Background: Matrix metalloproteinase-9 (MMP-9) gene -1562C/T polymorphism could regulate its expression level and thus affected people’s predisposition to essential hypertension. However, related studies yielded inconsistent or contradictory results.

Methods: To evaluate the association of MMP-9 -1562C/T polymorphism with essential hypertension, we performed a meta-analysis by combining all available independent case-control studies (n=6).A systematic literature search of PubMed, Web of Science, Scopus and CNKI (Chinese National Knowledge Infrastructure) databases was conducted by two researchers independently for all relevant articles published before March 2015.

Results: MMP-9 -1562C/T polymorphism was associated with essential hypertension under the allelic model (T vs.C, OR=1.36, 95% CI=1.17-1.59, P<0.0001). Subsequent sensitivity analysis confirmed the stability of the results. Such association was also observed in the dominant (TT+CT vs. CC, OR=1.30, 95% CI=1.10-1.54, P=0.002) and co-dominant (CT vs. TT+CC, OR=1.27, 95% CI=1.05-1.53, P=0.01) models but not in the recessive model (TT vs. CT+CC, OR=1.30, 95% CI=0.50-3.36, P=0.59).

Conclusion: MMP-9 -1562C/T polymorphism was associated with the risk of essential hypertension.

Keywords: MMP-9, Essential hypertension, Meta-analysis

Background: Communicable disease reporting and surveillance system has poor infrastructure and supporters in most of countries. Its quality improvement is a challenge and requires an accurate and efficient care and reporting systems at all levels to achieve new and simple models. This study evaluates reporting systems of communicable diseases using systematic review.

Methods: This was a systematic review study. For data collection, we used the following database and search engines: Proquest, Science direct, Pub MED, Scopes, Springer, and EBESCO. For Persian databases, we used SID, Iranmedex and Magiran. Our key words were "Communicable Diseases", "Notifiable Disease", "Disease Notification", "Reporting System"," Surveillance Systems" and "evaluation". Two independent researchers reviewed the resources and the results were classified in different domains.

Results: From 1889 cases, only 66 resources were studied. The results were classified in several domains, including those who were reporting, reporting methods and procedures, responsibilities and reporting system characteristics, problems and solutions of the report, the reporting process, and receptor level.

Conclusion: Disease-reporting system has similar problems in all parts of the world. Change, improve, update and continuous monitoring of the reporting system are very important. Although the reporting process can vary in different regions, but being perfect and timely are important principles in system design. Detailed explanations of tasks and providing appropriate instructions are the most important points to integrate an efficient reporting system.

Keywords: Reporting, Diseases surveillance system, Disease control

Background: We aimed to value the usefulness of free to total prostate-specific antigen and Prostate-specific antigen (PSA) density for prostate cancer in the patients with PSA levels of 4.0 ng/ml or less.

Methods: A total of 343 subjects with PSA levels of 4.0 ng/ml or less were biopsied. All patients were divided into four groups according to the PSA levels: 0 to 1.0 ng/ml, 1.1 to 2.0 ng/ml, 2.1 to 3.0 ng/ml, and 3.1 to 4.0 ng/ml. The reliability of cancer detection in relation to the f/t PSA ratio and PSAD were estimated.

Results: Overall, 65 people were diagnosed with prostate cancer. The detection rate was 16.28%、17.17%, 21.82%, 25.00% in subjects with PSA levels of 0 to 1.0 ng/ml, 1.1 to 2.0 ng/ml, 2.1 to 3.0 ng/ml, and 3.1 to 4.0 ng/ml, respectively. The f/t PSA ratio was significantly lower in patients with prostate cancer and PSA levels of 2.1 to 4.0 ng/ml (P＜0.05). The PSAD had no statistical significance between the two groups.

Conclusions: Routine prostate biopsy should be undertaken if the f/t PSA ratio less than 15% with /without abnormal DRE/TRUS findings.

Keywords: Biopsy, Prostate cancer, Prostate-specific antigen, PSA ratio, PSAD 

Background: Domestic and industrial wastewaters are mostly treated by biological process such as activated sludge, aerobic pond, and anaerobic treatment. This study focuses on characterizing the quality of sewage sludge in the Sultanate of Oman chosen from three industrial sewage treatment plants (STPs): Rusayl Industrial Estate (RSL.IE); Sohar Industrial Estate (SIE); and Raysut Industrial Estate (RIE).

Methods: Samples of recycled activated sludge (RAS) and wasted activated sludge (WAS) were collected over a period of 12 months across above mentioned STPs. Parameters analyzed are electrical conductivity (EC), potential of hydrogen (pH), cations, anions and volatile content (VC).

