International Journal of Preventive Medicine
Year:2015 | Volume:6 | Issue:1|Papers Count:6

Background: Irrational antibiotic prescribing as a global health problem has a major influence on medical care quality and healthcare expenditure. This study was aimed to determine the pattern of antibiotic use and to assess the seasonality and physician‑related factors associated with variability in antibiotic prescribing in Isfahan province of Iran.Methods: This cross‑sectional survey was conducted on all prescriptions issued by general physicians from rural and urban areas in 2011. Associations between season of prescribing and physician‑related variables including gender, practice location and time since graduation with antibiotic prescriptions and also the pattern of antibiotic prescribing were assessed using Chi‑square tests and multiple logistic regression models.Results: Of the 7439709 prescriptions issued by 3772 general practitioners, 51% contained at least one antibiotic. Penicillins were the most frequently prescribed antibiotics, followed by cephalosporins and macrolides. Over‑prescription of penicillins was associated with female gender (odds ratio [OR], 2.61; 95% confidence interval [CI] 2.13–3.19) and with moderate duration of time in practice (10–20 years) (OR, 1.42; 95% CI 1.14–1.76). Higher rates of cephalosporins prescription were observed in urban areas than rural areas and by male physicians. Seasonal peak was detected for penicillins and cephalosporins prescriptions in autumn.Conclusions: These findings showed the widespread use of antibiotics by general practitioners that was associated with the physicians’ gender, time since graduation and practice location and also season of prescribing. More researches are needed on other factors related to the overprescribing of antibiotics and they could be used to project educational programs for improvement of antibiotic prescribing quality in our country.

Background: In most of the studies, the association of vascular events is limited to migraine with aura or it is stronger in this group, whereas the link between migraine without aura (MO) and vascular events remained uncertain. Therefore, we decided to evaluate endothelial function by chemical and functional markers of endothelium in MO and compare with normal population.Methods: In this study, 39 patients and 25 healthy subjects were enrolled and flow‑mediated dilatation (FMD), C‑reactive protein (CRP), nitrite and nitrate were measured in these two groups.Results: The mean of FMD in healthy people was higher than the migraine patients (mean difference - 7.67%; 95% confidence interval [CI] -9.90-−5.44). The means of nitrite concentration in migraineurs was significantly lower than healthy subjects (mean difference - 2.0 mmol/L; 95% CI -3.45-−0.54). But the CRP concentrations in both groups were not significantly different (mean difference 0.42 pmol/L; 95% CI- 0.13-0.98).Conclusions: This study can show the endothelial dysfunction in migraineurs without aura and suggest that MO could also be a risk for cardiovascular disease.

Background: Several measures of adiposity have been used for predicting diabetes. The results of studies regarding superiority of waist circumference (WC) to body mass index (BMI) are inconsistent. This study designed to compare the ability of different anthropometric measures in predicting diabetes and to determine their optimal cut‑off values.Methods: A population‑based cross‑sectional study was conducted with 1, 000 representative sample among adults aged 20–80 years in Babol, the Northern Iran. The demographic data were collected in a household survey, and the anthropometric measures of weight, height, waist, and hip circumference were measured with a standard method. Fasting blood sugar (FBS) ³126 mg/ dl was considered as diabetes. receiver operating characteristic analysis was used to estimate the predictive ability of different anthropometric indexes and their optimal cut‑off values for high FBS.Results: The overall prevalence rate of diabetes was 14.0% (14.4% in men vs.13.5% in women, P=0.65). The prevalence rate was significantly higher in older age (>60 years), low educated and obese (P=0.001). The mean of BMI, WC, waist‑to‑hip ratio (WHR), and waist‑to‑height ratio (WHtR) were significantly higher among diabetic in both sexes (P=0.001). Among men, WC (area under the ROC curve [AUC] =0.64) and WHtR (AUC=0.63) have slightly higher accuracy index compared with BMI (AUC=0.62) or WHR (AUC=0.60). In contrast, among women, WHtR (AUC=0.69) and WC (AUC=0.68) yielded slightly better predictive than BMI (AUC=0.67). The optimal cut‑off values obtained for BMI and WHtR were similar between two sexes (BMI=24.95 kg/m2 for men and BMI=25.2 kg/m2 for women, WHtR=0.51 for both sexes) whereas the optimal cut‑off value for WC was higher in men than women (98.5 cm men vs.89.5 cm women).Conclusions: Overall WC and WHtR exhibited a slightly better discriminate performance than BMI for diabetes in both sexes, particularly in women.

Background: This study aims to explore the frequency of aggressive behaviors among a nationally representative sample of Iranian children and adolescents.Methods: This nationwide study was performed on a multi‑stage sample of 6–18 years students, living in 30 provinces in Iran. Students were asked to confidentially report the frequency of aggressive behaviors including physical fighting, bullying and being bullied in the previous 12 months, using the questionnaire of the World Health Organization Global School Health Survey.Results: In this cross‑sectional study, 13, 486 students completed the study (90.6% participation rate); they consisted of 49.2% girls and 75.6% urban residents. The mean age of participants was 12.47 years (95% confidence interval: 12.29, 12.65). In total, physical fight was more prevalent among boys than girls (48% vs.31%, P<0.001). Higher rates of involvement in two other behaviors namely being bullied and bulling to other classmates had a higher frequency among boys compared to girls (29% vs.25%, P<0.001 for being bullied) and (20% vs.14%, P<0.001 for bulling to others). Physical fighting was more prevalent among rural residents (40% vs.39%, respectively, P=0.61), while being bullied was more common among urban students (27% vs.26%, respectively, P=0.69).Conclusions: Although in this study the frequency of aggressive behaviors was lower than many other populations, still these findings emphasize on the importance of designing preventive interventions that target the students, especially in early adolescence, and to increase their awareness toward aggressive behaviors. Implications for future research and aggression prevention programming are recommended.

DEAR EDITOR, Over the years, owing to the emergence of infectious diseases, shooting up of lifestyle disorders, rise in the incidence of nutritional disorders, rapid growth in population, and deteriorating environmental conditions, significant weaknesses in the public health care delivery system/ existing health policies have been exposed.

Background: The purpose of this study was to evaluate the validity and reliability on the Persian translation of the Modifiable Activity Questionnaire (MAQ) in a sample of Tehranian adolescents.Methods: Of a total of 52 subjects, a sub‑sample of 40 participations (55.0% boys) was used to assess the reliability and the validity of the physical activity questionnaire. The reliability of the two MAQs was calculated by intraclass correlation coefficients, and validation was evaluated using Pearson correlation coefficients to compare data between mean of the two MAQs and mean of four physical activity records.Results: Intraclass correlation coefficient was calculated to assess the reliability between two MAQs and the results of leisure time physical activity over the past year were 0.97. Pearson correlation coefficients between mean of two MAQs and mean of four physical activity records were 0.49 (P<0.001), for leisure time physical activities.Conclusions: High reliability and relatively moderate validity were found for the Persian translation of the MAQ in a Tehranian adolescent population. Further studies with large sample size are suggested to assess the validity more precisely.