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PubMed2006

Chorionic villus sampling for beta-thalassemia: the first report of experience in Iran.

OBJECTIVES: Beta-thalassemia is one of the most common hereditary disorders in Iran. The prenatal diagnosis of beta-thalassemia is part of a control program in our country and it began 13 years ago. During the past 8 years the number of procedures has increased significantly as also the legal abortions. This is the first report made on the CVS program in Iran. MATERIALS AND METHODS: One thousand six hundred and sixty-one cases of transabdominal Chorionic Villus Sampling (CVS) have been retrospectively evaluated. Among them 1381 cases had inclusion criteria. CVS results, complications and fetal loss rate were evaluated. The distributions of the population at risk were divided between eight regions that have been proposed for beta-thalassemia mapping previously. RESULTS: The mean age of the patients was 26.2 +/- 5.2 years with mean gestational age of 11.4 +/- 1.4 weeks. CVS was successful in all the patients (100%) although 1% required a second procedure. Post CVS fetal loss was 1.45%. Other minor complications were bleeding or spotting (1.81%), amniotic fluid leak (0.5%), small sub-chorionic hematoma (0.58%), severe abdominal pain (0.6%) and severe vasovagal reaction (0.14%). Late complications were seen in 0.21% (oligohydraminos). Approximately 2/3 of the patients were referred from three regions of the country, North (26.8%), South West (22.4%), Central (19.5%) and the remainder (31.3%) were from the other five regions. CONCLUSION: CVS is a safe and effective method for prenatal diagnosis of beta-thalassemia in countries with a high prevalence as in Iran. The overall complication rate is quite low and acceptable. Fortunately the recent acceptance of legal abortion with respect to Muslim rules has increased the effectiveness of the procedure and made great advances in its application in Iran. Correspondingly, social knowledge has also improved but still there is a gap between the population at risk and the required prenatal diagnosis laboratories and sampling centers.

Abortion, Induced↗
PubMed2001

Use of systemic anti-infective agents in Iran during 1997-1998.

OBJECTIVE: Conduction of standardized national drug utilization review to investigate the pattern of systemic anti-infective agent use in Iran. METHODS: The wholesale data were used. The Anatomical Therapeutic Chemical (ATC) classification and the defined daily dose (DDD) methodology was employed. Data were presented as DDD/1,000 inhabitants"day. Results were compared using national drug statistics of Norway, Sweden, and Denmark. RESULTS: The overall sales of systemic anti-infective agents was 43.5 DDD/1,000 inhabitants/day. The parenteral form of drug accounted for 4.20% and broad-spectrum systemic antibacterial agents accounted for 86.2%. The three most commonly used agents, accounting for 74.1% of total sales, were amoxicillin, co-trimoxazole, and ampicillin. Seven kinds of anti-infective agents (17% of total available agents) accounted for 90% of antibacterial use, with dominance of broad-spectrum agents. Comparison showed differences in pattern and intensity of use. The sales of systemic anti-infective agents in general, particularly antibacterials and anti-tuberclotics, were greater in Iran than in three European countries. Broad-spectrum antibacterial agents accounted for a larger proportion of total sales in Iran. CONCLUSION: The high use of systemic antibacterial agents in general, particularly broad-spectrum agents, suggest the possibility of irrational prescribing, higher prescribed daily doses than DDDs, and a drug wastage. This survey, as a first attempt, provided an overview of anti-infective use in Iran. Thus, it may serve as a basis for further investigative studies and advanced drug policies.

Amoxicillin↗
PubMed2006

Gastrointestinal malformations in Gorgan, North of Iran: epidemiology and associated malformations.

The aim of this prospective study was to evaluate the prevalence and pattern of gastrointestinal malformations (GIM) among Iranian newborns in Gorgan, North of Iran. From 1998 through 2003, 37,951 live births in Dezyani hospital in Gorgan, North of Iran, were screened for gastrointestinal malformations. Clinical and demographic factors of diagnosed cases were recorded in a pre-designed questionnaire for analysis; sex, ethnicity, type of GIM and associated anomalies. The overall prevalence rate of gastrointestinal malformations was 10 per 10,000 births. The imperforate anus (5 per 10,000) was the commonest birth defect in gastrointestinal tract. The prevalence rate of GIM was 8.2 per 10,000 in males and 10.7 per 10,000 in females. According to the parental ethnicity, the prevalence rates of GIM were 6.7, 15.8 and 17.6 per 10,000 in Fars, Turkman, and Sistani, respectively. There were eight cases (21%) with associated anomalies. The prevalence rate of GIM in North of Iran is not similar to the previous studies in Iran and Middle East and ethnic background may be a causative factor in the rate of GIM in this area.

