The Investigation of Risk Factors Impacting Breast Cancer in Guilan Province

Joukar, Farahnaz,Ahmadnia, Zahra,Atrkar-Roushan, Zahra,Hasavari, Farideh,Rahimi, Abbas Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10

Introduction: Breast cancer is multifactorial therefore more recognition of risk factors is important in its prevention. Objective: This study was conducted in order to determine the factors influencing breast cancer in women referred to health centers in Guilan province in 2015-2016. Method: In a case- control study, 225 women with breast cancer were investigated. The control group consisted of 225 healthy women of the relatives (third-rank) whose phone numbers were obtained from the patients. Data were collected through telephone interviews. Results: The risk of breast cancer raised in women who have a family history of other cancers (OR= 3.5; 95% CI= 1.96-6.6), exposure to X-Ray (OR= 2.5; 95% CI=1.1-5.5), having more than 4 children (OR= 2.695% CI=1.2-4.8), age more than 36 years at first pregnancy(OR=2.3; 95% CI=0.7-5.1),primary levelof education (OR= 5.4;95% CI=2.8-11.2) and inadequate intake of fruit (OR=1.5; 95% CI=1-2.2). Also, presence of the following factors reduced breast cancer risk: regular menstruation (OR= 0.66; CI=0.4-0.9), duration of breastfeeding more than 12 months, less than 6 months and 7-12 months (OR=0.23; 95% CI=0.09-0.59, OR=0.29; 95% CI=0.17-0.49 and OR=0.03; 95% CI=0.01-0.08) and parity (OR=0.4; 95% CI=0.27-0.83) In multiple linear regression analysis of higher education (OR=0.16; 95% CI=0.03-0.77), using contraceptives for more than 16 years (OR=2.3; 95% CI=1.4-3.9), family history of other cancers (OR=6.1; 95% CI=1.9-19.3) and a history of X-Ray exposure (OR=4.4; 95% CI=1.07-18.1) were considered as predictive factors. Conclusion: The results of this study emphasize the importance of informing women about breast cancer risk factors. So, identification of these risk factors is required as important means of prevention and treatment of breast cancer.

Prioritization of Price Volatility Management Strategies in Construction Projects

Joukar, Alireza,Nahmens, Isabelina,Harvey, Craig Korea Institute of Construction Engineering and Ma 2017 Journal of construction engineering and project ma Vol.7 No.3

The existence of material price volatility in construction projects puts forward substantial risks for all parties involved. Depending on the parties involved in the project, type of contracts, and state of the market various risk management strategies are practiced by contracting parties to manage project risks related to price volatility. Unfortunately, in many cases companies fail to select an adequate approach to better manage volatilities of material prices due to the lack of a decision support system to aid in the selection of an appropriate strategy based on the project characteristics. The aim of this study is to identify critical project factors and align them to documented strategies to manage price volatility based on an extensive literature review and industry interviews. This study found Integrated Project Delivery (IPD) as the ideal strategy with respect to project duration; quantitative risk management methods with respect to the cost; and Price Adjustment Clauses (PAC) with respect to the risk allocation, as the top price volatility management strategies.

A comparative review on heart ion channels, action potentials and electrocardiogram in rodents and human: extrapolation of experimental insights to clinic

Siyavash Joukar 한국실험동물학회 2021 Laboratory Animal Research Vol.37 No.3

Electrocardiogram (ECG) is a non-invasive valuable diagnostic tool that is used in clinics for investigation and monitoring of heart electrical rhythm/conduction, ischemia/injury of heart, electrolyte disturbances and agents/drugs induced cardiac toxicity. Nowadays using animal models to study heart diseases such as electrical and mechanical disturbance is common. In addition, given to ethical consideration and availability, the use of small rodents has been a top priority for cardiovascular researchers. However, extrapolation of experimental findings from the lab to the clinic needs sufficient basic knowledge of similarities and differences between heart action potential and ECG of rodents and humans in normal and disease conditions. This review compares types of human action potentials, the dominant ion currents during action potential phases, alteration in ion channels activities in channelopathies-induced arrhythmias and the ECG appearance of mouse, rat, guinea pig, rabbit and human. Also, it briefly discusses the responsiveness and alterations in ECG following some interventions such as cardiac injury and arrhythmia induction. Overall, it provides a roadmap for researchers in selecting the best animal model/species whose studies results can be translated into clinical practice. In addition, this study will also be useful to biologists, physiologists, pharmacologists, veterinarians and physicians working in the fields of comparative physiology, pharmacology, toxicology and diseases.

