International Journal of Preventive Medicine
Volume:1 Issue: 3, summer 2010

Frailty, as a geriatric syndrome, is characterised by the increased vulnerability of the elderly person to internal and especially external stressors. The aim of laboratory diagnostics in the context of the concept of frailty is to record the conditions which encourage the development of frailty, in order to improve these conditions through individual measures or to avoid them for the purpose of preventing frailty. After a presentation of the features of laboratory diagnostics in old age, this article examines haematological aspects, the importance of an adequate vitamin supply, particularly of vitamin D and the adequate description of endocrine functions.

Sri Lanka experienced the worst ever outbreak of leptospirosis in 2008. One major determinant of control and prevention of communicable diseases is public awareness on the disease. The purpose of the present study was to determine the awareness on leptospirosis among public Sri Lanka. A national household survey was carried out as a part of research methodology training of first year medical undergraduates in Rajarata Medical School. Each student visited 10 households surrounding his/her house to complete the interviewer administered questionnaire. The questionnaire was based on the factsheet published by the Epidemiology Unit for public health. Altogether 602 participants from 14 districts participated in the study. Of them 93.7% were aware of rat as a reservoir animal, but only 3% were aware of the role of cattle and buffalo. Contact with infected water as a mode of transmission was reported by 57.9% of the population. Only 30.8% of the subjects were aware of that the infection can go through skin breeches. Farming as a risk activity was reported by 63.5% of the patients, but knowledge on other exposure activities were less than 20%. Paddy field work and cleaning garbage were correctly identified as risk occupations by 89.7% and 27.6% of the sample, respectively. Respondents were aware of fever (86%), malaise (30.8%), headache (29.6%) and muscle tenderness (28.8%) as main clinical features of the disease. Most of them (73.7%) knew leptospirosis as a lethal condition and 39.5% were aware of chemoprophylaxis. Although there is not adequate information on MDD prevalence in some areas of Iran, the overall current prevalence of MDD in the country is high and females are at the greater risk of disease.

Mesenchymal stem cells or ‘‘multipotent stromal cells’’ are heterogeneous cell population with self-renewal and multi-linage differentiation. The aim of this study was to examine and compare the expression of important stem cell surface markers on two populations of mesenchymal stem cells, one derived from human exfoliated deciduous teeth and the other derived from human adipose tissue. These new stem cells will offer a promising avenue for prevention and reversal of many human diseases such as type 1 diabetes and prevention of liver fibrotic process. Mesenchymal stem cells were isolated and cultured from human adipose tissue and dental pulp of human exfoliated deciduous teeth. The cultured cells then were harvested and stained by different fluorescent labeled monoclonal antibodies against surface markers and were analyzed using flow cytometry. Both different cell populations expressed CD44, CD90 and CD13 (stem cell markers) with similar intensity. They did not express hematopoietic markers (CD11b, CD19 and CD34), and lymphocyte or leukocyte antigens CD3, CD7, CD20, CD14, CD45, CCR5 (CD195), CD11b and CD10 on their surfaces. Two different cell types demonstrated different levels of expression in CD56 and CD146. Mesenchymal stem cells from human exfoliated deciduous teeth were positive for CD105 and were negative for CCR3 and CCR4 expression. Both cell populations derived from adipose tissue and dental pulp showed common phenotypic markers of mesenchymal stem cells. In conclusion, mesenchymal stem cells could be isolated and cultured successfully from dental pulp of human exfoliated deciduous teeth,they are very good candidates for treatment and prevention of human diseases.

Lipid Clinics are specialized centers for clinical assessment and follow up of patients with dyslipidaemia in order to deliver an acceptable improvement in their lipid profiles. We assessed the changes in lipid profile of dyslipidemic patients attending a Lipid Clinic over a 1 year period on lipid-lowering therapy. Dyslipidemic patients (n=238) were recruited from the Lipid Clinic at the Royal Surrey County Hospital, Guildford, UK. All patients were regularly seen at the clinic and the compliance of lipid-lowering drug consumption, prescribed by the consultant was assessed over a period of one year. The mean age of the patients was 55.2 ± 0.86 years and the male/female ratio was 143/95. The lipid profiles of patients attending the Lipid Clinic over the period of one year of close monitoring changed significantly. Triglyceride, total cholesterol and low density lipoprotein cholesterol were reduced by 27.04%, 20.48% and 22.67%, respectively (p<0.001) and high density lipoprotein cholesterol rose by 8.96% (p<0.001); the 10-year calculated coronary risk factor of all patients decreased significantly (39.29%, p<0.001). Our findings confirmed the effectiveness of a Lipid Clinic in the management of lipid profile and cardiovascular risk of dyslipidemic patients.

