Epidemiological characteristics of human brucellosis in Shahin Dezh, Western Azarbaijan, Iran, 2008-2012

Background: Brucellosis is still one of the most challenging issues for health and the economy in many developing countries such as Iran. Objectives: This study investigated the epidemiological features of brucellosis in Shahin Dezh, Western Azarbaijan province, North West of Iran. Patients and Methods: This study had across-sectional design and data was collected from private and public sectors over a five-year period (2008-2012). All cases were studied between years 2008 and 2012 in Shahin Dezh. Results: In total, 492 cases of brucellosis were reported. The prevalence of brucellosis decreased from 152 cases/100000 inhabitants in 2008 to 97 cases/100000 inhabitants at the beginning of 2012. About 52.3 of subjects were male, and most cases of brucellosis were aged 25-30 years. Eighty-one percent of subjects lived in rural areas. There was a statistically significant difference regarding contact with livestock between rural and urban areas (91.7 vs. 68.8) (P value <0.001). Raw milk was the most commonly consumed dairy product; consumed by 37 of cases. Finally, during winter and spring a high prevalence rate of brucellosis was reported. Conclusions: Comprehensive health-related interventions need to empower communities at risk, especially young men and young and adult women in the Shahin Dezh County. Health education is needed to raise awareness of people in the studied area. © 2015, Infectious Diseases and Tropical Medicine Research Center

Helicobacter pylori infection appears essential for stomach carcinogenesis: Observations in Semarang, Indonesia

The gastric cancer incidence in Semarang, Indonesia, is exceedingly low: only approximately 1/100th of the level in Japan. To elucidate the reason, we carried out an ecological study recruiting 69 male and 102 female participants from the general populace in January 2005. Positive urea breath tests were 0% for both men and women, and Helicobacter pylori (H. pylori) IgG antibodies were found in 2% (0–5, 95% confidence interval) of men and 2% (0–4) of women, significantly lower than the 62% (58–65) and 57% (53–60), respectively, in Japan. Furthermore, there were no positive findings with the pepsinogen tests in Semarang, again significant in comparison with the 23% (22–25) and 22% (20–23) in Japan. Variation in smoking levels and consumption of NaCl, vegetables and fruit were found, but not to an extent that would allow explanation of the major differences in gastric cancer incidence. We may conclude that the very low prevalence of H. pylori infection and thus chronic atrophic gastritis account for the rarity of stomach cancer in Semarang, Indonesia. (Cancer Sci 2005; 96: 873–875

The effect of triphala lavender tablets on the treatment of children with attention deficit/hyperactivity disorder

Background: Attention deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder in the children. The purpose of this study was to evaluate the efficacy of Triphala Lavender tablets as an adjuvant therapy along with methylphenidate on the treatment of children with attention deficit/hyperactivity disorder. Methods: In this clinical trial study that was done in Isfahan Province, Iran, in 2016, 44 children with attention deficit/hyperactivity disorder were enrolled according to inclusion (aged between 6 to 12 years) and exclusion (failure to follow up) criteria. The patients were randomly divided into two group as intervention (treated with methylphenidate and Triphala lavender tablets) and placebo (treated with methylphenidate and placebo). Patients were treated for 8 weeks. The assessment tool was Attention Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV), which was used at the onset, and 2, 4, and 8 weeks after the intervention. Findings: The ADHD-RS-IV scores significantly decreased in both groups after intervention (P &lt; 0.001 for both). In addition, the ADHD-RS-IV in the intervention group was significantly lower than placebo group at the 4th week after the intervention (P = 0.042); but there was no significant difference between the two groups in ADHD-RS-IV at onset, and 2 and 8 weeks after the intervention (P &gt; 0.050 for all). Conclusion: The use of Triphala Lavender tablets as an adjuvant therapy may be effective in patients with attention deficit/hyperactivity disorder, but due to limited study about the role of Triphala Lavender tablets in treatment of these patients, we need future studies with larger sample sizes and longer time. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved

Predicting complicated appendicitis based on clinical findings: the role of Alvarado and appendicitis inflammatory response scores