Digestive System Abnormalities↗
PubMed2006

Injectable diclofenac: a painful shot into Iran's health system.

Despite high accessibility to medicines, irrational prescribing of injections is a characteristic of Iran's health system and it has been reported that more than 40% of patients who visited a doctor receive at least one injection. The injectable dosage form of Diclofenac was introduced into the Iran drug market in 1993. However, its use rapidly increased shortly post commercialization and its sale increased to 85,520,000 ampoules in 1998. Not unexpectedly, the Iran pharmacovigilance center received a substantial number of reports indicating adverse drug reactions (ADR) following the use of injections and specifically with that of Diclofenac injection. A total number of 176 ADR citing major problems following intramuscular administration of Diclofenac were reported to Iran's pharmacovigilance center in the period of 1996-2002. Although a multi interventional policy including educational, regulatory and managerial interventions was able to bring ADR due to Diclofenac injection under control, statistics shows that prescribers are now trying to substitute Diclofenac injection by other injectable medicines.

Adverse Drug Reaction Reporting Systems↗
PubMed2005

Afghan refugees in Iran model renal transplantation program: ethical considerations.

During 23 years of civil war in Afghanistan, there has been a continuous flow of more than 5 million refugees out of the country. Iran has hosted about 40% of all refugees. The majority have resided outside of camps with opportunities to integrate locally, having access to the Iranian labor market and government services, such as dialysis and transplantation. Iran also has adopted a compensated living unrelated donor renal transplantation program in which foreigners can receive transplants from living related donors or volunteer living unrelated donors of the same nationality. In June 2004, among 241 refugees with end-stage kidney disease in Iran, 179 were on hemodialysis and 62 underwent renal transplantation. Nine patients received kidneys from living related donors, 1 from a spouse, 50 from Afghani living unrelated donors, and 1 from a cadaveric donor. No refugee had been used as a kidney donor to an Iranian patient. Transplantation of all Afghan refugees in need and the absence of their use as kidney donors to Iranian patients proffer strong evidence against commercialism and a reason to believe that the Iran Model transplantation is practiced with ethical standards. In the last 2 years since the civil war has ended, returning these patients to Afghanistan has raised important ethical concerns. Repatriation of dialysis patients and transplant recipients may be tantamount to their deaths. It is expected that The Transplantation Society and the World Health Organization will establish links with the United Nations High Commissioner for Refugee Offices to provide humanitarian assistance to these patients.

Afghanistan↗
PubMed2004

Inter and intra-specific genetic variation of avian Eimeria isolated from Iran by random amplified polymorphic DNA--polymerase chain reaction.

Eimeria species from poultry breeder farms without previous exposure to anticoccidial vaccines in five distinct geographical regions of Iran were examined for genetic relatedness by the random amplified polymorphic DNA (RAPD) assay. Eight different oligonucleotide decamers with arbitrary DNA sequences were tested as primers to amplify DNA from five isolates of each E. acervulina, E. tenella, and E. maxima. Depending on the species/isolate-primer combination, between 1 and 14 DNA fragments ranging in size from 240 to 3000 bp were amplified. The two isolates originated from Northeast and North parts of Iran showed minor differences and two isolates originated from Northeast and Southwest of Iran showed major differences in their amplified DNA patterns. The intra-specific similarity coefficient within five isolates of each species of, E. acervulina, E. tenella, E. maxima was 74, 82 and 72%, respectively. The distance indices observed between species were greater than those found between isolates (80-90%) with all examined primers. The inferred phylogenetic tree on the fingerprinting of all species revealed that the RAPD-PCR can easily differentiate within and between species and could be a useful and valuable tool in future epidemiological studies, designing and developing of vaccines against avian coccidosis, here in Iran and neighboring countries.

