Iranian Journal of Public Health
Volume:43 Issue: 5, May 2014

Alcohol - related violence among Australian Aboriginal and Torres Strait Islanders (also called as “Indigenous”) is a major public health concern in Northern Territory of Australia. There is dearth of epidemiological data that link three contributing epidemics: alcohol misuse, violence, and trauma in the Northern Territory. In this review, we aimed to concentrate on how these epidemics intersect among the Indigenous people in the Northern Territory. In our descriptive review, we have searched published papers, publicly available government and health department reports web sites reporting relevant data on these three risk factors in the Northern Territory. The high rate of family and domestic violence and assaults in the Australian Territory indicates an increased correlation with high risk alcohol use compared to unintentional injuries. Heavy drinking pattern and harmful use of alcohol among Indigenous people are more likely to be associated with the incidence of violent assaults and physical injuries in the Northern Territory. We are trying to emphasize our understanding of co-occurring risk factors on the alcohol - violence relationship and urging a need for interventional approaches to reduce the public health issues in the Northern Territory.

Unfortunately, the prevalence of cesarean section has increased in recent years. Whereas awareness of the prevalence and causes is inevitable for planning and effective interventions, so aim of this study has designed and conducted for reviewing of systematic Prevalence and caesarean causes in Iran. In this meta-analysis, the required information have been collected using several keywords which are Cesarean section rate, Cesarean section prevalence, delivery, childhood, childbirth, relative causes, relative frequency, Iran and their Persian equivalents have been collected from databases such as CINAHL, Science Direct, PubMed, Magiran, SID, Iranmedex. Finally, we found 706 related articles and selected 34 articles among them for studying of cesarean Prevalence. We used CMA software with random model for Meta-Analysis. The prevalence of Cesarean was estimated48%. Using content analysis, Factors influencing the incidence of cesarean section were divided to 3 categories including social and demographic factors, obstetric-medical causes and non-obstetric-medical causes. Maternal education and grand multiparity in the field of demographic and social factors, previous cesarean in the field of obstetric-medical causes and fear of normal-vaginal delivery (NVD) and doctor’s suggestion in the field of non-obstetric-medical causes were major causes of Cesarean. According to the high prevalence of caesarean section and it upward development, it seems to be essential designing and implementing of programs and interventions effectiveness including providing of Possibility of painless childbirth and education and psychological interventions, increasing of quality of natural delivery services, proper culture and prohibiting of doctors from Personal opinions and profit.

Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily of genus Actinomyces, which colonize the mouth, colon and vagina. Mucosal disruption may lead to infection virtually at any sites in the body. The aim of this study was to underline different features of actinomycosis and to represent total data about etiologic agents, clinical, diagnostic and therapeutic approaches these infections. From a total of 38 case reports or series, ninety one cases were obtained by using of relevant articles reported as recorded cases in Iran (1972 to 2012). Analyzed data represented 21 cases of oral-servicofacial (23.1%), 7 cases of thoracic (7.7%), 17 cases of abdominal (18.7%), 21 cases of dis­seminated forms (23.1%) and 25 cases of others (27.5%). Findings indicated more common of these infections in men (61.5%). Actinomyces naeslundii (21 cases) was found as the most common causative agents in comparison with A. Israeli (15 cases), A. viscosus (3 cases) and A. bovis (1 case). The most patients had been successfully treated with peni­cillin although some cases needed surgery along with antibiotic therapy. Since some clinical features of actino­mycosis are similar to malignancies, so the differential diagnosis of invasive forms must be considered. This report empha­sizes on the importance of differential diagnosis of actinomycosis from similar diseases by clinicians.

North Darfur State has been affected by conflict since 2003 and the government has not been able to provide adequate curative health services to the people. The government has come to rely on Non-Governmental Organizations (NGOs) to provide curative health services. This study was conducted to examine the existing collaboration between government and NGOs in curative health service delivery in North Darfur State, and to identify the challenges that affect their collaboration. Documentary data were collected from government offices and medical organizations. Primary data were obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) and (2), health professionals and administrators working in the health sector (N= 45). The collaboration between the government and NGOs has been very weak because of security issues and lack of trust. The NGOs collaborate by providing human and financial resources, material and equipment, and communication facilities. The NGOs supply 70% of curative health services, and contribute 52.9% of the health budget in North Darfur State. The NGOs have employed 1 390 health personnel, established 44 health centres and manage and support 83 health facilities across the State. The NGOs have played a positive role in collaborating with the government in North Darfur State in delivering curative health services, while government’s role has been negative. The problem that faces the government in future is how health facilities will be run should a peaceful settlement be reached and NGOs leave the region.

