Iranian Journal of Public Health
Year:2015 | Volume:44 | Issue:8|Papers Count:24

Violence is a great challenge threatening the world peace. It includes a wide range of behaviors like; fight, war and genocide. There are different definitions of violence. Therefore, providing a suitable definition is necessary. In literature, according to the cultural and social text, there are different definitions for violence. The definitions are pro-vided based on the goal of research and text. The best definition is provided by WHO: "It covers a wide range of acts, going beyond physical acts to include threats and intimidation. It also includes the myriad and often less obvious consequences of violent behavior, such as physical harm, deprivation and mal development that compromise the well-being of individuals, families and communities."

Background: Gestational Diabetes (GD) is one of the major public health issues. The purpose of the present study was to perform a systematic review and meta-analysis to assess the risk factors and prevalence rate of this disorder in Iran.Methods: This systematic review and meta- analysis article was prepared using the databases of Science Direct, Pub-Med, Scopus, Magiran, Iranmedex and SID, Google search engine, Gray Literature, reference lists check and hand searching using keywords such as "prevalence", "gestational diabetes mellitus", "GDM", "risk factor*", "Iran" and "Postpartum Diabetes". The selected papers were fully reviewed and the required information for the systematic re-view was extracted and summarized using extraction table in Microsoft Office Excel software.Results: Twenty-four of 1011 papers were quite relevant to the objectives of the review so they were included. The mean age of the participants was 29.43±4.97 yr and the prevalence of GDMwas 3.41% (the highest and the lowest prevalence rates were 18.6% and 1.3% respectively). Among the influential factors mentioned in the literature, potential causes of GDM are gestational age, history of gestational diabetes, family history of diabetes, body mass index, abortions and parity, and history of macrosomia.Conclusion: Considering the high prevalence of postpartum diabetes and its related factors in Iran, strategic planning for disease prevention and reduction is inevitable.

Background: This study aimed to investigate the association of seven common inflammatory diseases with Type 2 diabetes (T2D) in the Chinese Mainland population.Methods: Participants were recruited from a great swathe of mainland from 2009 to 2013 for the cohort study. The demographic characteristics between patients with T2D or with inflammatory diseases, including age, sex, smoking status, hypertension etc. were analyzed using the c2 test. Cox proportional hazard regression models were used to de-termine the independent effects of diabetes on the risks of any types of inflammatory diseases in the model and age, sex, hypertension and gout adjusted were used after that.Results: A total of 39367 participants were enrolled in the study and 1634 (4.2%) subjects with missing information on T2D and the inflammatory diseases were excluded. Compared to those without diabetes, after adjusting for age, sex, hypertension and gout, the incidences of asthma, chronic hepatitis, chronic bronchitis, chronic gastroenteritis, chronic gastritis or ulcer in diabetic patients were independently higher, with odd ratios of 0.235 (95% Confidence Interval [CI], 0.117-0.473), 0.845 (95% CI, 0.731-0.976), 0.585 (95% CI, 0.540-0.634), 0.875 (95% CI, 0.806-0.951), 0.843 (95% CI, 0.787-0.903) respectively. Only inflammatory hemorrhoid did not show any clinical significance.Conclusion: There was a decreased incidence of inflammatory diseases in the diabetic patients compared with non-diabetic subjects. Except for inflammatory hemorrhoid, asthma, chronic hepatitis, chronic bronchitis, chronic gastro-enteritis, chronic gastritis and ulcer were associated with T2D of Chinese individuals, independently of hypertension and gout, and T2D might reduce the risk of these diseases.

Background: Sedentary lifestyle represents a growing health problem and considering that there is already a range of unhealthy habits that are marked as health risk factors and the increasing prevalence of sedentary lifestyle worldwide, we aimed to investigate association of sedentary way of living in suburb, working class local community with socioeconomic determinants such as educational level, occupation and income status.Methods: In this community-based cross-sectional study, 1126 independently functioning adults were enrolled into the study. The study protocol included a complete clinical and biochemical investigation revealing age, gender, lipid status, height, weight and blood pressure. Trained interviewers (nurses) collected information from patients about cur-rent state of chronic diseases (diabetes mellitus, arterial hypertension) smoking, medication and other socioeconomic data. Descriptive analysis, Chi-square and logistic regression were performed as statistical calculations.Results: Patients with elementary school were seven times more likely to be classified in category with sedentary life-style compared to patients with college or faculty degree. Being retired and reporting low income were significantly associated with higher odds of sedentary behavior when compared with students and patients with high-income status, respectively.Conclusions: The significance of this study lies in the fact that our results may help to easier identification of patients who may have a tendency towards a sedentary lifestyle.

