Epidemiology and Health System Journal
Year:2020 | Volume:7 | Issue:3|Papers Count:8

Menarche is a sign of puberty and the beginning of ovarian and other endocrine functions relating to reproduction. It is an important event demonstrating the end of childhood and the start of reproductive years for each woman that is preceded by the complex process of some hormonal changes in the puberty period. Moreover, it is an important clinical indicator of girls’ physical, nutritional, and reproductive health. Early age at menarche, as the onset of menstrual periods in girls, has a substantial effect on their physical and sexual health and is related to the increased risks of unfavorable health outcomes. Further, menarche appears to be associated with several risk factors of emergent chronic disease. In recent decades, the age at menarche has shown a gradual decline from 16-17 years to less than 13 years. Evidence indicates that childhood obesity is related to earlier menarche. Finally, this change may be partially explained by the global epidemic of obesity. . .

Background and aims: Cutaneous leishmaniasis (CL) is one of the most important parasitic diseases in the world. Sabzevar city is endemic area for CL in the north east of Iran. The aim of this study was to evaluate the time distribution of cutaneous leishmaniasis (CL) in Sabzevar County using the segmented regression model. Methods: This ecological study used the existing data related to the rural districts of Sabzevar County that were obtained from the Health Deputy of this county during 2011-2017. In addition, the segmented regression model was applied to evaluate the time trend of CLs. Finally, Joinpoint software was used for time series analysis. Results: A total of 1912 CL cases occurred in Sabzevar County from 2011 to 2017, with an incidence rate of 93. 61 per 100 000. The highest and lowest observed incidence rates were in 2011 (25 per 10 000 persons) and 2015 (3. 24 per 10 000 persons), respectively. Based on the results, the annual incidence of CL in the intended region decreased and the annual percent change was equal to-22. 40. Further, the time series analysis using segmented regression by rural districts showed a change point in the trend of the incidence of leishmaniasis in three rural districts (Pain Joveyn and Joghatai in 2014 and Qasabeh-ye Sharqi in 2013). In other words, the trend was different before and after the change point in the mentioned districts. Conclusion: In general, the results indicated that interventional, preventive, and therapeutic measures for breaking the chain of CL transmission in Sabzevar have been desirable in recent years. Eventually, it is suggested that further time-series studies be conducted at the level of the month or a longer interval in order to better evaluate the period effect and secular trend.

Background and aims: Although actual and perceived obesity are associated, some research has shown that this association may differ across racial and ethnic groups. Accordingly, this cross-sectional study tested racial differences regarding the association between actual and perceived obesity among American adults. Methods: The Health Information National Trends Survey (HINTS 5-Cycle 3) is a representative survey of American adults conducted in 2019. A total number of 3731 adults entered our analysis, including 3054 (81. 9%) non-Hispanic Whites and 677 (18. 1%) African Americans (AAs). The independent variable was actual obesity, which was defined as a body mass index of 30 or greater. The outcome was perceived as obesity. In addition, age, gender, marital status, education, and income were considered as control variables (confounders), and the race was the focal effect modifier. Finally, logistic regressions without and with interaction terms were utilized to analyze the data. Results: Overall, actual and perceived obesity were associated, with obese individuals having higher odds of seeing themselves as obese (odds ratio [OR] = 25. 82, 95% CI = 18. 58-35. 89, P < 0. 001). Furthermore, race showed a statistical interaction with actual on perceived obesity (OR = 0. 27, 95% CI = 0. 14-0. 55, P < 0. 001), indicating a weaker link between the two for AAs compared to non-Hispanic Whites. Race-stratified models also confirmed the same pattern with the actual and perceived obesity, showing a weaker association for AAs (OR = 15. 61, 95% CI = 9. 53-25. 59, P < 0. 001) in comparison with non-Hispanic Whites (OR = 46. 23, 95% CI = 27. 01-709. 14, P < 0. 001). Conclusion: AAs compared to non-Hispanic Whites differed in the effect of their actual obesity on their perceived obesity. This may explain the looser association of obesity and depression in AAs as compared to Whites.

Background and aims: Injection drug use is considered as an international public health threat that can lead to serious health-related outcomes. The aim of this study was to obtain a profile of injection drug users (IDUs) in Kermanshah, Iran, in 2017. Methods: This cross-sectional study was carried out on 606 male IDUs who were recruited from 2 drop-in centers in Kermanshah using a snowball sampling method. Continuous and categorical variables are expressed as the mean and standard deviation, as well as frequency and percentage, respectively. Results: The mean age of participants in this study was 36. 7 ± 8. 51 years and at first drug injection was 29. 35 ± 8. 04 years. In addition, the highest frequency of injection drugs belonged to heroin (99. 00%), methamphetamine (86. 00%), and opium (85. 00%), respectively. However, the lowest injection drugs were opium syrup (0. 50%), ecstasy (0. 50%), and amphorphine (0. 20%). Conclusion: Based on the findings of this study, heroin, methamphetamine, and opium had the highest frequency injection among male IDUs in Kermanshah, and the age of the first drug injection was low among these individuals. Accordingly, wider coverage prevention programs are highly recommended, including harm reduction programs, counseling centers with improved quality of services, treatment programs, and greater attention to human resource development-based counseling and education.

