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Sara Ayazian Mavi,1 Mohammad Hossein Modarressi,2 Mehdi Mohebali,1,3 Saeedeh Shojaee,1 Hojjat Zeraati,4 Aref Teimouri,1,5 Hossein Keshavarz1,31Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 3Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran; 4Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 5Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, IranBackground: Toxoplasmosis, a protozoan parasitic disease caused by Toxoplasma gondii, has been a serious human and veterinary medicine problem with global distribution. In the current study, we assessed immunogenicity and protective efficiency of a novel dual-promoter DNA vaccine, harboring SAG1 and GRA7 genes, from RH strain of Toxoplasma gondii (T. gondii) with or without CpG-ODN as adjuvant in a murine model.Methods: BALB/c mice were immunized intramuscularly with pVitro-SAG1-GRA7 alone and pVitro-SAG1-GRA7 with CpG-ODN three times at three-week intervals. Enzyme-linked immunosorbent assay (ELISA) was used to assess total IgG, IgG1 and IgG2a antibodies and gamma interferon (IFN-γ) and interleukin-10 (IL-10) cytokines in mice sera. Four weeks post final vaccination, MTT assay and lethal challenge-infection with 1×103 tachyzoites of T. gondii RH strain were carried out to assess stimulation index (SI) and mice survival time, respectively.Results: The IgG levels in mice immunized with multicomponent vaccines, including pVitro-SAG1–GRA7 alone and pVitro-SAG1–GRA7 with CpG-ODN, were significantly higher than those in control mice or single-gene DNA-vaccinated ones (P

Saeed Akhlaghi,1 Maryam Sahebari,2 Mahmoud Mahmoodi,1 Mehdi Yaseri,1 Mohammad Ali Mansournia,1 Houshang Rafatpanah,3 Hojjat Zeraati1 1Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 2Rheumatic Diseases Research Center (RDRC), Mashhad University of Medical Sciences, Mashhad, Iran; 3Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Purpose: One of the most important long-term side effects of therapy for rheumatoid arthritis (RA) is the elevation of liver function tests, with earlier studies reporting an elevation of more than 1× the upper limit of normal (>1 × ULN). The current study expands the literature by comparing the trends of transaminase changes caused by conventional and biologic disease-modifying antirheumatic drugs (DMARDs).Patients and methods: The drug categories examined were methotrexate (MTX) and all other nonbiologic DMARDs. Where RA patients exhibited inadequate response to conventional DMARDs (cDMARDs), we added biologic DMARDs (bDMARDs) to the treatment. We compared the trend of changes in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the patients receiving MTX with the trend observed in the patients whose treatment encompassed both bDMARDs and MTX. The comparison was conducted using random intercept models, which are a type of linear mixed effects model.Results: This work involved 512 RA patients (MTX: 450, MTX + infliximab [INF]: 26, MTX + etanercept [ETA]: 36), whose ALT and/or AST levels were measured in 1,786 visits (MTX: 1,543, MTX + INF: 107, MTX + ETA: 136). ALT and/or AST elevations greater than 1 × ULN were observed in 344 (19.3%) visits (MTX: 295 [19.1%], MTX + INF/ETA: 49 [20.2%]). In this study, the trends of ALT and AST changes increased when receiving MTX, while the INF/ETA addition decreased these trends. The random intercept models indicated that changes in the mean ALT levels were significantly different over the time for MTX and MTX + INF/ETA groups (β [SE] =-0.190 [0.093], P= 0.040) but changes in the mean AST levels were nonsignificantly different over the time for such groups (β [SE] =-0.099 [0.064], P=0.120).Conclusion: Despite a higher incidence of elevated transaminases during the use of MTX + INF/ETA, the combination of INF/ETA with MTX reduced transaminase levels and returned ALT levels to normal concentrations. Keywords: longitudinal, ALT, AST, DMARDs, biologic DMARDs, MTX

Background: In spite of the increasing degree of automation in industry, manual material handling (MMH) is still performed in many occupational settings. The aim of the current study was to determine the maximum acceptable weight of lift using psychophysical and electromyography indices. Methods: This experimental study was conducted among 15 male students recruited from Tehran University of Medical Sciences. Each participant performed 18 different lifting tasks which involved three lifting frequencies, three lifting heights and two box sizes. Each set of experiments was conducted during the 20 min work period using free-style lifting technique and subjective as well as objective assessment methodologies. SPSS version 18 software was used for descriptive and analytical analyses by Friedman, Wilcoxon and Spearman correlation techniques. Results: The results demonstrated that muscle activity increased with increasing frequency, height of lift and box size (P