Results: The obtained values for pH and EC were low for both RAS and WAS samples, except EC values of RIE that was more than 1000 µS/cm. The range of VC percentages in RAS and WAS samples were 44 to 86% and 41 to 77%, respectively. The measured values for chloride, sulfate, nitrate and phosphate were higher than the other anions.

Conclusion: The average values of the cations in RAS and WAS samples were within the Omani Standards, suitable for the re-use of sludge in agriculture except for Cd in RSL.IE. The study recommends that a regular maintenance should be performed at the studied STPs to prevent any accumulation of some harmful substances, which may affect the sludge quality, and the sludge drying beds should be large enough to handle the produced sludge for better management.

Keywords: Industrial Wastewater sludge, Characterization, Analysis, physicochemical, Heavy metals, Sultanate of Oman

Background: We explored the level of Jordanian patients' knowledge, diabetes related distress, self-management activities and these effects on the A1C level.

Methodology: This descriptive cross-sectional correlational design (conducted in 2013) was utilized to recruit 289 diabetic patients from outpatient diabetes clinics, using self-reported questionnaires (Diabetes Knowledge Test, Diabetes Distress Scale, and Diabetes Self-Management Questionnaire) in addition to chart review for selected variables.

Results: Participants' had mean glycated hemoglobin of 7.88%. Good glycemic control was significantly associated with higher self-management activities (r= -.147), high income (r= -.171), older age (r= -.252), shorter duration of illness (r= .153), and low levels of distress. Despite these relationships only age, duration of illness and income significantly predicted A1C (F (5, 284) = 11.57, P<.001, R² = .17). Further, diabetes knowledge, diabetes-related distress, and self-management could not predict A1C level.

Conclusion: Only diabetes-related distress and self-management correlated with patients' A1C, with no predictive power. Thus, further research is required to shed the light on the large unexplained components of the A1C variance.

Keywords: Glycated hemoglobin, Diabetes related distress, Self-management, Diabetes

Background: Electrolytes play an important role in the normal functioning of human body. Electrolyte imbalance and mineral disturbances is the common clinical manifestation in several infectious diseases including malaria. Malaria is a mosquito borne serious infectious disease of the world. Plasmodium vivax and P. falciparum are the main agents responsible for malaria in Pakistan. Electrolyte imbalance in malarial infection may lead towards the severity of disease.

Methods: The present study analyzed the electrolytes levels (Na, K, Ca and Mg) in malarial patients and healthy individuals. Patients were categorized into two groups, P. falciparum and P. vivax, based on causative species of Plasmodium. Study consisted of 173 individuals, out of which 73 were malarial patients and 100 were normal healthy individuals.

Results: Concentrations of Na, K, and Ca were low in the blood of malarial patients as compared to healthy individuals (P<0.05). No significant difference for these electrolytes exists between P. falciparum and P. vivax infected groups (P>0.05). The concentration of Mg was changed based on exposure to the type of parasite. In P. falciparum infection, the level of Mg was lower than healthy individuals was (P<0.05). Discordantly, in case of P. vivaxinfection, Mg level was higher than healthy individuals were (P<0.05). No variation was noticed in electrolytes levels due to gender differences (P>0.05).

Conclusion: Variation in Mg levels occurs due to exposure of Plasmodium depending on its type. The levels of Na, K and Ca are also changed due to Plasmodium, regardless of its type.

Keywords: Malaria, Electrolytes, Plasmodium falciparum, Plasmodium vivax

Background: Hamadan Province is one of the high-risk regions in Iran for Multiple sclerosis (MS). A majority of the epidemiological studies conducted in Iran addressing MS are descriptive. This study was conducted to assess MS and its associated risk factors in Hamadan Province, the west of Iran.

Methods: This case-control study compared 100 patients with MS (case group) and 100 patients with acute infectious diseases (control group) from September 2013 to March 2014. A checklist was used to assess the demographic, medical, and family history of the patients. The Friedman-Rosenman questionnaire was also used to assess personality type. Statistical analysis was performed using logistic regression model with Stata 11 software program.

Results: The adjusted odds ratio (OR) estimate of MS was 4.37 (95% CI: 2.33, 8.20) for females compared to males; 0.15 (95% CI: 0.06, 0.43) for people aged above 50 years compared to aged 14 to 29 years; 0.44 (95% CI: 0.21, 0.91) for overweight or obese people compared to normal weights. Crude OR indicated a significant association between the occurrence of MS and exclusive breast feeding, season of birth, and smoking. However, the association was not statistically significant after adjustment for other covariates.

