Antiretroviral drug resistance mutations in naïve and experienced patients in Shiraz, Iran, 2014

Resistance to antiretroviral agents is a significant concern in the clinical management of HIV-infected individuals, particularly in areas of the world where treatment options are limited. In this study, we aimed to identify HIV drug-resistance-associated mutations in 40 drug-naïve patients and 62 patients under antiretroviral therapy (ART) referred to the Shiraz HIV/AIDS Research Center – the first such data available for the south of Iran. HIV reverse transcriptase and protease genes were amplified and sequenced to determine subtypes and antiretroviral- resistance-associated mutations (RAMs). Subtype CRF35-AD recombinant was the most prevalent in all patients (98 of 102, 96 % ), followed by subtype A1, and subtype B (one each, 2 % ). Among the 40 ART-naïve patients, two mutations associated with nucleoside reverse transcriptase inhibitor (NRTI) resistance (two with Y115F and T215I) and three associated with non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance (two with G190S and Y181C, four with V179T) were found. Among ART-experienced patients, four mutations associated with resistance to NRTI, four with NNRTI, and five with protease inhibitors (PI) were found. Twenty patients with high levels of resistance were already on second-line therapy. We document for the first time in this region of Iran high levels of ART resistance to multiple drugs. Our findings call for more vigilant systematic ART resistance surveillance, increased resistance testing, careful management of patients with existing regimens, and strong advocacy for expansion of available drugs in Iran. © 2016, Springer-Verlag Wien

Prevalence of gestational diabetes mellitus in Rafsanjan: A comparison of different criteria

Background: Gestational diabetes mellitus (GDM) is common during pregnancy. This survey was designed based on the frequency of GDM among an urban population according to the American Diabetes Association (ADA) and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Methods: We included all pregnant women who were admitted to a gynecology clinic from September 2012 until May 2013. The fasting blood sugar (FBS) was measured. Those having FBS� 126 mg/dl were excluded from the study. All women underwent a standard OGTT (oral glucose tolerance test) by ingesting 75g of glucose in the 24th to 32nd week of their pregnancy. Results: Two hundred ninety pregnant women with a mean±SD age of 27.72±5.091 years were included in the study. The mean±SD FBS, blood glucose one hour and two hours after ingesting 75g of glucose were 82.48±9.41, 146.86±34.22 and 114.21±27.79 mg/ dl, respectively. Based on the criteria of the ADA, 9.3 (n= 27) of the admitted patients suffered from GDM. For the IADPSG and the WHO, those numbers were 31 (n= 90) and 15.2 (n= 44), respectively. Conclusion: The prevalence of GDM was 1.5-times and 3 times higher when the IADPSG based data were compared to those of the WHO or the ADA

First record of Limnodrilus claparedeianus ratzel, 1868 (Annelida: Oligochaeta: tubificidae) from Anzali wetland, Guilan Province, Iran

Oligochaeta worms are important organisms in aquatic ecosystem. Their omnipresence makes them as an indicator of environmental changes and health of aquatic ecosystem. The members of the family Tubificidae and in particular, genus Limnodrilus are considered as the most tolerant oligochaets to aquatic pollution. Therefore identification and biological characteristics of this taxon are of great help to evaluate the ecosystem of water bodies. Limnodrilus claparedeianus were collected from Anzali Wetland with a grab of 0.04 m2 capacity at 13 stations from August 2012 through June 2013. Penis sheath was one of the main characteristics to identify them. Results showed their maximum and the minimum density in spring (601.27 ± 466.8346 Ind.m-2) and in autumn (156.12 ± 136.3 Ind.m-2) respectively which was significantly different (P<0.05). Comparative spatial distribution of L. claparedeianus among 13 stations revealed significant differences in the west stations (P<0.05). According to the results, correlation analysis did not exhibit any relation between abundance of L. claparedeianus and total organic matter, abundance of the species and percentage of silt in substrate sediment

