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Volume 72, Issue 6 (September 2014)
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.
Volume 74, Issue 1 (April 2016)
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).
Volume 74, Issue 2 (May 2016)
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.
Volume 74, Issue 9 (December 2016)
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Background: Considering the high incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) in the Iranian society and the limited number of studies to investigate its associated risk factors, the current study was designed to identify any relevant risk factor of this disease. Methods: The present case-control study was performed among 150 nonalcoholic fatty liver disease patients and 150 normal liver participants who attended to gastroenterology clinics in Ilam city, Iran during 2014-2015. All demographic data, clinical trials and health behaviors associated with lifestyle such as nutritional status, smoking, physical activities were collected and compared between two groups. Results: Among a total of 300 participants in the current study, the male female ratio was 46.54% and the mean±standard deviation of all participants was 42.13±12.15 years. The mean values of total cholesterol, triglycerides (TG), low density lipoprotein (LDL), alanine transaminase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were significantly higher in cases than controls group (P< 0.0001). A significant relationship was revealed between positive familial history, marriage, and low physical activities with NAFLD (P< 0.05). In the patient's group, consumption of red meat was significantly higher and dairy intake was significantly lower compared to the control group (P< 0.05). Using the multivariate logistic regression analysis, the adjusted odds ratio for variables of waist circumference, triglyceride, ALT and body mass index (BMI) were statistically significant [1.11, (1.04-1.18); 2.58, (1.01-6.67); 5.34, (1.84-15.52) and 7.28,) 1.89-27.99) respectively] (P< 0.05). Also, a significant association was observed among the variables of ALT, AST and BMI with the severity grade of NAFLD (P< 0.05). |
Conclusion: The results of this study showed that waist circumference, BMI, serum level of ALT and TG concentrations can predict the occurrence of non-alcoholic fatty liver disease. BMI, ALT, and AST seem to be associated with the ultrasonography staging of liver in NAFLD. Therefore, these parameters could be used to predict the ultrasonography staging of liver in these patients.
Volume 75, Issue 7 (October 2017)
Methods: In this retrospective study, the required data, including demographic variables, outcomes and the kind of invasive method was extracted from a comprehensive registration system of suicide cases, recorded by Ilam University of Medical Sciences (IUMS), to investigate the invasive suicides during the 1993-2013 years. The study was approved by the Ethics Committee of Ilam University of Medical Sciences and based on this approval the permission to access the suicide data was issued. Data were entered into the SPSS 20 software (SPSS Inc., Chicago, IL, USA) and using descriptive statistical methods and chi-square were analyzed based on completed or attempted outcome of suicide.
Results: Among a total of 1516 cases of invasive suicide, 643 (42.6%) were attempted and 867 (57.4%) were completed suicides. Self-immolation method showed the highest frequency of suicide (both completed and attempted). The highest frequency of completed suicide was occurred in females (52.8%) but the attempted suicide was higher in males (63.6%). The age groups of 25-34 years and above 65 years indicated the highest frequencies of attempted and completed suicides respectively.
Conclusion: One of the main objectives of this study was identification of high risk groups who used the invasive methods for suicide commitments, based on their epidemiological characteristics such as gender and age. The results showed that women and elderly individuals were among the high-risk groups who committed completed suicide using the invasive methods and self-immolation attributed the most frequent method among invasive methods for suicide in Ilam province which resulted in death.
Volume 75, Issue 9 (December 2017)
Methods: The present study was conducted ecologically and descriptively-analytically on 59745 neonates with G6PD deficiency in Fars province, Iran from April 2011 to March 2015. To determine the defect, a point fluorescence test and Kimia commercial kit (KimiaPajoohan Co., Tehran, Iran) were used. To determine the areas with malaria, factors associated with malaria-causing cells in Fars province, including the presence of carriers, the presence of malaria, the incidence of new malaria and the presence of malaria activated sites were studied. The incidence of defect was calculated using the statistical method of estimating the annual incidence rate. ArcGIS software, version 10.3 (ESRI, Redlands, CA, USA) was used to provide geographic mappings and distribution patterns in malarious areas.
Results: The total incidence of G6PD deficiency in newborns was estimated as 15.58 per 100 live births, including 16.25 for boys and 14.85 for girls. The incidence of this defect in malaria-prone areas was higher than other areas. As a region was more malaria-prone, the incidence of G6PD deficiency increased too, which was statistically significant (P= 0.039).
Conclusion: Based on the findings of this study, Fars province is among areas with high incidence of G6PD deficiency. The incidence of G6PD deficiency in malaria-prone areas of Fars province, Iran, is higher than other regions, which indicates better survival of patients against malaria in the past.
