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Diagnosis of frailty in geriatric patients: Is the pictorial fit frail scale an appropriate screening tool in hospital settings?
No full textBackground: Frailty is accompanied by serious health complications in the elderly, especially during hospitalization. Visual scales have been designed for quick and easy evaluation of frailty in different cultures and settings. Therefore, this study aimed to define the accuracy of the Pictorial Fit Frail Scale (PFFS) for frailty screening in the hospitalized elderly in Iran. Methods: This cross-sectional study was conducted on 304 hospitalized participants, aged 65-85 years old admitted at Ziaeian Hospital (Tehran) were enrolled through the inclusion criteria from August to December 2019. All participants were evaluated based on the Minimum Data Set-Home Care, the Pictorial Fit Frail Scale, and the Quality-of-Life instrument, through face-to-face interviews by a trained nurse at the admission time. Spearman's correlation coefficient, and ROC analysis were performed using SPSS at p<0.05. Results: The highest correlation was obtained by Frailty Index (FI) and PFFS (0.770). FI had a negative correlation with QoL (-0.48). The optimal cut-points for PFFS according to FI � 0.08 (robust vs. pre-frail) was obtained 0.10 with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00 and the best cut-point for PFFS based on FI � 0.25 (pre-frail vs. frail) was obtained 0.29 with sensitivity and specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00. Conclusion: It seems the Pictorial Fit-Frail Scale (PFFS) is a reliable scale with a high level of accuracy, and excellent sensitivity and specificity to measure the frailty level in hospitalized elderlies. © 2020, Babol University of Medical Sciences
The prevalence and correlates of fissured tongue among outpatients in andkhoy city, afghanistan: A cross-sectional study
No full textBackground: Fissured tongue is a common manifestation of the tongue, marked by the presence of multiple prominent grooves or fissures on the dorsal surface of the tongue. However, there is a lack of studies focusing on the prevalence and factors associated with fissured tongue among patients attending an outpatient clinic in Afghanistan. Aim: The purpose of the current study was to determine the prevalence and factors associated with fissured tongue and its effects on the general health of adult outpatients in Afghanistan. Patients and Methods: The cross-sectional survey was conducted among outpatient populations in Andkhoy City, Afghanistan, between September 2019 and December 2019. A convenience technique was applied by including 1182 patient aged 18�80 years. Socio-economic status, smoking, nass use (smokeless tobacco use) and medical data were collected using face-to-face interviews. We used logistic regression analysis to identify factors associated with fissured tongue. A convenience technique was applied by including patient aged 18�80 years. Results: The studied population consisted of 1182 participants, of whom 573 (48.5) were males and 609 (51.5) females. The prevalence of fissured tongue was 27.2 (95 CI: 24.7�29.9) with males having significantly higher prevalence than females (47.5, 95 CI: 43.3�51.6 versus 8.2, 95 CI: 6.2�10.7, p<0.001). Male participants (OR=7.1, 95 CI: 4.8�10.3), diabetes mellitus (OR=1.6, 95 CI: 1.1�2.3) and smokeless tobacco use (OR=12.0, 95 CI: 8.1�17.6) were the only variables independently associated with fissured tongue. Conclusion: This study suggested that there was a high rate of fissured tongue among an outpatient clinic in Andkhoy, Afghanistan. Male gender, diabetes mellitus, and nass consumption were associated with fissured tongue. Therefore, these factors might usefully be targeted in local health promotion, prevention and early intervention programs. © 2021 Hamrah et al
Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990�2019: a systematic analysis from the Global Burden of Disease Study 2019
No full textBackground: Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods: We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings: Globally in 2019, 1·14 billion (95 uncertainty interval 1·13�1·16) individuals were current smokers, who consumed 7·41 trillion (7·11�7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5 26·5�28·5 reduction) and females (37·7% 35·4�39·9 reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98�1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16�8·20) deaths and 200 million (185�214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% 19·3�21·1 of male deaths). 6·68 million 86·9% of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation: In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Gastric cancer in Iran: An overview of risk factors and preventive measures
