ORIGINAL_ARTICLE
Microbiological Quality of Food Contact Surfaces in A Hospital Kitchen in Shiraz, Iran, 2014
Background: The consumption of healthy food is considered as an essential need to devoid the physical, chemical, and biological hazards. The importance of this issue is more conspicuous in places such as hospitals where people with somehow compromised immune systems are under treatment. Therefore, this research aimed to evaluate the microbiological quality of food contact surfaces in a kitchen in one of the hospitals of Shiraz University of Medical Sciences. Methods: In the present study, samples were taken from 48 food contact surfaces according to ISO 18593:2004(E) and placed into the bags containing diluting solution; they were then transferred to the laboratory for microbial analysis in the cold chain. The microbial analysis was carried out according to ISO 4833-1:2013 and BS ISO 4832:2006 for enumeration of total bacterial count and coliform. Results: Based on the results presented here, 39.6% and 85.7% of the samples showed acceptable contamination with regard to the enumeration of total bacterial and coliform count. Besides, 18.2% and 72.7 % of work surfaces groups (cutting board, table, and hand) showed acceptable contamination with regard to the enumeration of total bacterial count and coliform in comparison to the standards. Furthermore, 45.9% and 89.2% of other surfaces showed acceptable total bacterial and coliform count, respectively. Conclusion: The results showed that safe management of the kitchen, education of the staff and also improvement of the equipment used are necessary.
https://jhsss.sums.ac.ir/article_42786_02aa6d3bb8ba460000b48ce9f0c36bdb.pdf
2015-10-12
128
132
Total bacterial count
Coliform
Food contact surfaces
hospital
Mohammad Ali
Baghapour
1
Department of Environmental Health
Engineering, School of Health,
Shiraz University of Medical Sciences,
Shiraz, Iran;
AUTHOR
Seyed Mohammad
Mazloomi
smmazloomi@gmail.com
2
Research Center of Nutrition and Food
Sciences, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Kourosh
Azizi
azizik@sums.ac.ir
3
Department of Medical Entomology,
School of Health, Shiraz University of
Medical Sciences, Shiraz, Iran
AUTHOR
Razieh
Sefidkar
rozisefidkar@yahoo.com
4
Department of Environmental Health
Engineering, School of Health,
Shiraz University of Medical Sciences,
Shiraz, Iran;
LEAD_AUTHOR
Marzano M, Balzaretti CM. Cook-serve method in
1
mass catering establishments: Is it still appropriate
2
to ensure a high level of microbiological quality and
3
safety? Food control 2011; 22(12): 1844-50.
4
Veiros M, Proença R, Santos M, Kent-Smith L, Rocha
5
A. Food safety practices in a Portuguese canteen. Food
6
Control 2009; 20(10): 936-41.
7
Azevedo I, Albano H, Silva J, Teixeira P. Food safety
8
in the domestic environment. Food Control 2014; 37:
9
Lund BM, OâBrien SJ. Microbiological safety of food
10
in hospitals and other healthcare settings. Journal of
11
Hospital Infection 2009; 73(2): 109-20.
12
Buccheri C, Casuccio A, Giammanco S, Giammanco
13
M, La Guardia M, Mammina C. Food safety in hospital:
14
knowledge, attitudes and practices of nursing staff
15
of two hospitals in Sicily, Italy. BMC health services
16
research 2007; 7(1): 45.
17
Konecka-Matyjek E, MaÄkiw E, Krygier B, Tomczuk
18
K, StoÅ K, Jarosz M. National monitoring study on
19
microbial contamination of food-contact surfaces in
20
hospital kitchens in Poland. Annals of agricultural and
21
environmental medicine: AAEM 2012; 19(3): 457-63.
22
Lahou E, Jacxsens L, Daelman J, Van Landeghem F,
23
Uyttendaele M. Microbiological performance of a food
24
safety management system in a food service operation.
25
Journal of Food Protection 2012; 75(4): 706-16.
26
Polong T, Tombe B, Begani RK. Effectiveness of
27
cleaning and sanitation of food contact surfaces in
28
the PNG fish canning industry. DWU Research Journal
29
; 16: 68-81.
30
ISO 18593:2004. Microbiology of food and animal
31
feeding stuffsâhorizontal methods for sampling
32
techniques from surfaces using contact plates and
33
swabs. 2004.
34
ISO 4833-1:2013. Microbiology of the food chain
35
âHorizontal method for the enumeration of
36
microorganismsâPart 1:Colony count at 30 °C by
37
the pour plate technique. 2013.
38
BS ISO 4832:2006. Microbiology of food and animal
39
feeding stuffs Horizontal method for the enumeration
40
of coliform Colony count technique.2006.
41
Domenech-Sanchez A, Laso E, Perez MJ, Berrocal
42
CI. Microbiological levels of randomly selected food
43
contact surfaces in hotels located in Spain during
44
â2009. Food borne pathogens and disease 2011;
45
(9): 1025-9.
46
Legnani P, Leoni E, Berveglieri M, Mirolo G, Alvaro
47
N. Hygienic control of mass catering establishments,
48
microbiological monitoring of food and equipment.
49
Food Control 2004; 15(3): 205-11.
50
Di Ciccio P, Vergara A, Festino A, Paludi D, Zanardi E,
51
Ghidini S, et al. Biofilm formation by Staphylococcus
52
aureus on food contact surfaces:Relationship with
53
temperature and cell surface hydrophobicity. Food
54
Control 2015; 50: 930-6.
55
Balzaretti CM, Marzano MA. Prevention of travelrelated
56
foodborne diseases: Microbiological risk
57
assessment of food handlers and ready-to-eat foods
58
in northern Italy airport restaurants. Food control 2013;
59
(1): 202-7.
60
Saad M, See TP, Abdullah MFF, Nor NM. Use of Rapid
61
Microbial Kits for Regular Monitoring of Food-contact
62
Surfaces towards Hygiene Practices. Procedia-Social
63
and Behavioral Sciences 2013; 105: 273-83.
64
Garayoa R, Diez-Leturia M, Bes-Rastrollo M, Garcia-
65
Jalon I, Vitas AI. Catering services and HACCP:
66
Temperature assessment and surface hygiene control
67
before and after audits and a specific training session.
68
Food Control 2014; 43: 193-8.
69
Soares K, Garcia-Diez J, Esteves A, Oliveira I, Saraiva
70
C. Evaluation of food safety training on hygienic
71
conditions in food establishments. Food Control 2013;
72
(2): 613-18.
73
Tofighi Sh, Hamouzadeh P, Sadeghifar J, Raad Abadi
74
M, Roshani M, Salimi M, et al. The Compliance
75
Status of HACCP Implementation Requirements in
76
Nutrition Departments of the Selected Hospitals of
77
Tehran University of Medical Sciences. Jundishapur
78
Journal of Health Sciences 2012: 4(3): 15-23.
