International Journal of Preventive Medicine
Year:2010 | Volume:1 | Issue:2|Papers Count:8

Objectives: There are a large number of primary researches on the prevalence of major depressive disorder (MDD) in Iran; however, their findings are varied considerably. A systematic review was performed in order to summarize the findings.Methods: Electronic and manual searches in international and Iranian journals were conducted to find relevant studies reporting MDD prevalence. To maximize the sensitivity of the search, the references of relevant papers were also explored. We explored the potential sources of heterogeneity such as diagnostic tools, gender and other characteristics using meta-regression model. The combined mean prevalence rates were calculated for genders, studies using each type of instruments and for each province using meta-analysis method. Results: From 44 articles included in the systematic review, 24 reported current prevalence and 20 reported lifetime prevalence of MDD. The overall estimation of current prevalence of MDD was 4.1% (95% CI: 3.1-5.1). Women were 1.95 (95% CI: 1.55-2.45) times more likely to have MDD. The current prevalence of MDD in urban inhabitants was not significantly different from rural inhabitants. The analysis identified the variations in diagnostic tools as an important source of heterogeneity. Conclusions: Although there is not adequate information on MDD prevalence in some areas of Iran, the overall current prevalence of MDD in the country is high and females are at the greater risk of disease.

Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH). Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients. Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges. Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9 ± 13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respectively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH. Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

Objectives: Fruits and vegetables are important components of a healthy diet, and their consumption could help prevent a wide range of diseases. In this study, fruit and vegetable consumption in elderly people were assessed. Methods: This cross-sectional study was conducted among elderly (³65 year-old) people who came to pharmacies affiliated with Isfahan University of Medical Science. Face-to-face interview using a questionnaire including Food Frequency Questionnaire and demographic and socioeconomic variables was administered.Results: Of the total 504 participants, 56.3% were male and 43.7% were female. The mean daily serving of fruit and vegetable (combined) consumption in men and women were 4.58±1.31 and 4.65±1.28, respectively. The prevalence of daily fruit and vegetable intake of 5 or more servings was 37.9%. Low educational and low income participants ate lower fruits and vegetables (combined). Age, gender, smoking, and chronic disease had no significant influence on their consumption. Educational level was the only independent predictor of fruit and vegetable consumption (OR: 3.81, CI: 1.64-8.84). Conclusions: Most elderly people ate less than the recommended levels of fruits and vegetables. From the point of view of prevention of chronic disease, health education programs which targeted elderly people particularly for those at the risk of low consumption are needed and recommended.

Objectives: Assessment of nutritional habits and associations with cardio-metabolic risk factors in four age groups of women participating in the Prevention Education Program, Family Heart Study. Methods: Anthropometric variables, systolic and diastolic blood pressures (SBP, DBP), lipoproteins, glucose and insulin were measured in 141 children, 211 adolescents, 151 women <55 years and 150 women ³ 55 years. Nutritional data were assessed by 7 days weighted dietary records. For statistics, SPSS 15.0 was used; associations were calculated by multiple logistic regression; p<0.05 was considered for significance.Results: The prevalence of CVD risk factors was similar in children and adolescents except for hypertriglyceridemia which was > 3 times more common in adolescents. Thirty six percent of junior women were overweight (BMI ³25 kg/m2) and 21% had central adiposity obese. Sixty eight year-old women had a far more adverse risk profile than 35 year-old women. In terms of energy consumption, 14 year-old women had the lowest fat intake and the highest consumption of carbohydrates whereas intake of protein was lowest in 10 year-old girls. Intake of unsaturated fat was lower in youths than in adults amounting to 37 g unsaturated fat respectively 53.4% of total fat consumption. The association between energy consumption and overweight was significant and calorie intake was associated with clustering of ³3 cardiovascular risk factors (OR 4.72; 95% CI 1.22-18.33).Conclusions: The prevalence of CVD risk factors increased continuously from girls and adolescents to junior and senior women. However, dietary intake was different in the four age groups. Caloric intake was associated with overweight and clustering of risk factors in adult women.

Objectives: The beneficial or detrimental effects of dietary fats on health and well-being largely depend on their fatty acid composition. The contribution of high intake of trans fatty acids (TFAs) and saturated fatty acids (SFAs) to the risk of coronary heart disease is well documented. In this study, the fatty acid composition of different samples of mayonnaise salad dressing produced in Iran wasanalyzed. Methods: Three most consumed samples from four different brands of Iranian mayonnaises were purchased. Total lipids were extracted with Folch technique. All samples were transformed into methyl ester and analysis of fatty acid methyl esters were performed by gas chromatography (GC) with 60 meters capillary columns and flame ionization detectors.Results: TFAs ranged from 0.6% to 3.5% ,with linolelaidic acid (C18:2 9t, 12t) being the most common form of fatty acid in Iranian mayonnaises, which had high amounts of SFAs (from18.1% to 24.9%) and unsaturated fatty acids (68.4%to 74.4%). Conclusions: The most common type of fatty acids in Iranian tested mayonnaises were unsaturated ones followed by SFAs. Significant variations were found among the contents of TFAs in these products, which is related to their procedure. Improvement of the fat quality in this highly consumed food product might have a long-term impact on prevention of chronic diseases.

