Shiraz Emedical Journal
Volume:11 Issue: 1, jan 2010

Back ground and During the 8 year Iraq-Iran war (1980-1988) chemical weapons were frequently used against Iran. The aim of this study was to determine some related factors besides a spirometry test that can predict and evaluate late pulmonary effects on persons exposed to mustard gas. In a cross sectional study of 500 mustard gas exposed persons, we measured spirometric parameters with an assessment of their relationship with related factors including respiratory symptoms and signs, age, number of exposure episodes, length of post first exposure time and use of protective mask at time of exposure. Of 500 exposed persons with the mean age of (45.6±6.5y), 91.6 %(n= 458) had lung Symptoms, dyspnea 88.2% (n=441, productive cough 36.2 % (n=181), dry cough 29.4 % (n= 147), haemopthesis 18.6 % (n= 93), and 8.2 % (n=41) had positive findings of the following in physical examination: wheezing 6.6 % (n=33), ronchi 1.2 % (n=6), and crackles 0.4 % (n=2). In a spirometry test, 52.4 % (n=262) had a dysfunction. Of these, 27.2 %(n=136) showed obstructive pattern, and 25.2 % (n= 126) showed a restrictive pattern. Prevalence of mild lung restrictive was 94.44% (n= 119) and mild obstructive pattern was 36.03 % (n=49). For moderate lung restrictive pattern prevalence was 5.56 % (n=7) and moderate obstructive pattern was 33.09 % (n=45). For moderate to severe lung obstructive pattern prevalence was 11.76 % (n= 16), and of severe lung obstructive pattern prevalence was 19.12% (n=26). Prevalence of dysfunction spirometry test increased with increasing the length of post first exposure time and no use of protective mask at the time of exposure. There wasn''t any statistical significant relationship between respiratory symptoms and signs, the number of exposure episodes, and age with dysfunction spirometry test. The most common type of dysfunction spirometry test is obstructive and then restrictive pattern in mustard gas exposed persons. The factors contributing to the increase of prevalence of dysfunction spirometry test include increasing the length of post first exposure time and no use of protective mask.

Medical students are a population who are at great risk to develop sleep disruption due to demanding clinical and academic duties. Knowing how much change in sleep –wake pattern is associated with subsequent psychological distress could be useful to establish a systematic mental health program in medical schools. We performed a cross-sectional study to identify the sleep quality and its correlation to psychological distress among 159 medical students.The instruments employed for data collection were a self report sleep- wake questionnaire, Pittsburg sleep quality index (PSQI), the general health questionnaire (GHQ) and a general questionnaire regarding demographic characteristics, use of drugs and history of psychopathology. In descriptive analysis 57.2% of subjects were defined as poor sleeper. Moreover, there was a significant correlation between sleep quality and general health status of students (r=.6, p=. 000, n= 159). Further Regression analysis showed that number of sleep disruption was a predictor for both sleep quality and psychological distress. Sleep disruption due to shift work or other academic demanding could be a predictor for mental health morbidity in medical students which should be considered in education and mental health policy for this group of students.

Too much diversity and an ever increasing number of genetic disorders appear as a big challenge in the coming future. One of the main sources of genetic disorders is the consanguineous marriages which are, unfortunately, very common in our society. In order to prepare ourselves to accept the challenges regarding congenital malformations due to consanguineous marriages, the first step is to get complete information of their prevalence and their risk factors. The study was made during 2003-2007 in the city of Tabriz, Iran. We selected 6000 families and data was obtained via a questionnaire comprised of information including marital ages, number of pregnancies, type of delivery, ratio of consanguineous and non consanguineous marriages, jobs of parents, and effects on child malformations. Consanguineous marriages of all types were related with increased congenital malformations (with ratio 43/1000 for consanguineous marriages and for non consanguineous marriages 28/1000). Mother age less than 18 and more than 35 particularly was accompanied with increased malformations while education of mother came out to be inversely related to congenital malformation. Increased stillbirths, consanguineous marriage and malformations, especially of musculoskeletal system, require new planning on a national level to control and inform people of the consequences of consanguineous marriages.

Human immunodeficiency virus (HIV) still continues to ravage the world since its discovery about three decades ago in spite of global intervention efforts. Women are the most infected, majority of which are found in sub-saharan Africa. We set out to determine the sero-prevalence of HIV-1 and HIV-2 and to evaluate risk factors among women of child-bearing age in Obi Local Government Area, Nasarawa State, Nigeria. In a cross-sectional study, blood samples were randomly collected by venepuncture from 426 women aged 16-40 years, between February and April 2002; after having obtained ethical clearance, informed consent, structured questionnaires were self-administered. rLAV EIA (Bio-Rad Laboratories, USA) and vironostika microelisa (Organon Teknika, USA) were both used for initial and confirmatory tests respectively. Overall 48 (11.3 %) were sero-positive for HIV. Of these, 38 (8.9 %) had HIV-1 and 10 (2.3 %) had HIV-2. Those aged 16-20 years had the highest prevalence rate of 13.9 % (38). Subjects who had history of STIs and multiple sex partners were significantly more likely to be infected. The high prevalence with a worse situation in the young age brackets underscores the necessity for sustainable intervention initiatives among women with the youth as a special focus. Efforts for vaccine development should take into consideration the reality of HIV-2 in Nigeria.

We conducted this study to clarify the prevalence of thyroid dysfunction in patients with Systemic Lupus Erythematosus (SLE) and compared it to a matched healthy controls group. Eighty-three SLE and 166 matched healthy controls underwent clinical examination and laboratory evaluation for serum T3, T4, TSH and Thyroid peroxides antibody (TPO AB). 24.1% of SLE patients and 13.3% of control group had thyroid dysfunction (p value = 0.04). Clinical thyroid dysfunction was seen neither in SLE patients nor in the control group. Elevated TSH levels were the most common dysfunction (19.3%) of the SLE, compared with control group (5.4%). Positive TPO antibody was detected in 16.9% of SLE and 16.3% of the control group. Mean level of TPO antibody was higher in SLE patients with thyroid dysfunction (137.05) than SLE patients without the disorder (30.8) (p value=0.007). We concluded thyroid dysfunction was more frequent in SLE patients than in healthy controls. Moreover, SLE patients with anti TPO were more likely to have thyroid dysfunction than the control group.

Current issues that are associated with the development of hepatitis B vaccine, combination vaccines, modes of administration, immunogenicity, and efficacy of different types of hepatitis B vaccines are reviewed. Hepatitis B viral mutants can emerge as a result of either immune response or treatment options. Several studies are in progress on treatment of chronic hepatitis B infection by immunization with multiple antigenic components; DNA vaccines alone or with DNA encoded immunomodulatory cytokines; combination of vaccine with antiviral drugs and cytokines; and genetic manipulation of antigen presenting cells. Integrating hepatitis B vaccine doses into the global infant immunization program is not sufficient for hepatitis B virus (HBV) infection eradication. Implementing HBV schedule to high risk groups such as injection drug users, inmates of correctional centers, and persons at risk for sexually transmitted diseases, surveillance of hepatitis B infected subjects and refugees, access to immunization services and treatment is necessary. Further investigation is needed to assess factors that can impede an adequate antibody response, HBV variants, and the need for booster doses to preserve vaccine-induced immunity, vaccinating schedule for older children, evaluation of those vaccinated but in persistent contact in HBV-endemic areas