Mental health status among female sex workers in Tabriz,Iran

Female sex workers are a deprived part of Islamic communities. It is necessary for public health policy makers to have knowledge about their mental health status. This study aims to have an evaluation of mental health among female sex workers in Tabriz for the first time in northwest of Iran. In this cross-sectional study, 48 female sex workers who had accepted to be evaluated were included. Sociodemographic and general mental health statuses, using General Health Questionnaire (GHQ-28), were recorded. Those with GHQ-28 score more than 23/24 in the first session were thoroughly interviewed in a second session in order to find out their specific mental disorder, using Structured Clinical Interview for DSM-IV axis 1 and 2 Disorders (SCID 1 and 2). This study suggests that 62.5% of female sex workers suffer from a mental health problem which is in accordance with previous studies. Mood and anxiety disorder were two of the most common, and there were also records of personality disorders among participants of this survey. There were also high rates of addiction in female sex workers of this study. Based on findings of this study, high rates of mental disorders such as personality disorders, anxiety disorder, and mood disorder were detected among female sex workers in the northwest of Iran. Financial incentive was reported to be the primary motivation for choosing sex work as a source of income.

     

Effectiveness of dust control methods for crystalline silica and respirable suspended particulate matter exposure during manual concrete surface grinding

Concrete grinding exposes workers to unacceptable levels of crystalline silica dust, known to cause diseases such as silicosis and possibly lung cancer. This study examined the influence of major factors of exposure and effectiveness of existing dust control methods by simulating field concrete grinding in an enclosed workplace laboratory. Air was monitored during 201 concrete grinding sessions while using a variety of grinders, accessories, and existing dust control methods, including general ventilation (GV), local exhaust ventilation (LEV), and wet grinding. Task-specific geometric mean (GM) of respirable crystalline silica dust concentrations (mg/m3 for LEV:HEPA-, LEV:Shop-vac-, wet-, and uncontrolled-grinding, while GV was off/on, were 0.17/0.09, 0.57/0.13, 1.11/0.44, and 23.1/6.80, respectively. Silica dust concentrations (mg/m3 using 100-125 mm (4-5 inch) and 180 mm (7 inch) grinding cups were 0.53/0.22 and 2.43/0.56, respectively. GM concentrations of silica dust were significantly lower for (1) GV on (66.0%) vs. off, and (2) LEV:HEPA- (99.0%), LEV:Shop-vac- (98.1%) or wet- (94.4%) vs. uncontrolled-grinding. Task-specific GM of respirable suspended particulate matter (RSP) concentrations (mg/m3 for LEV:HEPA-, LEV:Shop-vac-, wet-, and uncontrolled grinding, while GV was off/on, were 1.58/0.63, 7.20/1.15, 9.52/4.13, and 152/47.8, respectively. GM concentrations of RSP using 100-125 mm and 180 mm grinding cups were 4.78/1.62 and 22.2/5.06, respectively. GM concentrations of RSP were significantly lower for (1) GV on (70.2%) vs. off, and (2) LEV:HEPA- (98.9%), LEV:Shop-vac- (96.9%) or wet- (92.6%) vs. uncontrolled grinding. Silica dust and RSP were not significantly affected by (1) orientation of grinding surfaces (vertical vs. inclined); (2) water flow rates for wet grinding; (3) length of task-specific sampling time; or, (4) among cup sizes of 100, 115 or 125 mm. No combination of factors or control methods reduced an 8-hr exposure level to below the recommended criterion of 0.025 mg/m3 for crystalline silica, requiring further refinement in engineering controls, administrative controls, or the use of respirators.     

Cancer Incidence in the Kurdistan Region of Iraq: Results of a Seven-Year Cancer Registration in Erbil and Duhok Governorates

Introduction: There are limited published data regarding the recent incidence trends of cancer in Iraqi Kurdistan. Methods: The present study assessed the epidemiological estimates of cancer incidence, as well providing a projection of future cancer trends in the upcoming decade by analysing the population-based cancer registry between 2013 and 2019, in both the Erbil and Duhok governorates. A retrospective analysis was performed on data retrieved from the Medical Statistics Department at the Ministry of Health, Kurdistan Regional Government (KRG). Results: The total number of female cancer patients was higher in both governorates, and the total incidence of patients with cancer increased by over 2x between 2013 and 2019 in Erbil and Duhok, from 73 to 174 patients/100,000 individuals for women, and 36 to 85 patients/100,000 individuals for men. Analysis indicated that the percentage of patients with cancer is projected to increase by >2x in the current decade, from 3,457 cases to 4,547 and 4,449 cases in the Erbil governorate; and from 1,365 to 2,633 and 2,737 cases in 2028 based on LSTM and bi-LTSM analysis in the Duhok governorate. Lung cancer (LC) and female breast cancer (BC) were the most prominent types of cancers diagnosed since 2013 in both the Erbil and Duhok governorates. Conclusion: The striking pattern of trends for both present and future cancer incidence rates require urgent solutions and comprehensive efforts to control risk factors that promote the increasing incidence of cancer in these two KRG governorates.     

