Iranian Journal of Public Health
Volume:41 Issue: 2, Feb 2012

Cigarette smoking is the largest preventable cause of death worldwide. No systematic review is available on the situation of the smoking in Iran, so we decided to provide an overview of the studies in the field of smoking in Iranian populations. Published Persian-language papers of all types until 2009 indexed in the IranMedex (http://www.iranmedex.com) and Magiran (http://www.magiran.com). Reports of World Health Organization were also searched and optionally employed. The studies concerning passive smoking or presenting the statistically insignificant side effects were excluded. Databases were searched using various combinations of the following terms: cigarette, smoking, smoking cessation, prevalence, history, side effects, and lung cancer by independent reviewers. All the 83 articles concerning the prevalence or side effects of the smoking habit in any Iranian population were selected. The prevalence rate of daily cigarette smoking and the 95% confidence interval as well as smoking health risk associated odds ratio (OR) were retrieved from the articles or calculated. The reported prevalence rates of the included studies, the summary of smoking-related side effects and the ORs (95%CI) of smoking associated risks and the available data on smoking cessation in Iran have been shown in the article. Because of lack of certain data, special studies on local pattern of tobacco use in different districts, about the relationship between tobacco use and other diseases, especially non communicable diseases, and besides extension of smoking cessation strategies, studies on efficacy of these methods seems to be essential in this field.

Increasing evidence suggests an association between ele­vated serum aminotransferase levels and metabolic disorders (metabolic syndrome, hyperlipemia and diabetes mellitus). However, the significance of relatively low levels of aminotransferases in relation to metabolic disorders has not been fully investigated in the general population. We inves­tigated the association between serum amiontransferase levels and metabolic disorders using data from a survey in Jilin province, China. In 2007, a survey was conducted throughout Jilin, China, covering both urban and rural areas. A total of 3835 people, 18 to 79 years old including 1761 men and 2074 women, underwent real-time ultrasonography, blood tests including aspartate aminotransferase and alanine aminotransferase, and had interviews with a structured questionnaire. Serum aminotransferase levels within the normal range were asso­ciated with metabolic syndrome independent of age, occupation, cultural and educational level, income, body mass index, waist circumference, smoking, and alcohol intake. Compared with the lowest level (<20 IU/L), the adjusted odds ratios for ALT levels of 20-29, 30-39, 40-49 and >50 IU/L were 1.92, 2.50, 2.97, and 3.52 in men, and 1.38, 1.54, 3.06, and 2.62 in women, respectively. Near-normal serum aminotransferase levels asso­ciated with hyperlipemia, NAFLD, DM were also found in the study. Normal to near-normal serum aminotransferase levels are associated with metabolic disorders. Serum ALT levels of 21-25 IU/L for men, and 17-22 IU/L for women are suggested as cutoff levels that detect metabolic disorders affecting the liver.

Reference charts are widely used in healthcare as a screening tool. This study aimed to produce reference growth charts for school children from West Malaysia in comparison with the United States Centers for Disease Control and Prevention (CDC) chart. A total of 14,360 school children ranging from 7 to 17 years old from six states in West Malaysia were collected. A two-stage stratified random sampling technique was used to recruit the subjects. Curves were adjusted using Cole''s LMS method. The LOWESS method was used to smooth the data. The means and standard deviations for height and weight for both genders are presented. The results showed good agreement with growth patterns in other countries, i.e., males tend to be taller and heavier than females for most age groups. Height and weight of females reached a plateau at 17 years of age; however, males were still growing at this age. The growth charts for West Malaysian school children were compared with the CDC 2000 growth charts for school children in the United States. The height and weight for males and females at the start of school-going ages were almost similar. The comparison between the growth charts from this study and the CDC 2000 growth charts indicated that the growth patterns of West Malaysian school children have improved, although the height and weight of American school children were higher than those for West Malaysian school children.

Knowledge production and evaluation are two important functions of health research system (HRS). In this article, we aimed to reveal the correlation between evaluation of health research organizations and health knowledge production promotion. A comprehensive evaluation system was developed to evaluate the academic performance of national medical science universities on an annual basis. It assess following domains; stewardship, capacity building and knowledge production. Measurable indicators for each domain were assigned, a ‘research profile'' for each department was provided. In this study, we compared the results of annually national Health Research System evaluation findings during 2005-2008. The number of scientific articles has been increased from 4672 to 8816 during 2005 to 2008. It is mentionable that, the number of articles which has been published in indexed data bases has risen too. This fact could be related to directed policy for more international publication of scientific articles from Iran. The proportion of total articles to the number of academic members was 1.14 in 2008, comparing to 0.84 in 2005. It means that this proportion have increased about twice (0.7 Vs 0.45) during mentioned time. Moreover, other scientific products such as authored books based on domestic researches and cited articles in textbooks have increased according to special attention to knowledge production by policy makers. We conclude that Health System Research evaluation could be used as a mean for implementing policies and promoting knowledge production.

To determine a cut-off point of tPSA and PSAD to prevent unnecessary invasive cancer-diagnosing tests in the community. This study was performed on 688 consecutive patients referred to our center due to prostatism, suspicious lesions on digital rectal examination and/or elevated serum PSA levels. All patients underwent transrectal ultrasound guided biopsies and obtained PSAD. Serum levels of tPSA and fPSA were measured by chemiluminescence. Comparisons were done using tests of accuracy (AUC-ROC). Prostate cancer was detected in 334 patients, whereas the other 354 patients were suffering from benign prostate diseases. The mean tPSA in case and control groups were 28.32±63.62 ng/ml and 7.14±10.04 ng/ml; the mean f/tPSA ratios were 0.13± 0.21 and 0.26±0.24 in PCa and benign prostate disease groups; the mean PSAD rates were 0.69±2.24, 0.12±0.11, respectively. Statistically significant differences were found (P <0.05). Using ROC curve analysis, it was revealed that AUC was 0.78 for tPSA and 0.80 for f/tPSA. Sensitivity was 71% for the cut-off value of 7.85ng/ml. For f/tPSA ratio, the optimal cut-off value was 0.13 which produced the sensitivity of 81.4% and for PSAD, it was15%. As this trial is different from the European and American values, we should be more cautious in dealing with the prostate cancer upon the obtained sensitivity and specificity for PCa diagnosis (7.85ng/mL fortPSA, 15% for PSAD and 0.13 for f/tPSA ratio).

