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Background: Primary biliary cholangitis (PBC) can impact both the quality of life and the survival of patients. The study aimed to determine the survival rate and associated variables in patients with PBC. Materials and Methods: This cohort research comprised 65 patients diagnosed with PBC who were admitted to the pathology section between January 2010 and December 2019. Survival was determined by reviewing hospital medical data and following up with the patients. The impact of demographic factors, clinical, laboratory, and histopathological aspects on patient survival time was investigated using Kaplan-Meier survival analysis and Cox regression. Results: The average period of follow-up was 6.25 years with a standard deviation of 3.2 years. In surviving patients, the baseline bilirubin level was 2.83, but in deceased or transplanted patients, it was 8.95 (P = 0.002). The baseline albumin level was 3.99 in surviving patients and 3.66 in deceased or transplanted patients (P = 0.024). The incidence of cirrhosis in those who survived was 1.8%, but in patients who died or underwent a transplant, it was 40%. Out of 65 cases, 3 patients (4.7%) died and 7 (10%) had liver transplants. Survival rates of patients vary based on factors such as jaundice (P = 0.002), weariness (P = 0.03), cirrhosis (P < 0.001), and vitiligo (P = 0.033). There were notable variations in the average Mayo score between the two groups of patients who had liver transplantation and survived, with scores of 7.21 and 5.61, respectively. Conclusion: The study found that aspartate aminotransferase and alanine aminotransferase levels, baseline and final bilirubin, albumin, antinuclear antibody, the presence of cirrhosis, and jaundice significantly influenced patient survival with PBC. [ABSTRACT FROM AUTHOR]

Background: In this study, the relationship between involvement by COVID 19 and the recurrence of symptoms of rheumatoid arthritis (RA) was investigated. Materials and Methods: This cross sectional study was conducted on 112 patients with RA with and without a history of COVID 19. The severity and recurrence of RA symptoms were measured and recorded by the Disease Activity Score in 28 joints (DAS 28) index and clinical evaluations by a rheumatologist. Results: The results showed that the recurrence of RA in patients with and without a history of COVID 19 had a statistically significant difference (P < 0.001). In addition, there was a statistically significant relationship between erythrocyte sedimentation rate, visual analogue scale (VAS), tender joint count, swollen joint count, and DAS 28 and the history of COVID 19 (P < 0.05). Conclusion: The present study showed that infection with COVID 19 leads to the recurrence of joint symptoms in RA patients. [ABSTRACT FROM AUTHOR]

Background: Psychosomatic medicine is a systemic model of care based on the biopsychosocial model in which the physical, emotional, and social aspects of clinical conditions are considered. Family Medicine (FM) and psychosomatic medicine have many similarities in their community-based and family-based approaches. Studies have shown the necessity and effectiveness of psychosomatic medicine training for general practitioners (GPs) and family physicians. Methods: We designed a psychosomatic course for FM residents. This semi-experimental study was performed at Isfahan University of Medical Sciences, Iran, in 2018. The target population included 11 FM residents. A compact 20-hour module (4 days, 5 hours each) was designed for the training. The Knowledge and Practice of Psychosomatic Medicine Questionnaire (self-administered) for the concepts and skills of psychosomatic medicine was filled out by each of the FM residents before and after the intervention. For each resident, caring for patients was monitored and a Performance Appraisal Checklist was completed by the supervisor. Finally, the questionnaire scores before and after the intervention were compared using paired t-test. Results: The total knowledge and practice score increased significantly after the intervention (258.5 ± 40.3 vs. 174.6 ± 62.9; P = 0.002). There was also a significant increase in the mean psychosomatic care performance scores after the intervention (28.65 ± 3.52) compared with baseline (21.18 ± 5.94) (P = 0.001). Conclusion: This study showed that basic psychosomatic care training for family physician residents, even in short courses, can have a positive effect on their clinical knowledge and performance. [ABSTRACT FROM AUTHOR]

Dyslipidemia is an important cause of cardiovascular diseases with increasing rates among adult populations. Nutrition and physical activity are known to have an impact on degrees of dyslipidemia. In this article, we had a study on nutritional behaviors and physical activities among middle-aged adults with and without dyslipidemia. In this case-control study, 200 middle-aged adults were entered. One hundred adults with dyslipidemia and 100 normal adults were included in this study. Data regarding desirable or undesirable use of fruits, vegetables, dairy, saturated fatty acids, fast foods, carbonated drinks, and extra salt intake with every meal were collected. Intensity and duration of physical activities were also collected from our data bank and analyzed with SPSS software. Our results indicated that people with dyslipidemia had a significantly increased usage of fast foods and saturated fatty acids, while the normal population had increased usage of vegetables and dairy. There were also significantly increased in intensity, duration per day, and weekly days of physical activity in healthy groups. Logistic regression indicated that undesirable consumption of fast foods, dairy, fatty acids, vegetables, and undesirable physical activity increases the risks for dyslipidemia (OR=8.2, OR=16.2, OR=8.2, OR=18.3, and OR=25.3 respectively) (P<0.05). This article emphasizes the role of proper nutritional behaviors and higher physical activities in decreasing the risks of dyslipidemia, and we suggest that further preventive interventions could be made based on the results of our study. [ABSTRACT FROM AUTHOR]

