Journal of Mazandaran University of Medical Sciences
Year:2018 | Volume:27 | Issue:158 |Papers Count:25

Background and purpose: Cadmium is a highly toxic industrial and environmental pollutantthat is known as an important risk factor for developing diabetes. Oxidative stress is reported to be highlyassociated with diabetes and its complications. The aim of this study was to evaluate the effects ofcadmium on oxidative stress response and secretory function of islets of Langerhans from rat pancreas. Materials and methods: Male Sprague-Dawley rats weighing 260-230 g, were divided into twogroups, including a control and an experimental group that received cadmium chloride. Afterintraperitoneal glucose tolerance test (IPGTT) on day 30, the animals were deeply anesthetized and thepancreas was removed for pancreatic islet isolation. Oxidative stress, islet insulin content and secretionwere also evaluated in pancreas. Results: The findings showed a significant increase in blood glucose concentration andsignificant decreases in body weight, blood insulin level, insulin content, and secretion of pancreatic isletin response to glucose concentrations in cadmium exposed group compared with those of the controlgroup (P< 0. 05). We found that the effects of cadmium on the parameters of oxidative stress led to asignificant increase in level of MDA and significant decrease in GSH and activity of antioxidant enzymesin pancreas tissue (P< 0. 05). Conclusion: In this study, cadmium led to increase in oxidative stress which can be an importantfactor in the decreased insulin synthesis and secretion from pancreatic beta cells.

Background and purpose: Diazinon (DZN), as an organophosphate insecticide, is used inagriculture and have destructive effects on heart. Zingiber officinale (ginger), as a medicinal plant hasantioxidant properties. This study was designed to evaluate the effect of ginger against DZN-inducedcardiotoxicity in rats. Materials and methods: In this experimental study, 32 adult female Wistar rats were randomlydivided into 4 groups, including control, and experimental groups that received ginger (100 mg/kg/day, gavage), DZN (10 mg/kg/day, IP injection), and ginger plus DZN. Ginger was given one hour beforediazinon. All drugs were treated for 30 consecutive days. One day after receiving the last drug, oxidativestress parameters (MDA and GSH), serum biochemical, and histopathological assays of heart have beendone. Data were analysed using One-Way ANOVA and Tukey test. Results: The results revealed that DZN significantly increased oxidative stress (increased MDAand decreased GSH content). Histopathological changes induced in heart tissue, were associated with asignificant increase in level of cardiac injury markers (CPK and LDH level) in serum. Gingersignificantly reduced oxidative stress, decreased CPK, LDH, and improved histopathological damages. Conclusion: Ginger with antioxidant activity has an effective role against DZN-induced cardiacinjury by reducing oxidative stress.

Background and purpose: Allium (Liliaceae) genus has about 600 spp. This investigation wasdesigned to study the impact of extraction methods on total phenolic and flavonoid contents, antioxidant, and antihypoxic properties of A. ampeloprasum in mice. Materials and methods: The aerial parts were extracted by three different methods, i. e. maceration, ultrasonic assisted (UAE) and Soxhlet assisted extraction (SAE). The total phenolic andflavonoid contents were determined. Antioxidative capacity was assessed utilizing four different methods. Antihypoxic activities of maceration extract against hypoxia-induced lethality in haemic, asphytic andcirculatory hypoxia models. Results: Soxhlet assisted extract showed the highest amount of total phenolic contents (89. 1± 3. 3GAE) and Ultrasonic assisted extract showed the highest amount of total flavonoid contents (36. 9± 1. 7QE). In DPPH radical scavenging activity, maceration extract had higher activity which was significantlydifferent from that of other extracts (IC50 622. 6± 12. 7). Extraction method did not show any effect onreducing power. All extracts showed the same activity (P>0. 05). Extracts did not show any good nitricoxide radical scavenging and iron chelating activities. In haemic and asphytic models, the extract at 250mg/kg showed statistically significant activities compared with that in the controls. In circulatory modelthe extract at 500 mg/kg, significantly prolonged the latency for death compared with that in controlgroups (P<0. 05). Conclusion: According to current study, extraction methods significantly affected antioxidantcapacities and total phenolic and flavonoid contents. For A. ampeloprasum, maceration extraction wasfound to be more efficient. It showed high antihypoxic properties.

