Tehran University Medical Journal

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Infant mortality and morbidity present important challenges to those concerned with community health. We did this research to study epidemiology of diseases of infancy in city of Tehran. During 15 days, of 6395 deliveries in Tehran hospitals a cohort of 6267 live births entered this study. Follow up data were gathered in 1st, 3rd, 6th and 12th months of birth. In this period, 5382 occurrence of disease were reported. The most frequent were cardiopulmonary (52.3%) and Gastrointestinal (26.6%) diseases. Most of the events were seen in 6-12 months age group (30.5%). The lowest frequencies of infant diseases were seen in 19-35 years of maternal age (15.3%), as compared with >35 (35.4%) and <19 (49.3%) groups. Mortality ratio was 32/1000 live birth (198 death). The most common causes of death were cardiopulmonary (38%), infectious (21%) and gastrointestinal (18%) diseases. Control of infectious disease, development of educational programs for breast feeding and planning of proper age and interval of pregnancy are effective measures for reducing infant mortality and morbidity.

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The aim of the present investigation was to determine the prevalence of metabolic syndrome.
Materials and Methods: Metabolic syndrome was defined by the presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-C, high blood pressure, and high fasting glucose.
Results: In this study, 10368 of the adults (4397 men and 5971 women) aged 20 years and over, participated in Tehran Lipid and Glucose study. The unadjusted prevalence of metabolic syndrome in the study population was 30.1% (CI 95%: 29.2-31.0), and age-standardized prevalence was 33.7% (CI 95%: 32.8-34.6). The prevalence increased with age in both sexes. Metabolic syndrome was more commonly seen in women than men (42% vs. 24%, p< 0.001). Low HDL-C was the most common metabolic abnormality in both sexes. Except for high FPG, all abnormalities were more common in women than in men (p< 0.001). Most of those with metabolic syndrome had 3 components of the syndrome (58%), 33% had four, and 9% had five
components.
Conclusion: This first report on metabolic syndrome from Iran shows a high
prevalence of this disorder, imposing serious impacts on health care system. Efforts
on promoting healthy diets, physical activity, and blood pressure control must be
undertaken.

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Kimura's disease (K.D) is an uncommon, benign, chronic inflammatory condition of unknown etiology and pathogenesis involving subcutaneous tissue presenting as a tumor like lesion with a predilection for the head and neck region. If parotid gland is affected clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnosis before tissue biopsy and fine middle aspiration (FNA) has only limited value. There is no evidence of malignant transformation and occasional spontaneous resolution occurs. Various treatment modalities have been suggested in the management of this condition but none is proved best and recurrence is common. we describe a 33 - year- old man with KD who presented with left parotid mass.

 

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Background: Stenotic coronary arteryIt is essential to identify the best simple anthropometric index in any population to predict chronic disease risk. This study was designed to compare the ability of waist circumference (WC), body mass index (BMI) and waist-to-hip ratio (WHR) to predict cardiovascular risk factors in an urban adult population of Tehranian men.

Materials and Methods: This population-based cross-sectional study was conducted on 4449 men aged 18-74 years, participants of Tehran Lipid and Glucose Study (TLGS). Demographic data was collected. Anthropometric indices were measured according to standard protocol. Blood pressure was measured and hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as FBS≥126 mg/dl and dyslipidemia based on ATP II. The presence of “at least one” and “at least two” risk factors from the four major cardiovascular risk factors (hypertension, dyslipidemia, diabetes and smoking) was also evaluated.

Results: Mean age of men was 41.8±15.4. Mean BMI, WHR and waist circumference was 25.6±4.2 kg/m2, 0.91±0.07 and 87.7±11.7 cm, respectively. Of the three individual indicators, WHR had the highest sensitivity for all risk factors. No combination of indicators had higher average sensitivity + specificity than WHR alone. WHR had a higher percentage of correct prediction than BMI and waist circumference for all risk factors. No combination of measures was significantly more accurate than WHR alone, except for combinations where another indicator has been combined with WHR by “or”.