Background: Placenta adherent abnormality (PAA) is abnormal attachment of the placenta to the myometrium. This abnormal placenta binding has severe clinical consequences for the mother and the fetus. We investigated the outcomes of hypogastric arterial ligation (HAL) before hysterectomy compared to hysterectomy alone in pregnant women with PAA. Materials and Methods: In this randomized controlled clinical trial, 70 patients were randomly allocated to HAL along with hysterectomy and hysterectomy alone groups (35 in each Group). The total amount of intraoperative blood loss, the need for intraoperative blood products transfusion, frequency of deep vein thrombosis, duration of surgery, duration of hospitalization, and visceral trauma were compared between 2 Groups. Results: Finally, 64 patients completed the study protocol with mean age of 33.84 ± 4.25 years. The study groups were comparable in terms of basic baseline demographic and clinical characteristics. Visceral trauma was less frequently occurred in HAL group compared to hysterectomy alone (0% vs. 15.6%; P = 0.02). Intraoperative blood loss (1525 ± 536.41 cc vs. 2075 ± 889.36 cc; P = 0.001) and were significantly lower in HAL group compared to hysterectomy alone. Duration of operation (179.06 ± 36.28 vs. 197.66 ± 39.47; P = 0.05) and hospitalization (4.97 ± 2.20 vs. 6.10 ± 2.39; P = 0.03) also were significantly lower in HAL group. Conclusion: Our findings suggest that prophylactic HAL has a protective effect on the reduction of blood loss and less visceral trauma in pregnant women with PAA. [ABSTRACT FROM AUTHOR]

Background: A number of researchers have suggested that the clinical course of hepatitis A virus (HAV) infection is more severe in patients with chronic liver disease (CLD). However, there is not adequate information about the seroprevalence and risk factors of HAV in the population with chronic hepatitis B or C infection in Isfahan, Iran. Methods: We studied 168 patients with chronic hepatitis B or C between spring 2007 and spring 2009. Patients were stratified based on age, gender, family size, intravenous drug abuse, education, and genotype of hepatitis C. Independent predictors of HAV were identified by logistic regression analysis. Findings: Of 168 patients, 162 persons (96.4%) were HAV seropositive. We found a significant relation between genotypes of hepatitis C and HAV seropositivity (P < 0.001). Other risk factors were not identified as independent predictors. Conclusion: Considering the high seroprevalence of HAV in patients with hepatitis B or hepatitis C, general vaccination against HAV is not necessary. Further studies should be conducted to draw a firm decision on vaccination of seronegative patients. [ABSTRACT FROM AUTHOR]

Background: Street children are at increased risk of mortality and morbidity due to a variety of diseases such as hepatitis A as a result of both the circumstances that made them vagrant and as a direct consequence of life on the streets. The aim of study was to determine the seroprevalence of hepatitis A and its associated risk factors in street children, Isfahan, Iran. Methods: A total number of 348 subjects, aging between 7-18 years old, were enrolled in a crosssectional study. They completed a demographic and risk factor assessment questionnaire and undertook serological screening for hepatitis A. Chi-square test and t-test were used for statistical analysis in SPSS15. P-values < 0.05 were considered significant. Findings: The subjects included 228 (65.5%) boys and 120 (34.5%) girls with mean age of 12.97 ± 3.34 years. In addition, 15.8% of the participants were sexually active and 3.7% reported using drugs. Overall, the prevalence of hepatitis A virus antibody (HAV-Ab) was 91.4%. Statistical correlations were seen between HAV-Ab and gender, education, nationality, sexual activity, and drug abuse. Conclusion: The prevalence of positive HAV-Ab among the studied street children was 9-fold higher than the rate among the peer group in general population of Isfahan (10.63%). Educational programs and access to health care facilities should thus be considered for theses children. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B is one of the common liver diseases. It also affects mental and social aspects of life. Methods: In this cross-sectional study, patients affected with chronic hepatitis B who referred to Infectious Diseases and Tropical Medicine Research Center, Isfahan, Iran were studied. After filling a validated questionnaire including demographics and information related to depression and anxiety, the data was analyzed. Findings: Among 107 patients with chronic hepatitis B (78 males and 29 females with mean age of 39 ± 13 years), none had depression and only 2.8% suffered from anxiety. Conclusion: This study demonstrated that patients with chronic hepatitis B do not have depression. One of the causes might be inadequate information about the disease. Such lack of information needs to be taken care of by physicians and authorities. [ABSTRACT FROM AUTHOR]

Objectives: Hepatitis C virus (HCV) infection is a major public health problem worldwide with serious complications. According to the importance of intravenous drug use (IDU) as the main risk factor for HCV infection and transmission and prison as the main source of risky behaviors, this study conducted to define HCV infection and related risk factors in prison inmates with history of IDU in Isfahan province, Iran. Methods: This is a cross -sectional study which the prison inmates with IDU history in voluntary basis were enrolled. A validated questionnaire was asked and blood sample was obtained from each subject for the presence of HCV antibody. Odds ratio and logistic regression were used for data analysis and P-value < 0.05 considered significant. Results: I943 inmates with history of IDU participated in the study. The overall prevalence of HCV antibody was 41.6%. The main independent risk factors were number of injection in the month [OR: 1.006 (1.002- 1.011)], Length of drug addiction [OR: 1.05 (1.004-1.098)], multiple incarceration [OR: 1.15 (1.05-1.23)] and use of needle/syringe share inside prison [OR: 4.19 (2.22-7.9)]. In our study, marriage was a protective factor for HCV infection [OR: 0.34 (0.18-0.64)] as well. Conclusions: According to relatively high prevalence of HCV infection and associated risk factors which observed in this study it is important to primary prevention in prisons through syringe/needle exchange and counsel with imprisoned IDUs. [ABSTRACT FROM AUTHOR]

