Iranian Journal of Public Health
Year:2009 | Volume:38 | Issue:4|Papers Count:20

Background: The goal was to upgrade and/or uprate the traditional non-contact array by producing few modifications in the configuration of this model in order to maximize light receiving of water from the UV lamp and a better disinfection. Methods: An innovative non-contact model was made with a design based on irradiation of water, which was flowing as two thin waterfalls around a UV lamp in order to have direct germicidal rays from all positions of the lamp. By this water circulating and traditional water flow in an ordinary canal below the lamp, UV light would reach every drop of water effectively. Another model which had been studied was a simple stair type design in which a bare lamp was fixed over the shiny steel steps. Results of water disinfection in two flow rates of 12 and 24 L/min were compared with traditional design at exactly similar conditions. Results: Disinfection in this new model produced more reduction in fecal coliforms concentration than the traditional array and the inactivation efficiency was specified to be 3.65 log reduction compared to 2.93 log, in the turbidity of 0.5 NTU. Besides, this new model was quite capable in disinfection of water with high turbidities up to 20 NTU. Conclusion: The reduction in disinfection efficiency at higher flow rates for new model was much less than traditional array. Results of water disinfection in the simple stair type were not wonderful and even it was less satisfactory compared to traditional model. The reason is that the flow of water was not set parallel to the length of the lamp.

Background: Coronary heart disease is one of the most important problems of public health. One risk factor is dyslipidemia. Evidence from molecular and animal research and epidemiologic investigations indicate that calcium intake may influence lipid metabolism. But intervention studies have produced conflicting results.Objective of this study was to determine the effects of calcium supplementation on serum lipid profiles in the face of caloric restriction in obese adults. Methods: A double blind randomized placebo-controlled trial on 40 adults with Body Mass Index (BMI)>25kg/m² was conducted in Iran University of Medical Sciences in 2006. Subjects were maintained for 24 weeks on a balanced deficit diet (-500 kcal/d deficit) and randomly assigned to two groups with 1000 mg ca/d as calcium carbonate, or placebo. A General Linear Model was used for the analyses. Results: There were no significant differences in variables at the 12th and 24th week between the two groups (P> 0.015). But the total cholesterol, LDL–C decreased significantly at the 12th and 24th week in the two groups compared to the initial values (P< 0.05). Ratios of TC/HDL–C,TC/LDL–C and LDL–C/HDL–C decreased significantly at the 12th and 24th week compared to baseline only in the calcium group (P< 0.05). Similarly, TG and VLDL–C decreased significantly at the 24th week compared to baseline only in the calcium group (P< 0.05). Conclusions: Twenty four weeks of supplementation with 1000 mg ca/d did not have any effect on serum lipoprotein beyond what can be achieved in an energy restricted diet in obese adults. Therefore further investigations are a necessity.

Background: Infant mortality is one of the main indexes in the assessment of a society’s access to the primary health care services. Many factors are involved in this regard. The present study aimed at determining the structural association between socio-economic variables and the rate of infant mortality rate.Methods: The required data and information were collected from the multiple indicator cluster surveys (MICS,1998), reports of the Statistical Centre of Iran (SCI) from the population indices in 2003, the project of Incomes and Costs of the Iranian Families (2002) and the National Health Survey on Iran (NHS- 1999). In this study dependent variable was IMR and independent variable was demographic and socioeconomic factors. The data were analyzed by Path Analysis method.Results: According to the standardized coefficients, the illiteracy rate of the women aged 15-46 years is one of the main factors that, not directly but indirectly awareness, attitude and performance of the women, increases IMR by as much as 0.8, partly about 0.3 due to the lack of access to the health services such as urbanity and the percentage of caesarean. In addition, the index of consumption costs has direct and decreasing effect of about 0.353 on the infant mortality rate. Conclusion: Reduction in women’s illiteracy rate, increase of the families, welfare and the present of access to high quality services are the most important factors that decrease IMR.

