HAKIM RESEARCH JOURNAL
Year:2004 | Volume:7 | Issue:1|Papers Count:11

Introduction: Unintentional injury is the second leading cause of death in Iran. Traffic injuries are the most common cause among all deaths due to unintentional injuries. Driving under influence of drugs (DUID) have been known as one of the major causes of traffic accidents. This study is a road-side survey which was carried out to determine the prevalence of driving under influence of opiates in heavy vehicle drivers of Iran. Methods: Using non-probability quota sampling, 1168 drivers were selected from 51 police stations all around the country. A physician interviewed the drivers and urine samples were collected The presence of morphine in the urine samples was investigated by latex agglutination test. Positive samples were transferred to police force central drug laboratory to perform Thin Layer Chromatography (TLC) test. Results: The study showed that 14.4% of drivers (Cl 95%, 12.4-16.4) were positive for opiates. Smoking, age (26-45 years) and lack of seat belt were found to be associated with positive opiate tests. Other variables like: education, type of vehicle, years of driving, total distance of driving during last year, ownership of vehicle were not associated with opiate abuse. Conclusion: According to these findings it seems that antidrug driving efforts should be a major component of road safety activities in Iran. Enforcement of laws need to be done by passing new and more powerful acts. Educational campaigns should be performed and drivers' beliefs and attitudes must be studied for planning of educational programs.

Introduction: This research was performed with the aim of determining the prevalence of substance abuse in the rural areas of the west of Tehran province (Hashtgerd and Taleghan) using the key persons (i. e. mental health workers) and evaluating the reliability and the efficacy of this method. Methods: This epidemiological study was conducted in two phases, the pilot and the main phases. The population consisted of all the residents above the age of 15 in the Hashtgerd and Taleghan towns (with the population of 83632) which were under the coverage of 65 health houses and 125 Behvarzes. In the pilot study, two towns were randomly studied and in the main phase all of the families receiving services from the health houses were included in the study. To ensure the specificity, sensitivity and efficacy of this method and to identify substance abusers, 300 individuals (100 substance abusers and 200 non abusers) were randomly selected and evaluated by a psychiatrist. The instruments consisted of a checklist used by mental health workers to identify substance abusers and a clinical interview schedule based on DSM-IV. Data were analyzed using descriptive statistical methods and χ2  test. Results: Results showed that the sensitivity, specificity and effectiveness of using key persons in identifying substance abusers were 95%, 99% and 98%, respectively. The results also showed that 1) the prevalence of substance abuse among the population above the age of 15 years old in the region was 3.51 %, 2) the most common substances of abuse among the identified drug abusers were opium (94.4%), combination of opium and hashish (1.9%), and combination of opium and heroin (1.1%) and 3) there were significant relationships between demographic variables (age, sex, marital status, and education) and substance abuse. Most of the substance abusers were male (96.2%), married (84.4%) and between the ages of 31 to 50 years (55.5%). They were either illiterate or had middle school level of education (87%). Conclusion: The findings indicated that this method could be used reliably and effectively in similar studies to identify substance users.

Introduction: Breast cancer is the most common type of cancer among women of developing countries and the second one after lung cancer in developed countries except Japan. The incidence of this cancer is increasing in the world and knowing about its risk factors is necessary for preventing it. In Iran also there are some reports about increasing of incidence of the cancer as the first one between all type of cancers in1996. There are some studies about breast cancer and related factors, but with controversy, yet. The aim of this study was to determine the relation between some related hormonal factors and breast cancer. Methods: This study performed between 1999 to 2001, with a hospital-based case-control study in Tehran and Mashhad. One hundred and fifty women with breast cancer and 430 women as control group recruited in the study. Non- probability convenience sampling was used for selection of the subjects. As related factors with breast cancer, oral contraceptive use and duration of usage, age in first complete pregnancy, total duration of breast feeding, history of incomplete pregnancy, age of menarche, and history of irregular menstruation are measured. We used Chi-square, t-test, and multiple logistic regression for analyzing data. Results: The proportion oral contraceptive use history was 54.8 % in cases and 44.4 % in control group. About 39% of the women with breast cancer reported history of incomplete pregnancy and this proportion was 43.5 % in control group. Oral contraceptive use over 48 months was known as a risk factor for breast cancer (OR =2. 04, P=0.01). Total breast feeding more than 60 months had a protective role for breast cancer (OR=0.9, P=0.001). There were not any significant association between other variables (age at first pregnancy, irregular menstruation, age of menarche and incomplete pregnancy) and breast cancer. Conclusion: This study showed a significant association between duration of oral contraceptive use, and total duration of breast feeding, and breast cancer.

Introduction: Periodontal disease is a common infection-induced inflammatory disease among individuals suffering from diabetes mellitus. The purpose of this study was to assess the effects of treatment of periodontal disease on the level of metabolic control of diabetes. Methods: From a total of 156 patients suffering from periodontal disease and type 2 diabetes that had referred to the diabetes clinic of Shariati Hospital (Tehran-Iran) finally the study was performed on 71patients who were randomly divided into 4 groups. 1) Control group which only received oral hygien education. 2) Periodontal treatment included ultrasonic scaling. 3) Periodontal treatment included ultrasonic scaling and topical chlorhexidine 0.2% for two weeks. 4) Periodontal treatment included ultrasonic scaling and topical chlorhexidine 0.2% and systemic doxycycline 100mg daily for two weeks. Assessments were performed prior one to and 3 months after treatment and included probing depth (PD), gingival index (GI), plaque index (PI) bleeding on probing (BOP), fasting blood sugar (FBS) and Hb A1C. Results: After 3 months follow-up control groups showed a significant increase (P<0.001) in Hb A1C, but we found a significant reduction (P<0.01) in Hb A1C among group 3. After 3 months follow-up all 3 groups receiving scaling, showed significant reduction (P<0.001) in Hb A1C in comparison to control group. Conclusion: It can be concluded that periodontal treatments have clear effect in metabolic control improvement of diabetic patients, therefore we must consider the role of periodontal treatment in managing of diabetic patients.