79
Baniardalan M, Sabzghabaee AM, Jalali M, Badri Sh .
80
Bacterial Safety of Commercial and Handmade Enteral
81
Feeds in an Iranian Teaching Hospital. International
82
Journal of Preventive Medicine 2014: 5(5): 604-10.
83
ORIGINAL_ARTICLE
Age, Sex and Site Specific Incidence of Cancer in Kohgilooyeh and Boyerahmad- Iran: A Province with Low Cancer Incidence (2007-2009)
Background: Cancer is the third cause of death in Iran and its incidence is rising alarmingly. However, a study reported that Kohgilooyeh and Boyerahmad (a small province in Iran) seems to have substantially lower incidence rate of cancer compared to the other parts of the country. This study is conducted to investigate the epidemiological features of cancer regarding three key factors (sex, age and sites of cancer). Methods: The data collection strategy for this study is similar to the Iranian National Cancer Registry programme. Results: For the study period (2007-2009), 660 eligible cases of cancer were reported to Kohgilooyeh and Boyerahmad’s National Cancer Registry provincial office with average annual age standardized rate (ASR)=64.58 per 100000 (74.95 per 100000 and 45.85 per 100000 for men and women, respectively). The five leading primary cancer sites for both genders in K and B are skin, stomach, blood, bladder and breast. Regarding the sex specific incidence rates of cancer, the skin, stomach, bladder, blood and prostate in men and the skin, breast, stomach, blood and ovary in women are suggested to be the five leading sites of cancer. The trends of age-site specific incidence rates of skin cancer obtained in the current study are essentially similar to what is expected. Conclusion: Compared to the national and international figures, significant differences were found in the age-site specific rates of cancer in the province.
https://jhsss.sums.ac.ir/article_42789_ea88e5bf912a531c845ebc3c5be96c38.pdf
2015-10-12
133
138
Cancer incidence
Age distribution
Gender
Hosein
Oriad
1
Social Determinants of Health Research
Center, Yasuj University of Medical
Sciences, Yasuj, Iran;
AUTHOR
Zafar
Parisai
2
Yasuj Health Center, Yasuj University of
Medical Sciences, Yasuj, Iran;
AUTHOR
Roksana
Estakhrian Haghigh
3
Namazi Hospital, Shiraz University of
Medical Sciences, Shiraz, Iran;
AUTHOR
Mehdi
Akbartabar Toori
4
Shiraz University of Medical Sciences,
Shiraz, Iran;
AUTHOR
Mohammad
Fararouei
fararooei@gmail.com
5
HIV/AIDS Research Center,
Shiraz University of Medical Sciences,
Shiraz, Iran
LEAD_AUTHOR
Mousavi SM, Gouya MM, Ramazani R, Davanlou
1
M, Hajsadeghi N, Seddighi Z. Cancer incidence and
2
mortality in Iran. Ann Oncol 2009; 20(3): 556-63.
3
Malekzadeh R, Bishehsari F, Mahdavinia M, Ansari
4
R. Epidemiology and molecular genetics of colorectal
5
cancer in Iran: a review. Arch Iran Med 2009; 12(2):
6
Babaei M, Jaafarzadeh H, Sadjadi AR, Samadi F,
7
Yazdanbod A, Fallah M, et al. Cancer incidence and
8
mortality in Ardabil: Report of an ongoing populationbased
9
cancer registry in Iran, 2004-2006. Iranian J Publ
10
Health, 2009; 38(4): 35-45.
11
Mehrdad R. Health system in Iran. JMAJ 2009; 52(1):
12
Etemadi A, Sadjadi A, Semnani Sh, Nouraie SM,
13
Khademi H, Bahadori M. Cancer registry in Iran: a
14
brief overview. Arch Iranian Med 2008; 11(5): 577-80.
15
S.C.I, Official report on Iranian census. 2011, Statistical
16
Center of Iran.
17
Jung KW, Park S, Kong HJ, Won YJ, Lee JY, Seo HG,
18
et al. Cancer Statistics in Korea: Incidence, Mortality,
19
Survival, and Prevalence in 2009. Cancer Res Treat
20
; 44(1): 11-24.
21
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ.
22
Cancer statistics, 2009. CA Cancer J Clin 2009; 59(4):
23
ORIGINAL_ARTICLE
Optimization of the Parameters Affecting the Fenton Process for Decolorization of Reactive Red 198 (RR-198) from the Aqueous Phase
Background: Recently, there has been a great concern about the consumption of dyes because of their toxicity, mutagenicity, carcinogenicity, and persistence in the aquatic environment. Reactive dyes are widely used in textile industry. Advanced oxidation processes are one of the cost-effective methods for the removal of these dyes. The main aims of this study were determining the feasibility of using Fenton process in removing Reactive Red 198 (RR-198) dye from aqueous solution and determining the optimal conditions. Methods: This is a cross-sectional study conducted at a laboratory scale. A total of 69 samples were considered and the effect of pH, Fe (II) concentration, H2O2 concentration, initial dye concentration and reaction time were investigated. Results: According to the results, a maximum removal efficiency of 92% was obtained at pH of 3 and the reaction time of 90 min; also, the concentration of Fe (II), H2O2, initial dye concentration were 100 mg/L, 50 mg/L, and 100 mg/L, respectively. The results revealed that by increasing the concentration of Fe (II), H2O2 and initial dye, the removal efficiency was increased. Conclusions: The results showed that Fenton process could be used as a cost-effective method for removing RR-198 dye from textile wastewater efficiently.
https://jhsss.sums.ac.ir/article_42790_a39e5b968fa68e03955696b32465d146.pdf
2015-10-12
139
145
Reactive Red 198
Waste water
Fenton process
Dye removal
Mansooreh
Dehghani
mandehghani@yahoo.com
1
Research Center for Health
Sciences, Department of Environmental
Health, School of Health, Shiraz
University of Medical Sciences, Shiraz,
Iran;
AUTHOR
Mahshid
Ghadami
ehe1392@gmail.com
2
Department of Environmental Health
Engineering, School of Health, Student
Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
AUTHOR
Talat
Gholami
3
Department of Environmental Health
Engineering, School of Health, Student
Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
AUTHOR
Marzieh
Ansari Shiri
4
Department of Environmental Health
Engineering, School of Health, Student
Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
AUTHOR
Zahra
Elhameyan
5
Department of Environmental Health
Engineering, School of Health, Student
Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
AUTHOR
Mohammad Reza
Javaheri
6
Department of Environmental Health
Engineering, School of Health, Student
Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
AUTHOR
narges
shamsedini
nshamsedin@sums.ac.ir
7
Department of Environmental Health
Engineering, School of Health, Student
Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Samaneh
Shahsavani
8
Department of Environmental Health
Engineering, School of Health, Student
Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
AUTHOR
Moradipasand L, Ayati B. Optimization of Reactive
1
Blue 171 dye removal using advanced process UV/H2O2.
