Iranian Journal of Public Health
Year:2013 | Volume:42 | Issue:5|Papers Count:16

The Mediterranean tradition offers a cousine rich in colors, aromas and memories, which support the taste and the spirit of those who live in harmony with nature. Everyone is talking about the Mediterranean diet, but few are those who do it properly, thus generating a lot of confusion in the reader. And so for some it coincides with the pizza, others identified it with the noodles with meat sauce, in a mixture of pseudo historical traditions and folklore that do not help to solve the question that is at the basis of any diet: combine and balance the food so as to satisfy the qualitative and quantitative needs of an individual and in a sense, preserves his health through the use of substances that help the body to perform normal vital functions. The purpose of our work is to demonstrate that the combination of taste and health is a goal that can be absolutely carried out by everybody, despite those who believe that only a generous caloric intake can guarantee the goodness of a dish and the satisfaction of the consumers. That should not be an absolute novelty, since the sound traditions of the Mediterranean cuisine we have used for some time in a wide variety of tasty gastronomic choices, from inviting colors and strong scents and absolutely in line with health.

Background: Several studies have been conducted in Iran in order to investigate the prevalence of depression among infertile couples. However, there is a remarkable diversity among the results. This meta-analysis was conducted to estimate an overall prevalence rate of depression among infertile couples in Iran.Methods: International and national electronic databases were searched up to June 2011 including MEDLINE, Science Citation Index Expanded, Scopus, SID, Mag Iran, and Iran Medex as well as conference databases. Furthermore, reference lists of articles were screened and the studies' authors were contacted for additional references. Cross-sectional studies addressing the prevalence of depression among infertile couples were included in this meta analysis. We assessed 12 separate studies involving overall 2818 participants of which 1251 had depression.Results: Overall prevalence rate of depression among infertile couples was 0.47 (95% CI: 0.40, 0.55). The prevalence rate of depression was 0.44 (95% CI: 0.32, 0.56) during 2000 to 2005 and 0.50 (95% CI: 0.43, 0.57 during 2006 to 2011. The prevalence rate of depression was 0.46 (95% CI: 0.39, 0.53) among women and 0.47 (95% CI: 0.40, 0.54) among men.Conclusion: Not only the prevalence of depression in infertile couples was high but also had increasing growth in recent years. Furthermore, despite many studies conducted addressing the prevalence of depression in infertile couples, there is however a remarkable diversity between the results. Thus, one can hardly give a precise estimation of the prevalence rate of depression among infertile couples in Iran now.

Background: This study was carried out to compare the effect between nutrition education intervention and non-nutrition education intervention on awareness regarding iron deficiency among schooling adolescents in Tanah Merah, one of rural district in Kelantan, Malaysia.Methods: This study which was started in year 2010 involved 280 respondents (223 girls, 57 boys, age: 16 yr) from schools in Tanah Merah. The selection criteria were based on hemoglobin level (Hb=7-11.9 g/dL for girls, Hb=7-12.9 g/dL for boys). They were divided into 2 groups. The first group received nutrition education package (Nutrition education, NE), whereas another group was entitled to receive non-nutrition education intervention (Non-Nutrition Education, NNE) (supplement only). Both interventions were implemented for 3 months. The changes in awareness among respondents of both groups were evaluated using multi-choices questionnaire.Results: Nutrition education receiver group (NE) demonstrated improvement in awareness at post-intervention. No substantial improvement was demonstrated by the counterpart group (NNE).Conclusion: Multimedia nutrition education program conducted at school setting was in fact practical and effective in improving awareness on iron deficiency among anemic adolescents.

Background: To evaluate off-label and off-NCCN guidelines uses of antineoplastic drugs in a major Chinese hospital.Methods: Totally 1122 patients were selected from July to December 2011. Then, the off-label and off-NCCN guidelines uses of antineoplastic drugs were analyzed.Results: In 798 of 1122 patients (71.12%), drugs were used for off-label. In 317 of 1122 patients (28.25%), the drugs were prescribed for off-label and off-NCCN guidelines.2591 medical orders for 1122 patients, 1051/2591 (40.56%) medical orders were off-label, 445/2591 (17.17%) medical orders were off-label and off-NCCN guidelines. In 445 off-label and off-NCCN medical orders, 399 (89.66%) were unapproved indications, 38 (8.54%) were unapproved drug concentration and 12 (2.70%) were unapproved route of administration. Percentage of off-label and off-NCCN guidelines drug uses in male was higher than that in female (21.92% vs.11.39%, P<0.01). Compared with other lines of treatment, percentage of off-label and off-NCCN guidelines drug uses in postoperative adjuvant was the smallest (P<0.01) and percentage in three or multi-line treatments was the highest (P<0.01). The pancreatic cancer possessed the highest percentage (38.74%) of off-label and off-NCCN guidelines drug uses among all types of cancer (P<0.01).Conclusion: Off-label uses of antineoplastic drugs are generally common in China hospitals based on NCCN guidelines. The fact suggests that anti-tumor treatment was relatively standard in China. Off-label and off-NCCN guidelines drug uses were mainly for individual treatment. Doctors should fully consider the adverse drug reaction, contraindication, cautions and increase the drug security monitoring. Uncorrected drug concentration should be avoided for drug risk.

