International Journal of Preventive Medicine
Year:2018 | Volume:9 | Issue:-|Papers Count:14

Background: Maternal thrombophilia has been identified as a risk factor for recurrent pregnancy loss (RPL). The aim of this study was to investigate the association between prothrombin G20210A and factor V Leiden (FVL) polymorphisms in women with RPL and a control group of parous women in Isfahan province of Iran.Methods: We studied 250 women with idiopathic RPL and 116 control cases. Prothrombin and FVL different genotypes were determined using polymerase chain reaction and reverse hybridization technique.Results: The frequencies of heterozygous mutation prothrombin G20210A were 6% and 0.9%, respectively (P=0.025), in cases compared to the control group. The frequencies of homozygous mutation prothrombin G20210A were 0.4% and 0%, respectively, in cases compared to controls (P=0.02). The prothrombin mutation was significantly higher in cases compared to the control group (odds ratio 8.81; 95% confidence interval: 1.16–66.62). There was no significant difference between the FVL mutation and pregnancy loss.Conclusions: The results indicated a significant higher frequency of prothrombin G20210A in women with RPL in comparison with controls. Our data suggest that the prothrombin G20210A mutation, but not the FVL mutation, may be an unrecognized cause of RPL in our population.

Dear Editor: One of the major factors driving the cost of healthcare upward in developing countries is aging population. [1] Policy makers and health‑care providers face the challenge of optimally allocating scarce health‑care resources over competing alternatives for elderly population. Research work has been conducted in India depicting the quality‑adjusted life years (QALYs) of the elderly population within the context of various therapeutic areas; [2, 3] however, there is a lack of research which specifically assesses the cost‑effectiveness of health care for the elderly.

Background: Hypovitaminosis D is highly prevalent and has several adverse health effects. This study aims to assess the relationship of serum concentrations of 25‑hydroxyvitamin D (25 [OH] D) and liver enzymes in adolescents.Methods: This population‑based cross‑sectional survey was conducted among a nationally representative multistage sample of 1095 adolescents (52% boys), aged 10–18 years, living in different provinces of Iran. Serum 25 (OH) D concentration<30 ng/ mL was considered as hypovitaminosis D, and liver enzymes (alanine aminotransaminase [ALT] and aspartate aminotransaminase [AST]) of>40 U/L was considered as high level. To determine the association between serum 25 (OH) D categories and elevated levels of liver enzymes, multiple regression models and linear regression analysis were applied, after adjustment for potential confounders. Odds ratios (95% confidence interval) of serum 25 (OH) D and elevated liver enzymes were assessed by logistic regression analysis.Results: Higher rates of Vitamin D deficiency were documented among individuals with increased levels of liver enzymes. Compared to boys, median of 25 (OH) D was lower in girls with elevated levels of liver function tests (12.75 vs.25.60 ng/mL for ALT and 13 vs.14.10 ng/mL for AST), with marginally significant gender differences regarding AST.Conclusions: We found a relatively high frequency of hypovitaminosis D among adolescents with abnormal liver function. Further prospective studies are needed to examine these associations from early life.

Background: The presence of air pollutants such as CO, NO2, SO2, O3, and PM in the ambient air mainly emitted from fossil fuels combustion has become a major health concern. The aims of this study were to estimate the attribution of NO2, SO2, and O3 in the premature deaths and prevalence of cardiovascular and respiratory diseases in Isfahan in 2013–2014.Methods: In this study, short‑term health effects (total mortality, cardiovascular and respiratory mortality, chronic obstructive pulmonary disease, and acute myocardial infarction) of exposure NO2, SO2, and O3 on the population of Isfahan were assessed using AirQ 2.2.3 software suggested by the World Health Organization (WHO).Results: The result showed that from nonaccident total mortality in 2013–2014 in Isfahan, the attributable proportion related to NO2, SO2, and O3 were 1.03% (109 cases), 3.46% (365 cases), and 1.29% (136 cases), respectively. The percentage of days that people were exposed to the highest concentration of NO2 (40–49 mg/m3), SO2 (60–69 mg/m3), and O3 (40–49 mg/m3) was 34.46%, 16.85%, and 42.74% of a year, respectively. Total mortality attributed to NO2, SO2, and O3 exposure was 0.36%, 0.79%, and 0.83%, respectively.Conclusions: The concentrations of NO2 and SO2 were upper than the WHO guidelines. The Air‑Q software in spite of its limitations can provide useful information regarding the health outcome of the air pollutants. The results estimated in this study were considerable. This information can help the health authorities and policy makers to draw suitable strategies and fulfill effective emission control programs.

