Health inequalities and development plans in Iran: An analysis of the past three decades (1984–2010)

Introduction: Reducing inequalities in health care is one of the main challenges in all countries. In Iran as in other oil-exporting upper middle income countries, we expected to witness fewer inequalities especially in the health sector with the increase in governmental revenues. Methods: This study presents an inequalities assessment of health care expenditures in Iran. We used data from the Household Income and Expenditure Survey (HIES) in Iran from 1984–2010. The analysis included 308,735 urban and 342,532 rural households. Results: The results suggest heightened inequality in health care expenditures in Iran over the past three decades, including an increase in the gap between urban and rural areas. Furthermore, inflation has affected the poor more than the rich. The Kakwani progressivity index in all years is positive, averaging 0.436 in rural and 0.470 in urban areas during the time period of analysis. Compared to inequality in income distribution over the last 30 years, health expenditures continuously show more inequality and progressivity over the same period of time. Conclusions: According to the result of our study, during this period Iran introduced four National Development Plans (NDPs); however, the NDPs failed to provide sustainable strategies for reducing inequalities in health care expenditures. Policies that protect vulnerable groups should be prioritized

Aflatoxin contamination in wheat flour samples from Golestan province, Northeast of Iran

Background: Due to the high toxicity of aflatoxin and its effects on public health, determination of aflatoxin level in Wheat flour samples in the Golestan province, north of Iran was investigated. To examine the effect of seasonal changes, summer and winter sampling was performed with standard sampling methods. Methods: A total of 200 flour samples were collected from 25 factories. HPLC method with immunoaffinity chromatography was used to measure aflatoxin types (G2, G1, B2 and B1). Statistical analysis was performed by the Pearson correlation test, One-way ANOVA and multivariate regression analysis. Results: Mean total aflatoxin levels of samples were 0.82 and 1.99 ng/g in summer and winter, respectively. Aflatoxin B1 levels were detected in 3.1%, 7.4% over permissible limits by worldwide regulations in samples collected in summer and winter, respectively. Aflatoxins in winter were higher than summer. The highest frequency of aflatoxin contamination in winter was B2 (98%) and in summer G1 (51%). The relationship between humidity and rate of aflatoxin B1 and total aflatoxin was significant in winter. Results of multivariate regression were showed the strongest relationship with humidity and aflatoxin level. Despite the contamination of flour samples, there was no contamination higher than the standard limit of Iran Standard Institute. But it was significantly higher than similar studies from other regions. Conclusions: Therefore, with regard to negative impacts of aflatoxin on health, aflatoxin contamination should be considered in future programs. Decrease of aflatoxin contamination may be made practical through reducing wheat storage duration and controlling humidity

Marked increase in the incidence rate of esophageal adenocarcinoma in a high-risk area for esophageal cancer

BACKGROUND: Esophageal cancer (EC) is the eighth common cancer worldwide. Esophageal squamous cell carcinoma (ESCC) and adenocarcinoma (EAD) are the most common histologic types of EC. Many recent reports showed an increasing trend in EAD and a decreasing trend in ESCC in many Western countries. Golestan Province in northeastern Iran has been known as a high-risk area for EC. The aim of this study was to describe the time trend of EAD in this area between 2000-2009. METHODS: Data on cancer cases were obtained from Golestan Population-based Cancer Registry. Analysis was done using Joinpoint software. To examine the incidence trends, the annual percent change was calculated. The possibilities of anatomic and histologic misclassification were considered by assessing the trend of ESCC and gastric adenocarcinoma. RESULTS: A total number of 1186 histologically-confirmed EC cases were recruited. The incidence rate of EAD showed a significant increasing trend. There was no significant trend in the incidence of ESCC during the study period. A significant increase in the incidence rate of gastric adenocarcinoma was observed during the period of 2000-2005, followed by a plateau during the period of 2005-2009. CONCLUSIONS: We found a significant increasing trend in the incidence rate of EAD. We find no evidence to support an alternative explanation including anatomic and histologic misclassification. So, the observed rise in the incidence of EAD seems to be real. Therefore, designing and implementation of control programs, including control of preventable risk factors of EAD, should be considered in this high- risk area

Determinants of healthcare utilisation and predictors of outcome in colorectal cancer patients from Northern Iran

We aimed to assess healthcare utilisation (HU), its determinants, as well as its relationship with survival in colorectal cancer (CRC) patients. This study was conducted on incident CRC cases from Northern Iran. Information on HU was collected using a valid questionnaire, considering eight diagnostic and four therapeutic services. The results were categorised as good and poor HU. Multivariate logistic regression analysis was used to assess the relationship between HU and other variables. Cox regression analysis was performed to determine major predictors of survival. In total, 227 new cases of CRC were enrolled. HU could be assessed in 218 subjects (96). Living in rural areas was the strongest variable related to poor HU (adjusted OR, odds ratio=2.65; CI, confidence interval: 1.30-5.40). The median survival time was 40.5months. The 1-, 3- and 5-year survival rates were 71, 52 and 44 respectively. Cox regression analysis showed a significant lower survival rate in patients with poor HU (HR=2.3; CI: 1.46-3.64). HU was an independent predictor of survival in our CRC patients. Patients' place of residence was a significant determinant of HU. Regarding its effects on patients' outcome, HU and its determinants should be considered in designing CRC controlling programmes in our region and similar high-risk populations. © 2016 John Wiley & Sons Ltd

Follicular dynamics in neonate vitrified ovarian grafts after host treatment with melatonin

