JOURNAL OF SCHOOL OF PUBLIC HEALTH AND INSTITUTE OF PUBLIC HEALTH RESEARCH
Year:2007 | Volume:4 | Issue:4|Papers Count:10

Background and Aim: In 1991, the world health organization initiated a project to simultaneously develop an instrument for measuring quality of life in 15 countries. The study yielded two questionnaires, namely WHOQOL-100 and WHOQOL-BREF. These were intended as generic QOL measurement tools to be used in a broad range of diseases, for different degrees of disease severity, and in various cultural subgroups. The objective of the current study was to evaluate the Iranian version of the WHOQOL-BREF. This 26-item instrument comprises four domains: Physical Health, Psychological, Social Relationship, Environment and the overall QOL/health.Material and Methods: We administered the questionnaire to 1167 adults in Tehran. The stratified sample consisted of 476 diseased subjects and 700 healthy ones. We tested the instrument's reliability (internal consistency, test-retest), discriminate validity and factorial structure.Results: The participants had an age mean of 36.3 years (SD=13.2) and had an average 11.5 years of education. Using Cronbach's a. and intraclass correlation, all domains met the minimum reliability standards, with the exception of social relationship domain (a=0.55). The latter could be attributed the small number of questions in this domain and the sensitive nature of the questions themselves. Since 83% of the questions show maximum correlation with their original domain, the factorial structure of the questionnaire was regarded as acceptable. The questionnaire has the ability to discriminate different groups after adjustment for confounding factors in regression analysis.Conclusion: This study demonstrated good to excellent reliability and acceptable validity in various groups of subjects in Iran. The instrument may be used in future studies, albeit with minor modifications in the domain of social relations, as determined by expert opinion.

Background and Aim: Nowadays, community health and different methods for health service delivery are among the most important public health issues in many countries. Most developing nations are trying to establish a health care system capable of meeting their basic needs. Hospitals are the most important service delivery points, and they need skilled manpower and adequate equipment for efficient performance of their medical care and educational functions. Today, the health of the mankind is facing greater hazards and challenges than at any other time in history, and within this context, hospitals are supposed to provide service of the highest standards and with minimum delay. Emergency wards are the sections where these principles apply more than anywhere else. These are rightly regarded as the "heart" of any hospital and a quick, efficient workflow in the emergency room can literally save lives.Material and Methods: This was a cross-sectional (descriptive/analytic) performed in 2005 to assess the structure, process & performance in the emergency wards of 12 teaching hospitals affiliated to Tehran University of Medical Sciences.Results: 33.3% of the ward chiefs were women the rest were men; they were all more than 30 years of age. The average rate for implementing proper managerial standards was 90.6%. The "manpower index" was 69.1%, and the "facilities & equipment" index was 44/5%. The "directions index" and "activities index" were 66.97% and 93.5%, respectively.Conclusion: The findings show that there is a positive and significant relationship between standards of management at the emergency department and the facilities and equipment index. Also, there are positive correlations between the emergency department's "manpower and rules" index instructions, activities, and years of service in hospitals.

Background and aim: The chromium mist generator is an essential tool for research and for making evidence-based recommendations in evaluating air pollution and its control systems. The purpose of this study was to design and construct a homogeneous chromium mist generator and to look at the effects of factors such as sampling height and distance between samplers in side-by-side sampling on the chromium mist sampling method.Material and Methods: First we developed a mist generator, using a chromium electroplating bath in pilot scale. Concentrations of CrO3 and sulfuric acid in plating solution were 125 g L-1 and 1.25 g L-1, respectively. To set up permanent air sampling locations, a Plexiglas cylindrical chamber (75 cm height, 55 cm i.d) was installed as the bath overhead. Sixty holes were made on the chamber in 3 rows (20 in each row). The distance between rows and holes was 15 and 7.5 cm, respectively. Homogeneity and the related factors were studied using a side-by-side air sampling method. Forty-eight clusters of samples were collected on polyvinyl chloride (PVC) filters contained in sampling closed-face cassettes. Cassettes were located 35, 50, and 65 cm above the solution surface with < 7.5 and/or 7.5-15 cm distance between heads. All samples were analyzed by the NIOSH method 7600.Results: ANOVA tests showed no significant differences between locations in side-by-side sampling (P=0.82) or between different sampling heights or sampler distances (P=0.86 and 0.86, respectively). However, there were notable differences between means of coefficients of variation (CV) in various heights and distances.Conclusion: We conclude that the most chromium mist homogeneity could be obtained at a height of 50 cm from the bath solution surface and with a distance of < 7.5 cm between samplers.