Background and aims: Leishmaniasis is one of the most overlooked diseases in tropical areas, which can lead to many deaths and illnesses. The present study was designed to determine the trend of cutaneous leishmaniasis in the south of Fars Province (south of Iran) during 2007-2016. Methods: The population of this cross-sectional study consisted of all people with cutaneous leishmaniasis referring to the Center for Infectious Diseases in Larestan, Gerash, Evaz, and Khonj in the south of Fars Province during 2007-2016. The incidence of cutaneous leishmaniasis was analyzed using the Cochrane-Armitage trend test, and the significance level was considered 5%. Results: In general, 4602 cases of cutaneous leishmaniasis were reported from 2007 to 2016. The highest and lowest incidence rates (659. 1 versus 88. 3 per 100 000 people) were observed in 2008 and 2012, respectively. In addition, the incidence of the disease significantly reduced (P Trend = 0. 003). Finally, the 0-4 age group had the highest incidence of the disease (69. 64 per 100 000 people), and the hands were the most common organ affected by cutaneous leishmaniasis (37%). Conclusion: According to the research findings, the incidence rate of cutaneous leishmaniasis is declining although leishmaniasis is still one of the endemic diseases in the region. Therefore, preventive and controlling interventional programs can be effective in reducing new cases of the disease, including the education of individuals, especially children, environmental cleanup, and extermination and control of stray dogs and rodents in the suburbs.

Background and aims: The diagnostic workup for pulmonary embolism (PE) includes D-dimer assay and computed tomographic angiography. Several D-dimer assays have been approved for PE diagnosis with different sensitivity and specificity. We aimed to study the sensitivity and specificity of the quantitative latex agglutination D-dimer assay used in a referral teaching hospital in Lebanon for the diagnosis of acute PE. Methods: Using a retrospective chart review, we studied 300 patients who had D-dimer test at Rafik Hariri University Hospital in the period between January 1, 2012 and December 31, 2013. Accordingly, 93 patients had a CT angiography after being suspected to have acute PE. A statistical table 2*2 was used to compare the results of CT angiography and D-dimer test. Results: Thirteen patients (13. 97%) had PE and 60 patients (64. 51%) had positive D-dimer test. Quantitative latex agglutination D-dimer assay had a sensitivity of 69%, specificity of 36%, and negative predictive value of 88%. False positive ratio was also 64%. Moreover, the receiver operating characteristic (ROC) curve was obtained with an area under the curve measuring 0. 527. Conclusion: Quantitative latex agglutination D-dimer assay has a high negative predictive value; thus, it can exclude a PE diagnosis if it is associated with low clinical pretest probability.

Background and aims: Quality of life (QOL) is poor in hemodialysis (HD) patients. High oxidative stress and inflammatory conditions disturb their normal physiological, emotional, and physical functions. This study aimed to assess the effects of pomegranate peel extract (PPE) alone and in combination with vitamin E (Vit E) as anti-oxidant and anti-inflammatory substances on QOL of HD patients using Shortform 36 (SF-36) QOL questionnaire. Methods: This study was a double-blinded, placebo-controlled randomized clinical trial on HD patients. A total of 100 HD patients were randomly divided into 4 equal groups as follows: Pom+Vit E group, which received 2 PPE tablets + 1 Vit E soft gel daily, Pom group, which received 2 PPE tablets+1 Vit E placebo soft gel daily, Vit E group, which received 1 Vit E soft gel+2 PPE placebo tablets daily, and Placebo group, which received 2 PPE placebo tablets + 1 Vit E placebo soft gel daily. The intervention duration was 8 weeks. The stratified block randomization method based on sex, age, HD duration, and employment status was used for randomization. Results: The mean age of participants ranged between 51 and 57 years with an HD duration of 9-11. 2 months. Bodily pain score and general health score significantly increased in the Pom group and Pom+ Vit E group. The emotional role functioning score of the Pom+Vit E group was significantly higher than that of the placebo group (P < 0. 05). Conclusion: The consumption of PPE and Vit E had beneficial effects on mental components but not the physical components of QOL. Moreover, combination therapy was more effective than single therapy.

Background and aims: This study aimed to compare non-Hispanic Black (NHB) and non-Hispanic White (NHW) American adults for the associations of educational attainment and household income with perceived racial discrimination. Methods: The 2010 National Alcohol Survey (NAS N12), a nationally representative study, included 2635 adults who were either NHB (n = 273) or NHW (n = 2362). We compared NHBs and NHWs for the associations between education, income, and perceived racial discrimination. We used linear regression for data analysis. Outcome was perceived racial discrimination; the predictors were educational attainment and household income; covariates were age and gender; and moderator was race. Results: In the total sample, high income was associated with lower levels of perceived racial discrimination, while educational attainment was not significantly associated with perceived racial discrimination. There was also an interaction between race and education but not household income, suggesting a difference in the association between educational attainment and perceived racial discrimination between NHB and NHW individuals. For NHW individuals, household income was inversely associated with perceived racial discrimination. For NHB individuals, however, household income was not related to perceived racial discrimination. For NHB but not NHW individuals, educational attainment was correlated with more not less perceived racial discrimination. Conclusion: High income protects NHW but not NHB individuals against perceived racial discrimination, and NHB individuals with high education levels report more not less perceived racial discrimination.