HAKIM RESEARCH JOURNAL
Year:2001 | Volume:4 | Issue:2|Papers Count:14

This study was conducted to assess -the prevalence of cigarette smoking and to determine the age distribution of first smoking among senior high school students in Tehran.A total of 4023 students (2018 girls, 2005 boys) were asked for answering questionnaires , consist of the pattern of acquisition of smoking behavior, first smoking age, and continuing the habit.The population"s average age was 17.8.years. The results showed that in this group, the prevalence of smoking was 7.2% in boys and 1% in girls. Thirty five percent of boys and 26.9% of girls had experienced smoking.The average age of first cigarette experience was 14.29 years among girl smokers and 13.97 years among non smoker girls, who had experienced somking.Cigarette smoking experience was 9% before attending "school (before 6 years), 23.7% by the end of primary school (before 11 years age) and 40.5% by the end of the midschool (before 14 years age) among those girls who were habitual or experimental smokers. Cigarette smoking experience was 4.5% before attending school (before 6 years age), 22.7% by the end of primary school (before 11 years age) and 45.9% by the end of midschool (before 14 years age) among those boys who were habitual or experimental smokers.The average age of first cigarette experience was 14.36 years among habitual boy smokers and 13.7 years among non-smoker boys, who had experienced smoking.It was documented that the experience of somking was associated with a risk of 20% c in boys and 3% in girls, for transforning into habitual somking behavior. So there was a Significant effect. Boys were shown to be at greater risk The average age of fust smoking was similar in habitual and experimental smokers. irrespective of sex and the curve had two peaks in 9 and 14 years of age.Thus, it is suggested that the best period for implementation of preventing preventing are before these peaks.

In a retrospective survey, fertility history of Iranian women aged 15-49 years investigated in order to study the trend of stillbirth and the trend of stillbirth at first delivery of them during 4 decades from 1957 up to 1996. One per thousand of country population sampled through systematic and cluster (cluster of 14 . dwellings) sampling, which led to 9898 women aged 15-49 years who have had at least one delivery. Stillbirth rate of all deliveries of these women has been 12.8 and stillbirth rate at first delivery of them has been 18.0 per thousand. These rates for 5 years period at the end of study are 12.0 and 13.5 per thousand, respectively. Generally, stillbirth rates at first delivery have been more than stillbirth rates of all deliveries in all age groups and during, the same time periods. The most stillbirth rate of all deliveries with 18.6 per thousand belongs to women who are 15-19 years old and have had peregnancy during 1992-1996. The most stillbirth rate at first delivery with 28.3 per thousand belongs to women who are 45-49 years old and their first delivery has happend during 1957-1977 , the time that they have had less than 34 years old. Generally, the highest stillbirth rates both in first and all deliveries of women belong to the times that these women have had low ages, specially less than 15 years. This could be the result of their insufficient physical growth. The point to be noted in this study is the existence of partially low decrease of stillbirth rate with respect to the time. Ages 20-29 are the best for deliveries of women and the stillbirth of this group showes the lowest rate. Ages 20-24 have been the best for first deliveries since the stillbirth rate at first delivery of this group have had the lowest rates in all time periods.

In the past decade, diabetes prevalence and it"s associated factors have been studied in Islamshahr, Tehran, Isfahan and a few other urban areas of the country, but information on rural areas is little. In order to study the prevalence of diabetes and its associated factors in rural areas, 2705 subjects over 30 years of age were selected from 100 villages in Tehran province by stepwise random sampling. Fasting blood samples were obtained from each subject followed by feeding 75g glucose in the form of water solution. Second blood sample was collected after two hours for blood sugar measurement. Classification of diabetic, IGT and healthy people was based on WHO recommendations. The subjects comprised 1296 men (48%) and 1409 women (52%). The results showed that 7.6% of subjects (5.5% male and 9.5%female) were diabetic. Out of them 4.1% were known diabetics and in the remaining 3.5%, diabetes was newly diagnosed in this survey, while 7.5% (4.6% male and 10.1% female) had IGT. Sixty-five percent of the diabetics and 70% of the IGT subjects were females. Diabetes and IGT prevalence increased with age, rising from 2.8% and 4.8% in 30-39 years old to 8.5% and 13.5% in the over 70 years old subjects, respectively. Sixty-four precent of the diabetics, and 51 % of the IGT subjects were over 50 years old age. Two-thirds of the diabetics were illiterate. Percentage of illiterate subjects was higher in the diabetic and IGT group compared with the normal group (P<0.001). Forty percent of the diabetic, 32.5% of the IGT and 20% of the normal subjects had positive familial history of diabetes. Prevalence of diabetes and IGT was 13.6% and 10.9% in those with positive familial history ,of diabetes 5.9% and 6.5% in the negative familial history group, respectively. This survey showed high prevalence of diabetes and IGT in rural areas of Tehran province. Increased diabetes prevalence with age especially in women and in subjects with positive family history of diabetes is worthy of notice. Controlling the disease by correcting food habits, physical exercise and education of the individvals are recommended.

