Iranian Journal of Public Health
Volume:42 Issue: 3, Mar 2013

Type 2 diabetes mellitus (T2DM) occurs around the world with high prevalence and causes serious physical harm and economic burden to the afflicted. Haikou City is China’s southernmost tropical island city, which has not been previously studied for its T2DM prevalence. The objective of the study in employing a cross-sectional survey is to discuss the epidemiologic status of T2DM in Haikou City and to analyze the possible determinants. A total of 12,000 community residents over 18 years old from four districts in Haikou City were stratified-randomly sampled. A questionnaire survey and physical examination were conducted. Data entry and statistical analysis were performed using SPSS17.0 software. The prevalence of T2DM in Haikou City was 5.3% (5.15% for males and 5.46% for females). According to the multivariate analysis, the positive factors mainly associated with T2DM in the city included family history, Waist-to-Hip Ratio (WHR), triglycerides, low high-density lipoproteins (HDL), and blood pressure. For both men and women, family history was the highest independent risk factor associated with T2DM (OR= 47.128). The T2DM risk increased with increasing metabolic aggregate. The prevalence of T2DM for the community population of Haikou City was low. The possible risk factors included age, occupation, BMI, waist circumference, WHR, overweight, systemic obesity, central obesity, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoproteins, family history, and HDL.

The article provides the analysis of death rates in road traffic accidents in Kazakhstan from 2004 to 2010 and explores the use of sanitary aviation. Data of fatalities caused by road traffic accidents were collected and analysed. Descriptive and analytical methods of epidemiology and biomedical statistics were applied. Totaly 27,003 people died as a result of road traffic accidents in this period. The death rate for the total population due to road traffic accidents was 25.0±2.10/0000. The death rate for men was (38.3±3.20/0000), which was higher (P<0.05) than that for women (12.6±1.10/0000). High death rates in the entire male population were identified among men of 30-39 years old, whereas the highest rates for women were attributed to the groups of 50-59 years old and 70-79 years old. In time dynamics, death rates tended to decrease: the total population (Тdec=−2.4%), men (Тdec=−2.3%) and women (Тdec=−1.4%). When researching territorial relevance, the rates were established as low (to 18.30/0000), average (between18.3 and24.00/0000) and high (from 24.00/0000 and above). Thus, the regions with high rates included Akmola region (24.30/0000), Mangistau region (25.90/0000), Zhambyl region (27.30/0000), Almaty region (29.30/0000) and South Kazakhstan region (32.40/0000). The identified epidemiological characteristics of the population deaths rates from road traffic accidents should be used in integrated and targeted interventions to enhance prevention of injuries in accidents.

This study aimed to determine the prevalence of anxiety among prostate cancer patients, and to ascertain the association between stress status, socio-demographic, medical and surgical illness, current urinary problem and cancer status with general health-related quality of life (HRQOL) among these patients. A hospital based, cross sectional study was conducted at Surgical Clinic, University Malaya Medical Centre (UMMC) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using universal sampling. A total of 193 patients were recruited. The prevalence of anxiety was 25.4% (95%CI: 19.2 – 31.6). The anxiety ratings were mild anxiety (10.4%), moderate anxiety (13.6%) and severe anxiety (1.6%). The total quality of life among stress group was 59.2 ± 14.7 and among non-stress group was 73.9 ± 12.7. There was a significant negative weak correlation between anxiety score and total quality of life (rs=-0.534, P<0.001). In multivariable analysis, there was a significant difference in the total quality of life (QOL) among anxiety status [adj. mean diff. = -9.1 (95%CI: -15.2, -4.7)]. The adjusted mean difference was associated by age category of the patients (P<0.001); living partner (P<0.001); intermittency (P=0.035) and problem of hematuria during micturition (P=0.005). The prevalence of anxiety among prostate cancer was moderately high. Treating the urination problem as well as encouraging living with spouse/family may improve the quality of life among anxiety condition of these patients.