2
Ninth International Congress on Civil Engineering.
3
Isfahan University of Technology 2012; 19-21.
4
Bahmani P, Maleki A, Ghahremani A, Kohzadi Sh.
5
Efficiency of Fenton oxidation process in removal
6
Black-B from aqueous medium. Journal Health and
7
Hygiene 2013; 4(1): 57-67.
8
Rezaee-Mofrad MR, Miranzadeh MB, Pourgholi M,
9
Akbari H, Dehghani R. Evaluating the efficiency of
10
advanced oxidation methods on dye removal from
11
textile wastewater. Journal Feyz 2013; 17(1): 32-9.
12
Hashemian S, Heidarian M. Removal of Indigo carmine
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by adsorption with sawdust .the 3rd National Conference
14
on Textile and Clothing Engineering. Yazd. 2011.
15
Anousha M, Samadi MT, Samarghandi M, Hossani N.
16
Evaluate the efficacy of advanced oxidation using TiO2/
17
UV in removal of acid dyes in textile effluent. Eleventh
18
National Conference on Environmental Health, 2008.
19
Mahvi AH, Heibati B. Removal Efficiency of Azo Dyes
20
from textile effluent using activated carbon made from wood and determination of isotherms of Acid Red 18.
21
Journal Health and Hygiene 2010; 1(3): 7-15.
22
Hasani Zonoozi M, Alavimoghaddam MR, Arami M.
23
Removal of C.I. Acid Blue 292 using Polyaluminum
24
Chloride. Journal of Color Science and Technology
25
; (2): 94-87.
26
Barghaee M, Hasani AH, Sharifi. Evaluation of
27
Performance moving bed biological treatment system
28
(MBBR) in Textile Wastewater Treatment. Journal of
29
Environmental Science and Technology 2011; 13(1):
30
Emami F, Tehrani-Bagha AR, Gharajig K. Influence
31
of Operational Parameters on the Decolorization of an
32
Azo Reactive Dye ( C.I. Reactive Red120) by Fenton
33
Process. Journal of Color Science and Technology
34
; (4): 105-14.
35
Dehghani MH, Norozi Z, Nikfar E, Vosoghi M,
36
Oskoei V. Investigation of Nano Alumina Efficiency
37
for removal of Acid Red 18 dye from aqueous solutions.
38
Journal Alborz Univ Med Sci 2013; 2(3): 167-74.
39
Maleki A, Zandsalimi Y, Shahmoradi B, Rezaie
40
R, Pordel M. Comparison of the efficiency of
41
photochemical processes combined with UV/H2O2
42
and UV/TiO2 in removal of Acid Red 18 from aqueous
43
solutions. SJKU 2012; 16(4): 101-8.
44
Bahmani P, Maleki A, Ghahremani A, Kohzadi SH.
45
Efficiency of Fenton oxidation process in removal of
46
Remazol Black-B from aqueous medium. Journal of
47
health 2012; 4(1): 57-67.
48
Noori motlagh Z, Shams khorram abadi Gh, Godini
49
H, Darvishi Cheshme Soltani R. Evaluate the
50
performance of ZnO nanoparticles on the photocatalytic
51
decolorization of methylene blue and COD removal
52
from synthetic wastewater. Journal Lorestan Univ Med
53
Sci 2012; 14(5): 51-61.
54
Yousefi Z, Mohseni Bandpei A, Dianati Tileki
55
RA, Malaki A, Alimohamadpur R, Ghahramani
56
E. Evaluation of the combined GAC-SBR system
57
performance in the removal of Yellow 3 and disperse
58
Yellow 3 Reactive dyes from the waste. Journal Mazand
59
Univ Med Sci 2012; 22(1): 41-9.
60
Nateghi R, Assadi A, Bonyadinejad Gh, Safa S.
61
Effectiveness of coagulation process in removing
62
Reactive Blue 19 dye from textile industry wastewater.
63
Journal of Color Science and Technology 2011; 5(1):
64
Alizadeh M, Bazrafshan E, Mahvi A, Kord Mostafapour
65
F, Ghahremani E. Efficiency of Pistaciaatlantica seed
66
extract as natural coagulant in the removal of Reactive
67
Red 198 dye from aqueous solution. SJKU 2014; 19(1):
68
Ay F, Catalkaya E, Kargi F. A statistical experiment
69
design approach for advanced oxidation of Direct Red
70
azo- dye by photo-Fenton treatment. J Hazard Mater
71
; 162: 230-6.
72
Ghaneian MT, Ehrampoush MH, Ghanizadeh Gh,
73
Dehvary M, Abootoraby M, Jasemizad T. Application
74
of solar irradiation/K2S2O8 photochemical oxidation process for the removal of Reactive Blue 19 Dye from
75
aqueous solutions. Journal Health & Environ 2010;
76
(2): 165-76.
77
Bouafia-Chergui S, Oturan N, Khalaf H, Oturan MA.
78
A photo-Fenton treatment of a mixture of three cationic
79
dyes. Procedia Engineering 2012; 33: 181-7.
80
American Public Health Association. Standards
81
Methods for the Examination of Water and Wastewaters.
82
th ed. Washington, DC: American Public Health
83
Association; 2005.
84
Asadi A, Nateghi R, Nasseri S, Mohammadiyan M,
85
Mohammadi H, Bonyadinejad Gh . Direct Poly Azo
86
Dye decolorization using nanophotocatalytic UV/NiO
87
process. Journal of Water and Wastewater 2011; (3):
88
Aliabadi M, Fazel Sh, Vahabzadeh F. Application of
89
Acid Cracking and Fenton processes in treating Olive
90
Mill wastewater. Journal of Water and Wastewater
91
; (57): 30-6.
92
Dehghani M, Farzadkia M, Shahsavani E, Samaei MR.
93
Optimizing photo-Fenton like process for the removal
94
of diesel fuel from the aqueous phase J Environ Health
95
Sci Eng 2014; 12(87).
96
Farzadkia M, Dehghani M, Moafian M. The effects
97
of Fenton process on the removal of petroleum
98
hydrocarbons from oily sludge in Shiraz oil refinery,
99
Iran. J Environ Health Sci Eng 2014; 12(31).
100
Ehrampoush MH, Ghaneian MT, Ghanizadeh GH,
101
Rahimi S. Application of TiO2/UV-C Photocatalytical
102
processes for the removal of Reactive Red 198 dye from
103
synthetic textile wastewater. Journal Yazd Univ Med
104
Sci 2011; 10(3): 65-81.
105
Shirmardi M, Khodarahmi F, Heidari Farsani M,
106
Naeimabadi A, Vosughi Niri M, Jafari J. Application
107
of oxidized multiwall carbon nanotubes as a novel
108
adsorbent for removal of Acid Red 18 dye from aqueous
109
solution. Journal of North Khorasan University of
110
Medical Sciences 2012; 4(3): 335-46.