Group B streptococci (GBS) or Streptococcus agalactiae are members of the normal flora of the female genital tract. GBS normally colonizes the vagina in many women asymptomatically. During labor this organism may infect the newborn, leading to neonatal sepsis and meningitis. This study aimed to investigate the prevalence of group B streptococcus in pregnant women by a rapid and easy culture method. It seems that in cases in which GBS carriage is not suspected until the time of labor, using such a quick and specific culture method would be valuable. A total of 330 vaginal swabs were collected from women attending delivery room at Hedayat hospital, Tehran, Iran, from April through July 2008. Cotton swabs contaminated with vaginal fluid were placed into Amies transport medium and transported to the Avicenna laboratory daily. Vaginal specimens were cultured on selective GBS Agar Base medium (ISLAM) for isolation and detection of group B streptococcus. The plates were incubated at 35-37°C under anaerobic condition for 24 hours. Incubated S.agalactiae developed orange/red pigmented colonies in GBS agar plates. Among the 330 women, the results of the culture were positive for GBS in 68 women (20.6%). Statistical analyses showed no significant relationship between demographics, reproductive histories and obstetric characteristics of subjects with the test results. Solely the antibiotic therapy was associated with GBS colonization. The results are indicating that the relatively high maternal GBS colonization rate in pregnant women warrants a routine screening and prophylactic treatment of the infected women. Colonization with group B streptococcus can be identified directly by GBS agar medium and decrease the time to detection of GBS.

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Chlamydia trachomatis is a common and curable STI that may be symptomatic or asymptomatic. The few studies on C. trachomatis among Iranian women have had, for the most part, small sample sizes and are therefore unsuitable for epidemiological deductions. The aim of this study was to estimate the prevalence of urogenital C. trachomatis infections by PCR on urine samples of married women in their fertile years in order to determine the need for a C. trachomatis screening program for asymptomatic women in Iran."n"n Methods: This descriptive-analytical and cross-sectional study was performed on 991 married women. The research material consisted of questionnaires and urine samples, which were transported daily to Avesina Research Institute, Tehran, Iran, to extract their DNA and prepare them for PCR tests. The gathered data were analyzed by SPSS, version 13, and evaluated statistically by t-test, chi-square test, Fisher's exact test and logistic regression, considering p

Background: Laboratory bred sand flies are essential for the study of different biological phenomena including the transmis­sion dynamics of Leishmania. The aim of the study was to determine the suitable situation for colonization and main­tenance of Iranian strain of Phlebotomus papatasi at laboratory conditions from an endemic focus of cutaneous leishmani­asis due to Leishmania major.Methods: One hundred and thirty P. papatasi were collected by CDC miniature light traps and aspirator from indoors in Badrood, central Iran. The fly was maintained by the procedures of Modi & Tesh (1983) with minor modifications for 7 generations. Results: Minimum and maximum rate of productivity was calculated to be 8.5 and 56.1 in F7 and F3, respectively and signifi­cant difference was observed among productivity of some generations (P< 0.001). The sex ratio ranged between 70(F1) and 101.8(F6). The mean duration of egg to adult emergence varied between 47.21±4.46 and 52.6±7.85 days. The life cycle was completed in 34.4 to 60 days at 26±1 ºC. Conclusion: P. papatasi was colonized and maintained successfully for the first time as a laboratory strain. Using larval diet without liver powder is recommended. The blood of white hamster was preferred to golden hamster and guinea pig for the sand fly vector blood feeding at the insectary.

Introduction and objectives: Despite the advances in the control of food-borne diseases, still one of the dilemmas in the health of most societies and a matter of concern for health authorities is food poi­soning and food-borne diseases by unsafe foods.Materials and methods: In total 390 samples, including 195 samples of raw kebabs and hamburgers and 195 samples of the cooked ones were gathered from shops, sampling raw and cooked meat at the same time, and they were sent to the laboratory for testing, over a period of one year. The methods used for the tests were based on the Iranian National Standard procedures, numbers 356 and 2394.Results: All the cooked specimens had bacterial contamination in acceptable standard levels and there­fore were considered consumable. From the 165 raw kebab samples, 90 samples (54.5%) were con­sumable but 75 samples (45.5%) were not fit for consumption, where from 30 raw hamburger samples, 22 samples (73.3%) were consumable and 8 (26.7%) were inconsumable. In serological evaluations, Thompson serotype had the highest prevalence in kebab and hamburger samples.Conclusion: The results of present study show that there is no reason for concern in consuming cooked kebabs.

