascular risk factors in an urban population in Iran. Methods: During a hypertensive awareness program, a cross-sectional study was conducted on 2036 people. All participants completed a questionnaire about their demographic and anthropometric indices and were asked about symptoms, risk factors and preventive measures of hypertension. Data were compared between prehypertensive and non-hypertensive groups. Results: Prehypertension was detected in 30 (n=611) of the subjects. Previous CHD, diabetes, and hyperlipidemia were more prevalent in low prehypertension group compared to high normal blood pressure. The male sex, increasing age and body weight were positively associated with the rate of prehypertension. Only 8 of participants with prehypertension were aware about the symptoms of hypertension, 12 correctly mentioned at least three risk factors of hypertension, and 48 explained appropriate preventive measures. Conclusion: Prehypertension was prevalent in this population. Age, body weight, male sex, and previous CHD were the major determinants. Furthermore, hypertension awareness was alarmingly poor. Therefore, hypertension prevention programs focused on increasing public awareness are essential

Attitude and practice regarding breast cancer early detection among Iranian women: A systematic review

Objectives: To determining attitudes and practice regarding breast cancer early detection techniques (breast self-examination (BSE), clinical breast examination (CBE) and mammography) among Iranian woman. Methods: International (PubMed, ISI, and Google Scholar) and national (SID and Magiran) databases were reviewed up to September 2017 to identify articles related to the attitudes and practices of Iranian women concerning breast cancer screening behavior with reference to BSE, CBE and mammography. The screening steps, analysis of quality of the studies and extraction of the papers were performed by two reviewers. Results: Of the 532 studies included initially, 21 performed on 10,521 people were considered eligible. Subjects with a positive attitude toward BSE in various studies were 13.5 to 94.0 with an average of 47.6. Positive attitudes to CBE and mammography were found in 21.0 and 26.4, respectively. Participant performance of BSE ranged from 2.6 to 84.7, with an average of 21.9. The respective figures for CBE and mammography were 15.8 and 16.7. Conclusion: Considering the poor performance and low rates for positive attitudes, it is suggested that educational programs should be conducted across the country

The Effects of Selenium Supplementation on Gene Expression Related to Insulin and Lipid Metabolism, and Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus: a Randomized, Double-Blind, Placebo-Controlled Trial

This study was performed to evaluate the effects of selenium supplementation on gene expression related to insulin and lipid metabolism, and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). The current randomized, double-blind, placebo-controlled clinical trial was conducted in 36 patients with GDM. Participants were randomly divided into two groups to intake either 200 μg/day selenium supplements as selenium yeast or placebo (n = 18 each group) for 6 weeks. Selenium supplementation upregulated peroxisome proliferator-activated receptor gamma (P = 0.03) and glucose transporter 1 (GLUT-1) (P = 0.01) in lymphocytes of subjects with GDM compared with the placebo. Selenium supplementation did not affect gene expression of low-density lipoprotein receptor (LDLR) and lipoprotein(a) Lp(a). Supplementation with selenium had a significant decrease in incidence of newborns� hyperbilirubinemia (5.6% vs. 33.3%, P = 0.03) and newborns� hospitalization (5.6% vs. 33.3%, P = 0.03) compared with the placebo. Overall, we found that selenium supplementation for 6 weeks among patients with GDM significantly increased PPAR-γ and GLUT-1 expression, but did not affect gene expression of LDLR and LP(a). It also reduced incidence of newborns� hyperbilirubinemia and newborns� hospitalization. Clinical trial registration number: http://www.irct.ir: IRCT20170513033941N35. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Prevalence of gestational diabetes mellitus in Eastern Mediterranean region: a systematic review and meta-analysis

Purpose: Gestational diabetes mellitus (GDM) is one of the costly challenges in the health field. Despite the individual studies in the Eastern Mediterranean, there is no comprehensive study in this regard. The aim of this study was to determine the prevalence of GDM in the Eastern Mediterranean region. Methods: In this meta-analysis and systematic review, three international databases (PubMed, Web of science and Scopus) were searched from inception until 30 December 2018. The Hui tool was used to assess the quality of the included studies. Results: Thirty-three studies performed on 887166 participants were included in the meta-analysis. Based on the results of random effect method, the overall prevalence of GDM was 11.7%. Between six country with have three or more study, pooled prevalence for Saudi Arabi it was 3.6 times more than Israel (17.6 vs. 4.9%), and for Pakistan, Qatar, Bahrain and Iran were 15.3%, 14.7%, 12.2%, and 8.6%, respectively. Conclusion: Despite the high diversity of methods, the results of the present study indicate a high prevalence of GDM in the Eastern Mediterranean region, indicating more policymakers’ interest in timely screening and proper management

Considering the causes of inefficiency of supervision programs of Ilam city health center

In the context of health services, the main philosophy of health cares is proper distribution of health resources. According to definition, this purpose is attainable when the necessary facilities have been provided to respond the most preliminary and necessary health needs of society in home and work place and access to them must be easy and sustainable. This research has performed with a cross-sectional method in Ilam city in order to improve the present facilities in parallel with development of health indices. Materials and methods: In this research, it was investigated 17 rural and urban health centers, 3 health bases and 29 health houses. Necessary data and Figures in various contexts have been collected through prepared and pre-planned questionnaire. In the next step, the ideas of both observer and observed group were described based on respective questions and variables. With regard to this fact that in this study the purpose was to answer various questions from the perspective of both mentioned groups, then a special statistical test has not been performed. Findings: The findings of this research show that 34/2 of observed subjects mentioned that the supervision programs are varied and interesting,45/8 said they were repetitive. On the contrary 81/3 observers had the same idea. This investigation showed that 90/8 milieu forces (observed) and 62/5 observers were interested to their works. In this research 93/8 observers and 75/5 observed subjects have believed to effective role of education in improving health services. Results: Results obtained from this research showed that observed and observer groups were interested in their work and continued their activity seriously. The research results also showed that the main cause of the loss of health indices is (support) financial facilities and services which are not available to milieu and operational departments on time. As such in this research 77/5 observed subjects and 100 observed believed to this issue. © 2010, INSInet Publication

Biofilm formation in Methicillin Resistant Staphylococcus aureus

Methicillin Resistant Staphylococcus aureus (MRSA) is one of the important antibiotic resistance pathogen. Chronic hospital acquired infections by S. aureus have become a major problem in recent years. One of the main mechanisms for chronic hospital acquired infections is defined by biofilm formation. Therefore, the current research aimed to identify the prevalence of biofilm formation among MRSA clinical isolates in Ilam hospitals and to determine the gene responsible for biofilm formation. For this reason, 26 MRSA clinical isolates were identified and subjected to biofilm by micro-plate assay and PCR for identification of icaa and icaD. The results demonstrated that 69.2 (n = 18) of MRSA clinical isolates possess icaD and were interestingly were negative for icaa; while biofilm formation were negative in three isolates that were positive for icaD. The current study strongly recommended icaD as a main factor to produce the biofilm formation in MRSA clinical isolates and suggested this gene as a target for antibiofilm therapy. The reason for negatively in 2 isolates could be explained in the abstract by low accuracy of micro-late assay. Another reason that could be concluded was silencing of icaD in these three isolates. © 2020 Elsevier Inc