Dietary Patterns and Risk of Breast Cancer in Women in Guilan Province, Iran

Ahmadnia, Zahra,Joukar, Farahnaz,Hasavari, Farideh,Roushan, Zahra Atrkar,Khalili, Malahat Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

Background: Several studies have pointed to roles of dietary and food groups in the pathogenesis of breast cancer, but information on dietary patterns among women with breast cancer and their healthy counterparts in Iran is limited. Therefore the present investigation was conducted in Guilan province in 2014-2015. Materials and Methods: In a case-control study, 450 women with breast cancer and one of their relatives (third-rank) were investigated. At first the phone numbers of patients in Razi Hospital in radiotherapy and chemotherapy and oncology centers of Guilan were taken. Data were collected through telephone interviews by the researcher. The questionnaire had two parts comprising demographic clinical and food frequency data including a list of 40 food items. To analyze the variables, Chi-square test and univariate logistic regression models were used. Results: In each group, 225 subjects were investigated. The majority of samples in both groups of experiment and control were consumed than two glasses of milk and dairy products per day. Regarding consumption of meat and its products, 56% of the cancer group had more than three servings per day while 26.7% of the control group had less than 2 servings per day. The majority of subjects had less than six servings of cereal per day. Some 54. 7 % of the cancer and 62.2 % of the control group consumed less than two servings of fruit per day. Consumption of vegetables in experimental and control groups were 52.9% and 76.9% respectively, more than five servings per day. There was a meaningful difference between two groups regarding the consumption of milk and dairy items (OR=0.6,95%CI= 0.4-0.9), meat and its products (OR=0.49,95%CI=0.3-0.7), bread and cereals (OR=0.4,95%CI=0.2-0.8), vegetables (OR=0.5,95%CI= 0.3-0.9). (P-value<0.05). Conclusions: The results of this study emphasize the importance of informing women, particularly those at higher risk of breast cancer, in relation to dietary factors.

Screening of Precancerous Gastric Lesions by Serum Pepsinogen, Gastrin-17, Anti-Helicobacter Pylori and Anti-Caga Antibodies in Dyspeptic Patients over 50 years Old in Guilan Province, North of Iran

Mansour-Ghanaei, Fariborz,Joukar, Farahnaz,Rajpout, Yaghoub,Hasandokht, Tolou Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.18

Background: The aim of this study was to investigate the value of serum gastric markers to differentiate between patients with precancerous lesions and nonatrophic chronic gastritis. Materials and Methods: Serum samples of 128 patients with dyspepsia who were candidates for endoscopic examination were tested for pepsinogen (PG I and PG II), PG I/II ratio, gastrin 17(G-17), anti-Helicobacter pylori (anti-H pylori ) and anti-CagA antibodies. Two sample t-tests, chi-square tests and Pearson's correlation analyses were used for analysis using SPSS (version 20). Results: PGI, PG I/II ratio values were decreased significantly in the precancerous lesion group (0.05, 0.001 respectively). The frequency of H pylori infection was significantly (p=0.03) different between the two groups ofthe study. Conclusions: We suggest PGI and the PG I/II ratio as valuable markers for screening of premalignant gastric lesions.

Gastric Precancerous Lesions in First Degree Relatives of Patients with Known Gastric Cancer: a Cross-Sectional Prospective Study in Guilan Province, North of Iran

Mansour-Ghanaei, Fariborz,Joukar, Farahnaz,Baghaei, Seyed Mohammad,Yousefi-Mashhoor, Mahmood,Naghipour, Mohammad Reza,Sanaei, Omid,Naghdipour, Misa,Shafighnia, Shora,Atrkar-Roushan, Zahra Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