PURPOSE: The pre-interventional differentiation between complicated and uncomplicated appendicitis is decisive for treatment. In the context of conservative therapy, the definitive diagnosis of uncomplicated appendicitis is mandatory. This study investigates the ability of clinical scoring systems and imaging to differentiate between the two entities. METHODS: This is a retrospective analysis of two cohorts from two tertiary referral centers in Switzerland and Germany. All consecutive patients underwent appendectomy between January 2008 and April 2013 (in the first cohort) or between January 2017 and June 2019 (the second cohort). Exclusion criteria did not apply as all patients found by the database search and received an appendectomy were included. Diagnostic testing and calculation of a receiver operating curve were performed to identify a cutoff for clinical scores that resulted in a minimum sensitivity of 90% to detect complicated appendicitis. The cutoff was combined with additional diagnostic imaging criteria to see if diagnostic properties could be improved. RESULTS: Nine hundred fifty-six patients were included in the analysis. Two hundred twenty patients (23%) had complicated appendicitis, and 736 patients (77%) had uncomplicated appendicitis or no inflammation. The complicated appendicitis cohort had a mean Alvarado score of 7.03 and a mean AIR of 5.21. This compared to a mean Alvarado of 6.53 and a mean AIR of 4.07 for the uncomplicated appendicitis cohort. The highest Alvarado score with a sensitivity of > 90% to detect complicated appendicitis was >== 5 (sensitivity = 95%, specificity 8.99%). The highest AIR score with a sensitivity of > 90% to detect complicated appendicitis was >== 3 (sensitivity 91.82%, specificity 18.53). The analysis showed that additional CT information did not improve the sensitivity of the proposed cut-offs. CONCLUSION: AIR and Alvarado scores showed limited capability to distinguish between complicated and uncomplicated appendicitis even with additional imaging in this retrospective cohort. As conservative management of appendicitis needs to exclude patients with complicated disease reliably, appendectomy seems until now to remain the safest option to prevent undertreatment of this mostly benign disease

Design and psychometric evaluation of epilepsy-related apathy scale (E-RAS) in adults with epilepsy: a sequential exploratory mixed methods design

Background: Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient�s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy�related apathy scale (E-RAS) in adults with epilepsy. Methods: This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200), convergent and divergent Validity and reliability (internal consistency and stability) were investigated. Results: The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach�s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001). Conclusion: E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients. © 2021, The Author(s)

Imaging findings of multisystem inflammatory syndrome in children associated with COVID-19

[Background] A hyperinflammatory immune-mediated shock syndrome has been recognised in children exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19).[Objective] To describe typical imaging findings in children with multisystem inflammatory syndrome associated with COVID-19.[Materials and methods] During the first wave of the COVID-19 pandemic, imaging studies and clinical data from children treated for multisystem inflammatory syndrome were collected from multiple centres. Standardised case templates including demographic, biochemical and imaging information were completed by participating centres and reviewed by paediatric radiologists and paediatricians.[Results] We included 37 children (21 boys; median age 8.0 years). Polymerase chain reaction (PCR) testing was positive for SARS-CoV-2 in 15/37 (41%) children and immunoglobulins in 13/19 children (68%). Common clinical presentations were fever (100%), abdominal pain (68%), rash (54%), conjunctivitis (38%) and cough (32%). Thirty-three children (89%) showed laboratory or imaging findings of cardiac involvement. Thirty of the 37 children (81%) required admission to the intensive care unit, with good recovery in all cases. Chest radiographs demonstrated cardiomegaly in 54% and signs of pulmonary venous hypertension/congestion in 73%. The most common chest CT abnormalities were ground-glass and interstitial opacities (83%), airspace consolidation (58%), pleural effusion (58%) and bronchial wall thickening (42%). Echocardiography revealed impaired cardiac function in half of cases (51%) and coronary artery abnormalities in 14%. Cardiac MRI showed myocardial oedema in 58%, pericardial effusion in 42% and decreased left ventricular function in 25%. Twenty children required imaging for abdominal symptoms, the commonest abnormalities being free fluid (71%) and terminal ileum wall thickening (57%). Twelve children underwent brain imaging, showing abnormalities in two cases.[Conclusion] Children with multisystem inflammatory syndrome showed pulmonary, cardiac, abdominal and brain imaging findings, reflecting the multisystem inflammatory disease. Awareness of the imaging features of this disease is important for early diagnosis and treatment.Peer reviewe

The Association between Carbohydrate Intake and Periodontal Health in the Elderly

Background and Objective: Periodontal disease is one of the most common chronic oral diseases worldwide. A variety of foods may affect periodontal health. Due to the importance of periodontal health in the old age, this study was designed to investigate the association between carbohydrate intake and periodontal health in the elderly in Amirkola, northern Iran. Methods: This cross-sectional study is part of the second phase of the Amirkola Health and Ageing Project (AHAP). The evaluated participants included 400 elderly people (200 men and 200 women). Socio-demographic data of all subjects were recorded in the information form. Periodontal status, including plaque index (PI), periodontal disease index (PDI) and Oral Hygiene Index (OHI) were evaluated. Then, the Semi-Quantitative Food Frequency Questionnaire (SQFFQ) was completed in order to receive daily carbohydrates in grams per day for all Participants. Then, the relationship between carbohydrate intake and periodontal health was evaluated. Findings: The participants consumed an average of 316±102.4 gr/day carbohydrates. The mean range of PI, OHI, PDI and in the high carbohydrate intake (>300 gr) group were 2.18±1.39, 2.84±1.51 and 1.51±0.86, respectively, and this rate was lower than the group with low carbohydrate intake (<300 gr) (1.96±1.52, 2.56±1.53 and 1.37±0.91), but the difference between the two groups was not significant. Conclusion: In the present study, there was no relationship between periodontal health indices and carbohydrate intake