Volume 79, Issue 9 (December 2021)
Methods: Search was done in databases such as; Scopus, Web of Science(ISI), and PubMed using keywords: Idiopathic, Short Stature, Body Height, Aromatase Inhibitors, Growth hormone, Letrozole, Oxandrolone, Anastrozole. Randomized clinical trial studies ,that have investigated the efficacy of growth hormone and aromatase inhibitors on height gain in children and adolescents with short stature, were selected. Height standard deviation score (HSDS) before intervention and after treatment has been used to measure the rate of height increase in various studies. This study was written based on the PRISMA checklist and the heterogeneity of this study was evaluated using the Q statistic and I2 index.
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Results: Height increase index (HSDS) was obtained with the use of growth hormone combined with one of the aromatase inhibitors (0.38-3.58=95%CI) (SMD=0.98), with the use of growth hormone (0.62-1.14=95%CI) (SMD=0.88), with the use of Letrozole (0.51-16.51=95%CI) (SMD=0.83), with the use of Oxandrolone (0.99-0.99=95%CI) (SMD=0.56), and with the use of Anastrozole (0.00-0.63=95%CI) (SMD=0.31), which shows that all these drugs have a significant effect on height increase. (P<0.05)
Conclusion: Although the effect of growth hormone on height increase was greater than that of aromatase inhibitors, but according to our results, adding an aromatase inhibitor to growth hormone can increase the effectiveness of it. |
Volume 80, Issue 9 (December 2022)
Methods: This descriptive-cross-sectional study was conducted on 122 patients referred to Fajr Ilam Clinic in October 2015 to January 2018.Clinical characteristics such as age, gender, BMI and history of underlying thyroid diseases and Hashimoto's thyroiditis were collected with the help of a questionnaire.The dependence of ultrasound characteristics with thyroid malignancy was determined using a multivariate analysis test. This ultrasound feature was compared with the results of fine needle aspiration cytology and the diagnostic accuracy indices were calculated for each ultrasound feature.This article was conducted using statistical tests, chi-square, independent t-test, Mann-Whitney test, and bivariate logistic regression using Spss software.
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Results: The study sample included of 30(24.6%) malignant and 92(75.4%) benign nodules. Hypoechogenicity and microcalcification showed statistically significant positive associations with thyroid malignancy (P<0.05).Also, according to Fisher's exact test, 7% and 20% of men had benign and malignant nodules, and 86% and 80% of women had benign and malignant nodules, respectively. But there was no statistically significant difference between the two groups (P>0.05). Hypoechogenicity had 63.3% sensitivity and 67.04% specificity, microcalcification had 60% sensitivity and 65.93% specificity. Having at least one good sonographic feature resulted in the highest sensitivity (86.67%), while the presence of both features had almost perfect specificity (91.3%) and the highest positive likelihood ratio (4.21).
Conclusion: According to the results of this article, the presence of Microcalcification variables and Hypoechogenicity are the most important criteria in predicting thyroid malignancy, and they are Locate in the TI-RADS grading. Therefore, nodules larger than 1 cm in size with the characteristics of microcalcification and homogeneity ultrasound should be the main focus of diagnostic evaluations. |
Volume 82, Issue 5 (August 2024)
Methods: Type of study of this research was a systematic review and network meta-analysis. Databases such as Scopus, PubMed, ISI, Science Direct, Google Scholar, SID, MagIran, web of Science, and Cochrane Library were searched. Keywords atorvastatin, simvastatin, and rosuvastatin were used in the search strategy. We did both standard meta-analyses and network meta-analyses. Consistency was checked by comparing direct and indirect effect sizes. The time period for searching articles was from 2000 to June 2024. All relevant articles published in English or Persian were reviewed. Paired wised comparisons were made using the intervalplot command in STATA. The surface under the cumulative ranking (SUCRA) was used to rank the efficacy of treatments. The Q test and I2 index were used to assess the heterogeneity of the studies. Data were analyzed using STATA Ver. 17.
Results: From the 61 articles that were included in the network meta-analysis (atorvastatin 43 studies, rosuvastatin 22 studies, simvastatin 21 studies, and placebo 15 studies). The total sample size was 62178 patients. The results showed that the effect of, atorvastatin, rosuvastatin, and simvastatin with placebo on fat lipids was significant (P<0.001). Still, there was not a substantial difference between the effects of the three drugs. The best treatment for reducing LDL was atorvastatin (standard mean difference (SMD) =-5.18, 95% confidence interval (CI);-7.42,-2.95, P<.001). SMD LDL for rosuvastatin and simvastatin were -4.35(95% CI; -6.81,-1.89), and -3.44(95% CI;-5.89,-.98) respectively. The surface under the cumulative ranking (SUCRA) showed that the probability that Rosuvastatin was the best drug for reducing triglycerides was 82.4% and the likelihood that atorvastatin was the best drug for reducing cholesterol was 80.3%.
Conclusion: Atorvastatin, rosuvastatin, and simvastatin have a better effectiveness than placebo in reducing fat lipids. Atorvastatin was the best treatment to reduce LDL, and TC and increase HDL. Rosuvastatin was the best drug to reduce TG. Atorvastatin, rosuvastatin, and simvastatin were the effective treatments to reduce fat lipids respectively.
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