Background: Case finding was improved to the population‑based method at the Isfahan Cancer Registry (ICR) during 2005–2008. However, its effects on the number of registered colorectal cancer (CRC) cases and patients’ age are not investigated. Therefore, present study designed to investigate the effect of that improvement on the trend of incidence of CRC, and age of CRC cases in ICR’s catchment area.Methods: Data from the ICR were retrieved by years for 2000–2011. Annual age‑standardized incidence rates (ASRs), truncated ASRs and 95% confidence intervals (95% CIs) were estimated for both genders. Rates were standardized based on the 2000 world standard population. Trends were analyzed, and significant change‑points were identified using Joinpoint Regression software. Age of CRC cases compared between periods before and after the improvement.Results: A total of 2902 CRC cases had been registered by ICR. Estimated ASRs (95% CI) for 2000 and 2011 were 3.47 (3.45, 3.50) and 10.22 (10.19, 1025) per 100, 000 persons, respectively. Two significant change‑points were identified (i.e., at 2003 and 2006). However, estimated average annual percent change was as 11. There was no significant difference between mean of patients’ age before and after the time of improvement (P=0.88). Conclusions: Trends of incidence of CRC had been rising in central Iran for males and females, during 2000–2011. It seems that the estimated slope for this trend had been partially artificial and significantly affected by the improvement of case‑finding method. However, the improvement had no effect on the patients’ age.

Background: Tendency toward addiction is provided before drug use begins. The present study aimed to identify the risk factors for addiction potential in the students of Arak University of Medical Sciences.Methods: We conducted this cross‑sectional study among 305 students from Arak University of Medical Sciences, Iran in 2016. We selected the students by stratified random sampling and collected the data by family and sociodemographic factors questionnaires and Addiction Potential Scale.Results: Male students, students with low economic status and high family members were more prone to addiction. We identified variable; addiction in close friends, adverse family conditions (dispute with the family), poor economic condition of families, and family size by controlling the effect of other variables, as risk factors for addiction potential.Conclusions: Preventive and intervention actions appear necessary considering the mentioned factors.

Background: Considering all the latest achievements in neonatal respiratory care, bronchopulmonary dysplasia (BPD) is still among the most prevalent morbidity causes in premature infants.Involvement in this process results in longer period of hospitalization for the newborn and in the long run makes the living conditions more difficult. Taking the multifactorial pathogenesis into account, approaches to tackle chronic lung disease (CLD) are mainly focused on interventions and prevention procedures. This study tries to investigate the potential capability of inhaled budesonide in the prevention of BPD in newborns with gestational age of<28 weeks with the respiratory distress syndrome (RDS).Methods: This study was a randomized clinical trial done on seventy newborns with gestational ages of 23–28 weeks with RDS in Isfahan Shahid Beheshti Educational Hospital from June 2014 to April 2016. Patients were randomly assigned to two groups of intervention with budesonide and control. There were 35 newborns in each group. Upon recording demographic characteristics, the newborns in two groups were compared based on the length of noninvasive ventilation, the need for invasive mechanical ventilation, the number of surfactant administrations, pneumothorax, intraventricular hemorrhage, patent ductus arteriosus (PDA), CLD, and death.Results: The length of the need for nasal continuous positive airway pressure showed no statistically significant difference between the groups (P=0.54). The number of newborns who needed invasive mechanical ventilation also revealed no meaningful difference (P=0.14). Similarly, the number of newborns who were characterized as affected by CLD also showed no significant difference between the groups (P=0.053). Moreover, the number of newborns who experienced pneumothorax was not significantly different for the groups (P=0.057). The number of newborns who received three administrations of surfactant had also no statistically meaningful difference between the groups (P=0.69). However, the number of newborns who received two doses of surfactant was statistically lower in budesonide intervention group than the control (P=0.041).The prevalence of intraventricular hemorrhage with degrees of I, II, and III also showed no statistically meaningful difference between the groups with P=0.74, 0.32, and 0.49, respectively.The occurrence of PDA had no meaningful difference between the groups (P=0.66). Relative death cases also revealed no significant difference between the groups (P=0.53). Conclusions: The current study revealed a decrease in CLD prevalence for newborns in interventional group; however, this decrease was not statistically meaningful. The newborns, in the intervention group, who had received two doses of surfactant (survanta) showed a significant decrease, which can be the basis for further research in this field.