Health-care access and utilization among individuals with low back pain in Iran: a WHO-ILAR COPCORD study

Background: Low back pain (LBP) is a major contributor to chronic pain and disability. The purpose of this study was to evaluate health-care access and utilization among patients with LBP in Iran. We also sought to study the pattern and characteristics of care-utilization behavior in these patients. Methods: Data from the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) were used for this study. Three cities (Zahedan, Sanandaj, Yazd) were selected to represent the Iranian population, with different socioeconomic status and ethnic, cultural, and religious background. Demographic data, acute or chronic LBP, disability index, and utilizing care from conventional medicine (CM), allied health providers (AHP), and complementary and alternative medicine (CAM) providers were recorded. Results: Of 9101 patients, 38.6 reported LBP. Only 3.3 did not utilize care of any kind, 66.7 referred to CM providers, 20.8 to AHP, and 9.2 to CAM care. Health-care utilization was higher in female patients, older age, higher education, and higher disability index. Conclusions: The findings of this study indicate a high rate of health-care utilization among patients with LBP in Iran. CM is the most prevalent health-care resource sought by patients. These findings could be used as a framework in developing more efficient health-care programs according to the needs of specific populations. © 2020 The Author(s)

DNA index determination with Automated Cellular Imaging System (ACIS) in Barrett's esophagus: Comparison with CAS 200

BACKGROUND: For solid tumors, image cytometry has been shown to be more sensitive for diagnosing DNA content abnormalities (aneuploidy) than flow cytometry. Image cytometry has often been performed using the semi-automated CAS 200 system. Recently, an Automated Cellular Imaging System (ACIS) was introduced to determine DNA content (DNA index), but it has not been validated. METHODS: Using the CAS 200 system and ACIS, we compared the DNA index (DI) obtained from the same archived formalin-fixed and paraffin embedded tissue samples from Barrett's esophagus related lesions, including samples with specialized intestinal metaplasia without dysplasia, low-grade dysplasia, high-grade dysplasia and adenocarcinoma. RESULTS: Although there was a very good correlation between the DI values determined by ACIS and CAS 200, the former was 25% more sensitive in detecting aneuploidy. ACIS yielded a mean DI value 18% higher than that obtained by CAS 200 (p < 0.001; paired t test). In addition, the average time required to perform a DNA ploidy analysis was shorter with the ACIS (30–40 min) than with the CAS 200 (40–70 min). Results obtained by ACIS gave excellent inter-and intra-observer variability (coefficient of correlation >0.9 for both, p < 0.0001). CONCLUSION: Compared with the CAS 200, the ACIS is a more sensitive and less time consuming technique for determining DNA ploidy. Results obtained by ACIS are also highly reproducible

Effect of yoghurt containing Bifidobacterium lactis Bb12® on faecal excretion of secretory immunoglobulin A and human beta-defensin 2 in healthy adult volunteers

<p>Abstract</p> <p>Background</p> <p>Probiotics are used to provide health benefits. The present study tested the effect of a probiotic yoghurt on faecal output of beta-defensin and immunoglobulin A in a group of young healthy women eating a defined diet.</p> <p>Findings</p> <p>26 women aged 18-21 (median 19) years residing in a hostel were given 200 ml normal yoghurt every day for a week, followed by probiotic yoghurt containing <it>Bifidobacterium lactis </it>Bb12^®(10⁹in 200 ml) for three weeks, followed again by normal yoghurt for four weeks. Stool samples were collected at 0, 4 and 8 weeks and assayed for immunoglobulin A and human beta-defensin-2 by ELISA. All participants tolerated both normal and probiotic yoghurt well. Human beta-defensin-2 levels in faeces were not altered during the course of the study. On the other hand, compared to the basal sample, faecal IgA increased during probiotic feeding (P = 0.0184) and returned to normal after cessation of probiotic yoghurt intake.</p> <p>Conclusions</p> <p><it>Bifidobacterium lactis </it>Bb12^®increased secretory IgA output in faeces. This property may explain the ability of probiotics to prevent gastrointestinal and lower respiratory tract infections.</p