Background: Human cytomegalovirus (HCMV) is one of the commonest agents that cause congenital malformation such as mental retardation and deafness. Seroprevalence of HCMV varies in different populations and age groups. This study tried to determine the seroprevalence and contributory factors of CMV in order to develop successful strategies for HCMV diseases prevention. Methods: We examined 595 serum samples from different age groups for the presence of IgG antibodies against HCMV by enzyme-linked immunosorbent assay (ELISA) technique. Findings: Overall, 586 out of 595 cases were seropositive for HCMV-IgG while 9 cases were seronegative. Educational level, sex, marital status, and place of residence were not associated with CMV seropositivity. Conclusion: Our results indicated that in Isfahan, Similar to other developing countries, most patients are infected during puberty and not through sexual intercourse. Therefore, frequent audiological assessments and urine samples to evaluate CMV in case of defect in hearing ability are mandatory. We also recommend transmission of eradicated blood for immunocompromised patient and immature neonates. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C, as a major public health problem, is associated with increased prevalence of psychiatric disorders, particularly depression. This study was performed to determine the prevalence of depression and anxiety in patients with hepatitis C and to detect related risk factors among these patients. Methods: In this cross-sectional study, patients with chronic hepatitis C who referred to Infectious Diseases and Tropical Medicine Research Center of Isfahan, Iran were studied. Subjects were selected by simple random sampling during a 4-month period. They all completed a validated questionnaire including demographics and information related to depression and anxiety. Zung Self rating Anxiety Scale and Beck Depression Inventory were used. The data was finally analyzed. Findings: Among 264 patients with chronic hepatitis C (262 males and 2 females; mean age: 34.4 ± 6.7 years), 85.7% had no depression, 8.9% had mild depression and 5.4% had moderate depression. Anxiety was observed in 17.9% of the subjects from which 17% had mild to moderate and 0.9% had sever anxiety. There were significant relationships between depression and marital status and job. Anxiety also had significant relationships with history of addiction, job, time of drug usage and place of living. Conclusion: The results of this study indicated the high prevalence of depression and anxiety in patients with hepatitis C. Such patients, especially those with related risk factors such as unemployment, being single, etc.) require psychiatry consultation and constant monitoring of psychiatric disorders. [ABSTRACT FROM AUTHOR]

# BACKGROUND: During August 2009, novel H1N1 influenza virus began causing illness in Isfahan. Since rates of hospitalization and mortality due to the disease have varied widely in different countries, we described the clinical, radiologic, and demographic features of H1N1 hospitalized patients in a hospital in Isfahan. # METHODS: This cross-sectional study was conducted in Alzahra Hospital during September 2009 to February 2010. Totally, 216 patients with confirmed, probable, or suspected cases of 2009 influenza A (H1N1) were admitted. # RESULTS: Most patients were female (50.5%). Mean age of patients was 26.6 ± 19.5 years. The most common complains on admission were respiratory symptoms (91.6%, n= 198), fever (88.4%, n = 191), myalgia (65.7%, n = 142). In addition, 120 patients (56%) had at least one underlying medical disorder. Thirty-six patients (16.7%) died. Mortality was higher in children under 5 years old (10/36, 10%) and female cases (63.9% of died patients). Predicting variables affecting mortality were intensive care unit (ICU) admission and procalcitonin (PCT). Antiviral treatment was prescribed for 200 (92.5%) of the 216 patients. # CONCLUSIONS: Based on the findings of the present study, novel H1N1 influenza is highly prevalent among the youth. Moreover, it causes a relatively high morbidity rate. Therefore, people need to be encouraged to have vaccination against 2009 H1N1. Early diagnosis and treatment is related to less admission and shorter duration of hospitalization. [ABSTRACT FROM AUTHOR]

Background: Many studies have recognized high-risk behaviors in prisoner populations. The prevalence of sexually transmitted diseases and blood born diseases in prisoners are often higher than the general population. AIDS and hepatitis are the most important diseases among prisoners. The purpose of the present study was to determine the prevalence of high-risk behaviors, in women prisoners in Isfahan, Iran. Methods: In this cross-sectional study, all of the women prisoners in the central prison of Isfahan were investigated. Demographic characteristics and high-risk behaviors information were fetched by a standardized questionnaire. Data was analyzed by descriptive tests and χ2, Kruskal-Wallis, and Mann- Whitney tests. P < 0.05 was considered statically significant. Findings: 160 women prisoners were investigated. Smoking (31.3%), addiction (30.1%), multiple arrests (26.4%), extra-marital sex in their husbands (22.1%), alcohol drinking, extra-marital sex and temporary marriage (17.8%) were the most common high-risk behaviors in the studied population. Smoking, drinking and addiction was seen respectively in 92 persons (60.2%), 42 persons (26.9%) and 62 persons (39.2%) of prisoners family. 10 women (6.4%) claimed intravenous drug abusing in their families. Conclusion: Regarding the results of this study, performing the harm reduction and preventing programs in prisons and obligation of raising awareness in high-risk groups is recommended. [ABSTRACT FROM AUTHOR]