No full textDespite all recent treatment advances and the worldwide decline in the incidence rate, gastric cancer (GC) remains an ongoing global health challenge and one of the major leading causes of cancer-specific deaths, particularly in high-incidence regions including Iran. Since GC is often diagnosed in advanced stages, the best action may be to enable early diagnosis of the disease or even prevent it in the first place through identification and control of the underlying risk factors. Endoscopy, as the gold standard method, is both expensive and invasive, making it an unfavorable device in this regard. Therefore, it is crucial to implement a reliable region-specific screening and surveillance program to identify high-risk individuals with more efficient screening modalities. Here, in addition to a review of current GC knowledge, we presented the data of newly-established Population-based Cancer Registries (PBCRs) in Iran. Our assessment confirmed earlier reports of a very high GC incidence rate in the northwestern and northern provinces of Iran, most notably Ardabil. Along with the important role of conventional risk factors such as Helicobacter pylori (HP) infection and high dietary intake of salt, of more interest, we highlighted new region-specific risk factors, namely hookah, and opium. In conclusion, it seems the best results in reducing GC incidence and mortality rates on larger scales arise from modifying behavioral and environmental risk factors and advancing genetic and molecular biomarkers in order to supersede endoscopy. Regular endoscopic screening and antibiotic chemoprophylaxis against HP are still more appropriate in high-risk groups with specified criteria. © 2021 Academy of Medical Sciences of I.R. Iran. All rights reserved
Lifetime cost effectiveness of phenylketonuria screening national program in iran
No full textBackground: Phenylketonuria (PKU) is an autosomal recessive disorder that screening and timely control of this disorder can prevent the adverse effects. Regarding the high prevalence of PKU in Iran, the PKU screening program was started in Iran in 2006. This study was conducted to determine the cost-effectiveness of PKU screening in Iran. Methods: An economic evaluation was performed among screened and treated individuals compared to no screening in 2013. The study population included 1356132 newborns that screened for PKU diagnosis. Lifetime costs, quality-adjusted life year (QALY) gains and incremental cost-effectiveness ratio (ICER) were calculated from the perspective of government. A discount rate of 3 was considered for both QALYs and costs. A one-way sensitivity analysis was used for assessing the robustness of the results. Results: The discounted lifetime cost of intervention and non-intervention were 59528953.8 and 85295501.6 re-spectively. Therefore, the total estimated cost saving was 25766547.84. PKU screening produces an ICER of 1844420 per QALY gained. Conclusion: Screening and early treatment for PKU is highly cost-effective. Therefore, the screening can improve quality of life of the patients and increase financial saving in health system. © 2021 Heidari et al. Published by Tehran University of Medical Sciences
Three-dimensional evaluation of maxillary sinuses in the Turkmen population, North of Iran
No full textIntroduction: Understanding the variation in the size and shape of the paranasal sinuses in detail is a clinically relevant matter for sinusitis patients. This study was performed to determine the right and left maxillary sinus dimensions by computed tomographic (CT) scan based on gender in the Turkmen ethnic groups in Gorgan, northern Iran. Material and Methods: In this descriptive-analytical study, 100 Turkmen subjects (50 males and 50 females) aged 18-45 were measured with 2 mm and 3 mm slices in the coronal and Axial Planes by the CT scanner SOMATOM Emotion of the multi-slice from the SIEMENS model and using the 'Syngo software Siemens.' Results: Maximum width, height, and volume of right and left maxillary sinuses in the Turkmen ethnic group were more in males than females (P < 0.05). In the right maxillary sinus; the mean maximum of width in males and females was 29.6 ± 4.91 mm and 26.53 ± 5.26 mm, respectively (P < 0.05). The mean maximum height in males and females was 40.5 ± 4.27 mm and 38.16 ± 5.96 mm, respectively (P < 0.05). In the left maxillary sinus, the mean maximum width in males and females was 29.61 ± 4.31 mm and 26.79 ± 5 mm, respectively (P < 0.05). The mean maximum height in males and females was 40.46 ± 4.55 mm and 38.03 ± 5.4 mm, respectively (P < 0.05). Discussion and Conclusion: Understanding the dimensions of the maxillary sinuses helps for better diagnosis and treatment of patients with maxillary sinuses diseases. © 2021 Journal of the Anatomical Society of India. All rights reserved
