Prevalence of smoking in northwest Iran: a meta-analysis

Background: Tobacco addiction is a major cause of preventable death worldwide. Thus, efforts to eliminate its use have the potential of producing significant health benefits. The purpose of this study was to conduct a meta-analysis to estimate the prevalence of cigarette smoking among people in the age range of 15 to 64. The specific objective of this meta-analysis was to provide valid data that policy makers can use to make evidence-based decisions. Methods: To determine the prevalence of smoking among the adult population in northwest Iran, we used reports published by the surveillance system used to assess the risk factors for non-communicable diseases in different provinces in northwest Iran for the years 2004 and 2006-2009. Several variables were extracted, including the years of study, gender, ages, and smoking prevalence. Based on the heterogeneity of the results, we used fixed or random effects models to estimate the overall prevalence of cigarette smoking. The analyses were performed using Stata 11 software. Results: A total of 28,436 subjects (14,248 males and 14,188 females) in five age groups, i.e., 15-24, 25-34, 35-44, 45-54, and 55-64, were interviewed. Meta-analysis in men showed that, across the age groups, the lowest prevalence was 22.9%, the highest prevalence was 26.5%, and the average prevalence was 24.7%. Among women, the lowest prevalence was 0.3%, the highest prevalence was 0.8%, and the average prevalence was 0.5%. Conclusion: We found that approximately one-fourth of males in the age range of 15-64 in northwest Iran smoked cigarettes daily. Therefore, it is necessary to conduct effective interventions to reduce the prevalence of addiction to tobacco in this area

Effect of spinal anesthesia with sufentanil on length of stages I and II of labor in singleton pregnant women: a randomized controlled trial

Background Labor pain is one of the most painful experiences in a women's life. One of the methods of pain relief is spinal anesthesia. The purpose of this study was to evaluate the effect of spinal anesthesia with sufentanil on the length of the first and second stages of labor in singleton pregnant women. Methods A randomized clinical trial was conducted involving 56 women who had to be at least 37 weeks pregnant with a singleton pregnancy and 20 to 35 years of age, as well as seeking a spontaneous natural delivery. They were randomized into an intervention group (spinal anesthesia with sufentanil) of 28 subjects and a control group (no spinal anesthesia) of 28 subjects. Statistical analysis was performed using SPSS software program 20.0. Results Mean duration of stage I of labor was 152.32 ± 92.01 and 187.68 ± 121.01 minutes in the intervention and control groups, respectively (p=0.34), whereas mean duration of stage II of labor in the 2 groups was 15.96 ± 14.26 and 26.43 ± 20.90 minutes, respectively (p=0.06). Twenty five percent of women in the intervention group and 35.71% of women in the control group experienced a long stage I, whereas 21.43% of women in the intervention group and 35.71% of women in the control group experienced a long stage II (p>0.05). Conclusion This study suggests that spinal anesthesia with sufentanil does not increase the duration of labor stages. It is recommended that more studies be performed in the future using larger sample sizes to allow for the drawing of solid conclusions

Evaluation of Liver Enzymes in Normal Pregnancies in a University Hospital of Zabol Iran: A Cross-Sectional Study

Objective: Changes in endocrine, nervous, renal, cardiovascular, and respiratory systems during pregnancy have been studied, but changes in liver function have been poorly studied. Therefore, the purpose of this study was to investigate the trend of changes in liver enzymes in normal pregnancy. Materials and methods: This prospective longitudinal study included 68 pregnant women who were referred to the Obstetrics and Gynecology Clinic of Amiral Momenin Hospital in Zabol in 2021. In terms of the trimester of pregnancy, the presence of underlying diseases, history of previous pregnancies, disorders of the enzymes of recent patients, the patients were evaluated, and the information from the patients' files was analyzed. Results: The average AST levels in pregnant women in the first, second, and third trimesters were 16.82, 17.47, and 18.00, respectively, which show that garlic consumption is increasing. The average PT in pregnant women decreased in the first, second, and third trimesters. The average direct and total bilirubin levels in pregnant women in the first and second trimesters showed a constant trend. The amount of total protein increased in pregnant women during the first, second, and third trimesters. In the second and third trimesters, the enzyme level was significantly higher in pregnant women than in nonpregnant women. The level of GGT in pregnant women in the first, second, and third trimesters showed a different trend. Conclusion: Accurate evaluation of patients, especially in the third trimester, is necessary from the point of view of increasing enzyme levels in other countries.

Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis

Compared to the adult onset of multiple sclerosis (AOMS), both early-onset (EOMS) and late-onset (LOMS) are much less frequent, but are often under- or misdiagnosed. The aims of the present study were: 1. To compare demographic and clinical features of individuals with EOMS, AOMS and LOMS, and 2. To identify predictors for disability progression from relapsing remitting MS (RRMS) to secondary progressive MS (SPMS).; Data were taken from the Isfahan Hakim MS database. Cases were classified as EOMS (MS onset 18 years), LOMS (MS onset >50 years) and AOMS (MS >18 and 50 years). Patients' demographic and clinical (initial symptoms; course of disease; disease patterns from MRI; disease progress) information were gathered and assessed. Kaplan-Meier and Cox proportional hazard regressions were conducted to determine differences between the three groups in the time lapse in conversion from relapsing remitting MS to secondary progressive MS.; A total of 2627 MS cases were assessed; of these 127 were EOMS, 84 LOMS and 2416 AOMS. The mean age of those with EOMS was 14.5 years; key symptoms were visual impairments, brain stem dysfunction, sensory disturbances and motor dysfunctions. On average, 24.6 years after disease onset, 14.2% with relapsing remitting MS (RRMS) were diagnosed with secondary progressive MS (SPMS). The key predictor variable was a higher Expanded Disability Status Scale (EDSS) score at disease onset. Compared to individuals with AOMS and LOMS, those with EOMS more often had one or two relapses in the first two years, and more often gadolinium-enhancing brain lesions. For individuals with AOMS, mean age was 29.4 years; key symptoms were sensory disturbances, motor dysfunctions and visual impairments. On average, 20.5 years after disease onset, 15.6% with RRMS progressed to SPMS. The key predictors at disease onset were: a higher EDSS score, younger age, a shorter inter-attack interval and spinal lesions. Compared to individuals with EOMS and LOMS, individuals with AOMS more often had either no or three and more relapses in the first two years. For individuals with LOMS, mean age was 53.8 years; key symptoms were motor dysfunctions, sensory disturbances and visual impairments. On average, 14 years after disease onset, 25.3% with RRMS switched to an SPMS. The key predictors at disease onset were: occurrence of spinal lesions and spinal gadolinium-enhancement. Compared to individuals with EOMS and AOMS, individuals with LOMS more often had no relapses in the first two years, and higher EDSS scores at disease onset and at follow-up.; Among a large sample of MS sufferers, cases with early onset and late onset are observable. Individuals with early, adult and late onset MS each display distinct features which should be taken in consideration in their treatment

Opium use and covid-19 infection, a retrospective study in Iran

The situation of Covid-19 patients with opium consumption has not been comprehensively investigated especially in Iran. This study is aimed to investigate the effect of current opium addiction on the severity and outcome of the Covid-19 infection. During a retrospective cohort study, clinical, demographic and all variables related to the severity and death due to the Corona virus infection were collected from the medical records of patients hospitalized from February 2020 to June 2021 in the study area. The role of current addiction in the severity and outcome of the disease was investigated using Cox, logistic and linear regression models. Of 939 confirmed Covid-19 cases admitted during the study period, 70 (7.5%) patients were currently addicted. Multivariate regression models showed that current opium addiction significantly increased the chance of endotracheal intubation (OR=2.96, p=0.005) and reduced the mean length of stay in hospital (beta coefficient =-0.42, p<0.0001). However, opium addiction did not change the risk of death (HR= 1.54, p=0.063) or O2 saturation (OR=1, p>0.99). Opium addiction can be associated with the severity of Covid-19 infection, but does not play a considerable role in the mortality of the patients

Comparing Blood Lead Level among Oral/inhaled Opium Addicts with a Non-addict Control Group in the Southeast of Iran

