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Summary Introduction Voice, as one of the most important communication tools in humans, can cause many problems in a person's daily life if it is damaged. One type of voice complaint is vocal fatigue, which is common among people who use their voices a lot. Rehabilitation therapists may be more vulnerable to a variety of vocal disorders and complaints due to extensive voice use and long-term relationships with clients. The aim of this study is to investigate and compare vocal fatigue among therapists in Ahvaz rehabilitation fields. Method This cross-sectional, descriptive-analytical study was performed on 100 therapists in Ahvaz rehabilitation fields. For this purpose, the Persian version of the vocal fatigue index questionnaire has been used. One Way Anova parametric tests were used to compare target variables. The relationship between vocal fatigue and work experience and working hours per day was calculated using Spearman correlation coefficient. Results A comparison of the scores of the vocal fatigue index in the rehabilitation therapists showed that there was a significant difference between the therapists scores in the field of speech therapy and the therapists scores in other fields (P Conclusion Due to the nature of rehabilitation fields and the use of voice during daily interactions with different clients, especially clients with special disabilities, the possibility of voice disorders and complaints in this population should be considered. Therefore, providing the necessary training for voice care and voice health of this population should be noted in order to prevent voice disorders and complaints

OBJECTIVE Melasma is an acquired hyperpigmentation disorder, and reactive oxygen species play important role in regulating melanin synthesis. Lycopene is one of the most effective oxygen neutralizers among tomato-derived carotenoids. Also, hydroquinone is a compound that has been used for the treatment of hyperpigmentation by mechanism of tyrosinase inhibition and can be found in wheat. METHODS An appropriate cream formulation containing 0.05% tomato lycopene and 3.45% wheat bran extract was prepared, and physicochemical characterization was performed. The prepared formulations were applied twice a day for three months in combination with SPF = 30 sunscreen by 22 patients diagnosed with melasma. MASI score in two groups was evaluated at weeks 0, 3, 6, 9, and 12 and 1 month after the treatment. RESULTS The prepared formulation shows smooth and homogeneous appearance with suitable spreadability and viscosity. The MASI score of intervention group from the sixth week until the end of the treatment was significantly decreased compared to the onset of the treatment (P

Introduction The association of individuals’ anthropometric indices with their development of metabolic syndrome (MetS) has been investigated in several studies. Taking into account the ethnic differences, this study aimed to determine the most appropriate cut-off points of anthropometric indices in predicting the incidence of MetS and its components in Ahvaz. Methods This study is part of a cohort study conducted at the Diabetes Research Center of Ahvaz Jundishapur University of Medical Sciences on a population of over 20 in Ahvaz during 2009–2014. Of the 592 patients, 505 patients who were not diagnosed with MetS in 2009, were entered into this study. The data analyzed involved demographic information including age and sex, anthropometric information including height, weight, waist circumference (WC), hip circumference (HC) and the ratios between them, laboratory data including blood levels of Triglyceride (TG), Fasting plasma glucose (FPG) and High-density lipoprotein cholesterol (HDL-C), and clinical data including systolic(S) and diastolic(D)blood pressure(BP). After 5 years, the subjects were re-evaluated for MetS based on the National Cholesterol Education Program – Adult Treatment Panel III (NCEP-ATP III) criteria and the most appropriate cut-off points of anthropometric indices for the prediction of the incidence of MetS using the Receiver Operative Characteristic (ROC) curves were obtained. Results Waist-to-Height Ratio (WHtR) index with a cut-off point of 0.53 followed by WC with a cut-off point of 87.5 cm had the highest power to predict the incidence of MetS. The cut-off points of WC and Body mass index (BMI) were respectively 89.5 cm and 26 kg/m2 for men, and 83.5 cm and 27.5 kg/m2 for women. All anthropometric indices were able to predict the components of this syndrome (with the exception of low HDL-C). The cut-off point of WC in predicting High FBS, High TG and High BP was 84.5, 84.8, and 86.5 cm, respectively. Conclusion Overall, it seems that given its ease of measurement, the WC index is preferred to other indices for predicting the incidence of MetS and its components in clinical screening.

Background: Low levels of vitamin D are found in a great part of breast cancer women. Study subjects using vitamin D3 supplement had lower rates of cancers and fewer markers of inflammation. Additionally, recent studies demonstrate the power of vitamin D supplementation to lower inflammation and oxidative stress biomarkers associate with VDR polymorphism to reduce inflammation. This study was aimed to assess the impact of vitamin D3 supplementation on the serum concentration of inflammatory markers and antioxidant capacity with regard to VDR polymorphism in the VDR gene in breast cancer women. Methods: A randomized, double-blind, placebo-controlled trial was conducted on 56 breast cancer women. Participants were assigned to 2 treatment arms: placebo and vitamin D3 for 2 months intervention. Supplementation group received 50,000 IU of vitamin weekly. Blood samples were collected at baseline and after the intervention to measure the 25(OH) D3, TNF-α, TGF- β and TAC. Genotyping was performed for FokI, BsmI, ApaI, and TaqI polymorphism. Results: After eight weeks supplementation, the intervention group showed a significant increase in the serum concentration of 25(OH) D3 (28±2.6 to 39±3.5; p=0.004 and TAC (48.9±13.3 to 63.5±13.3; p= 0.017). Changes in TNF-α, TGF- β1 were not significant. Serum TAC levels of participants with the TT/Tt, Ff genotypes were more responsive to supplementation. Conclusions: Supplementation with a vitamin D3 increased the TAC in breast cancer women, although it had no effect on inflammatory markers. Serum TAC in the TT/Tt, Ff were more responsive to vitamin D supplement compared with those with the FF/ff and tt genotypes.

To investigate the effects of glaucomatous damage on the mfVEP parameters of patients suffering from primary open-angle glaucoma (POAG). Fifteen healthy subjects and 15 patients with unilateral POAG participated in this study. In addition, routine ophthalmological examinations including visual acuity, anterior segment examination, posterior segment examination, intraocular pressure, mfVEP with electrophysiological system, RETI-port/Scan 21, and visual field test with automated Humphrey ZEISS HFA II 750i Perimeter were also performed. The results show that there was a strong correlation between the ∆MDs and the number of abnormal points with the ∆amplitudes more than 256 nV, in patients (n = 15, r = 0.802, p

Diabetes mellitus is a metabolic disease that manifested as hyperglycemia due to the defect in secretion or function of insulin. Studies have shown that saffron and its derivatives cause a significant reduction in plasma glucose levels in experimental models. The purpose of this study was to investigate the effect of the saffron extract on fasting plasma glucose (FPG), glycated hemoglobin level (HbA1c), lipid profile, liver enzymes, and renal function tests in type 2 diabetic patients. In this double-blind randomized clinical trial, 64 type 2 diabetic patients who were on oral anti-diabetic drugs were examined. Participants received either 15 mg of saffron or placebo capsules (two pills per day) for 3 months. Anthropometric indices, dietary intake, FPG, HbA1c, lipid profiles, liver enzymes (ALT, AST, ALP), and renal function (BUN, Cr.) tests were measured pre and post intervention after 3 months. Independent t test and paired t test were used for data analysis. After 3-months intervention, mean difference of FPG, Cholesterol, LDL-c, and LDL/HDL ratio between two groups showed significant reduction(p 0.05). In saffron group, FPG, HbA1c, cholesterol, LDL-c, and LDL/HDL ratio decreased significantly after 3-months intervention compare with baseline (p < 0.0001).