Given limited health sources, how to make DRGs (Diagnosis Related Groups) more feasible is a big question in developing countries. This study contributes to the debate on how to bridge the pay-for-service and DRGs during the transitional period of payment reform. From 2008 to 2012, 20740 patients with cirrhosis or duodenal ulcer disease were chosen as sample. Using multiple linear regression analysis, the interrelationships between the total medical expenses of the inpatients, and age, gender of the inpatients, length of stay (LOS), region and economic level of the hospitals were examined. The main findings were 1) length of stay (LOS) and the economic level of treatment location had a statistically significant impact on patients with cirrhosis or duodenal ulcer disease. Meanwhile gender is not a significant factor for both of them. 2) Under the premise of limited resources, developing countries should first narrow down to screen for common and frequently occurring diseases, then study the key factors which affect the treatment cost of the diseases. Based on picking out common diseases and their key factors, Simplification of the DRGs setting process will greatly increase the efficiency of implementing DRGs in the developing world.

We conducted this cross-sectional study to examine the relationships between problematic alcohol drinking, unhealthy habits and socio-demographic factors based on the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). We analyzed a total of 13,488 participants based on the data collected from the KNHANES IV performed between 2007 and 2009. The frequency of binge and heavy drinking was significantly higher in men and the married participants with intermediate income. The frequency of binge drinking was higher in younger adults and individuals with at least high school graduates. After the adjustment of socio-demographic factors, the odds of current smoking (adjusted Odds Ratio [aOR] 4.11, 95% CI 3.35-5.03), abdominal obesity (aOR 1.26, 95% CI 1.08-1.48), stress (aOR 1.45, 95% CI 1.26-1.68), and depressed mood (aOR 1.31, 95% CI 1.08-1.58) were greater in heavy drinkers than in nondrinkers. The odds of current smoking (aOR 1.73, 95% CI 1.42-2.09 for infrequent binge drinking and aOR 4.95, 95% CI 4.25-5.77 for frequent binge drinking), obesity (aOR 1.22, 95% CI 1.06-1.41 for infrequent binge drinking and aOR 1.64, 95% CI 1.46-1.85 for frequent binge drinking), and abdominal obesity (aOR 1.22, 95% CI 1.04-1.43 for infrequent binge drinking and aOR 1.55, 95% CI 1.36-1.77 for frequent binge drinking) were increased with the increased frequency of the binge drinking. Our results would be of help for screening a specific subgroup of individuals who are vulnerable to alcohol drinking by establishing effective population-based strategies to reduce the problematic drinking.

The purpose of this study was to examine the relationship of physical activity levels with sleep duration (SD), and self-rated health (SRH) using the fifth Korean National Health and Nutrition Examination Survey data from 2010 and 2011. Overall, 12,188 Korean people were evaluated in relation to meeting guidelines for vigorous PA (MVPA), moderate PA (MMPA), and low PA (MLPA) associated with SD and SRH. The adjusted odds ratio (AOR) of males who slept seven hours with MMPA (AOR=0.84) and MLPA (AOR=0.85) and eight hours with MMPA (AOR=0.76) and MLPA (AOR=0.78) significantly decreased compared to subjects who sleep 6 hours/day. In females, an AOR of less than 5 (AOR=1.40) and 6 hours (AOR=1.12) with MVPA was significantly increased compared to 7 hours sleep/day, while sleeping more than 8 hours/day was significantly decreased with MLPA (AOR=0.73). Compared to the very good SHR, the AORs of more negative SHR status with MVPA, MMPA, and MLPA in males and with MMVP and MLVP in females decreased significantly. Sleeping 6-8 hours/day for MMPA and MLPA in males and 7-8 hours/day for MVPA and MLPA in females, and a very good SRH for MVPA, MMPA, and MLPA in males and for MMPA and MLPA in females are recommended to participate physical activity for the Korean population. We therefore, the independent association between PA levels and SD or SRH according to gender supports public health program to participate physical activity for the Korean population.

