International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120703771771ENArteriosclerosis-Prevention-Institute Munich- Nuremberg and Ludwig-Maximilians-University Munich, Germany20120703-http://ijpm.mui.ac.ir/index.php/ijpm/article/view/771http://ijpm.mui.ac.ir/index.php/ijpm/article/download/771/703

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120414668668ENDepartment of General Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS) Soura, Srinagar, IndiaDepartment of Cardiac Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS) Soura, Srinagar, IndiaDepartment of Cardiac Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS) Soura, Srinagar, IndiaDepartment of Plastic Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS) Soura, Srinagar, IndiaDepartment of Radiology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS) Soura, Srinagar, IndiaDepartment of General Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS) Soura, Srinagar, India20120414<p>Ulcerative colitis is a chronic disease that specifically affects the mucosa of the rectum and colon. Although the etiology of this recurring inflammatory disorder remains essentially unknown, there have been significant advances in identifying the likely genetic and environmental factors that contribute to its pathogenesis. The clinical course of the disease typically manifests with remissions and exacerbations characterized by rectal bleeding and diarrhea. Since ulcerative colitis most commonly affects patients in their youth or early middle age, the disease can have serious long‑term local and systemic consequences. There is no specific medical therapy that is curative. Although medical therapy can ameliorate the inflammatory process and control most symptomatic flares, it provides no definitive treatment for the disease. Proctocolectomy or total removal of the colon and rectum provides the only complete cure; however, innovative surgical alternatives have eliminated the need for a permanent ileostomy. The aim of this review is to provide a detailed account of the surgical management of ulcerative colitis.</p> <strong>Key words: </strong>Ileostomy, proctocolectomy, ulcerative colitishttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/668http://ijpm.mui.ac.ir/index.php/ijpm/article/download/668/704

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120703768768ENDepartment of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran20120703<p><strong>Background: </strong>Hepatorenal syndrome (HRS) is known as development of acute renal failure in a patient who usually has advanced liver disease. The aim of the present study was to determine the safety and the efficacy of noradrenalin in comparison with midodrine‑octreotide in patients with HRS.</p> <p><strong>Methods: </strong>This study was registered to the Iranian Registry of Clinical trials (IRCT). This study was a single‑center, randomized, clinical trial that performed in Alzahra hospital, Isfahan, Iran. Since March 2011 to January 2012, twenty‑three patients were enrolled in the study. Eligible patients were allocated in 2 groups. In the first group, patients received infusion of NA with the dose of 0.1&ndash;0.7 &mu;g/kg/min, and in the other groups, patients received octreotide 100‑200 &mu;g subcutaneously 3 times daily and midodrine 5‑15 mg orally 3 times daily. In both study groups, patient received albumin infusion in addition to noradrenalin or midodrine‑octreotide.</p> <p><strong>Results: </strong>Complete response of HRS was observed in 8 of the 11 patients (73%) treated with noradrenalin and in 9 of the 12 patients (75%) treated with midodrine‑octreotide (<em>P </em>&gt; 0.05). HRS recurred after treatment withdrawal in 2 of 11 in NA and 3 of 12 in MO group. That shows no significant difference between 2 groups (<em>P </em>&gt; 0.05).</p> <p><strong>Conclusion: </strong>We deduce that NA has the same efficacy and safety with MO and can induce a complete response in high percentage of the patients. Moreover, we observed no significant differences in the recurrence rate and outcomes after 3 months among the patients in both study groups; this result could support the use of NA in HRS management. The IRCT ID is: IRCT201107217085N1.</p> <strong>Key words: </strong>Clinical trial, hepatorenal syndrome, midodrine, noradrenalin, octreotidehttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/768http://ijpm.mui.ac.ir/index.php/ijpm/article/download/768/705