Type 2 diabetes has a high spread and growing process. Using appropriate food diets is among therapeutic approaches has been applied for diabetic patients. Soya utilization has shown effective results in controlling metabolic abnormalities of these patients. The aim of this study is to investigate the effects of soy nut on glycemic conditions, blood pressure, lipid profile, antioxidant effects and vascular endothelial function of these patients.70 patients with type 2 diabetes were randomly divided into two groups of the test (35 people) and control (35 people). The patients in the intervention group were subjected to 60 g soy nut diet as a part of daily protein for 8 weeks and the control group under the usual diet of diabetes. The fasting glucose, blood pressure, lipid profile, brachial blood flow, the level of serum E-Selectin and total antioxidant capacity in control and test group were assessed before and after diet.Consuming 60 g soy nut for 8 weeks significantly decreased the fasting blood glucose (P = 0.03), total serum cholesterol (P 0.01), LDL-c (P = 0.01), and E-Selectin (P 0.01) and increased the capacity of serum total antioxidants (P 0.01), brachial blood flow (P 0.01) but didn't have any significant effect on systolic/diastolic blood pressure, HDL-c, and TG.Soy nut utilization in the patients with type-2 diabetes can significantly improve the glycemic condition, increase brachial blood flow, decrease E-selectin (improvement of endothelial function), increase serum total antioxidants and lipid profile but has no significant effect on blood pressure and HDL-c.

The purpose of this study was to investigate the incidence of obesity, overweight and hypertension in children and adolescents aged 10-15 in Ahvaz.This is a epidemiologic study performed on 176 people aged 10-15 in Ahvaz. In 2009, 300 people underwent weight, height and blood pressure measurements. Five years later, the same people were reassessed for obesity, overweight and hypertension, of whom a total of 176 people agreed to repeat the procedure.The study included 100 (57%) males and 76 (43%) females. Mean BMI was 22.1 ± 4.3 kg / m2 in year 2014, without any significant difference between the two sexes (P = 0.518). In the same year, the prevalence of obesity and overweight was 26 (14.8%) and 13 (7.4%), respectively. After 5years, BMI increased significantly (P 0.001). Of the 150 norma participants with normal BMI in 2009, 15 (10%) and 6 (4%) became overweight and obese in 2014 respectively. The mean systolic and diastolic blood pressures increased significantly over 5 years P = 0.042 and P 0.001.This study shows an increase in mean BMI and mean systolic and diastolic blood pressures after 5 years among people aged 10-15 in Ahvaz.

Aims Child growth is one of the important health indicators in pediatric care. Few studies focused on the impact of prenatal exposure to gestational diabetes mellitus (GDM) on growth trajectories particular in early years of childhood. The aim of this study was identifying growth pattern of GDM exposed offspring's, comparison with new WHO child growth standards. Methods and materials In a population-based Longitudinal study 438 infants exposed to gestational diabetes in utero, aged 0–24 months, born between 2014 and 2016 with at least 9 visits in first 2 years of life were enrolled. Twenty health centers of Ahvaz city (Capital of Khuzestan province, located in south western of Iran) and two referral centers for neonatal hypothyroidism involved the study. Results Of 438 GDM exposed infants, 54.6% were boys. Incidence of low birth weight and macrosomia were 4.6% and 8.7% respectively. Results 4.6% had birth weight less than 2500gr and 8.7% was rate of macrosomia. Boys had higher weight and BMI than girls. Peak of BMI was 17.8 (±2.07) at 6 months after Gender was significant factor in predicted of BMI growth trajectories in GDM exposed children (p = 0.001). BMI in GDM exposed infants, in first 2 years of life was higher than WHO growth standards 2006 (P Conclusion Medians of BMI in GDM exposed infants in all measures was higher than WHO reference data 2006 (P

Aims Various studies have demonstrated that the majority of the factors affecting the reluctance of individuals to insulin injections are rooted in psychological factors. Present study aimed to determine relationships between main causes of refusal to insulin injection in diabetic patients and factors such as age, gender, and educational degree of patients. Material & Methods This was a descriptive study which was conducted on diabetic patients (n = 505) who need insulin therapy. The data were collected with a questionnaire in following steps. First, the most important causes of patients’ reluctance, in the patients’ opinion, to insulin therapy were determined using the data of the previous studies. In the second step, the patients were asked to express their opinion on each of these factors and the recorded responses were analyzed. Results The results of the study showed that fear of ampoules, fear of pain caused by insulin and the embarrassment of patients from injections in public significantly depended on the gender of the patients, so that these factors were much lower in men than women. In addition, these factors in the patients with higher degrees of education led to lower level of refusal to insulin injections. Another factor influencing the reluctance to insulin injections was the forming of a sense of addiction due to daily insulin injections, which was significantly lower among the patients with higher education, but did not have a significant relationship with sex of the patients. In this regard, another factor was fear of hypoglycemia and insulin side effects, which did not have a significant relationship with gender and educational degree. In addition, there was no significant relationship between the patient's age and any of the factors effective in patients' reluctance to insulin injections. Conclusion Psychological factors seem to be effective in the emergence of the sense of reluctance to insulin injections. Therefore, not only patients but also the entire society need to receive training and appropriate services to improve their attitude to this issue with a psychological approach and help to solve this problem.