Background & Objectives: In patients with gastric cancer, the most frequently reported family history of cancer also involves the stomach. The aim of this study was to assess the presence of gastric precancerous lesions in first-degree relatives of patients with gastric cancer and to compare the obtained results with those of individuals with no such family history. Methods: Between 2007 and 2009, 503 consecutive persons more than 30 years old were enrolled in the study covering siblings, parents or children of patients with confirmed adenocarcinoma of stomach. The control group was made up of 592 patients who were synchronously undergoing upper gastrointestinal endoscopy for evaluation of dyspepsia without gastric cancer or any family history. All subjects were endoscopically examined. Results: The overall prevalence of Helicobacter pylori was 77.7% in the cancer relatives and in 75.7% in the control group. Chronic gastritis was found in 90.4% vs. 81.1% (P<0.001). Regarding histological findings, 37(7.4%) of the study group had atrophy vs. 12(1.7%) in the control group (P<0.001), while no difference was observed for intestinal metaplasia (20.3%vs. 21.6%, P=0.58). Dysplasia were shown in 4% of cancer relatives but only 0.4% of the control group (P<0.001). There was no gender specificity. Conclusions: Findings of our study point to great importance of screening in relatives of gastric cancer patients in Iran.

Knowledge about Colorectal Cancer in Northern Iran: a Population-Based Telephone Survey

Mansour-Ghanaei, Alireza,Joukar, Farahnaz,Mansour-Ghanaei, Fariborz,Rasoulian, Javid,Naghipour, Mohammad Reza,Fani, Arezoo,Kazemnejad, Ehsan Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Background: Colorectal cancer (CRC) is one of the most common malignancies of the gastrointestinal tract. The aim of this study was to assess the general knowledge of CRC in individuals living in Rasht, Iran, using a population-based cross-sectional telephone survey. Materials and Methods: A total of 1557 participants between 18 and 80 years of age were interviewed using random sampling from the telephone directory. Knowledge of risk factors, symptoms, diagnosis, and prevention of CRC was assessed using a validated questionnaire. Results: The mean knowledge level of the 1,557 respondents (average age 46 y) was $13.5{\pm}4.29$ (maximum possible score = 26), and 46.4% (722/1,557) of the subjects achieved grades lower than the mean score. The mean scores for knowledge of symptoms and risk factors were $3.97{\pm}1.83$ (range: 0-7) and $5.17{\pm}1.65$ (range: 0-9), respectively. Older age, higher education, and employment were significantly associated with better scores for recognition of risk factors and warning symptoms. The majority of subjects correctly identified weight loss (70.2%; 1,093/1,557) and rectal bleeding (63.3%; 986/1,557) as symptoms of CRC, and that smoking (85.9%; 1,337/1,557) and a low-fiber diet (73.4%; 1,143/1,557) were risk factors. Approximately half of the subjects noted increasing age, genetic background and fried food as other risk factors. A considerable number (54.8%; 853/1,557) identified colonoscopy as a screening method for detecting CRC in asymptomatic patients. However, a third of the subjects in the target group for screening (${\geq}50y$) were not interested in undergoing screening, primarily due to a lack of symptoms. Conclusions: Our results suggest that the knowledge of CRC is poor among the public, and therefore greater attempts should be made to increase awareness. Public education emphasizing the risk factors and symptoms of CRC, as well as the importance of regular screening regardless of the presence of symptoms, may help to reduce CRC morbidity and mortality.

Does treatment of Helicobacter Pylori Infection Reduce Gastric Precancerous Lesions?

Mansour-Ghanaei, Fariborz,Joukar, Farahnaz,Mojtahedi, Kourosh,Sokhanvar, Homayoon,Askari, Kourosh,Shafaeizadeh, Ahmad Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.4

Background: Treatment of Helicobacter pylori (H. pylori) decreases the prevalence of gastric cancer, and may inhibit gastric precancerous lesions progression into gastric cancer. The aim of this study was to determine the effect of treatment on subsequent gastric precancerous lesion development. Materials and Methods: We prospectively studied 27 patients who had low grade dysplasia at the time of enrollment, in addition to dysplasia atrophic gastritis and intestinal metaplasia observed in all patients. All were prescribed quadruple therapy to treat H. Pylori infection for 10 days. Patients underwent endoscopy with biopsy at enrollment and then at follow up two years later. Biopsy samples included five biopsies from the antrum of lesser curvature, antrum of greater curvature, angularis, body of stomach and fundus. Results of these biopsies were compared before and after treatment. Results: Overall, the successful eradication rate after two years was 15/27 (55.6%). After antibiotic therapy, the number of patients with low grade dysplasia decreased significantly (p=0.03), also with reduction of the atrophic lesions (p=0.01), but not metaplasia. Conclusions: Treatment of H. pylori likely is an effective therapy in preventing the development of subsequent gastric premalignant lesions.