Conclusion: It is concluded that WHR is the best predictor of cardiovascular risk factors compared to BMI and WC in Tehranian adult men residing in district-13.

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Background: No evidence exists regarding the prevalence of the hypertriglyceridemic waist phenotype in adolescents. We aimed to evaluate the prevalence of this phenotype in a representative sample of Tehranian adolescents.
Materials and Methods: Anthropometry and biochemical measurement were assessed in a population-based cross-sectional study of 3036 Tehranian adolescents (1413 male and 1623 female) aged 10-19 years. Hypertriglyceridemic waist phenotype was defined as concurrently having serum triglyceride concentration ≥110 mg/dl and waist circumference ≥90th percentile for age and sex. Overweight (≥95th percentile) and at risk for overweight (≥85th-<95th percentile) was defined based on the standardized percentile curves of body mass index suggested for Iranian adolescents.
Results: The prevalence of the hypertriglyceridemic waist phenotype was 6.4% (95%CI: 5.5-7.2) among Tehranian adolescents (males: 7.3%, 5.9-8.7 and females: 5.6%, 4.4-6.7). Overweight subjects had the highest proportion of hypertriglyceridemic waist phenotype than those at risk for overweight and those with normal-weight (male: 42.9 vs 2.9 and 0.0%, respectively, P<0.01 female: 32.5 vs 11.3 and 1.3%, respectively, P<0.01).
Conclusion: This study provides evidence showing high prevalence of the hypertriglyceridemic waist phenotype in Tehranian adolescents, particularly among overweight adolescents. This finding highlights the need for effective preventive and therapeutic strategies relying on diet, physical activity and lifestyle modification.

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Background: The NCEP step II diet produced a desirable lipoprotein response in hypercholesterolemia. A relation between plasma concentrations of small dense LDL and cardiovascular risk factors has also been mentioned in children. This study was conducted to determine the effects of the National Cholesterol Education Program (NCEP) step 2 diets on the low density and high density lipoprotein particle size in dyslipidemic adolescents.
Methods: Forty- four dyslipidemic adolescents, aged 10-18 years, participated in this case-control study. The control group was not given a diet prescription and was simply instructed to “eat as usual”. Their eating patterns reflected the consumption of macronutrients, fruit, vegetables and dairy products, typical of what many Tehranian eat. NCEP step 2 diets was a diet with 30% of calories as total fat, less than 7% saturated fat, less than 200 mg cholesterol, less than 15% of calories as monounsaturated fat and less than 10% as polyunsaturated fat per day. Lipoprotein particle size was the major outcome variables, which was measured after 3 months of intervention. Lipoprotein particle size was estimated by nondenaturing polyacrylamide gradient gel electrophoresis using Krauss and Burke methodtion.
Results: The mean body mass index was 26.3±4.2 kg/m2. Baseline characteristics of these adolescents did not differ significantly across the NCEP step 2 and control diet groups. The NCEP diet resulted in higher reduction in total cholesterol (-13±4 vs –2±0.3 mg/dl, p<0.001), LDL (-9±2 vs 3±0.6 mg/dl, p<0.01) and higher increase in size of the LDL (1.7±0.4 vs 0.1±0.4 mg/dl, p<0.001). HDL particle size did not change significantly. The prevalence of hypercholesterolemia decreased significantly (p<0.05) in NCEP step 2 group (68% in NCEP step 2 vs 100% in the control group) after 3 months.
Conclusion: NCEP step 2 diet not only reduces the serum LDL concentration of hypercholesterolemic adolescents but also has a favorable effect on the LDL particle size distribution. The related mechanism needs to be studied in future experimental designs.

