سال:1394 | دوره: | شماره: |تعداد مقالات:10

Background: Depression is one of the most important medical problems in today’s world; despite its high prevalence, its causes unfortunately remain not fully known. Among important issues regarding this is its relation with heart diseases. Based on studies this comorbidity increase morbidity and mortality and leads to worst prognosis. However the cause of such high rate of comorbidity is unclear and instead of efforts to understand this correlation has prompted the medical world to consult other medicinal disciplines, not only to find the answer but also to increase the effectiveness of treatment and decrease its cost.Methods: We first reviewed the most important ancient causes for depression mentioned by Avicenna and considered those as the key words for our next step. Then, we made a literature search (PubMed and Scopus) with those key words to find out new scientific findings in modern medicine about the Avicenna’s suggestions.Results: Avicenna does not regard depression as only a mental ailment, but as a disorder resulted by the involvement of brain, heart and blood. He believed that the main causes of depressive events are rooted in heart diseases; in most cases brain is only affected secondary to the heart. Thus he declared that for the treatment of depressive disorders, the underlying cardiovascular diseases should be considered.Conclusions: It is worthwhile to consider the Avicenna’s recommended causes of depression and to design future scientific studies based on his suggestions.

Background: This study aimed to investigate the additive effects of socio‑economic factors, number of psychiatric disorders, and religiosity on suicidal ideation among Blacks, based on the intersection of ethnicity and gender.Methods: With a cross‑sectional design, data came from the National Survey of American Life, 2001–2003, which included 3570 African‑American and 1621 Caribbean Black adults.Socio‑demographics, perceived religiosity, number of lifetime psychiatric disorders and lifetime suicidal ideation were measured. Logistic regressions were fitted specific to groups based on the intersection of gender and ethnicity, while socioeconomics, number of life time psychiatric disorders, and subjective religiosity were independent variables, and lifetime serious suicidal ideation was the dependent variable.Results: Irrespective of ethnicity and gender, number of lifetime psychiatric disorders was a risk factor for lifetime suicidal ideation (odds ratio [OR] ranging from 2.4 for Caribbean Black women to 6.0 for Caribbean Black men). Only among African‑American men (OR=0.8, 95% confidence interval=0.7–0.9), perceived religiosity had a residual protective effect against suicidal ideation above and beyond number of lifetime psychiatric disorders. The direction of the effect of education on suicidal ideating also varied based on the group.Conclusions: Residual protective effect of subjective religiosity in the presence of psychiatric disorders on suicidal ideation among Blacks depends on ethnicity and gender. African‑American men with multiple psychiatric disorders and low religiosity are at very high risk for suicidal ideation.

DEAR EDITOR: Pustular bacterid (PB) is a pustular disorder of the hands and/or feet. It was first described by Andrews et al. There is controversy as to whether PB is a separate disease or is a variant of psoriasis pustulosa palmaris et plantaris (PPP). Until date, the etiology of PB has not been elucidated.

Background: Natural compounds including flavonoids like genistein (GE) are able to inhibit cell proliferation and induce apoptosis. GE is the main representative of these groups. GE inhibits carcinogenic tumors such as colon, stomach, lung, and pancreas tumors. The aim of the present study was to analyze the apoptotic effect of GE in the hepatocellular carcinoma (HCC) PLC/PRF5 cell line.Methods: Cells were treated with various doses of GE (1, 5, 10, 25, 50, 75, and 100 mM/L) at different times (24, 48, and 72 h) and the MTT assay was commonly used. Furthermore, cells were treated with single dose of GE (25 mM) at different times and flow cytometry was performed.Results: GE inhibited the growth of liver cancer cells significantly with a time‑ and dose‑dependent manner. The percentage of living cells in GE treatment groups with a concentration of 25 mM at different times were 53, 48 and 47%, respectively (P<0.001). Result of flow cytometry demonstrated that GE at a 25 mM concentration induces apoptosis significantly in a time‑dependent manner. The percentage of apoptotic cells at different times were 44, 56, and 60%, respectively (P<0.001).Conclusions: GE can significantly inhibit the growth of HCC cells and plays a significant role in apoptosis of this cell line.

Background: Urban family physician program has been launched as a pilot in Fars and Mazandaran provinces of Iran since 2012. Attitudes of policy makers and people toward urban family physician program have become challenging. This study shows what people know and practice toward this program.Methods: This cross‑sectional population‑based study was conducted by a multistage randomized sampling in Shiraz, Southern Iran. Knowledge and practice of adults toward urban family physician program were queried through filing the questionnaires. Single and multiple variable analyzes of data were performed.Results: Participation rate was 1257 of 1382 (90.9%), and the mean age of the respondents was 38.1±13.2 years. Of 1257, 634 (50.4%) were men and 882 (70.2%) were married. Peoples’ total knowledge toward urban family physician program was 5±2.7 of 19, showed that 1121 (89.2%) had a low level of knowledge. This was correlated positively and in order to being under coverage of this program (P<0.001), being under coverage of one of the main insurance systems (P=0.04) and being married (P=0.002). The mean score of people’s practice toward the program was 2.3±0.9 of total score 7, showed that 942 (74%) had poor performance, and it was correlated positively and in order to being under coverage of this program (P<0.001) and having higher than 1000$ monthly income (P=0.004). Correlation of people’s knowledge and practice toward the program was 24%.Conclusions: Current evidences show a low level of knowledge, poor practice and weak correlation of knowledge‑practice of people toward urban family physician program.