Background: Avian influenza virus (AIV) infection is a major cause of bird and human morbidity and mortality. We aimed to evaluate a specific and sensitive multiplex RT-PCR that can simultaneously detect influenza type A viruses and differentiate the two most important subtypes of avian influenza viruses H7 and H9 subtypes.Methods: A multiplex reverse transcriptase-polymerase chain reaction (mRT-PCR) was developed and optimized for the detection of type A influenza virus. Simultaneously avian H7 and H9 hemagglutinin subtypes was differentiated. Three sets of specific oligonucleotide primers were used in this test for type A influenza virus, H7 and H9 heamagglutinin subtypes.Results: The mRT-PCR DNA products were visualized by gel electrophoresis and consisted of fragments of 313 bp for H7 and 428 bp for H9 hemagglutinin subtypes, and 101 bp for type A influenza virus. The common set of primers for type A influenza virus were able to amplify a 101 bp DNA band for any of the other subtypes of influenza A virus Conclusion: The mRT-PCR assay developed in this study was found to be sensitive and specific. No specific amplification bands of the same sizes (313 and 428 bp) could be amplified for RNA of other influenza hemagglutinin subtypes, nor specific amplification bands of type A influenza (101 bp) for Influenza B, C, or other viral or bacterial pathogens tested in this study.

Background: Ardabil cancer registry is the first population-based cancer registry in Iran that was established in 2000. The first report from this registry revealed that Ardabil has one of the highest rate of gastric cardia cancer and the lowest rate of cervical cancer in the world. We aim to update the cancer incidence in this area by the second follow up report from this registry.Method: Data on all newly diagnosed cancer cases between 2004 and 2006 were actively collected. CanReg4 software was used for data entry and the data of cancer-related death were obtained from the comprehensive death registry system. Results: More than 4300 new cases were registered during 3 years. Diagnosis of cancer was based on histopathology in 69%, clinical investigation 8%, clinical only 5%, and Death Certificate Only (DCO) in 18% of cases. In terms of age-standardized rate (/100,000), the five leading cancers in men (excluding skin cancer) were stomach (51.8), esophagus (19.5), bladder (13.1), lung and bronchus (10.8), and colorectal (9.6); in women, they were stomach (24.9), esophagus (19.7), breast (11.9), colon and rectum (7.4), and brain tumors (6.9). According to death registration data, upper gastrointestinal cancers constituted more than 43% of cancer-related death in Ardabil.Conclusions: The ASR for gastric cancer is among the highest rate for this cancer in male and female in the world. Most of the cancers, especially in female, have a significant increase compared to previous report from Ardabil. This is most likely due to the change in the registration practice.

Background: Disability Weights (DWs) are main components for computing summary measure of population health (SMPH) and economic studies. They are specific for each community, but there are no previous studies in Iran. In this study, we investigated the feasibility of health state valuation (HSV) in Iranian population.Methods: Twelve cardiologists in 3 sessions of expert panels, defined 25 states, related to cardiovascular diseases (3 major and 22 specific diseases). From January to March 2008, 80 persons in 4 groups including: physicians, patients, patients’ families and general public’s (each group 20), were interviewed and valuated the states, using visual analogue scale (VAS) method. SPSS® 15 for window® (SPSS Corporation, Chicago, Illinois) was used for statistical analysis. Results: Data showed that the defined health states had various severities. All the 4 groups ranked the “3 major-diseases” and “very-mild” and “very-severe” states, similarly. Non-physicians were not able to differentiate among “valvular-diseases” and “pacemakers” properly. The reliability of responses was acceptable.Conclusion: VAS is an appropriate and reliable method for HSV in Iranian population. Non-physicians’ opinions can be consider in major cardiac diseases. Valuation of more specific situations must perform by physicians.

