فهرست مطالب

Archives of Iranian Medicine - Volume:23 Issue: 13, 2020
  • Volume:23 Issue: 13, 2020
  • تاریخ انتشار: 1398/10/19
  • تعداد عناوین: 10
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  • Marzieh Araghi, Gholamreza Roshandel*, Susan Hasanpour Heidari, Abdolreza Fazel, Seyed Mehdi Sedaghat, Amirhoushang Pourkhani, Vahideh Kazeminejhad, Adalberto Miranda Filho, Freddie Bray, Melina Arnold Pages 1-6
    Background

    Brain and other central nervous system (CNS) tumors represent almost 3% of all new cancer cases worldwide and comprise a heterogeneous group of tumors with varying epidemiologic and clinical characteristics. The aim of this study is to present the distribution and trends in brain and other CNS cancer incidence in Golestan, Iran during a 10-year period.

    Methods

    Data on primary brain and other CNS cancers diagnosed between 2004 and 2013 were obtained from the Golestan population-based cancer registry (GPCR) dataset. We computed age-standardized incidence rates (ASRs) per 100 000 personyears. In order to assess changes in incidence over time, we calculated the estimated annual percentage change (EAPC) and corresponding 95% confidence intervals (CIs) to detect significant trends.

    Results

    Over the 10-year period (2004-2013), the incidence of brain and other CNS cancer was observed to increase for all ages (EAPC: 1.13, 95% CI: -6.06, 8.87). After 2008, the trends appear to have stabilized. Incidence rates were higher in males than females (ratio: 1.2) and glioblastoma was the most common tumor subtype (15.1% of all malignant tumors).

    Conclusion

    Trends and patterns in the burden of brain and other CNS cancer require careful monitoring alongside future research to increase our understanding of potential risk factors.

    Keywords: Brain tumors, Central nervous system tumors, Epidemiology, Incidence rates
  • Sara Kadkhodaei, Farideh Siavoshi*, Alireza Foroumadi, Abdolfattah Sarrafnejad, Shadi Kolahdoozan Pages 7-14
    Background

    Proton pump inhibitors (PPIs) with lipophilic nature may interact with lipid components of H. pylori cell membrane, disrupting cell structure and viability. In this study, the effect of PPIs on fatty acid and cholesterol components of H. pylori cell membrane was assessed.

    Methods

    One H. pylori isolate was treated with 1X and 2X MICs (μg/mL) of lansoprazole (LPZ: 8 and 16) and pantoprazole (PAN: 128 and 256) in brain heart infusion broth plus serum. Treated H. pylori was cultured on brucella blood agar (BBA) and tetrazolium egg yolk agar (TEYA). Bacterial cells stained with Live/Dead kit were examined by fluorescent microscopy. Fatty acid and cholesterol contents of treated H. pylori were measured by gas chromatography.

    Results

    PPI-treated H. pylori did not grow on BBA but grew on TEYA. Fluorescent microscopy showed H. pylori stained red. Analyses showed high frequency of saturated fatty acids, C14:0, C16:0 and C18:0. Among unsaturated fatty acids, C18:1 and C18:2c were increased, while five were eliminated and five were synthesized de novo. Cholesteryl-6-O-tetradecanoyl-α-D- glucopyranoside was detected as the only glycosylated cholesterol in treated H. pylori. Growth of PPI-treated H. pylori on cholesterol-rich TEYA showed that occurrence of cholesterol can reverse the growth inhibition by PPIs. Red- bacilli form of H. pylori showed dye entry through damaged cell membrane without lysis.

    Conclusion

    Incorporation of lipophilic PPI into H. pylori cell membrane disrupted lipids and inhibited growth. However, H. pylori adjusted the defected membrane by replacing the lipid components and resisted lysis.

    Keywords: Cell membrane, Cholesterol, Fatty Acids, Helicobacter pylori, Proton pump inhibitors
  • Mahboubeh Bayat, Azad Shokri, Elmira Mirbahaeddin, Roghayeh Khalilnezhad, Seyed Reza Khatibi, Hamed Fattahi, Gholamhossein Salehi Zalani, Faeze Ghasemi Seproo, Mahmoud Khodadost* Pages 15-22
    Background

    Estimation of health workforce supply becomes problematic when there is no knowledge about the number of active specialists. The aim of this study is to estimate active specialists and their geographic accessibility in Iran.

