Iranian Journal of Public Health
Volume:41 Issue: 10, Oct 2012

Organophosphorous (OP) pesticides are used frequently in agriculture, particularly in Asian countries over the past decades. Poisoning by these agents, either as acute or chronic in these nations, is a serious health problem. OP pesticides residue in fruits and vegetables that may not induce early clinical features, could also affect the human health. Therefore, medical and health professionals should be aware and learn more on the toxicology, prevention and proper management of OP poisoning. The well-known mechanism of OP toxicity is the inhibition of acetyl cholinesterase, resulting in an accumulation of acetylcholine and continued stimulation of acetylcholine receptors. Therefore, they are also called anticholinesterase agents. Determination of blood acetyl cholinesterase and butyryl cholinesterase activities remains a mainstay for the rapid initial screening of OP pesticides. Quantitative analysis of OP and their degradation products in plasma and urine by mass spectrometric methods is a more specific method, but is expensive and limited to specialized laboratories. Therefore, history of OP pesticides exposure and clinical manifestations of a cholinergic syndrome is sufficient for management of the exposed patients. However, electrophysiological tests may be required for the diagnosis of delayed neuropathy of OP poisoning. The standard management of OP poisoning includes decontamination, atropine sulphate with an oxime. Recent advances focus on blood alkalinisation and magnesium sulphate as promising adjunctive therapies. Preventive measures in OP exposure are of great importance in human health in developing countries. Therefore, regulations and controls on safe use of OP particularly in Asian countries are recommended.

The aim of the study was a recommendation and establishment the concept of the appropriate communication between public health, other competent services and population in emergency as the corner stone which guarantee that all goals which are important for community life will be achieved. We used methodology appropriate for social science: analyses of documents, historical approach and comparative analysis. The finding shows the urgent need for accepting of crises and emergency risk communication principles, or some similar concepts, in Serbia, and implementing effective two way communication especially in multiethnic region. The pragmatic value of the paper lays in information about the recent improvement of health workforce and emergency services in emergencies using new concept of communication and as source of numerous useful documents published in USA and few recent Serbian examples. Health workforce has significant role in the process of protection of population in emergencies. Policy makers should work on finding a way to improve their coordination and communication, creating new academic programs, providing of adequate training, and financial means in order to give them different role in society and provide visibility. From other side health workforce should build back to the citizen trust in what they are doing for society welfare using all their skills and abilities.

The aim of this study was to evaluate whether an eight-week group mindfulness-based stress reduction program would be an acceptable and effective treatment for patients suffering from GAD. Eligible subjects with generalized anxiety disorder were recruited to Parsa Hospital and Shahid Rajaee Counseling and Social Work Center from June 2009 to October 2011. An experienced psychiatrist diagnosed these patients with a structured clinical interview for axis I disorders and a clinical psychologist conducted a clinical interview for in order to confirm the diagnosis. Subjects were randomized to an eight week course of group mindfulness based stress reduction program (16 subjects) or a control group (15 subjects). Subjects completed measures of anxiety, depressive symptoms and worry at baseline and end of treatment. To investigate the relationship between anxiety, depression and worry symptoms and mindfulness based stress reduction as well as controlling pretest effect, data were analyzed with analysis of covariance. There were significant reductions in anxiety (P<0/001), depressive (P<0/001) and worry symptoms (P<0/001) from baseline to end of treatment. Mindfulness- based stress reduction may be an acceptable intervention in the improvement of generalized anxiety disorder symptoms. Future trials include development of randomized clinical trials of MBSR for GAD.

The aim of this study was to identify the most common aeroallergens in patients with asthma and rhinitis. The study enrolled 102 participants including 64 patients with respiratory allergies (among them 15 were clinically diagnosed as asthma patients, 41 with rhinitis, 8 were both) and 38 healthy controls. All of participants were subject of skin prick tests (SPT) with series of common allergenic extracts. Sera from all participants were tested for total IgE and eosinophil count. To measure airflow limitation and reversibility in asthma patients the pulmonary function testing were carried out. M/F ratio was 1:1.6 in patients and 1:0.7 in control group with mean age 28.88 year (SD 13.16; range 6 - 55 year) and 20.47 respectively (SD 1.16; range 19-23 year). The most common risk factors in these patients were total IgE more than 100 IU/ml, eosinophils above 4% and positive family history of atopy. Skin prick testing results showed prevalence rates for allergen groups in this manner: house dust mites 81.3 %, pollens 57.8 %, animal dandruff 12.5% and moulds 4.9%. Polysensitization was common in 51.6% of all sensitized patients being positive to more than one group of allergens. House dust mites are the main sensitizing allergens among our allergic patients as well as healthy controls. Next in importance, in all participants, are grasses. This pattern of prevalence was expected based on herbal geography, climate and specially lifestyle. It was also compatible with the results from studies carried out in places with the same habitat.