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Background: Aluminum salts are common adjuvants in human and animal vaccine preparations. The two adjuvants aluminum phosphate and aluminum hydroxide show acceptable immunoadjuvant properties with many antigens. These two salts have different physicochemical characteristics that make each one suitable for certain antigens. The surface antigen of Hepatitis B (HBsAg) has several antigenic epitopes that bind to aluminum adjuvants by a ligand exchange mechanism. Although HBV vaccines using an aluminum hydroxide adjuvant are available, higher antigenicity is needed for the subgroup of people who do not respond sufficiently to the currently available vaccines.
Methods: A solution of recombinant HBsAg for making different formulations of vaccines with aluminum phosphate (Adju-Phos®) and aluminum hydroxide (Alhydrogel®) adjuvants was obtained from Darupakhsh Pharmaceutical Company. The total protein content, antigenicity, and purity of HBsAg solution were determined using BCA, ELISA, and SDS-PAGE methods, respectively. The different formulations were prepared in the lab and administered i.p. to two test groups of Balb/C mice and a third test group received the Engerix vaccine, which is currently available on the market and uses an aluminum hydroxide adjuvant. The control group of animals received the solution without antigen. After 28 days, heart blood samples were collected and serum was separated to determine the antibody titer against HBsAg using an ELISA kit.
Results: This study shows that the vaccine formulated with aluminum phosphate exerted more immunogenicity than both the aluminum hydroxide laboratory formulation and the Engerix vaccines.
Conclusion: Although the results of our study indicate higher immunogenic properties of the vaccine formulated with the aluminum phosphate adjuvant, complementary experiments are needed to further evaluate the biological properties with respect to effectiveness, adverse effects, product stability and finally possibility for manufacturing and distribution of this new formulation as a Hepatitis B vaccine.

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Background: Rapid tissue growth and development during puberty increases the need for energy and nutrients. On the other hand, the prevalence of obesity is accelerating among adolescents. Controversies exist regarding meal frequency, obesity and adequacy of nutrients in particular, a more frequent snacking pattern has been associated with overconsumption of calories in children and adolescents and also with greater body weight. We investigated the meal frequency of adolescents in relation to meeting nutrient requirements.
Methods: This cross-sectional study, in the framework of the Tehran Lipid and Glucose Study (TLGS), included 367 boys and girls aged 10-19 years that were randomly selected. Dietary recalls for 48 hours were gathered and participants divided to three groups according to meal frequency group 1, 2 and 3 with <4 meals, 4-6 meals and ≥ 7 meals, respectively. The nutrient intakes were compared with the dietary reference intake (DRI). ANCOVA, Bonferroni and partial correlation by adjusting total energy intake were used for statistical analyses.
Results: The mean age of these 169 boys and 198 girls was 14±3 years old. The weight of the first group was higher by one-third in boys (54±18 vs. 45±13 kilogram, p<0.05). There were no other significant differences in anthropometric indices of the studied subjects, nor was there any difference in the vegetable and meat intake between the groups. But the first group had lower intake of fruits and milk groups (p<0.01). Individuals in all three groups had inadequate intake of calcium, zinc, copper, magnesium, pyridoxine compared with the DRI, although the vitamin C and riboflavin intakes were adequate. Higher meal frequency was associated with sufficient intake of magnesium, vitamin C, riboflavin and pyridoxine.
Conclusion: Adolescents tend to have inadequate intakes of calcium, pyridoxine, zinc, copper, all of which are essential for health and proper growth. Increasing the number of meals per day, without increasing energy intake could help to boost the quality of the diet.