BACKGROUND: Metabolic syndrome (MetS) is composed of a collection of risk factors for heart diseases and diabetes. In recent decades, metabolic syndrome has been identified as one of the important risk factors leading to the development of work-related diseases. OBJECTIVE: Since few studies have been conducted on evaluating the prevalence of MetS among Iranian workers, this cross-sectional study aimed at assessing the prevalence of MetS and the factors affecting it among Iranian steel workers. METHODS: This study was carried out on 510 employees working in a large steel producing company. The data pertaining to blood pressure, triglycerides, cholesterol, glucose, and demographic information were collected and the Adult Treatment Panel (ATP III) criteria were implemented to diagnose MetS. RESULTS: The prevalence of Mets was obtained equal to 13% and a significant positive relationship was observed between age and the prevalence of metabolic syndrome. From among MetS elements, low HDL cholesterol and increased waist circumference were recognized as the most and the least frequently involved elements with 39.3% and 6.5% prevalence, respectively. Chi-square test was run and the results showed that the prevalence of MetS and some of its components rose at higher BMI values. It was also indicated that MetS and its components had no significant relationship with shift work. CONCLUSION: The current findings revealed that the prevalence of MetS increased with aging. Low HDL and high triglycerides levels were among the main risk factors for MetS. Therefore, considering these risk factors, it should be attempted to develop relevant strategies at workplace to encourage workers to go for a healthier lifestyle so that they can prevent the incidence of MetS.

Human adenovirus 36 (Ad-36) causes obesity with increased adiposity, in contrast, Ad-36 infection reduces glucose and lipid metabolism; the results, however, are not consistent. In the current study, the effects of Ad-36 infection on glucose and lipid profile and inflammatory markers in Wistar rats were investigated. Sixty male Wistar rats were randomly divided into infected and control groups. Ad-36 virus suspension was injected in the experimental group rats. Blood samples were collected in the beginning and after 12 weeks in both groups. After 12 weeks, a significant improvement was observed in fasting blood glucose, fasting serum insulin, insulin sensitivity, serum triglycerides and total cholesterol in the infected group compared with the non-infected groups. There were no significant differences in inflammatory biomarkers including tumor necrosis factor-α, interleukin 6 and monocyte chemoattractant protein-1 levels between infected and control groups. This study showed that Ad-36 had favorable effects on glycemic and lipid control in infected rats, but inflammatory biomarker levels were similar for 2 groups. Ad-36 infections could potentially be a new way to develop novel antidiabetic and antihyperlipidemic therapeutic agents.

Aims Diabetes mellitus is a metabolic disease that manifested as hyperglycemia due to the defect in secretion or function of insulin. This study aimed was to survey about frequency type I and II diabetes in newly diagnosed diabetic patients base on c-peptide and anti-glutamate acid decarboxylase (GAD) tests. Materials & methods This study was conducted as a prospective study on 70 diabetic patients aged 15–45 years old who referred to diabetes clinics in Ahvaz city during 2012–2014 and their diabetes was diagnosed for the first time, but their type of diabetes was not clinically definitive. Patients with anti-GAD positive and fasting C-peptide level of less than 0.65 were diagnosed as type I diabetes. Patients with anti-GAD negative fasting C-peptide level of greater than or equal to 0.65 were considered as type II diabetes. Results Eighty two patients (49 males and 33 females) with a mean age of 21.64 ± 4.36 years (range 15–34) and a mean BMI of 22.05 ± 4.41 kg/m2 (range 14–18) were studied. Twenty three patients (28.5%) had type I diabetes and 59 patients (71.95%) had type II diabetes. In patients with type I diabetes, the mean BMI was 24.86 ± 2.36 kg/m2 and the number of patients with family history (56.22%) was higher. In type II diabetic patients, the number of women (62.71%) was higher than that of men. Conclusion Anti-GAD test can be used as a predictive test for early diagnosis of disease and screening of people with a diagnosis of diabetes based on the type of diabetes.

Aims The aim of this study is comparison the level of Vitamin D deficiency in non-diabetic adult people with metabolic syndrome in Ahvaz. Material & methods This descriptive study investigation carried out on a population of individuals with metabolic syndrome. ATPIII criteria were used for metabolic syndrome. Serum concentration of 25 (OH Vit D) of below 5 ng/ml was considered as severe deficiency, 5–10 ng/ml as average deficiency, 10–20 ng/ml as slight deficiency, and above 20 ng/ml as normal. Results The results showed mean level of vitamin D was not significant in individuals with and without HTN and in different genders (P > 0.5). No significant difference was found between case and control groups in terms of the distribution level of vitamin D (P > 0.5). In both groups, the difference between blood pressure (systole and diastole) was not significant in cases of severe and average deficiencies. But it was significant different in the group with slight deficiency (P = 0.03). In the case group, 58% of the participants had FBS>100. Conclusion The group with metabolic syndrome had a higher intensity of vitamin D deficiency compared to the control group.

Background Today, obesity epidemic is one of the major health problems of the present century. One of the phenotypes of obesity is metabolically healthy obesity. It seems that these obese individuals suffer less from cardiovascular disease and metabolically unhealthy obesity. This study aimed to investigate the prevalence of metabolically healthy obesity (MHO) and its relationship with incidence of metabolic syndrome, diabetes and hypertension in individuals over 20 years in the city of Ahvaz. Materials and methods This study was a 5-year cohort study, which was conducted on adults between years 2009 to 2014.Participants who were randomly selected from individuals covered by the health centers in the city of Ahvaz in baseline population, were again recalled by these centers. The subjects completed the question aires, and anthropometric measurements and blood samples were prepared for performing tests based on Phase 1. Results A total of 591 individuals Participated in this study, 281 (47.5%) were males and 310 (52.5%) females with mean age of 42.2 ± 13.3 years. The prevalence of MHO was 19.5% in the baseline population. The cumulative incidence of metabolic syndrome, diabetes and hypertension in MHO individuals were 29.6%, 24.3% and 13%, respectively. Conclusion The prevalence of MHO was 19.5% in the baseline population. There was a specific relationship between MHO and incidence of metabolic syndrome and diabetes; however, there was a less significant relationship between MHO and hypertension.

Context: Host factors including single-nucleotide polymorphisms (SNPs) in or near interferon lambda (IFNL) gene are the important factors in predicting response to treatment of chronic hepatitis C (CHC). Aims: The aim of this study was to determine the frequency and association of IFNL4 rs368234815 with IFNL3 SNPs rs12979860, rs8099917 and other factors including cholesterol, alanine aminotransferase, fibrosis, viral load, age and body mass index in genotype 1a treated CHC patients, to achieve rapid virologic response (RVR) and sustained virologic response (SVR). Subjects and Methods: A total of 71 hepatitis C virus genotype 1a patients were enrolled from 2013 to 2015. The genotypes of rs12979860, rs8099917 were identified by polymerase chain reaction (PCR) and restriction fragment length polymorphism while the genotype rs368234815 detected by amplification-refractory mutation system-PCR. Results: The rate of RVR and SVR were 43/71 (60.6%) and 46/71 (64.8%), respectively. To achieve an SVR in patients with rs368234815, TT/TT genotype 20/24 (83.3%) was found to be higher than other SNPs. The correlation coefficient of rs368234815 was strongly associated with rs12979860 (r = 0.788, P < 0.001). Multivariate logistic regression showed that the cholesterol (odds ratio [OR]: 0.205, confidence interval [CI] 95%: 0.047–0.891, P = 0.035), age (OR: 0.160, CI 95%: 0.035–0.730, P = 0.018), baseline viral load (OR: 0.167, CI 95%: 0.032–879, P < 0.035) and IFNL4 (OR: 5.453, CI 95%: 1.015–29.293, P < 0.048) could be independent predictors of SVR. Conclusions: The results of these findings emphasise that factors such as age, cholesterol, baseline viral load and IFNL4 rs368234815 are better predictive factors and should be evaluated before CHC treatment.