This research studies the quality of medical prescriptions for children under 5 years of age and their effective factors carried out by Behvarzes at Eslamshar town."nMaterials and Methods: The study took place in 19 health houses considering the medical family files of patient children seeking for medical care by 33 Behvarz for quality of medical prescription. Two questionnaire were used for the study. The first questionnaire contained information about children medical prescription and variables evaluated in relation to medical prescription dose, duration of consumption and the cure duration period, which carried out for both girl and boy group separately. The second questionnaire contained information about the condition of working Behvarzes demographic in health houses considered variable for Behvarzes are: Age, Sex , experience, education, place of residence marital status."nResults: The important points of the study are as follow: - In cases that according to Behvarzy training patient follow up is necessary, 56.9%of the needed cases did not full fill the appropriate and necessary follow up program. - One of the important constraints of the research is the high percent of unrecorded cases by Behvarzes including:"n1 - 1.2% unknown medical prescriptions."n2- 44.2% unknown dose of prescribed medicine"n3- 52.4% unknown care duration period"n4- 36.5% unknown period of time for taking the medicine. Conclusion: According to the information: 1- 64.9 dose of prescribed medicine"n2- 73.2 period of time for taking the medicine"n3- 84.1 care duration period There were appropriate.

Objective(s): To detcnninc the short-term reacrogenicity of diphtheria-tetanus-whole cell pertussis (DTwP) vaccine administered to preschool children in a number of health centers of Tehran in 2006. Methods: In this prospective cohort study, 337 children aged 4-6 years were injected with DTwP vaccine manufactured by Razi Institute of Iran. Reactogenicity was assessed by the parents for 7 days post vaccination using diary cards. Local (pain, redness and swelling) and systemic (fever, loss of appetite, gasterointestinal symptoms, vomiting and eczema) side effects were recorded daily. Results: Out of 337 children, 312 (92.6%) reported local reactions and 220 (65.3%) reported systemic reactions. No serious adverse events related to vaccination were reported. Among local reacuons, pain was the most frequent (86.9%), but 11 was mostly mild or moderate. Redness (52.8%) and swelling (41.2%) were the most frequently observed signs in the second day. The systemic reactions observed in children included fever (48.4%), loss of appetite (24%), gastrointestinal symptoms (5 6%), vomiting (8%) and eczema (2.7%). Only 3.6% of children had auxiliary fever above 39 chr('39')c. All signs were observed to have reduced or completely disappeared during a week. Conclusion: Compared with previous reports in Iran, reactogenicity of DTwP of Razi Institute seems to be reduced, but it was still more frequent than the internationally approved cellular vaccine counterparts. Reactogcnicity of the cellular triple vaccine may be related to the vaccine formulation or the bacterial cell fragments used in vaccine production.

Background and Objective: Anesthetic agents and type of surgery may lead to liver damage after surgery. Inhaled agents are associated with liver dysfunction after surgery. Propofol is expected to have a lower potential for postoperative liver damage. The present study was conducted to compare liver enzyme function after anesthesia with isoflurane and total intravenous anesthesia (TIVA). Methods: This clinical trial was conducted on 70 patients referred to Imam Ali Hospital in Bojnord. Patients were selected using convenience sampling and then divided into TIVA and Isoflurane groups using block randomization method. During surgery, anesthesia was maintained in the isoflurane group with isoflurane gas (1.2 MAC) and in the TIVA group with infusion of propofol (100 micrograms/kg/minute) and remifentanil (0.1 micrograms/kg/minute). The levels of ALT, AST, ALP, PTT, and INR factors of the patients were examined and compared using laboratory devices before the operation, immediately, 24 and 48 hours after the operation. Findings: There is no significant difference between the two groups in terms of demographic and interventional variables. ALT enzyme level in TIVA group increased from 17.6±10.7 to 21.2±14.2 and in isoflurane group from 16.7±9.4 to 28.4±16.1 (p<0.05). In other enzymes, this difference was not significant. Conclusion: The results of the study showed that the use of both TIVA and Isoflurane methods has an effect on the level of liver enzymes in patients undergoing laparoscopic cholecystectomy surgery. [ABSTRACT FROM AUTHOR]