The purpose of this study was to investigate the association between physical inactivity and academic record in Korean adolescents. Adolescent students from the first grade of middle school to the third grade of high school (n=75,066) participated in the 5th Korea Youth Risk Behavior Web-based Survey project in 2009. The association between physical inactivity and academic record was assessed using multivariate logistic regression analysis after adjusting for gender, age, body mass index, family''s socioeconomic status, parents'' education level, and frequency of vigorous or moderate physical activity (PA) as well as muscular strength exercises. During weekdays, the odds ratios (ORs) (95% confidence interval [CI]) for reporting a higher than average academic record, as compared with <1 hour of physical inactivity per day, was 0.796 (0.761-0.832, for ≥1 to <2 hours, 0.632 (0.603-0.663, for ≥2 to <3 hours, 0.567 (0.535-0.601, for ≥3 to <4 hours, and 0.494 (0.468-0.522, P < 0.001 for all cases) for ≥4 hours of physical inactivity per day. During the weekends, the ORs (95% CI) for reporting a higher than average academic record, as compared with <1 hour of physical inactivity per day, were 0.901 (0.848-0.957, P = 0.001) for ≥3 to <4 hours and 0.785 (0.743-0.830, P < 0.001) for ≥4 hours of physical inactivity per day. Korean adolescents who spend more time engaged in physical inactivity are predisposed to a below-average academic record.

Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well.

We aimed to define and compare the risk factors of spinal and femoral osteoporosis in postmenopausal Iranian women. It was a multicentre based study carried out in two stages during 2002 to 2005 among post menopausal women in Tehran. In first stage case group included 140 women with diagnosed spinal osteoporosis using DEXA method as definition of WHO and Controls were 167 women with normal spinal BMD. In second stage, among the same study population case groups were 72 women with total femoral neck osteoporosis. The controls included 191 women with normal femoral BMD.` Odds Ratio was used for estimation the association of risk factors with spinal and femoral osteoporosis. Plus common well known osteoporosis risk factors, significant risk factors for each region with their odds ratios included: Steroid use (2.4) and low activity (3.6) for femoral osteoporosis and parity>3 (2) and lactation duration > 2 yr (1.9) for spinal osteoporosis. There are some common and different protective and risk factors for spinal and femoral osteoporosis in this population.

The aim of this study was to estimate the frequency and rate of the first 50 common types of invasive procedures in Iran. Data about the number of all invasive procedures and each type of procedure that were conducted in Iran in 2010 were collected using the main insurance organizations database. These numbers were sorted in an excel database, and the first 50 invasive procedures with the most common frequency were selected. Then according to the population covered by the given insurance organizations, and based on the total population of Iran in 2011, we estimated the number and rate of each invasive procedure for the selective procedures. It was estimated that a total of 769,500 (1,026 per 100,000 population) natural vaginal delivery (NVD) was performed in Iran in 2011, followed by 416,790 cataract operation (556 per 100,000 population), 401,436 cesarean delivery (535 per 100,000 population), 260,514 coronary angiography disease (347 per 100,000 population), 181,836 varicocele (242 per 100,000 population), 144,918 appendectomy (193 per 100,000 population), 134,766 rhinoplasty (180 per 100,000 population) and 105,912 pilonidal cyst (141 per 100,000 population). The result could be used to identify and select the most frequent invasive procedures in Iran, to calculate the average cost of each procedure and to use these costs to estimate hospital budget and improve policy-making.

