Topiramate augmentation in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial

Background: This study aimed to assess the efficacy of topiramate, a glutamate-modulating agent, in patients with treatment-resistant obsessive-compulsive disorder (OCD) as an adjunct to serotonin reuptake inhibitors (SRIs). Materials and Methods: Thirty-eight patients with refractory OCD, were randomly assigned to receive topiramate or placebo. This study was designed as a 12 weeks, double-blind, placebo-controlled trial. Primary outcome measures were the change in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score and the rate of treatment response in each group at the study end point. Treatment response was considered as 25% or more reduction in Y-BOCS score. Results: A total of 13 patients in the topiramate group and 14 ones in the placebo group completed the trial. Topiramate-assigned patients showed significantly improved mean Y-BOCS score over time (P < 0.001). Although differences between two groups were significant in the Y-BOCS score at the first 2 months (P = 0.01), this was not significant at the end of the study (P = 0.10). Changes of Clinical Global Impression (CGI)-Severity of Illness Scale score and CGI-Improvement Scale score were not significantly different between two groups (P > 0.05). Treatment response was almost significantly different in the topiramate group comparing placebo group (P = 0.054). Mean topiramate dosage was 137.5 mg/day (range, 100-200). Conclusion: This study didn’t show efficacy of topiramate as an agent to augment SRIs in treatment-resistant OCD patients

Spatio-temporal pattern of two common cancers among Iranian women:An adaptive smoothing model

Purpose: Considering the increase in incidence of breast and cervix uteri cancers in Iran, this study investigates spatio-temporal patterns of the incidence of these two cancers by estimating the step changes between pairs of adjacent regions and between the Iranian women from 2004 to 2009. Methods: Using an adaptive smoothing model, spatio-temporal mapping of the breast and cervix uteri cancers and their changes were studied. Identification of step changes between the neighboring spatial units was carried out by modeling adjacency matrix elements as random variables. Results: There was a high relative risk of breast cancer around the central northern half of Iran, and a high relative risk of cervix uteri cancer was seen in the northeastern part of Iran. Northwest and southeast of Iran had a relatively low risk of breast and cervix uteri cancer. In general, step changes were largely similar between the two diseases Introduction Women are about half of the world’s population, and their proper health is of particular impor- tance as it ensures the health of the community. According to the World Health Organization, 25% of women’s deaths are due to malignant tumors. Breast cancer is the most common malignancy of women throughout the world and accounts for 30% of all cancers in women. In 2000, more with an agreement coefficient of 56%. This was observed in the Chaharmahal & Bakhtiari, and Kohgiluye & Boyerah- mad provinces on the central band of Iran, as well as some eastern and northern regions on the map that were distinct from their adjacent provinces from the aspect of relative risk of both cancers. Conclusion: Identifying areas with high/low incidence risk can help health authorities to make better decisions to prevent and control breast and cervix uteri cancers and allocate resources more efficiently. In addition, determining and identifying the step changes in unexplained components of the disease risk can lead to a deeper understanding of the spatial structure of unmeasured confounding factors

The Effect of Iranian Evaporative Cold Vest on Physiological Indices in Hot and Dry Climate in a Climatic Chamber

Background: Heat stress is a threat for health and safety in workplaces. The aim of this study was to examine the cooling ability of the Iranian evaporative vest in hot and dry conditions in a climatic chamber. Method: This interventional study was conducted on 12 male students in 2013. Heat strain score index, skin temperature, oral temperature and heartbeat in two phases of with and without wearing cold vest were measured in two intensity different activities on a treadmill in a climatic chamber (mean temperature 38.8ºC, relative humidity 32.9% and WBGT 29.9ºC). Data were analyzed using t-test and repeated measures test. Results: In two trials with and without wearing the evaporative cooling vest, the skin mean temperature differed significantly but heat strain score, heartbeat rate and oral temperature in both activities did not show a significant difference. Conclusion: The results showed that Iranian evaporative cooling vest is effective in reducing skin temperature, in light and moderate activities, in hot and dry conditions; but it has a little effect on oral temperature, heart rate and heat strain score index

Prevalence hearing loss of truck and bus drivers in a cross-sectional study of 65533 subjects