Right bundle branch block is not a predictor of coronary artery disease

Right bundle branch block (RBBB) is considered as an important predictor of poor outcome in patients with acute myocardial infarction, but the prognostic implication of RBBB in patients with suspected coronary artery disease (CAD) is unclear. Furthermore, the association between RBBB and incidence of CAD also its influence on the severity of stenosis in coronary arteries has not been established. This study was designed to assess the relationship between RBBB and the presence and the severity of CAD in patients with suspected CAD. The study population consisted of 172 patients with RBBB and 174 patients with normal resting electrocardiography (ECG). Severity of CAD was defined as estimated Gensini score according to the degree, quantity and distribution of lesions in angiographic study. According to our study based on angiographic investigations, in patients with RBBB the prevalence of CAD was 77.3 percent versus 70.1 percent in patients with normal resting ECG (P=0.13). Also, there was no significant association between the presence of RBBB and magnitude of Gensini score (OR=0.87, P=0.62). However, male gender and history of diabetes mellitus were associated with higher Gensini score (OR=3.41; 95% CI: 1.96-5.93, P<0.0001 and OR=3.22; 95% CI: 1.77-5.87, P<0.0001 respectively). This study suggests that although RBBB was associated with more severity of stenosis in left coronary system (LAD&LCX), but as a whole there was no association between RBBB and the presence and severity of CAD.     

Do pelvic dimensions and prostate location contribute to the risk of experiencing complications after radical prostatectomy?

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Surgical complications are more commonly observed in older patients, men with a greater BMI, higher pretreatment PSA greater ASA score, and those who have a longer operative duration. In rectal cancer surgery and prostate cancer surgery, reports suggest that patients with a smaller pelvic size had a higher likelihood of having a positive surgical margin, assumedly due to a more challenging operation in an anatomically narrower pelvis. Whether complication rates are impacted by pelvic size and prostate location has not been investigated yet. To the best of our knowledge our study investigates the largest cohort to date where pelvic bony and soft tissue dimensions were measured on preoperative prostate MRI and correlated with medical and surgical complications to assess if these anatomical factors might impact or predict the development of medical or surgical complications. Anatomical factors that might contribute to the likelihood of developing complications after radical prostatectomy should be identified to adjust and optimize prostate cancer surgery. Preoperative MRI of the prostate and pelvis provides an optimal tool to measure pelvic size and prostate dimensions, as well as prostate location which might be associated with the development of complications after radical prostatectomy. Whether unfavorable anatomy such as a narrow and steep pelvis or a deeply‐situated prostate might lead to a technically more demanding operation, being associated with a higher probability of postoperative complications, remains unclear. Our data suggests that anatomical variation of the pelvis and prostate location do not significantly impact surgical technique in regard to the risk of developing complications after radical prostatectomy in the hand of experienced surgeons.

OBJECTIVE

? To assess if pelvic size, such as a narrow, steep pelvis, as well as prostate location in relation to the pelvic anatomy might have an impact on the likelihood of experiencing complications after radical prostatectomy.

PATIENTS AND METHODS

? In a standardized manner, different bony and soft tissue dimensions on preoperative staging MRI were retrospectively measured in a study cohort of 934 patients undergoing radical prostatectomy. Measurements were defined aimed at assessing pelvic size and prostate location. ? Medical and surgical complications after radical prostatectomy were meticulously reviewed and grouped into subcategories to assess whether a narrow, steep pelvis and an anatomically deeply situated prostate (which is thought to be more surgically challenging) might be associated with a higher likelihood of postoperative complications. ? Multivariate Cox regression was performed to assess if dimensions have a significant impact on the likelihood of postoperative complications.

RESULTS

? While known parameters such as a higher preoperative PSA and presence of comorbidities were associated with an increased risk of experiencing complications after surgical treatment, none of the dimensions assessed on preoperative MRI had a significant impact on the development of any medical or surgical complication.

CONCLUSION

? We report the largest cohort of patients where pelvic dimensions were evaluated in a standardized manner on preoperative MRI aimed at assessing anatomic factors and their impact on complications after radical prostatectomy. None of the measurements could significantly predict the likelihood of developing medical or surgical complications.     

Islet cell autoantibodies in patients younger than 20 years of age with recently diagnosed diabetes in Northwest of Iran

The presence or absence of islet cell autoantibodies is one of the most direct ways to distinguish between type 1 and 2 diabetic patients. The objective of the present study was to assess the prevalence of β-cell autoantibodies such as glutamic acid decarboxylase-65 antibodies (GADAs) and islet cell antibodies (ICA) among patients younger than 20 years of age with recently diagnosed diabetes in northwest of Iran. From 2006 to 2008, 163 patients were enrolled in this study. They were clinically classified into two groups: 136 with type 1 diabetes (T1D) and 27 with type 2 diabetes (T2D). Serum levels of GADAs, ICA and C-peptide were determined with enzyme linked immunosorbent assay (ELISA) kits. Fasting blood glucose and HbA1c levels were also determined. Chi-square test, independent t test and one-way analysis of variance were used for data analysis. The prevalence of GADAs in T1D patients was 33.1%, slightly lower than that of ICA 35.3%. Forty-eight patients (35.3%) with T1D were positive for ICA compared to only one (3.7%) in T2D patients. The overall occurrence of any autoantibody in T1D patients (60.3%) was significantly higher than that of T2D patients (18.5%) (P?<?0.001). There was a statistically different association with family history of diabetes among the autoantibody positive versus autoantibody negative patients with T1D (P?<?0.01). Our results confirmed the presence of GADAs and ICA in T1D patients in Iran, though roughly at a lower prevalence than that reported for Caucasian T1D patients, but very similar to other non-Caucasian ethnic populations.