Background: We investigated whether the C-819T SNP of the CTLA4 gene is associated with Type 1 diabetes (T1D) for the Egyptian population, a multi-ethnic group. We determined if expression of the C-819T SNP correlated with onset of T1D for Egyptian children and the prevalence of this polymorphism with respect to gender.Methods: The association of the C-819T SNP in intron 1 of the CTLA-4 gene with T1D was investigated in 396 Egyptian patients £ 14 years old and 396 control subjects >24 years old, with a similar ratio of males to females in both groups. The diagnosis of T1D was made based on ketoacidosis or ketosis with severe symptoms of acute onset at presentation and continuous dependence on insulin. Controls were negative for anti-GAD antibodies and were greater than 24 years of age. Genotyping was performed using single strand conformation polymorphism (SSCP), temperature gradient gel electrophoresis (TGGE), polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and reverse dot blot (RDB). Results: The results demonstrated an association of the C-819T SNP in the CTLA-4 gene with T1D patients (P= 0.0096). This association was more pronounced in children £ 5 years of age (P= 0.0178) than in children 6-14 years of age (P= 0.0437). Moreover, this association was stratified by gender and age to female patients with age at onset 0-5 years old (P= 0.0186) more than male patient with the age at onset 0-5 years old (P= 0.3120). Conclusion: The results support an association of the C-819T SNP in the CTLA-4 gene with Egyptian children, specifically, females of onset age 0-5 years old.

Background: The Internet addiction, also described as pathological Internet use (PIU), is conceptualized by an individual’s inability to control his or her use of the Internet, which eventually causes marked distress and/or functional impairment. The aim of the present study was to investigate the prevalence of the PIU among adolescence, in relation to different Internet activities, and to excessive use of the Internet in Samsun, Turkey.Methods: A cross-sectional study was conducted between October 1 and 31, 2005 in Samsun, Turkey. In total, 1315 high school students (760 male, 555 female; mean age, 15.2±1.1 years) were recruited. A self-administered questionnaire and Young’s Internet Addiction Scale (IAS) was applied to the participants.Results: Although only 506 (38.5%) of the participants have a computer at their home, total 1054 (80.2%) used a computer at home or public, such as an internet cafe. Eight hundred and ten (76.9%) of the participants, used a computer, to access to the Internet. Of the internet users, 10(1.2%), 161 (19.9%) and 639 (78.9%) were Internet addicts (IAs), possible Internet addicts (PAs), and nonaddicts (NAs), respectively. It is found that males were more likely than females to be pathological users in this study (P< 0.05).Conclusion: Our results still demonstrate that the Internet plays an important role in the lives of Turkish adolescents.

Background: Tuberculosis remains a worldwide public health problem and India accounts for highest TB burden in the world. The aim of the study was to evaluate the trend and treatment outcome of tuberculosis (TB) cases treated under DOTS strategy at a district level in Karnataka, India.Methods: This was a Retrospective record based study conducted in Dakshina Kannada district of Karnataka, during January 2007 to April 2007. Patients registered for treatment in the entire district since its inception in 2003 to 2006 were considered for analysis.Results: Totally, 7620 patients were treated under DOTS strategy. Of these, 3308 cases (43%) were found to be new sputum smear positive for acid-fast bacilli (AFB). The case notification rate has increased from 55% in 2003 to 85% in 2005. The incidence of new sputum positive TB cases were maximum among productive age group (15-44 years) and was significant (χ2= 150.08, P=< 0.001). Males constituted 70% of the total new sputum positive TB cases and the difference seen in males and females was also statistically significant (χ2= 551.254, P< 0.001). Defaulter cases have been increasing among new smear positive cases and this was statistically significant (χ2=4.9, P= 0.03). Conclusion: The cure rate is declining along with the increasing default rate among new smear positive cases over a period.