Comprehensive data on drug-resistant patterns of Acinetobacter baumannii isolates in developing countries is limited. We conducted a multihospital study to assess the rate and trend of drug-resistant phenotypes in Ac. baumannii using standardized definitions and to determine the remaining therapeutic options against resistant phenotypes. The 401 nonduplicate isolates were collected from six hospitals which are geographically distributed across Tehran, Iran over a 3-year period. Following PCR of bla OXA-51-like gene, susceptibility testing was performed against nine antimicrobial agent categories. Three hundred and ninety (97%) isolates were resistant to least two carbapenems; carbapenem-resistant Ac. baumannii. The majority of isolates (366, 91·3%) were extensively drug resistant ( XDR) and the rest of the isolates were classified as multidrug resistant (26, 6·8%) and susceptible (9, 2·2%). The rate of XDR- AB slightly decreased from 93·8% in 2011 to 89·8% in 2013. A considerable decrease in resistance to doxycycline, minocycline and tigecycline was demonstrated. The XDR- AB isolates showed susceptibility to gentamicin (10·4%), tobramycin (23%), ampicilin-sulbactam (30·1%), minocycline (32·8%), tigecycline (10·7%), doxycycline (21·6%), colistin (100%) and polymixin B (100%). We demonstrated the rising trend of resistance to all antibiotic categories except tetracyclines and folate pathway inhibitors. We found that the treatment options against XDR- AB are extremely limited and each treatment alternative including even old, but safe, antibiotics might be considered. Significance and Impact of the Study The high frequency of drug-resistant phenotypes including carbapenem-resistant Acinetobacter baumannii, multidrug-resistant, and extensively resistant has been demonstrated in Ac. baumannii isolates tested here. As the antibiotic resistance pattern of isolates varies in different geographical regions, this study can provide comprehensive information about the antibiotic resistance profile of Ac. baumannii isolates in Tehran. In addition, the resistance profiles could be effectively considered by clinicians to manage antibiotic therapy. This work also emphasizes on the prudent use of antibiotics and the monitoring of antibiotic susceptibility trend and rate. [ABSTRACT FROM AUTHOR]

Background and Objective: Stenotrphomonas maltophilia is an opportunistic nosocomial pathogen with high mortality in immunocompromised cases. The aim of this study was to isolate and identify Stenotrphomonas maltophilia in the hospitals' environment and wards. Material and Methods: In this cross-sectional study, a total of 1108 samples were collected from environment of two hospitals during 12 months. Identification of isolates was performed using biochemical, phenotypic (intrinsic resistance to carbapenems) and molecular methods (amplification of 23S rRNA gene). Results: Of the studied samples, 186 (16.78%) nonfermentative gram negative bacilli (NFGNB) were identified. Amongst NFGNB, 18 (1.62%) isolates were identified as S. maltophilia by using biochemical tests. Of 18 biochemically identified isolates, 15 (83.3%) were confirmed via PCR. Sinks (40%) and men surgery ward ( 33.3 %( were the most contaminated sites and wards of hospitals, respectively. Conclusion: S. maltophilia is repeatedly isolated from sink which shows that the moist hospital environments need to be considered as a source for dissemination of bacteria. [ABSTRACT FROM AUTHOR]

Background: One of the most important topics in clinical psychology is finding and measuring of independent tools that have the same results for the evaluation of a psychological characteristic. There are only few studies that have examined the agreement between these methods. This study aimed to compare the three screening instruments for mental disorder among students of Kashan University of Medical Sciences during 2011-2012. Materials and Methods: In this cross-sectional study, 983 students of Kashan University of Medical Sciences were selected using simple random sampling during 2011-2012. Students were asked to complete three mental health questionnaires including GHQ-28, BSI and MMPI. Data were analyzed using SPSS software. Results: Findings showed that the prevalence rates for mental disorder based on the GHQ-28, BSI and MMPI questionnaires were 39.1%, 44.8%, and 44%, respectively. Correlation coefficients for GHQ-28 with BSI, GHQ-28 with MMPI and BSI with MMPI were 0.588, 0.488, and 0.533, respectively. The corrected classification of GHQ28 with BSI was 73.3%, GHQ28 with MMPI 71.5% and BSI with MMPI 69.8%. Kappa coefficient showed high level of agreement between the three tests. Conclusion: According to the results of the study, there is a relatively high correlation between the three instruments in diagnosis of mental disorder among the students. [ABSTRACT FROM AUTHOR]