Animals↗
PubMedDate not supplied

Cyclical evolution of nursing education and profession in Iran: religious, cultural, and political influences.

This article was written to gain some insight into the underlying social and/or cultural forces that have, over the centuries, influenced the development of nursing education and the nursing profession in Iran, one of the most ancient civilizations of the world. As a native of Iran deeply involved in the nursing profession and in many aspects of nursing education, I decided to review my many years of experience and observations in these fields in Iran to better understand how the noble profession evolved as it did in my native country. For the years following the Islamic Revolution of 1977 to 1979, I was forced to rely on information gathered from my professional colleagues. An extensive search of the literature yielded a better understanding of the very early years. Analysis of this data seemingly produced a potpourri of such basic issues as modes of education, cultural/religious states of consciousness, and the rights of women. These are not factors generally considered germane to the development of the nursing profession and nursing education, although the latter two have proven to be crucial issues in understanding the development and current status of nursing education and the nursing profession in Iran.

Arab World↗
PubMed2000

Natural occurrence of fumonisins in corn from Iran.

Corn collected in the Mazandaran and Isfahan Provinces of Iran was analyzed for fumonisin B(1) (FB(1)), fumonisin B(2) (FB(2)), and fumonisin B(3) (FB(3)). The samples from Mazandaran Province, situated on the Caspian littoral of Iran, were random samples from farmers' corn lots collected in September 1998, whereas those from Isfahan Province, situated further south in the center of Iran, were bought as corn cobs in the local retail market during October 1998. All 11 samples from Mazandaran showed high levels of fumonisin contamination with FB(1) levels between 1.270 and 3.980 microg/g, FB(2) levels between 0.190 and 1.175 microg/g, and FB(3) levels between 0.155 and 0.960 microg/g. Samples from Isfahan showed lower levels of contamination with eight of eight samples having detectable FB(1) (0.010-0.590 microg/g), two of eight samples having detectable FB(2) (0.050-0.075 microg/g), and two of eight samples having detectable FB(3) (0.050-0.075 microg/g). This is the first report of fumonisin contamination of corn from Iran, in which samples from the area of high esophageal cancer on the Caspian littoral have been shown to contain high levels of fumonisins.

Carboxylic Acids↗
PubMed1999

Pseudoexfoliation syndrome in central Iran: a population-based survey.

PURPOSE: To determine prevalence and clinical characteristics of pseudoexfoliation syndrome (PES) in central Iran in a population-based survey. METHODS: A random sample of people aged 50 years or older from Falavarjan county, central Iran, was examined for signs of PES. RESULTS: Eight hundred-six eyes belonging to 405 cases (210 women and 195 men) were examined. Seventy-seven eyes (9.6%; 95% C.I. = 7.6%-11.6%) of 53 cases (13.1%; 95% C.I. = 9.8%-16.4%) showed pseudoexfoliative deposits. Anterior lens capsule was the most common site for deposition of pseudoexfoliative deposits. Several pigmentary signs were significantly associated with presence of PES (p < 0.001 for all signs). Ten out of 77 eyes (13%) with PES demonstrated increased intraocular pressure or glaucoma. CONCLUSION: Pseudoexfoliation syndrome is a frequent finding in the elderly in central Iran. Most cases can be diagnosed by a careful examination of the anterior lens capsule after pupillary dilation. Glaucoma or ocular hypertension is not common in people with PES in central Iran.

Adult↗
PubMed2001

Distinct pattern of TP53 mutations in squamous cell carcinoma of the esophagus in Iran.