Immunologic factors in patients with chronic polypoid sinusitis

Nasal polyposis is the benign protrusion of soft tissue into the nasal cavity, with multifactorial origin. This study is designed to examine the suggested role of IgE and CD4 and CD8 lymphocytes in the pathogenesis of nasal polyposis. Blood samples were taken from 32 patients with chronic polypoid sinusitis and 32 controls. CD4 and CD8 total lymphocyte count were determined by flow cytometry and the level of serum IgE was measured by ELISA. Nasal discharge samples were also collected for determining IgE level in both patients and controls during surgery. In 68.8% of patients a history of allergy was present. The level of nasal discharge IgE was significantly higher (p 0.05). CD8 concentration and blood lymphocytes were significantly higher (

Aphthous ulcer and the effective factors on it's incidence among the students of Golestan Medical Sciences University in the north of Iran

The aim of this study was to determine the prevalence and probable predisposing factors of Aphthous ulcer among the medical students. This project was a cross-sectional and descriptive study, which was carried out on 485 students of Golestan University of medical sciences in the north of Iran. Data was collected by filling the questionnaire. The gathered informations entered into SPSS software and were analyzed by Chi square method. The mean age of the students was 21.8 years. 36.9% (179 persons) of subjects had positive history and 8.9% (43 persons) of them had present Aphthous ulcer at the time of interview. 70.6% of students with positive personal history of Aphthous ulcer had positive family history of Aphthous ulcer too. Internal labial mucosa was the commonest site of the lesion among the subjects with present Aphthous ulcer. We found that gender, positive family history, the field of study, the form of diet and stress had a major correlation with the incidence of Aphthous ulcer. © 2007 Asian Network for Scientific Information

Evaluation of near final height in boys with constitutional delay in growth and puberty

Background: This study was conducted to find out whether boys with constitutional delay in growth and puberty (CDGP) could attain their target height and predicted adult height (PAH) in adulthood or not. Methods: After measuring the height, weight, pubertal stage, parental height and bone age data of the patients at their first presentation were extracted from the files and their height and weight were measured at the end of the study, wrist X-Ray was performed in order to determine the bone age. PAH was calculated using Bayley-Pinneau method and target height was estimated by mid parental height. Final or near final heights of the patients were measured and compared with the target height and PAH. Results: The mean age at presentation and the end of study was 15.2 ± 0.95, 20 ± 0.75 years respectively. Mean of bone age at the beginning of study was 12.97 ± 1 years and at the end of study were 17.6 ± 0.58 years. Mean of delayed bone age was 2.2 ± 0.82 years. Mean of the primary measured heights was 150.16 ± 7 cm (138-160 cm). Mean of final or near final heights was 165.7 ± 2.89 cm (161-170.5 cm). Final or near final heights in our subjects were smaller than either their PAH (165.7 ± 2.89 vs 170.7 ± 5.17) (P value <0.005) or target height (165.7 ± 2.89 vs 171.8 ± 4.65) (P value <0.0001). Conclusion: Most patients with CDGP do not reach their target height or predicted adult height; they are usually shorter than their parents and general population. Such patients need to be followed up until they reach their final height and, in some cases, adjunctive medical treatment might be indicated. © 2018 The authors

Prediction of neonatal deaths in NICUs: development and validation of machine learning models

Background: Prediction of neonatal deaths in NICUs is important for benchmarking and evaluating healthcare services in NICUs. Application of machine learning techniques can improve physicians� ability to predict the neonatal deaths. The aim of this study was to present a neonatal death risk prediction model using machine learning techniques. Methods: This study was conducted in Tehran, Iran in two phases. Initially, important risk factors in neonatal death were identified and then several machine learning models including Artificial Neural Network (ANN), decision tree (Random Forest (RF), C5.0 and CHART tree), Support Vector Machine (SVM), Bayesian Network and Ensemble models were developed. Finally, we prospectively applied these models to predict neonatal death in a NICU and followed up the neonates to compare the outcomes of these neonates with real outcomes. Results: 17 factors were considered important in neonatal mortality prediction. The highest Area Under the Curve (AUC) was achieved for the SVM and Ensemble models with 0.98. The best precision and specificity were 0.98 and 0.94, respectively for the RF model. The highest accuracy, sensitivity and F-score were achieved for the SVM model with 0.94, 0.95 and 0.96, respectively. The best performance of models in prospective evaluation was for the ANN, C5.0 and CHAID tree models. Conclusion: Using the developed machine learning models can help physicians predict the neonatal deaths in NICUs. © 2021, The Author(s)