Background: 5-Fluorouracil could lead to a decline in fertility in Caenorhabditis elegans. The aim of this study was to describe the mechanisms underlying such an altered fertility phenotype and to illustrate the specific genes and path-ways that are involved in the related phenotypic changes in C. elegans.Methods: We isolated total RNA from the samples and used a new method called Digital Gene Expression (DGE), which can rapidly identify genes with altered transcript levels. The random genes were confirmed by real-time RT-PCR.Results: We analyzed the results of two methods to draw conclusions based on a comparison between C. elegans and other harmful parasites. Compared with controls, 1147 genes were up-regulated, and 1067 were down-regulated. Overall, 101 up-regulated genes had a log2 ratio higher than 8, whereas the log2 ratio of 141 down-regulated genes was higher than 8. After mapping to the reference database, 4 pathways were confirmed to be involved in this phenomenon, with statistically significant participation from 19 genes.Conclusion: For the first time, the transcript sequence of 5-Fu-treated worms and controls was detected. We found that 4 possible pathways, i.e., ECM-receptor interaction pathway, TGF-beta signaling pathway, Focal adhesion and Hypertrophic cardiomyopathy, may be involved in the number decline in the embryos of C. elegans. Specifically, the ECM-receptor interaction pathway and Focal adhesion may be very important pathways that alter the reproduction of C. elegans.

Background: Cardiac arrest is a condition in which the heart is completely stopped and is not pumping any blood. Although most cardiac arrest cases are reported from homes or hospitals, about 20% occur in public areas. Therefore, these areas need to be investigated in terms of cardiac arrest incidence so that places of high incidence can be identified and cardiac rehabilitation defibrillators installed there.Methods: In order to investigate a study area in Petersburg, Pennsylvania State, and to determine appropriate places for installing defibrillators with 5-year period data, swarm intelligence algorithms were used. Moreover, the location of the defibrillators was determined based on the following five evaluation criteria: land use, altitude of the area, economic conditions, distance from hospitals and approximate areas of reported cases of cardiac arrest for public places that were created in geospatial information system (GIS).Results: The A-P HADEL algorithm results were more precise about 27.36%. The validation results indicated a wider coverage of real values and the verification results confirmed the faster and more exact optimization of the cost function in the PSO method.Conclusion: The study findings emphasize the necessity of applying optimal optimization methods along with GIS and precise selection of criteria in the selection of optimal locations for installing medical facilities because the selected algorithm and criteria dramatically affect the final responses. Meanwhile, providing land suitability maps for installing facilities across hot and risky spots has the potential to save many lives.

Background: China has become an aging society, and the mental health problem of the elderly is increasingly becoming prominent. This paper aimed to analyze the effect of air pollution and rural-urban difference on mental health of the elderly in China.Methods: Using the data from the China Health and Retirement Longitudinal Survey (CHARLS, 2013), after control-ling the social demography variable via Tobit and Probit, a regression analysis of the effect of air pollution and rural-urban difference on mental health and psychological disorder was conducted on 6, 630 old people (³60 yr old) of China from February to April 2015. Mental health and psychological disorder of the elderly were measured by the CES-D score of respondents. Air pollution degree of counties and cities (n=123) were measured by SO2 emission.Results: 27.8% of old people had psychological disorders. Air pollution significantly influenced the mental health of the elderly, showing a positive "U-shaped" curve (P<0.001). In China, the urban elderly had better psychological status than the rural elderly had. The female elderly had more serious mental health problems. Marriage, education, and social activities had positive effects on the mental health of the elderly.Conclusion: China’s local governments should consider the influence of air pollution on the mental health of the elderly during economic development. This paper recommends paying attention to the difference in mental health between the urban and rural elderly when making public health policies. Governments could improve the mental health of the elderly by enriching social activities and increasing employment opportunities of the elderly.

