Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II

<p>Abstract</p> <p>Background</p> <p>The Tehran Lipid and Glucose Study (TLGS) is a long term integrated community-based program for prevention of non-communicable disorders (NCD) by development of a healthy lifestyle and reduction of NCD risk factors. The study begun in 1999, is ongoing, to be continued for at least 20 years. A primary survey was done to collect baseline data in 15005 individuals, over 3 years of age, selected from cohorts of three medical heath centers. A questionnaire for past medical history and data was completed during interviews; blood pressure, pulse rate, and anthropometrical measurements and a limited physical examination were performed and lipid profiles, fasting blood sugar and 2-hours-postload-glucose challenge were measured. A DNA bank was also collected. For those subjects aged over 30 years, Rose questionnaire was completed and an electrocardiogram was taken. Data collected were directly stored in computers as database software- computer assisted system. The aim of this study is to evaluate the feasibility and effectiveness of lifestyle modification in preventing or postponing the development of NCD risk factors and outcomes in the TLGS population.</p> <p>Design and methods</p> <p>In phase II of the TLGS, lifestyle interventions were implemented in 5630 people and 9375 individuals served as controls. Primary, secondary and tertiary interventions were designed based on specific target groups including schoolchildren, housewives, and high-risk persons. Officials of various sectors such as health, education, municipality, police, media, traders and community leaders were actively engaged as decision makers and collaborators. Interventional strategies were based on lifestyle modifications in diet, smoking and physical activity through face-to-face education, leaflets & brochures, school program alterations, training volunteers as health team and treating patients with NCD risk factors. Collection of demographic, clinical and laboratory data will be repeated every 3 years to assess the effects of different interventions in the intervention group as compared to control group.</p> <p>Conclusion</p> <p>This controlled community intervention will test the possibility of preventing or delaying the onset of non-communicable risk factors and disorders in a population in nutrition transition.</p> <p>Trial registration</p> <p>ISRCTN52588395</p

An Integrated and Optimal Joint Scheduling of Energy Resources to Feed Electrical, Thermal and Potable Water Demands in Remote Area

The continuous spread of distributed energy resources (DERs) such as combined heating and power (CHP), diesel generators, boilers and renewable energy sources provide an effective solution to energy related problems to serve the power and heat demands with minimum cost. Moreover, the DERs may play a significant role for supplying power and heat in rural areas, where grid electricity is not available. Also, some dry areas may face water scarcity and salinity problems. So, one important solution is the use of DERs to drive desalination units in order to solve water scarcity and salinity problems. In this study, the optimal scheduling of DERs and reverse osmosis (RO) desalination unit that feed the required electric, thermal and potable water demands are determined. The present paper describes the operation constraints and cost function of components of the system in detail. Operation constraints of generation units as well as feasible region of operation CHP in dual dependency characteristic are taken into account. To confirm the performance of the proposed model the approach is tested on a realistic remote area over a 24-h period. The results show that the economical scheduling of DERs and desalination units can be obtained using proposed methodology by implementing the proposed formulation

Oral isotretinoin for acne, adjusting treatment according to patient's response.

BACKGROUND: Oral isotretinoin is an established effective therapy for acne. No published data is available on the efficacy and side effects of this drug in Iranian patients. PATIENTS AND METHODS: A total of 132 acne patients with a mean age of 22.9 +/- 6.2 years were treated with oral isotretinoin (Roaccutane) and followed-up from 1999 through 2005. Each patient was started with a dose of 0.75 mg/kg per day until all active lesions healed, followed by a maintenance dose of 20 mg/kg per day for one more month. Laboratory tests were done at monthly intervals. Evaluation of clinical response was based on Leeds technique. Patients were followed-up for a mean period of 4.4 years. RESULTS: Most of the patients had severe nodulocystic acne involving both trunk and face. Treatment was continued for 6.6 +/- 2.5 months with a cumulative dose of 111.5 mg/kg +/- 33.9. The mean final improvement rate was 96.7 (95 CI, 84.9 to 108.5). There was no correlation between improvement rate and age, sex, duration of acne, length of treatment, or cumulative dose. Side effects were generally mild and treated conservatively. In the follow-up, period 18.35 experienced relapse after a mean interval of 1.28 years, 9.17 required a second course of isotretinoin, and only one case needed 3 courses of treatment. CONCLUSION: Isotretinoin is an effective and safe treatment for acne in Iranian patients. Starting treatment with a high dose and modifying the length of treatment based on the therapeutic response in each patient, might lead to a rapid and good response rate with minimal side effects

"CLINICORADIOLOGICAL FINDINGS AND TREATMENT OUTCOME IN PATIENTS WITH INTRACRANIAL HYDATID CYST "

Human infection with echinococcus granulosis is a common disease throughout south America, The Mediterranean littoral, The Middle East, Central Asia and East Africa, which usually occur in children and young adults. Formation of avascular cystic lesions in the liver, kidney, pancreas, bones, vitreus and brain can cause protean of signs and symptoms. Intracranial cysts usually present with focal neurological deficit and features of raised intracranial pressure. ‎Primary hydatid disease of the brain is a rare entity but may pose various diagnostic problems. In this study we report the clinicoradiological findings, treatment outcome and some other properties of intracranial hydatid cysts in 24 cases, emphasizing the fact that hydatid cyst should always be suspected in cystic lesions affecting intracranial cavity specially in endemic areas. Sixty five percent of our patients were children and young adults, 85% of whom came from rural areas. We found in contrast to other studies a female predominance (58%). Headache and vomiting were the most common symptoms. All but one of the patients had a solitary lesion in the cerebral hemisphere. In 21/24 (87%), cysts were removed intact. Four patients (three ruptured cysts during surgery and one case with additional cyst in the lung) received mebendazole (800 mg daily). Surgical mortality and postoperative complications were 8.3 and 20.8% respectively