OBJECTIVES:Diabetes is a major public health problem that is approaching epidemic proportions globally. Diabetes self-management can reduce complications and mortality in type 2 diabetic patients. The purpose of this study was to examine associations between diabetes self-management and microvascular complications in patients with type 2 diabetes. METHODS:In this cross-sectional study, 562 Iranian patients older than 30 years of age with type 2 diabetes who received treatment at the Diabetes Research Center of the Endocrinology and Metabolism Research Institute of the Tehran University of Medical Sciences were identified. The participants were enrolled and completed questionnaires between January and April 2014. Patients' diabetes self-management was assessed as an independent variable by using the Diabetes Self-Management Questionnaire translated into Persian. The outcomes were the microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy), identified from the clinical records of each patient. A multiple logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between diabetes self-management and the microvascular complications of type 2 diabetes, adjusting for potential confounders. RESULTS:After adjusting for potential confounders, a significant association was found between the diabetes self-management sum scale and neuropathy (adjusted OR, 0.64; 95% CI, 0.45 to 0.92, p= 0.01). Additionally, weak evidence was found of an association between the sum scale score of diabetes self-management and nephropathy (adjusted OR, 0.71; 95% CI, 0.47 to 1.05, p= 0.09). CONCLUSIONS:Among patients with type 2 diabetes, a lower diabetes self-management score was associated with higher rates of nephropathy and neuropathy.

OBJECTIVES:Diabetes is a major public health problem that is approaching epidemic proportions globally. Diabetes self-management can reduce complications and mortality in type 2 diabetic patients. The purpose of this study was to examine associations between diabetes self-management and microvascular complications in patients with type 2 diabetes. METHODS:In this cross-sectional study, 562 Iranian patients older than 30 years of age with type 2 diabetes who received treatment at the Diabetes Research Center of the Endocrinology and Metabolism Research Institute of the Tehran University of Medical Sciences were identified. The participants were enrolled and completed questionnaires between January and April 2014. Patients' diabetes self-management was assessed as an independent variable by using the Diabetes Self-Management Questionnaire translated into Persian. The outcomes were the microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy), identified from the clinical records of each patient. A multiple logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between diabetes self-management and the microvascular complications of type 2 diabetes, adjusting for potential confounders. RESULTS:After adjusting for potential confounders, a significant association was found between the diabetes self-management sum scale and neuropathy (adjusted OR, 0.64; 95% CI, 0.45 to 0.92, p= 0.01). Additionally, weak evidence was found of an association between the sum scale score of diabetes self-management and nephropathy (adjusted OR, 0.71; 95% CI, 0.47 to 1.05, p= 0.09). CONCLUSIONS:Among patients with type 2 diabetes, a lower diabetes self-management score was associated with higher rates of nephropathy and neuropathy.

BackgroundBreast tuberculosis (breast TB) is an extremely rare disease, so case reviews are also rare.MethodsThis study is a retrospective review of patients with breast TB who were treated between 2002 and 2012 at the Health Center of Gorgan City.ResultsAll 22 patients were females, their mean age was 32.4 years, and all were new cases. Patients presented with swelling of the breast (22%), lump (55%) and excretion from the involved breast (27%), and breast pain (55%). The highest rate of breast TB occurred in 2011 (27%). All patients received the DOTS regimen for a mean duration of 7.3 ± 0.7 months; in addition, segmental resection was performed on 11 patients (50%).ConclusionsThe findings confirmed that breast TB in Iran should be considered as a differential diagnosis of breast masses. All patients in our study received the daily and ‘Directly Observed Treatment Short-course’ (DOTS) regimens. Anti-tubercular therapy for six months with or without minimal surgical intervention currently is the main treatment.

Asthma is the most common chronic disease among children, and its incidences are often imminent among elementary schoolchildren. This study aimed to examine the prevalence of asthma symptoms in Golestan schoolchildren aged 6-7 and 13-14 years in Northeast Iran. The prevalence rate was compared according to age group (aged 6-7 years vs. aged 13-14 years) and gender (male vs. female). In this cross-sectional study, 1706 Iranian schoolchildren aged 6-7 and 13-14 years in Golestan Province were enrolled. Participants completed questionnaires between February and July 2014. Asthma symptoms were assessed using the questionnaire of the International Study of Asthma and Allergies in Childhood protocol in Persian. The logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the asthma symptoms for each of the gender and age groups. The prevalence rates of "current asthma" symptoms and "asthma ever" in all the children were estimated as 9.5% and 7.5%, respectively. The prevalence of asthma ("asthma ever" and "wheezing in the past 12 months") in junior high schoolchildren (aged 13-14 years) is higher than that in elementary schoolchildren (aged 6-7 years) (P < 0.05). The prevalence of the severity of wheezing in girls is lower than that in boys (OR = 1.7, 95%CI = 1.06-2.96, P = 0.02). Asthma is still a major public health problem. This study shows that the prevalence of the asthma symptoms in boys is lower than that in girls in both age groups, and the severity of asthma in girls is higher than that in boys aged 13-14 years.