Objectives: Ulcerative colitis is characterized by local inflammation. Targeting drugs directly to the site of injury has the benefit of lower adverse effects and more effective therapy. The aim of this study was colon targeted delivery of budesonide to deliver the major part of the drug to the colon.Methods: Matrix tablets of budesonide from solid dispersion of drug with dextran were prepared using different drug to polymer ratios and three molecular weights of dextran. The physical evaluation and drug release behavior were studied. In vivo efficacy of the selected formulation against acetic acid induced colitis in rats was evaluated and compared to the control (untreated) and references (mesalasine and budesonide suspensions) groups.Results: The results showed that solid dispersion of budesonide with dextran in the ratio of 1:7 using molecular weight (MW) of 10,000 dextran (SDT710) released 25% of the drug in the first 6 hours and 100% in caecal and colonic contents. It could target the drug to colon with improvement in some of the inflammatory signs of induced ulcerative colitis in rat. Treatment with SDT710 could improve not only the percent of involvement also macroscopic damage parameters. The macroscopic parameters included weight/length ratio of the colon, ulcer area, damage score, and ulcer index reduced in comparison to the control group and conventional suspension of budesonide; however, only weight/length ratio was significant. Conclusions: In the experimental model studied, the new colonic delivery system significantly improved the efficacy of budesonide in the weight/length ratio of the colon in induced colitis in rats.

Objectives: Supervised exercise cardiac rehabilitation programs have been suggested to all patients specially patients with post-myocardial infarction (MI) for many years. However, limited information is available on the usefulness of exercise rehabilitation programs in chronic MI. The aim of this study was to evaluate the outcome of supervised exercise training on MI patients by measuring both physical and physiological factors.Methods: This was a semi-experimental randomized study. Itincluded seventy two (35 cases, 37 controls) post-MI patients aged 40 to 67 years. They wererandomly selected from those with MI based on WHO criteria who were referred to cardiac rehabilitation unit of Isfahan Shahid-Chamrancardiovascular research center. After initial measurements includingweight, height, functional capacity, diastolic blood pressure (DBP) and systolic blood pressure (SBP) in both resting and exercise states, , patients were randomized into either the training group (n =35) or the control group (n =37). The training group had supervised aerobic training program, three times a week, with 60-70% of the maximal heart rate (HR) reserve for two months. After the training program was completed, all measurements were repeated in both groups. Data were analyzed using one-way analysis of variance (ANOVA) with repeated measures.Results: Patients in exercise group showed statistically significant improvement inresting HR (81.27±7.75 bpm vs. 74.17±10.11bpm, p£0.001), resting SBP (125.92±9.30 mmHg vs. 123.54±6.82 mmHg, p£0.01), SBP peak (150.22±7.12 mmHg vs. 133.54±6.82 mmHg, p£0.001), HR peak (132.51±3.06 bpm vs. 142.00±3.14bpm, p£0.001), and exercise capacity (8.49±1.18 METs vs. 9.42±1.19 METs, p£0.01). Conclusions: The results from the study showed that a 2-month exercise rehabilitationprogram in post-MI patients is useful for improving both blood pressure and exercisecapacity and should be encouraged more commonly.

Objectives: This study was conducted to explore the barriers to physical activity in a representative sample of Iranian children and adolescents. Methods: The study was conducted in 2007 in urban and rural areas of Isfahan district in Iran. In the qualitative part, we used the grounded theory approach, including semi-structured focus group discussions and in-depth interviews. The quantitative part comprised 600 randomly selected students.Results: The qualitative study included 34 school students (16 girls), 20 parents (11 mothers) and 11 school staff. All students disclosed that studying was a priority. They pointed to lack of safe and easy-access place for physical activity and unsupportive family as the main barriers. Lack of self-confidence and low self-worth were the two other concepts developed in this context. Parents pointed to lack of safe and easy-access place for activity followed by the priority of studying. The concepts derived from interviews with school staff included unhealthy modeling of parents, priority of studying, and inadequate public knowledge about how to integrate physical activity in routine daily life. The quantitative survey comprised 600 students including 286 (47.8%) girls. Parents’ education level had inverse association with children’s physical activity level. Significant inverse associations of self-efficacy and physical activity levels were documented.Conclusions: Increasing the public knowledge about adopting physical activity habits in routine daily life, informing the families and students about the benefits of physical activity to improve learning, as well as providing safe places such as using the school facilities in non-school hours should be considered in planning effective preventive strategies and interventions.