Severe tetanus is one of the indications for admissions into the intensive care unit requiring muscular paralysis, tracheostomy and mechanical ventilatory support. This study aimed to evaluate tetanus patients managed with tracheostomy and to determine associated complications. This was a 16-year review of patients who were managed for tetanus with tracheostomy in an intensive care unit between 1999 and 2009. The data collected from the medical records including demographic data, clinical presentations, tetanus immunization history, suspected portal entry of infection, duration of ICU admission, endotracheal intubation, tracheostomy, and complications. Of the 31 patients studied, 11 (35.48%) were aged ≤15years and all had history of completed childhood tetanus vaccination. Only 6 (19.35%) patients who were above 15 year-old had no history of previous childhood tetanus vaccination. None of these patients had tetanus booster shot. All patients had tracheostomy and 42% developed complications following tracheostomy. Tetanus is still a major health problem in developing countries and this can be prevented if recommended childhood tetanus vaccination and booster shots regimen are properly taken. Although, tracheostomy is associated with complications in severe tetanus patients, these patients would have all died of cardio-respiratory failure if tracheostomy had not been performed.

There is some controversy regarding the effect of opium addiction on the coronary artery disease (CAD). The aim of this study was to determine the association between chronic opium consumption and CAD. This study had a case-control design. The patients recruited to the study were selected from angiography files in Department of Cardiology in Kerman University of Medical Sciences, Kerman, Iran. The comparison was done between CAD patients and normal subjects. Opium addiction was diagnosed by patient self-report and confirmed with interview based on DSM-IV criteria. Odds ratio with 95% confidence interval were estimated by unconditional logistic regression. The risk factor of CAD was the same in the two study groups. The significant difference in opium consumption was demonstrated between CAD patients and normal coronary artery subjects (OR=3.8, 95%CI=1.5-9.5). Because of the strong association between cigarette smoking and opium addiction, analysis was done in smoker and non-smoker groups separately. Logistic regression showed opium addiction was the independent risk factor for CAD in non-smokers after adjusting to other CAD risk factors (OR=38, 95%CI=2.7-531.7), but in cigarette smokers opium was not a significant risk factor (OR=13.2, 95%CI=0.85-206.5). We confirmed that the opium was an independent risk factor for CAD. Health managers and policy makers should try to aware general population and prepare many preventive programs against substance abuse.

Early diagnosis of diabetes is crucially important in reduction of the complications. Although HbA1c is an accurate marker for the prediction of complications, less information is available about its accuracy in diagnosis of diabetes. In this study, the association between HbA1c and FBS was assessed through a cross-sectional population-based study. A random sample of population in Kerman city was selected. The total number was 604 people. Their HbA1c and fasting blood sugar (FBS) were tested. The association between HbA1c and FBS and also their sensitivity, specificity and predictive values in detection of abnormal values of each other were determined. The association of HbA1c with FBS was relatively strong particularly in diabetic subjects. Generally, FBS was a more accurate predictor for HbA1c compared with HbA1c as a predictor of FBS. Although the optimum cutoff point of HbA1c was >6.15%, its precision was comparable with the conventional cutoff point of >6%. In conclusion, FBS sounds more reliable to separate diabetic from non-diabetic subjects than HbA1c. In case of being interested in using HbA1C in screening, the conventional cutoff points of 6% is an acceptable threshold for discrimination of diabetics from non-diabetics.

There is no study about correlation between vitamin D serum level and multiple sclerosis (MS) in Iran. So in this survey, we investigated the serum level of 25-hydroxy vitamin D in MS patients and compared it with controls in central region of Iran, an area with medium to high risk for MS disease, in spite of high sun exposure. A case-control study was conducted from July 1, 2008 to July 31, 2009. We enrolled 50 definitive MS patients, according to McDonald's criteria as case group and 50 matched controls. Our age limits were 15 to 55 years and those patients with estimated expanded disability status scale less than 5 were introduced to the study. We measured serum level of 25-hydroxy vitamin D and compared them in both groups. We gathered 42 females and 8 males as case group and the same numbers as control group without significant age difference. The mean serum level of 25-hydroxy vitamin D in case and control groups were 48 and 62 nmol/L, respectively, and the difference was significant (P=0.036). Also, our study showed significant discrepancy between the two groups according to the rate of deficiency, insufficiency and normal range of vitamin D categories (P=0.021). We found the same results as those studies carried out in Europe and North America; i.e., lower serum vitamin D level in MS patients than that in normal population, in spite of sufficient sun exposure in Isfahan region.

The third National Festival on Health Promotion by Prevention& Control of Childhood Obesity was held on August 1-5, 2010 in Isfahan, Iran. Similar to previous times,1 the motto of this symbolic event was "Isfahan, Free of Childhood Obesity" and it aimed to celebrate overweight children and adolescents who have been successful in weight control, to encourage other overweight children and families and to sensitize the community about health hazards as well as ways for prevention and control of childhood obesity. The festival included four main parts