International Journal of Preventive Medicine
Volume:5 Issue: 9, Sep 2014

To present the basic principles and standards of Ethics in medical research and publishing, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. An analysis of relevant materials and documents, sources from the published literature. Investing in education of researches and potential researches, already in the level of medical schools. Educating them on research ethics, what constitutes research misconduct and the seriousness of it repercussion is essential for finding a solution to this problem and ensuring careers are constructed on honesty and integrity.

This study aims to assess the frequency of some hygienic behaviors that is, tooth brushing and hand‑washing, in Iranian school students at national level. This nationwide study was conducted in 2011-2012 among 14,880 elementary, secondary and high school students who were selected by random cluster stratified multistage sampling from 30 provinces in Iran. We used the global school‑based health survey questionnaire of the World Health Organization. The population of this survey consisted of 13,486 children and adolescents (participation rate of 90.6%) including 49.2% girls and 75.6% urban inhabitants. The mean age of participants was 12.5 years (12.3-12.6, 95% confidence interval) According to the self‑report of students, 26.9% of them (20.2% of boys and 33.9% of girls) brushed their teeth more than once a day, 37.8% of boys and 42.1% of girls brushed their teeth once a day. In general, girls brushed their teeth more than boys. The frequency of those students who never brushed their teeth was twice in rural than in urban students (11.4% vs. 6.2%, respectively). In total, 3.4% of the students stated that their school had not an appropriate place for washing hands after toilet, with three‑fold higher frequency in rural than in urban schools (6.8% vs. 2.3%, respectively). 85% of students (87% of girls vs. 83% of boys) reported that they had always washed their hands after toilet, 10.1% did it occasionally and 4.1% did not. This nationwide survey revealed that Iranian students have an acceptable level of hygienic behaviors both in urban and rural areas; however, still it is necessary to improve school health facilities and hygienic habits in Iranian students.

Since tumor necrosis factor‑α (TNF‑α) could be one of the risk factors at the development of diabetes complications; as well as serum leptin deficiency is related to increased susceptibility to infections in diabetic patients, they are potential indices from the preventive medicine viewpoint. This study was conducted to represent the effect of supplemental vitamin D3 on serum leptin, TNF‑α and adiposity in type 2 diabetic patients. In this randomized double‑blind placebo‑controlled trial, study sample was selected through type 2 diabetic patients (n = 51). A total of 26 patients were orally supplemented by vitamin D3 (400 IU/d) (vitamin D group) and 25 patients by placebo (placebo group) for 14 weeks. The blood glycated hemoglobin (HbA1c) and the serum ionized Ca, leptin, TNF‑α, and serum 25‑hydroxyvitamin D (25[OH] D) were measured at the two groups in the baseline and postintervention stages. It was shown that despite of theplacebo group, serum 25(OH) D and serum leptin was significantly increased (P = 0.001 and P = 0.002, respectively), while serum TNF‑α was decreased significantly (P = 0.001) in vitamin D group. The remaining parameters, including body fat mass and HbA1c had no alterations between baseline and postintervention stages in vitamin D group. This study may advocate vitamin D supplementation among type 2 diabetic patients due to its beneficial effects on prevention of diabetes complications.

The prevalence of prediabetes in the world continues to increase. These patients have elevated the risk of atherosclerosis. The current study was designed to assess the prevalence of peripheral arterial disease (PAD) and its related risk factors in prediabetes patients. This was the case-control study in which 135 adults in three groups: Diabetes, prediabetes, and normal were studied. We evaluated the prevalence of PAD through the measurement of ankle‑brachial index (ABI). All the patients were interviewed about demographic and medical data, including age, sex, disease duration, body mass index, hypertension (HTN), fasting blood glucose, hemoglobin A1C (HbA1C), lipid profile, and medication use. The prevalence of PAD in diabetes patients was higher than the normal group (8.5%vs. 0.0%) (P < 0.05), but the differences between prediabetes compared with diabetes and normal group were not significant. The mean level of ABI in normal, prediabetes, and diabetes group was (1.11 ± 0.11), (1.09 ± 0.12), and (1.05 ± 0.03) respectively (P < 0.1). There were marginally significant differences of ABI observed between the normal group and the diabetes group. The observed differences between groups in the ABI were significant after adjusting the effects of age and sex (P < 0.05). There was an association observed between ABI and HbA1C in diabetes patients (r = 0.249, P < 0.01) and a significant association seen between PAD and HTN in the prediabetes group (P < 0.01). Peripheral arterial disease is common in asymptomatic diabetes and prediabetes patients. Management of hypertensive prediabetes patients and early detection of PAD in this group as well as in asymptomatic patients is important.