Background: Gastric cancer is the one of the most prevalent reason of cancer-related death in the world. Survival of patients after surgery involves identifying risk factors. There are various models to detect the effect of risk factors on patients’ survival. The present study aims at evaluating these models.Methods: Data from 330 gastric cancer patients diagnosed at the Iran cancer institute during 1995-99 and followed up the end of 2011 were analyzed. The survival status of these patients in 2011 was determined by reopening the files as well as phone calls and the effect of various factors such as demographic, clinical, treatment, and post-surgical on patients’ survival was studied. To compare various models of survival, Akaike Information Criterion and Cox-Snell Residuals were used. STATA 11 was used for data analyses.Results: Based on Cox-Snell Residuals and Akaike Information Criterion, the exponential (AIC=969.14) and Gompertz (AIC=970.70) models were more efficient than other accelerated failure-time models. Results of Cox proportional hazard model as well as the analysis of accelerated failure-time models showed that variables such as age (at diagnosis), marital status, relapse, number of supplementary treatments, disease stage, and type of surgery were among factors affecting survival (P<0.05).Conclusion: Although most cancer researchers tend to use proportional hazard model, accelerated failure-time mod-els in analogous conditions - as they do not require proportional hazards assumption and consider a parametric statistical distribution for survival time- will be credible alternatives to proportional hazard model.

Background: Inequality in households’ payments on food and health expenditures presents the accessibility and utilization patterns between them. This study investigated the Iranian rural and urban households’ inequality in payments on food and Out-of-Pocket health expenditures from 1998 to 2012.Methods: This descriptive study was conducted through the analysis of Iranian Statistics Centre data on Iranian households’ income and expenditures. The Gini Coefficients, Concentration and Kakwani indices have been calculated for Iranian rural and urban households’ Out-of-Pocket health and food expenditures.Results: The means of Iranian rural and urban total consumption expenditures inequality were 0.48 and 0.48, respectively. The means of concentration index of food expenditures for rural and urban regions were 0.35 and 0.34, respectively. The means of Out-of-Pocket payments for health services for rural and urban regions were 0.51 and 0.5, respectively. Finally the means of Kakwani index of Out-of-Pocket health payments in rural and urban households were -0.005 and -0.018, respectively.Conclusion: There are relative high levels of inequality in Iranian households’ payments on food and Out-of-Pocket health expenditures.

Background: Brucellosis is a major bacterial zoonosis of global importance with the causative organisms of Gram-negative facultative intracellular pathogens. The aims of this study were to standardize two immunoelectrophoretic techniques, rocket and cross immunoelectrophoresis, and compare their results with other conventional serodiagnostic tests.Methods: Sera from 15 sheep, without any history of brucellosis vaccination, infected with Brucella melitensis M16 sub-cutaneously, were employed in a comparison of culture, precipitating, and immunoelectrophoretic tests. A 125 days serologic follow-up was performed after the infection was started. As a reference, these tests also done in the five healthy sheep.Results: The results obtained with the rocket immunoelectrophoresis test correlated very well with those of the cross immunoelectrophoresis, whereas results of other tests such as culture, Rose Bengal, standard tube agglutination and 2-mercaptoethanol seruagglutination tests were inferior.Conclusion: As agglutination test shows cross reaction and a prozone phenomenon, and in blood culture, the bacteria is not always detectable, so they are time consuming rocket and cross immunoelectrophoresis are recommended because their results can be obtained in a shorter time.

Background: The aim of this study was to detect fungi in atherosclerotic plaques and investigate their possible role in atherosclerosis.Methods: Coronary atherosclerotic plaques specimen were obtained from patients with atherosclerosis. Direct examination, culture, histopathology study, PCR and sequencing were performed to detect/identify the mycotic elements in the plaques. Age, sex, smoking, obesity, hypertension, hyperlipidemia, family history of heart diseases and diabetes were considered and data were analyzed using Chi Square test by SPSS version 15.Results: A total of 41 specimens were analyzed. Direct examination for fungal elements was negative in all cases but in culture only one specimen grew as a mold colony. The presence of fungal elements were confirmed in 6 and 2 tissue sections stained by Gomori methenamine silver and Hematoxylin and Eosin methods, respectively. Using PCR, 11 cases were positive for fungi. The DNA sequence analysis of six positive specimens which were randomly selected revealed fungi as Candida albicans (n=3), Candida guilliermondii (n=2) and Monilia sp. (n=1).Conclusion: A significant association between the presence of fungi in atherosclerotic plaques and severity of athero-genesis and atherosclerotic disease was not found. This could be due to limited numbers of patients included in our study. However, the presence of fungal elements in 26.8% of our specimens is considerable and the results does not exclude the correlation between the presence of fungi with atherosclerosis and coronary artery disease.