Background: Medical and health advances have led to relative increases in human longevity and the elderly population. Common diseases in the elderly can be prevented by healthy lifestyle. Identifying the current status of seniors is necessary to design educational intervention programs to improve their health and quality of life. Therefore, the aim of this study was to assess the lifestyle of the elderly in Isfahan, Iran. Methods: This cross-sectional study was performed in Isfahan in 2010-2011. Using stratified multistage random cluster sampling, 1124 seniors were selected. Data was collected based on elderly healthy lifestyle questionnaire. Data was analyzed by SPSS15 using descriptive statistics, t-test, and analysis of variance (ANOVA). Findings: Mean of total lifestyle score was 148.95 ± 12.8. Men and women scored 149.87 ± 13.62 and 148 ± 11.94, respectively (P = 0.02). Conclusion: The status of healthy lifestyle among the elderly in the province of Isfahan is relatively moderate. However, more studies are needed for further information. [ABSTRACT FROM AUTHOR]

Background: Serum biomarkers can be used as alternative method for liver biopsy in order to assess the level of fibrosis in patients with chronic Hepatitis C. The determination of Hepascore is a noninvasive method to assess the level of fibrosis among patients. This study aims to compare the liver biopsy results with Hepascore among the Genotype 1 Hepatitis C patients in Isfahan. Methods: A sample of 39 patients with chronic Hepatitis C is selected through the simple non-random sampling method for a liver biopsy and Hepascore test. After biopsy, the patients are categorized based on the Metavir scoring system. The Hepascore algorithm is computed based on age, sex, total Billirubin, δ-glutamyl transferase, α2-Macroglobin, Hyaluronic acid. Using the Spearman and ROC test in SPSS15, collected data have been analyzed. Findings: The liver biopsy results showed 6 patients with F0, 12 patients with F1, 10 patients with F2, 3 patients with F3, and 8 patients with F4. The Hepascore value above 0.37 cut off point for detecting significant level of fibrosis has shown 67% sensitivity, 61% specificity, 67% positive predictive value, 61% negative predictive value. For a Hepascore value above 0.66, the results are: 82% sensitivity, 89% specificity, 75% positive predictive, 89% negative predictive value. For a Hepascore value higher than 0.84 for detecting cirrhosis, the results are: 100% sensitivity, 97% specificity, 89% positive predictive, and 100% negative predictive value. Conclusion: This study shows that the Hepascore method is accurate enough to measure the level of fibrosis, particularly cirrhosis. Therefore, it can use for screening of patients that need liver biopsy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT) scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1) in an appropriate clinical setting. METHODS: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23(rd) 2009 to February 20(th) 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1) virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. RESULTS: Patchy infiltration (34.6%), lobar consolidation (30.8%), and interstitial infiltration (26.9%) with airbronchogram (38.5%) were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8%) showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS). CONCLUSIONS: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1) in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific. [ABSTRACT FROM AUTHOR]

BACKGROUND: Toxoplasmosis is a worldwide infection. Most studies on toxoplasmosis are in women in child bearing ages. We conducted an epidemiological survey on the population of the Isfahan Province to identify characteristics of the individuals associated with seropositivity. METHODS: In a cross sectional study, 599 serum samples were randomly collected for seroepidemiology of Hepatitis A and E, and were also used for titration of IgG anti-toxoplasma gondii antibody by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Data were analyzed using SPSS software(15). Chi square and Fisher exact tests were employed to examine antibody status in different age, gender, education and residency groups. RESULTS: The overall prevalence was 41.4% (248/599). There was a statistical significant association between seroprevalence with age, education, and gender (p < 0.05) but not with residency state. The peak age for acquisition of the infection in females was 20-29 and in males 20-39 years old. CONCLUSIONS: Results of current study showed a moderate prevalence of toxoplasma gondii infection. However higher seroconversion rate in active social and reproductive ages, females and low educated individuals necessitate active preventive programs in these high risk groups. [ABSTRACT FROM AUTHOR]

BACKGROUND: Toxoplasmosis is a worldwide infection. Most studies on toxoplasmosis are in women in child bearing ages. We conducted an epidemiological survey on the population of the Isfahan Province to identify characteristics of the individuals associated with seropositivity. METHODS: In a cross sectional study, 599 serum samples were randomly collected for seroepidemiology of Hepatitis A and E, and were also used for titration of IgG anti-toxoplasma gondii antibody by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Data were analyzed using SPSS software15. Chi square and Fisher exact tests were employed to examine antibody status in different age, gender, education and residency groups. RESULTS: The overall prevalence was 41.4% (248/599). There was a statistical significant association between seroprevalence with age, education, and gender (p < 0.05) but not with residency state. The peak age for acquisition of the infection in females was 20-29 and in males 20-39 years old. CONCLUSIONS: Results of current study showed a moderate prevalence of toxoplasma gondii infection. However higher seroconversion rate in active social and reproductive ages, females and low educated individuals necessitate active preventive programs in these high risk groups. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C, as a major public health problem, has serious complications and intravenous drug users are the most high risk group for it. This study was performed to determine hepatitis C seroepidemiolgy and related risk factors among intravenous drug users in Isfahan province. Methods: In this cross-sectional study, intravenous drug users (IVDUs) in central prison, Assadabad camp and Drop in Centers in Isfahan province were selected using census sampling method. After completion validated questionaire including demographic and risk factors by interiew, a 5 cc blood sample was obtained and HCV-Ab was detected using ELISA method. Finding: Among 1485 intravenous drug users (1457 male) with mean age of 32 ± 7 years, 644 (43.4%) were HCV-Ab positive. Not being married, tatooing, needle share, prison history, history of going to dentist and duration of intravenous drug abuse were indepenedent risk factors for hepatitis C. Also, men with men sex, sex with intravenous drug users and unprotected sex (without condom) had significant relationship with hepatitis C. Among HCV risk factors, needle share and prison history had hightest relative and attributable risks. Using ROC curve, the cut off point for duration of intravenous drug abuse was estiamted as three months. Conclusion: The main results of this study indicated high prevalence rate of hepatitis C and the major role of needle share and prison history among intravenous drug users population in Isfahan province that needs to pay attention by governments. [ABSTRACT FROM AUTHOR]