Each country faces a continuing challenge to collect enough blood to meet the national needs. According to WHO, there should be at least 20 blood donations per 1,000 population for developing countries, in Kazakhstan this indicator was only 16.8 in 2011. Thus, we conducted an epidemiological assessment and drew a map of the regional distribution of blood and plasma donations in Kazakhstan during the years 2000-2011. The retrospective study was conducted from 2000 to 2011. Data on blood and its components donations were acquired from the Ministry of Health (annual statistical reporting form № 39). During 2000-2011, number of blood donors decreased to 17.4% and blood donations to 6.3%. The proportion of non-remunerated blood donations and donors decreased from 97.6% to 77.9% and 97.9% to 87.7%, respectively. The paid donations had the opposite trend. Number of plasma donors increased in 2.1 times, plasma donations in 2.4 times, nevertheless the proportion of non-remunerated plasma donations decreased from 60.1% to 29.8%. The average number of blood donations per 1,000 population decreased from 19.8 (2000) to 16.8 (2011), plasma donations increased from 1.4 to 3.1. Regionally, annual average rates of blood and plasma donations per 1,000 population over 12 years varied greatly. This is the first study conducted in Kazakhstan to provide detailed information, including the regional characteristics of blood and plasma donations over an extended period of time, which can be used in blood transfusion services work.

The aim of this study was to determine the monthly DTR mass load of amphetamine-type compounds in Poland as well as an investigation of cyclical behaviour by using time series analysis and especially trends analysis. Amphetamine, methamphetamine and MDMA (ecstasy) were detected in wastewater samples collected from the main Wastewater Treatment Plant in the city of Poznan using liquid chromatography / tandem mass spectrometry (LC-MS-MS). Back-calculations used in the sewage epidemiology approach were applied to estimate the DTR mass load level of the drugs analyzed. Trends analysis was performed by fitting the data to a simple linear regression and then by using smoothing by means of a moving average (Mat lab 2013a). Trend analysis displays a steady tendency of increase or decrease throughout time series. When we plot the observation against time, we may notice that a straight line can describe the increase or decrease in the series as time goes on. Simple linear regression and method of last squares to estimate parameters of a straight-line model were used. Additionally, a lagged plot (autocorrelation plot) was used to investigate an appearance of correlation between amphetamines throughout time. Trends analysis showed the slight increase in consumption of amphetamine and decreasing trend in case of ecstasy and methamphetamine within the investigated period. There is also visible, strong correlation between ecstasy and methamphetamine consumption which cannot be stated in case of amphetamine. Trends analysis is a very useful tool to analyse the increasing or decreasing tendency in consumption of illicit drugs based on the DTR mass load data.

Multiple Sclerosis (MS) is a disease with high disabling disorders and considerable social and economic impacts. This study was conducted to analyze the spatial distribution of MS disease in Tehran, Iran during 2001-2012. The existing information in the MS patients’ medical files who had registered in Iranian MS Society (IMSS), located in Tehran office, was used for analysis. The relationship between diseases incidences in 22 zones of Tehran based on estimated socio-economic status (SES) of each zone was evaluated. High and low clustering approach was used in order to investigate the disease’s distribution pattern meanwhile, Getis Ord’s Gi test and Hot Spot analysis approach has been used to detect high risk zones of the disease. A total of 6027 MS patients were registered between 2001- 2012 which 4580 (%75.99) were women. During the study period, zone number 6 figured as the most high risk zone for the disease (P<0.1). A heterogeneous distribution was shown for the disease. Cumulative incidence of the disease in northern zones (101.73 per 100,000 inhabitants) was two times more of Southern zones (53.79 per 100,000 inhabitants). There seems to be a direct linear relationship between estimated incidence rate of the disease in each zones with the level of SES (P<0.001). Heterogeneous geographical distribution of MS and its higher estimated incidence for northern zones in Tehran may be because of higher SES and other factors in mentioned zones. It is recommended to consider the surveillance with long-term and cost-effective interventional strategies along with disease in high risk zones.