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120121437437ENBaqiyatallah University of Medical Sciences, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Tehran, IranWestfälische Wilhelms-Universität Münster, St.-Marien-Hospital GmbH, Gastroenterologishe Klinik, Lünen, GermanyKurdistan University of Medical Sciences, Kurdistan, IranKurdistan University of Medical Sciences, Kurdistan, IranDepartment of Gastroentrology, Iranian Blood Transfusion Organization Research Center, Tehran, IranDepartment of Gastroentrology, Iranian Blood Transfusion Organization Research Center, Tehran, IranDepartment of Gastroentrology, Iranian Blood Transfusion Organization Research Center, Tehran, Iran2012010620120120<p><strong>Introduction: </strong>Hepatitis B virus (HBV) infection is a serious global public health problem affecting billions of people globally. The lack of information of its seroprevalence among the general population is an obstacle for formulating effective policies to reduce the burden viral hepatitis. Therefore, this population based serological survey was conducted in Kurdistan province, where no epidemiological data was available to determine the prevalence and risk factors of HBV infection.</p> <p><strong>Methods: </strong>1613 healthy subjects were selected from all districts of Kurdistan province (in the western of Iran) using random cluster sampling. The subjects&rsquo; age ranged from 6 to 65 years old. Serum samples were tested for HBcAb, HBsAg and anti‑HDV antibody. Screening tests were carried out by the third generation of ELISA. Various risk factors were recorded and multivariate analysis was performed.</p> <p><strong>Results: </strong>The prevalence of HBsAg and HBcAb in Kurdistan was before 0.80% (95% CI 0.44; 1.34) and 5.02% (95% CI 4.03; 6.17), respectively. None of HBsAg carriers had positive anti‑HDV antibody. Predictors of HBsAg or HBcAb in multivariate analysis were: older age and marriage. We did not find any significant differences between males and females.</p> <p><strong>Conclusion: </strong>Our population based study suggests that intrafamilial HBV transmission plays a major role in HBV transmission in Kurdistan province. Furthermore, approximately 5% of general population in this province has prior exposure to HBV and less than 1% is HBsAg carriers. However, we could not find any case of HDV infection among them.</p> <strong>Key words: </strong>Hepatitis B virus, prevalence, epidemiology, Iranhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/437http://ijpm.mui.ac.ir/index.php/ijpm/article/download/437/706

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120412650650ENDepartment of Occupational Health Engineering, Faculty of Health, Isfahan University of Medical Science, Isfahan, IranDepartment of Occupational Health Engineering, Faculty of Health, Isfahan University of Medical Science, Isfahan, IranDepartment of Occupational Health Engineering, Faculty of Health, Isfahan University of Medical Science, Isfahan, IranDepartment of Occupational Health Engineering, Faculty of Health, Isfahan University of Medical Science, Isfahan, IranDepartment of Biological Statistics and Epidemiology, Isfahan University of Medical Science, Isfahan, Iran20120412<p><strong>Background: </strong>The purpose of this research is to establish the ability of employees by work ability index (WAI), physical work capacity (PWC), and finding the correlation between them<strong>. </strong>Establishing the PWC index with attention to WAI values for the purpose of saving in costs and time of PWC measurements is another aim of this project.</p> <p><strong>Methods: </strong>The present research is an analytic cross-sectional and one-trail study. The study population consists of 228 randomly selected registered nurses from hospitals in Isfahan (Iran). The WAI and PWC were established through WAI questionnaire and Fax equation and by using ergometer bicycle, respectively. The resulting data were analyzed using SPSS 16 software.</p> <p><strong>Results: </strong>Average WAI and PWC among the study population were 38.25&plusmn;4.4 and 4.45&plusmn;0.7, respectively. Pearson test results showed no significant correlation between PWC and WAI in different age groups (r=0.3 and <em>P&gt;</em>0.05). Multiple linear regression analysis showed that the variables of age and diagnosed diseases were the most effective factors of WAI (&beta;=0.18 and <em>P&gt;</em>0.05). Pearson test revealed a significant correlation between the number of diagnosed diseases and PWC index in age groups of 40-49 years.</p> <p><strong>Conclusion: </strong>Average WAI in this research, like other studies on similar jobs is in the acceptable level of &gt;36. Work ability index and PWC index in different age groups did not show a significant correlation and this suggests that there are essential discrepancies in work ability evaluations made by each index and it is not possible to predict PWC index using WAI values. Given the PWC results and the level of nursing staff &rsquo;s activity (low, medium) the WAI is a suitable instrument to establish the professionals&rsquo; abilities. This study revealed that 27.6% of individuals were subject to medium-low work ability risk (WAI&lt;37), which was 1.8 times that of Finland&rsquo;s professional health Institute, which could be caused by shift working and increased working hours.</p> <strong>Key words: </strong>Fax equation, hospital nurses, physical work capacity, work ability indexhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/650http://ijpm.mui.ac.ir/index.php/ijpm/article/download/650/707