Extremely high rates of squamous cell carcinoma of the esophagus (SCCE) are observed in Iran, reflecting unknown, genetic and/or epidemiological risk factors. Among genetic alterations in SCCE, TP53 mutations are the most frequent, vary among populations, and may provide clues on etiological mechanisms. We have analysed mutations in TP53 (exons 5-8) in 98 SCCE from Iran by temporal temperature gel electrophoresis and direct sequencing. We found 58 mutations in 49 patients (50%), with a high prevalence of C to T transitions at CpG dinucleotides (29.3%). The TP53 mutation pattern in Iran was significantly different from that observed in SCCEs from high incidence areas of China and Western Europe (P=0.007). Moreover, the prevalence of mutations at A : T base pairs (transitions and transversions) was higher in men than in women (38.7% vs 11.1%, P=0.033). COX-2 overexpression was detected in 69% of the cases evaluated (24/35), without significant association with TP53 mutation. Accumulation of nitrotyrosine, a marker of protein damage by excess levels of nitric oxide, was observed in tumor cells in six of 18 [corrected] cases analysed. These results are consistent with the hypothesis that several factors are involved in TP53 mutagenesis in Iran. These factors include a baseline of chronic inflammatory stress, which may have a multiplicative impact on the sensitivity of esophageal cells to exogenous factors of risk.

Adult↗
PubMed2001

Prevalence of gallstone disease in Iran.

BACKGROUND: Prevalence of gallstone disease is different depending on the geographic region involved. Few studies, in Asia but not from Iran, about the frequency of gallstone disease have been published. The aim of this study is to examine the prevalence of gallstone disease in Iran. METHODS: Four hundred and seventy-seven nomads from southern Iran, 513 industrial laborers older than 34 years, and 421 laborers from a pharmaceutical company above 30 years of age, and 471 elderly persons from three nursing homes near Tehran underwent abdominal sonography. RESULTS: There were 1373 men and 509 women. Eighty-nine subjects had gallstone disease and 10.1% of them were cholecystectomized. While the prevalence in the men and women in the age group 31-40 years was very low (0.3% in men and 1.8% in women), it increases sharply in men older than 60 years and women older than 50 years to more than 10-fold (12.5 and 24.6% in male and female with an age 71-80 years, respectively). CONCLUSION: In Iran, gallstone disease is very uncommon in middle-aged people, but increases sharply in older people. However, this does not reach the high prevalence seen in Western countries. The intake of a high fiber-containing diet, a low number of overweight people, smoking habit and hyperlipidemia are probably the cause for this low prevalence.

Adult↗
PubMed2006

Nitric oxide induction as a novel immunoepidemiological target in malaria-infected patients from endemic areas of the Islamic Republic of Iran.

OBJECTIVE: Malaria has been prevalent for a long time in Iran and continues to be a health problem despite substantial control programs. In addition to numerous cytokines, nitric oxide (NO) is thought to be a key molecule and a novel target of malaria immunopathology. MATERIAL AND METHODS: The objective of this research was to measure reactive nitrogen intermediates (RNI) as stable metabolites of NO induction in plasma of malaria-infected patients in Iran. In this study, 235 blood samples from malaria patients and 80 blood samples from healthy controls were randomly collected from different malarial endemic provinces of Iran, located in southeastern (Sistan & Balouchestan, Hormozgan, Kerman) and northwestern (Ardabil) areas. The involvement of NO in malaria patients has been investigated by statistical analysis of RNI values. Griess micro assay (GMA) was used during Plasmodium vivax, P. falciparum and mixed infections, in order to evaluate whether RNI changes are related to the provincial areas, parasite strains, clinical symptoms and age and gender parameters. RESULTS: The results showed a significant increase of RNI level in malaria patients compared with the control groups of Ardabil (p<0.01), Sistan & Balouchestan, Hormozgan and Kerman (p<0.001) provinces. The level of RNI was higher in mixed plasmodial infection than in single infection. CONCLUSIONS: The high level of RNI was dependent on the type of infection, the plasmodia strain, the clinical symptoms, the age groups and the endemic provinces. Although, this study did not clarify the pathogenic and/or protective role of NO in malaria, our findings provide a novel immunoepidemiological aspect of basal NO production in patients with malaria in endemic areas in Iran.

Adolescent↗
PubMed2002

Fumonisin B(1) in maize harvested in Iran during 1999.

The fumonisin B(1) (FB(1)) contamination of maize collected in two areas of Iran during 1999 was determined. The 20 maize samples from Mazandaran Province, situated on the Caspian littoral of Iran, consisted of random samples of farmers' lots and were all contaminated with FB(1) at a mean level of 3.18 mg kg(-1) (range 0.68-7.66 mg kg(-1)). The 10 samples (of the same maize cultivar) from Isfahan Province in central Iran were purchased as maize cobs in local retail markets and had mean FB levels of 0.22 mg kg(-1) (mean of all samples, 6/10 samples positive, range <0.01-0.88 mg kg(-1)). The FB levels in Mazandaran, an area of high oesophageal cancer, were significantly (p < 0.0001) higher than the FB levels found in maize from Isfahan, an area of low oesophageal cancer in Iran.