Background: Frequent transfusion of blood and blood products to patients with thalassemia major and hemophilia and under hemodialysis patients may cause infections such as hepatitis infection in them. This study aimed to determine the prevalence of hepatitis C and associated risk factors in these patients in Isfahan, the second big province in Iran. Methods: In a descriptive study, all the patients with hemophilia and thalassemia and under hemodialysis in Isfahan province were enrolled. A questionnaire, including demographic and risk factors of hepatitis C was completed through a structured interview with closed questions by a trained interviewer for each patient and HCV-Ab test results were extracted from patient records. Finding: In this study, 60of 570 patients with thalassemia major (10.5%), 232 of 350 patients with hemophilia A and B (66%) and 17 of 800 under hemodialysis patients (2.1%) were positive for hepatitis C. Based on Multivariate Logistic Regression model, no independent risk factor was found. Conclusion: Prevalence of hepatitis C in patients with recurrent blood transfusion in Isfahan is high. Since no independent risk factor for hepatitis C disease was found in these three groups, it can be concluded that multitransfusion is the only predictor for hepatitis C. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C is a major worldwide problem with remarkable medical burden which is emerging mostly due to intravenuos drug abuse. The prevalence of hepatitis C infection is higher among prison inmates because of the high proportion of injecting drug users. So, the aim of this study was to determine the seroprevalnce of hepatitis C infection among prisoners with history of intravenous drug abuse in Isfahan province-Iran. Methods: In this cross-sectional study, active and inactvie intravenous drug abusers were enrolled into study volluntarily with ethical considerations. Participants were interviwed using a structured questionnaire and a blood sample was collected for detection HCV antibody using ELISA method. Finding: From 6000 prison inmates in Isfahn central prison and Assadabad Camp, approximatly 20 percent (1200 ones) had hsitory of intravenous drug abuse from which, 951 ones (80%) were intered in this study. The prevalenc of HCV infection was 42 percent and the main factores earned from this project experience were: problem in giving samples, problem in prison interance, separate interveiw and sample collecting, and desirable participants' cooperation. Conclusion: According to success in obtaning nearly 80% of prison inmates with history of drug abuse, this is a good experience for other investigators and health directors to design simillar studies or executive protocols. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) is a major public health problem in the world which drug injection is a primary mode of transmission for it. So, this study was conducted to determine seroprevalence of HCV in intravenous drug abusers (IVDA) in Isfahan province Drop in centers (DIC). Methods: This qualitative/quantitave study used triangulation method in data collection and analysis. Five semi-structured focus groups with open-ended questions were disposed to evaluate and discuss on aspects of the study. Intravenous drug abusers in Isfahan province Drop in centers by non-probable purposive sampling method entered into the study voluntarily and blood sample was obtained from them. Serum samples were tested for HCV-Ab using ELISA method. Finding: There were seven govermental Drop in centers including 4 related to Isfahan University of Medical Sciences and 3 related to welfare organization which contained 1581 intravenous drug abusers members. From them, 539 patients (34%) enterd into the study from which, 250 (47.1%) patients were positive for HCV-Ab without significant differences between men and women. The main impressive factors for the project were wage for blood obtaning, occupational insurance, problems in interview and sampling, and time restriction. Conclusion: This was a good experience for other investigators and health directors' strategies to design simillar studies or harm reduction. [ABSTRACT FROM AUTHOR]

Background: Standard isolation precautions are designed to reduce the risk of acquiring occupational infections from both known and unknown sources in the healthcare setting. Awareness and compliance with these recommendations is crucial for the prevention of occupational nosocomial infections in healthcare workers. Improving the compliance of standard precautions (SP) is one of the most important ways to reduce healthcare associated infections, but also the most difficult to achieve. The aim of this study was to evaluate the levels of knowledge, attitude and practice of surgeons and surgical residents in Isfahan, regarding standard precautions. Methods: In a cross-sectional, 140 surgeons and surgical residents were evaluated about standard precaution in Isfahan University of Medical Sciences. Questionnaires were handed to participants who were willing to take part in the survey. The questionnaire included demographic data and also knowledge, attitude and practice of standard precaution. The questionnaire was self-administered. Descriptive and inferential statistics including Spearman and Mann-Withney tests were performed. Finding: In this study, 91 residents and 48 surgeons were assessed with the mean age of 38.26 ± 10.86 years. The mean for surgeons' knowledge was 8.25 ± 1.22 and mean for surgical residents' knowledge was 7.94 ± 1.37 (P > 0.05). The mean for surgeons' attitude was 40.56 ± 3.46 and mean for residents' was 38.68 ± 3.70 (P < 0.05). The mean of surgeons' practice was 4.78 ± 2.29 and mean of surgical residents' practice was 3.80 ± 2.21 (P < 0.05). Conclusion: The results suggest that among study groups, the levels of knowledge and attitude regarding standard isolation precautions were acceptable; although compliance level was moderate. Therfore, for better acting attitude and practice, we have to educate and update healthcare worker especially who had poor practice. [ABSTRACT FROM AUTHOR]