Background and purpose: Controlling inflammation is a major approach in periodontaltreatments, but scaling and root planing are not always effective enough. Curcumin is anti-inflammatoryand can adjust inflammatory reactions and its efficacy and immunity is proven. The present researchaimed at evaluating the potential of Curcumin BCM-95 in treatment of patients with chronic periodontitis. Materials and methods: In a double blind clinical trial, the clinical parameters including, Gingival Sulcus Bleeding Index (GSBI), Loe and Silness Gingival Index (GI), Probing Pocket Depth(PPD), and Clinical Attachment Level (CAL) were recorded at the beginning of the study, at week 6, andmonth 4. In case group, patients with moderate chronic periodontitis who had no systemic disease with atleast one periodontal pocket with 4-6mm depth in each quadrant and bleeding on probing were chosen. After scaling and root planing, the patients took 2 Curcumin oral capsules per day for 4 weeks. Thepatients in the control group were given placebos. Results: The effect of time was found to be significant in PPD, GI, CAL, and GSBI. Moreover, significant differences were seen between PPD average measurements before medication, at first followup, and second follow-up (P<0. 05). But, in GI, GSBI, and CAL the group effect was not significant. Inother words, the reduction was seen in these parameters in both groups but they were not significant. Conclusion: The effect of Biocurcumax TM Curcumin (BCM-95) was significant in treatment ofmoderate chronic periodontitis in PPD between the two groups which reduced this parameter.

Background and purpose: Sore throat and hoarseness are some postoperative complicationsfollowing endotracheal intubation and inflammation of the pharynx, larynx, and trachea. The aim of thisstudy was to determine the effect of eucalyptus vapor on sore throat and hoarseness after trachealextubation in patients undergoing coronary artery bypass graft (CABG). Materials and methods: In a clinical trial, 100 patients undergoing CABG were selected usingconvenience sampling. They were randomly divided into two groups (control and experimental). Demographic and clinical data, and the information on sore throat and hoarseness were recorded in bothgroups, before the intervention and after tracheal extubation. The patients in experimental group wereexposed to eucalyptus vapor for about ten minutes after tracheal extubation. This was performed at 1 and12 hours after extubation. The severity of sore throat and hoarseness was recorded in the two groups at 0, 1, 6, 12 and 24 hours after extubation. Results: The severity of hoarseness in case group showed no significant difference at the times ofimmediate to 24 hours after extubation. But, the severity of sore throat significantly reduced at 6 and 12hours after extubation (P= 0. 02 and P= 0. 02, respectively). Conclusion: The eucalyptus vapor in this study could not significantly decrease the severity ofhoarseness, but reduced the sore throat.

Background and purpose: Prevalence of depression in patients with acute coronary syndrome(ACS) is reported to be 10-40%. Post-ACS depression is associated with higher mortality and morbidityin patients, therefore, it requires more attention. Materials and methods: In a clinical trial (conducted in Babol University of Medical Sciences, 2015-2016), 47 hospitalized patients with ACS diagnosis were randomly allocated into two groups. Twenty-four patients in intervention group received 20 mg/day citalopram and 23 individuals in thecontrol group were followed without receiving citalopram. Hospital anxiety and depression scale (HADS)was applied at weeks 0, 3, and 8. The participants’ quality of life was evaluated at weeks 0 and 8. Sevenpatients were excluded from the study since they did not return for follow-up. Results: A total of 40 patients was studied including 14 (35%) males and 26 (65%) females. Mean ages of patients in in intervention group and controls were 63. 1± 8. 8 and 68. 4± 7. 9 years, respectively. Depression and anxiety levels reduced significantly in intervention group and their qualityof life increased in week 8 (P<0. 001). These changes were significantly different between the two groupsin physical functioning, social functioning, emotional well-being and energy/fatigue subscales (P<0. 05). A significant correlation was observed between reduced depression and anxiety and improvements inquality of life (P<0. 001). Conclusion: Citalopram could be effective in reducing depression and improving quality of lifein acute coronary syndrome.