Background: Marital satisfaction is affected by many factors. Satisfaction with one's sexual life tends to be a pivotal factor in marital satisfaction. In Iran, Socio-cultural and political limitations are obstacles for sexuality-related studies, therefore, insufficient information is available in the area. Unique in its own, in this paper we report how sexual relationships relate to marital satisfaction among Iranians.Methods: This descriptive-correlation study was conducted in 2007 in Tehran, continuous sampling was used to recruit 292 married men, and women aged 19-58 yr from selected hospitals in Tehran while visiting their hospitalized relatives. Sometimes the participants were couple too. Three questionnaires were used for data collection. The data were analyzed using descriptive and inferential statistics (x2، Fisher and Anova) with SPSS.Results: Marital satisfaction significantly relates to sexual satisfaction (P= 0/00). There was also a significant relation between sexual satisfaction and the following variables: age difference of couples (P= 0.04), length of marital life (P= 0.05), and a drug abused participant (P= 0.007). Of these variables, only the age difference of couples significantly relates to marital satisfaction (0.00).Conclusion: Findings suggest that sexual satisfaction plays a seminal role in marital satisfaction of Iranians. Therefore, we need to develop culturally appropriate practical strategies to improve Iranian couples’ awareness in sexuality issues as well as training them in communication skills through their sexual encounters.

Background: Lack of nutritional knowledge is one of the most important reasons of nutritional problems and consequently improper practice, which can lead to several complications. This study has been designed in order to compare knowledge, attitude and practices of the urban and rural households regarding iron deficiency anemia (IDA) in Boushehr, Golestan and Sistan & Balouchestan provinces in 2004.Methods: The sampling method at household's level in each province was the single-stage cluster sampling with equal size clusters. The necessary data were gathered with a structured questionnaire and via the interviews between the questioners and the eligible people in each household. Comparison of frequency of variables between urban and rural areas was tested by chi square test.Results: A total of 2306 households were selected as overall sample size. In urban areas, people recognized iron food sources better than rural areas. Knowledge level of respondents about vulnerable group for IDA and the favorite attitude of households toward IDA were better in urban areas of Sistan & Blouchestan and Golestan provinces. In Sistan & Balouchestan and Golestan, rural households who drank tea immediately before or after meal was more than urban ones. The majority of pregnant and lactating mothers (except for rural areas of Bushehr) did not take iron supplement regularly. Less than 60 percent of children used iron drop regularly.Conclusion: Knowledge, attitude, and practice levels of households toward IDA were not acceptable. One of the best ways of improving nutritional practice is nutritional education with focus on applying available food resources.

Background: The present study was conducted to know about the association between amount of smoking and mental health plus demographic factors in the Iranian adolescents.Methods: Data of this research was drawn from the National Health Survey in Iran from April 1999-March 2000. All 1745 adolescents aged 15-20 yr that were residence in the eight northwest provinces of Iran, were included in this study. In order to evident zero-inflation and because of sampling design, multilevel zero-inflated Poisson (ZIP) regression applied for analysis of data. We analyzed data with programs written with s-plus. Results: Zero-inflated part of ZIP model shows that gender of female effects to increase the chance of "not to smoke cigarette at all" (P< 0.001) and older adolescents are less at risk of smoking than younger (P= 0.036). It also shows that, unemployed (P= 0.028) and Housewife (P= 0. 003), adolescents are more at risk of smoking compare with student adolescents. Under Poisson part of this model, depression (P= 0.012) and gender of female (P< 0.001) are indirectly associated with number of cigarette smoked per day by adolescents.Conclusion: Among adolescent smokers, males smoke more number of cigarettes than females, younger teenager is more at risk of being a smoker than older ones and dropping out of high school is an important risk factor for smoking. We did not find any relation between mental disorders and being a smoker while we did for the relation between Number of Smoked Cigarette (NSC) and depression.

Background: We investigated the rate of vaginal childbirth and Cesarean and its causes in maternity wards of Imam Khomeini Educational Hospital in Ahwaz the capital city of Khuzestan Province and Al- Hadi Hospital in Shoostar as a traditional city. Methods: In this comparative descriptive study data were obtained from medical records of birth deliveries in six months (March to September) in year 2007. Data were analyzed using SPSS software. Results: The results show a total rate of 29% Cesarean and 71% vaginal childbirth in hospitals. The rate of Cesarean in Imam and Al -Hadi Hospitals was 23% and 33%, respectively. The main cause of Cesarean in Imam and Al-Hadi Hospitals was failure of labor progression (35% and 33%, respectively). Most Cesarean s were occurred in an age range of 20-25 yr. Conclusion: Comparing with international acceptable rate (20-22%), Cesarean rate in both hospitals was high. It seems special attention should be made by persons, committees or organizations in charge of community health to child birth practices in both hospitals.