Background: Addiction is considered as one of the major problems in the society. Various social psychological and biological issues affect creating interest to drugs and continuing it. Besides, being an illness itself, addiction is a basis for transmitting diseases; the most important of them are AIDS and hepatitis. In this study, we tried to investigate high-risk personal behaviors of intravenous drug abusers that can increase the incidence of infectious diseases transmitting. Methods: In this descriptive study, the persons who had history of intravenous drug abuse referred to Isfahan addition prohibition centers were investigated. They were 539 persons totally. Required information about high-risk behaviors and demographic characteristic were fetched by a standardized questionnaire, by a same-sex researcher. Finding: The ratio of illegal sex was about 55%; most of condom and tattooing consumers was young people. Seniors had intravenous drug abuser sexual partners more than the others. Also, subtle linear ratio between number of arrests and aging existed. But there was not any significant difference in terms of age, utilizing share syringe, different ways of drug abuse and sexual relationship between different age groups. Conclusion: Regarding the results, increasing the number of intravenous drug abusers, the obligation of awareness in various fields including protected sexual relationship, avoiding use of shared syringe and preventing tattoo is obvious. [ABSTRACT FROM AUTHOR]

Background: Millions of children around the world live on the street. They are at higher risk of viral diseases (eg. hepatitis B virus) because of physical, sexual and drug abuse. The aim of this study was to evaluate the prevalence of hepatitis B virus (HBV) and its risk factors in Isfahan street children. Methods: In a cross-sectional study, we selected 399 street children. After getting information and performing the tests for HBs Ag, HBs Ab and HBc Ab, data were analyzed by SPSS software version 15 used t-test, χ², Mann-Whitney and logistic regression. Findings: We studied 271 (68%) boys and 128 (32%) girls. Their mean age was 12.74 ± 3.27 years. In our study, poverty was the main motivation for street children (68% of participants). 91.7%, 94.7% and 96.7% of the participants had no history of smoking, drinking alcoholic beverages or drug abuse, respectively. 34.4% of girls and 4.4% of boys (P = 0.001) were sexually abused and 68% of girls and 17.3% of boys (P = 0.001) were involved in physical fighting. HBs Ag, HBs Ab and HBc Ab seroprevalence were 3.3%, 14.4% and 2.1% respectively. No significant statistical difference was between HBV-seroprevalence and its probable risk factors. Conclusion: Educational programs for safer behaviors, training them to improve their quality of life, and hepatitis B vaccination in those who are nonimmune should be performed. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is in the 7th grade according to Disability Adjusted Life Years (DALY) and will stay in this grade until 2020. In the developing countries, 25% of preventable deaths are due to tuberculosis, 75% of them occurs in producing people. The main reason of this outcome is ineffective national programs for tuberculosis surveillance in the countries. Therefore, periodic program evaluation of tuberculosis surveillance would be essential. Methods: This was a Health system research (program evaluation) study that has been conducted in Isfahan district (2005-2006). Data were collected from epidemiologic forms sent to Isfahan provincial health center. All samples were analyzed. Data were analyzed using SPSS 11.5 software. The outcome and process indices were computed and compared with standards. Findings: The computed indices in 2005 and 2006 were as case detection rate (CDR) 90% and 77%, incidence of smear-positive cases per 100000 population 2.28 and 1.11, conversion rate 87.5% and 81%, cure rate 77.5% and 56%, completion rate 2.5% and 2%, success rate 80% and 58%, failure rate 2.5% and 4%, respectively. Conclusion: This study revealed that there is a gap between new-case incidence of smear positive lung tuberculosis, cure rate, success rate and the standards. This reveals a problem in accomplishment of tuberculosis surveillance program and continuous monitoring of this program will lead to improvement the indices. [ABSTRACT FROM AUTHOR]

Background and Aims: Assessment of heart failure (HF) therapy based on guideline was less frequently performed. Objectives: In this study, we aimed to evaluate the frequency of readmission or mortality in HF patients according to guideline directed medical treatment. Materials and Methods: This retrospective cohort study was done from March 2016 to March 2017 in one of the tertiary heart centers located in Isfahan, named Chamran Hospital. A total of 503 patients with a diagnosis of HF were recruited in the research. Demographic data, prescribed medication, and para-clinic information were gathered during hospitalization period. The frequency of re-hospitalization and mortality was assessed 6 months after discharge, and its relation with aforementioned variables was evaluated. Results: The mean age of participants with the dominance of males (61.8%) was 70.8 ± 11.8 years. A total of 175 (34.8%) patients had been readmitted or died during 6-month follow-up. Participants with New York Heart Association (NYHA) functional class of IV and renal diseases had raised likelihood of re-hospitalization or death (odds ratio [OR]: 5.59, 95% confidence interval [CI] = 1.42-21.5, P = 001 and OR: 2.53, 95% CI = 1.11-5.79, P = 0.02, respectively). In contrast, individuals with heart rates (HR) of 80-100 beats/min showed decreased chance of adverse clinical outcomes compared to subjects with HRs of <60 beats/min (OR: 0.08, 95% CI = 0.009-0.77, P = 0.02). Conclusion: Our data suggested that HF patients having higher NYHA functional class or kidney problems and HRs of 80-100 beats/min had increased and decreased likelihood of readmission and mortality, respectively. Several longitudinal studies are required confirming these associations. [ABSTRACT FROM AUTHOR]