Conclusion: The risk of MS is significantly lower in male gender, obese/overweight, and old people. Furthermore, non-smoking, non-exclusive breast-feeding, and born in autumn may increase the risk of MS but need further investigation. However, long-term large prospective cohort studies are needed to investigate the true effect of the potential risk factors on MS.

Keywords: Multiple sclerosis, Risk factors, Case-control study, Iran

Background: The aim of this study was to assess the prevalence of absenteeism in patients with psoriasis and determine the factors influencing the incidence of absenteeism in these patients.

Methods: A cross-sectional study from December 2012 to November of 2013 was conducted on 192 psoriasis patients referred to the Dermatology Clinic of Imam Khomeini Hospital, Tehran, Iran. The number day of absence from work due to psoriasis in the last year was asked from the patients; the absence of 7 days has been considered as short-term and more than 7 days as long-term. Logistic regression was used to data analysis.

Results: Sickness absence in 21.4% of patients was positive. The average numbers of days of absence were 10.25 and the duration of absence from work in 48.7% were long-term ≥7 days. 51.3% had short-term absence (<7 days). Among disease factors: moderate to severe disease (SAPASI score >10), palms and soles involvement, joint problems and radiation therapy and among job factors: hazardous physical and chemical exposures in the workplace, non-office work, disability, exacerbations of disease on work days and problem on employment were associated with high incidence of sickness absence.

Conclusion: Psoriasis with its chronic and recurrent nature especially in higher severities causes disabilities that deeply affect Work performance and can decrease the efficiency. In better management of psoriasis patients, physicians should pay special attention to occupational factors.

Keywords: Sickness absence, Occupational stress, Psoriasis patients, SAPASI

Background: Nowadays, due to increased public awareness about water pollution and water borne diseases as well as water network deficiencies, bottled water consumers have increased dramatically worldwide, including Iran. Pseudomonas aeruginosa is an opportunistic human pathogen capable of causing widespread infections in burn and immune-compromised patients. The aim of this study was to investigate, P. aeruginosa in bottled waters selling in Iranian markets.

Methods: One hundred and twenty samples of five unknown (not famous) domestic bottled water brands were purchased from Tehran retailers during 2013. The samples were evaluated for the presence of P. aeruginosa. In addition, heterotrophic plate counts were determined by incubation at 37 °C for 24 h.

Results: P. aeruginosa was detected in 36.7% (44 samples) of all samples examined. In addition, heterotrophic bacteria in 32.5% (39 samples) of the samples were higher than 100 CFU/mL, while in 7.5% (9 samples) of the samples HPC relied between 20 and 100 CFU/ml.

Conclusion: In contrast to public believe, bottled waters are not free of microorganisms, and it is suggested that authorities should provide stricter monitoring and control plan for water resources and plants. Concerning HPC and P. aeruginosa brands B and D were not suitable for drinking.

Keywords: Heterotrophic plate count, Pseudomonas aeruginosa, Bottled water

Background: Fascioliasis, caused by Fasciola hepatica and F. gigantica, is one of the most important plant and water borne disease in Iran. This study aimed to determine the prevalence of fascioliasis and intestinal helminthes in inhabitants of rural areas of Boyer-Ahmad in Kohgiluyeh and Boyer-Ahmad province in Southwest of Iran.

Methods: Stool samples (1025) were collected from inhabitant of 50 randomly selected villages in Boyer-Ahmad Township. Samples were evaluated with modified Telemann and formalin-ethyl acetate methods. Blood samples of Fasciola positive cases were assessed with ELISA and Western blotting. DNA was extracted from Fasciola eggs from stool of positive individuals and evaluated by molecular (PCR) method and the PCR products were sequenced and analyzed.

Results: Of the 1025 participants, 473 (46.1%) were male and 552 (53.9%) were female. The mean age of the subjects was 20.25 (±15.86) years. Fasciola eggs were detected in stools of two cases (0.19%). Blood samples were obtained from the Fasciola positive cases and their infection was further confirmed by ELISA and Western blotting. Molecular analysis revealed that both cases are infected with F. hepatica.

Furthermore, seven of participants (0.68%) were found to be infected with H. nana, 4 cases (0.39%) with E. vermicularis, and one case (0.09%) with Trichuris trichiura.

Conclusion: Findings of this study showed that Boyer-Ahmad district is one of the endemic areas of human fascioliasis in Iran. The study also documented that the rate of helminthic infections in rural areas of the district has drastically declined over the past years.