111
Bazrafshan E, Biglari H. Survey on applicability of
112
Photo-Fenton process for humic acid removal from
113
aqueous sol. Journal Rostamineh Zabol Univ Med Sci
114
; 3(3): 10-19.
115
Mehrasbi MR, Safa S, Mahvi AH, Assadi A,
116
Mohammadi H. Application of photo-Fenton process
117
for COD removal from wastewater produced from
118
surfactant-washed oil-contaminated (TPH) soils.
119
Journal Health and Environ 2012; 5(4): 295-306.
120
Zarrabi M, Rahmaani AR, Samarghandi MR, Barjasteh
121
Askary F. Investigation the Zero-valence Iron (ZVI)
122
Performance in the Presence of UV light and hydrogen
123
peroxide on removal of Azo Dyes Acid Orange 7
124
and Reactive Black 5 from aquatic solutions. Health
125
Environ 2012; 6(1): 342-469.
126
Ay F, Catalkaya EC, Kargi F. A statistical experiment
127
design approach for advanced oxidation of Direct Red
128
azo-dye by photo-Fenton treatment. J Hazard Mater 31 Sun JH, Sun SP, Fan MH, Guo HQ, Lee YF, Sun RX.
129
Oxidative decomposition of p-nitroaniline in water
130
by solar photo-Fenton advanced oxidation process. J
131
Hazard Mater 2008; (153): 187-93.
132
Daneshvar N, Khataee A, Rasoulifard MH, Seyed
133
Dorraji M. Removal of organic dyes from industrial
134
wastewaters using UV/H2O2, UV/ H2O2/Fe (II),
135
UV/ H2O2/Fe (III) processes. Journal of Water and
136
Wastewater 2007; (61): 34-42.
137
Jafari Mansoorian H, Mahvi AH, Kord Mostafapoor
138
F, Alizadeh M. Equilibrium and synthetic studies of
139
methylene blue dye removal using ash of walnut shell.
140
Journal of Health in the Field 2013; 1(3): 48-55.
141
Hashemzadeh F, Rahimi R, Gaffarinejad A. Influence
142
of operational key parameters on the photocatalytic
143
decolorization of Rhodamine B dye using Fe2+/H2O2/
144
Nb2O5/UV system. Environ Sci Pollut Res Int 2014;
145
(7): 5121-31.
146
Dehghani M, Shabestari R, Anushiravani A,
147
Shamsedini N. Application of Electrocoagulation
148
Process for Reactive Red 198 Dye Removal from the
149
Aqueous Solution, Iranian Journal of Health Sciences
150
; 2(2): 1-9.
151
Dalvand A, Jonidi jafari A, Gholami M, Ameri A,
152
Mahmoodi NM. Treatment of synthetic wastewater
153
containing Reactive Red 198 by electrocoagulation
154
process. Journal Health & Environ 2011; 4(1): 11-22.
155
Asgari GH, Hoseinzadeh E, Taghavi M, Jafari J,
156
Sidmohammadi A. Removal of Reactive Black 5 from
157
aqueous solution using catalytic ozonation Process with
158
bone char. Journal Ahvaz Jundishapur Univ Med Sci
159
; 4(2): 21-30.
160
Ghaneian MT, Dehvari M, Jourabi Yazdi N, Mootab
161
M, Jamshidi B. Evaluation of efficiency of Russian
162
Knapweed flower powder in removal of Reactive
163
Blue 19 from synthetic textile wastewater. Journal of
164
Rafsanjan Univ Med Sci 2014; 12(10): 831-42.
165
Rahmani AR, Asgari GH, Barjasteh Askari F, Samadi
166
MT, Godini K. Investigation of the catalytic ozonation
167
performance using copper coated zeolite in the removal
168
of Reactive Red 198 from aqueous solutions. Journal
169
Ilam Univ Med Sci 2012; (21): 215-25.
170
Bazrafshan E, Kord Mostafapour F, Barikbin B.
171
Decolorization of Reactive Red 198 by means of
172
pistachio-nut shell ash. Journal Birjand Univ Med Sci
173
; 19(3): 266-76.
174
Eslami A, Massoudinejad MR, Ghanbari F, Veisi
175
F, Moradi M, Mehdipour F. Decolorization and
176
mineralization of real textile wastewater using
177
electrogenerated hydrogen peroxide in the presence
178
of copper ion. Journal Mazandaran Univ Med Sci 2013;
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(106): 103-11.
180
Mesdaghinia A, Mahvi AH, Fazlzadeh M, Dehghani
181
MH, Heibati B, Samdaliri Z, et al. Comparing efficiency
182
natural pumice and modified with iron in removal
183
Reactive Black 5 dye. Journal North Khorasan Univ
184
Med Sci 2013; 5(2): 449-58.
185
ORIGINAL_ARTICLE
Supplementation with Glucosamine Has no Adverse Effects on Glycemic Level and Insulin Resistance in Type 2 Diabetic Patients
Background: Use of glucosamine as an alternative treatment for osteoarthritis is becoming more frequent, including in those who have diabetes at the same time. The results from in vitro and animal studies propose that glucosamine may inversely affect glucose metabolism. However, the recommended dose of oral glucosamine in healthy people or diabetics did not have such effects consistently. The aim of the present study was to assess the effect of glucosamine on glycemic control and insulin resistance in type 2 diabetic patients. Methods: Fifty-four patients with type 2 diabetes participated in this randomized, double-blind, placebo-controlled study. The participants were assigned to receive 1500 mg glucosamine hydrochloride or placebo for 12 weeks. After determining their baseline characteristics, body mass index and dietary intake components, fasting blood glucose and fasting insulin were measured at weeks of 0, 8, and 12. Indices of insulin function including quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated by specific formulas. Independent t-test and general linear model repeated measures were used to analyze the data. Results: In the glucosamine group, the means of fasting blood glucose and insulin were 107.31±24.07 mg/dl and 8.75±4.37 μu/ ml, respectively at baseline, which reached 112.38±31.50 and 9.10±4.17 at week 12. In the placebo group, the mean for fasting blood glucose and insulin were 103.84±24.15 and 9.79±4.02 at the beginning of the study, which reached to 111.40±26.43 and 8.58±3.68 at week 12. The results showed that there were no significant differences in fasting blood glucose, insulin, HOMA-IR and QUICKI indices at all the studied time points (weeks of 0, 8 and 12) within or between the groups. Conclusion: Twelve weeks of a normal recommended dose of glucosamine supplements may not have adverse effects on glycemic control and insulin resistance in type 2 diabetic patients.Trial registration number: IRCT2014031811785N2.
https://jhsss.sums.ac.ir/article_42791_dc10c4c911b0918d6a342a13f5e6a0b4.pdf
2015-10-12
146
152
diabetes mellitus
Glucosamine
Blood glucose
Insulin Resistance
Zohreh
Mazloom
zohreh.mazloom@gmail.com
1
Professor, School of Nutrition and
Food Sciences, Shiraz University of
Medical Sciences, Shiraz, Iran;
LEAD_AUTHOR
Mohammad Hossein
Dabbaghmanesh
2
Professor, Endocrine and Metabolism
Research Center, Nemazee Hospital,
Shiraz University of Medical Sciences,
Shiraz, Iran;
AUTHOR
Mahsa
Moazen
mahsa_moazen@yahoo.com
3
PhD Candidate, Student Research
Committee, School of Nutrition and Food
Sciences, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Sara
Bagheri
4
MSc, Student Research Committee,
School of Nutrition and Food Sciences,
Shiraz University of Medical Sciences,
Shiraz, Iran
AUTHOR
Rahimi R, Nikfar S, Larijani B, Abdollahi M. A review
1
on the role of antioxidants in the management of
2
diabetes and its complications. Biomed Pharmacother
3
; 59(7): 365-73.