The effect of carvacrol on respiratory syncytial virus infection in mice model: Caution in the use of herbal medicines
No full textBackground and Objectives: Respiratory syncytial virus (RSV) is one of the most common viruses associated with acute lower respiratory tract infections in infants, young children, and the elderly. Due to a lack of effective anti-viral drugs or vaccines, using an immunomodulatory strategy is probably the best option to decrease the burden of RSV disease. Here, we studied carvacrol as a known immunomodulator on RSV infection outcome in a mice model. Materials and Methods: Balb/c mice were infected by intranasal inoculation of RSV-A2, and treatment started daily 24 h after infection. Mice were sacrificed on day five after infection and experimental analyses were performed to study airway immune cell influx, CD4 and CD8 subtypes, cytokine/chemokine secretion, lung histopathology, and viral load. Results: Results showed that using carvacrol enhanced immune cell influx, cytokine/chemokine production, and virus titer, and aggravated lung pathology. Our result showed that carvacrol administration increased viral titer compared to the RSVPBS group. Also, carvacrol significantly induced IFN-γ production and did not induce IL-10 production. Besides, carvacrol non-significantly increased lymphocytes and monocytes count but did not affect the neutrophil count. Conclusion: Carvacrol at the concentration of 80 (mg/kg) did not show immunomodulatory activity to alleviate the RSV infection outcome. Further research is needed to uncover the effects of the carvacrol intervention on virus replication and immune responses following RSV infection. Many herbal remedies in use contain carvacrol. However, the use of herbal remedies to treat viral respiratory infections such as RSV has to be performed with caution. © 2021 The Authors. Published by Tehran University of Medical Sciences. This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Noncommercial uses of the work are permitted, provided the original work is properly cited
The prevalence of shiga toxin-1 in non-shigella dysenteriae isolates collected from diarrhea samples in patients, ahvaz, iran
No full textBackground: Acute diarrhea is a major public health problem, particularly in develop-ing countries. Shigellosis is one of the substantial causative agents of microbial dysentery and still has a remarkable prevalence, particularly in areas with poor hygienic infrastructures. The probable existence of the deadly Shiga toxin (Stx) protein in some Shigella strains would manifest life-threat-ening clinical symptoms of the infection. 4 Methods: The aim of this study was to determine the presence of Shigella toxin 1 (Stx1) in isolated from patients with diarrhea. Totally, 227 Shigella species, including 60 S. flexneri, 157 S. sonnei, and 10 S. boydii were collected from diarrheal patients in the tropical infectious diseases research center of Ahvaz, Iran, during 2013-2015. The isolates were collected mostly from the intensive care unit, infectious disease, and surgery settings. The isolates were identified, and the polymerase chain reaction (PCR) was performed to detect the stx gene. Results: The results indicated that none of them encode the stx1 gene. Conclusion: Isolates of this study were not capable of stx1 encoding. Future investigations should consider the relations between other Shigella species and Shigella toxin in Iran. © 2021 Bentham Science Publishers
Antioxidant supplementations ameliorate PCOS complications: a review of RCTs and insights into the underlying mechanisms
No full textPolycystic ovary syndrome (PCOS) is one of the most important gynecological disorders of women in the age of reproduction. Different hormonal and inflammatory cross-talks may play in the appearance of its eventual complications as a leading cause of infertility. Excessive production of reactive oxygen species over the power of the antioxidant system as oxidative stress is known to contribute to a variety of diseases like PCOS. Thus, the utilization of antioxidants can be efficient in preventing or assistant in treating these diseases. In this review, we describe the clinical trial studies that have examined the efficiency of antioxidant strategies against PCOS and the possible underlying mechanisms. The investigations presented here lead us to consider that targeting oxidative stress pathways is probably a powerful promising therapeutic approach towards PCOS. There is preparatory evidence of the effectiveness of antioxidant interventions in ameliorating some of the PCOS complications, including metabolic and hormonal disorders. Due to limited data and relatively few clinical trials, many of these interventions need further investigation before they can be considered effective agents for routine clinical use. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature