Epidemiology and Health System Journal
Year:2016 | Volume:3 | Issue:3|Papers Count:12

Due to special conditions of Iran; i.e., neighboring to major centers of drug production in Afghanistan during the last few decades, it was the passageway of the drug to Europe. Moreover, because of appropriate context of social, economic and cultural situations, there was an increased addiction and drug trafficking in Iran. It is obvious that a lot of people would be involved directly and indirectly with drugs; so the drug has become a major problem in Iranian society, especially in the provinces in near of Afghanistan and Pakistan borders. The reports have indicated an increasing spread of drug addiction in Iran. Addiction among all social classes and occupational groups, age and sex, is raised. In fact, an important part of social problems, directly or indirectly related to drug dependence. Therefore, prevention of addiction as the basis of many diseases is vital priority for Iran. Fair distribution of facilities and services in society and equal opportunities for all members of society can legitimately, step forward in to deal with social ills such as addiction.

Background and aims: This study aimed to investigate the deaths and injuries following pedestrian traffic accidents and factors associated with death of pedestrian in Tehran and Alborz provinces.Methods: In this cross-sectional study all traffic accidents related to pedestrians in Tehran and Alborz provinces reported from March 21, 2013 to March 21, 2014 by the traffic police were studied. The Database related to death of Legal Medicine Organization was used in order to determine the exact number of deaths. The standard population of World Health Organization was used in order to calculate the age-standardized incidence rate. We used Chi-square test, T-test and logistic regression to extract statistically significant associations. P-value under 0.05 was considered significant.Result: The age-standardized mortality and injury rate were respectively, 6.1 and 65.1 per 100, 000 populations. The pedestrian’s road traffic (PRT) mortality and injury rates in men were 3 and 1.5 times more than women respectively. Statistically significant relationships were observed between the pedestrian’s age, the direct cause in the accident, classification of road, month of occurrence, days of week, type of vehicle, accident location and pedestrian action with the death of pedestrians.Conclusion: Given that the highest incidence rate of death was observed in the age group over 65 years old, it is necessary to pay special attention to the physiologic characteristics of this age group by predicting safety plans and also to provide more secure conditions for this high risk group in accident-prone road sections.

Background and aims: The most common reason in neonatal mortality rate in the world is low birth weight (LBW). The objective of our study was to determine the prevalence and related factors associated in birth weight in Garmsar, Iran in 2013.Methods: This cross sectional study was carried out on 683 live births which delivered in Garmsar in 2013. The required information was collected by examining the health records of pregnant women and completion of the data registration forms. Data collection was controlled by using SPSSand analyzed by using an Independent T-test, Chi-square test and logistic regression.Results: According to the results, 32 infants out of 683 infants born in 2013 had low birth weight, i.e. the weight less than 2500g. LBW prevalence estimated in this study was 4.7%. There were significant statistical relations between low birth weight and the variables including number of births, mothers’ occupation and interval of less than 3 years between pregnancies and systolic and diastolic blood pressures.Conclusion: Although our results regarding LBW prevalence and risk factors confirm the results of other studies, it was recommended perspective studies to reconfirm the LBW risk factors.

Background and aims: Nutrition has a determinant role in success of professional athletes and dietary supplements can play an important role for supplying the nutritional needs for them in some situations. Consumption of Dietary Supplements (DS) was significantly increased in recent years. Based on this fact, assessing the amount, purposes and type of the supplements are all as prior as the affective factors on the choice and preparation of that. Therefore, we are going to evaluate the consumption of dietary supplement among athletes of Karaj, a big city near Tehran, capital of Iran.Methods: In this cross-sectional study, we enrolled 195 athletes that were randomly selected from 8 sport clubs of Karaj city between December 2014 and February 2015. A self-administered questionnaire containing 17 questions was used to evaluate the field of sport, history and reasons of consuming the supplements, source of information and providing centers. Validity and reliability of questionnaire determined through panel of experts and Cronbach’s alpha (N=25, a=0.85) respectively.Results: The mean age of the athletes was 24±7 years old. Thirty six percent of participants consumed the supplement during the study and 49% reported the previous use of it. The most important reasons of supplement’s consumption were empowering sport’s ability by 48%. Also supplying needs of body by 39% and increasing muscle’s mass by 31% named the second and third reason of supplement use. For 64% of participants coach is the most important source of information and question about DS, and then nutritionists (24%) and Internet (23%) were after that in order. Sixty one percent of participants considered the coach as the most important source for buying supplements and then 51% of participants mentioned pharmacies as second main source for buying DS. Protein supplements, vitamins, creatine and glutamine were named as the most commonly used DS.Discussions: The results of this study indicate that dietary supplements usage is common among athletes. According to these results, coaches have a significant role in athlete information and supplying the required supplements of athletes. It is necessary to consider the appropriate policy to remove coaches from the supply chain of dietary supplements.

Background and aims: Sexual dysfunction is a common complaint among drug abusers in the treatment with Methadone and Buprenorphine. The aim of this study was to assess sexual dysfunction in patients undergoing Methadone or Buprenorphine for maintenance therapy.Methods: This research was a cross-sectional study. A 3-parts questionnaire (demographic questions, international index of erectile function questionnaire (IIEF) and Beck Depression Inventory (BDI-II)) was used for data collection.Results: Overall, 3.5% reported no Erectile Dysfunction (ED), 79.9 % reported mild to moderate ED, and 10% reported severe ED. There were no statistical differences in the components of the IIEF questionnaire between Methadone maintenance treatment (MMT) and Buprenorphine maintenance treatment (BMT) group. Statistical analysis show that depressed subjects has a higher sexual dysfunction (r=-0.435, P<0.001). The results showed no significant relation between drug dose and sexual function (r=0.031, P=780).Conclusions: Based on our findings, sexual dysfunction was relatively high among males who received MMT and BMT and the disorder was more prevalent in depressed people. As the results, the problem needs more attention and should be offered the right solution to solve it.

Background and aims: Visit quality is a crucial component of patient-physician interaction that its inadequacy can negatively influence the diagnosis and treatment efficiency. The waiting time and visit length are important determinants of quality in the outpatient care setting. Thus, the aim of this study was to determine waiting time and visit length and to compare them before Implementation of health sector evolution in Iran.Methods: A cross-sectional study was conducted during autumn 2014. A sample of 540 patients who referred to the outpatient clinics of Sheikh Al Raeis of Tabriz Province (North West of Iran) were randomly selected and surveyed. Data were collected by the collection tools and analyzed using descriptive statistical methods.Results: The average visit time and standard deviation were 8.52 min and 3.14 respectively, which is significantly lower than the minimum average of 15 min approved by the Iranian Ministry of Health and Medical Educations (MOHME). Average of waiting time was 101.57 min for patients. The result showed that visit time was shorter than standard (7.5 min per patient) of health sector evolution in specialties of general Surgery, ophthalmologist, ENT, orthopedics and pediatrics. Also, the variables such as: number of visits, age of physicians, experience of physicians, men physicians, working shift of afternoon influenced on visit time significantly.Conclusions: The starting points of health care delivery to patients are consultations. This study showed that visit time is short and waiting time is very long. But, it seems that implementation of health sector evolution and plan of visit quality improvement led to increased visit time.

Background and aims: Depression disorder is one of the most common diseases, but the diagnosis is widely complicated and controversial because of interventions, overlapping and confusing nature of the disease. So, keeping previous patients’ profile seems effective for diagnosis and treatment of present patients. Use of this memory is latent in synthetic neuro-fuzzy algorithm. Present article introduces two neuro-fuzzy and artificial neural network algorithms as an aid for psychologists and psychiatrists to diagnose and treat depression.Methods: Neuro-fuzzy has been carried out using data evaluated by psychiatrists and scholars in Tabriz city with the convenience sampling method. Sixty-five patients were studied from whom 40 patients were taught feed forward, back propagation by artificial neural network algorithm and 14 patients were tested. An inductive neuro-fuzzy intervention created neuro-fuzzy rules to decide about depression diagnosis.Results: The proposed neuro-fuzzy model created better classifications. Reaching maximum accuracy of 13.97%is appropriate in diagnosis prediction. The results of the present study indicated that neuro-fuzzy is more powerful than artificial neural network with accuracy 76.88%.Conclusion: Findings of the research showed the depression scores of beck inventory can be predicted and explained with the accuracy of 87% using EEG in F4 and alpha peak frequency. It can be said that such accuracy in predicting can’t be obtained by any regression or route analysis method. The research can be the first step to predict and even identify depression using taking the data directly from the brain. So, there is no need for inventory and even a specialist diagnosis.

Background and aims: Life expectancy is one of the most important indicators of health and well-being of a society. Since it is claimed that in Aran-Bidgol region, center of Iran, life expectancy is higher than the average of the country, this study was designed.Methods: During a cross-sectional study, population and mortality data of Kashan University of Medical Sciences (KAUMS) in 2011 were used for calculating life expectancy. Brass Growth-Balance method was used to adjust mortality data with over 5 years old and to correct under reporting of deaths. Completeness and coverage of death registration data and the correction factor were calculated. Finally, an adjustedlife table for males and females was calculated separately. Microsoft Excel 2007 was used for calculations.Results: Population of Aran-Bidgol was 93571 in 2012 based on KAUMS data. Among the total population, 47331 (50.6%) were males. Number of registered deaths was 479 [280 male (58.4%)]. Completeness of the death registration data was found to be %74.9 for males and %70.1 for females. Correction factor (K) for adjustment of reported death was calculated to be 1.33 and 1.42 for males and females respectively. Adjusted life expectancy at birth for males and females was 71.3 and 76.5 years respectively.Conclusion: Although adjusted life expectancy for females in our study was to some extent more than the average life expectancy of Iranian women, but this indicator was slightly lower in men. Generally, it seems that there is no considerable difference between life expectancy of Aran-Bidgol population and national average life expectancy.