Incidence, prevalence, and mortality rate of gastrointestinal cancer in Isfahan, Iran: Application of the MIAMOD method

Gastrointestinal cancers remain the most prevalent cancers in many developing countries such as Iran. The aim of this study was to estimate incidence, prevalence and mortality, as well as time trends for gastrointestinal cancers in Isfahan province of Iran for the period 2001 to 2010 and to project these estimates to the year 2020. Estimates were driven by applying the MIAMOD method (a backward calculation approach using mortality and relative survival rates). Mortality data were obtained from the Ministry of Health and the relative survival rate for all gastrointestinal cancers combined was derived from the Eurocare 3 study. Results indicated that there were clear upward trends in age adjusted incidence (males 22.9 to 74.2 and females 14.9 to 44.2), prevalence (males 52.6 to 177.7 and females 38.3 to 111.03), and mortality (males 14.6 to 47.2 and females 9.6 to 28.2) rates per 100,000 for the period of 2001 to 2010 and this upward state would persist for the projected period. For the entire period, the male to female ratio increased slightly for all parameters (incidence rate increased from 1.5 to 1.7, prevalence from 1.4 to 1.6, and mortality from 1.5 to 1.7). In males, totals of 2,179 incident cases, 5,097 prevalent cases and 1,398 mortality cases were predicated to occur during the study period. For females the predicted figures were 1,379, 3,190 and 891, respectively. It was concluded that the upward trend of incidence alongside increase in survival rates would induce a high burden on the health care infrastructure in the province of Isfahan in the future. © 2016, Asian Pacific Journal of Cancer Prevention

Burden of spinal cord injury in Tehran, Iran

Study Design:Investigation of burden of traumatic spinal cord injury (SCI) using disease modeling. Objectives:The present paper is intended to estimate the SCI burden for the year 2008. Setting:Tehran, capital of Iran. Methods:Epidemiological data needed to calculate Disability-Adjusted Life-Years (DALYs) for SCI, was estimated according to prevalence, duration and relative risk of mortality using DISMOD software. For DALY calculation, the years of life lost because of premature mortality (YLL) was added to the number of years lost because of disability (YLD). To calculate DALYs for SCI, first year DALY calculated separately and for the next years, the DALY was assessed for six different clinical presentations of traumatic SCI including quadriplegia, quadriparesis, paraplegia, paraparesis, hemiplegia and hemiparesis. Results:In first year following SCI, the DALY was 3772 years, which has 0.5 DALY per 1000 people and YLL/DALY was 89.3. Following the first year, the DALY was 435 for quadriplegia, 163 for quadriparesis, 868 for paraplegia, 164 for paraparesis, 26 for hemiplegia and 14 for hemiparesis. The total YLL for traumatic SCI was 4077 years and total YLD was 1364 years (total YLL/DALY was 74.9) and total DALY was 5441 years, (M/F=2.0), which has 0.7 DALY per 1000 people in Tehran in 2008.Conclusions:This study showed a high burden for SCI. Identifying the risk factors of SCI, and performing cost-effective preventive interventions for reducing burden of SCI is recommended. © 2010 International Spinal Cord Society All rights reserved

Effect of electromagnetic fields on the creation of scalar particles in a flat Robertson-Walker space-time

The influence of electromagnetic fields on the creation of scalar particles from vacuum in a flat Robertson-Walker space-time is studied. The Klein Gordon equation with varying electric field and constant magnetic one is solved. The Bogoliubov transformation method is applied to calculate the pair creation probability and the number density of created particles. It is shown that the electric field amplifies the creation of scalar particles while the magnetic field minimizes it.Comment: Important modifications, 20 pages, To appear in Eurpean Physical Journal C. arXiv admin note: text overlap with arXiv:1108.033