The autoimmune disease known as Idiopathic (immune thrombocytopenic purpura thrombocytopenic purpura (ITP) is clinically defined by a low numbers of platelets in the circulation blood. This study aimed to isolate autoantibodies made against the platelet glycoproteins using platelets from healthy volunteers, to determine their specificity and further elucidate their effects on platelet function. This study used a phage display system to recognize Fab anti-platelet antibodies. Anti-platelet After isolation, the anti-platelet Fab-expressing phage was characterized by ELISA and Western blotting. The Fab-bearing phage pool obtained from five rounds of panning was analysed in order to determine its anti-platelet reactivity. Of the phage colonies obtained, 100 colonies of different sizes were randomly selected for reaction with whole platelets, using M13 phage as a negative control. Twelve colonies of them had strong reactions against the whole platelet preparation, but only four colonies showed substantial reactivity against the lysed platelet preparation (lysate). Three of the four colonies showed three bands representing proteins with different molecular weights. The fourth colony showed only a single band. The final experiment to characterise the protein isolated from the phage library was a DNA gel agarose test. Each colony showed a DNA band that corresponded with the molecular size marker for 5.4 kbase pairs, and this suggested the presence of heavy and light antibody chains in the phage.

The purpose of this research was to determine the relation between negative or positive qualitative troponin I test and the short term prognosis of patients presenting to emergency department with chest pain or angina equivalent symptoms. we assessed the qualitative rapid troponin I in patients with chest pain or angina equivalent symptoms after at least 4 hours and then we followed the patients in 72 hours after presentation for adverse events such as death, CCU admission, fatal arrhythmias and heart failure. After comparing qualitative troponin I test results and adverse events, we concluded that the troponin I was significantly more positive in patients with adverse events (i.e. CCU admission, fatal arrhythmias and heart failure) (P=0.031). A single measurement of rapid qualitative troponin I test can be used as a prognostic factor in patients with chest pain or angina equivalent symptoms and also as a device for risk stratification of moderate and high risk patients.

The metabolic syndrome (MES) is associated with a high risk of diabetes and cardiovascular disease. The aim of the present study was to determine the prevalence of the metabolic syndrome as well as cut-off points for waist circumference (WC) for diagnosis of MES in Zahedan, southeast Iran. Totally, 1802 people (735 men and 1067 women) with metabolic syndrome were surveyed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the International Diabetes Federation (IDF) criteria as well as obtained WC cut-off points for IDF criteria. The prevalence of metabolic syndrome was higher in women than in men. In both sexes the prevalence increased with age. The prevalence of metabolic syndrome among 1802 individuals aged ≥19 years according to NCEP ATP III, IDF and IDF -AHA/NHLBI were 21.0% (15.4% in male, 24.9% female), 24.8 (20.0% in male, 28.1% in female) and 23.3% (19.7% in male, 25.8% in female), respectively. Low HDL-C (60.6%) and high WC (43.3%) were the most common components of the metabolic syndrome, followed by high triglycerides (32%), elevated glucose (17.1%) and high blood pressure (13%). Our data shows a high prevalence of MES in Zahedan, Southeast Iran, therefore, future health prevention strategies are required for the prevention of MES.

Air pollution is a major problem in urban\industrial areas, like Tehran, and has several impacts on human health. This study aimed at assessing concentrations of criteria air pollutants (CO, SO2, NO2, O3, PM10) in Tehran, extracting patterns of hourly, daily, weekly, and monthly variations of concentrations, and making comparisons to National Standards and WHO Guidelines. Air quality data were taken from Air Quality Control Corporation and 5 sampling stations (out of 13) were selected for analysis according to data availability. Microsoft Excel 2003 was used for data analysis and plotting the charts. Patterns of temporal variation (hourly, daily, weekly, and monthly) of air pollutant concentrations were extracted. In some cases extracted patterns matched with the patterns proposed by other researchers. Pollutant concentrations were compared to National Standards and WHO Guidelines and it was observed that in most of the days, we exceeded the limit values. Air pollution in Tehran is quite high and there are many days that we exceed the standards; therefore appropriate control strategies are needed. Although the number of sampling stations is high enough to be representative of whole city, it is proposed that an independent sampling station is setup to check the validity of the measurements.

This study aimed to assess the incidence and survival rates of neonates weighing less than 2500g for duration of the first 28 days in an Iranian community. In this prospective longitudinal study, all neonates with birth weight less than 2500g were selected from the list of all neonates born in the only public-sector referral hospital, for a six months period. The weight of neonates at birth along with some demographic variables was recorded on a checklist. A cohort of neonates with birth weight less than 2500g were followed for 28 days. Mortality within 28 days of birth was used as end point. Continuous variables were summarized using mean and 95% confidence intervals, while categorical variables were presented as ratios and percentages. About 1750 neonates were born of which 168 neonates with birth weights less than 2500g were recorded giving a proportion of 9.6%. Of 168 neonates, 21 (12.5%) had very low birth weights (VLBW) (birth weights<1500g). Survival rates for the groups of LBW (1500Conclusion