Vaccination status is more often evaluated by up-to-date vaccination coverage rather than timeliness of immunization. This study was conducted to evaluate delayed vaccination during infancy period and to determine the predictors effecting on vaccination delay. This cross-sectional study was conducted from June to September 2011 in Hamadan Province, the west of Iran, recruiting 2460 children from 12 to 24 months of age via stratified cluster random sampling with 123 clusters of 20 persons. Data on vaccination were extracted from children''s vaccination card. Additional data were collected through interview. Vaccination coverage of infants was >99.4% for all vaccines. However, 42% to 67.6% of infants received vaccine with delay. The delay time was longer in urban areas (P<0.001), among children with high educated mothers (P<0.001), and for the vaccines delivered at the end of infancy period. Delay time had a direct correlation with vaccinators'' education level (P<0.001) and an inverse correlation with the number of periodical visits of health centers (P<0.001). No correlation was detected between delay time and gender (P=0.507) and distance from health centers (P=0.627). Considerable number of the infants received delayed vaccine, although, vaccination coverage was nearly completes. This issue indicates that delay time is very problematic to be resolved in any given situation even in areas with nearly full vaccination coverage and may require a major effort to be corrected. Furthermore, this study assessed the effect of some factors on delayed vaccination which may help policy makers who plan immunization programs.

Aflatoxin contamination of food and feed stuff is a serious health problem and significant economic concerns. In the present study, the inhibitory effect of Candida parapsilosis IP1698 on mycelial growth and aflatoxin production in aflatoxigenic strains of Aspergillus species was investigated. Mycelial growth inhibitions of nine strains of aflatoxigenic and non-aflatoxigenic Aspergillus species in the presence of C. parapsilosis investigated by pour plate technique at different pH, temperature and time of incubation. Reduction of aflatoxin was evaluated in co-cultured fungi in yeast extract sucrose broth after seven days of incubation using HPLC method. The data were analyzed by SPSS 11.5. The presence of the C. parapsilosis at different pH did not affect significantly the growth rate of Aspergillus isolates. On the other hand, temperature and time of incubation showed to be significantly effective when compared to controls without C. parapsilosis (P≤0.05). In aflatoxigenic strains, minimum percentage of reductions in total aflatoxin and B1, B2, G1, G2 fractions were 92.98, 92.54, 77.48, 54.54 and 72.22 and maximum percentage of reductions were 99.59, not detectable, 94.42, and not detectable in both G1 and G2, respectively. C. parapsilosis might employ as a good biocontrol agent against growth and aflatoxin production by aflatoxigenic Aspergillus species

We aimed to determine the incidence of co-inheritance as well as interaction of sickle cell trait (SCT) and αthal/βthal mutations in south and south central of Iran. We employed a PCR and restriction fragment length polymorphism techniques to confirm diagnosis of sickle cell trait. All subjects were screened for any α/β -thalassemia mutations using a gap-polymerase chain reaction and amplification refractory mutations system. Our results showed combination of sickle cell trait and β-globin mutation results in a severe clinical course of similar to sickle cell disease, while coinheritance of α-globin gene defects usually modulates the clinical course. A coexistence of sickle cell trait and α-globin gene mutation was the frequent genotype in overall samples (57. 5%). Sickle cell trait mainly co-inherits with α-globin gene mutation in the south and south central region of Iran. This combination modulates hematological indices and interferes with the SCT diagnosis.

Routinely collected data from tuberculosis surveillance system can be used to investigate and monitor the irregularities and abrupt changes of the disease incidence. We aimed at using a Hidden Markov Model in order to detect the abnormal states of pulmonary tuberculosis in Iran. Data for this study were the weekly number of newly diagnosed cases with sputum smear-positive pulmonary tuberculosis reported between April 2005 and March 2011 throughout Iran. In order to detect the unusual states of the disease, two Hidden Markov Models were applied to the data with and without seasonal trends as baselines. Consequently, the best model was selected and compared with the results of Serfling epidemic threshold which is typically used in the surveillance of infectious diseases. Both adjusted R-squared and Bayesian Information Criterion (BIC) reflected better goodness-of-fit for the model with seasonal trends (0.72 and -1336.66, respectively) than the model without seasonality (0.56 and -1386.75). Moreover, according to the Serfling epidemic threshold, higher values of sensitivity and specificity suggest a higher validity for the seasonal model (0.87 and 0.94, respectively) than model without seasonality (0.73 and 0.68, respectively). A two-state Hidden Markov Model along with a seasonal trend as a function of the model parameters provides an effective warning system for the surveillance of tuberculosis.

Aspergillums can produce and secrete directly afla­toxin M1. During the previous decade several papers pertaining to aflatoxin M1 have been published in different journals. Not mention of their more or less scientific aspects, they have fundamentally some problems in different features. In this paper we are going to have a bird''s eye view on some articles published on this topic. It is suggested that complete research must be performed in order to find out the source of aflatoxin M1 contamination.