Evaluation of the Quit and Win contest for smoking cessation in the Islamic Republic of Iran

Quit and Win is an international biannual smoking cessation contest. Although more than 70 countries participate, few are from the Eastern Mediterranean Region. This study evaluated 4 Quit and Win campaigns in Isfahan province, Islamic Republic of Iran, from 1998 to 2004, documenting participation rates, self-reported 1-month and 1-year abstinence rates and related factors. Participation rates among smokers ranged from 0.7%-2.4% of the smokers in Isfahan. One-month quit rates varied from 41.8% in 1998 to 92.8% in 2004. At 1-year follow-up, self-reported quit rates varied from 22.5% in 1998 to 91.2% in 2004. This model was found to be feasible and successful in our community, and can be implemented in other low- and middle-income countries.

Needlestick Injuries among Nurses

BACKGROUND

Needlestick injuries (NSIs) are among the most important occupational injuries for health care workers (HCWs). In Iran, the problem of exposure to contaminated blood among nursing personnels has not well documented. The aim of this study was to determine the incidence of needlestick injuries in population of nurses in Shahroud Imam Hossein Hospital, northern Iran.

METHODS

A self-administrated questionnaire was completed by 180 nurses in September and October 2005 for their NSIs experience in the past year. In this study, needlestick injury was defined as percutaneous injury caused by hollow-borne needles, suturing needles, scalpel blades and lancets.

RESULTS

The case incidence of NSIs was 63.3% (114/180). The total number of episodes of NSIs among respondents was 220 (range: 1-5 episodes) with incidence rate of episodes i.e. 1.2 per person/year. 12.8% of nurses had not been vaccinated against hepatitis B virus (HBV). The causal devices in 105 cases (92.1%) were hollow-borne needles and the main causes of percutaneous injuries with hollow-bore needles were recapping (32.4%) and manipulating needles in patients (18.1%). The majority (51.8%) of injuries occurred after use and before disposal of the objects.

CONCLUSION

Nurses working in Imam Hossein Hospital are frequently exposed to blood-borne infection. NSIs were highly prevalent in these nurses therefore more intensive education programs should be directed at nurses to increase their awareness of and compliance with universal precautions (UP). We recommend a surveillance system and a center for managing injured persons.

Effects of different concentrations of aflatoxin B on ram epididymal and ejaculatory sperm viability and motility in vitro

The present study was carried to observe the effect of aflatoxin on ovine sperm in vitro. Ram epididymal and ejaculatory sperm cells were added into media containing different concentrations of aflatoxin B1. When ram epididymal sperm were put in different concentrations of aflatoxin, one-hour post incubation in control group, 81.25% of sperm cells were alive of which, 82.88% were motile. Significantly (p < 0.05) higher than medium with 31.25 ppb and higher concentration. The lowest motility (15.93%) was observed in 62.5 ppb aflatoxin. Sperm viability did not significantly changed after 2nd and 3rd h incubation but significantly decreased in 4th and 5th h post incubation. However, motility was not altered in the 2nd, 3rd, 4th and 5th h post incubation. In ejaculatory sperm, one hour post-incubation, in control group, 83.24% of sperm were alive of which 93.98% were motile, significantly (p < 0.05) higher than motility in medium with 7.81 ppb and higher concentrations of aflatoxin but not different with 1.96 ppb aflatoxin. In 62.5 ppb aflatoxin, the lowest motility was observed (18.9%). Sperm motility patterns for both epididymal and ejaculatory sperm cells were different after incubation in different concentrations of aflatoxin. The results of the present experiment showed that aflatoxin could decrease sperm motility obtained from ejaculation or epididymis.

Prevalence of migraine and tension-type headache in primary-school children in Shiraz

From January to June 2003 we determined the prevalence of the various types of headache in 2226 schoolchildren in Shiraz (age 6-13 years) selected by multistage random sampling. Data were collected by questionnaire and clinical examination. International Headache Society criteria were used for diagnosis. The overall prevalence of headache was 31%. Prevalence rates of migraine and tension-type headache were 1.7% and 5.5% respectively. The prevalence of headache increased with age and girls were significantly more likely to report tensions-type headache. Positive family history of headache and abnormal sleep pattern were significantly associated with migraine.

Effect of closed minimized cardiopulmonary bypass on cerebral tissue oxygenation and microembolization

OBJECTIVE

Coronary artery bypass grafting with cardiopulmonary bypass carries a risk for neurologic complications because of cerebral hypoperfusion and microembolization. The basic goals of a novel closed minimized extracorporeal circulation are to prevent excessive hemodilution and to avoid blood-air interface. The aim of this prospective randomized study was to determine the effect of using the minimized extracorporeal circulation system compared with open conventional extracorporeal circulation on cerebral tissue oxygenation and microembolization.

METHODS

Forty patients undergoing coronary artery bypass grafting (20 in each group) were continuously monitored for changes in cerebral oxygenated hemoglobin and tissue oxygenation index by using near-infrared spectroscopy. Total microembolic count and gaseous embolic count in both median cerebral arteries were monitored with multifrequency transcranial Doppler instrumentation.

RESULTS

In the conventional extracorporeal circulation group there was a highly significant reduction in both cerebral oxygenated hemoglobin and tissue oxygenation index from the start to the end of cardiopulmonary bypass (P < .01). The rate of decrease in cerebral oxygenated hemoglobin after aortic cannulation was faster in the conventional extracorporeal circulation group (F test = 9.03, P < .001). No significant changes with respect to cerebral oxygenated hemoglobin or tissue oxygenation index occurred in the minimized extracorporeal circulation group, except at the beginning of rewarming (P < .01). Total embolic count, as well as gaseous embolic count, in the left and right median cerebral arteries was significantly lower in the minimized extracorporeal circulation group (all P < .05). Postoperative bleeding was greater (P < .05) and the transfusion rate was higher (P < .05) in the conventional extracorporeal circulation group.