Carboxylic Acids↗
PubMedDate not supplied

Infants' growth charts for southern Iran.

Currently there are no growth charts based on local norms available for infants in Iran, and their growth is assessed by the National Centre for Health Statistics (NCHS) reference data, which is misleading. Growth charts for a cohort of 317 infants (164 girls and 153 boys) born in Shiraz (Southern Iran) in 1996 and followed for 2 years from birth are presented. All the centiles of length and weight charts are slightly above those of the NCHS charts under the age of 6 months and fall substantially below those over the age of 6 months. However, the spread is similar, so there is no suggestion that the difference is due to the prevalence of gross malnutrition. The difference shows that the use of locally based growth charts are essential for assessing the growth of children in Iran. The representativeness of our data leads us to conclude that the charts presented here are likely to be applied to the urban infant population of Iran.

Age Factors↗
PubMed1999

Fluoride concentration in foods from Iran.

Knowledge of fluoride intake is important in optimizing the caries-preventive role of fluoride, and the measurement of fluoride intake usually requires information on the fluoride concentration in foods and drinks. Most information comes from developed countries and there are no data on fluoride concentration in foods in Middle Eastern countries including Iran. The aim of the study was to: (a) describe a modification to the silicon-facilitated diffusion method for determining fluoride concentration, (b) provide information on fluoride content of foods in Iran to supplement food tables for the Middle East, and (c) determine the effect of variation in the fluoride concentration of drinking water on the fluoride concentration of prepared foods. Five hundred and ten samples of 84 popular foods and drinks were collected from three areas of Iran where water fluoride concentrations were 0.32, 0.58 and 4.05 mg/L. The mean recovery of fluoride added to food samples before diffusion was 98 +/- 5%. Values for duplicate analysis of 20 food samples were within 0.03 microgram F/g. Most of the samples of foods and drinks came from the area with 0.32 mg F/L in water supplies. For 30 of the 84 items, fluoride concentration was below 0.1 microgram/g. Fluoride concentrations in the cereals group (which constituted much of the diet) were mainly between 0.2 and 0.3 microgram/g, when prepared for consumption. It was concluded that: (a) modification of a published method for determining fluoride concentration of foods appeared to be an advance, (b) values for fluoride concentration of foods commonly consumed in Iran showed variation between groups but were in broad agreement with published data, and (c) concentration of fluoride in water influences positively fluoride concentration in foods cooked in water, but the increase in foods was less than the increase in fluoride concentration in water.

Fluoridation↗
PubMed2002

The epidemiology of end-stage renal disease in Iran in an international perspective.

INTRODUCTION: The epidemiology of end-stage renal disease (ESRD) and renal replacement therapy (RRT) is under continuous evolution all over the world. We report here the epidemiological analysis of ESRD and RRT in Iran and discuss it against the background of the international situation. METHODS: This epidemiological report is based on data from centre questionnaires which were collected in Iran from 1997 onwards, with a response rate of 100%. RESULTS: The prevalence/incidence of RRT patients were 238/49.9 p.m.p. in the year 2000. Haemodialysis and kidney transplantation were the most common RRT modalities, accounting for 53.7% and 45.5% of prevalent RRT patients, respectively. The proportion treated by peritoneal dialysis was very low (<1%). Home haemodialysis was not performed. The majority of haemodialysis centres used synthetic membranes (70%) and 100% of the sessions were performed using acetate as a buffer; 42.5% of haemodialysis patients were treated with a twice-weekly regimen, whilst 49.6% were on the standard thrice-weekly regimen. The majority of RRT patients in Iran were young to middle aged. The great majority of renal allografts came from living donors (mainly unrelated to recipients). The main renal diseases leading to ESRD were diabetes and hypertension. The third most common category was "cause unknown". CONCLUSION: The epidemiology of RRT in Iran is characterized by: (i) young patient age (younger than the international average); (ii) high proportion of patients receiving renal allograft; (iii) use of living-unrelated donors as the major source of renal allografts.