Keyword: Fascioliasis, Prevalence, Helminthes infection, Iran

Background: Determining the temporal variation and forecasting the incidence of smear positive tuberculosis (TB) can play an important role in promoting the TB control program. Its results may be used as a decision-supportive tool for planning and allocating resources. The present study forecasts the incidence of smear positive TB in Iran.

Methods: This a longitudinal study using monthly tuberculosis incidence data recorded in the Iranian National Tuberculosis Control Program. The sum of registered cases in each month created 84 time points. Time series methods were used for analysis. Based on the residual chart of ACF, PACF, Ljung-Box tests and the lowest levels of AIC and BIC, the most suitable model was selected.

Results: From April 2005 until March 2012, 34012 smear positive TB cases were recorded. The mean of TB monthly incidence was 404.9 (SD=54.7). The highest number of cases was registered in May and the difference in monthly incidence of smear positive TB was significant (P<0.001). SARIMA (0,1,1)(0,1,1)₁₂ was selected as the most adequate model for prediction. It was predicted that the incidence of smear positive TB for 2015 will be about 9.8 per 100,000 people.

Conclusion: Based on the seasonal pattern of smear positive TB recorded cases, seasonal ARIMA model was suitable for predicting its incidence. Meanwhile, prediction results show an increasing trend of smear positive TB cases in Iran.

Keywords: Tuberculosis, Forecasting, SARIMA, Box-Jenkins, Iran

Background: General and abdominal obesity are major global health problems. This cross-sectional study was conducted to evaluate the association between consumption of sugar-sweetened beverages (SSBs) and body mass index and waist circumference status in 5852 Iranian adults within the framework of the Tehran Lipid and Glucose Study (TLGS).

Methods: Intakes of SSBs including carbonated drinks and synthetic fruit juices were measured using a validated food frequency questionnaire. The association between body mass index, waist circumference and body adiposity index in each quartile category of SSB consumption were determined using the multivariable linear regression models. The odds ratio (OR) of general and abdominal obesity in each quartile of SSB consumption was also determined using the multivariable logistic regression models.

Results: Mean dietary intake of SSBs was 48.9 g/d or 0.25 servings/d. After adjustment for all potential confounding variables, significant associations were observed between SSB consumption and BMI (β: 0.49, 95% CI: 0.13-0.86), and waist circumference (β: 1.28, 95% CI: 0.40-2.16) in the fourth quartile. There was no significant association between SSB consumption and body adiposity index. Participants who consumed > 57.1 g/d of SSBs had 22% higher risk of general obesity (OR: 1.22, 95% CI: 1.00-1.48) and 35% higher risk of abdominal obesity (OR: 1.35, 95% CI: 1.12-1.61), compared with those in the lowest quartile of SSB consumption.

Conclusion: Higher intakes of SSBs were associated with the higher risk of general and abdominal obesity in adults suggesting that limiting the consumption of SSBs may be a practical approach to prevent and manage obesity.

Keywords: Sugar-sweetened beverages, Obesity, Abdominal obesity, Iran

Background: The widespread use of chemical insecticides, resistance in vectors and environmental problems, all have led to an increased interest in the use of biological agents in malaria control programs. The most important functional elements are the native fish. The aim of this study was to identify the native species of lavivorous fish in Rudan County, southern Iran, to introduce an effective species and to propose its’ implementation in the national malaria control program.

Methods: This ecologically descriptive study was conducted during 2011-2012 using random sampling from different fish habitats of Rudan County. The shoals of fish were caught using fishing net. Fish samples were then identified in the Ichthyology lab, Department of Fisheries and the Environment, Hormozgan University. 

Results: Three species of larvivorous fish were identified as follows: Gambusia holbrooki, Aphaniusdispar dispar and Aphanius sp. The latter species has the most distribution in the study area and needs more morphological and molecular studies for identification at the species level.

Conclusion: Two species of native fish, i.e., A. dispar and A. sp. with larvivorous potential live in the area. Further studies on their predatory property are recommended in order to apply this local potential against malaria vectors in the area.

Keywords: Malaria, Biological control, Larvivorous fish, Aphanius, Iran

Crohn's disease is a type of chronic inflammatory bowel disease (IBD) of unknown etiology that may affect any part of the gastrointestinal tract from mouth to anus and shows extra-intestinal involvement. It characteristically shows skip lesions. This case report reported in 2014 describes a middle age Pakistani male known to have documented evidence of significant crohn's disease since past 18 years. He was diagnosed with multiple fistulas that are a rare entity of patients with crohn's disease, which is itself a rare disease in Asian countries.

Keywords: Crohn's disease, Inflammatory bowel disease (IBD), Multiple fistulas

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