Background: Childbearing is a cause of concern for women living with HIV. To improve reproductive right of women with HIV and prevent the spread of HIV; it is needed to understand fertility experiences of infected women with HIV. The aim of this study was to explore fertility intentions and experiences of HIV-infected women in Iran.Methods: Totally, 15 in-depth interviews were conducted with HIV- infected women who were at reproductive age and had referred to Imam Khomeini Hospital Consultation Center for Clients with Risky Behaviors in Tehran, Iran. Data were analyzed using the conventional content analysis method in MAXQDA 10.Results: Analysis of the meaning units of interviews showed themes in describing of fertility desires of HIV women as follows: 1) Motherhood as a way for stability of life; 2) Uncertainties about the future; and 3) Unpleasant experience of pregnancy and delivery. This theme has three sub-themes as stigma, discrimination and weakness in health care system.Conclusion: Health care provider and community should respect the right of infected women and inform them on sexual and reproductive health.

Background: The ability to accept illness is a major issue in the life of a person with cancer. Acceptance of disease is simultaneously conducted at two levels: the emotional and cognitive-behavioral one. It is consequential to cancer affecting numerous aspects of patient's life, i.e. the physical, mental, social and the spiritual area. The aim of the study was to verify the influence of socioeconomic factors on acceptance of illness in patients suffering from breast, lung, colorectal and prostate carcinoma.Methods: The study included 902 patients treated on an outpatient basis at the Center of Oncology, the Maria Sklodowska-Curie Institute in Warsaw, in the year 2013. The Paper and Pencil Interview (PAPI) technique was applied. The questionnaire comprised basic demographic questions (socioeconomic factors) and Acceptance of Illness Scale (AIS) test estimating the level of disease acceptance in patients.Results: Prostate carcinoma patients scored highest (30, 39), whereas lung carcinoma patients scored lowest (23, 17) concerning illness acceptance according to the AIS scale. In all cases, linear dependence between the net income-per-household-member and the AIS score could be observed. Another diversification factor in the case of prostate carcinoma patients was the level of education. Yet one more dependence could be observed between the level of illness acceptance and chemotherapy over the course of past twelve months.Conclusion: The degree of disease acceptance is subject to a type of carcinoma. Patient income is an economic factor significantly affecting the acceptance of illness score.

A 6.5 yr old girl was admitted with a category of clinical signs and symptoms including recurrent gross hematuria, abdominal pain, and fever. After different examinations including genetic analysis, the disease was diagnosed as Familial Mediterranean fever (FMF). It is suggested to consider FMF as a rare cause of recurrent gross hematuria, which is responsive to colchicine treatment.

Dear Editor-in-Chief: Smoking is a major risk factor of several types of cancer and cardiovascular disease. According to WHO report, every year, approximately 6 million people worldwide die of heart diseases, lung cancer, or other diseases associated with tobacco smoking. If this trend continues, 8 million people are estimated to die every year by 2030. From this perspective, smoking is obviously a serious health-related issue. Regular exercise is recommended for the prevention of coronary heart dis-eases, as it counterbalances the prevalence of the-se diseases. Heart rate response and coronary heart disease are highly correlated.

Colorectal cancer is the third most common cause of cancer-related mortality in the whole world. About one-third of colorectal carcinoma patients with acute colonic obstruction mandate emergency surgery. Current surgical options include intraoperative lavage, colonic segment resection involved with primary anastomosis, subtotal colectomy, colostomy followed by resection, a two-stage procedure (Hartmann’s procedure) and permanent colostomy in advanced stages of the disease. Thus, major patients with malignant large-bowel obstruction need an emergency open surgery to relieve the obstruction and resect the tumor. However, temporary or permanent stomas were observed in many patients after the surgery, finally affecting their health-related quality of life. For patients with acute left-sided colorectal malignant obstruction, complications in elcetive surgery would be remarkably reduced than in emergency surgery.