Background: Opium is widely used among addicts in the Middle East countries such as Iran. Recent reports suggest that opium sellers cheat their customers by adding lead to the opium. Contaminated opium can threaten the health of consumers. This study was designed to evaluate the lead concentration in blood sample of oral and inhaled opium user’s referring to Amir Al-Momenin Hospital in Zabol, Iran, during spring 2015 in comparison with those of control group.Methods: Blood lead level (BLL) of 188 subjects with a mean age of 52.06 years in three categories - including oral opium addicted (55 patients), inhaled opium addicted (55 patients), and healthy control group (n = 78) - was assessed. The BLL of all the subjects was assessed using an atomic absorption spectrophotometer.Findings: Almost all participants consumed “Tariak” (99.09%). Mean ± standard deviation (SD) duration of opium addiction was 13.21 ± 10.26 years. The average blood lead concentration among oral users, inhaled users, and control group were 34.31 ± 21.54, 41.13 ± 26.40, and 9.86 ± 4.40 µg/dl, respectively (P = 0.001).Conclusion: Our study showed significant differences of BLLs between opium users and control group. We also did not find any association between blood lead concentration and method of opium consumption

Clinical and Epidemiological Aspects of Multiple Sclerosis in Children

How to Cite This Article: Nasehi MM, Sahraian MA, Naser Moghaddasi A, Ghofrani M, Ashtari F, Taghdiri MM, Tonekaboni SH, Karimzadeh P, Afshari M, Moosazadeh M. Clinical and Epidemiological Aspects of Multiple Sclerosis in Children. Iran J Child Neurol. Spring 2017; 11(2):37-43.AbstractObjectiveOverall, 2%-5% of patients with multiple sclerosis (MS) experienced the first episode of disease before the age 18 years old. Since the age of onset among children is not similar to that in general population, clinicians often fail to early diagnose the disease. This study aimed to determine the epidemiological and clinical patterns of MS among Iranian children.Materials &amp; Methods In this cross-sectional study carried out in Iran in 2014-2015, information was collected using a checklist with approved reliability and validity. Method sampling was consensus. Data were analyzed using frequency, mean and standard deviation indices by means of SPSS ver. 20 software.Results Totally, 177 MS children were investigated. 75.7% of them were female. Mean (SD), minimum and maximum age of subjects were 15.9 (2), 7 and 18 yr, respectively. The most reported symptoms were sensory (28.2%), motor (29.4%), diplopia (20.3%) and visual (32.8%). Primary MRI results showed 91.5% and 53.1% periventricular and spinal cord lesions, respectively.Conclusion MS is significantly more common among women. The most common age of onset is during the second decades. Sensory and motor problems are the most symptoms, while, periventricular and spinal cord lesions are the most MRI results. References 1. Ascherio A, Munger K. Epidemiology of multiple sclerosis: from risk factors to prevention. Semin Neurol 2008; 28(1): 17-28.2. Abedidni M, Habibi Saravi R, Zarvani A, Farahmand M. Epidemiologic study of multiple sclerosis in Mazandaran,Iran, 2007. J Mazandaran Univ Med Sci 2008; 18(66): 82-6.3. Taghdiri MM, Gofrani M, Barzegar M, Moayyedi A, Tonekaboni H. The survey of 20 cases of multiple sclerosis in children in mofid hospital of Tehran. J Rehabil, 2001; 4(6-7):61-67.4. Benito-Leon J, Martinez P. Health-related quality of life in multiple sclerosis. Neurologia 2003; 18: 207-10.5. Nedjat S, Montazeri A, Mohammad K, Majdzadeh R, Nabavi N, Nedjat F, et al . Quality of Life in Multiple Sclerosis Compared to the