Adolescence is transitional stage of physical and mental human development occuring between childhood and adult life. Social interactions and environmental factors together are important predictors of adolescent cannabis use. This study aimed to examine the relationship between the social determinants and adolescents behavior with cannabis consumption. A cross sectional study as part of the European School Survey Project on Alcohol and other Drugs was conducted among 6.150 adolescents aged 16 years in three regions of Serbia, and three types of schools (gymnasium, vocational – professional, and vocational – handicraft) during May – June 2008. A multivariate logistic regression analysis was carried out to obtain adjusted odds ratios with 95% confidence intervals in which the dependent variable was cannabis consumption non-user and user. Among 6.7% of adolescents who had tried cannabis at least one in their lives, boys were more involved in cannabis use than girls, especially boys from gymnasium school. Well off family, lower education of mother, worse relations with parents were significantly associated with cannabis use (P < 0.05). Behaviors like skipping from schools, frequent evening outs, and playing on slot machines were also related to cannabis use (P < 0.05). The study confirmed the importance of family relationship development. Drug use preventive programmes should include building interpersonal trust in a family lifecycle and school culture.

The purpose of this study was to describe the influence of organizational variables on hospital staff nurses’ job performance as reported by staff nurses in two cities in Turkey. Hospital ownership status, employment status were examined for their effect on this influence. The reported influence of organizational variables on job performance was measured by a questionnaire developed for this study. Nurses were asked to evaluate the influence of 28 organizational variables on their job performance using a five-point Likert-type scale (1- Never effective, 5- Very effective). The study used comparative and descriptive study design. The staff nurses who were included in this study were 831 hospital staff nurses. Descriptive statistics, frequencies, t-test, ANOVA and factor analysis were used for data analysis. The study showed the relative importance of the 28 organizational variables in influencing nurses’ job performance. Nurses in this study reported that workload and technological support are the most influential organizational variables on their job performance. Factor analysis yielded a five-factor model that explained 53.99% of total variance. Administratively controllable influence job organizational variables influence job performance of nurses in different magnitude.

The aim of the present study was to appraisal the prose and cone of Shiraz City in terms of its potential in the context of health tourism. The statistical sample included medical and health tourism sector in the city of Shiraz in the northwest of Fars Province, south of Iran. The efficient authorities on the topic were identified through the hospitals engaging in medical tourism. The research was based on theoretical sampling through which the experienced people of extensive knowledge on medical tourism were interviewed. Active hospitals on attraction foreign patients averagely admit 15 and 50 foreign patients monthly and annually, respectively. Arab countries in the Persian Gulf were detected as the main marketing for Shiraz medical tourism. Oman encompassed the highest rate with 20% of admitted patients. Eye treatments with 30% and orthopedic with 6% were demonstrated as the highest and lowest rates in terms of foreign patients’ needs, respectively. Closeness of cultural and religious beliefs and familial relationships on one hand and trusting to Iranian physicians on the other hand were amongst the most reasons for selecting Iran as a destination for medical tourism by patients. Implementing 4 strategies on monitoring medical tourism would result into significant improvement of attracting more foreigner patients not only into Shiraz but all around Iran. These items have been discussed in the text.

Diabetic self-management is important for controlling the diabetes complications and promoting health-related quality of life in these patients. The objective of this study was to examine a hypothetical model regarding influences of sociostructural determinants, collaborative decision-making and patient''s beliefs system on diabetes self-management. In a cross-sectional descriptive study from Dec 2010 to Mar 2010, 500 patients of Iranian adult patients with type II diabetes attended the outpatient diabetic clinics of the Shariati Hospital in Tehran were selected by convenience sampling. Data were collected by The Demographical Information, Social- Economical Status and Diabetic History Questionnaire and eleven self-reported scales of this research. Structural equation modeling (SEM) with LIZREL software applied for data analysis. The modified model had a desirable fitness to the observed data. Patient’s beliefs system directly influenced the diabetes self-management. Sociostructural determinants influenced diabetes self-management indirectly via collaborative decision-making and Patient’s beliefs system. In addition, collaborative decision-making significantly influenced patient’s beliefs system that thereby impacted diabetes self-management. Sociostructural determinants, collaborative decision-making and patient’s beliefs system are integrated and cooperatively affect on diabetes self-management. Comprehensive intervention schedules required to improve these agents for encouragement the type II diabetes self-management.