Background: The aim of the study was to explore the mechanisms underlying the association of birth weight with later body mass index (BMI) from the biochemical markers related to metabolism and the Apa I polymorphism in IGF-II gene.Methods: A total of 300 children were selected randomly from the Macrosomia Birth Cohort in Wuxi, China. The height and weight were measured and blood samples were collected. Plasma concentrations of 8 biochemical markers were detected. Apa I polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Results: Biochemical markers were detected for 296 subjects and 271 subjects were genotyped for the Apa I polymorphism. No association was found between birth weight and 8 biochemical markers. In boys, the BMIs of AA, AG and GG genotypes were 16.10±2.24 kg/m2, 17.40±3.20 kg/m2, 17.65±2.66 kg/m2. And there was statistical difference among the three genotypes. But in girls, there was no statistical difference. The birth weights of AA, AG and GG genotypes were 3751.13±492.43 g, 3734.00±456.88 g, 3782.00±461.78 g. And there was no statistical difference among the three genotypes.Conclusion: Biochemical markers are not associated with birth weight. Apa I polymorphism may be related to child-hood BMI, but it may be not associated with birth weight. Therefore, biochemical markers and Apa I polymorphism might not play a role in the association of birth weight and BMI.

Background: Whilst there seem to be available data on blood pressure profiles of South African children, especially in urban areas, few data exist on rural children. The aims of this study were to determine the blood pressure profiles of rural South African children residing in Thohoyandou, and to examine the relationship between body mass index and blood pressure among the children.Methods: The study involved 296 (134 boys and 135 girls) children aged 7-13 years. Body weight and height were measured using standard procedures. Overweight was defined by body mass index (BMI) for gender and age. Blood pressure was monitored in each child thrice using validated electronic devices (Omron 7051T). Hypertension was determined as the average of three separate blood pressure readings where the systolic or diastolic blood pressure was³90th percentile for age and sex.Results: Overweight among the girls (4.7%) was higher compared with the boys (3.9%). Both systolic and diastolic pressures (SBP and DBP) increase with age in both sexes. The proportion of children with>90th percentile occur at only ages 12 and 13 years. The incidence of hypertension (SBP>90th percentile) was 0.4% and 0.2% in boys and girls, respectively. The SBP and DBP pressures significantly (P<0.05) correlate with age, body mass, height and BMI.Conclusion: Elevated blood pressure is prevalent among rural South African children residing in this region. Also, blood pressure increased with age in both boys and girls, and this positively correlated with age, body weight, height and BMI.

Background: The incidence and hematological effects of helminth infection during pregnancy were investigated among pregnant women in Isiala, Mbano, Southeast Nigeria.Methods: Totally 282 pregnant women were enlisted for the study between October 2011 and September 2012. Stool samples were examined for intestinal helminths using formalin-ether sedimentation technique. Hemoglobin (Hb) and Packed Cell Volume (PCV) levels were evaluated in venous blood samples using Sahli's and microhaematocrit methods respectively.Results: Forty six (16.3%) subjects were infected with at least one helminth parasite, 24 (8.5%) hookworm, 14 (5.0%) and 2 (0.7%) A. lumbricoides and Trichuris trichiura infections respectively. Intestinal helminthiases in pregnant women was significantly associated with age (P<0.05). The prevalence of intestinal helminthiases by parity was also significantly different (P<0.05) with primigravidae having the highest infection rate (27.5%). Hematological assessment showed that the prevalence of anemia among the women was 58.9% (mean±SD=9.3±1.0). The differences in hemoglobin levels by age groups was statistically significant (P<0.05). The contributory effect of gastrointestinal helminths in anemia showed that infected pregnant women had lower mean hemoglobin (8.60±0.22g/dl) than the uninfected (9.72±0.07g/dl). Significant difference (t-value=5.660, P<0.05) was observed between the Hb of the infected and uninfected pregnant women. In addition, infected pregnant women had mean PCV of 26.09±0.65% while the uninfected had 34.54±2.96%. The mean PCV of infected pregnant women was significantly different (t-value=0.013, P<0.05) from that of the uninfected.Conclusion Anti-helminthic therapy after the first trimester should be part of the antenatal programme. Intestinal helminth infection showed significant negative correlation with Hb and PCV and contributed moderately to anemia.