Background: A new microextraction method named dispersive liquid-liquid microextraction (DLLME) for determination of chloroform in pool water and blood of swimmers after swimming is described. Methods: This method was performed based on coupling dispersive liquid-liquid microextraction (DLLME) with gas chromatography-mass spectrometry (GC-MS). Methanol and trichloroethylenes were used as the disperser solvent and the extraction solvents, respectively. The volumes of these solvents were optimized for pool water by central composite design. The study involved three indoor swimming pools and nine swimmers.Results: Chloroform concentration of pool water was 118-135 mg L-1 and of blood ranged from 1.26 to 1.66 mg L-1. Conclusion: Indoor swimming pools are closed environments presenting detectable levels of trihalomethanes (THMs). Chloroform (CHCl3) is the most represented THMs. Therefore, the presence of CHCl3 may be considered representative of the THMs. The new method DLLME was applied for determination of CHCl3 in pool water and blood of swimmers after swimming inside the indoor swimming pool. The method was optimized by experimental design. Chloroform concentrations in the specified pool waters were 135, 124, 118 mg L-1.

Background: Rice is one of the crops, which are prone to be contaminated with toxigenic fungi and their mycotoxins. This study aimed to investigate the natural occurrence of T-2 toxin in domestic and imported rice in Iran.Methods: In a cross-sectional descriptive study in winter 2007, 140 samples of imported rice (125 samples of Thai and 25 samples of Pakistani rice) and 60 samples of Iranian rice were collected from warehouses of canteens of governmental offices in Tehran. After grinding and methanol extraction of the rice samples, the amount of T-2 toxin was measured using a sandwich ELISA. INSTATA statistical software was used for data analysis. Results: All samples of rice were more or less contaminated with T-2 toxin but the amount did not exceed the permissible limit. Mean contamination of domestic and imported rice was 11.2±2.3 and 13±2.7 mg/kg, respectively. Regarding imported rice, mean of contamination was 14.5±4.6 mg/kg for the Pakistani rice and 12.6±2.2 mg/kg for the Thai rice. There was no significant difference between domestic and imported rice, nor did we find a meaningful difference among Iranian, Pakistani and Thai rice regarding the amount of contamination (P= 0.2).Conclusion: Although the amount of contamination is less than the safe limit, the extent of natural occurrence of T-2 toxin in rice in Iran indicates that contamination occurs somewhere in the production process. This, in turn, necessitates screening of rice for contamination with mycotoxins from farm to table.

Background: Acute lymphoblastic leukemia (ALL) is the most common subtype of childhood cancer. Chromosomal abnormality, specially the replacement of chromosomal material is one of the main reasons in generating leukemia, wherein the kind of translocation play a key role in managing the remedy. The goal of the present study was to develop a reliable, rapid, and cost effective method to detect translocations, which are the main sources of leukemia.Methods: Twenty seven samples were collected from leukemia affected individuals that were referred to the Shafa Hospital in Ahwaz from summer 2007 to spring2008. Total RNA was extracted from one milliliter whole blood, and then reversely transcribed using reverse transcriptase. Finally, multiplex RT-PCR was performed for each sample. Results: Cell lines (K562, Jurkat E 6.1) that are harboring known translocations were used as positive control, with additional internal control to prove false negative results. Translocations t (9; 22), t (12; 21), t (1; 19) and t (4; 11) were observed in patients that have been diagnosed with the ALL, respectively. No Translocation has been seen in individuals suffering lymphoma. Conclusion: Multiplex RT-PCR assay is an effective, sensitive, accurate, and cost-effective diagnostic tool, which can improve the ability to accurately and rapidly risk-stratify patients that were diagnosed with acute lymphoblastic leukemia.