Background: As an ancient zoonosis, cystic echinococcosis still is prevalent among livestock worldwide. Early diagnosis is of utmost clinical importance. Objectives: Herein, we compared the efficacy of ELISA with native antigen B and a commercial ELISA kit to detect human hydatidosis in Khuzestan province, southwestern Iran. Methods: The current study consisted of 90 serum samples, including 50 samples obtained from hydatid-affected patients approved by surgery, 20 samples from patients affected by other diseases (having anti-Toxoplasma antibody, giardiasis, hepatitis, etc.), and 20 serum samples from healthy individuals. Native antigen B was prepared from sheep-isolated hydatid cysts. Checkerboard procedure was performed to determine the optimum dilution of antigen, serum and conjugate. Commercial ELISA was done using Vircell indirect immunoenzyme assay to detect anti-hydatidosis IgG. The cut-off point for native ELISA was the sum of two-fold standard deviation and the mean optical density of all negative samples. Results: Using commercial ELISA kit and native ELISA test, 22 out of 90 and 52 out of 90 sera were positive for hydatid-specific IgG, respectively. Compared to the operation, the sensitivity of native and commercial ELISA tests was 100% and 44%, respectively. However, the specificity was not determined due to the lack of surgical information among the heterologous and control groups. In comparison to the commercial ELISA, both tests showed the same sensitivity (97%), while the specificity of native and commercial ELISA was 95% and 96%, respectively. Conclusions: Developing ELISA tests using native antigens would be a reliable method to improve the efficacy of human hydatidosis detection.

Sleep is one of the fundamental needs of human and one of the most important circadian cycles [1].

The aim of current study was to evaluate the function of thyroid during diabetic acidosis, just after the treatment and two weeks after the treatment. This was the analytic study. The study subjects included 20 patients, aged 18-36 years old, with type1 diabetes and diabetic ketoacidosis. All subjects were evaluated for thyroid function tests such as triiodothyronine (T3), thyroxine (T4), T3 resin uptake (T3RU), free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH), before treatment. After completing DKA treatment and two weeks after discharge, the thyroid function tests were repeated on the subjects and the results were analyzed using paired T-test, ANOVA or repeated measure and Pearson correlation tests. the current study showed that the mean levels of T3 and T4 were at hyperthyroid range and lower than normal before the treatment and significantly increased after the treatment (P

Aims Different approaches for screening and diagnosis of gestational diabetes mellitus(GDM) have great impact on all process of management of gestational diabetes and its future complications. The aims of this study were to evaluate rate, risk factors and outcomes of GDM based on International Association of Diabetes and Pregnancy Study Groups diagnostic criteria. Materials In a prospective study pregnant women attended 5 clinics in Ahvaz, screened for gestational diabetes mellitus using IADPSG criteria and followed up delivery from August 2014 to February 2015. At the first prenatal visit women underwent the fasting blood sugar test. A 75-g oral glucose tolerance test (OGTT) was performed for 750 mothers between 24 and 32 weeks of gestation. Logistic regression test for calculating the odds ratios and 95% confidence intervals was used. Results The mean age of participants was 28.43 ± 5.52 years. The overall rate of GDM in our study was 29.9% (224/750). Incidence of gestational diabetes was associated with age group ≥ 35 years [OR = 1.92(95% CI, 1.19–3.09)], family history of diabetes [OR = 2.47(95% CI, 1.33–4.59)], previous GDM [OR = 3.12(1.35–7.19)], BMI ≥ 25 [OR = 1, 71(1.10–2.67)] Using logistic regression. The most common maternal complication in studied women was cesarean section followed by hypertension and preeclampsia. Conclusion About one third of studied women diagnosed as GDM according to the IADPSG criteria. Risk factors of GDM were maternal age, family history of diabetes, Previous GDM, overweight and obesity before pregnancy, the same reported factors with 2 steps approach. Higher rate of GDM using this criterion may increase concern about healthcare costs and workloads.

Background Hypercholesterolemia is one of the main causes of the disease burden in developed and developing countries. The present study is planned to access the prevalence of dyslipidemia and its risk factors among the general population of Ahvaz over 20 years of age. Method In this descriptive-analytic study, using multi-stage cluster method, out of the 25 existing health centers in the city of Ahvaz (four health centers in the Eastern Ahvaz and two centers in the west were chosen based on the population they covered). The blood samples of the participants were taken after 12 h of fasting for measure FBS, TG, Chol, HDLand LDL level their heights, and weights were measured using the standard methods. Interviewing the participants, the research questionnaires were filled by the trained health workers. Results Out of 2505 participants, 1155 samples (%46.1) were male with mean age of 42.9 ± 14.5 years and 1350 samples (%53.9) were women with the mean age of 39.9 ± 12.6 years. The prevalence of dyslipidemia among the individuals over 20 years of age in Ahvaz was %80.9 (%75.9 in male and %85.1 in female). Age and BMI were positively correlated with increase in the risk of dyslipidemia. Women had a higher risk of dyslipidemia Conclusion This study showed that more than %80 over 20 years old Ahvazian population had dyslipidemia(female more than male). Age and BMI are positively correlated with increasing dyslipidemia in my population.

Metabolic syndrome as a cardiovascular disease predictor, is proposed to be reduced by following a Mediterranean diet. This study was aimed to explore the relationships between metabolic syndrome and Mediterranean diet in type 2 diabetes mellitus patients.A cross-sectional study was performed on 158 type 2 diabetes mellitus patients 28-75 years old (mean age: 54.3±9.6 yrs). Fasting glucose and lipid profile were measured. Blood pressure and anthropometric characteristics of each participant were recorded. Food frequency questionnaires were evaluated using an 11-item score to determine the adherence to Mediterranean diet.Totally, 55.4% of participants had a good adherence to Mediterranean diet. The risk of metabolic syndrome in women was significantly higher than in men (OR=8.65, CI 95%=2.88-25.99; p0.001). Nuts, legumes and seeds consumption were associated with a significant lower risk of metabolic syndrome (OR=0.42, CI 95%=0.188-0.917; p0.05). No considerable association was observed between metabolic syndrome and adherence to Mediterranean diet (p=0.167).Results demonstrated no association between Mediterranean diet adherence and metabolic syndrome in type 2 diabetes mellitus patients. However, nuts, legumes and seeds might have greater benefits for diabetics.