Background: Considering how many people obtain information about their health online, the aim of this study was to describe the content of the currently most widely viewed YouTube videos related to concussions and to test the hypothesis that consumer videos would be anecdotal, while other sources would be more informational.Methods: The term “concussion” was used to search for videos with 100, 000 or more views on YouTube that were posted in English or Spanish. Descriptive information about each video was recorded, as was information on whether certain content was conveyed during the video. The main outcome measures are sources of upload and content of videos.Results: Consumer videos accounted for 48% of the videos, television based accounted for 50% of the videos, and internet based accounted for only 2% of the videos. None of the videos viewed fell into the professional category. Television based videos were viewed significantly more than consumer or internet based videos. Consumer and television based videos were equally anecdotal. Many of the videos focused on adolescents and were related to sports injuries. The majority of the videos (70.4%) addressed concussion causes, with 48% stating sports. Few videos discussed symptoms of concussion and prevention.Conclusions: The potential for widespread misinformation necessitates caution when obtaining information on concussion on a freely accessible and editable medium, such as YouTube.

Background: This study aimed Persian translation and validation of the hip disability and osteoarthritis outcome score (HOOS) questionnaire.Methods: The study was carried out in two phases. First, we translated the HOOS according to acceptable guidelines. We assessed HOOS content convergent validity on 203 hip osteoarthritis patients using SF‑36. Internal consistency was tested using Cronbach’s alpha coefficient if each item removed and intraclass correlation coefficient (ICC) for the assessment of test‑retest reproducibility.Results: Patients had mean (standard deviation) age of 39 (17). Test‑retest ICC in whole was 0.95 (P=0.014) showing excellent reliability. ICC was 0.92 for the “pain”subscale (P=0.02), 0.81 for the “symptom” subscale (P=0.002), 0.81 for the “function of daily living (FDL) ” (P=0.022), 0.88 for the “function of sports and recreational activities” (P=0.006), but it was 0.62 (P=0.1) for the “quality of life (QOL).” Cronbach’s alpha was 0.92, 0.73, 0.97, 0.86, 0.80, and 0.80 for the pain, symptom, FDL, function of sports, QOL, and stiffness, respectively, showing good to excellent internal consistancy. Having SF‑36 for the assessment of convergent validity, there was a strong correlation between total HOOS score and the physical component summary domain of SF‑36 (r=0.64, P=0.0001), whereas the t correlation with the mental component summary domain was weak (r=0.16, P=0.04). Conclusions: The Persian version of the HOOS questionnaire is a valid (regarding physical not mental aspects) and reliable assessment tool in patients with hip osteoarthritis.

Background: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system which has no any known definitive treatment. Studies have shown that thyroid hormones (THs) in addition to their roles in the development of the nervous system and the production of myelin have important roles in the adult’s brain function. Since the only way to treat MS is the restoration of myelin, the aim of this study was to evaluate the effects of levothyroxine on visual evoked potential (VEP) impairment following local injections of lysolecithin into the rat optic chiasm.Methods: To induce demyelination, lysolecithin was injected into the optic chiasm of male Wistar rats. VEP recording was used to evaluate demyelination and remyelination before and 10, 17, and 24 days after the lysolecithin injection. The rats received an intraperitoneal injection of levothyroxine with doses 20, 50, and 100mg/kg in different experimental groups.Results: VEP latency and amplitude showed demyelination at 10 and 17 days after an induced lesion in MS group which was reversed at day 24. Levothyroxine prevented these impairments, especially in high doses.Conclusions: According to the results, lysolecithin‑induced demyelination at optic chiasm and VEP impairments can be restored by administration of levothyroxine. Therefore, THs probably have positive effects in demyelinating diseases.

Background: There is not enough studies to determine the frequency of using the prophylaxis against deep venous thrombosis (DVT) based on the American College of Chest Physician’s (ACCP) guidelines in Iran. Thus, providing such statistics is essential to improve thromboprophylaxis in hospital. The present study aimed to determine the frequency of using the prophylaxis against DVT based on ACCP guidelines in patients hospitalized in surgical wards in one of teaching hospital in Ilam, Iran.Methods: In a cross‑sectional, the samples were selected among medical records of patients who were hospitalized and underwent surgery in surgical wards of the hospital from April 2012 to September 2013. Type of prophylaxis was determined based on ACCP guidelines. After reviewing inclusion and exclusion criteria, patients’ data were extracted from medical records based on required variables.Results: In reviewing 169 qualified samples, 46.2% (78 patients) were women. Of these, 132 patients were at risk of DVT and needed prophylaxis, only 39 patients (29.5%) received prophylaxis. Thromboprophylaxis based on ACCP guidelines had been fully implemented only in 30 cases (22.7%) of patients with the risk of DVT.. The highest thromboprophylaxis was in the intensive care unit (46.6%) and neurosurgery (37.5%), and the least rate was in urology (0%).Conclusions: As the results of this study, there are differences between clinical practice and the ACCP guidelines recommendation in prophylaxis against DVT. Thromboprophylaxis has not been implemented based on ACCP guidelines in more than 75% of patients with the risk of DVT. Thus, new strategies are needed to implement thromboprophylaxis against DVT in Iranian hospitals.