Background and Aim: Differential diagnosis of Entamoeba histolytica and Entamoeba dispar is important in clinical and epidemiological studies. The two organisms are morphologically identical but they differ in their genetics, biochemistry, and pathogenicity. The present study was carried out with the aim of distinguishing the two species and determining the prevalence of each organism in the rural areas of Ahwaz and Hamidieh.Material and Methods: A total of 782 stool specimens were randomly collected and examined by formalin-ether concentration and direct methods. Twenty-one isolates of E. histolytical E. dispar were successfully cultured on Robinson's medium. DNA was extracted by the phenol/chloroformmethod and identified by PCR-RFLP after digestion with HinfI.Results: Over 75% of the individuals were infected with at least one of the intestinal parasites. Entamoeba coli infection rates were very high (51.9%) among the population, while only 0.76% of individuals were positive for Dientamoeba fragile. Sixty-five individual (8/3%) were infected with E. histolytica /E. dispar.The PCR-RFLP showed that 19 samples (90.48%) were positive for E. dispar; one sample (4.76%) was positive for E. histolytica and another sample (4.76%) showed mixed infection.Conclusion these findings show that the nonpathogenic E. dispar is predominant in Ahwaz and Hamidieh rural area.

Background and Aim: Visceral leishmaniasis (kala-azar), the most dangerous form of leishmaniasis, is endemic in some parts of Iran, e.g. Ardabil, Fars, East Azerbaijan, Bushehr and Qom provinces. In recent years, the incidence of VL has increased in the Nourabad-Mamassani district in Fars Province. This study was carried out to detect VL vectors and infection rates in this region over the 2003-2004 periods.Material and Methods: Sand flies were captured in the selected villages by means of sticky traps, aspirators and CDC miniature light traps. Heads and distal abdominal segments were used for species identification and other body parts were used for DNA extraction. We employed a semi-nested PCR technique to detect Leishmania, with specific kDNA primers (LIN R4 - LIN 17 – LIN19). Some specimens were dissected for leptomonad infection.Results: A total of 12688 sand flies were collected. Phlebotomus (Paraphlebotomus) alexandri was the second most prevalent species (17.34%). The anthropophilic index of this species was 32.5%. Five cases (4.17%) of L. infantum infection were detected among the 120 P. alexandri examined by PCR method. We also observed two cases of leptomonad infection among the 112 dissected specimens.Conclusion: High prevalence rates and anthropophilic index of P. alexandri plus its natural infection with L. infantum provide enough evidence to implicate this species as the main vector species of VL in the region and the second proven kala-azar vector in Iran. Besides, the Mahoor-Milaty district of Noorabad-Mamassani was identified as a new endemic focus.