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120110828316316ENTehran University of Medical Sciences, Tehran, IranMashad University of Meidcal Sciences, Mashad, IranTehran University of Medical Sciences, Tehran, IranTehran University of Medical Sciences, Tehran, IranTehran University of Medical Sciences, Tehran, IranTehran University of Medical Sciences201108172011082720110827<p>-</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/316http://ijpm.mui.ac.ir/index.php/ijpm/article/download/316/715

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120414654654ENIsfahan Kidney Diseases Research Center, Child Growth and Development Research Center, Department of Pediatric Nephrology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,Talented Students Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IranTalented Students Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IranTalented Students Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IranTalented Students Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IranChild Growth and Development Research Center, Department of Pediatric Nephrology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IranProfessor of Pharmacology, Isfahan University of Medical SciencesDepartment of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran20120414<p><strong>Background: </strong>Potassium citrate (K‑Cit) is one of the medications widely used in patients with urolithiasis. However, in some cases with calcium oxalate (CaOx) urolithiasis, the significant response to alkaline therapy with K‑Cit alone does not occur. There is scarce published data on the effect of magnesium chloride (Mg‑Cl2) on urolithiasis in pediatric patients. This study aimed to evaluate the effect of a combination of K‑Cit ‑ MgCl2 as oral supplements on urinary parameters in children with CaOx urolithiasis.</p> <p><strong>Methods: </strong>This study was conducted on 24 children with CaOx urolithiasis supplements included potassium citrate (K‑Cit) and magnesium chloride (Mg‑Cl2). The serum and urinary electrolytes were measured before (phase 0) and after prescribing K‑Cit alone (phase 1) and a combination of K‑Cit and Mg‑Cl2 (phase 2). Each phase of therapy lasted for 4 weeks.</p> <p><strong>Results: </strong>The mean age of patients was 6.46 &plusmn; 2.7 years. Hyperoxaluria and hypercalciuria were seen in 66% and 41% of patients, respectively. Serum magnesium increased significantly during phase 2 comparing with phase 0. Urinary citrate level was significantly higher in phase 1 and 2 in comparison with phase 0, <em>P </em>&lt; 0.05. In addition, urinary oxalate excretion was significantly diminished in phase 2 comparing with phase 0 and 1, <em>P </em>&lt; 0.05. Soft stool was reported by 4 patients, but not severe enough to discontinue medications.</p> <p><strong>Conclusions: </strong>These results suggested that a combination of K‑Cit and Mg‑Cl2 chloride is more effective on decreasing urinary oxalate excretion than K‑Cit alone. The Iranian Clinical Trial registration number IRCT138707091282N1.</p> <strong>Key words: </strong>Children, magnesium chloride, nephrolithiasis, potassium citrate, urinary parametershttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/654http://ijpm.mui.ac.ir/index.php/ijpm/article/download/654/708

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120419686686ENDepartment of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Science, Tehran, IranDepartment of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Science, Tehran, IranDepartment of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Science, Tehran, IranFood Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran20120419<p><strong>Background: </strong>Soy milk replacement in the diet might have beneficial effects on waist circumference and cardiovascular risk factors for overweight and obese subjects. Therefore, we are going to determine the effects of soy milk replacements on the waist circumference and cardiovascular risk factors among overweight and obese female adults.</p> <p><strong>Methods: </strong>In this crossover randomized clinical trail, 24 over weight and obese female adults were on a diet with soy milk or the diet with cow&rsquo;s milk for four weeks. In the diet with soy milk only one glass of soy milk (240 cc) was replaced instead of one glass of cow&rsquo;s milk (240 cc). Measurements were done according to the standard protocol.</p> <p><strong>Results: </strong>Waist circumference reduced significantly following soy milk period (mean percent change in soy milk period for waist circumference: ‑3.79 &plusmn; 0.51 vs. ‑1.78 &plusmn; 0.55 %; <em>P </em>= 0.02 in the cow&rsquo;s milk period). Blood pressure, weight, liver enzymes and glycemic control indices did not changed significantly after soy milk period compared to the cow&rsquo;s milk period.</p> <p><strong>Conclusion: </strong>Among over weight and obese patients, soy milk can play an important role in reducing waist circumference. However, soy milk replacement had no significant effects on weight, glycemic control indices, liver enzymes, fibrinogen and blood pressure in a short term trial.</p> <strong>Key words: </strong>Obese, overweight, soymilkhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/686http://ijpm.mui.ac.ir/index.php/ijpm/article/download/686/710