Background and purpose: Breast cancer is the second leading cause of cancer death in womenand the most common cancer causing liver metastases. Radiofrequency ablation (RFA) is a new methodin treatment of liver metastases. This study was designed to evaluate the efficacy of RFA on livermetastatic breast tumors. Materials and methods: In a randomized clinical trial, 52 patients with liver metastases frombreast cancer who had less than 5 lesions < 5 cm enrolled. They were divided into two groups; anintervention group that received both chemotherapy and RFA and a control group who had onlychemotherapy. Different variables were evaluated e. g. changes in lesion size, residual tumor status, andtherapy complications. Data was analyzed in SPSS V20. Results: In a randomized clinical trial, 52 patients with liver metastases from breast cancer whohad less than 5 lesions < 5 cm enrolled. They were divided into two groups; an intervention group thatreceived both chemotherapy and RFA and a control group who had only chemotherapy. Differentvariables were evaluated e. g. changes in lesion size, residual tumor status, and therapy complications. Data was analyzed in SPSS V20. Conclusion: RFA was found as a safe and efficient method in treatment of liver metastases frombreast carcinoma and showed a significant synergistic effect in patients under ingesting chemotherapydrugs.

Background and purpose: Today, cognitive-behavioral group therapy is empirically supportedin treatment of emotional disorders and in some chronic diseases such as diabetes. The aim of the presentresearch was to study the effect of cognitive-behavioral group therapy on glycosylated hemoglobin(HbA1c), self-efficacy, depression, illness perception, and quality of life in patients with type II diabetes. Materials and methods: In this clinical trial, 43 patients were found eligible, of whom 30 wereselected using simple random sampling and were divided into two groups: experimental and control. HbA1c was measured in all participants and they completed the Beck Depression Inventory (BDI), Selfefficacyin diabetic patients (DMSES), Illness Perception Questionnaire (IPQ), and Diabetes D-39. Theexperimental group attended 10 training sessions based on cognitive-behavioral therapy (Beck approach), for 1. 5 hours, twice a week. The scales were completed again, after the intervention and a month later. The HbA1c was also measured again. Results: The mean age of participants was 46. 5± 7. 21 years. At first, both groups wereheterogeneous in dependent variables. Cognitive behavioral group therapy decraesed depression(P=0. 049) and increased illness perception (P=0. 005) in patients with type II diabetes, but HbA1c, selfefficacy, and quality of life did not change significantly. Conclusion: In this study, cognitive-behavioral group therapy was found to have positive effectson reducing depression and increasing the illness perception in diabetic patients. Hence, it is suggestedalong with current treatments in type II diabetes.

Background and purpose: Rheumatoid arthritis (RA) is an autoimmune disease that increasethe risk of coronary artery diseases. Metabolic syndrome (MetS) is considered as a risk factor fordeveloping coronary artery diseases. There are some concerns about the association between RA andMetS, therefore, this study was done to evaluate the prevalence of MetS in male RA patients. Materials and methods: In a cross sectional study, male RA patients (n= 50) were evaluatedregarding demographic and clinical features including disease activity score 28 (DAS28), healthassessment questionnaire (HAQ), visual analogue scale (VAS), and laboratory parameters and comparedwith 50 age-matched controls. MetS was diagnosed according to the 2005 National Cholesterol EducationProgram Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF)definition. The prevalence of MetS was compared in RA patients and controls. Statistical analysis wasperformed in SPSS V19, and results were considered significant at P< 0. 05. Results: The mean ages of RA patients and controls were 49. 04± 10. 2 and 46. 12± 9. 4 years, respectively (P= 0. 139). MetS according to NCEP and IDF criteria was present in 12 (24%) and 18 (36%)of RA patients vs 16 (32%) and 18 (36%) of controls, respectively that was not significantly different. Controls were more likely to have hyperglycemia and hypercholesterolemia, especially higher levels oflow density lipoprotein (P<0. 05). Conclusion: According to the present study, prevalence of MetS was similar in RA patients andcontrols. MetS components should be routinely investigated in male RA patients to reduce the occurrenceof MetS and its complications.

Background and purpose: The pace of population aging is fast, so maintenance of mentalhealth in elderly is an important issue. This study aimed to assess mental health in older adults and somerelating factors. Materials and methods: In a cross sectional study, 400 old people were selected by multi-stagesampling in Tehran 2014-15. Data was collected using General Health Questionnaire (GHQ-28) and thelifestyle questionnaire. Multiple linear regression model was used to determine the adjusted associationbetween demographics and underlying factors with mental health. Results: The mean age of participants was 67. 7± 7. 63 years and mean score for their mentalhealth was 21. 82± 11. 37. According to regression model after adjusting other covariates, some variables, including gender, age, education, employment, life satisfaction, motor-physical limitations, and usingrehabilitation instruments were the predictors of participants’ mental health (P˂ 0. 05). Conclusion: This study revealed that physical health in elderly has a key role in their mentalhealth. Motor-physical disability is one of the main predictors of mental health among old people. Physical activities and health and also employment situation should be considered in interventionsdesigned to promote mental health in older population.