Dear Editor-in-Chief: The treatment of Plantar Fasciitis (PF) is primarily conservative, initially with rest and icing to give pain relief. In about 10% of the cases who do not respond to such treatments, surgical intervention is suggested. An alternative to the surgical treatment of PF is Extracorporeal Shockwave Therapy-ESWT (1, 2). The aim of the study was to com-pare analgesic effects of ESWT and P-ESWT in males with chronic PF.

Dear Editor-in-Chief: Modern agriculture faces pressing problems, such as salinization that is a very common, but difficult to control and ameliorate process. Non-enzymatic compounds such as polyphenols and flavonoids are generally stimulated in response to biotic/abiotic stresses such as salinity. Halophytes are naturally salt-tolerant plants that may be potentially useful for economical (oilseed, forage, production of metabolites) purposes. Recent data suggest that halophytes can serve as a source of valuable secondary metabolites with assumed economic value. Total phenolics and flavonoids were attributed as antioxidants with use in food, cosmetic, pharmacognosy, functional foods and nutraceuticals.

Dear Editor-in-Chief: The internal conflict that arises in response to the desire to undertake a pleasant but unhealthy activity involves several self-regulation strategies. Compensatory health beliefs (CHB) are a popular strategy that is used to resolve the temptation dilemma in a way that enables the belief holder to avoid feelings of guilt. Compensatory health beliefs are defined as the conviction that unhealthy but gratifying behaviors can be compensated with a healthy behavior, for example: "I can eat this cake now if I go jogging tonight". Such beliefs relieve the holder of a guilty conscience and justify giving in to temptation. Compensatory beliefs do not always have negative implications for health. However, habitual unhealthy behaviors with a promise of delayed "redemption" usually have ad-verse health consequences, mostly because people fail to carry out the promise. In this way, un-healthy self-regulation strategies such as diet-re-lated CHBs can contribute to problems with weight maintenance or weight regulation.

Dear Editor-in-Chief: In resource-deprived countries like Pakistan, the contribution of basic health units (BHUs) in reducing the burden of disease among local communities cannot be overlooked. As foundational tiers of the healthcare infrastructure, BHUs are instrumental in providing accessible healthcare services at community level. Pakistan has a comprehensive network of BHUs for primary healthcare service delivery. There are approximately 5, 301 BHUs in the country, each encompassing a catchment population of around 10, 000-20, 000 persons. However, the vast majority of BHUs remain underutilised with an average turnover of 20-30 patients a day.

Dear Editor-in-Chief: Although there is no agreement on the definition for the term of fast food, it is mainly defined as "easily prepared processed food served in snack bars and restaurants as a quick meal or to be taken away". Over the past two decades, an increasing trend in global fast food marketing and a public interest for consuming of take-away foods has developed. Fast foods are quick, convenient, relatively inexpensive, and liked by people of most different age groups; they are rich in highly processed meat and refined carbohydrate, sodium, total fat, saturated and trans fatty acids, cholesterol, and poor in essential nutrients and dietary fibers.

Dear Editor-in-Chief: The history of leprosy dates back to the time of human existence and is also mentioned in the Avesta. The Vandidad refers to Thrita as the first Aryan physician who was capable of treating several diseases including leprosy. However, no visual example indicating the effect of leprosy on the Iranian culture and artifacts has been re-ported while it can be seen in other cultures in forms of paintings, carvings, and even the remaining masks. The author has recently found something in the remains of the Teppe Hasanlu dating back to the 1st millennium BC which can be considered as the first visual instance of the effect of leprosy on the Iranian art.

Dear Editor-in-Chief: Nausea and vomiting are common in pregnant women. Prevalence of nausea is between 50% - 80% and the rate of vomiting and retching is 50% (1). There are various pharmacologic treatments for nausea and vomiting in pregnancy such as vitamin B6, doxylamine, metoclopramide, and on-dansetron. Although, they have positive effects, it is not possible to ignore their adverse effects.

Dear Editor-in-Chief: Bile reflux is severe in patients with gasteroeso-phageal reflux, especially who has severe esophagitis and Barrett esophagus. It is one of the primary factors leading to gastric mucosal lesions in chronic gastritis. High concentration of bile acid seems to be associated with an elevated risk of intestinal metaplasia. The treatment is the same as acidic reflux but non-operative therapy largely is ineffective. Unfortunately, now, there are no drugs in clinical practice to avoid bile production specifically.