The main objective of the present study was to determine the association between completed suicides and season of the year in Iran during 2006-2010. Data on completed suicides were collected by questionnaires field out by the family members of the victims in Legal Medicine Centers throughout the country over the period from 2006 to 2010. The maximum number of completed suicides (380) was observed in August, while the minimum number (231) was reported in February. Season-wise, completed suicides were most prevalent in summer (1040), whereas least prevalent in winter (726). Mean (SD) age of individuals having committed suicide was 31.5 (14.6) years. This value did not change significantly in different seasons (P=0.051); nor, was a statistically significant difference observed in the educational level and the reason for suicide across different seasons of the year. Self-immolation and toxic poisoning were found to be significantly less common in autumn and winter (P<0.05), respectively. The number of completed suicides was higher in warm seasons Season of the year had significant relationships with gender as well the method of suicide, while no significant association was observed for age, level of education, and reason for suicide.

Pneumocystis jirovecii causes Pneumocystis pneumonia (PCP) in immunocompromised patients with a high rate of morbidity and mortality. Colonization with this fungus may stimulate pulmonary inflammation or lead to PCP in susceptible patients. The epidemiology of this infection and routs of its transmission has poorly studied in Iran. We examined Pneumosystis colonization in patients with various lung underlying diseases. Bronchoalveolar lavage (BAL) fluids of 458 patients with different underlying diseases or pulmonary signs were collected between August 2010 and January 2012. Patients were divided into four groups: transplant recipients, malignant patients, immunosuppressive drug recipients and patients with other different lung diseases. A sensitive nested-PCR method targeted 18S ribosomal RNA gene was used for investigating P. jirovecii in the specimens. P. jirovecii DNA was detected in 57 out of 458 (12.5%) BAL samples by nested-PCR. Colonization rate in malignant patients, transplant recipients, immunosuppressive therapy recipients and patients with other various lung diseases was 21.7%, 20.3%, 12.7% and 7.3%, respectively. The enzyme BanI cuts all PCR products producing fragments with the size of 228 and 104 base pair. This finding as well as sequencing of four random positive samples validated and reconfirmed the PCR results. P. jirovecii cysts were found in 5 out of 57 PCR positive samples. A significant number of patients with pulmonary diseases were colonized by P. jirovecii that can develop to PCP in these patients or they may transmit the fungus to other susceptible patients.

It is important to focus on creating opportunities for patients’ participation at all levels of health systems in order to promote their ability to improve patient safety and quality of services. The general aim of this study was to determine patient safety level in Tehran University of Medical Sciences’ (TUMS) general hospitals, Tehran, Iran from patients’ perspective and to determine the contributory factors on their perspective. This was a cross-sectional study. In the spring 2011, the list of clinical departments of the six general hospitals affiliated to TUMS was obtained through the Website of TUMS. By using stratified random sampling, the sample size was calculated 300 patients. Data were collected by using a structured questionnaire and its validity and reliability were acceptable. Descriptive statistics, linear regression and logistic regression were used for analyzing the data. Totally, 60% of patients were female. Patient safety was evaluated high by 60% of respondents. The unmarried or educated or employed individuals tend to score lower than others. TUMS’s general hospitals are enough safe from patients’ perspective, patient safety should be improved. In clinical governance, contributing patients’ perspective to the improvement of patient safety reforms is critical in generating new models of good practice.

Rhabditidae is a family of free-living nematodes. Free living nematodes due to their active movement and resistance to chlorination, do not remove in conventional water treatment processes thus can be entered to distribution systems and cause adverse health effects. Ultraviolet radiation (UV) can be used as a method of inactivating for these organisms. This cross sectional study was done to investigate the efficiency of ultraviolet lamp in the inactivation of free living nematode in water. The effects of radation time, turbidity, pH and temperature were invistigated in this study. Ultraviolet lamp used in this study was a 11 W lamp and intensity of this lamp was 24 µw / cm2. Radiation time required to achieve 100% efficiency for larvae nematode and adults was 9 and 10 minutes respectively. There was a significant correlation between the increase in radiation time, temperature rise and turbidity reduction with inactivation efficiency of lamp (P<0.001). Increase of turbidity up 25 NTU decreased inactivation efficiency of larvae and adult nematodes from 100% to 66% and 100% to 64% respectively. Change in pH range from 6 to 9 did not affect the efficiency of inactivation. With increasing temperature inactivation rate increased. Also the effect of the lamp on inactivation of larvae nematod was mor than adults. It seems that with requiring the favorable conditions low-pressure ultraviolet radiation systems can be used for disinfection of water containing Rhabitidae nematode.