Background and purpose: Cutaneous leishmaniasis is endemic parasitic disease in different regions ofthe world especially in Iran. Khorasan province is endemic for anthroponootic and zoonotic cutaneousleishmaniasis with unequal outbreak. Identification of species could have important implications for thedisease and reservoirs control and finding the epidemiologic map. There is no study on this protozoadisease in Fariman, northeast Iran. The aim of this study was to determine the protozoa genotyping in thisarea. Materials and methods: A cross-sectional study was done in 50 suspected cases in Fariman 2015-2016. After light microscope checking, scrapings from all smears were done for DNA extraction andspecies identification was done using kDNA-PCR. Results: Among 50 suspected cases, 40 patients (80%) were found positive with direct smearsand 42 (84%) were identified by PCR. Leishmania tropica was identified in 13 (31%) and 29 (69%) wereinfected with Leishmania major. Two negative smears were positive with PCR. The disease mainlyinvolved those aged 11-20 years (28. 6%) and the most common site of lesions was hands (38. 1%) asulcerative form (58%). From 13 cases of Leishmania tropica 75% and 25% were in urban and ruraldistricts, respectively. Also, from 29 cases of Leishmania major 17. 2% and 82. 8% were in urban and ruraldistricts, respectively. This difference was statistically significant (P= 0. 004). Conclusion: Fariman is a zoonotic leishmaniasis foci in northeast Iran. Further studies ondisease reservoirs and vectors seems necessary to control and reduce the number of people affected.

Background and purpose: Head and neck cancers are amongst the most common cancers in theworld with increasing incidence rate. The aim of this study was to evaluate the quality of life in patientswith head and neck cancers in Babolsar, Iran 2016-2017. Materials and methods: This descriptive cross-sectional study was conducted in 65 patientswith head and neck cancers attending Babolsar Shahid Rajaii Hospital. The UW-QOL4 was applied andthe quality of life was assessed in three stages; before, during, and after treatment. Data analysis wascarried out in SPSS V16. Results: The study population included 49 males (75. 4%) with mean age of 62. 44± 12. 44 yearsand 16 females (24. 6%) with the mean age of 59. 31± 12. 27 years. The age range of subjects was 30 to 91years. Larynx (70%) and tongue (21. 5%) were the two most involved areas. The mean scores for patients’ quality of life before, during, and after treatment were 17. 7± 0. 9, 9. 1± 3. 3, and 15. 2± 2. 6, respectively. According to ANOVA analysis these changes were found to be significant (P<0. 001). Conclusion: Quality of life of patients during treatment was significantly lower than that beforetreatment which increased after treatment. It is suggested to evaluate quality of life of cancer patientsalong with their treatment to improve their conditions and provide them with appropriate rehabilitationprograms.

Background and purpose: When couples understand about their fertility problems their mentalimage might change or experience problems in sexual activities. This research aimed at investigating theeffect of sex education on genital self-image in infertile women. Materials and methods: In this clinical trial, convenient sampling was done and randomallocation was conducted according to odd and even days in 108 women in Mashhad Milad InfertilityCenter, 2016. Fifty four infertile women were randomly placed in experimental groups (n= 5-8 pergroup) and 54 women were in control group. Three 90-minute educational sessions were held whithinthree weeks. After a month, post-test was taken by both groups. Data was collected using a demographicquestiionnare, Depression, Anxiety and Stress Scale (DASS-21), and Female Genital Self-Image Scale(FGSIS). Data analysis was done in SPSS V16 applying Kolmogorov-Smirnov Test, Mann-Whitney, Wilcoxon, covariance analysis, Chi-square, and Fisher test. Results: The scores for sexual self-image was not significantly different between the interventionand control groups before the intervention (P=0. 715). But, a month after sex education, the score showedsignificant differences between the two groups (P=0. 001). Conclusion: Sex education was found to have positive effects on genital self-image in infertilewomen, therefore, infertility centers are suggested to use such interventions to improve female genitalself-image.