Inflammatory bowel disease (IBD) is a chronic disease of unknown etiology, in which genetic factors, seem to play an important role in the disease predisposition and course. Assessment of tumor necrosis factor (TNF-α) gene polymorphisms in many populations showed a possible association with IBD. Considering the genetic variety in different ethnic groups, the aim of the present study was to investigate the association of five important single nucleotide polymorphisms (SNPs) in the promoter region of (TNF-α) gene with IBD in Iran. In this case-control study, 156 Ulcerative colitis (UC) patients, 50 Crohn’s disease (CD) patients and 200 sex and age matched healthy controls of Iranian origin were enrolled. The study was performed during a two year period (2008-2010) at Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. DNA samples were evaluated for (TNF-α) gene polymorphisms (including -1031, -863, -857, -308 and -238) by PCR and RFLP methods. The frequency of the mutant allele of -1031 polymorphism was significantly higher in Iranian patients with Crohn’s disease compared to healthy controls (P=0.01, OR=1.92; 95% CI: 1.14-3.23). None of the other evaluated polymorphisms demonstrated a significant higher frequency of mutant alleles in Iranian IBD patients compared to controls. Among the five assessed (SNPs), only -1031 polymorphism of (TNF-α) gene may play a role in disease susceptibility for Crohn’s disease in Iran. This pattern of distribution of (TNF-α) gene polymorphisms could be specific in this population.

Outbreaks of legionellosis may be a side effect of institution-water treatment. However, the long-term outcomes and the predictive factors of Legionella prevalence in such systems have still not been fully studied. This study was therefore conducted to investigate the prevalence of Legionella spp. and to evaluate the role of bacteriological water quality parameters on its prevalence and removal in hospital water systems. A total of 45 samples were collected from distinct sites at seven hospitals in Tehran, Iran. The prevalence of this bacterium was assayed through a sensitive and specific technique for DNA detection using PCR. Multivariable stepwise regression analysis was used to explore the independent effects of the baseline factors on the incidence of Legionella. Two positive samples were also identified for species by DNA sequencing. Legionella were detected in 31.1% of samples. Showerheads and cold-water taps were the most and the least contaminated sources with 55.3 and 9 percent positive samples, respectively. Total mean of residual chlorine was 0.38 mg/L, with the peak value of 1.7 mg/L. Legionella detection was proportional to the residual chlorine content of water and the results indicated that residual chlorine content is a critical factor in the incidence and proliferation of Legionella (r=-0.33). The prevalence of Legionella also coincided with the prevalence of HPC and amoeba cysts. The high positive rate of Legionella colonization shows that hospital-acquired legionellosis might be under diagnosed in studied hospitals. Further, Legionella colonization is independent of the type of water, system characteristics and of preventive maintenance measures.

4-chloro-2-methylphenoxy acetic acid (MCPA) is one of the most important pesticides which is extensively used to control weeds in arable farmland. Exposure to this compound occurs in general population and persons who occupationally handle it. The aim of this present work was the preparation of MCPA imprinting polymer and its application as a selective sample preparation technique for trace determination of MCPA in biological and environmental samples. In this study, MCPA imprinting polymer was obtained by precipitation polymerization using methacrylic acid (the functional monomer), ethylene glycol dimethacrylate (the cross-linker), 2,2′-azobisisobutyronitrile (the initiator) and MCPA (the template molecule) in acetonitrile solution. The MIP-NPs were characterized by thermogravimetric analysis and scanning electron microscopy. The optimization process was carried out applying batch method. After optimization of the parameters, affecting the adsorption and desorption of analyte, urine and different water samples were used to determine MCPA. Imprinted MCPA molecules were removed from the polymeric structure using acetic acid in methanol (20:80 v/v %) as the eluting solvent. Both sorption and desorption process occur within 10 min. The maximum sorbent capacity of the molecular imprinted polymer is 87.4 mg g-1. The relative standard deviation and limit of detection for water samples by introduced selective solid phase extraction were 4.8% and 0.9 µg L-1, and these data for urine samples were 4.5% and 1.60 µg L-1, respectively. The developed method was successfully applied to determine MCPA in urine and different water samples.