Introduction This study was designed to assess the prevalence of diabetes in people aged over 20 years in Ahvaz, Iran. Materials and methods The study population was chosen by cluster sampling. A checklist included: age, sex, weight, height, blood pressure, waist circumference, educational level, smoking status and previous history of diabetes was completed for each patient. Fasting Plasma Glucose (FPG) ≥126 mg/dl and/or oral hypoglycemic treatment and/or insulin consumption was defined as diabetes, FPG = 100–125 mg/dl as Impaired Fasting Glucose (IFG) and FPG Results Study population was 944 persons. Mean age of population was 42.2 ± 14 years. Diabetes was detected in 15.1% of population. Only 40.4% of cases were aware of their disease. Diabetes was detected in 14.7% of female and 15.7% of male participants. Diabetes was related to age, waist circumference, family history of diabetes, hypertension, waist to hip ratio, educational level, marital status, serum triglyceride, cholesterol and body mass index (BMI) in both genders. But by using logistic regression analysis, age, family history of diabetes, hypertension, hypertriglyceridemia, and marital status had significant effect on diabetes. Conclusion This study showed that using FPG criteria or current medication 15.1% of this population had diabetes and about 60% of patients were unaware of their disease. Age, hypertension, family history of diabetes, hypertriglyceridemia and marital status are the risk factors of diabetes in Ahvaz population. IFG have high prevalence and diabetes screening should be intensified in this population.

Background. The present study is the fourth cohort study conducted in the Middle East on the evaluation of prediabetes and type 2 diabetes, implemented in Ahvaz, Iran.Methodology. The individuals aged over twenty years who had participated in a study on the prevalence of metabolic syndrome in 2009 (Phase 1) in Ahvaz were invited again in 2014. The questionnaires were completed via interview, and anthropometric parameters were measured by standard method. The logistic regression and chi-square test were used for data analysis.Results. In the median of five-year follow-up, a number of 593 people participated in reexamination from which 396 individuals were nondiabetic in Phase 1. The incidence of diabetes and prediabetes was 21.9 and 40.6 per 1000 person-years, respectively. Among Phase 1 prediabetics, 16.8% were diagnosed with diabetes in a five-year period. The factors affecting the incidence of prediabetes among the people younger than 65 years include age, family history of diabetes, and gender. The age factor plays an important role in the transformation of prediabetes to diabetes.Conclusion. The city of Ahvaz with type 2 diabetes incidence of 13.64 per 1000 person-years is one of the areas with high incidence of diabetes in Iran.

Background: Pentraxin 3 (PTX3) is an inflammatory mediator, reaches to the high levels after ischemic heart diseases (IHD) and could be a helpful tool to predict cardiac rehabilitation (CR) outcomes. The aim of this study was to investigate the possibility of the circulating levels of PTX3 in prediction of CR outcomes in patients with IHD who had undergone coronary artery bypass grafting (CABG). Methods: One hundred patients who had undergone CABG were included in this study. The CR plan was started 6 weeks after CABG and then PTX3 level, high-sensitivity C-reactive protein (hs-CRP), ejection fraction (EF) and metabolic equivalent (MET) were assessed before and after the CR program. Finally, all gathered data were analyzed using SPSS version 22. Results: After a 3-month course of CR program, EF, MET, PTX3 and hs-CRP values changed. Statistically significant changes were observed in EF, MET and PTX3 values (P < 0.05) after the CR program and no statistically significant changes were seen in hs-CRP value (P = 0.546) at the end of CR program. Correlations between EF levels and MET with pre-PTX3 levels were also assessed and most changes were observed in the group with pre-PTX3 level more than 0.40 ng/dL. Conclusion: Our study showed that a regular sufficient CR program based on exercises in IHD patients after CABG increases EF and MET levels, particularly in those patients with pre-PTX3 levels more than 0.40 ng/dL. Cardiol Res. 2016;7(2):59-65 doi: http://dx.doi.org/10.14740/cr462w

Introduction The cinnamon is one of the most popular and the oldest spices used as a traditional herbal medicine. The aim of this study was to determine the antibacterial properties of Cinnamomum zeylanicum bark essential oil (EO) against some extensively drug-resistant (XDR) clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VR E. faecium), Acinetobacter baumannii, Pseudomonas aeruginosa, and Escherichia coli. Methods A total of 150 XDR isolates, which includes 30 MRSA, 30 VR E. faecium, 30 A. baumannii, 30 P. aeruginosa, and 30 E. coli were collected from different clinical samples. The XDR isolates were defined as resistance to ≥1 antibiotic in all but ≤2 classes using disc diffusion method. Antibacterial efficacy of cinnamon EO was performed by the agar disc diffusion and microdilution broth methods. Results In total, all studied XDR isolates were sensitive against C. zeylanicum EO. The most sensitive isolate was MRSA, followed by VR E. faecium, E. coli, P. aeruginosa, and A. baumannii. The MIC value ranges were as follows: MRSA 0.15–1.25 μl/mL, VR E. faecium 0.15–2.5 μl/mL, E. coli and P. aeruginosa 0.15−5 μl/mL, and A. baumannii 0.31−10 μl/mL. The MIC50, MIC90, MBC50, and MBC90 values of C. zeylanicum EO was 1.25 μl/mL, 5 μl/mL, 2.5 μl/mL, and 5 μl/mL, respectively. Conclusions The potent antibacterial effects of C. zeylanicum EO may be encouraging for further in vivo investigations of this essential oil to determine its effective ingredients for the synthesis of a new antimicrobial agent for treatment of human pathogens, particularly drug-resistant bacteria.