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120219386386Department of Community Dentistry, Sri Siddhartha Dental College and Hospital, Agalakote, Karnataka, IndiaDepartment of Community Medicine, Mysore Medical College and Research Institutes, Karnataka, IndiaDepartment of Oral Pathology, Sri Siddhartha Dental College and Hospital, Agalakote, Karnataka, India201110142012021720120217<p><strong>Background: </strong>Diabetes mellitus, according to World Health Organization (WHO) is a silent epidemic which affects large number of people around the world and is directly related to the oral health status of the patients.</p> <p><strong>Objectives: </strong>To know the prevalence of common dental diseases such as dental caries, periodontal diseases (pyorrhea), and treatment needs in a group of adult diabetic patients in private medical establishments of Tumkur city, south India, in comparison with non-diabetic patients. To create awareness among general medical practitioners about the common oral manifestations of diabetes and the importance of periodical dental check up for diabetics.</p> <p><strong>Methods: </strong>A group of 300 diabetic patients (males = 186, females = 114) and a control group of 300 non-diabetics (males = 180, females = 120) matched by age and sex were examined according to WHO criteria, for a period of eight months.</p> <p><strong>Results: </strong>The prevalence of dental caries was comparatively more in non-diabetics (32.3%) than in diabetics (13.6%). However, the prevalence of periodontal diseases (pyorrhea) was more in diabetics (92.6%) when compared to non-diabetics (83%).</p> <p><strong>Conclusions: </strong>Oral health is an integral part of general health. Though dental caries was comparatively low in diabetics, periodontal status was compromised. Complex treatment needs was more in the diabetics (58%) when compared to controls (41%). Regular follow-up of dental problems of the diabetics and oral health education is much required.</p> <strong>Key words: </strong>Dental caries, diabetes, oral health awareness, pyorrheahttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/386http://ijpm.mui.ac.ir/index.php/ijpm/article/download/386/711

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120414659659ENDepartment of Pathology, ESI PGIMSR, Rajajinagar, Bangalore-10, IndiaDepartment of General Surgery, ESI PGIMSR, Rajajinagar, Bangalore-10, India20120414<p>Nipple discharge (ND) can be the earliest presenting symptom of breast cancer. We hereby present two cases of breast cancer with no palpable mass manifesting as isolated ND, which was whitish in color. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. Mammography showed diffuse, extensive microcalcifications. Simple mastectomy with axillary clearance was done. Histology in both cases revealed diffusely spreading intraductal carcinoma, with focus of microinvasion in one case. ND if scanty or not blood stained is often ignored by the patients and at times, the clinicians. This article highlights that ND can be an early warning sign of intraductal carcinomas that are non-invasive in early stage. Irrespective of the color or nature of the discharge, unilateral ND needs to be evaluated. Proper clinical assessment, cytological evaluation of the ND, and mammography ought to be performed in all such cases. Considering the low level of awareness in women regarding the warning signs of breast cancer, the current focus is to create &ldquo;breast awareness.&rdquo; Women should be sensitized to recognize any unusual changes in their breasts and report to their health care providers at the earliest.</p> <strong>Key words: </strong>Breast awareness, breast cancer, cytology, nipple discharge (ND), mammographyhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/659http://ijpm.mui.ac.ir/index.php/ijpm/article/download/659/712

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120816873873ENDepartment of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Kurdistan Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, IranDepartment of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran20120816-http://ijpm.mui.ac.ir/index.php/ijpm/article/view/873http://ijpm.mui.ac.ir/index.php/ijpm/article/download/873/714

International Journal of Preventive Medicine (Int J Prev Med)2008-780231120120704778778ENDepartment of Infectious Diseases and Clinical Microbiology, Sakarya Training and Research Hospital, Turkey20120704-http://ijpm.mui.ac.ir/index.php/ijpm/article/view/778http://ijpm.mui.ac.ir/index.php/ijpm/article/download/778/713