Retinol binding protein4 (RBP4) is a type of adipokine which transports vitamin A to serum. RBP4 could be a bridge between obesity and insulin resistance. This study aimed to investigate the effects of aerobic exercises on RBP4 serum’s concentration and metabolic syndrome risk factors in obese women. Twenty obese women with body max index 35.81±3.67Kg/m2, fat percentage 43.98±4.02, and waist to hip ratio 1.03±0.05 were included and were randomly assigned to experimental and control groups. The experimental group received aerobic exercises for a period of 12 weeks each three sessions on treadmill workout. The treadmill speed were based on a 60-65 and 80-85 maximal heart rate percentage and duration of 15-20 and 45-50 minutes, at the beginning and the end of exercise, respectively. Body composition, serum glucose, insulin, TG, LDL-C, HDL-C, total cholesterol, and RBP4, were measured in both groups before and after the treatment by ELISA method. Insulin resistance was measured by HOMA-IR. To compare within group differences and between group comparisons t-correlated and t-independent tests were used, respectively. After 12 week aerobic exercises; weight, fat percentage, WHR, and BMI in the experimental group was significantly decreased (P<0.05). RBP4, insulin, insulin resistance, TG and HDL-C had significant differences between two groups. The cholesterol level, LDL-C and glucose did not have any significant changes. The aerobic exercises can decrease body composition, insulin resistance, TG, and RBP4, so it can be beneficial for obese women’s health, because it.

Welders exposure to nickel and hexavalent chromium in welding fumes is associated with increase of cancer risk in welders. In this study we calculated cancer risk due to exposure to these compounds in welders. The role of exposure parameters in welders on derived incremental lifetime cancer risk were determined by stochastic modeling of cancer risk. Input parameters were determined by field investigation in Iranian welders in 2013 and literature review. The 90% upper band cancer risk due to hexavalent chromium and nickel exposure was in the range of 6.03E-03 to 2.12E-02 and 7.18E-03 to 2.61E-02 respectively. Scenario analysis showed that asthmatic and project welders are significantly at higher cancer risk in comparison with other welders (P<0.05). Shift duration was responsible for 37% and 33% of variances for hexavalent chromium and nickel respectively. Welders are at high and unacceptable risk of cancer. Control measures according to scenario analysis findings are advisable.

Drinking water quality can be deteriorated by microbial and toxic chemicals during transport, storage and handling before using by the consumer. This study was conducted to evaluate the microbial and physicochemical quality of drinking water from bottled water coolers. A total of 64 water samples, over a 5-month period in 2012-2013, were collected from free standing bottled water coolers and water taps in Isfahan. Water samples were analyzed for heterotrophic plate count (HPC), temperature, pH, residual chlorine, turbidity, electrical conductivity (EC) and total organic carbon (TOC). Identification of predominant bacteria was also performed by sequence analysis of 16S rDNA. The mean HPC of water coolers was determined at 38864 CFU/ml which exceeded the acceptable level for drinking water in 62% of analyzed samples. The HPC from the water coolers was also found to be significantly (P < 0.05) higher than that of the tap waters. The statistical analysis showed no significant difference between the values of pH, EC, turbidity and TOC in water coolers and tap waters. According to sequence analysis eleven species of bacteria were identified. A high HPC is indicative of microbial water quality deterioration in water coolers. The presence of some opportunistic pathogens in water coolers, furthermore, is a concern from a public health point of view. The results highlight the importance of a periodic disinfection procedure and monitoring system for water coolers in order to keep the level of microbial contamination under control.

The lipophilic yeasts of Malassezia species are members of the normal skin microbial that are cause of pityriasis versicolor. Pityriasis versicolor is a common superficial fungal infection with world-wide distribution. The phenotypic methods for identification of Malassezia species usually are time consuming and unreliable to differentiate newly identified species. But DNA-based techniques rapidly and accurately identified Malassezia species. The purpose of this study was isolation and identification of Malassezia Species from patients with pityriasis versicolor by molecular methods in Markazi Province, Central Iran in 2012. Mycologic examinations including direct microscopy and culture were performed on clinical samples. DNA extraction was performed from colonies. The ITS1 region of rDNA from isolates of Malassezia species were amplified by PCR reaction. The PCR were digested by Cfo I enzyme.From 70 skin samples, were microscopically positive for Malassezia elements, 60 samples were grown on culture medium (85.7%). Using PCR–RFLP method, that was performed on 60 isolates, 37(61.6%) M. globosa, 14(23.3%) M. furfur, 5(8.4%) M. sympodialis and 4(6.7%) M. restrictawere identified. In one case was isolated M. globosa along with M. restricta. The PCR-RFLP method is a useful and reliable technique for identification of differentiation of Malassezia species.