Healthy Population in Tehran. Iran J Epidemiol 2006; 2 (3 and 4) :19-24.6. Marrie RA. Environmental risk factors in multiple sclerosis aetiology. Lancet Neurol 2004; 3(12):709-18.7. Milo R, Kahana E. Multiple sclerosis:geoepidemiology, genetics and the environment. Autoimmun Rev 2010; 9(5): A387-A394.8. Banwell B, Ghezzi A, Bar-Or A, Mikaeloff Y. Multiple sclerosis in children: clinical diagnosis, therapeutic strategies, and future directions. The Lancet Neurol, 2007;6(10):887-902.9. Ebers GC. Environmental factors and multiple sclerosis. The Lancet Neurol, 2008;7(3):268-277.10. Noseworthy JH, Lucchinetti C, Rodriguez M, Weinshenker BG. Multiple Sclerosis. N Engl J Med 2000; 343(13):938-52.11. Rudick RA, Cohen JA, Weinstock-Guttman B, Kinkel RP, Ransohoff RM. Management of multiple sclerosis. N Engl J Med 1997: 337(22): 1604-11.12. Greer JM, McCombe PA. Role of gender in multiple sclerosis: clinical effects and potential molecular mechanisms. J Neuroimmunol 2011;234(1-2): 7-18.13. Boiko A, Vorobeychik G, Paty D, Devonshire V, Sadovnick D. Early onset multiple sclerosis A longitudinal study. Neurology 2002; 59(7):1006-1010.14. . Ashtari F, Shaygannejad V, Heidari F, Akbari M. Prevalence of Familial Multiple Sclerosis in Isfahan, Iran. Journal of Isfahan Medical School, 2011;29(138.2):555- 561.15. Mazaheri S, Fazlian M, Hossein Zadeh A. Clinical and Epidemiological Features of Early and Adult Onset Multiple Sclerosis in Hamedan, Iran, 2004–2005. Yafteh 2008; 9 (4) :39-44.16. Saman-Nezhad B, Rezaee T, Bostani A, Najafi F, Aghaei A. Epidemiological Characteristics of Patients with Multiple Sclerosis in Kermanshah, Iran in 2012. J Mazand Univ Med Sci 2013; 23(104): 97-101 (In Persian).17. Renoux C, Vukusic S, Mikaeloff Y, Edan G. Natural history of multiple sclerosis with childhood onset. N Engl J Med 2007. 356(25): p. 2603-2613.18. Ness JM, Chabas D, Sadovnick AD, Pohl D, Banwell B, Weinstock-Guttman B. Clinical features of children and adolescents with multiple sclerosis. Neurology 2007; 68(16 suppl 2):S37-S45.19. Etemadifar M, Janghorbani M,Shaygannejad V, Ashtari F . Prevalence of multiple sclerosis in Isfahan. Iran. Neuroepidemiology 2006; 27(1):39-44 (In Persian).20. Saadatnia M, Etemadifar M, Maghzi AH. Multiple sclerosis in Isfahan, Iran. Int Rev Neurobiol 2007; 79: 357-75.21. Nabavi SM, Poorfarzam S, Ghassemi H. Clinical Course and prognosis of 203 patients with MS in shahid Mostafa Khomeini Hospital, Tehran 2002, Tehran University Medical Journal, 200l 64( 7)6: 90-97

Reactions of Various Cultivars of Almond to Toxin-Producing Aspergillus flavus Isolates

Samples were collected from different regions of two provinces, Markazi and Semnan, their contamination by Aspergillus flavus was examined. The results of A. flavus colony counts in different samples of almond showed that among 20 experimented samples, 11 samples were contaminated by fungus; therefore, 8 cultivars of almond, Shahroud 6, Shahroud 21, Shahroud 12, Shahroud 8, Shahroud 17, Rabie, Mengha, and Sangi Shireen, were collected in order to evaluate their sensitivity to fungal colonization and the sporulation rate of fungus on them. The results of statistical analysis showed that on the third, fifth, and seventh days, Shahroud 12 was the least resistant cultivar [average pollution (99.5%)], whereas Shahroud 6 was the most resistant [average contamination (7.36%)] at a level of 5 % for growth of A. flavus after 7 days. Experiments related to the testa of almond show that the testa can be a barrier against penetration of fungus into the inner part of the almond, decreaseing fungal growth, and thus reducing the weight of mycelium and sporulation in almonds