Background: The main goal of the present study was to develop a new sensitive and specific PCR based method for Identification of Cryptosporidium sp. using novel primers from 18S ribosomal RNA. Cryptosporidiosis in high-risk host groups particularly in neonates and immuno-compromised individuals may result in death. To the best of our knowledge this is the first study regarding develop a new PCR based method to diagnose the cryptosporidiosis in Iran. Methods: A total of 850 human fecal samples from patients clinically suspected to cryptosporidiosis and 100 healthy and diarrheic cattle stool specimens were collected. The simplified formol-ether concentration method was carried out for all samples. They were then examined microscopically by modified Ziehl-Neelsen staining method. Total DNA was extracted by QIA amp DNA stool mini kit. PCR and nested-PCR was carried out by using designed primers. Results: Twenty nine cases of cryptosporidiosis infection in human and 30 samples from cattle microscopically were positive. The described primary and nested PCR method could detect all Cryptosporidium positive samples from human and cattle. Regards to suspected negative samples in primary PCR examination, the Nested PCR could approve two more positive results. Furthermore, Nested PCR analysis was able to detect one more case which was negative in both microscopically examination and primary PCR. Specificity of the test was 100%. Sensitivity of Nested PCR in comparison to our gold standard; microscopy after Ridley concentration modified ziehl-Neelsen, was 100 %. Conclusion: Our developed PCR based method by using new primers devised from 18S ribosomal RNA revealed the ability for identification of the Cryptosporidium species such as C. parvum and C. huminis with high specificity and sensitivity. [ABSTRACT FROM AUTHOR]

Background and Aim: Many researchers have studied survival (time to death) of gastric cancer patients. Although gastric cancer diagnosed in early stages can be cured by surgery, chance of relapse still exists after operation. Hence, we should consider both events, that is, relapse of the disease and death, in order to be able to make a more precise estimation for survival of the patients. The purpose of this study was to use the competing risks method to estimate the cumulative incidence functions (CIF) of the relapse of disease and death and consequently to estimate the postoperative disease-free survival. Materials and Methods: A total of 330 patients admitted to Iran Cancer Institute and operated between March 1995 and March 1999 were enrolled in the study. They were followed up for at least 5 years to estimate their 5-year disease-free survival. Information on their demographic, clinical, and therapeutic characteristics, as well as on the type and time of occurrence of the first event (relapse of disease or death) after surgery was collected from their medical records. The direct parametric method was applied to estimate CIFs of relapse of the disease and death, while to adjust the effects of some covariates the parametric regression model was used. Data analysis was done using the R software and a p-value <0.05 was considered statistically significant. The findings were compared with the results obtained on the basis of data analysis in which the competing events were not considered. Results: The median follow-up time was 37.9 months. Of all the patients 13% experienced relapse and 60.9% death as the first event after surgery. The CIFs of relapse of disease and death 5 years after operation, with due consideration of covariates, were estimated at 11.0% and 68.6%, respectively. Age, stage of disease, and complementary treatment were statistically associated with the CIF of death, while only complementary treatment was related to the CIF of relapse. Older patients and those in more advanced stages of disease were more likely to die after operation. Moreover, while complementary treatment after operation decreased the CIF of relapse of disease, it increased the CIF of death. The disease-free survival of patients 5 years after surgery was 20.4% (considering the effects of some covariates). Conclusion: The competing risks method is recommended for analyzing survival data because of its capability in considering different events and, therefore, making it possible to make more precise estimations. By using this method, considering smaller variance estimates for model parameters and also narrow confidence intervals for the cumulative incidence functions of competing events, it is expected to obtain more precise results. Unfortunately, the results have revealed that the disease-free survival of gastric cancer patients is low in Iran. [ABSTRACT FROM AUTHOR]