4
Oh S, Kalyani RR, Dobs A. Nutritional management of
5
diabetes mellitus. In: Ross AC, Caballero B, Cousins
6
RJ, Tucker KL, Ziegler TR. Modern nutrition in health
7
and disease. 11th ed. Philadelphia: Lippincott Williams
8
& Wilkins; 2014.
9
Gomez FE, Kaufer-Horwitz M. Medical nutrition
10
therapy for rheumatic disease. In: Mahan LK, Escott-
11
Stump S, Raymond J. Krauseâs food and the nutrition
12
care process. 13th ed. St. Louis, Mo: Elsevier/Saunders;
13
Scroggie DA, Albright A, Harris MD. The effect
14
of glucosamine-chondroitin supplementation on
15
glycosylated hemoglobin levels in patients with type
16
diabetes mellitus: a placebo-controlled, doubleblinded,
17
randomized clinical trial. Arch Intern Med
18
; 163(13): 1587-90.
19
Rahman N, Penm E, Bhatia K. Arthritis and
20
musculoskeletal conditions in Australia 2005, with
21
a focus on osteoarthritis, rheumatoid arthritis and
22
osteoporosis/ Australian Institute of Health and
23
Welfare. Canberra: 2005.
24
Anderson JW, Nicolosi RJ, Borzelleca JF. Glucosamine
25
effects in humans: a review of effects on glucose
26
metabolism, side effects, safety considerations and
27
efficacy. Food Chem Toxicol 2005; 43(2): 187-201.
28
Al-Saeed A. Gastrointestinal and cardiovascular risk
29
of nonsteroidal anti-inflammatory drugs. Oman Med
30
J 2011; 26(6): 385-91.
31
Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune
32
E, Bruyere O, et al. Long-term effects of glucosamine
33
sulphate on osteoarthritis progression: a randomised,
34
placebo-controlled clinical trial. Lancet 2001;
35
(9252): 251-6.
36
Derfoul A, Miyoshi AD, Freeman DE, Tuan RS.
37
Glucosamine promotes chondrogenic phenotype in
38
both chondrocytes and mesenchymal stem cells and
39
inhibits MMP-13 expression and matrix degradation.
40
Osteoarthritis Cartilage 2007; 15(6): 646-55.
41
Yu JG, Boies SM, Olefsky JM. The effect of oral
42
glucosamine sulfate on insulin sensitivity in human
43
subjects. Diabetes Care 2003; 26(6): 1941-2.
44
Stumpf JL, Lin SW. Effect of glucosamine on glucose
45
control. Ann Pharmacother 2006; 40(4): 694-8.
46
Tannis AJ, Barban J, Conquer JA. Effect of glucosamine
47
supplementation on fasting and non-fasting plasma
48
glucose and serum insulin concentrations in healthy
49
individuals. Osteoarthritis Cartilage 2004; 12(6):
50
Nakaishi Y, Bando M, Shimizu H, Watanabe K,
51
Goto F, Tsuge H, et al. Structural analysis of human
52
glutamine:fructose-6-phosphate amidotransferase, a
53
key regulator in type 2 diabetes. FEBS Lett 2009;
54
(1): 163-7.
55
Munoz N. Glucosamine reduces glycogen storage in L6
56
skeletal muscle cells [MSc thesis]: Washington State
57
University; 2007.
58
Hawkins M, Hu M, Yu J, Eder H, Vuguin P, She L, et al.
59
Discordant effects of glucosamine on insulin-stimulated
60
glucose metabolism and phosphatidylinositol 3-kinase
61
activity. J Biol Chem 1999; 274(44): 31312-9.
62
Dostrovsky NR, Towheed TE, Hudson RW,
63
Anastassiades TP. The effect of glucosamine on glucose
64
metabolism in humans: a systematic review of the
65
literature. Osteoarthritis Cartilage 2011; 19(4): 375-80.
66
Albert SG, Oiknine RF, Parseghian S, Mooradian AD,
67
Haas MJ, McPherson T. The effect of glucosamine on
68
Serum HDL cholesterol and apolipoprotein AI levels
69
in people with diabetes. Diabetes Care 2007; 30(11):
70
Namvaran F, Azarpira N, Rahimi-Moghaddam P,
71
Dabbaghmanesh MH. Polymorphism of peroxisome
72
proliferator-activated receptor γ (PPARγ) Pro12Ala in
73
the Iranian population: relation with insulin resistance
74
and response to treatment with pioglitazone in type 2
75
diabetes. Eur J Pharmacol 2011; 671(1-3): 1-6.
76
Pouwels MJ, Jacobs JR, Span PN, Lutterman JA, Smits
77
P, Tack CJ. Short-term glucosamine infusion does not
78
affect insulin sensitivity in humans. J Clin Endocrinol
79
Metab 2001; 86(5): 2099-103.
80
Monauni T, Zenti MG, Cretti A, Daniels MC, Targher
81
G, Caruso B,et al. Effects of glucosamine infusion on
82
insulin secretion and insulin action in humans. Diabetes
83
; 49(6): 926-35.
84
Biggee BA, Blinn CM, Nuite M, Silbert JE, McAlindon
85
TE. Effects of oral glucosamine sulphate on serum
86
glucose and insulin during an oral glucose tolerance
87
test of subjects with osteoarthritis. Ann Rheum Dis
88
; 66(2): 260-2.
89
Singh B, Saxena A. Surrogate markers of insulin
90
resistance: A review. World J Diabetes 2010; 1(2): 36-47.