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Background: Aflatoxins are severe toxic secondary metabolites found in most plant products. When animals consume contaminated feed stuff to Aflatoxin B1 (AFB1), the toxin is metabolized by liver and is excreted as Aflatoxin M1 (AFM1) via milk. Aflatoxins are acute toxic compounds, immunosuppressive, mutagen, tratogen and carcinogen.
Methods: During the winter of 2006, pasteurized and sterilized (ultra high temperature) (UHT) milk packages were collected from supermarkets in Babol city. 78 pasteurized and 33 sterilized milk, totally 111 samples were tested for AFM1 by competitive Enzyme Linked Immunosorbent Assay (ELISA). Solid phase in plastic micro wells coated whit anti-Aflatoxin M1 antibodies. We added 100 microliter skimmed milk and Aflatoxin M1 standard solutions in each well. In each plate, we appointed seven wells for standards. Plates were incubated at 20-25° centigrade for 45 min. Each well was washed four times by washing buffer 20X concentration. Then 100 micro liter conjugated solution (100X) was added to each well, and the plate was incubated at 20-25 centigrade for 15 min. After that, the wells were washed. After adding the substrates to wells, we incubated the plate at 20-25° centigrade in a dark place for 15 min. The reaction was stopped by stop solution. After one hour, light absorption was read at 450 nm by ELISA reader.
Results: AFM1 were detected in 100% of all samples. 100% of samples were above of European community regulations (50ng/l). AFM1 contamination mean levels pasteurized and sterilized milk were 230.5 and 221.66 respectively. Therefore more than four fold levels European community. There is not a significant relationship between AFM1 contamina-tion level and different months of winter applying statistical test.
Conclusion: The results showed the need for introducing safety limits for AFM1 levels in child milk under Food Legislative liable of Iran. Aflatoxin M1 contamination is a serious problem for public health, and it is potentially hazardous for human health.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Paraquat is an herbicide produced and used prevalently worldwide. Studies have shown that lung fibrosis induced by paraquat can be prevented or delayed by certain antioxidants, iron chelating agents, melatonin, and, recently, blood pressure lowering drugs such as captopril.
Methods: The protective effects of captopril on paraquat toxicity were studied using RT-PCR and immunohistochemistry to determine the gene and protein expression of p53 and Bcl-2 in lung tissue samples from rats treated with captopril before and after exposure to paraquat.
Results: We found no significant difference in the gene and protein expression of p53 in different tissue samples, except for mRNA levels in the lung tissue of captopril-treated rats. However, the protein expression of Bcl-2 is greater in tissue from rats exposed to paraquat alone and paraquat together with pre- and posttreatment with captopril compared to tissue from untreated control rats and from those treated with captopril alone, which can be due to inflammatory responses of lung tissue. By RT-PCR, we were unable to detect Bcl-2 in lung tissue samples.
Conclusion: These results show that paraquat does not induce significant DNA damage therefore, the gene and protein expression of p53 was not changed. Paraquat does induce lung tissue inflammation, which in turn increases Bcl-2 protein expression. Finally, captopril had no significant effect on the lung tissue toxicity induced by paraquat. Considering these results and the cellular interactions in lung tissue, we suggest that complementary assays and in-vitro cell culture experiments be performed to further elucidate the molecular events underlying paraquat lung toxicity.

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Background: Although metabolic syndrome (METs) is receiving attention from physicians, data on the syndrome's association with coronary heart disease (CHD) in the Iranian population are limited. This study was designed to determine the association of different definitions of METs and its components with CHD.

Methods: Logistic regression analysis was used to analyze data from 5981 subjects aged ≥30 years. METs definitions by the International Diabetes Federation (IDF), the Adult Treatment Panel (ATP III) and the WHO for CHD were used in three models: model 1 an age adjusted model, model 2 adjusted for age, smoking status, premature history of CHD and LDL-cholesterol and model 3 adjusted for the mentioned variables plus the METs components.

Results: METs as delineated by all three definitions was associated with CHD in models 1 and 2. In model 2, METs was most closely associated with CHD in men, as defined by the WHO [2.3 (1.8-3)] and in women by the ATP III definition [1.6 (1.3-2)]. In model 3, METs lost its association with CHD. However, in men high fasting plasma glucose and high blood pressure plus obesity (by the WHO definition) and in women high blood pressure plus high waist circumference (by the ATP III definition), obesity and glucose domain (by the WHO definition) remained associated with CHD.

Conclusions: In Iranian men and women, all three definitions of METs were associated with CHD when considering the conventional risk factors. After further adjustments for the components of METs, none of these definitions showed an association with CHD and only high blood pressure correlated with CHD in both sexes for all definitions.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Diabetes and dysglycemia have a high prevalence in Iranian population but the information about their impact on the cardiovascular disease (CVD) risk is scarce in this population. This study aimed to determine the risk of CVD according to glucose tolerance status.
Methods: We ascertained cases with incident CVD in a population of 1752 men and 2273 women, 40 years old and over and free of CVD at the beginning of study, during a follow up with a median of 7.6 years. To calculate hazard ratio (HR) for CVD, we controlled traditional risk factors, including age, body mass index, waist, total cholesterol, HDL-cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, education, smoking, hypertension medication, lipid lowering medication and family history of premature CVD and diabetes.
Results: Cardiovascular events occurred in 197 men and 143 women. Its incidence density was 11.8 per 1000 person-years (95% confidence interval: 10.6 to 13.1) totally. Multiple adjusted HR in women with known diabetes was 3.88 (95%CI: 2.40 to 6.27) and with newly diagnosed was 2.34 (95%CI: 1.39 to 3.95) and the corresponding values for men were 1.72 (95%CI: 1.00- 2.95) and 1.52 (95%CI: 1.01- 2.31) respectively. Impaired fasting glucose and impaired glucose tolerance increased 56% the risk of CVD in women (HR: 1.56 with 95% CI, 1.00 to 2.45), just in the age adjusted model.
Conclusion: All diabetic patients should receive primary prevention for CVD intensively, regardless of whether they are newly diagnosed or are known cases specially, females who have abnormal glucose metabolism.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Cystic fibrosis is a monogenic recessive disorder founds predominantly in caucasian population causes exocrine glands function defect. This disease arises from mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Because of heterogeneity of the mutations in CFTR gene, phenotypic symptoms in this disease are very variable. In this study we consider poly T polymorphism (T₅, T₇, T₉) in the intron 8 of CFTR gene in normal individuals and cystic fibrosis patients in mazandaran province.
Methods: Forty cases of cystic fibrosis patients and 40 normal individuals were screened for poly T polymorphism in intron 8 of CFTR gene using Reverse Dot Blot method.
Results: T₇ allele is the most prevalent in normal individuals and CF patients and it's abundance is approximately 75%. T₉ and T₅ represent approximately 20% and 5% of normal or mutant alleles respectively. T₇/T₇ genotypes in normal individuals and CF patients are the most prevalent with 72.5% and 60% prevalence rate, respectively. T₅/T₉ and T₅/T₅ genotypes were not found. 22.5% of normal individuals and 30% of CF patients had heterozygote genotypes.
Conclusion: The abundance of T₅, T₇, T₉ alleles and the presence of 22.5-30% heterozygote genotypes in normal individuals and CF patients indicates that poly T polymorphism in intron 8 of CFTR gene can be used as a marker for detection of normal and mutant alleles in prenatal diagnosis or can be used in carrier assessment in families with previous history of the disease.

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Background: Cancer is a multistep process that develops very rapidly after its onset. Previous studies have confirmed antitumor effects of curcumin (1,7-bis (4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione diferuloylmethane) that can potentially prevent colon cancer development with low side-effects. Different methods have been performed to increase the efficiency and effectiveness of curcumin among which dendrosome, a nanoparticle created by Sarbolouki et al. was used in this study. The present study was undertaken to evaluate the effects of dendrosomal curcumin on rat colon cancer.

Methods: In this study which was performed in Cancer Research Center of Tehran University of Medical Sciences in 2010 year, forty rats were equally divided into control, curcumin and curcumin-dendrosome groups. Animals received azoxymethane (15 mg/kg s.c.), a carcinogen, once a week for two weeks. Curcumin (0.2%) and curcumin-dendrosome were administered to the respective animals 2 weeks before the first and 14 weeks after the last azoxymethane injections. Eventually, colorectal specimens from tumoral and adjacent non-tumoral mucosal tissues were fixed in 10% formaldehyde, and passaged and embedded in paraffin. Histopathological and immunohistochemical studies were performed on the specimens.

Results: The mean number of lesions, nuclear/cytoplasmic ratio, epithelial stratification, loss of nuclear polarity, goblet depletion, structural abnormality and beta-catenin expression were higher in the control group compared to curcumin and curcumin-dendrosome groups. These parameters had significantly decreased in the dendrosomal curcumin group (P<0.05).

Conclusion: The present study shows that dendrosome can be used as a suitable nanoparticle to increase curcumin efficiency in the prevention or treatment of colon cancer.