Background: In Iran, there is limited evidence on the prevalence of hepatitis B and C viruses (HBV and HCV) among females who engage in illegal sexual behavior. Objectives: To determine the prevalence of HBV and HCV infections and their associated factors in this population in Isfahan-Iran. Patients and Methods: In this cross-sectional study, 100 females who engaged in illegal sexual behavior during 2009-2010 in Isfahan were recruited from welfare to the DIC for women, and referrals were made among those who knew others who engaged in prostitution. Markers for HBV and HCV-Ab were measured by ELISA, and recombinant immunoblot assay was used for confirmation of HCV infection. Also, a questionnaire on demographics and prostitution-associated risk data in a face-to-face interview was completed for each participant. Chi-square and multivariate logistic regression models were used for data analysis. Results: Of the 100 samples collected, 91 were sufficient for testing. The mean age and time spent in sex work were 30.84 ± 9.34 years and 36 ± 28.5 months, respectively. HBsAg was detected in 1 (1.1%), anti-HBc in 4 (4.4%), anti-HBs in 60 (65.9%), and HCV Ab in 9 (9.9%) subjects. The evidence of vaccination was seen in 54 subjects (59.3%). There were no significant differences in the prevalence of HBV or HCV infection by estimated risk factors, and there was no independent risk factor for these infections. Conclusions: The high prevalence of HCV infection in this study indicates the need to implement preventive interventions for female sex workers and, perhaps more importantly, to involve their male clients. [ABSTRACT FROM AUTHOR]

Background: Hepatitis D virus (HDV) is dependent on hepatitis B virus (HBV) infection. Acute infection with HDV can occur simultaneously with acute HBV infection or be superimposed onto a chronic HBV infection. Objectives: This study aimed to identify cases of HDV and determine its prevalence in patients with chronic HBV infection for the first time study in Isfahan, central Iran. Patients and Methods: In a cross-sectional study in 2009, 346 who had been diagnosed for at least 6 months with chronic HBV were enrolled consecutively. Anti-HDV was measured by ELISA in the serum of these patients. Results: The study included 245 males (70.8%) and 101 (29.2%) females with a mean age of 39 ± 12.4 years. Anti-HDV was present in 8 (3.5%) HBe antibody-positive patients (p = 0.36) and in 2 (2.3%) HBe antigen- positive cases (p = 0.68). No association was found between hepatitis D and probable risk factors. Conclusions: This study demonstrates that the prevalence of HDV infection is higher in patients who are positive for HBeAb compared those who are HBeAg-positive. Therefore, most HDV antibody-positive cases in Isfahan are HBV/HDV superinfections but not coinfections. [ABSTRACT FROM AUTHOR]

Background and Aims: Patients with human immunodeficiency virus (HIV) are also likely to be at risk for other infectious pathogens including hepatitis B (HBV) and C (HCV) viruses, which complicate the clinical course, management, and therapy. The literature on the prevalence of HBV/HCV coinfection with HIV in Iran is sparse. Hence this study was conducted to investigate this coinfection pattern and its risk factors in Isfahan, Iran. Methods: All of the HIV-infected patients attending clinics for acquired immune deficiency syndrome (AIDS) research and education in Isfahan province during the period of May 1998 through April 2007 were included in this cross-sectional study. After giving their informed consent, the patients were screened for hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C virus (anti-HCV), and anti-HCV-positive cases were confirmed with the RIBA test. The demographic data and information about risk behaviors were collected as well. Multivariate logistic regression was used to identify independent risk factors for HBV and HCV. Results: The subjects included 130 patients (128 males and 2 females) with a mean age of 50.23 ± 8.81 years. Most of the subjects were unemployed (61.5%) and single (56.2%). A history of imprisonment, , intravenous drug abuse, and high-risk sexual activity were reported by 83.7%, 83.5%, and 48% of the subjects, respectively. Coinfection with hepatitis viruses was observed in 78.5% of the subjects. Low levels of education, a history of imprisonment, and youth were the main risk factors for HCV/HIV coinfection (OR = 196, 114, and 0.9 respectively). Conclusions: Our study showed that there is a high prevalence rate of HCV/HIV coinfection in Isfahan, Iran, with the major risk factor being a history of imprisonment. [ABSTRACT FROM AUTHOR]

