Vol 11 No 4 (2019)

Original Articles

  • XML | PDF | downloads: 748 | views: 393 | pages: 156-165
    Background: To assess socio-economic inequality in the prevalence of tobacco smoking among Iranian adults in 2010. Methods: Data from the fifth national STEPS survey were analyzed. A blinder- Oaxaca decomposition model was applied to assess socio-economic inequality in the prevalence of daily cigarette and water-pipe smoking in men and women. Results: Overall, 4,203 participants appeared to be in the first and fifth quintiles of SES For men, the prevalence of daily cigarette smoking was higher among those with low SES  (23.1%) than those with high SES (11.1%) (P<0.001), which was mainly related to educational level (8.6%), residential area (-2.7%) and being exposed to cigarette smoker at home/work (1.3%). Likewise, we found a higher prevalence of daily water-pipe use among low SES (4.4%) women than high SES women (1.3%), Education plays a significant role in this difference (P=0.003). Conclusion: In conclusion, our findings reflect a strong association of education and economic level with tobacco smoking. Such factors must be considered as a pivotal basis for the design of tobacco control program at national and sub-national scales.
  • XML | PDF | downloads: 635 | views: 289 | pages: 166-172
    Background: Because of the decreasing effect of metformin on insulin resistance, it has been suggested as an anti-obesity and anti-cancer drug. So, we aimed to study the effect of metformin therapy on tumor cell proliferation in non-diabetic breast cancer patients.Methods: We conducted a prospective clinical trial and studied the effect of metformin therapy on the level of Ki67 as a measure of tumor cell proliferation. Our primary endpoint was to evaluate the changes in Ki67. The intervention group consisted of 25 non-diabetic breast cancer patients with no indication for neoadjuvant chemo- therapy. They were followed up from the time of biopsy to operation. Metformin (1500 mg/day) was prescribed in the intervention group from the date of diagnosis until the surgery (2.8 weeks). Controls were 20 early breast cancer patients who had been followed up with no prescription from biopsy until operation.Results: We could not find any statistically significant difference between the two groups regarding baseline clinical or tumor characteristics such as age, stage, grade, estrogen receptor, HER2 status or time, and type of surgery. However, the immuno- histochemistry (IHS) study showed a decrease in median Ki67 from 35.14 to 29.6 in the intervention group (P-value= 0.02). While an increase from 24.5 to 30.6 was detected in the control group (P-value= 0.02). Both of these changes were statistically significant. Although mild gastrointestinal symptoms were seen in approximately 50% of cases, generally, patients tolerated metformin well. There was a correlation between the score of HOMA, a metabolic factor, and the changes in KI67.Conclusion: Metformin prescription in a short period of time between biopsy and definitive surgery leads to the inhibition of breast cancer cell growth. We found a relationship between metformin anti-proliferative effect and glucose and insulin metabolism.
  • XML | PDF | downloads: 449 | views: 254 | pages: 173-181
    Background: A substitution of G to T at nucleotide 1849 in exon 14 of the Janus kinase2 (JAK2) gene is recognized to MPNs disorders. Based on WHO guidelines detection of the mutation is very important to confirm the disease in the suspected patients. Methods: Eighty-seven patients with different background diseases were tested for JAK2 V617F mutation by four different methods, including polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP), amplification refractory mutation system (ARMS), polymerase chain reaction-high resolution melting(PCR-HRM), and two different commercial kits. Results: The mean age of patients was 53.38±17.43 years, 72.4% were males, and 37.6% were females. JAK2 mutation was detected in 16 patients (18.3%). Of those, 7 (43.75%) suffered from PV, 5 (31.25%) from ET, 3 (18.75%) from PMF, and 1 (6.15%) from unclassified neoplastic disorders. The frequency of JAK2 mutationwas 71.4% (5/7) in PV, 80% (4/5) in ET, and 66.7% (2/3) in PMF patients. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and GE of PCR-HRM for detection of the JAK2 mutation was 86.7%, 100%, 100%, 97.3%, and 97.7%, respectively. While the sensitivity, specificity, PPV, NPV, andGE of PCR-RFLP were 93.3%, 80.5%, 50%, 98.3%, and 82.7%, respectively. On the other hand, the sensitivity, specificity, PPV, NPV, and GE of ARMS assays were evaluated by about 80%, 96%, 100%, 96%, and 96.5%, respectively. Conclusion: This study showed that PCR-HRM was a more sensitive assay to detect the JAK2 V617F mutation than the other assays. So, it can be used as a quick, easy, and effective method for screening the JAK2 V617F mutation in patients with MPNs disorders. PCR-RFLP must accompany it as a gold standard method for confirmation of the mutation of JAK2 V617F.
  • XML | PDF | downloads: 367 | views: 272 | pages: 182-187
    Background: Preoperative psychological distress, including anxiety, stress, and depression, is an important issue in psychological pathology. It is of double importance among vulnerable groups such as patients with incurable chronic diseases (such as breast cancer) and simple diseases (such as cholecystitis). We assessed the development of anxiety and stress symptoms in two groups undergoing surgery; breast cancer patients and patients undergoing cholecystectomy. Methods: In a causal-comparative study, 30 participants were selected consecutively from a list of candidates for mastectomy and were compared with 30 patients undergoing cholecystectomy in terms of psychological distress. All samples completed the Depression, Anxiety, and Stress Scales-21 (DASS-21). Results: Our results showed that the average scores of stress (P < .000F=1/71), anxiety (P< .000F=117/556), and depression (P < .000F=3/41) were higher in patients with breast cancer surgery (mastectomy) than in those undergoing cholecystectomy surgery. Conclusions: Patients themselves have significant effects on the level of their stress. So, in this study, we attempted to examine the effects of stress and anxiety on people before surgery.