Tehran University Medical Journal

---

Background: Tuberculosis is still one of the main causes of mortality and disability in developing countries. Despite of socio-economic development of communities and controlling majority of communicable diseases, With respect to importance and high incidence of Tuberculosis in marginal provinces, the present study was aimed to assess the epidemiology of Tuberculosis. Methods: In this Descriptive-Analytical Retrospective Study, documents of 6363 patients diagnosed with TB in the beginning of March 2005 to the end of the September 2012 in Khuzestan province, Iran, by used census sampling size, were used. Demographic variables and other necessity data were recorded by TB-Register software and then these data were analyzed by SPSS 16.0 software and Chi-square and independent t-tests with a significance level of less than 5%. For comparison Tuberculosis incidence in consecutive years used by Poisson tests (with a significance level of less than 5%). Results: mean age of patients and median age of patients were 39.3±18 and 35±6.5 years, for women mean age was older 2.1 years than men and there was significant relationship to age (P=0.0001). Of all patients 75.7% were pulmonary tuberculosis, 2.7% were infected with HIV and 91.2% were new cases. Cumulative incidence in province was 148.84/100,000. Most prevalent in Non-pulmonary TB was Lymphatic glands. Poisson test showed that changing trends of TB incidence in study years was statistically significant (P<0.05). Conclusion: Increasing concurrent of HIV infection and TB and decreasing patients mean age (39.3±18) and median (35±6.5) in southwest of Iran has high prevalence. Screening, training and preventive activities for controlling of disease is highly recommended for the whole country and in margin provinces in particular.

---

Background: Distribution of Tuberculosis (TB) has a special template affected by geographic and social factors. Nowadays Geographical Information System (GIS) software is one of the most important and useful epidemiologic devise for identifying geographic areas and high risk population for infection by TB. Aim of this study was assessment of Tuberculosis distribution by GIS in Khuzestan province, Iran. Methods: In this retrospective cohort study, documents of 6363 TB patients identified in Khuzestan province at the beginning of 2005 until the end of the September of 2012 were assessed and sampling method was census. The data was gathered by TB-Register Center. TB incidence was evaluated by GIS maps according to climatic and vegetation with 1:25,000 scale. The data was analyzed in SPSS software and means plot and Independent’s t-test, ANOVA with a significance level of less than 5% and Eta Correlation. Results: Spread of Tuberculosis in climatic and vegetation were plotted in GIS maps, cumulative incidence rate was calculated separately for each area. There was a statistical significant relationship between cumulative incidence rate of disease and climatic (P=0.017) and the Eta correlation coefficient was 0.379 (P=0.011). There was a statistical significant relationship between cumulative incidence rate of TB and vegetation (P=0.004) and the Eta correlation coefficient was 0.388 (P=0.188). Mean age and median age of patients were 39.3±18 and 35±6.5 years respectively. For women, mean age was 2.1 years older than men and this difference was statistically significant. (P=0.0001). Conclusion: The risk of TB infection is closely associated with the climatic and vegetation. So the risk of TB in extra-dry climate and vegetation of highland meadows is more than other areas. Special care and services to high-risk areas is recommended.

---

Background: Many studies have reported the effect of metronidazole on reducing blood lipids in different ways, but there is no comprehensive estimation about its effect. Therefore, this study aimed to determine the effect of metronidazole on reducing blood lipid by meta-analysis method.

Methods: This is a systematic review based on the reliable local and international websites including SID, Magiran, Iranmedex, ISI, Pubmed and Scopus. The keywords used for searching were metronidazole, blood lipid, cholesterol, triglyceride, low density lipoprotein (LDL) and height density lipoprotein (HDL). All articles published until the end of March, 2015, about the effect of metronidazole on blood lipids reduction which met the inclusion criteria were reviewed. Three independent reviewers checked studies for quality and eligibility and finally extracted the data. The collected data were analyzed by meta-analysis method (random effects model) and by means of Stata, ver. 11.1 (College Station, TX, USA) with a significance level of less than 5%.

Results: In 10 researches, 292 people had been studied and after taking metronidazole, the calculated amount of reduction in blood lipids was 11% (95% CI: 6%-16%) for cholesterol, 14% (95% CI: 4%-24%) for triglyceride and 8% (95% CI: 1%-15%) for low density lipoprotein (LDL) which was statistically significant (P= 0.001). The amount of increase in high density lipoprotein (HDL) was also calculated to be 1% (95% CI: 1%-2%) which was not statistically significant (P= 0.08).

Conclusion: The results of this study showed that, using metronidazole leads to decrease in the amount of cholesterol, triglyceride and low density lipoprotein (LDL) but it seems that it has not any effect on the increase in high density lipoprotein (HDL).

---

Background: Breast cancer is one of the most prevalent cancers among women and features increasing trends of incidence rates. Worldwide, yearly about 1.67 million of new cases and 522,000 of deaths from breast cancer are registered. The aim of this study was to determine the risk factors of breast cancer in women and to identify high risk groups.

Methods: In a case-control study, 170 women with breast cancer who were registered in cancer registration system from 2011 to 2015 at Dezful City, Iran, were compared with 170 healthy women with confirmation of mammography. After age matching of groups, the needed information about risk factors and demographic information including information, educational level, marital status, family history of breast cancer, age at menarche, parity, oral contraceptive use, age at first pregnancy, menopausal status, and age at menopause, breastfeeding, stress, abortion, alcohol use and smoking, hormone therapy and physical activity was collected by a questionnaire. The analysis of collected data was performed by using odds ratio and logistic regression model and SPSS software, version 16 (SPSS, Inc., Chicago, IL, USA). The statistical significance was set at a two-sided p-value of %5.

Results: The results of this study showed that, women with the family history [OR: 6.78 (95% CI: 2.15-21.41)] and women with the stress history [OR: 4.86 (95% CI: 2.46-9.59)] had higher risk of breast canser, while women with the history of having physical activity at least once a week [OR: 0.29 (95% CI: 0.13-0.65)] and women with the history breast feeding for 3 to 4 years [OR: 0.36 (95% CI: 0.16-0.81)] had lower risk of breast cancer.

Conclusion: It is recommended that the mentioned risk factors and protective factors be considered in first and second level (screening) of preventive programs.

---

Results: Seven are male and thirteen are female and the age range of patients is between 17 and 67 years. After collecting wound healing times in two groups, we used the means comparison method to evaluate the effect of PRP on wound healing rate and analyzed the results (T-Test). Because the data followed a normal distribution, we used the Independent T-test method, which resulted in 0.416, which was higher than the alpha level equal to 0.05. Conclusion: In this study, we found that PRP had a positive effect on wound healing time and increased the speed of wound healing. It is suggested that the effect of the PRP method on various organs that have not been tested before, be discussed in future studies.