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Background: Nowadays, nanomaterials are used in daily life extensively. One of the most common of these materials is nano titanium dioxide (TiO2) which is used to purify the air and also sunscreens, shampoos and other hygienic products. Although nano-particles are useful, can also have potential hazards. The aim of this study is to evaluate the effects of TiO2 on lung tissue in rabbits.
Methods: We divided 18 male rabbits into three groups randomly. The first group recei-ved 50 µl of TiO2 with dose of 50 mg/kg by intratracheal instillation. The second group received 50 µl of TiO2 with dose of 100 mg/kg and the third group received 50 µl of nor-mal saline by the same route. Chest X-rays were taken from all rabbits before injection and on days of 10, 17 and 24 after injection. Twenty four days after injection, rabbits anesthetized and histopathological assays, blood samples and biochemical factors were evaluated.
Results: Radiographic assays showed a progressive pulmonary fibrosis in rabbits recei-ved TiO2 rather than the control group and this lesion developed to maximum at 24th day of the experiment. We also showed pulmonary emphysema and inflammation in histo-pathologycal study of groups treated with TiO2. Moreover, we observed a significant increase in the amount of liver enzymes, white blood cells and hematocrit in TiO2 treat-ed groups compared to control group (P≤0.05). There were no significant differences between plasma levels of creatinine in different groups (P>0.05).
Conclusion: Results showed that nanotitanium dioxide particles can lead to pulmonary fibrosis and inflammation and also increasing liver enzymes and inflammatory cells.

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Background: Curcumin, the active ingredient of turmeric, has the ability to inhibit the carcinogenic pathways, and thus can prevent or postpone the carcinogenic process in different animal species. Retention time of curcumin is short due to the quick excretion of the body, so, the therapeutic effects of curcumin are restricted resulting in short-term retention in the plasma. Therefore, several methods are used for increasing the efficien-cy of curcumin in plasma and tissues. The present study is designed to evaluate the effects of the anti-proliferative and anti-carcinogenic of nano-curcumin in rat colon cancer.
Methods: In this study which was performed in Cancer Research Center of Tehran University of Medical Sciences in 2012. Thirty rats have divided into control, curcumin and nano-curcumin groups. All animals received azoxymethane (15 mg/kg, s.c) as a carcinogen, once a week for two consecutive weeks. Animals received curcumin 0.2% and nano-curcumin 2 weeks before azoxymethane injection up to 14 weeks after the last injection of azoxymethane in curcumin and nano-curcumin groups, respectively. At the end of experiment, the colorectal specimens from all mucosal lesions were obtained for histo-and-immunohistochemical (Ki-67 and COX-2) studies.
Results: The cytological and morphological changes of the cells in nano-curcumin group were significantly lower compared to other groups (P<0.05). In addition, the Ki-67 and COX-2 proteins expression was lower in the nano-curcumin group in compare-son with the curcumin and control groups (P<0.05).
Conclusion: The results indicate that the using a suitable nanoparticle can be appropria-tely resolved the low bioavailability of curcumin. This can be an important method to use of natural products in the prevention and/or treatment of cancer.

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Background: In Nov 2013, the instruction for controlling high cholesterol has been released by the American College of Cardiology (ACC) and the American Heart Association (AHA) which need to be assessed in the different communities. Methods: Of total 6275 individual aged 40-75 years who entered at the Tehran Lipids and Glucose Study from March 1999 to 20 March 2010 in first examination cycle, 5153 with the median follow-up of more than ten years were eligible to enter in this study. The 10-year risk of hard cardiovascular disease (Hard CVD) for Statin therapy based on ACC/AHA clinical guideline was calculated and this risk was calculated for each subgroup of the guideline who recommended for statin therapy comparing to the risk in individuals with prevalent CVD. Results: Of nearly 6.5 million urban population of Iran (according to the 1996 census) about 4 million individuals (2.55 million men and 1.4 million women) were eligible for statin therapy. With respect to the urban population growth from the 1996 to the 2011 census (about 2.5 percent increases) the number of individuals for receiving statin increased by 50% (5 million men and 3 million women). Also, the risk in non-diabetic men with calculated risk of 5-7.5% and diabetic women with calculated risk of <5% for hard CVD was lower than 0.2. By removing these people from total eligible population, the burden of statin therapy will reduced about 8% which is about 540.752 persons, according to the Census 1996 and 1.155.079 individuals based on the census 2011. Conclusion: The new guideline of ACC/AHA for statin therapy is relatively reasonable except for some subgroups. To reduce the burden of medical expenses, statin prescription can be ignored by physicians in these subgroups. Of course further research is required to calculate the net benefit for estimating the clinical usefulness of statin therapy in recommended guideline subgroups.