Summary Purpose In this study, we attempted to assess the phonation and articulation subsystem changes in patients with multiple sclerosis compared to healthy individuals using Dysphonia Severity Index and Formant Centralization Ratio with the aim of evaluating the correlation between these two indexes with neurological status. Materials and Methods A sample of 47 patients with multiple sclerosis and 20 healthy speakers were evaluated. Patients’ disease duration and disability were monitored by a neurologist. Dysphonia Severity Index and Formant Centralization Ratio scores were computed for each individual. Acoustic analysis was performed by Praat software; the statistical analysis was run using SPSS 21. To compare multiple sclerosis patients with the control group, Mann-Whitney U test was used for non-normal data and independent-samples t test for normal data. Also a logistic regression was used to compare the data. Correlation between acoustic characteristics and neurological status was verified using Spearman correlation coefficient and linear regression was performed to evaluate the simultaneous effects of neurological data. Results Statistical analysis revealed that a significant difference existed between multiple sclerosis and healthy participants. Formant Centralization Ratio had a significant correlation with disease severity. Conclusion Multiple sclerosis patients would be differentiated from healthy individuals by their phonation and articulatory features. Scores of these two indexes can be considered as appropriate criteria for onset of the speech problems in multiple sclerosis. Also, articulation subsystem changes might be useful signs for the progression of the disease.

Early identification of at-risk groups is an important step in preventing gestational diabetes and its subsequent side effects. This study aimed to evaluate the risk factors of gestational diabetes based on the International Association of Diabetes and Pregnancy Study Groups criteria in Ahvaz.In a cross-sectional case control study, 520 pregnant women involving life after gestational diabetes Ahvaz cohort study (LAGAs) were investigated for risk factors of gestational diabetes mellitus.The prevalence of overweight and obesity were 40% and25.8% in the GMD group and in 35.8% and 16.2% in the control group respectively (p = 0.002). According to NCEP-ATP III criteria, 16.9% of women with GDM and 6.9% of mothers in the control group had metabolic syndrome in first visit of pregnancy (p 0.001. Logistic regression showed that there is a significant relationship between maternal age[OR = 1.05(95% CI, 1.01-1.10)] (p = 0.01), previous GDM [OR = 5.60(95% CI, 2.21-14.18)] (p = 0.001), positive family history of diabetes[OR = 1.86(95% CI, 1.19-2.94)] (p = 0.006), pre-pregnancy BMI [OR = 1.05(95% CI, 1.007-1.11)] (p = 0.04) and metabolic syndrome in first visit of pregnancy[OR = 2.34 (95% CI, 1.038-5.30)] (p = 0.04) with GDM.Factors including maternal age, previous GDM, family history of diabetes, pre-pregnancy BMI reported in previous studies around the world. A significant association between metabolic syndrome in the first visit of pregnancy and GDM is novel finding of this study. Therefore screening of pre-pregnancy metabolic syndrome in women at risk of gestational diabetes is recommended.

Background: Diabetes mellitus is one of the most common metabolic diseases in the world. Recently, willingness to use alternative treatments to control and reduce blood sugar levels has noticeably increased. The general objective of this study is to investigate the hypoglycemic effect of the active ingredient of Berberis (Berberine) in patients with type 2 diabetes. Methods: In this double-blind randomized controlled placebo trial, 84 patients with type 2 diabetes were evaluated. The patients were divided in 2 groups (42 each). In addition to their previous drugs, new diet, and life style each group received Berberine capsules 500 mg or placebo twice daily for 4 weeks. At baseline, weight, height, blood pressure, and BMI were calculated for all patients. Fasting plasma glucose, post- meal plasma glucose, fructosamine, lipid profile, fasting blood insulin levels, BUN, creatinine, and liver enzymes were taken from all patients before the study and after 4 weeks. HOMA-IR and HOMA-β% were calculated. Results: After administration of Berberine for a month, average blood sugar (FBS) in the Berberine group decreased from 192 ± 59.6 to 167.7 ± 51.8, which was statistically significant compared with the results of the placebo group (P = 0.036). There was a significant decrease from 266.1 ± 93.7 mg dl to 222.5 ± 76 in 2HPP in the Berberine group compared with the placebo group (P = 0.001). There was also a significant decrease from 425.7 ± 139.7 micromoles per liter to 344.9± 126.1 micromoles per liter in fructoseamine in the Berberine group compared with the placebo group (P = 0.014). In addition, fasting insulin, HOMA-β%, and HOMA-IR increased in the Berberine group compared with the placebo group, however, this increase was not statistically significant. There was a significant decrease in LDL, TG, VLDL in the Berberine group, however, it was not lower than that in the placebo group. Also, total cholesterol in the Berberine group decreased insignificantly compared to the placebo group. There was no significant difference between the 2 groups in terms of BMI, systolic, and diastolic blood pressure. Conclusions: The results showed taking Berberine in patients with type 2 diabetes for 1 month significantly reduces the fasting plasma glucose, post- meal blood glucose, and fructosamine. No signification changes were found in lipid profiles, fasting insulin, HOMA-IR, and HOMA-β%.

Aims The aim of this study was to evaluate the prevalence of diabetic foot ulcer and its related risk factors. Materials and methods In this descriptive cross-sectional study, 605 patients with diabetes were evaluated in July 2014. A checklist was used to obtain demographic data, diabetes related data, past medical history, and physical examination data. Results The prevalence of diabetic foot ulcer was 6.4% (95% CI: 4.64–8.73). Seventeen cases of them were female (4.9%). In univariate analysis, the following variables had statistically significant relationship with DFU prevalence: diabetes duration, educational level, 10 g monofilament sensation, Ankle Brachial Index (ABI) and Body Mass Index (BMI). Patients' age, glycemic control and smoking did not show any significant relationship with DFU. After logistic regression analysis, the patients with decreased 10 g monofilament sensation had DFU more than patients with normal sensation (OR = 8.84, 95% CI: 3.5–22.3). Abnormal ABI increased the odds of DFU (OR = 5.6, 95% CI: 1.3–24.18). The DFU prevalence in patients with diabetes duration of 11–20 years, was more than patients with ≤5 years (OR = 3.8, 95% CI: 1.33–10.8).The odds of DFU development in educated patients compared with illiterate patients was 0.27(95% CI: 0.12–0.57). BMI had a significant relationship with DFU prevalence. The odds in overweight patients was 0.259(95% CI: 0.108–0.623) and in obese patients was 0.263 (95% CI: 0.1–0.687). Conclusion The prevalence of DFU was 6.4% in this study. Final associated risk factors of DFU were decreased 10 g monofilament sensation, abnormal ABI, diabetes duration, educational level and BMI.