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Aflatoxin M1 is a derivate of aflatoxin B1 and an important contaminant of milk and dairy products. This systematic review and meta-analysis was conducted on relevant Persian and English original articles in national and international databases with no time limits until 1 January 2018. In total 605 articles were found among which 70 articles met the inclusion criteria for meta-analysis. The prevalence (95% confidence interval (CI)) and mean concentration (95% CI) of aflatoxin M1 was found to be 64% (53-75%) and 39.7 ng/l (31.9-47.4 ng/l) in raw milk, 95% (89-98%) and 62.3 ng/l (40.6-84 ng/l) in pasteurised milk, 71% (56-84%) and 60.1 ng/l (30.9-89.3 ng/l) in sterilised milk, 59% (20-93%) and 5.5 ng/l (3.3-7.7 ng/l) in breast milk and 72% (61-81%) and 82.3 ng/kg (63.7-100.9 ng/kg) in dairy products. In general, 9% (4-16%) of milks and 10% (4-17%) of dairy products had aflatoxin M1 in concentrations exceeding the permitted level of Iranian standards (500 ng/l). Based on the maximum permitted aflatoxin M1 concentration in standards of Europe (50 ng/l), these percentages increase to 25% (18-32%) for milks and 18% (9-29%) for dairy products. According to the results, further control and preventive measures should be applied on livestock feeds because decreased aflatoxin B1 contamination at this level results in decreased aflatoxin M1 in milk and dairy products.

Introduction: Mucopurulent cervicitis (MPC) is a clinical syndrome characterized by mucopurulent discharge from the cervix and other signs of inflammation. In this study, we evaluated the prevalence and risk factors of MPC in married women referred to health centers of Shahroud (northeast of Iran) in 2016. Methods: In this cross-sectional study, 346 married women aged ≥18 years were screened for MPC via clinical examination by a gynecologist. Logistic regression was used to evaluate association of sociodemographic, behavioral and sexual health related variables with prevalence of cervicitis. Results: Mean age of subjects was 31.5 years (range 14-69 years) and 121 (35%) subjects had MPC. In addition, 38.2% of the subjects were with less than a high school diploma and 72.8% were housekeeper. The mean (standard deviation) value of body mass index was 25.2 (4.3) Kg/m 2 (range: 16.2-38.5 Kg/m 2). Coital frequency per week (P=0.004) and method of delivery (P=0.02) were significantly associated with the prevalence of cervicitis. Conclusion: Our findings suggest that weekly coital frequency, method of delivery, vaginal discharge and history of genital herpes may be associated with the risk of cervicitis.

Background: The clinical result severity of Helicobacter pylori infection is determined by a combination of environmental factors, host genetic background, and H. pylori virulence factors. A number of genes containing vacA, iceA, babA2, cagA, cagE, hsp60-70, and hpa have been identified to enhance H. pylori pathogenicity by encoding virulent proteins. The babA and hpa proteins are considered 2 major adhesion molecules, and thus they are key agents in the initial step of H. pylori invasion. Objectives: This study aimed at investigating the existence of babA2 and hpa virulence factors of H. pylori in Iranian patients with gastrointestinal complications. The relationship between these agents and clinical results was also investigated. Methods: A total of 80 positive biopsies out of 156 samples were studied to determine babA2 and hpa gene frequency by PCR. The positive biopsies were collected from patients suffering from gastric cancer (n =18), peptic ulcer (n = 26), and gastritis (n =36). Results:The babA2+ strains were found in 51 (64%) patients and the hpa+ strains in 57 (71%) patients were associated with sex (P = 0.02). However, the frequency of these factors was not significant between gastric disease groups (P > 0.05). Conclusions: Our results revealed different frequency of these virulence factors in Iran, which emphasized the effects of geographical influences. Also, it was found that male patients had higher rate of hpa than females, highlighting the gender specific factors.