91
ORIGINAL_ARTICLE
Leaching Zn, Cd, Pb, and Cu from Wastewater Sludge Using Fenton Process
Background: High amount of heavy metals in sludge is one of the major obstacles to its use on farms. The present study aimed to investigate the possibility of leaching heavy metals from wastewater sludge by Fenton method and determine the optimum level of parameters, such as iron, hydrogen peroxide, time, and pH for Fenton reaction. Methods: The effects of various parameters, such as pH (2-9), hydrogen peroxide concentration (0.5-6 g/l), Fe concentration (0.5-4 g/l), and leaching time (5-60 min), were studied. Results: The results showed that the optimal condition for leaching of heavy metals occurred at pH of 2 3, hydrogen peroxide concentration of 3 g/l, iron concentration of 2 g/l, and leaching time of 15 min. Under these optimal conditions, 92% of Zn, 100% of Cd, 100% of Pb, and 80% of Cu were leached from the wastewater sludge. Conclusions: Fenton method can leach heavy metals from wastewater sludge through decomposition of organic materials at H2O2/Fe ratio of 1.5:2.
https://jhsss.sums.ac.ir/article_42792_7ee953570656b6a6df712ad2f44dd9eb.pdf
2015-10-12
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159
Fenton
Heavy metals
Hydrogen peroxide
Wastewater sludge
Abooalfazl
Azhdarpoor
azhdarpoor@sums.ac.ir
1
Assistant Professor, Department of
Environmental Health, School of Health,
Shiraz University of Medical Sciences,
Shiraz, Iran;
LEAD_AUTHOR
Rabieh
Hoseini
2
MA student of Environmental Health
Engineering, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Mansoureh
Dehghani
mdehghany@sums.ac.ir
3
Associate Professor, Department of
Environmental Health, School of Health,
Shiraz University of Medical Sciences,
Shiraz, Iran
AUTHOR
Wu Q, Cui Y, Li Q, Sun J. Effective removal of
1
heavy metals from industrial sludge with the aid of a
2
biodegradable chelating ligand GLDA. J Hazard Mater
3
; 283: 748-54.
4
Yan X, Zhang F, Zeng C, Zhang M, Devkota LP, Yao T.
5
Relationship between Heavy Metal Concentrations in
6
Soils and Grasses of Roadside Farmland in Nepal. Int
7
J Environ Res Public Health 2012; 9: 3209-26.
8
Peng G, Tian G, Liu J, Bao Q, Zang L. Removal of
9
heavy metals from sewage sludge with a combination of
10
bioleaching and electrokinetic remediation technology.
11
Desalination 2011; 271: 100-4.
12
Dewil R, Baeyens J, Appels L. Enhancing the use of
13
waste activated sludge as bio-fuel through selectively
14
reducing its heavy metal content. J Hazard Mater 2007;
15
(3): 703-7.
16
Malakootian M, Mansoorian HJ, Moosavi S,
17
Daneshpazhoh M. Performance Evaluation of Fenton
18
Process to Remove Chromium, COD and Turbidity
19
from Electroplating Industry Wastewater. Journal of
20
water and wastewater 2011; 2: 2-10. (persion)
21
KAYNAK GE, FILIBELI A. Assessment of Fenton
22
Process as a Minimization Technique for Biological
23
Sludge: Effects on Anaerobic Sludge Bioprocessing.
24
Journal of Residuals Science & Technology 2008; 5(3):
25
Erden G, Filibeli A. Improving anaerobic
26
biodegradability of biological sludges by Fenton
27
pre-treatment: Effects on single stage and two-stage
28
anaerobic digestion. Desalination 2010; 251(1-3): 58-63.
29
Zhu Y, Zeng G, Zhang P, Zhang C, Ren M, Zhang J, et
30
al. Feasibility of bioleaching combined with Fenton-like
31
reaction to remove heavy metals from sewage sludge.
32
Bioresour Technol 2013; 142: 530-4.
33
Fu F, Xie L, Tang B, Wang Q, Jiang S. Application of a
34
novel strategy-Advanced Fenton-chemical precipitation
35
to the treatment of strong stability chelated heavy metal
36
containing wastewater. Chemical Engineering Journal
37
; 189-190: 283-7.
38
Zeng X, Twardowska I, Wei S, Sun L, Wang J, Zhu
39
J, et al. Removal of trace metals and improvement
40
of dredged sediment dewaterability by bioleaching
41
combined with Fenton-like reaction. J Hazard Mater
42
; 288: 51-9
43
Dewil R, Baeyens J, Neyens E. Reducing the Heavy
44
Metal Content of Sewage Sludge by Advanced Sludge
45
Treatment Methods. Environmental Engineering
46
Science 2006; 23(6): 994-9
47
Bulletin A. Determination of cadmium, lead and copper
48
in foodstuffs, waste water and sewage sludge by anodic
49
stripping voltammetry after digestion.
50
Chakinala AG, Gogate PR, Burgess AE, Bremner DH.
51
Treatment of industrial wastewater effluents using
52
hydrodynamic cavitation and the advanced Fenton
53
process. Ultrason Sonochem 2008; 15(1): 49-54.
54
Chakinala AG, Gogate PR, Burgess AE, Bremner DH.
55
Industrial wastewater treatment using hydrodynamic
56
cavitation and heterogeneous advanced Fenton
57
processing. Chemical Engineering Journal 2009; 152:
58
Hermosilla D, Cortijo M, Huang CP. Optimizing the
59
treatment of landfill leachate by conventional Fenton
60
and photo-Fenton processes. Sci Total Environ 2009;
61
(11): 3473-81.
62
Wang C-T, Chou W-L, Chung M-H, Kuo Y-M. COD
63
removal from real dyeing wastewater by electro-Fenton
64
technology using an activated carbon fiber cathode.
65
Desalination 2010; 253(1-3): 129-34.
66
Lin SH, Jiang CD. Fenton oxidation and sequencing
67
batch reactor (SBR) treatments of high-strength
68
semiconductor wastewater. Desalination 2003; 154(2):
69
Andrews JP, Asaadi M, Clarke B, Ouki S. Potentially
70
toxic element release by Fenton oxidation of sewage
71
sludge. Water Sci Technol 2006; 54(5): 197-205.
72
Miretzky P, Muñoz C. Enhanced metal removal from
73
aqueous solution by Fenton activated macrophyte
74
biomass. Desalination 2011; 271: 20-8.
75
Gulkaya Ä°, Surucu GA, Dilek FB. Importance of H2O2/
76
Fe2+ ratio in Fentonâs treatment of a carpet dyeing
77
wastewater. J Hazard Mater 2006; 3(136): 763-9.
78
Mandal T, Dasgupta D, Mandala S, Datta S. Treatment
79
of leather industry wastewater by aerobic biological
80
and Fenton oxidation process. J Hazard Mater 2010;
81
(1-3): 204-11.
82
Wang L, Yuan X, Zhong H, Wang H, Wu Z, Chen X, et
83
al. Release behavior of heavy metals during treatment
84
of dredged sediment by microwave-assisted hydrogen
85
peroxide oxidation. Chemical Engineering Journal
86
; 258: 334-40.
87
Pathak A, Dastidar MG, Sreekrishnan TR. Bioleaching
88
of heavy metals from sewage sludge: A review. J
89
Environ Manage 2009; 90(8): 2343-53.