Strategic planning defines the formal decision of a company for its future. Like all organizations, health care sectors need to prepare their strategic planning and act according to it. UNESCO chair in health education as a leader health sector, describes the course and steps for preparing its strategic planning based on SWOT analysis technique.

Background: The purpose of this study was to evaluate oral health attitude and behavior of a group of Turkish children aged between 6-12 years.Methods: A sample of 139 children attending Marmara University Dentistry School (MUDS) Department of Pediatrics Dentistry between December 2002 to April 2003 was selected.Results: The mean age for girls was 8.82 yr (SD=2.06) and for boys was 8.87 yr (SD= 2.04). The reported age of starting tooth brushing was 4.5. 11.5 % of children declared that they changed their brush once a year, 38.8 % twice a year and 25.9% three times a year. 52.5% of children declared that they learned the principles of tooth brushing and the use of dental care products from the MUSD Department of Pediatrics Dentistry dentists during their visits and 78% of those children have applied what they learned from them.Conclusion: It is found necessary to educate mothers of tooth brushing; since the children mostly receive their first training from their mothers. Besides, schools and kindergartens should provide oral hygiene instruction to parents and children.

Background: Fasciolosis is a well known parasitic disease of animals with public health importance. In Rasht and Bandar- Anzali, in Gilan Province, where experienced two large human fasciolosis outbreaks, no update information is available on animal fasciolosis. Paucity of information on animal fasciolosis in these regions and its possible impacts on human fasciolosis called us for carrying out this study. Methods: During 2005, coprologic surveys using flotation method were applied to fecal samples of 156 stray cattle, 171 calves, 178 sheep, 85 buffaloes, 79 horses and 10 samples from 10 different preserved animal manure collections to detect Fasciola egg.Results: Fecal samples of 32 % of sheep, 32.1% of cattle, 0% of calves, 17% of buffaloes, 50% of horses and 100% of animal manure samples harbored Fasciola egg. The mean intensity of Fasciola egg per gram of feces (EPG) was low (0-13). Conclusion: Fasciolosis was very prevalent among animals in studied regions. Because sheep breeding is not a common practice in Rasht and Bandar -Anzali and horse population is low, cattle and to a lesser extent buffalo were the predominant reservoir hosts of infection. Regular treatment of all animals with an effective flukicide and sanitation of animal manure through its preservation for two month should be applied in order to reduce the level of infection in animals, water, wild and cultivated vegetables and consequently human beings.

Background: The haplotype phasing is more useful than genotyping markers independently at carrier detection and prenatal diagnosis of diseases. The PAH gene region contains several markers used in detection of PKU disease. In the present study, the efficiency of BglII-EcoRI-VNTR haplotype phasing in Iranian family trios was investigated. Then, this information was compared with those obtained for unrelated individuals.Methods: Blood samples were collected from 20 healthy family trios and 60 unrelated individuals. The genomic DNA was extracted by use of salting-out procedure. The two markers BglII and EcoRI were genotyped by use of PCR-RFLP. The genotype of VNTR marker was identified by use of PCR and electrophoresis. The genotyping data obtained from family trios was used to infer haplotype phase. We also compared this data with results obtained from a widely used method for haplotype frequency inference from unrelated individuals, the PHASE program.Results: The haplotype phase of all members was only ascertained at eight family trios. The comparison of this data with the results obtained by use of PHASE program showed that eight haplotypes [211, 221, 215, 216, 214, 121, 225 and 111] were informative haplotypes in Iranian population. Conclusion: Since diversity of BglII-EcoRI-VNTR haplotypes was high in Iranian population, haplotype phasing at family trios was difficult. The results of this study showed that the genotyping data obtained from family trios could not provide enough information for BglII-EcoRI-VNTR haplotype phasing at Iranian PKU families and the genotyping of other family members was necessary at most cases.