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Background: Most problems related to quality of care and patient safety are related to human negligence. One of the causes of these problems is forgetting to do something. This problem can be avoided with information technology in many cases. Some forgotten are very important. Among these is failure to comply with vaccination schedule by parents that can result in inappropriate outcomes. In this study, we developed and evaluated a SMS reminder system for regular and timely vaccination of children.

Methods: In this developmental-applied research, firstly, a child vaccination reminder system was designed and implemented to help parents reduce the forgetfulness. This system based on the child's vaccination history and the date of birth, offer time and type of future vaccines. Then the parents of 27 children, that their vaccination was between 22 June and 21 August 2015, referred to Children's Medical Center, were sent text messages by using this system. We evaluated the accuracy of the system logic by using some scenarios. In addition, we evaluated parents' satisfaction with the system using a questionnaire.

Results: In all cases but one, the system proposed the type and date of future children vaccines correctly. All the parents who have received text messages had good perception and satisfaction on the majority of questions (total mean score of 4.15 out of 5). Most parents (4.92 out of 5) stated that using the system to remind their visit for child immunization was helpful and willing to offer the system to their friends and other families.

Conclusion: Using the short message system is beneficial for parents to remind their children’s vaccination time and increases their satisfaction. So, it can be considered as an important and essential tool in providing healthcare services. SMS is an easy, cheap and effective way to improve the quality of care services.

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Background: The modern science of nanotechnology is an interdisciplinary science that has contributed to advances in cancer treatment. This study was performed to evaluate the therapeutic effects of biosynthesized silver nanoparticles on breast cancer cell of line MCF-7 in vitro. Methods: This analytical study was performed in Kerman and Bam University of Medical Sciences, Bam City, Kerman Province, Iran from March 2015 to March 2016. Silver nanoparticles suspension was synthesized using palm kernel extract. The resulting silver nanoparticles were studied and characterized. The ultraviolet-visible spectroscopy and transmission electron microscopy used for screening of physicochemical properties. The average particle size of the biosynthesized silver nanoparticles was determined by transmission electron microscopy. The properties of different concentrations of synthesized silver nanoparticles (1 to 3 μg/ml) and palm kernel extract (containing the same concentration of the extract was used for the synthesis of silver nanoparticles) against MCF-7 human breast cancer cells were determined by MTT assay. MTT is used to assess cell viability as a function of redox potential. Actively respiring cells convert the water-soluble MTT to an insoluble purple formazan. Results: The ultraviolet-visible spectroscopy showed strong absorption peak at 429 nm. The X-ray diffraction (XRD) and transmission electron microscopy (TEM) images revealed the formation of silver nanoparticles with spherical and octagon shape and sizes in the range between 1-40 nm, with an average size approximately 17 nm. The anti-cancer effect of silver nanoparticles on cell viability was strongly depends on the concentration of silver nanoparticles and greatly decrease with increasing the concentration of silver nanoparticles. The IC50 amount of silver nanoparticle was 2 μg/ml. Conclusion: The biosynthesized silver nanoparticles showed a dose-dependent toxicity against MCF-7 human breast cancer cells.

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Results: 60 patients with urinary tract infections were examined: 57 (47.5%) of the subjects were men and 63 (52.5%) women. There was a significant relationship between the rate of red blood cell deposition in the first hour and systolic blood pressure. There was no significant correlation between the numerical value of white blood cell count and systolic or diastolic blood pressure in the studied patients.