Background: Due to its high prevalence, the survey on gastric cancer survival in Iran seems too important. In the case of relative long-term survival of the cases, using standard models is not conventional. So cure models are used to estimate the proportion of the cured patients that will never experience the event of interest and also to evaluate the survival function of susceptible individuals who may experience the event and effective factors. This study was carried out to determine the five-year survival rate of gastric cancer patients who have undergone surgical treatment. Materials and Methods: Three hundred and thirty gastric cancer operated patients with a maximum 10-year survival were enrolled in the study. The patients' life expectancy after surgery and cure fraction and their relationships with some variables were evaluated. Kaplan-Meier and Weibull Cure models were utilized for analyses. Results: The five-year survival rate and the median life expectancy were 24% and 19.9 months, respectively. Univariate analysis using the Weibull model showed that age, existence/site of metastasis and stage of disease influenced on the probability of curing (P<0.05). On assessing the simultaneous effect of different variables the age and stage of disease proved to be effective on curing (P<0.05), but none of the variables affected the life expectancy of patients (P>0.05). Conclusion: Using the cure models is beneficial in situations which the population under study suggests the presence of subpopulation. The cure/immune model methodology may separeltery identify the sets of covariates related to the cured proportion and also the failure time distribution of uncured one. [ABSTRACT FROM AUTHOR]

Background and Aim: Length of stay (LOS) in a hospital is one of the best hospital indicators that can be used for various purposes. In this survey, we studied the hospital LOS and its associated factors in Tehran University of Medical Sciences Women's Hospital (a teaching hospital) in Tehran using the Cox proportional hazards semi parametric model and compared the results with the results obtained using the multiple linear regression. Materials and Methods: This was a descriptive-analytical study in which we reviewed 3421 files of inpatients hospitalized in, and those discharged from, the oncology, surgery and obstetrics units in 2008. The required data were collected using a data collection sheet and inpatient interviews. A P<0.05 was considered statistically significant. Results: The median of patients' LOS in the hospital was 50.8 hours, that in the obstetrics, surgical and oncology units being 48.5, 54.4 and 94.2 hours, respectively. Of all the patients, 2632 (76.9%) had been discharged with a recovery status and the rest (23.1%) with a no-recovery status. Results of the Cox proportional hazards model showed that the following variables had increased LOS: a distance longer than 200 km between a patent's residence and the hospital, hospitalization in the surgery and oncology units, admission on a Thursday, admission by an internist, hospitalization for neoplastic, endocrine, nutritional, or genitourinary system diseases (P<0.005), as well as a high number of diagnostic laboratory tests, radiographies or sonographies (P<0.001). Patients admitted and hospitalized as an emergency case had a shorter LOS (P<0.001) than others. On the other hand, based on the multiple linear regression model results, some occupations (being a worker, a farmer, a stockbreeder, or a retired spouse) admission on a Thursday, (The first day of the weekend in Iran), suffering from a neoplastic disease, and a high number of diagnostic tests or radiographies or sonographies increased, and admission by a resident decreased, patients' LOS (P<0.05). Conclusion: Considering having censored data, the Cox proportional hazards model is a more suitable model than the multiple linear regression models for identifying factors influencing patients' LOS in a hospital. From among the LOS Cox model's associated factors as identified in this study, policy-makers and managers can only change admission days and the number of diagnostic tests. That is to say, they should try to prevent admission on a Thursday (unless emergency cases) and also perform the required primary diagnostic tests before admitting a patient into the hospital, which would lead to a more effective utilization of hospital beds and other resources [ABSTRACT FROM AUTHOR]

Background and Aim: The most common cancer in Iran is digestive system cancer, the highest incidence of which is reported from the Caspian Sea littoral. This study aimed to determine factors affecting the survival of patients with gastrointestinal cancer using the Cox and parametric models; the 2 models were compared. Materials and Methods: This survey was a prospective study conducted between 1990 and 1991. Data were collected through the Cancer Registry Center in Babol, which functions under supervision of the School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences. We tried to identify cases of gastrointestinal cancers. The individual characteristics of 484 patients, namely, age, sex, family history, marital status, smoking status, occupation, ethnicity, medication status, education, residence (urban, rural), and type of cancer were recorded. The patients were followed up for a period of 15 years, i.e., until 2006 year. To determine the effective factors on survival of patients, the Cox model and parametric models such as exponential, weibull, log-normal, log-logistic, and the AIC criteria and residuals were used to compare the effectiveness of the models. The SAS and STATA software were used for data analysis, with a significant level of 0.05. Results: Sixty-six percent of the patients (total n=484) were males and 34% females, with a mean age of 59 and 55 years, respectively. Their distribution according to type of cancer was as follows: esophageal cancer, 359 (74.2%); stomach cancer, 110 (22.7%); colorectal cancer, 15(3.1%). Estimated one-, three-, and five-year survival rates were 24%, 16% and 15%, respectively. Conclusion: The results of this study reveal that gender and family history can be strong risk factors for GI cancer. Log-normal and log-logistic models in multivariate and univariate analyses gave almost similar results. However, based on AIC criteria and residuals analysis, the log-logistic model gives the best fit as compared to other parametric models and can be used instead of the Cox model for determining factors affecting survival of patients with gastrointestinal tract cancer. [ABSTRACT FROM AUTHOR]