Background and aims: Stomach cancer is one of the most common cancers and the second cause of deaths among cancers worldwide cancer in the world. This study aimed to estimate the rate and trend of death from stomach cancer in Iranian population between 2006 and 2010.Methods: This study was a cross-sectional conducted using mortality data in Iranian population between 2006 and 2010. The number of deaths, death rate, and sex ratio of mortality, mortality rates by age and gender groups, and trends of mortality from stomach cancer were calculated and reported. Cochrane Armitage test was used for linear trend by Winpepi software to study the trends of Stomach cancer mortality.Results: The results showed that between 2006 and 2010, 34950 cases of death have been reported from stomach cancer. The mortality rate per 100, 000 reached from 11.22 in 2006 to 11.06 in 2010. All years studied indicated that death due to stomach cancer were higher in males than females. Also, with increasing age, the mortality rate of stomach cancer was increased.Conclusion: Our findings showed the decreasing trend of mortality due to stomach cancer may be due to increasing in lifespan and survival, enjoying the better diagnostic and therapeutic procedures for patients, and underestimation of the number of stomach cancer deaths. Since the cancer is the most frequent cause of death among cancers in Iran, additional investigation is necessary to determine the risk factors of the cancer to decline the mortality rate.

Background and aims: Depression is an affective (mood) disorder accompanied by the sense of disappointment, incompetence, sense of transgression, fear and sense of humility. Depression is the daily depressed-mood for two weeks. The aim of this study is analysis of the prevalence and effective factors on post-natal depression in women referring to Garmsar city health centers in 2015.Methods: This study is a descriptive and periodical study. The statistical population in this research includes the women who went to Garmsar city health centers during the second and third quarters in 2015, two months after their labor. The method of collecting data in this study was by census, and the data-collecting tool was Edinburg standard questionnaire for post-natal depression diagnosis. After collecting and re-controlling, the data were analyzed by SPSS 20 software package. Descriptive statistics (average and standard deviation) were used for describing the data. The analytical statistical tests (chi square and independent t-test) were used for the data analysis.Results: The findings showed that 40 out of 110 mothers were depressed (score of over 12), and the prevalence of post-natal depression mothers referred to Garmsar health centers was about 36%. The results indicated that there were no significant statistical relations between mother’s age, education, number of labor, types of childbirth, children’s sex, unwanted pregnancies, the history of sterility, and post-natal depression.Conclusion: Due to unpleasant effects of depression on the living qualities of mothers’ and the embryos’ and eventually the families, and due to its extensive prevalence in the city of Garmsar, precise identification of effective factors in emergence of this disorder seems to be essential. By awareness from its risk factors, some of the inevitable factors could be reduced or even confronted, and the relevant consequences can be reduced by timely and proper interventions.

Background and aims: Nowadays heavy metals are the environmental priority pollutants and are becoming as the most serious environmental problems. In recent years removing those from diverse industrial effluents and metal cleaning have been studied. The aim of the present study was to investigate the different methods for cooper removal of cooper ions from industrial wastewater.Methods: This study was a review research. Data were collected from different database in various articles. The various methods for cooper removal from industrial effluents were compared to each other.Results: The present study showed the various methods for cooper removal from industrial wastewater including chemical precipitation, ion exchange, membrane filtration, flotation, electrochemical treatments, coagulation/flocculation and adsorption. High efficiency, cost-effectiveness and easy handling are important factors in the selection of the most suitable treatment systems for industrial effluents.Conclusion: Adsorption is recommended as an effective and economical method for maintaining of cooper ions from aqueous industrial wastes because of high efficiency, cost-effectiveness and simplicity.

Background and aims: The World Health Organization and United Nations Children’s Fund (UNICEF) recommended executive breastfeeding for 6 months after birth. The purpose of this study was to determine the prevalence of executive breastfeeding in Iran by a meta-analysis study to be used by policy-makers in order to health programmer plan in this field.Methods: In this meta-analysis study, the databases of ISI Web of Knowledge, PubMed, Science Direct, Scopus, Google Scholar and domestic databases were searched between January 2007 and March 2015. Between the studies with regard to the inclusion and exclusion criteria, 16 studies were selected. Data were analyzed using Stata 11 software.Results: Sever heterogeneity was observed among reported prevalence based on the results of Chi-square based on Q test and I2 statistics (Q=6132.55, P<0.001 and I2=99.8 %) and consequently, random effect model was used for themeta-analysis. The overall estimated prevalence of exclusive breastfeeding in Iran was 49.1% (95% CI: 33.4-64.9).Conclusions: In the present study, it was summarized the results of previous studies and showed that the prevalence of exclusive breastfeeding in Iran has been increased and currently is in a satisfactory level. The ongoing national programs for preservation and promoting of exclusive breastfeeding should continue.