Background: We evaluated the relationship between secondhand smoke (SHS) inhalation, as verified by urinary cotinine levels, and bone health.Methods: We analyzed the nationwide, population‑based, cross‑sectional health survey. We included 1936 men aged 50 years or older who checked bone mineral density (BMD) from the Korean National Health and Nutrition Examination Survey (2008–2010). Current smokers assessed by urinary cotinine levels higher than 500 ng/mL were excluded (n=616). Exposure to SHS was determined using a 50 ng/mL urinary cotinine threshold.Results: The estimated prevalence of SHS exposure in our cohort was 13.9%. After adjusting for age and body mass index (BMI), T‑scores at total femur (P<0.001), femoral neck (P<0.001), and lumbar spine (P=0.004) were lower in SHS exposure versus nonexposure groups. Impaired bone health (osteopenia or osteoporosis) at femoral neck or lumbar spine was evident in 61.7% and 48.6% of SHS exposure and nonexposure cases, respectively (P=0.004). Moreover, after adjusting for age, BMI, and health habits, the odds ratio for impaired bone health in the SHS exposure group was 1.89 (95% confidence interval: 1.31–2.74).Conclusions: Our findings suggest that SHS exposure, determined by urinary cotinine levels, is negatively associated with BMD and is a leading cause of impaired bone health in Korean men.

Background: In recent decades, several medical and scientific studies on yoga proved it to be very useful in the treatment of some diseases. This study was conducted to investigate the effects of yoga on stress, anxiety, and depression in women living in Ilam, Iran.Methods: This study is a quasi‑experimental study with pre-post test. To collect data, the questionnaire of DASS‑21 (Depression Anxiety Stress Scale‑21) was used. For eligible samples, hatha yoga exercises and training sessions were held for 4 weeks (3 time/weeks; 60-70 min each) by a specialist. Data were analyzed using SPSS version 20.Results: 52 women with a mean age of 33.5±6.5 were included for analysis. Depression, anxiety, and stress decreased significantly in women after 12 sessions of regular hatha yoga practice (P<0.001). Conclusions: Yoga has an effective role in reducing stress, anxiety, and depression. Thus, it can be used as complementary medicine.

Background: One of the main causes of mortality is hepatocellular carcinoma (HCC) which accounts for the third leading cause of deaths and one in forty deaths worldwide. The flavonoids, natural antioxidant compounds, account for a major group of polyphenolic compounds. One of the major isoflavones in soybean is genistein (GE) which can inhibit proliferation and induce apoptosis.Isoflavones, major type of phenolic materials, derived from dietary plants and medicinal herbs play a significant role in cancer prevention and treatment. Correlation between dietary habits and cancer risk including breast, prostate, and colon cancer has been reported. Various bioactivities of these compounds such as anticarcinogenic and antioxidant are responsible for their chemopreventive activities by which induce migration, proliferation, cell cycle arrest, and apoptosis. GE, one of the major isoflavones, is considered as a potent chemopreventive agent against cancer. The aim of this study was to investigate the inhibitory and apoptotic effects of GE on HCC Hepa1‑6 cell line.Methods: Cell viability assay and cell cycle analysis with flow cytometry were used to evaluate proliferative and apoptotic effect GE.Results: GE inhibited the growth of Hepa1‑6 cells and induced apoptosis with a concentration and time‑dependent fashion. During GE treatment for 24, the half maximal inhibitory concentration (IC50) was 20mM, and the maximum inhibition of cell growth was 52% (P<0.01). The percentage of apoptotic cells with a concentration of 20 mM of GE after 24, 48, and 72 h was 35, 42, and 65%, respectively (P<0.01). Conclusions: Our finding clearly indicated that GE can significantly inhibit proliferation of hepatocellular carcinoma Hepa 1-6 cell line and induce apoptosis in this cell line.