Iranian Journal of

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Background & Objectives: Triglyceride/HDL-cholesterol ratio (TG/HDL-C) has been shown as an indicator for metabolic syndrome (MetS). This study aimed to detect the role of this ratio to predict coronary heart disease (CHD) outcome in an Iranian men population with high prevalence of MetS.
Methods: 1824 men ≥ 40 years old, free of clinical cardiovascular disease at baseline, were included in the study from February 1999 to August 2001. Serum level of total cholesterol (TC), HDL-C, TG, and risk factors of CHD including age, systolic blood pressure, diastolic blood pressure, body mass index, diabetes, smoking and family history of cardiovascular diseases were measured at initial phase of study.
Results: During a median follow up of 6.5 years until March 2007, a total of 163 new CHD events occurred. According to a Cox proportional hazard modeling, after adjustment for TC and other risk factors, men in the top quartile of TG/HDL-C relative to first quartile had a significant hazard ratio (HR) of 1.85 (95% CI, 1.07-3.17). Combined HR for TC and TG/HDL-C (men in the top quartiles of both TC and TG/HDL-C relative to first quartiles) after adjustment for other risk factors was 6.13 (95% CI, 2.37-15.86).
Conclusions: The evaluation of both TG/HDL-C ratio and TC should be considered for CHD risk prediction in Iranian male population.

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Background & Objectives: Medical Tourism has been recently paid more attention. Individual practitioners and medical organizations must be able to provide accurate information about this rapidly evolving trend. Since there has been little known about this issue, we decided to assess the knowledge about and attitude towards medical tourism in Rafsanjan, Iran.
Methods: A questionnaire including XXX questions were completed by Rafsanjan Medical University staff. All information was analyzed by SPSS software.
Results: Only 8.3% of individuals sated that they studied some articles about Medical Tourism, and only 14.7% of them had deal with these kinds of patients. The majority of participants (80.7%) hadn’t had any idea about the quality of medical expenses by Medical Tourists. Mainly (68.7%) believed that development of Medical Tourism in Iran would not have any bad social consequences and 62% believed that its development in Iran could improve the knowledge of Iranian doctors. The majority (67.3%) agreed to arrange for inviting tourism to Iran in order to use of Medical Tourists and 54.3 of them believed that development of Medical Tourism could improve treatment of Iranian patients.
Conclusions: The knowledge of participants seems is very low therefore appropriate educational programs should be tailored by responsible organizations in Iran. However medical staff’s attitude towards medical Tourism seems is very positive which indicates having necessary potential for any activity in this regard in future.

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Background & Objectives: The scorpionism is one of the important public health problem in several parts of the world becauseeither incidence or severity of envenomations is high and managed with difficulty by health services. The aim of this study was to describe the epidemiological and demographic information among humans stung by scorpion in Ramhormoz, Iran.
Methods: In this analytic-descriptive study relevant information were gathered from Imam Khomeini hospital in Ramhormoz, from April 2007 to April 2008.
Results: There were 3799 scorpion victims, 56% were from rural areas. Approximately 20 percent of the sting cases occurred in the month of July (the height temperature in this region). Near 50 percent of victims were between 11-30 years. Most of the stings were seen in exposed extremities (78.4%) mainly in the lower limbs (40.5%). Stings mainly occurred at night between 6 p.m. and 6 a.m (44.3%). The scorpions’ spices were, 53.9% yellow, 12.5% black and 34.6% unknown colors, respectively. The median time from sting to admission to the emergency room (patient delay) was 1.5 hour.
Conclusion: It is suggested that informing people with educational campaign about the importance of receiving prompt attention following a scorpion sting has potential value in reducing complications in the emergency room. We would advise that public awareness and physician readiness combined with the availability of effective antivenom significantly reduced lethality in this region.

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Background & Objectives: Although the population of elderly is increasing in Iran, few studies carried out on this group. The aim of this study was to identify life expectancy and contributory risk factors for the Tehranian elderly of ages above 60 years.
Methods: Individuals above 60 years old whom were recruited in the primary phase of the Tehran Lipid and Glucose Study (TLGS) during 1998-2001 were followed up for 12 years and their vital status were registered (1998-2011). Age and sex mortality rates for age groups (60-69, 70-79, 80+) were calculated and by using Cox proportional hazard model the mean of survival time and hazard rates with respect to risk factors were estimated.
Results: Life expectancy for females and males after crossing 60 years of age reaches to 81 and 80 years, respectively without any statistically significant differences between these two groups. Cox model showed that diabetes, BMI>33Kg/m2 and non ischmecic heart disease reduced survival time in women significantly. While diabetes, smoking, hypertension, ischemic heart disease, history of MI, stroke or sudden death of father, brother or son, lack of physical activity and antihypertensive medications are among the hazardous risk factors for men.
 Conclusion: Among the variables studied, only three (ABC) of them were found as risk factors of women's life, while for men seven risk factors were identified. It seems that more studies are needed to determine the risk factors for women.

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Background and Objectives: Breast cancer is the leading cause of death from cancer among women. In developing countries, the patients’ survival is less than developed countries. Metastasis, as an intermediate event, affects the survival of breast cancer patients. This study aimed to evaluate the survival of patients after surgery considering metastasis, as the intermediate event, using the illness-death model.
Methods: In this study, 165 cases of Iranian breast cancer patients who underwent surgery during 2006-2014 were investigated. The patients’ characteristics and their intermediate and final status were collected from their medical records. The illness-death model was used to assess prognostic factors in all stages of disease.
Results: The risk of metastasis in patients with tumor size between 2-5 cm was 3.8 times higher than patients whose tumors were below 2 cm (P=0.009). Patients who had 3 to 6 lymph nodes involved were 3.1 times more likely to have metastases that those with less than 2 lymph nodes (P=0.003). Also, the grade of tumor and HER-2 had a significant role in metastasis (P=0.04).
Conclusion: Using the illness-death model that is suitable for the analysis of such data, it was found that lymph node involved and tumor size had a significant role in metastasis. So, early detection of cancer is required to prevent metastasis and death.

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