Background: According to the World Health Organization in 2009, hypertension is responsible for 13% of all deaths. Hypertension can increase the risk of stroke, coronary artery disease, dementia, heart disorder, kidney, and other chronic diseases. In this study, the prevalence and incidence of hypertension and knowledge and awareness of it among adults in Ahvaz are investigated. Methods: This cohort study was carried out on 688 participants in a study on the prevalence of metabolic syndrome investigated in adults in the city of Ahvaz in 2009. In 2014, participants were again recruited. Based on the standard method and disease history, blood pressure, height, and weight were measured, and a demographic information questionnaire was completed through interviews. Results: In this study, 688 individuals over 20 years of age participated with an average age of 42.7 ± 13.3 years, 300 men (43.6%), and 388 women (56.4%). Hypertension incidence was 65/1000 person-years which included 67.7 and 57.8/1000 person-years in men and women, respectively. The awareness of patients about hypertension was 51.2% in phase 2 (hypertension new cases). Conclusions: In this study conducted in Ahvaz, the incidence rate of hypertension was 65/1000 person-years, higher in men than women. Hypertension awareness was 50.5%, 45.1% in men, and 55.1% in women.

Background When controlling diabetes in children, families suffer from burden of care imposed by the disease. The aim of this study was to investigate the effect of family psychoeducation on the burden of care imposed on families of adolescents with type 1 diabetes referring to Golestan diabetes clinic in Ahvaz city. Methods The present study was a clinical trial with before-after design. The study population included families with adolescents with type 1 diabetes aged 12 - 19 years. A total of 40 families of sick children and one parent who was more in touch with the patient were selected and randomly divided into experimental (20 families) and control groups (20 families). To measure family burden of care, burden of care Questionnaire (DFI-S) was used. Family psychoeducation was carried out for the experimental group twice a week for 8 sessions of 90 minutes. Independent and paired t-test and Mann-Whitney test were used to compare the mean score of family burden of care in both groups while Chi-square test was used to compare qualitative variables between the two groups. SPSS v. 20 was used for statistical analysis. Results The most frequent age range of diabetic children was 12 - 14 years (55%) and 15 - 19 years in the experimental and control groups (65%), respectively. Most fathers and mothers were self-employed (60%) and homemakers (85%), respectively. The mean score of burden of care imposed on families before the intervention in the experimental and control groups was 26.6 and 30.15, respectively, that reduced to 21.6 and 30.35 three months after the intervention, respectively, showing no change. Conclusions Family psychoeducation can reduce family burden of care imposed by adolescents suffering from type I diabetes and increase the period for families facing the disease. It also reduces medical treatment costs and length of stay in health centers and increases quality of home care.

Background Multiple sclerosis is a chronic neurological disease that may cause swallowing disorders. Dysphagia is a common problem, which patients with different levels of disability may encounter, but it is usually underestimated; therefore, effective assessments need to be performed before any serious complications. The aim of this study was to identify the frequency and characteristics of dysphagia in multiple sclerosis patients of Khuzestan MS society, using a Persian version of Dysphagia in Multiple Sclerosis (DYMUS) questionnaire. Method 105 consecutive MS patients (84 F and 21 M, mean age 33.8 ± 8.5 years, mean disease duration 3.5 ± 3.1 years, mean Expanded Disability Status Scale (EDSS) 1.8 ± 1.3) participated in the study and the DYMUS questionnaire was administered by a trained speech therapist. Results The results have shown that 55 MS patients (52.4%) had dysphagia and the dysphagia was significantly associated with the disease course of MS (p = 0.02). However, significant associations between DYMUS values and EDSS, disease duration, age, and gender were not observed. (Respectively, p = 0.4, p = 0.09, p = 0.1, p = 1.0). In the dysphagia group, based on dysphagia severity, 17.1% and 35.2% of patients had mild and alarming dysphagia, respectively. Although, the patients with alarming dysphagia had longer disease duration, higher EDSS score and more with SP, PP and PR disease course than the patients with mild dysphagia, these differences were not significant. Conclusion The oropharyngeal dysphagia in MS patients is very common even in early stages of the disease; therefore, it is important to assess these patients carefully and to initiate a treatment program if needed.

Introduction Dyslipidemia is one of the major risk factors for atherosclerosis and the main cause of death in the developing and developed countries. In this cohort study, the incidence of dyslipidemia and its components have been studied among individuals over 20 years old in Ahvaz, southwest of Iran. Materials and methods The Phase 1 of this study was conducted on the prevalence of Metabolic syndrome and its related factors by Diabetes Research Center in 2009. The target population included individuals over 20 years old who were selected using cluster sampling in Ahvaz health centers. In the second phase of the study, 5 years later in 2014, subjects were again recalled by health centers. Questionnaires, anthropometric indices and measurements were repeated similar to Phase 1. The blood sample was taken from everyone after 12 h of fasting and then the factors (Chol, TG, HDL) were measured. Results The cumulative incidence of dyslipidemia obtained 60.7% (males 56.7% and females 64.8%). lipid profile {HDL, Triglycerides and Cholesterol had changes in their means(a significant reduction in the mean about 10, 22.25 and 13 units respectively) between baseline and 5 years later. Waist circumference here associated with incidence of high LDL and high chol, also sex and High LDL ‘educational level and daily consumption of vegetables were associated with incidence of low HDL and dyslipidemia respectively. Conclusion Age, educational level and daily intake of fruits and vegetables were effective variables on incidence of dyslipidemia. According to various studies, LDL and HDL levels in different regions of Iran, seems to be influenced by factors such as climate, nutrition and activity levels.

Background High blood pressure is a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. Objectives The aim of this study was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. Patients and methods This descriptive analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran). A questionnaire include: height, weight, and body mass index, systolic and diastolic blood pressures filled for each participant. Blood pressure was measured twice for each person. For the diagnosis of hypertension, the fourth report of the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Health Institute of United States was used. Results Total participants of the study were 1707children and adolescents including 922 boys (54%) and 785 girls (46%). The prevalence of high blood pressure was 1.7% (2.5% in boys and 0.8%). The prevalence of pre-hypertension was 9%(7.6% in boys, 10.6% in girls). The mean systolic and diastolic blood pressures increased with increasing body mass index. Conclusions The prevalence of high blood pressure was found to be lower than other studies in our country. The prevalence of the high blood pressure in boys was significantly higher than girls. This study, like other studies showed high correlation between being overweight and an increase in systolic and diastolic blood pressure.