This study evaluates the effect of melatonin on follicular dynamics in neonate vitrified ovarian grafts. Vitrified ovaries from neonate F1 hybrid mice, candidates for transplantation to treated or non-treated groups, were thawed under standard conditions with or without the addition of 100 μM melatonin, respectively. Following transplantation, melatonin (20 mg/kg/day) or saline solution was injected i.p. into the treated and the non-treated groups, respectively. Vaginal cytology to monitor estrogenic activity together with follicle survival and development in the ovary grafts was examined. The results showed that the sites of transplantation became obvious within the oestrous phase. Histological analysis showed that there was a dynamic of the ovogenesis process in the vitrified ovary grafts. However, in the ovary graft the empty cavity together with jumbled oocyte-granulosa complex in the non-treated group was higher than in the melatonin treated group. Overall, the number of primary follicles in the ovary grafts of both groups remained constant throughout the oestrous period. However, the treated ovary grafts contained more secondary follicles throughout the oestrous period in comparison to non-treated ovary grafts. The antral follicle rates were more marked in the melatonin treated group than in the non-treated group during the oestrous period, whereas at other days of the cycle no significant difference was observed. The fresh corpora lutea rates were significantly higher in the treatment group than in the non-treatment group. The study showed that there is a positive effect with melatonin resulting in more grafts restoring puberty. Furthermore, the associated increase in healthy follicles suggests that melatonin has a preventative ischaemia/antioxidant action and may be useful to follicles. (Folia Morphol 2011; 70, 1: 18-23

Generation of pcdna 3.1+-gh as a recombinant expression vector of ostrich growth hormone cdna in saccharomyces cerevisiae

Growth hormone is essential hormone for vertebrates like the ostrich (Struthio camelus) for growth stimulation, carbohydrate metabolism, protein assimilation etc. Growth hormone is secreted by the pituitary gland and expressed in many cells and tissues. The purpose of this study was generation of pcDNA 3.1+-GH recombinant expression vector in order to sub-clone ostrich growth hormone cDNA into Escherichia coli. In brief, total RNA was extracted from the pituitary gland tissue and cDNA sample was synthesised. The cDNA was amplified by PCR and revealed a 672 bp fragment on 2% agarose gel electrophoresis. Then, the ostrich growth hormone cDNA was extracted from the gel and was cloned into pCR8/GW/TOPO vector by T/A cloning technique to produce pCR8/GW/TOPO-GH. After obtaining the sequence of cDNA of the ostrich in Iran, it was submitted in GenBank (Accession number: JN559394). Finally, the GH cDNA was sub-cloned using pcDNA 3.1+ into Saccharomyces cerevisiae and pcDNA 3.1+-GH recombinant expression vector was generated. The results of present study were showed that ostrich growth hormone cDNA was successfully sub-cloned into Saccharomyces cerevisiae. Therefore, the pcDNA 3.1+-GH recombinant expression vector generated in this study could be useful to express the ostrich growth hormone in yeast cells as a simple and affordable way to produce this hormone at a large scale

Uncertainty in the Fluctuations of the Price of Stocks

We report on a study of the Tehran Price Index (TEPIX) from 2001 to 2006 as an emerging market that has been affected by several political crises during the recent years, and analyze the non-Gaussian probability density function (PDF) of the log returns of the stocks' prices. We show that while the average of the index did not fall very much over the time period of the study, its day-to-day fluctuations strongly increased due to the crises. Using an approach based on multiplicative processes with a detrending procedure, we study the scale-dependence of the non-Gaussian PDFs, and show that the temporal dependence of their tails indicates a gradual and systematic increase in the probability of the appearance of large increments in the returns on approaching distinct critical time scales over which the TEPIX has exhibited maximum uncertainty.Comment: 5 pages, 5 figures. Accepted to appear in IJMP

Chewing activity, metabolic profile and performance of high- producing dairy cows fed conventional forages, wheat straw or rice straw

In this study, production and physiological responses of high-producing dairy cows fed wheat (WS) or rice (RS) straw, as a partial forage replacement for the conventional forages lucerne hay (LH) and maize silage (MS ), were investigated. The straws were treated under dry alkaline conditions, adjusted pH (pH ~12), and then ensiled. Twelve lactating Holstein cows were used in a replicated (n = 4) 3 × 3 Latin square design experiment with three periods of 21 days. Cows were offered one of three diets that differed in their forage sources: 1) 20% LH and 20% MS (control); 2) 12.8% LH, 12.8% MS; and 12.8% WS; and 3) 12.8% LH, 12.8% MS and 12.8% RS. Diet 1 had 60% concentrate, and diets 2 and 3 had 61.6% concentrate. Diets were iso-nitrogenous and iso-energetic. Supplemental buffer (NaHCO3) was omitted from the straw diets. However, straw diets contained greater sodium and dietary cation-anion difference (DCAD) compared with the control diet. Cows fed the WS had significantly greater apparent dry matter (DM) (69.7 versus 63.9%) and neutral detergent fibre (NDF) (55.4 versus 42.4%) digestibility than cows fed the control. Additionally, feeding either WS or RS significantly increased dry matter intake (DMI) (27.5 versus 25.6 kg/d ) and milk production (48.4 versus 45.6 kg/d) compared with control, but milk components were unaffected by treatments. Plasma minerals and metabolites concentrations and ruminal, urinary and faecal pH were similar across treatments. Feeding WS and RS resulted in lower time spent chewing per kg DMI compared with the control ( P = 0.01 ). Although there were no significant differences in performance between WS and RS, nutrient digestibility (DM, OM, and CP) was significantly higher while total chewing was lower for the WS diet than the RS diet. Partial inclusion of dry treated straw in lactating diets (12.8% DM basis) led to increases in sodium and DCAD levels and improved digestibility, DMI and milk yield without negative effects. Keywords: Cation and anion difference, cereal straw dietary sodium, lactating [email protected]