Background and purpose: Infertility is one of the most commonly diagnosed disease in womenthat is associated with physical, psychological, and social problems. A major problem that such womenare faced with is on their sexual and reproductive health (SRH). Despite extensive studies on thesatisfaction and sexual function of infertile couples, there is no studies that investigates SRH issues. Thecurrent study aimed at investigating SRH and its related factors among women. Materials and methods: A cross sectional study was conducted and 400 women attending twoinfertility centers in Sari, Iran, were recruited using convenience sampling (2016-2017). Inclusion criteriaincluded women > 18 years of age with infertility (primary or secondary) with any cause. The Sexual andReproductive Health Needs Assessment Questionnaire was administered. The participants recorded theirstress scores (0-5). Descriptive statistics were reported and logistic regression was used to evaluate thefactors related to SRH. Results: The SRH was found to be inappropriate in 250 (62. 5%) women. According tomultivariate regression analysis, inappropriate decision making in self health care (AOR=1. 75, 95% CI(1. 06-2. 9)), high stress level (AOR=1. 39, 95%, CI (1. 14-1. 7)), old age at marriage (AOR=0. 94, 95% CI(0. 9-0. 99)), and secondary infertility (AOR=4. 5, 95% CI (2. 6-7. 9)) were associated with SRH. Conclusion: Factors such as the person making decision about health care, the level of stress, and age at marriage were found to be the variables which could improve SRH in infertile women byappropriate planning and preventive measures.

Background and purpose: Today, due to the reduction of water resources, separation of graywater from domestic wastewater and its reuse has gained more interest. The aim of this study was toapply multi-layer filtration (MLF) for removal of nutrients from gray water. Materials and methods: This laboratory-scale study was carried out in 2. 3-19. 2 gr. COD / L. dorganic loading rates (OLR) over a period of 157 days. In this study, synthetic gray water was used asinput to the multi-layer filter. The MLF system included three layers: sand, silica, and granular activatedcarbon. Furthermore, the scanning electron microscopy (SEM) images were used to determine the biofilmformation on the media surface. Results: The best removal efficiencies of COD, BOD5, TKN, and TP were 98. 87, 99. 84, 99. 5, and 98% achieved in OLR 19. 2, 12. 8, (13. 2, 4. 6) gCOD/l. d, SOR 5. 76, 2. 88, and 5. 77 m/hr, respectively. The study on the effect of loading rate revealed that by increase in OLR, the system efficiency to removeBOD5 and COD increased. Nevertheless, for TKN and TP, the efficiency decreased with increase in OLR. Also, according to SEM images, biofilm had grown well in the media, which can be effective in removingpollutants from gray water. Conclusion: Using multilayer filtration could be an appropriate option in removing nutrientsfrom gray water in different loadings.

Background and purpose: There are several methods for removing oil contaminations from thepolluted environments. Bioremediation could be considered as one of the best and most practical methodsin the removal of oil contaminations. The aim of this research was to determine the bioremediationefficiency for soils contaminated with diesel by the biological stimulation of bioreactors containingvermicompost and activated sludge. Materials and methods: In an experimental study, the soil samples were collected from an areawhich was free of any oil pollution and 5 reactors containing one kilogram of soil were contaminated withdiesel at the mass concentration of 1%. Two reactors were mixed with vermicompost at 15% and 20%mass concentrations and two reactors were mixed with activated sludge at 5% and 10% massconcentrations. Additionally, one control reactor was used to control the process. The pH of the reactorswas between 7. 5 and 8 and the C: N: P ratio was 100: 5: 1. The amount of TPH was measured at sevenretention times within three months with two repetitions. The total removal of petroleum hydrocarbons(TPHs) was evaluated by GC-FID device. Results: The highest removal efficiency of TPH (40. 24%) was observed in bioreactorscontaining vermicompost at a 20% mass concentration. In this reactor, the highest percentage of removalwas observed in lighter hydrocarbons (50. 49%). In reactors containing activated sludge, the averagepercentage of TPH removal was 32% which was observed in the reactor containing the 10%concentration of sludge. In this reactor, the highest percentage of removal (44. 86%) was also observed inlighter hydrocarbons. Conclusion: Vermicompost and activated sludge can be used in the bioremediation of soilscontaminated with diesel. In current study, the performance of vermicompost was found to be moreefficient. Also, the results showed that by increasing the concentration of biological modifiers, theremoval rate would increase.