Background: Familial hypercholesterolemia (FH), an autosomal dominant disease, is associated with an increased risk of premature cardiovascular disease (CVD). This study aimed to examine the variations in serum levels of calcium, vitamin D, phosphorus, and parathyroid hormone (PTH) among FH patients, as these factors have been associated with an increased susceptibility to CVD., Materials and Methods: In this cross-sectional study, the authors used data from Isfahan FH registry. The Dutch Lipid Clinic Network (DLCN) criteria was used for diagnoses of FH patients. Control group included participants with hyperlipidemia and were unlikely FH according to DLCN criteria. All biochemical parameters were measured using standard methods., Results: A total of 131 patients (mean age, 53.1 ± 12.2; male, 51.4%) were included in the analysis. Patients with FH had lower serum vitamin D levels compared with control groups in the unadjusted model ( P = 0.028). The relationship between serum vitamin D and FH was not significant after adjustment for traditional risk factor ( P = 0.184). No significant association was observed between FH and serum calcium ( P = 0.886), phosphorus ( P = 0.463), and PTH ( P = 0.849). Besides, there was no significant association between LDL-C or total cholesterol and serum minerals in FH patients., Conclusion: This study found no significant changes in serum calcium, vitamin D, phosphorus, and PTH in patients with FH., Competing Interests: The authors declare no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Type 2 diabetes is a significant problem in today's society. Considering the possible effect of self-efficacy training on diabetes control, we aimed to investigate its impact on type 2 diabetes control., Methods: This randomized controlled clinical trial was performed in 2018 in Isfahan city. Iranian Registry of Clinical Trials (IRCT) code for this study is IRCT20190219042762N1 (https://en.irct.ir/trial/37677). In so doing, 161 patients with diabetes were divided into two groups: intervention and control. The intervention group received six self-efficacy and healthy lifestyle training sessions, and self-efficacy strategies were taught in all sessions. Metabolic indices and the data collected by Diabetes Management Self-Efficacy Scale (DMSES) were analyzed before and three months after training by descriptive and inferential statistics., Results: The self-efficacy score of the intervention group was significantly higher after training (175.7±18 vs. 163.7±26, P = 0.001). Also, the cholesterol level, LDL, and systolic blood pressure reduced significantly in this group after the intervention (167±39 vs. 179±43.7 mg/dl, 94.2±31 vs. 102.6±39 mg/dl, 115.6±1.4 vs. 120.1±1.8 mmHg, respectively. P<0.05)., Conclusion: Generally, self-efficacy training effectively improved metabolic control in patients with type 2 diabetes., Competing Interests: None., (IJPPP Copyright © 2022.)

Background: Hypertension is one of the most important causes of cardiovascular diseases. Patients with hypertension have a lower quality of life. We aimed to evaluate the effects of mindfulness meditation on blood pressure, mental health, and quality of life in patients with hypertension., Methods: This randomized clinical trial was performed in 2019 in Isfahan. Eighty adult women with Stage I or II hypertension were included and assigned randomly to 2 groups: 12 weeks of mindfulness-based stress reduction (MBSR) and routine care. At baseline and 1 week after the end of the intervention, blood pressure, stress, depression, anxiety, and quality of life of the studied participants were measured using the Depression, Anxiety, and Stress Scale-21 (DASS-21) and 36-Item Short Form Survey (SF-36) questionnaires. The data were analyzed using the independent t-test, the paired t-test, and the MANCOVA test., Results: After the intervention, the mean systolic and diastolic blood pressures decreased significantly in the intervention group compared with the baseline (142.82±11.01 mmHg vs 133.7±510.43 mmHg for systolic pressure and 86.12±8.24 mmHg vs 79.15±6.26 mmHg for diastolic pressure) and the control group (140.18±14.27 mmHg vs 142.15±10.23 mmHg for systolic pressure and 84.62±9.22 vs mmHg 88.51±8.54 mmHg for diastolic pressure; P=0.001). There was also a significant increase in quality of life, stress, anxiety, and depression scores in the intervention group (P<0.05)., Conclusion: The 12-week MBSR program resulted in a significant reduction in the mean systolic and diastolic blood pressures and improvement in mental health and different aspects of quality of life., (Copyright © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: Diabetes mellitus is one of the major health problems in the world. Stress and mental illnesses adversely affect glycemic control. In most patients, a multidisciplinary approach including physical activity, healthy diet, and stress management is required for glycemic control. Mindfulness-based stress reduction (MBSR) is a structured group program that reduces emotional distress through self-awareness and assuming the responsibility for individual choices, and results in increased effective health behaviors. Here, we aimed to evaluate the effects of mindfulness meditation on glycemic control and mental health in patients with type 2 diabetes., Materials and Methods: This randomized clinical trial study was performed in 2018 in Isfahan city. A total number of 108 patients with diabetes mellitus type 2 were selected and allocated randomly to two groups, intervention (12 weeks MBSR program) and control (routine care). Depression, anxiety, and stress scores regarding to depression, anxiety, and stress Scale - 21 questionnaire and also amounts of fasting blood sugar (FBS) and hemoglobin A1C (HbA1C) were assessed and analyzed using independent t -test, paired t -test, Mann-Whitney U-test, and Chi-square, before and 13 weeks after educational programs., Results: The means of HbA1C, FBS, and depression, anxiety, and stress scores improved significantly after intervention in the MBSR group. Except FBS levels, all outcome variable scores' mean change was significant between the two groups., Conclusions: In general, this study revealed that mindfulness meditation could be helpful in improving the quality of mental health and lowering glycemic control indices in patients with type 2 diabetes mellitus., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Advanced Biomedical Research.)