Background and Aim: Yersinia is an important water- and food-borne bacterium causing gastroenteritis in humans.Material and Methods: From December 2002 to July 2003, a total of 250 samples -including 158 meat samples and 92 chicken samples- were taken from butcheries and poultry shops operating under the supervision of Tehran University of Medical Sciences. We used a two-step enrichment procedure: phosphate buffer saline was used as primary enrichment within 3 weeks in refrigerator (cold enrichment). Then we applied KOH treatment as secondary enrichment and performed cultures on CIN agar.Results: In this study, 44.4% of all samples showed Yersinia contamination. The prevalence of Yersinia was 29.1% in meat and 70.7% in poultry. Of the 155 Yersinia isolates, 53 (34.2%) were identified as Y. enterocolitica, 47(30.3%) as Y. intermedia, 42 (27%) as Y. fredriksenii and one (0,6%) as Y. kristensenii. Biotyping of Y. enterocolitica showed that 51 strains (39.7%) corresponded to biotype 1A, 13 strains (24.6%) to biotype 1B, one (1.8%) to biotype 2, three (5,7%) to biotype 3 and one (1.8%) to biotype 4. Fourteen strains (26.4%) could not be classified.Conclusion: The high prevalence rates in meat and poultry implies that these products could be widely contaminated with Yersinia, thus serving as important vehicles for transmission to humans.

Background and Aim: Human herpes virus 8 (HHV-8), also known as Kaposi sarcoma-associated herpes virus, is believed to be the infectious trigger for Kaposi sarcoma. HHV-8 transmission takes place via different routes such as saliva, sexual intercourse, mucosal contact and possibly blood transfusion. The objective of this study was to determine HHV-8 seroprevalence in otherwise healthy blood donors as immunocompetent hosts, in HIV positive individuals (immunocompromised hosts), and in hemodialysis patients as multi-transfused patients. This is the first time that research of this magnitude on HHV-8 prevalence is conducted in Iran.Material and Methods: The study method was analytic-observational. We measured HHV-8 antibody levels in 118 hemodialysis patients, 35 HIV positive subjects and 256 healthy blood donors. The primary test method was ELISA; positive results were confirmed by IFA (immunofluorescence assay). Subjects with positive results on both ELISA and IFA were regarded as HHV-8 cases.Results: Overall, 20 hemodialysis patients (16.9%), 16 HIV individuals (45.7%) and 5 blood donors (2%) had HHV-8 antibodies. Analysis with i tests did not show any significant association with sex (p=0.24), blood transfusion or the number of transfused blood units (p=0.36 and 0.73, respectively). But there was positive correlation between age and the presence of antibodies (P=0.01).Conclusion: Serologic prevalence of HHV-8 in blood donors (as apparently healthy individuals) proved to be lower than in other studies and, in some cases, equal to the figures from other countries. The high prevalence of HHV-8 antibodies in HIV positive individuals may be partly attributed to high-risk sexual behavior and repeated exposure to pathogenic agents. The higher prevalence of HHV-8 antibodies in hemodialysis patients as compared to .blood donors (normal individuals) may be related to specific dialysis procedures or multiple transfusions with the resulting potential for infection.

Background and Aim: The Razi Petrochemical Complex is one of the greatest factories producing nitrogen and phosphate fertilizers and various other chemicals. The site, comprising 17 production units with a total surface area of around 100 hectares, is located on the outskirts of Imam Khomeini port. The ammonia (1) section of the plant, with its production capacity of 1000 tons/year, was selected as the setting for this research on the feasibility of waste minimization programs.Material and Methods: This study was conducted from October 2003 to May 2005, and it involved more than 20 visits to the site to gather data. We covered areas such as quality and quantity of liquid waste, reasons for waste generation and the production period. We also studied the current system of waste management. The materials were subsequently classified according to method proposed by the United Nations. Finally, strategies were proposed to minimize waste production.Results: Results showed that the unit produced 305509.38 cubic meters of liquid waste annually, and water used for cooling accounted for 62.35% of the total volume. The main reasons for the production of liquid waste were problems with the production. Over 95% of the waste was produced on a permanent basis. After classification, it emerged that 18.02% of the material was dangerous. Currently, 85.65% of the liquid waste in this factory is disposed of in the surrounding environment, and 14.35% is recycled.Conclusion: The proposed strategies for minimizing the liquid waste production materials in the factory are: recycling and re-use (95%), production process modifications (4.79%), and volume reduction (0.01%). With the use of waste minimization methods, we can avoid the dumping of huge amounts of waste into the environment, reduce the loss of raw material, and make out a strong case for the efficiency of waste minimization efforts.