A field study has been carried out to investigate whole-body vibration exposure levels experienced by the train operators of an old train which circulates between Tehran and Andimeshk in the south of Iran. The objective of this study was to measure whole-body vibration transmitted to personnel on the train. Fatigue Decreased Proficiency Boundary (FDPB) and Exposure Limit (EL) were used to evaluate the vibration measured in three directions. The health effects related to whole-body vibration were statistically analyzed after completing a questionnaire. The results indicated that the total equivalent acceleration level induced in the personnel was higher than the permissible level of FDPB (108dB) and exposure limit (114dB) for 12 hours of exposure, recommended by ISO 2631. There were no statistically significant relationships amongst the health variables and age except lack of concentration, P=0.014, as well as job history. Conversely, there was significant statistical relationship between EL and Hearing disorders, Vomiting and Loss of appetite among personnel. Therefore, the statistical test results only revealed some physiological effects with regard to WBV. Hence, beside WBV other factors must be taken into consideration to judge about other physiological or subjective disorders caused by WBV. [ABSTRACT FROM AUTHOR]

Background and Aim: Today human beings working in organizations are faced with various types of stress factors which jeopardize healthiness of their body and mind. These stresses are not easy to identify and eliminate and, as a result, produce undesirable effects on the efficiency of trained manpower, particularly managers who play important roles in development and success of organizations. The objective of this study was to identify stress factors and the effect of stress on performance of managers in different sections of hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. Methods and Materials: This descriptive-analytic study conducted in 2008 included 220 managers from different sections of hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. The data was collected using a standard questionnaire (Likert scale) with 70 questions in 4 parts. Results:About 68.2% of the managers were females, 72.8% were married, and 47.7% had a service record of 10-20 years. On the whole, 93.4% of the managers had had severe stresses in the previous 2 years. The work environment was the most stressful factor for 84.4% of the managers. Other stressful factors were the amount of work and expectations of the higher-ranking managers. The findings also indicated that stress had a negative impact on the managers' ability to make decisions effectively at work. There were statistically significant associations between stress factors and educational level (p=0.01) and between marital status and family stress factors (p = 0.05). In addition, an inverse relation was found between the effect of stress on performance and length of service record (-0.17, p=0.01 Conclusion: Based on the findings, it is suggested that the university authorities and hospitals' senior managers make attempts to minimize stressful conditions in the work environment. The following strategies can be adopted to achieve this end: sound management of human resources; social support of the personnel; better time management; delegating responsibilities to subordinates; and improving working conditions. [ABSTRACT FROM AUTHOR]

Background and Aim: The large volume of reports and statistics in the literature on the prevalence of musculoskeletal disorders (MSDs) in Iran and other countries indicates that it is essential to assess the ergonomic situation in different occupations. These disorders can be caused by long-term exposure to different agents or by trauma to the musculoskeletal system. A large part of the work force in Iran is engaged in general construction and dam construction workshops. The postures of these workers while working in the workshops are unsuitable postures. The objective of this study was to assess the ergonomic situation of workers in dam construction workshops. Methods and Materials: This was a cross-sectional study conducted in 2008. The sample included 110 randomly selected male-workers in a dam construction workshop in Takab City, Iran, engaged in 25 different jobs. Data were collected using the Nordic Musculoskeletal Questionnaire and the National Institute of Occupational Health-Center to Protect Worker Rights Checklist (NIOSH-CPWR), both developed by the National Institute of Occupational Health-Center to Protect Workers Rights. The software used to analyze data was SPSS. Results:The average service record of the workers was 36.6 ± 86.8 months. The data show that the most common (55.5%) MSDs were in the low back region. There were statistically significant positive associations between prevalence of MSDs and many independent variables, namely, age, weight, education level, service record, smoking, type of job, lengths of time of standing and sitting at work, total duration of work, work pressure, undesirable postures, and surface for walking. Conclusion: The results of this study generally confirm findings of previous investigators. It can be concluded that ergonomic assessment of jobs may give valuable information to be used by occupational health and safety authorities in planning preventive and educational programs. [ABSTRACT FROM AUTHOR]