The purpose of this study was to evaluate functions of Health worker and health volunteers in mental health care delivery in the PHC system in Brojen city of Chaharmahal and Bakhtiary province. In order to determine the effectiveness of educational intervention on knowledge and attitude of individual, 800 people above 15 years of age were selected by randomized cluster. Sampling from rural and urban areas of Brojen as experimental group and 800 people above 15 years of age from rural areas of Ardal and urban areas of Shahrekord as control group. In order to assess the level of knowledge and attitude of individual, the knowledge and attitud questionnaire was used. Findings of this study has shown that "behvarzes" and "health volunteers" have been able to increase the knowledge of individuals of experimental group up. to 58% and 52% respectively, within 2 years, whereas for the control group of both rural and urban areas, this measure were 0.9% and 2.4%, respectively. In order to assess the change of attitude of individuals, results has shown by taking educational courses on mental health and transfering these concepts to the community, "behvarzes" and "health volunteers" have been able to make a positive alteration of about 25.4% and 21% in the attitude of individuals within 2 years in urban rural areas of experimental group, whereas for rural areas of Ardal, 0.5% and for urban areas of Shahrekord was 3%. In addition the findings has shown that the behvarzes could identify only 132 patients among 41889 population before educational intervention, whereas after 2 years implementation of this project, the number of patients reached to 561 (from 3.2 to 13.5per thousand of the population). In the urban areas of experimental group, health volunteers could identify only 34 patients and after 2 years implementation of the project 206 patients in the 66430 population of urban areas of Brojen (from 0.5 to 3.1 per thousand). Comparative study of case finding of behvarzes and health volunteers with investigation team has shown that behvarzes could identify 61.9%, whereas health volunteers only 9.2%. Based on this findings the project has achieved all its predetermined specific goals except on case finding of health volunteers, which volunteers need more time to be familiar in the society and use different methods of case finding.

A prospective semi-experimental study has been done to evaluate and compare two surgical techniques for correction of urinary incontinence (SUI) in women. In this regard 40 patients with urinary incontinence were evaluated and those had moderate to severe SUI (at least S=2 in SEAPI scoring system) were admitted for surgical repair. The patients who had any other abdominal surgery were chosen as group I (No=21) for using Burch technique, and the other patients as group II (No=19) underwent for corner bladder and bladder neck suspension or Raz technique. All patients have been followed up (Mean: 541 days). We have not found recurrence of urinary incontinence objectively in any patient of both groups. In group II, there were almost . mild complications and discomfort in outcomes in comparison with group I. This follow up is too short to allow us compare these techniques exactly and needs more investigatian. It could be demonstrated that success rate of these techniques were equal and their complications were not significantly different. According to this study when there is no need for abdominal approach, the Raz technique could be a good substitute.

Cardiovascular diseases are the leading cause of mortality in Iranian population and the most common cause of contacting with prehospital emergency system in Iran. Considering the weak role of number 115 in transportation of patients with chest pain to hospitals, only half of them really require it. For making a correct diagnosis and qualitative and quantitative improvement in providing emergency care, this study was designed to evaluate of using questionnary for determining the real cardiac patients, effect of attendance of highly educated Health Care professionals in screening patients and comparing this method, with the current method which is already used in EMS. This cross- sectional study was performed on 355 patients with chest pain that contacted with the Tehran EMS system with randomized selection and by using two types of questionnaire. Personnels involved in this study were E.M. Ts, nurses and general physicians. The relation between" chest pain features, cardiovascular risk factors, consciousness level, history of cardiac problem and patients outcome were examined and the sensitivity, specifictity and accuray of personnel function were compared by using of Spearman, Chi- square and T-test. The 45.5% of patients had Positive outcome and 54.5% of them had negative outcome. Age average of patients with positive coutcome was 6 years more than negative outcome patients. The relation netween chest pain severity and outcome was 33% Relative that of risk of having positive outcome in patients. with consciousness disorder was 1.4. With regard fo 3 question in question nary about chest pain, Consciousness disorder and heart disease history had 98% sensitivity and with 16% specificity. EMS rescuers performance had 96% sensitivity, 41% specificity and 65% accuracy (in general physicians, 100%, 70% and 85% respectively) Considering the limitation in the usage of more advanced resources in Iran for screening and earlier initiation of therapeutic measures - especially Telecardiography - simultaneous use of screening questionnaire and physicians attendance on patients bedside, not only causes the lowering of EMS system expenses, unneccessary missions and increasing role of EMS System in transportation of emergency patients, but also comparison to pesent situation, don"t produce significant difference in the rate of missed patients.