Background: Noise pollution is one of the most important occupational pollutants in heavy-vehicle drivers. Therefore, this epidemiological research was conducted with the aim of determining the prevalence of hearing loss in heavy-vehicle drivers in Iran. Methods: This cross-sectional research was conducted on 65,533 heavy-vehicle drivers including truck and intercity bus drivers from February 2006 to March 2016. The air and bone threshold of pure tone was measured for each ear at 0.5, 1, 2, 3, 4, 6, and 8 kHz by a skillful radiology expert. The obtained data from this research was analyzed in SPSS software using statistical tests such as descriptive analysis and paired t test. Results: Mean (standard deviation) of hearing loss in left and right ears of all people was 23.02 (8.25) and 22.48 (7.86), respectively. Paired t test showed that hearing loss difference in left and right ears was significant (P < 0.001). Mean and standard deviation of paired t test showed that hearing loss difference in left and right ears was significant in all frequencies except 1000 Hz (P < 0.001). Conclusion: The findings of this research generally showed that 26.8% of the studied drivers have hearing loss. Hearing loss in the left ear was more than right ear keywords: Bus drivers, Hearing loss, Prevalence, Truck driver

The functional, communicative, and critical health literacy (FCCHL) scales: Cross-cultural adaptation and the psychometric properties of the Iranian version

Background: Patients today are required to understand more and more complex health information, and to navigate increasingly complex health systems. As a result, they need to develop skills such as finding, processing, understanding, and applying information about health issues, which has been conceptualized as health literacy (HL). Assessing HL is critical to providing meaningful health information to patients. Objectives: This study aimed to examine the cultural adaptation and the psychometric properties of the Iranian version of the functional, communicative and critical health literacy (FCCHL) scales measuring three aspects of HL among type 2 diabetic patients. Patients and Methods: We conducted a methodological survey of 187 patients with type 2 diabetes using a cross-sectional design. The study was carried out in two phases: the first phase was designed to obtain a cross-cultural equivalent of the FCCHL scales, based on Beaton’s guidelines. In the second phase, a cross-sectional study was conducted to evaluate the psychometric properties of the questionnaire. Results: Exploratory factor analysis (EFA) identified three main factors with 27.07%, 22.46%, and 16.23% of extracted variance, respectively. Confirmatory factor analysis (CFA) completely supported the three-factor model of the HL scales. Internal consistency was approved for the total scale (� = 0.82) and for the functional, communicative, and critical subscales (� = 0.91, 0.80, and 0.76, respectively). Convergent validity analysis indicated a significant positive correlation (r = 0.45; P < 0.01) between the scores on the functional HL scales and the Iranian version of the Short Test of Health Literacy in Adults (S-TOFHLA), which was to be expected. Conclusions: We concluded that the FCCHL scales are valid and reliable, and can be used to measure health literacy among Iranian diabetic patients. However, further research is needed to establish stronger psychometric properties for the use of this questionnaire in Iran

Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

Objectives: Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetesrelated behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. Methods: We conducted a crosssectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. Results: Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. Conclusions: This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient’s HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance

A Study of The Relationship Between The Components of The Five-Factor Model of Personality and The Occurrence of Occupational Accidents in Industry Workers

Accidents are among the most important problems of both the developed and the developing countries. Individual factors and personality traits are the primary causes of human errors and contribute to accidents. The present study aims to investigate the relationship between the components of the five-factor model of personality and the occurrence of occupational accidents in industrial workers. The independent T-test indicated that there is a meaningful relationship between the personality traits and accident proneness. In the two groups of industry workers injured in occupational accidents and industry workers without any occupational accidents, there is a significant relationship between personality traits, neuroticism (p=0.001), openness to experience (p=0.001), extraversion (p=0.024) and conscientiousness (p=0.021). Nonetheless, concerning the personality trait of agreeableness (p = 0.09), the group of workers with accidents did not differ significantly from the workers without any accidents. The results showed that there is a direct and significant relationship between accident proneness and the personality traits of neuroticism and openness to experience. Furthermore, there is a meaningful but inverse correlation between accident proneness and the personality traits of extraversion and conscientiousness, while there was no relationship between accident proneness and the personality trait of agreeableness

Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran

OBJECTIVES Hypertension (HTN) is an important risk factor for cardiovascular disease. Considering the importance of this disease for public health, this study was designed in order to determine the prevalence, awareness, treatment, control, and risk factors of HTN in the Iranian adult population. METHODS This cross-sectional study was conducted among 2,107 residents of Isfahan, Iran. Samples were selected through multi-stage random cluster sampling in 2015-2016. The outcome variable was HTN, determined by measuring blood pressure in the right arm via a digital arm blood pressure monitor. Awareness, treatment, and control of HTN were assessed by a validated and reliable researcher-developed questionnaire. Other demographic and clinical variables were assessed via a demographic questionnaire. RESULTS The overall prevalence of HTN was 17.3% (18.9 and 15.5% in men and women, respectively). The prevalence of HTN increased in both genders with age. The prevalence of awareness of HTN among people with HTN was 69.2%, of whom 92.4 and 59.9% were taking medication for HTN and had controlled HTN, respectively. Logistic regression identified age, body mass index, having diabetes and hyperlipidemia, and a positive family history of HTN as determinants of awareness of HTN. CONCLUSIONS The results showed that HTN was highly prevalent in the community, especially in men and in middle-aged and older adults. Approximately 30.8% of patients were unaware of their disease, and there was less awareness among younger adults. Despite the high frequency of taking medication to treat HTN, it was uncontrolled in more than 40.1% of patients. Health policy-makers should therefore consider appropriate preventive and therapeutic strategies for these high-risk groups

Melatonin Protects Mouse Type A Spermatogonial Stem Cells against Oxidative Stress via The Mitochondrial Thioredoxin System

Objective: Mitochondrial oxidative stress is an important factor in infertility. The mitochondrial thioredoxin systemplays an important role in this condition. N-acetyl-5-methoxy tryptamine (melatonin) plays a role in reducing oxidativestress and apoptosis in spermatogonial stem cells (SSCs). In this study, we explore the probable protective effects ofmelatonin on the mitochondrial thioredoxin system [thioredoxin 2 (Trx2)/Txnip] in SSCs under oxidative stress.Materials and Methods: In this experimental study, SSCs were co-cultured two-dimensionally (2D) with Sertoli cellsin DMEM culture medium that contained 10% fetal bovine serum (FBS), 1% antibiotics, and 10 ng/ml glial cell-derivedneurotrophic factor (GDNF) for 30 days. The cultured cells were subsequently divided into four groups: control; melatonin(250 μM, 24 hours); melatonin (250 μM, 24 hours)+hydrogen peroxide (H2O2, 50 μM, 24 hours); and H2O2 (50 μM, 24hours). Intracellular reactive oxygen species (ROS) production was determined by flow cytometry. Malondialdehyde(MDA) levels were measured by Fluorometry. The expressions of apoptotic and antioxidant genes and nuclear factorerythroid 2-related factor 2 (Nrf2), Trx2, and nicotinamide nucleotide transhydrogenase (NNT) proteins were determinedby quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. Adenosine triphosphate (ATP) levelswere measured by fluorometry.Results: Melatonin reduced H2O2-induced ROS levels and apoptosis in the SSCs. Melatonin also increased mRNAexpression of Nrf2, Trx2, NNT, Sirtuin 3 (Sirt3), and decreased mRNA expression of Txnip, and increased proteinexpressions of Nrf2, Trx2, NNT thereby increasing activity of the mitochondrial thioredoxin system. In addition, melatoninincreased ATP levels.Conclusion: Melatonin increased Trx2 expression through the Nrf2 pathway. This study suggests that melatonin mayprotect SSCs from oxidative stress in diseases related to infertility

The Impact of Hearing Protection Devices (HPDs) on Blood Pressure in Workers Exposed to Noise: A Cross-sectional Study in a Textile Industry

Many studies have reported that exposure to workplace noise leads to increase in blood pressure. The aim of this study was to investigate the effect of hearing protection devices (HPDs) including ear plug and ear muff on the systolic and diastolic blood pressures of workers exposed to workplace noise in a textile industry. A total of 120 male workers that exposed to 95 dB noise were investigated in this study. The systolic and diastolic blood pressures of the workers were measured for three situations of earplug, earmuff and earplug along earmuff applications. Data analyses were conducted through SPSS software (version 20) and statistical tests of ANOVA and Independent Sample Tests. The comparison of mean blood pressure in three situations showed that using ear muff had a significant effect on the systolic and diastolic blood pressures in the workers. Furthermore, the use of ear plug only had an effect on the systolic blood pressure. But, the application of ear muff caused to decrease in the systolic and diastolic blood pressures only in the third stage of the study. With regard to the results in this study, in order to control the blood pressure changes of the workers, it is recommended to use ear muff in the textile industry