Knowledge about Gastric Carcinoma in North of Iran, A High Prevalent Region for Gastric Carcinoma: A Population-Based Telephone Survey

Mansour-Ghanaei, Fariborz,Joukar, Farahnaz,Soati, Fatemeh,Mansour-Ghanaei, Alireza,Naserani, Sara Bakhshizadeh Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.7

Background & Objectives: The most northern and northwestern regions of Iran are at a high risk for gastric cancer. The aim of this study was to assess the general population's awareness about risk factors, symptoms and signs, preventive methods and management of gastric carcinoma in a high prevalence city in the North of Iran. Methods: A cross-sectional population-based telephone survey which was conducted on 3,457 residents of Rasht, the capital city of Guilan Province, to assess their awareness regarding gastric carcinoma. The questionnaires contained demographic data and statements on respondents' knowledge about risk factors, symptoms and signs, prevention and management of gastric cancer which were filled by general practitioners after asking the subjects. Data were analyzed in SPSS14. P<0.05 was considered significant. Results: The mean knowledge score of the respondents was $5.05{\pm}1.37$ regarding risk factors of gastric carcinoma, $4.39{\pm}1.99$ regarding symptoms and signs, $6.0{\pm}1.22$ regarding preventive strategies, and $1.6{\pm}1.16$ regarding management. Totally the mean knowledge level of the respondents toward gastric carcinoma would be $17.1{\pm}3.97$ from the maximum grade of 29. The age group of 45-55 y/o, bachelor degree and higher, physicians and nurses, those who had cancer history in friends or had the history of gastrointestinal diseases showed significantly higher knowledge scores (P=0.001). Conclusion: There is a general lack of awareness of cancer risk factors, symptoms and signs, methods of prevention, and importance of early diagnosis and treatment. Educational programs should be developed to promote adherence to recommended screening guidelines.

Naproxen, isosorbide dinitrate and co-administration cannot prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: Randomized controlled trial

Fariborz Mansour-Ghanaei,Farahnaz Joukar,Ali Akbar Khalesi,Mohammadreza Naghipour,Masood Sepehrimanesh,Kourosh Mojtahedi,Sara Yeganeh,Hamid Saeidi Saedi,Saba Fakhrieh Asl 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.3

Backgrounds/Aims: Acute pancreatitis is the most widespread complication of endoscopic retrograde cholangiopancreatography. Here, we investigated the efficacy of rectal suppository naproxen, sublingual isosorbide dinitrate and their co-administration in the prevention of post-ERCP pancreatitis. Methods: This double-blind randomized clinical trial carried out from June 2015 to February 2016 at the Gastrointestinal and Liver Diseases Research Center in Rasht, Iran. A total of 585 patients were selected from candidates for diagnostic or therapeutic ERCP by using the simple sampling method. Patients divided into three groups. Group A received 500 mg naproxen, group B took 5 mg isosorbide dinitrate, and group C was co-administrated both agents before ERCP. The primary outcome measure was the development of pancreatitis onset of pain in the upper abdomen and increase of serum amylase activity more than 3 times over the upper normal limit (60-100 IU/L) within first the 24 h post-ERCP. Results: Totally, 80 patients developed PEP included 29 (4.9%), 24 (4.1%), and 27 (4.6%) patients in groups A, B, and C, respectively (p=0.845). Longer ERCP time (p=0.041), using diazepam (p=0.033), a higher number of pancreatic ducts cannulation (p<0.001), pancreatic duct injection (p=0.013), and using pancreatic stent (p=0.004) were the predisposing factors for PEP. Conclusions: Our findings indicated that prophylactic naproxen suppository or isosorbide dinitrate sublingually or co-administration had no significant difference in the prevention and severity of PEP, however, enhancing the endoscopist’s skills can be effective. Departments and educational hospitals should develop their assessment and quality assurance measures for the training of fellows’ not only technical training but also an understanding of the diagnostic and therapeutic roles of the procedure.