Onychomycosis is a nail disorder associated with aesthetic problems, discomfort, physical injury and loss of dexterity. The purpose of the present study was to isolate and identify the causative fungi of onychomycosis in 2402 patients in Kermanshah Province, western Iran in 1994 to 2010. Mycologic assessment was carried out by standard methods including either microscopic or cultural procedures. Direct microscopy of the nail clips was positive in 1086 (45.2%) and fingernail and toenail onychomycoses were recognized in 773 (71.1%) and 313 (28.8%), respectively. Yeasts were detected in 853 (78.5%), dermatophytes in 201 (18.5%) and non-dermatophyte fungi in 32 (2.9%) patients. The results of fungal culture showed Candida albicans isolated in 384 (45.0%) and other Candida spp. isolated in 361 (54.0%) of the cases as the most common agents of onychomycosis while among dermatophytes, Trichophyton rubrum was found in 63 (37.0%) of the cases as the main dermatophytic agent followed by T. mentagrophytes 32 (15.9%) and Epidermophyton flocosum 30 (17.6%). Among the non-dermatophyte moulds, Aspergillus flavus was the most prevalent species 12 (37.5%) followed by A. niger 8 (25.0%) and A. fumigatus 4 (12.5%). Moreover, 139 (12.8%) samples with positive direct microscopy yielded no growth. The highest rate of onychomycosis was found in patients between 30-40 years of age. In sum, the current results identified the aetiological agents and primary epidemiological aspects of onychomycosis in west Iran.

According to willingness of the Ministry of Health, Iran and presence of appropriate conditions for disease elimination, national malaria control program decided to conduct a research to clarify malaria status in 2007 and to provide required information to perform the elimination program. This review is comprised of the basis of national malaria elimination program in vision of 2025, which was started in 2010. In this descriptive study, data were analyzed by applications of different variables at district level. All districts in the three south eastern provinces, in which malaria has local transmission, were considered. Malaria cases has been determined and studied based on the national malaria surveillance system. Since vivax malaria is predominant in Sistan & Baluchestan Province, number of vivax cases is equal to malaria positive cases approximately. The important point is that Nikshahr contains the maximum number of local vivax cases in this province and the maximum number of falciparum cases is reported from Sarbaz district. Among all districts of Hormozgan Province, no case of autochthonous falciparum was detected except in Bandar Jask and one case in Minab. There was no case of autochthonous falciparum in Kerman Province, except in Kahnoj and Ghale Ganj that each of them had one case in 2007. It appears that the report of locally transmitted cases in Iran is increasing over the past few years, before starting malaria elimination plan. Since the Afghan refugees started to return to their own country so the main source of reporting of imported malaria cases reduced and local cases would be demonstrated more clearly.

Abdominal wall hernia is common but reliable scientific data about its work relatedness is very limited and inconsistent. In this paper, a less common type of abdominal wall hernia in a 30 year old male worker is presented with recurrence after first surgery when he returned to work. In contrast with almost all kinds of hernia, a lifelong limitation for heavy lifting was recommended. It seems that contrary to popular belief, work relatedness of abdominal wall hernia is seriously doubtful, although conclusive evidences are not enough. It is preferable to make decisions cautiously for return to heavy duties of work after surgery of large umbilical, umbilical & epigastric or incisional hernia, while avoiding recommendations for long days off work after surgery of any hernia.

In the modern medical era sudden cardiac death and its causes among athletes have been described. Finding appropriate preventive ways from this tragic event is so important in sports medicine. According to different trials and observations, there are numerous reasons and some preventive strategies. Historically, sudden cardiac death among athletes had been described several hundred years ago by ancient physicians. The first physician who described this topic completely and recommended some preventive ways is Ibn Abi Sadiq al-Neishaburi. In this article, his opinion has been discussed.