Nitroglycerin is one of the important vasodilator drugs, which is routinely used in the prophylaxis and treatment of angina pectoris. Various dosage forms of this drug are available in the national and international drug market. One of these dosage forms, which is not available in the national drug market, is the sublingual pump spray delivering a single dose of 0.4 mg nitroglycerin. Because of the numerous advantages of sublingual pump spray systems, including delivery of unit and uniform doses, fast absorption rate and with regard to the lack of this dosage form in the national drug market, this study was conducted to evaluate the efficacy of a formulated sublingual nitroglycerin solution without propellant factor. This formulation is capable of delivering 0.4mg nitroglycerin to the patient in each puff. For the purpose of comparing the results obtained from this study, a similar foreign brand (Nitrolingual) was used. Both the formulated sublingual spray and Nitrolingual spray underwent quality control tests including visual characteristics (colour, odour, taste and clarity), pH, viscosity and rheological behaviour, assay amount of nitroglycelin and content uniformity within each pull The results obtained showed that the formulated nitroglycerin pray is acceptable in terms of visual characteristics and has a desirable taste and odour of menthol. Both pH and the amount of nitroglycerin present within the formulated spray complied with that of Nitrolingual spray. The rheological behaviour of the formulated product was similar. to that of Nitrolingual spray and was found to be non-newtonian. Its viscosity was also less than the foreign product, but suitable for use. Finally, it was found that the prepared spray formulation was capable of delivering uniform and accurate doses of drug with each puff used and hence could be introduced as a desirable and effective product.

study was corned out on 722 pupils in the schools of Tehran for screening of group A beta-hemolytic streptococci (SHBGA) in their throats during years 1996-1997 (crosssectional study). Sampling from throats was performed in different ages followed by completing a questionnaire consist of students identification, history of recurrent sore throat, tonsillectomy and symptoms and signs that verified by physician like fever, chill, nasal discharge, throat exudate and painfull lymphadenopathy. Then statistical evaluation was conducted. Sampling and identification was carried out by culturing and Bacitracin and Latex co agglutination methods. Periodic prevalence rate was 3.7% . Infection rate in pupils in Eastern areas was higher in comparison with other areas (5.2%) which is statistically significant (P<0.05). Among 31 students with history of tonsillectomy 4 (2.9o/c) were infected to microorganism otherwise this organism did not isolate ,from students who had exudate. The tonsillectomized cases were seen to be more infected than other groups (P<0.05). Sensitivity of antisera test in comparison with culture was 85.2% and specificity was 100% .

Exposure to sulfur mustard results in short-term and long-term complications in injured people. The short-term complications are such as dermal depigmentation and blisters of the skin, respiratory disturbances and ophtalmologic symptoms like conjunctivitis. The long-term complications consist of chronic bronchitis, severe asthma and higher incidence of malignancy. The exposure to mustard gas also affects the hematopoietic and immune systems. T cells are a major component of most aquired immune responses. Its functions can be influenced by exposure to toxic agents such as mustard gas. Such adverse effects attenuate defence mechanisms which would otherwise operate to eliminate mutated cells, leading to a higher risk of neoplastic transformation. In this study 75 chemical weapon victims of the war between Iran and Iraq were devided in three groups depending on the severity of the complications (mild, moderate and severe). In addition ten subjects were not exposed to sulfur mustard comprised as the control group. Five milliliter of peripheral blood were collected from 85 subjects" and analysed for complete blood count, cell morphology and flow cytometry. Cell morphology was analysed by blood smear preparation and light microscopic examination under 100X objective. Blood parameters including WBC, RBC platelet counts and hemoglubin concentration were calculated using a Sysmex K-1000. Besides, blood cells were analyzed for CD45, CD3, CD4, CDS and CD25 cell markers. CD45+ / CD3+ /CD4+ were regarded as T helper cells (TH), and CD45+ / CDS+ T cells were considered cytotoxic T cells (Tc). CD25 expression was used as an activation marker. Statistical analysis of data were "performed using analysis "of variance (ANOVA) and Least Significant Difference tests. The higher expression of CD25 on CD3+/ CD4+ T cells suggets immune activation most probably resulted from recurrent infection such as bacterial pneumonia seen frequently in these patients. On the other hand, Lower numbers of CD8+ T cells may contribute to higher incidence of malignancy in these patients.

An investigation was carried out to assess different epidemiological aspects and vectorial capacity (V.C) of malaria vectors in Ghassreghand district, Sistan and Baluchistan, in 1997, which is one the hypoendemic areas of malaria in Iran. The study included two phases which were coincident with two peaks of malaria cases in late Spring and with higher prevalence in late Summer and Autumn. The mosquitoe"s age was determined on the basis of their ovary dissection and counting dilation of the ovalioles and in those with dangerous age their midgut and salivary glands were dissected to determine oocyst and sporozoite infection. In the first and second phases of study 14 and 21 percent of the main anopheles species had reached la dangerous age, respectively. Sporozoite infection was seen in one Anopheles culicifacies which were caught from outdoor in control (unsprayed) village in second phase of study. with regard to Use of new methods, low sporozoite rate in the anopheles vectors of malaria in this endemic area, time and technical skill requirement in salivary my glands dissection, were compared and stressed.