Background: Adipose tissue secretes a large number of adipocytokines such as leptin, resistin, and adiponectin. Many of these hormones and cytokines are altered in obese individuals and may lead to disruption of the normal balance between cell proliferation, differentiation, and apoptosis. The aim of our work was to investigate the disturbance of secretion of adiponectin and resistin in de novo and relapsed acute lymphoblastic leukemia (ALL) in Egyptian children and determine whether adiponectin and resistin are implicated in increased risk relapse compared to healthy individu-als.Methods: Measurements of adiponectin and resistin were performed at diagnosis, in 32 patients with de novo ALL aged 3 to 18 years (mean 9.8 y) and 19 children with relapsed ALL aged 5 to 17 (mean 9.9 yr).10 apparently healthy children with matched age and sex were used as controls.Results: Mean adiponectin levels were low (P<0.05), whereas mean resistin levels were high (P<0.05) at diagnosis and relapsed ALL (compared to healthy controls). A significant decrease of adiponectin levels was observed in re-lapsed ALL compared to de novo ALL. In contrast resistin was significantly increased in relapsed ALL compared to de novo patients. Adiponectin in ALL subjects inversely correlated with resistin level (r=-0.51, P<0.001).Conclusion: Low adiponectin and high resistin level at diagnosis suggest their implication in ALL pathogenesis and may serve as potential clinically significant diagnostic markers to detect leukemic relapse.

Background: During the past few years, there has been an increasing recognition that Internet is playing a significant role in the synthesis, the distribution and the consumption of Novel Psychoactive Substances (NPS).The aim of this study was to assess the online availability of NPS in Persian language websites.Methods: The Google search engine was used to carry out an accurate qualitative assessment of information available on NPS in a sample of 104 websites.Results: The monitoring has led to the identification of 14 NPS including herbal, synthetic, pharmaceutical and combination drugs that have been sold online.Conclusion: The availability of online marketing of NPS in Persian language websites may constitute a public health challenge at least across three Farsi-speaking countries in the Middle East. Hence, descriptions of this phenomenon are valuable to clinicians and health professional in this region. Further international collaborative efforts may be able to tackle the growth and expansion of regular offer of NPS.

Background: The aim of this study was to assess the levels of Maslow's hierarchy of needs theory had been fulfilled and to compare the Maslow's hierarchy of needs among Iranian different ethnic groups at Tehran University of Medical Sciences (TUMS).Methods: This research was a descriptive-analytical study which conducted among administrative employees of Tehran University of Medical Sciences, Tehran, Iran. The structured questionnaire consisted of 20 questions and demographic details. Each question had 4 parts to measure Maslow's hierarchy of needs. The questionnaire was distributed randomly among 133 employees to fill-up the demographic details and the other questions. Data was collected and analyzed by SPSS software, and One Way ANOVA, T-test, Spearman and Mann Whitney statistical methods.Results: TUMS ethnic groups of the employees placed most importance on Basic, Self-esteem and Self-actualization. In addition, we found that Persians, Mazandaranians, and Turks ethnic groups, scored the most mean for Maslow's hierarchical needs compared to the other ethnic groups.Conclusion: Basic needs and safety needs is available amongst the different ethnic groups in Iran. As though, self-actualization needs are ultimate human goal, Iranian employees' ethnic groups pay emphasis on these needs. We believe that new structures and work practices such as prevailing cultural values and beliefs of the society or the organizations must be explored if Iranian-based organizations want to remain responsive to the needs of the workplace.

Background: To provide the validated and standardized form of the Persian version of the Ages and Stages Questionnaires as an appropriate developmental screening tool for evaluation of Iranian children's development.Methods: This was a cross- sectional study. Translation and back-translation, content validity determination, cultural and lingual modifications, pilot study on 100 parents and inter-rater reliability determinations were performed, respectively. The national and final stage was carried out 11000, 4-60 month- old children in selected cities throughout the country in order to determine the validity, standard deviation, reliability, sensitivity, specificity, and mean scores points of the test.Results: The reliability, determined by cronbach's alpha ranged from 0.76 to 0.86 and the inter-rater reliability was 0.93. The validity determined by factor analysis was satisfactory. The mean scores of Iranian children were identified and compared with those of the normative sample as well as with three other populations of children. The developmental status of Iranian children was higher in the communication, problem-solving and personal-social domains, especially under the age of 24 months, after which their developmental status seems to deteriorate, especially in the motor domains.Conclusion: The Persian version of the ASQ has appropriate validity and reliability for screening developmental disorders in Iran.