CONCLUSIONS

Use of closed minimized cardiopulmonary bypass compared with conventional open cardiopulmonary bypass preserves cerebral tissue oxygenation and reduces cerebral microembolization.

The metabolic syndrome in hypertensive and normotensive subjects: the Isfahan Healthy Heart Programme

INTRODUCTION

There are numerous correlations between hypertension and the metabolic syndrome, although this is not always the case. The objective of this study was to compare the prevalence of the metabolic syndrome and its different phenotypes among hypertensive and normotensive subjects.

MATERIALS AND METHODS

This cross-sectional study was performed on a representative sample of adults living in 3 cities in Iran. Among the 12,514 subjects selected by multi-stage random sampling, 1736 (13.9%) were hypertensive. The prevalence of the metabolic syndrome [according to the Adult Treatment Panel (ATP) III criteria] was significantly higher in hypertensive than normotensive subjects (51.6% versus 12.9%, respectively; OR, 7.15; 95% CI, 6.4 to 7.9). The metabolic syndrome was more prevalent in normotensive and hypertensive subjects living in urban areas than those living in rural areas (14.2% and 53.9% versus 9.5% and 45.6%, respectively, P < 0.05). The mean age of hypertensive subjects, with or without the metabolic syndrome, was not significantly different (55.7 +/- 12 years versus 55.4 +/- 15.5 years, P = 0.6). Hypertension with the metabolic syndrome was more prevalent in women than men (72% versus 28% respectively, P < 0.000), and in subjects living in urban areas than those in rural areas (75.1% versus 24.9%, respectively, P = 0.002).

CONCLUSION

The findings of this study indicate the need for metabolic screening in all hypertensive patients, and emphasise the importance of promoting primary and secondary prevention of high blood pressure and associated modifiable risk factors in order to counter the upcoming epidemic of non-communicable disease in developing countries.

The effect of ketamine and fentanyl in reducing the pain of diazepam injection

Diazepam is an effective drug that is used widely in modern anesthesia. Venous irritation is one of its major side effects attributed to its acqueous insolubility and requisite solvents. There is some evidence that ketamine may acts as a local anesthetic drug, because of its effect on N-methyl-D-aspartate receptors. Fentanyl also may reduce the pain of diazepam injection by blocking the opiate receptors in vessels walls. To determine the effectiveness of ketamine and fentanyl in reducing the pain of diazepam injection, 150 patients (ASA I, II) were randomly assigned to one of three Groups and before intravenous diazepam injection. 2 ml normal saline, 2 ml fentanyl or 10 mg ketamine were administered for Groups 1, 2, 3 respectively. The pain of diazepam injection was then evaluated at 30 minutes intervals. Our results showed that ketamine and fentanyl reduce the pain of diazepam dramaticaly (p < 0.001) in comparison with placebo. Ketamine is more effective than fentanyl in reducing such pain (p < 0.001).

Release of 5-amino salicylic acid from acrylic type polymeric prodrugs designed for colon-specific drug delivery

New acrylic type polymeric systems having degradable ester or amide bonds linked to the bioactive agent 5-amino salicylic acid (5-ASA), were prepared and evaluated as materials for colon-specific drug delivery. Methacryloyloxyethyl 5-amino salicylate (MOES), and N-methacryloylaminoethyl 5-amino salicylamide (MAES) were prepared as the polymerizable derivatives of 5-ASA using activated ester methodology. The drug-containing monomers were free radically copolymerized with methacrylic acid or hydroxyethyl methacrylate, utilizing azobisisobutyronitrile as initiator. The polymer bearing 5-ASA units as side substituents of the acrylic backbone were obtained in the form of poly pendent esters or poly pendent amides. The drug release studies were performed by hydrolysis in buffered solutions (pH 1, 7.2, 8.5), or simulated intestinal fluid containing pancreatin to measure the chemical degradation expected to occur in the intestinal tract. The release profiles indicated that the hydrolytic behavior of polymers strongly depends on their degree of swelling, type of comonomer, and the nature of hydrolyzable bond. Implication of the results for use of these polymers for colon targeting are discussed.

Determination of captopril in human serum by high performance liquid chromatography using solid-phase extraction

A rapid, simple and sensitive assay was developed for determination of captopril in human serum. We employed silica gel cartridge for efficient extraction of captopril adduct from human serum. Captopril was trapped with p-bromophenacyl bromide (pBPB) to give captopril-pBPB adduct. A 4-ml benzene extract of 1 ml acidified serum was passed through 1 ml silica gel cartridge. Potential interfering compounds were removed with 4-ml benzene wash. The captopril-pBPB adduct was eluted with 0.5 ml acetonitrile. Of this acetonitrile solution (100 microliters) was injected on an ODS reverse phase HPLC column (chromatography conditions; mobile phase; acetonitrile-water-acetic acid (225:270:5, v/v/v), flow rate; 1 ml min-1, detection; UV at 263 nm). It is found that this method is accurate and does not require time consuming evaporation-concentration steps. Recovery exceeds 94% and analytical responses are linear over captopril concentration range from 50 up to 1000 ng ml-1. The coefficients of variation from 108 ng ml-1 to 605 ng ml-1 varied between 3.7-7.7% and the relative error did not exceed 3.7%. Therefore, this method can be used for routine clinical monitoring and in pharmacokinetic studies of captopril.