90
Stylianou MA, Kollia D, Haralambous K-J, Inglezakis
91
VJ, Moustakas KG, Loizidou MD. Effect of acid
92
treatment on the removal of heavy metals from sewage
93
sludge. Desalination 2007; 215: 73-81.
94
Hosseini MH, Khodadadi M, Dori H. Heavy metal
95
concentrations in wastewater and sludgefrom
96
the factory would Ysazy Birjand in 2010. Journal
97
University of Medical Sciences Birjand 2013; 20(1):
98
-93. (persion)
99
ORIGINAL_ARTICLE
Phlebotomus papatasi (Diptera: Psychodidae) as the Vector of Leishmania Major in Kharameh District, Southern Iran
Background: Cutaneous Leishmaniasis (CL) is endemic in many parts of Iran. This study was conducted to investigate the fauna and some biologic factors of sand flies and detect CL vector(s) in Kharameh district which is one of the most important foci of the disease in Fars province, southern Iran. Methods: To identify the fauna, a total of 1549 sand flies were collected from April 2014 to March 2015. To determine the monthly activity, sand flies were collected from indoor and outdoor areas of the lowland and the highland regions. Results: Ten species of phlebotomine (four Phlebotomus spp. And six Sergentomyia spp.) were identified and Phlebotomus papatasi was the dominant species (53.45%). To determine the sand flies naturally infected by Leishmania spp., 188 female sand flies (145 P. papatasi, 29 P. sergenti, and 14 P. alexandri) were subjected to polymerase chain reaction (PCR) assay. Two (13.16%) specimens of P. papatasi were found to be positive for Leishmania major. Conclusions: To the best of our knowledge, this is the first PCR detection of L. major within naturally infected P. Papatasis and fly as the main vector in this region of south Iran.
https://jhsss.sums.ac.ir/article_42793_a094c0b4b30424efc2859f33a84aa215.pdf
2015-10-12
160
164
Sand flies
Fauna
Monthly activity
Kharameh
Iran
Zahra
Soltani
farscdc@sums.ac.ir
1
Department of Medical Entomology
and Vector Control, School of Health,
Shiraz University of Medical Sciences,
Shiraz, Iran;
AUTHOR
Mohammad Reza
Fakoorziba
fakoorziba@sums.ac.ir
2
Research Centre for Health Sciences,
Shiraz University of Medical Sciences,
Shiraz, Iran;
AUTHOR
Mohammad Djafar
Moemenbellah-Fard
3
Department of Medical Entomology
and Vector Control, School of Health,
Shiraz University of Medical Sciences,
Shiraz, Iran;
AUTHOR
Mohsen
Kalantari
kalantari22@yahoo.com
4
Research Centre for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran/Department of Health, School of Health, Mamasani Higher Education Complex for Health, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Mohsen
Akbarpour
5
CDC, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Hossein
Faramarzi
6
CDC, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Kourosh
Azizi
azizik@sums.ac.ir
7
Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran/Research Centre for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Pourmohammadi B, Motazedian MH, Kalantari M.
1
Rodent infection with Leishmania in a new focus of
2
human cutaneous leishmaniasis, in northern Iran. Ann
3
Trop Med Parasitol 2008; 102: 127-33.
4
Motazedian MH, Mehrabani D, Oryan A, Asgari Q,
5
Karamian M, Kalantari M. Life cycle of cutaneous
6
leishmaniasis in Larestan, Southern Iran. Infectious
7
Diseases and Tropical Medicine Research Center 2006;
8
Azizi K, RassiY, Moemenbellah-Fard MD. PCR-based
9
detection of L. Major KDNA within naturally infected
10
P.papatasi in southern Iran. Trans R Soc Trop Med
11
Hyg 2010; 104: 440-2.
12
Ardehali S, Moattari A, Hatam GR, Hosseini SM,
13
Sharifi I. Characterization of Leishmania isolated in
14
Iran. 1. Serotyping with species specific monoclonal
15
antibodies. Acta Tropica 2000; 31: 301-7.
16
Ghasemian M, Maraghi S, Samabafzadeh AR,
17
Jelowdar A, Kalantari M. The PCR-based detection and
18
identification of the parasites causing human cutaneous
19
leishmaniasis in the Iranian city of Ahvaz. Ann Trop
20
Med Parasitol 2011; 105: 209-15.
21
Azizi K, Abedi F, Moemenbellah-Fard MD.
22
Identification and frequency distribution of Leishmania
23
(L.) major infections in sand flies from a new endemic
24
ZCL focus in southeast Iran. Parasitol Res 2012; 111:
25
Azizi K, Rassi Y, Javadian E, Motazedian MH,
26
AsgariQ, Yaghoobi-Ershadi MR. First detection of L.
27
infantum in Phlebotomus(Larroussius) major (Diptera:
28
Psychodidae) from Iran. J Med Entomol 2008; 45:
29
Killick-Kendrick R. The biology and control of
30
Phlebotomine sand flies. Clin Dermatol 1999; 17:
31
Oshagi MA, Ravasan NM, Javadian E, Rassi Y, Sadraei
32
J, Enayati AA, et al. Application of predictive degree
33
day model for field development of sand fly vectors of
34
visceral leishmaniasis in northwest of Iran. J Vector
35
Borne Dis 2009; 46: 247-54.
36
Aransay AM, Testa JM, Morillas-Marquez F, Lucientes
37
J, Ready PD. Distribution of sand fly species in relation
38
to canine leishmaniasis from the Ebro Valley to
39
Valencia, northeastern Spain. Parasitol Res 2004; 94:
40
Fars Budget and Planning Organization Position of Fars
41
province: annual report. Management and Planning
42
Press 2000. (In Persian)
43
Smart J, Jordan K, Whittick RJ. A handbook for the
44
identification of Insects of Medical Importance. British
45
Musium (Natural History),Oxfords, Adlen Press 1956.
46
Lewis DJ. A taxonomic review of the genus
47
Phlebotomus(Diptera: Psychodidae). Bulletin of British
48
Museum 1982; 45: 121-209.
49
Theodor O, Mesghali A. On the Phlebotominae of Iran.
50
J Med Entomol 1965; 1: 285-300.
51
Motazedian H, Karamian M, Noyes HA, Ardehali
52
S. DNA extraction and amplification of Leishmania
53
from archived, Giemsa-stained slides, for the diagnosis
54
of cutaneous leishmaniasis by PCR. Ann Trop Med
55
Parasitol 2002; 96: 31-4.
56
Aransay AM, Scoulica E, Tselentis Y. Detection
57
and identification of Leishmania DNA within
58
naturally infected sandflies by semi-nested PCR on
59
minicirclekinetoplast DNA. Appl Environ Microbiol
60
; 66(5): 1933-8.