    Methods

    We enrolled all medical specialists from the Iranian Ministry of Health database (14 151), national hospitals survey (28 898) and Continuing Medical Education registries (13 159) in 2015. Duplicate records across the three registries were identified based on the similarity of national ID codes and medical council codes. The number of active medical specialists was estimated by three-source capture-recapture method using Stata 12 software.

    Results

    A total of 33,416 specialists were identified from three sources. We estimated the number of specialists at 39 127 (95% CI: 38823.6-39448.4) in 2015. Of these, 45.4% pertained to the province of Tehran while only less than 1.8% of specialists were in the provinces of Ilam (0.50%), South Khorasan (0.56%) and Kohgiloye and Boyerahmad (0.59%). The estimated ratio for specialists was 4.9 per 10 000 population and ranged from 9.2 per 10 000 in Tehran to 1.5 per 10 000 population in Sistan and Balochestan. The overall completeness of data registries by three sources was 85.4%.

    Conclusion

    The current distribution of specialists appears to be imbalanced. It is suggested to adopt appropriate policies to improve the distribution and maintenance of medical specialists in different parts of Iran.

    Keywords: Iran, Medical geography, Workforce
  • Mohsen Tabasi *, Taha Anbara, Seyed Davar Siadat, Jamil Kheirvari Khezerloo, Fezzeh Elyasinia, Saeed Bayanolhagh, Seyed Abbas Sadat Safavi, Mohammad Reza Yazdannasab, Ahmadreza Soroush, Saeid Bouzari Pages 23-30
    Background

    Eating disorders (EDs) are widely known by abnormal eating behaviors associated with significant medical complications. Bulimia nervosa (BN) is an eating disorder characterized by uncontrolled episodes of overeating typically followed by some form of compensatory behaviors. We aimed to determine the relationships between socio-demographic characteristics, biochemical markers, and cytokine levels in BN candidates for laparoscopic sleeve gastrectomy (LSG).

    Methods

    A case-control study was designed among 76 BN participants of Iranian descent who were candidates for LSG based on defined criteria for Bulimia by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The healthy control subjects (n = 42) were selected at random from academic staff in the college. Moreover, levels of biochemical parameters and serum cytokines were measured in serum samples.

    Results

    Routine consumption of caffeine (odds ratio [OR] = 3.1, 95% CI: 1.23–6.41, P = 0.013), tobacco (OR = 1.8, 95% CI: 0.67–3.57, P = 0.03), and alcohol (OR = 3.6, 95% CI: 0.84–7.18, P = 0.048), and depression history (OR = 2.8, 95% CI: 0.76– 5.79, P = 0.037) were substantially more common among patients with bulimia. Also, the serum levels of fasting blood sugar (P < 0.001), HbA1c (P = 0.04), cholesterol (P = 0.03), triglycerides (P = 0.01), blood urea nitrogen (P = 0.03), and pro-inflammatory cytokines including IL-1β, IL-6, and TNF-α were significantly higher in BN candidates for LSG (P ≤ 0.001).

    Conclusion

    Our findings reveal that lifestyle-related risk factors and a depression history were both related with a significantly increased risk of BN among the candidates for LSG. Furthermore, there is a relationship between clinical characteristics as well as levels of various biochemical and cytokines parameters in serum of BN patients.

    Keywords: Biological markers, Bulimia nervosa, Cytokines, Eating disorders, Gastrectomy
  • Mohammad Reza Edraki, Hamid Mohammadi*, Nima Mehdizadegan, Mojtaba Ghorashi, Hamid Amoozgar, Mohammad Borzouee, Gholamhossein Ajami, Kambiz Keshavarz, Elham Dehghani, Reza Bahrami Pages 31-36
    Background

    Kawasaki disease (KD) is the most frequent cause of coronary artery aneurysm (CAA) in children. This study tried to evaluate the accuracy of different KD scores developed for prediction of CAA, in an Iranian population.