Background and purpose: Diabetes causes adverse effects on the activity of reproductivesystem, including impaired spermatogenesis, decreased sperm count, testosterone serum, seminal fluidvolume, and loss of sexual desire. The aim of this study was to evaluate the effect of E. cyparissias extracton tissue changes of prostate and vesicle seminal in diabetic rats. Materials and methods: Thirty male Wistar rats were randomly selected and divided into threegroups (n=10), including a control group (healthy animals), a diabetic group and a treatment group. Diabetes was induced by streptozotocin in treatment group and the animals received E. cyparissias extract(500 mg/kg) for 28 days by oral gavage. Then, the samples of prostate and vesicle seminal tissue weretaken and prepared for histological study using light microscope. Results: Morphology findings showed increase in secretion and in diameter of tubules anddecrease in interstitial space of prostate and vesicle seminal in treatment group compared with those ofthe diabetic group. Histomorphometric results indicated significant increases in epithelium height, diameter of the tubules of the prostate and thickness of the muscle layer of seminal vesicles in treatmentgroup compared with those in diabetic group (P˂ 0. 05). The study also revealed that gland weight to bodyweight in treatment group increased significantly compared with that of the diabetic group (P˂ 0. 05). Conclusion: According to current findings, oral administration of E. cyparissias extractprevented diabetic induced tissue changes in prostate and seminal vesicle in rats.

Gabapentin was first approved for treatment of epilepsy by FDA, but later it received more attention dueto its effects on pain relief, especially neuropathic pain and post-herpetic neuralgia, and in treatment ofanxiety and insomnia. The most common side effects of gabapentin include somnolence, ataxia, andfatigue. However, no studies have reported gabapentin induced psychotic disorder. Here, we report apatient on gabapentin with symptoms of delusional disorder. A 42-year-old married housewife without any history of psychiatric disorder, received gabapentin (100mg once a day) for treatment of first time insomnia. Psychotic symptoms including persecutory delusionoccurred and about 12 hours after the onset of symptoms the patient discontinued gabapentin for 24hours. Consequently, all symptoms were quickly subsided. The patient's assessment was performed usingthe Naranjo scale. The patient’ s score was 9, thus other possible causes of psychosis were ruled out. According to this report, gabapentin could induce psychotic symptoms in patients who have not even hada history of drug use or specific illnesses.

Background and purpose: Violence is one of the main aspects of gender inequality that is amajor barrier to achieving the goals of global reproductive health. It is directly associated with women'saccess to health care and health outcomes. In a systematic review, we aimed to investigate the articles onthe relationship between intimate partner violence and women's reproductive health. Materials and methods: Electronic databases including, Scopus, ProQuest, PubMed, andGoogle Scholar were searched for articles published in English between 2010 and 2017. Results: After evaluation, 31 articles were selected. The lowest and highest prevalence ofviolence was associated with physical violence (2. 8%) and psychological violence (75. 9%), respectively. Moreover, violence was found to be associated with six domains of reproductive health including, notusing contraceptive methods, abortion, genital tract diseases, poor pregnancy outcomes, and not usingreproductive health services. Conclusion: Systematic review of studies investigated, showed a strong relationship betweendomestic violence and major aspects of reproductive health. Therefore, it is necessary to prevent domesticviolence in order to promote the health of whole community.

Environmental health inequalities (EHIs) refer to general differences in environmental healthconditions. This research aimed at introducing the EHI indicators and providing general recommendationsthat could improve environmental health and reduce the inequalities observed. This research is the reviewof WHO reports in various regions. A set of 14 EHI indicators was developed and categorized into threeinequality dimensions, including housing-related inequalities, group injury-related inequalities, andenvironment-related inequalities. The environment-related inequalities include four indicators such aslack of access to green/recreational areas, and noise exposure and second-hand smoke exposure at homeor work. The housing-related inequalities include six indicators such as inadequate water supply, lack of aflush toilet, lack of a bath or shower, overcrowding, dampness in home, and inability to keep the homeadequately warm. According to literature, EHIs exist in all countries, and most often affect disadvantagedpopulation groups. The magnitude of inequalities and the distribution of inequalities varies betweencountries and also depend on the socioeconomic or demographic variables. The socioeconomic anddemographic inequalities in exposure to environmental hazards exist everywhere and could be associatedwith factors that may affect the risk of being exposed such as income, education, employment, age, sex, race/ethnicity, and specific locations or settings. In addition to these differences in exposure, environmental health inequalities are also caused by social or demographic differences in vulnerabilitytowards certain risks. Finally, further studies are recommended for initial assessment of EHIs in Iran.