Adolescent↗
PubMed2007

Prevalence of obesity, central obesity and the associated factors in urban population aged 20-70 years, in the north of Iran: a population-based study and regression approach.

Obesity is an undesirable outcome of changing of lifestyle and behaviours. It is also reversible predisposing factor for the development of several debilitating diseases. This study was aimed to determine the prevalence rate of obesity, overweight, central obesity and their associated factors in the north of Iran. We conducted a population-based cross-sectional study with a sample of 1800 women and 1800 men with respective mean ages of 37.5 +/- 13.0 and 38.5 +/- 14.2 years of urban population aged 20-70 years living in the north of Iran. The demographic and lifestyle data, in particular, age, gender, marital status, marriage age, family history of obesity, educational level, occupation, occupational and leisure time physical activity, duration of exercise per week, parity and the number of children were collected with a designed questionnaire. Diagnosis of obesity and central obesity were confirmed by the WHO standard recommended method by determining of body mass index (BMI) and waist circumference (WC). Logistic regression model was used to estimate the adjusted odds ratio (OR) and its 95% confidence interval. Over half of the study subjects were at educational levels of high school or higher; 79.4% of population was married and 35.3% had a family history of parental obesity. The majority of subjects in particular women had none or low levels of physical activity. The overall prevalence rates of obesity and overweight were 18.8% and 34.8% respectively. The overall prevalence rate of central obesity was 28.3%. The rate of obesity in women was higher than men (P < 0.0001). In both genders, particularly in the women, the rate of obesity was raised by increasing age. There was an inverse relation between the risk of obesity and marriage age, the high level of education (OR = 0.19, P < 0.0001), severe occupational activity (OR = 0.44, P < 0.0001), the level of exercise (in subjects with 3-4 h exercise per week, OR = 0.58, P < 0.001) and leisure time activity. Marriage, history of parental obesity and parity > or =5 were associated with increased risk of obesity (OR = 2.2, P < 0.001 and OR = 2.43, P < 0.0001 and OR = 3.73, P < 0.0001 respectively). The results of this study indicate an increased rate of obesity and overweigh in the north population of Iran. With respect to these findings, low level of activity and education, parity, family history of obesity, marriage at earlier age and ageing are responsible for both obesity and central obesity in the north of Iran. Therefore, a community-based multiple strategies are required to combat with increasing rate of obesity and its subsequent complications such as diabetes, coronary artery disease, hypertension and osteoarthritis.

Adult↗
PubMed2006

HLA class II gene polymorphism in Parsees and Zoroastrians of Iran.

Extensive polymorphism of the HLA genes in different ethnic groups has been used as an invaluable tool for anthropological studies. In this study, HLA-DRB1, DQA1 and DQB1 allele frequencies and haplotypes were determined in 72 Parsees and 65 Zoroastrians living in Iran. The predominant DRB1 allele was *1103 = 4 in Parsees and *0701 in Zoroastrians. DQA1*0501 was the most common alleles in both spopulations. The most frequent DQB1 allele was *0301 in Parsees and *0201 in Zoroastrians. DRB1*1103 = 4-DQA1*0501-DQB1*0301 and DRB1*0701-DQA1*0201-DQB1*0201 were the most prevalent haplotypes in Parsees and Zoroastrians, respectively. Significant deviation from Hardy-Weinberg equilibrium was observed in DQA1 and DQB1 loci of Zoroastrians. The former locus also departed from neutrality due to balancing selection. All pairs of the studied loci in this study showed significant linkage disequilibrium. Analysis of molecular variance indicated that the main variation was confined to individuals within the studied populations. Neighbour-joining tree based on Nei's genetic distances according to DRB1 and DQB1 allele frequencies showed that Parsees and Zoroastrians of Iran were located in the same cluster of the phylogenetic tree. Furthermore, Zoroastrians of Iran and Pakistan are very close to each other. This study will serve as a reference for further anthropological studies when the HLA profile of all ethnic groups of Iran is investigated.

Ethnicity↗