Glomerular involvement occurs as a rare form of renal manifestation in Plasmodium falciparum malaria. Here, we report a rare case of falciparum malaria-associated IgA nephropathy. A 28-year-old man was admitted because of fever and abdominal pain. Ultrasound and computed tomography (CT) showed right kidney pyonenphrosis. Despite placing a nephrostomy tube, fever continued. Repeated CT was in favor of focal pyelonephritis. In addition, peripheral blood smear suggested malaria. Anti-malarial drugs were initiated and right nephrectomy was performed. One year after recovery from malaria, a persistent rise in serum creatinine was detected. A left kidney biopsy showed mesangial proliferation and dominant IgA deposits in immunofluorescence study while C1q was not deposited. The impression was IgA nephropathy with M1E0S0T0 of Oxford classification. The patient was prescribed a combination of low dose prednisolone and angiotensin converting enzyme inhibitor. Six months after treatment serum creatinine decreased from 1.6 mg/dL to 1.3 mg/dL and urine abnormalities were disappeared. Our findings suggest that malaria infection might be associated with IgA nephropathy.

Priority of health preservation and disease prevention to disease treatment is clear. During years, numerous studies with various aims have been done in relation with classification of health states based on some classification systems in order to determine level of healthiness among different groups of people. However it is thought that the need to classify interventions emerged for the first time in 1971, study of ancient medical sources results in getting some interesting things else. This study done through Qualitative research method on "Resale fi Hefzossehhat" authored by Galen, discusses about Galen's viewpoint about classification of health states.

Dear Editor-in-Chief: World Health Organization (WHO) has begun applying an approach known as Communication for Behavioural Impact (COMBI) in the design and implementation of behavioural-focused social mobilization and communication programmes for communicable diseases prevention and control as well as in Malaysia (1). A cross sectional study was carried out in Selangor, Malaysia to evaluate the effectiveness of the COMBI programme in prevent-ing and controlling dengue. The study conducted had qualitative (in-depth interview and a Focus Group Discussion) and quantitative components which compared the perception (knowledge, attitude and practice) from the community with COMBI and community without COMBI in Selangor. The programme did influenced the KAP of the respondents but only during its implementation weeks. The result from qualitative study was corres-ponded with conclusion made during a discussion in Asia Pacific Dengue Forum in February 2006 in Chiang Mai which listed weaknesses in dengue prevention and control programme in Asia Pacific countries including Malaysia (2). Problems on human resources and fund had significantly affected the sustainability of COMBI Programme in long term (3). A study in two districts in Khamphaeng Phet, Thailand in 2004 showed the same finding (4).The other study on KAP in Sao Paolo, Brazil in 1998 showed that urban residents with high economics and social status had a high level of knowledge on dengue (5).

Dear Editor-in-Chief: According to WHO report, the prevalence of HIV/AIDS in Iran has changed from low to concentrate. Despite the increase in awareness about HIV/ AIDS in many countries including Iran, there is a tremendous gap between the estimated (93250) and registered (24735) number of HIV infected individuals in this country (1, 2). This lack of knowledge is due to the long incubation period before symptoms appear, the iceberg appearance of the disease, hiding the infection because of social stigma and shortage of public access to counseling services. Moreover, limited access to diagnostic testing in high risk groups and the general public along with under-reporting or non-re-porting have resulted in detection of only a fraction of the people living with HIV. Although there is no prediction of a high peak occurring in the future in Iran, the likelihood of an unexpected outbreak cannot be ruled out (1).

Dear Editor-in-Chief: As one of the most populous country in the world, China's patients are also one of the largest in the world. China has emerged as the world's second largest economy after three decades of market transition (1), which has the largest number of ageing population and the aging population grows fastest in the world (2). Along with the social development, the human's physical life and spiritual life has been improved. More people are surviving cancer and chronic diseases such as heart disease, stroke. They need more considerable, professional family accompanies to make their life alive with warm and fragrant with happiness. But, under the pressure of work and life, most of their family members have no choice but to be away from home to work into the community, create social value.