Introduction: Mosquitoes of the Anopheles culicifacies complex are one of the main malaria vectors in Indian subcontinent and Middle East countries as well as in Iran. Based on cytological characteristics there are five morphologically indistinguishable species in this complex that called A, B, C, D and E. These species have got different biological and behaviour characteristics, and show different vectorial capacity. Methods: Due to problems inherent in the cytological studies a DNA based method mtDNA PCR-RFLP was conducted to study genetic variation and it's utility in identifying species composition of the complex in Baluchestan district of Iran. A 1512 bp mtDNA of cytochrome oxidase subunit I and II (COl-COIl) or an 875bp mtDNA of COl were amplified and treated by different restriction enzymes (PCR-RFLP). Results: Results of this study showed that at least two species, A and B, of the complex are present in the region. This is the first report on the occurrence of species B in Iran. In addition to species A and B, there were some other haplotypes within the specimens which represent either the occurrence of other members of the complex (presumably species E) or interspecies variation. Conclusion: These results are very important in epidemiology of malaria in the region and will be remain to be confirmed by further cytological and molecular works.

Introduction: There are several studies about the correlation between Various clinical parameters (plasma lithium concentration, lithium treatment duration and frequency of lithium administration) with lithium nephrotoxicity. In some of these studies the results are conflicting or the selected methods are expensive. Our objective was to find an accurate, available and inexpensive parameter for predicting and preventing renal side-effects of lithium. Methodss: During a case-control inpatient study the correlations between the lithium ratio (LR) and the incidence of some renal side-effects and the type of comedications were studied in 70 Iranian bipolar patients admitted at Roozbeh Mental Health Hospital by using direct method of measuring of erythrocyte lithium concentration. Blood samples were drawn 12± 0.5 hours after the last dose of lithium. The cases were patients who had urine specific gravity of 1.006 or less after 8-10 hours water deprivation at night and the controls had specific gravity of 1.011 or more after this period. Blood urea nitrogen, serum creatinine, sodium and potassium and urine pH, sodium and potassium were measured in all patients at this time. Renal indices were compared by using independent sample t-test at a significance level of a Pvalue of 0.05 or less. Pearson rank correlation test was used to investigate the relationship between clinical variables and the indices of renal function. Results: Results revealed that in case group mean serum sodium concentrations were significantly higher (P=0.008) and mean urine sodium and potassium were significantly lower than that of controls (P=0.004, P=0.007 respectively). We found no statistically significant difference in LRs between two groups. However, erythrocyte lithium concentrations were significantly higher in cases (P=0.026). There were no significant correlation between concomitant use of neuroleptics or benzodiazepine and LR or lithium renal side effects. Conclusion: This study showed that erythrocyte lithium concentration may be a better predictor of lithium nephrotoxicity than its plasma concentration and LR.

Introduction: The aim of this research was to assign the relation between antisocial and borderline personality disorder and addiction. Methods: The sample was selected among addicted Kermanshahi men (18-35 years old) who referred to rehabilitation centers during five years ago, through available sampling. Also, a normal matched group was selected as control group. Then, we completed Millon Personality Inventory (MCMI-II) and a questionnaire made by researcher for assessing demographic information and different variables. Results: results showed that most of addicts have borderline and antisocial characteristic personality disorders witch need to be considered in treatment modalities. Conclusion: Result showed that not only there were significant differences (P<0.05) among antisocial and borderline characteristics, but also in paranoid, schizotypal, sadistic, passive-aggressive, dependent, avoidant, and schizoid characteristics.

Introduction: Primary hypolactasia is a common disorder with an autosomal recessive pattern of inheritance. It results from a physiological decline in activity of lactase phlorizin hydrolase (LPH) in intestinal epithelium after weaning. PH is the most common enzyme deficiency in the world, with a high prevalence in Asia and Far East. Although there are a few cases of human beings in which the enzyme remains active, it usually decreases with the age. This could eliminate the consumption of the milk and provide other limitations, such as, failure to thrive in infants and children. Recent studies of sequence analysis of LCT, the gene encoding LPH, and adjacent regions on 2q21 have revealed that a DNA variant, C/T -13910, roughly 14kb upstream from the LCT locus in intron 13 of MCM6, is strongly associated with PH. Our aim was to estimate the prevalence of primary hypolactasia by the analysis of C/T -13910. Methods: The study population was a number of villagers and nomads settled around Esfahan who Iraised cattle or earned their living by agriculture. Out of them, 44 cases were selected. DNA extraction was performed and sent to the University of Helsinki, Finland, for evaluating the C/T -13910 variant on MCM6 domain, located in 21st chromosome. Results: We observed C/T-13910 in 16% of the samples; in other words the prevalence of PH was 84% in this population. Conclusion: This article is a novel study of the C/T -13910 variant in central Iran. According to the related results, and the past history of Iran, being one of the origins of agricultural pastoralism (approximately 9000 years ago), the geographical location may have an important role in establishing the persistence of C/T -13910 and the lactase enzyme in human genome. We suggest further investigations about hypolactasia in Iran that can throw light on this subject.