61
Rassi Y, Javadian E, Amin M, Rafizadeh S, Vatandoost
62
H, Motazedian MH. Merioneslibycus is the main
63
reservoir of zoonotic cutaneous leishmaniasis in south
64
Islamic Republic of Iran. East Mediterr Health J 2006;
65
Azizi K, Rassi Y, Javadian E, Motazedian MH,
66
Rafizadeh S, Yaghoobi-Ershadi M, et al. Phlebotomus
67
(Paraphlebotomus) alexandri: a probable vector of
68
L. infantum in Iran. Ann Trop Med Parasitol 2006;
69
Rassi Y, Gassemi MM, Javadian E, Rafizadeh S,
70
Motazedian H, Vatandoost H. Vectors and reservoirs
71
of cutaneous leishmaniasis in Marvdasht district,
72
Southern Islamic Republic of Iran. East Mediterr Health
73
J 2007; 13: 686-93.
74
ORIGINAL_ARTICLE
Clinical Guide for Family Physicians to Manage Type 2 Diabetes
Compiling clinical guidelines is one of the requirements of family physician plan and classification of health care services.1 The high prevalence of type 2 diabetes can easily be seen in general practice so that 2.5% of referrals to general practitioners are due to diabetes. More than half of the patients with Type 2 diabetes are left undiagnosed and most of them suffer from its complications at the time of diagnosis. For example, 6.2% of patients suffer from diabetic retinopathy at the time of diagnosis.2 Most patients diagnosed with diabetes take more than one type of medication to treat the complications; about 60% take only oral medications, and 14 percent take oral medications and insulin.3 Although the principles of care for people with Type 2 diabetes is well known, there is a gap between the quality of care in general practice and optimal care so that up to 50% of patients’ condition are weakly controlled.4 Chronic care model for patients with chronic diseases explains the necessary measures to improve the care of people with chronic diseases. These elements include supporting disease management by the patients themselves, patient care, and support teams. Consultation and training are often done in general practice while it is usually a brief consultation about weight, medication or exercise. There is little evidence that mere printed texts are effective in controlling the disease. Extensive training programs are designed to develop self-management skills for diabetes control.4 The implementation of clinical guidelines in medical practice is a challenging task. But, a number of evidences have been shown to accelerate effective clinical guideline implementation and care improvement.5 Management of diabetes mellitus type 2 is shown in Figure 1.
https://jhsss.sums.ac.ir/article_42787_f50bdc3b4528da02e9399f2b8b36caef.pdf
2015-10-12
165
166
Seyed Esmaeil
Managheb
managheba@sums.ac.ir
1
Quality Improvement in Clinical
Education Research Center, Education
Development Center, Shiraz University of
Medical Sciences, Shiraz, Iran;
LEAD_AUTHOR
Mesbah
Shams
2
Endocrinology and Metabolism
Research Center, Nemazee Teaching
Hospital, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Mahmood
Soveid
3
Department of Internal Medicine, School
of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Mohamad Hadi
Imanieh
4
Department of Pediatrics, Namazee
Hospital, Shiraz University of Medical
Sciences, Shiraz, Iran
AUTHOR
Mohsen
Moghadami
mohsen168@gmail.com
5
Department of Internal Medicine, School
of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Managheb SE, Shams M, Soveid M, Imanieh MH, Moghadami M. Screening
1
Type 2 Diabetes: A Clinical Guide for Family Physicians. J Health Sci
2
Surveillance Sys 2015; 3(3): 125-7.
3
Harch S, Reeve D, Reeve C. Management of type 2 diabetes, A community
4
partnership approach. Australian Family Physician 2012; 41(1/2): 73-6.
5
Harris M. Challenges in diabetes management. Australian Family Physician
6
Devitt M. ACP Updates Guideline on Oral Pharmacologic Treatments for
7
Type 2 Diabetes Mellitus. Practice Guidelines. American Family Physician
8
; 87(2): 142-4.
9
Redmon B, Caccamo D, Flavin P, Michels R, OâConnor P, Roberts J, et al.
10
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults. Institute
11
for Clinical Systems Improvement. Updated July 2014. www.icsi.org
12
Ehud Ur. Definition, Classification and Diagnosis of Diabetes and Other
13
Dysglycemic Categories. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes
14
; 37(1): 8-11.
15
Harper W, Clement M, Goldenberg R, Hanna A, Main
16
A, Retnakaran R, et al. Pharmacologic Management of
17
Type 2 Diabetes. Clinical Practice Guidelines for the
18
Prevention and Management of Diabetes in Canada.
19
Can J Diabetes 2013; 37(1): 61-8.
20
ORIGINAL_ARTICLE
Clinical Guidance on Screening Chronic Kidney Disease in Type 2 Diabetic Patients for Family Physicians
Incidence of diabetes is increasing in developing countries as well as Iran. Half of the patients are not aware of their disease so screening of diabetes is necessary. Lifestyle changes in society, high-saturated fat diet and decreased physical activity are the factors that influence the growing rate of diabetes in Iran.1 The need for addressing type 2 diabetes has been clarified for family physicians.2 Diabetes is a common disease that is associated with significant morbidity and mortality. It has an asymptomatic stage that may be present for up to several years before diagnosis.3 Diabetes is the leading cause of kidney disease.4 In a study among patients over 45 years with type 2 diabetes, these results were reported: 22% suffered from retinopathy, 7% had impaired vision, 6% had kidney diseases, 9% had clinical symptoms, and 19.1% were at risk for foot ulcers.5 Early treatment of type 2 diabetes can reduce or delay complications.6 Optimal glycemia and BP are important in the prevention of diabetic chronic kidney disease (CKD).4 Therapeutic goals in patients with complications, such as CKD, include maintaining renal function and stopping the trend of renal deterioration.5 Progression of diabetic nephropathy can be slowed through the use of some medications.4 How to screen and manage chronic kidney disease in patients with type 2 diabetes is shown in Figure 1.
https://jhsss.sums.ac.ir/article_42788_62fdb624383b1c0f66598c774e3d1cec.pdf
2015-10-12
167
168
Seyed Esmaeil
Managheb
managheba@sums.ac.ir
1
Quality Improvement in Clinical
Education Research Center, Education
Development Center, Shiraz University of
Medical Sciences, Shiraz, Iran;
LEAD_AUTHOR
Mesbah
Shams
2
Endocrinology and Metabolism
Research Center, Nemazee Teaching
Hospital, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Mahmood
Soveid
3
Department of Internal Medicine, School
of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Mohamad Hadi
Imanieh
4
Department of Pediatrics, Namazee
Hospital, Shiraz University of Medical
Sciences, Shiraz, Iran
AUTHOR
Mohsen
Moghadami
mohsen168@gmail.com
5
Department of Internal Medicine, School
of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran;
AUTHOR
Larijani B, Zahedi F. The epidemiology of diabetes in Iran. Journal of
1
Diabetes and Lipid of Iran 1380; 1(1): 1-8.
2
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