Background: The 1978 declaration (Alma-Ata declaration) made at the International Conference on Primary Health Care, meeting in Alma-Ata highlighted the critical role played by Community Health Workers (CHWs) to link communities to the health system. The flagship program of Government of India proposed introduction of CHWs namely Accredited Social Health Activist (ASHA). As a link between community and health system ASHA is in a unique position to generate awareness on tobacco-related issues. However, there is limited evidence on practices of ASHAs in tobacco control in India. The present study explores whether CHWs such as ASHAs can be utilized as a resource for informing and educating community on tobacco and its harmful effects. The study captured perceptions and practices of ASHAs regarding tobacco control.Methods: The study was a cross-sectional study conducted among 512 ASHAs in six intervention districts each in Gujarat and Andhra Pradesh. The study settings (i.e., health facilities and villages) were selected through systematic random sampling. The study participants were selected through simple random sampling. Responses were captured through self-administered questionnaire. Logistic regression model was applied to measure associations between variables such as knowledge level of ASHAs and information provided on different tobacco-related diseases by them in both the states, with statistical significance based on the Chi-square test.Results: Our findings indicate that ASHAs linked tobacco usage to diseases such as respiratory problems, lung cancer, tuberculosis, and oral disease. Only one-third of ASHAs reported informing all patients about the harmful health effects of tobacco, whereas more than half of them reported providing information only to patients suffering from specific illness. ASHAs who reported having received training in tobacco control were about Two times more likely to give information on effects of tobacco on respiratory diseases (odds ratio [OR] -1.5; confidence interval [CI]: 1.1–2.4) and adverse reproductive outcomes (OR-2.1; CI: 1.1–20.2).Conclusions: Study findings reflect suboptimal engagement of ASHAs in providing information pertaining to specific tobacco-related diseases. There is an urgent need to sensitize and train ASHAs in appropriate tobacco control practices.

DEAR EDITOR: I read with interest a recently published article in the “International Journal Prevention Medicine” by Jilanchi et al., entitled “Pomegranate flower extract does not prevent cisplatin‑induced nephrotoxicity in female rats.” The authors have concluded that administration of pomegranate flower extract not only did not ameliorate nephrotoxicity induced by cisplatin (CP) in female rats, but also aggravated renal damage. Here, I would like to explain the potential mechanism may be related to this effect. Pomegranate contains phytoestrogens, which are protective nonsteroidal plant chemicals, some of which structurally resemble endogenous estrogens from humans and animals. Phytoestrogens have estrogenic activity due to their structural resemblance to diethylstilbestrol, a synthetic estrogen.

Background: Obesity is commonly regarded as a risk factor for asthma development, poor asthma control, and poor response to asthma therapy.Methods: In a cross‑sectional study, 85 asthmatics (37 male and 48 female) participated. Pulmonary function tests (PFTs) and anthropometric parameters were measured for each patient.Results: Mean age and median duration were 43.9±10.61 and 6 (3–14) years, respectively. Among anthropometric parameters, only waist‑to‑hip ratio (WHR) indicated significant correlation with PFTs in both sex (P<0.05). There were negative associations between waist circumference, hip circumference and WHR with PFTs only in overweight and obese women (P<0.05).Conclusions: Some anthropometric parameters affected lung function, and it seems that gender differentially contributes to this effect.

Background: Health services for those in need. Inpatient care shows a more serious side of individual care and patients and their family members perceive a high level of stress and urge. We conducted this study to determine inequalities of in-patient health care utilization in Iranian people and to assess factors that influence utilization.Methods: In each province, the sample was comprised of 380 urban and 380 rural households that were recruited by a systematic random sampling method. A total of 23, 560 households, which included around 102, 000 individuals were recruited. We used the questionnaire for data collection. Met admission need (MAN) was the main variable and was considered household assets for determining the economic status. We did all analyses using the STATA version 9.1.Results: The rates of MAN for urban and rural areas were 83% and 81.3% respectively. The rate of MAN was significantly higher in patients with higher educational level. Patients with primary health insurance coverage had significantly higher rate of MAN.Conclusions: Meeting admission needs was estimated around 84% and it seems that modifying insurance coverage is the most feasible intervention for increasing utilization of health services.

Background: Methylphenidate (MPH) is a neural stimulant agent, which its neurochemical and behavioral effect remain unclear. Venlafaxine is a serotonin‑norepinephrine reuptake inhibitor antidepressant, which was used for management of depression and anxiety. In this study, protective effects of venlafaxine on MPH induced anxiety, depression and cognition impairment were investigated.Methods: Forty‑eight adult male rats were divided randomly to 5 groups. Group 1, received normal saline (0.2 ml/rat) for 21 days and served as control group. Group 2, received MPH (10 mg/kg) for 21 days. Groups, 3, 4, 5 and 6 concurrently were treated by MPH (10 mg/kg) and venlafaxine at doses of 25, 50, 75 and 100 mg/kg respectively for 21 days. On day 22, elevated plus maze (EPM), open field test (OFT), forced swim test (FST) and tail suspension test (TST) were used to investigate the level of anxiety and depression in animals. In addition, between days 17 and 21, Morris water maze (MWM) was used to evaluate the effect of MPH on spatial learning and memory.Results: MPH caused depression and anxiety in a dose‑dependent manner in FST, OFT, EPM and TST, which were significantly different compared with control group. Furthermore, MPH can significantly attenuate the motor activity in OFT. Venlafaxine in all doses can attenuate MPH induced anxiety, depression and motor activity alterations. MPH also can disturb learning and memory in MWM, but venlafaxine did not alter this effect of MPH.Conclusions: We conclude that venlafaxine can be protective in the brain against MPH induced anxiety and depression.