    Methods

    This is a cross-sectional retrospective investigation on pediatric patients with a diagnosis of KD. Clinical manifestations, laboratory, and echocardiographic data were recorded. Five Kawasaki scores, including Kobayashi, Egami, Sano, Nakano, and Harada, were assessed and analyzed in relation to CAA and intravenous immunoglobulin (IVIG) resistance.

    Results

    During five years, we recruited 121 cases of KD under 13 years of age. The rates of CAA and IVIG resistance were 16.5%, and 13.2% respectively. The IVIG resistance group was significantly younger than responder patients. All five scores had low sensitivity in predicting CAA or IVIG resistant cases; the highest sensitivity pertained to the Harada score with 50% sensitivity and 59% specificity (the area under the curve: 0.545, with a 95% confidence interval: 0.423 to 0.667) in predicting CAA, which is lower than the usual acceptable criteria for a screening test. The specificity of all other scores were more than 85% in predicting CAA or IVIG resistance. Gender, fever before therapy and laboratory data showed no significant difference between the groups.

    Conclusion

    The Kobayashi, Egami, Sano, Nakano and Harada scores have limited usefulness in the Iranian population to predict high risk patients for coronary artery involvement or IVIG resistance; in our study, age under one year was a risk factor for IVIG resistance.

    Keywords: Coronary aneurysm, Harada, IVIG
  • Mandana Shirazi, Maryam Modarres*, Mohammad Shariati, Afzal Sadat Hosseini Dehshiri Pages 37-43
    Background

    Promoting students’ creative thinking with new techniques is important in order to foster innovation in a pleasant educational atmosphere. This study aimed to determine the effect of technical simulation using Goldfish Bowl (GFB) method on creative thinking of midwifery students in Tehran University of Medical Sciences.

    Methods

    During 2015-2016, 70 students in two groups (n = 35 midwifery students in each group) were enrolled in this study and educational intervention was conducted on one of the groups. The intervention was the new GFB method. The students’ creative thinking was assessed using Dr. Abedi’s standardized creative thinking questionnaire in both groups before and after the intervention and in one-month follow-up. The results were gathered and entered into the SPSS software version 16. For data analysis, descriptive and analytical statistical tests were used to compare the scores of three stages of creative thinking, and variance analysis in the intervention and control groups with the significant level of 0.05.

    Results

    There were no significant differences between the results of the two groups before the intervention. The statistical results showed changes at different levels after intervention, indicating an improvement in the students’ creative thinking. The mean score of creative thinking was 70.71 ± 15.75 before the intervention, 80.40 ± 14.68 at the end of the eighth week of the intervention, and 72.09 ± 14.98 in the follow-up. The effect size of this technique on creative thinking was 0.91 in week 8.

    Conclusion

    The use of Goldfish Bowl technique in teaching medical students is recommended to promote their creative thinking.

    Keywords: Creativity, Creative thinking, Medical, Teaching
  • Zahra Mohammadi, Hossein Poustchi, Nazgol Motamed Gorji, Sareh Eghtesad, Azita Hekmatdoost, Parastoo Saniee, Shahin Merat* Pages 44-52
    Background

    With the increasing prevalence of obesity, non-alcoholic fatty liver disease (NAFLD), has become a frequent cause of chronic liver disease, often leading to cirrhosis. In recent decades, gut microbiota have been evaluated as an effective factor in NAFLD pathogenesis, causing steatohepatitis by involving the host immune system. The aim of this study is to evaluate gut microbiota dysbiosis in NAFLD/NASH patients in comparison to healthy controls.

    Methods

    We conducted a systematic search of published studies that have examined the composition of gut microbiota in relation to NAFLD. PubMed, Scopus and ISI Web of Science were searched. After the exclusion of irrelevant studies, 15 eligible studies were included and summarized.

    Results

    Overall, some studies reported the composition of microbiota at the phyla level, while others reported them at smaller subgroups; the results of studies were contradictory in some cases.

    Conclusion

    Overall, study findings indicate a relationship between microbial composition and NAFLD. Study methods and sequencing techniques influenced these results.

    Keywords: Fecal microbiota, Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis
  • Wala Ben Kridis*, Syrine Sghaier, Slim Charfi, Nabil Toumi, Kais Chaabène, Tahia Boudawara Pages 53-55
  • Mahshid Zohouri, Abbas Ghaderi* Pages 59-60