Aim Obesity and diabetes are contributed to cardiovascular disease risk. The current study was performed to evaluate the association of central and general obesity and cardio-metabolic risk factors, including dyslipidemia and hypertension in T2DM patients. Methods This was a cross-sectional study in T2DM adults. Body mass index (BMI) was used to identify general obesity and waist circumference (WC) was measured to define abdominal obesity (based on ATP III). Biochemical analyses, and anthropometric and blood pressure measurements were done for all participants. Results Participants with central obesity showed significantly higher systolic (132.5 mmHg vs. 125.4 mmHg, p = 0.024) and diastolic blood pressures (84.9 mmHg vs. 80 mmHg, p = 0.007) than participants without obesity. Dyslipidemia was more prevalent in all participants either by BMI (98.3% vs. 97%, 95% CI: 0.18–17.53) or by WC (97.2% vs. 98%, 95% CI: 0.07–7.19). Abdominal adiposity in diabetic subjects showed significant reverse association with high level of physical activity (OR = 0.22, 95% CI: 0.06–0.85). Hypertriglyceridemia rate was increased with both central (OR = 2.11; p = 0.040) and general obesity (OR = 2.68; p = 0.021). After adjustment for energy intake and age, females had higher risk of general (OR = 4.57, 95% CI = 1.88–11.11) and central obesity (OR = 7.93, 95% CI = 3.48–18.08). Conclusions Females were more susceptible to obesity. Hypertension was associated with both obesity measures. Dyslipidemia, except for hypertriglyceridemia, was correlated to neither abdominal nor general obesity.

Background Thalassemia is among the most common hematological diseases, but it has no definitive cure. The self-concept in adolescents with thalassemia major changes due to changes in their facial form. Among the factors affecting the patient’s self-concept is social capital. Objectives The study aims to examine the relationship between social capital and self-concept in adolescents with thalassemia major, using a sample of patients admitted to Shafa hospital in Ahvaz, Iran in 2014. Patients and Methods This descriptive-analytical study was performed on 146 adolescents (age range, 13 - 18 years) with thalassemia major who were referred to the hemoglobinopathy ward of Shafa hospital in Ahvaz, Iran to receive blood. The sampling method was a census. Data collection was completed using the Onyx and Bullen social capital questionnaire and Piers Harris’s children’s self-concept scale. After obtaining the informed consent of the patients’ parents, questionnaires were handed to patients in different shifts and answered in the presence of the researcher. To analyze the data, descriptive statistics and analytical statistics (mean, std. deviation, and Pearson correlation) were carried out (CI 95%). Results The mean and standard deviation of patients’ age was 1.76 ± 15.88. 53.4% were male. 58.7% of the sample had an average self-concept and 63.2% had average social capital. The mean score of the total sample’s self-concept was 11.50 ± 53.36, which is moderate. The average social capital of all adolescents with thalassemia major was 17.02 ± 87.38, i.e. in the mid-range. Among the aspects of self-concept, about 70% of participants had an average or poor appearance, attitude, and anxiety. For social trust, more than 90% of participants were average or weak and 75.2% had poor social participation. The dimensions of fame and popularity, appearance, and happiness all had maximal correlation with social capital (P = 0.0001). All aspects of social capital except for relations with neighbors and pioneering in social activities had a significant relationship with self-concept (P < 0.05). This study shows that a statistically significant relationship exists between social capital and self-concept (P = 0.001 and r = 0.280). Conclusions The results of this study indicate a significant relationship between social capital and self-concept and its dimensions; therefore, self-concept can be increased in adolescent patients by promoting their social capital components.

Background Diabetes mellitus is associated with an increased risk of psychological disorders and symptoms. Objectives This research investigated the effect of group reminiscence therapy on depression among women with type II diabetes. Patients and Methods The present study was a clinical trial study. Twenty-four patients referring to the diabetic clinic of Golestan hospital in Ahvaz, Iran were selected through simple random sampling and were divided in two groups. Data were collected through a demographic questionnaire and the Beck Depression Inventory. Group reminiscence therapy was held over eight biweekly sessions, each lasting 90 minutes. Finally, data were analyzed through descriptive statistics and the Mann-Whitney, Friedman, and Chi-Square tests, using SPSS version 20. Results A significant difference was observed between the two groups after the intervention (P = 0.001). The rating for depression decreased significantly in the experimental group. Before the group reminiscence therapy, the highest rating for depression obtained by the experimental group was “need for consultation” (50%), whereas after the intervention, the highest rating was “no depression” (50%). One month after the intervention, the highest rating obtained for depression was “low” (50%). Conclusions Reminiscence therapy decreased depression among diabetic female patients after the intervention and one month after the intervention. It can be said that, through the reminiscence therapy, patients’ past memories were reviewed and emphasis on the positive aspects thereof in the group setting was followed by an increased sense of self-worth and a decrease in depression.

Background Despite published guidelines emphasizing the importance of education in preventing readmissions, the most effective means of educating hospitalized patients with heart failure (HF) about their self-care remains unknown. Objectives The aim of this study was to determine the effects of group education with the teach-back method on the readmission of HF patients. Patients and Methods A randomized, controlled trial was conducted at two academic health care systems in Ahvaz. A total of 100 patients aged 50 years and older were enrolled during hospitalization for the treatment of heart failure. Patients in the intervention group were educated and evaluated using the teach-back method as part of usual care. Data on patients’ ability to recall educational information while hospitalized and during follow-up approximately seven days after hospital discharge were collected. Readmissions were confirmed through follow-up telephone calls and reviews of medical records. The data were analyzed with the Mann-Whitney statistical test to compare the proportion of readmissions in each study groups using SPSS. 22. Results Patients correctly answered three out of four, or 75%, of self-care teach-back questions. In the intervention group, greater time spent teaching was significantly associated with correctly answered questions (P < .001). The number of readmissions for heart failure was reduced by 56.2% in the intervention group (44 vs. 21, P = 0.04). Conclusions This study will be an important step in creating an evidence base for the relative benefits of different educational strategies for reducing readmissions.

Prevalence of diseases originated from air pollution such as asthma and allergies, can be attributed to the bioaerosols. Bacteria and fungi are the main sources of hospital infections, which cause most of the diseases and mortality. The aim of this study was to determine the ratio of indoor to outdoor fungi concentration, the effect of population and people density on fungi concentration and the relationship between indoor and outdoor environment. In this study, three stations were used: outdoor of the hospital, general indoor and ICU wards of the Ahvaz hospital. These locations were chosen for sampling of the airborne fungi from October to December 2010. The samples were collected in 2 min, flow rate of 28.3 L/min using quick take (SKC Inc., PA, USA), based on the Andersen method.The three dominant culturable fungi genera in sampling stations were Aspergillus, Penicillium, and Cladosporium. The average of total culturable fungi concentration before visiting time was 365.8 CFU m-3 and increased to 578CFU m-3 after visiting time. The indoor to outdoor ratios (I/O) in ICU and internal for fungi before visit were 0.36 and 0.68, respectively. However, these ratios in ICU and internal station for fungi after visit were 0.78 and 0.99, respectively. Following the visit of the visitors, the concentration of fungi available indoor was conspicuously higher (even in the wards in which no visitors were allowed; e.g. ICU, etc). Hence the amount of indoor fungi was affected by the concentration of outdoor fungi and visitors crowd.