Tobacco smoking is the leading cause of preventable mortality. The prevalence of smoking in adolescents in high schools ranges from 23.5% to 41%, respectively. In Colombia, these figures are similar and students entering the University are exposed to initiate smoking. The purpose of this study was to establish the determinants associated with the initiation of tobacco smoking among university students. A case–control paired by sex and age study design was used. The study population was the students of a private university of Bucaramanga, Santander, Colombia. The final sample consisted of 167 cases and 314 controls randomly select undergraduate university students. Data analysis was performed using a Logistic regression model adjusted by gender and age; using the initiation of tobacco smoking as the dependent variable, and as independent variables relationship with parents, history of parental smoking, university social environment, being away from hometown, steady girlfriend/boyfriend who smokes, alcohol consumption, physical activity, and Francis Score. The social environment (odds ratio [OR]: 32.70, 7.40-144.55), being away from hometown (OR: 3.06, 1.55-6.07), history of steady girlfriend/boyfriend who smoke (OR: 2.87, 1.43-5.76), a bad relationship with the father (OR: 8.01, 2.01-31.83), history of tobacco consumption of the mother (OR: 2.66, 1.37-5.17) and alcohol consumption (OR: 4.79, 1.91-12.00) appeared as determinants of initiation of tobacco smoking. As protector factors we found media advertisement (OR: 0.19, 0.05-0.71), light physical activity 2-3 times a week (OR: 0.33, 0.12-0.88), and a high result in Francis score (OR: 0.95, 0.919-0.99). University efforts for tobacco‑free policies should focus on preventive advertisement, promoting physical activity and awareness among young students of social environmental factors that could influence their decision to start smoking tobacco.

Migraine is a chronic disorder affecting women more than men. Sexual dysfunction is one the complaints of women with migraine, which is not regarded as it should be. The goal of this study was to determine sexual dysfunction in women with migraine, and possible effects of depression and sleep quality on their sexual function. One hundred married migraineurs women were enrolled. All participants were asked to fill out valid and reliable Persian versions of Pittsburgh Sleep Questionnaire (PSQI), female sexual function index (FSFI) and beck depression inventory (BDI). Mean BDI, PSQI, and FSFI scores were 15.1 ± 9.1, 7.6 ± 4, and 21.6 ± 8.8 in all patients, respectively. Sexual dysfunction found in 68% and 79% were poor sleepers. Mean BDI and PSQI scores were significantly higher in women with sexual dysfunction (FSFI < 26.55). There was significant negative correlation between BDI score and FSFI (r = −0.1, P = 0.001) as well as significant positive correlation between BDI and PSQI (r = 0.42, P < 0.001). Multiple linear regression analysis showed that BDI and age were independent predictors of FSFI score. Physicians should consider sexual dysfunction in women with migraine along with depression and poor sleep in such cases.

Tourniquets used repeatedly on patients for blood sampling are a potential source of nosocomial infections. They harbor numerous microorganisms, including methicillin‑resistant Staphylococcus aureus (MRSA). The aim of this study was to investigate tourniquets for the presence of microorganisms and to ascertain the infection control practices of health care workers. A cross‑sectional study was carried out in 2012 on 100 samples of tourniquets collected from public and private sector hospitals in Karachi, Pakistan. The samples were cultured, and pathogenic microorganisms were identified and tested for methicillin resistance. A questionnaire was administered simultaneously to 100 health care workers who had used the tourniquets. Descriptive data are represented as frequencies and percentages. Ethical considerations were taken into account. The total colonization rate was 51%, with no bacterial growth in 17/40 and 32/60 samples from public and private sector hospitals, respectively. S. aureus was isolated from 12 (42%) private sector hospital samples and 10 (43%) public sector hospital samples. Although MRSA was found in more samples from public than private sector hospitals, the difference was not statistically significant. Nevertheless, 90% of all elastic and 41% of all rubber tourniquets harbored microorganisms (P < 0.001). Although 96% of health care workers agreed that hospital staff and fomites can transmit infection, none identified tourniquets as a potential source. When asked whether tourniquets appeared clean before use, 66% agreed, and only 25% considered that tourniquets should be washed or cleaned before use. Tourniquets are a potential reservoir and vehicle for the spread of nosocomial infections, including MRSA. Health care workers have inadequate knowledge about infection control procedures and personal hygiene for disinfecting reusable items.

The aim was to compare the intensity of pain caused by suprapubic aspiration (SPA) and urethral catheterization for urine sampling in premature infants. A prospective randomized controlled design with 80 premature infants in Alzahra University Hospital, Isfahan, Iran was conducted. Premature newborns who needed urine samples for microbiologic analysis were randomly assigned into two groups: SPA group and urethral catheterization group. Newborn faces and upper parts of the body were videotaped during the study and the pain was assessed during urine collection using Premature Infant Pain Profile (PIPP) score. Furthermore, crying time compared between groups. The mean crying time was significantly higher in SPA than urethral catheterization group (77 vs. 34.4 s) (P < 0.001). The PIPP score was significantly lower in urethral catheterization group (13.4) than SPA group (11.5) P < 0.001. The success rate of SPA was 53% compared with 71% success rate of urethral catheterization. SPA is more painful than urethral catheterization in premature male infants as assessed by PIPP score and is more likely leads to procedure failure.

Multiple sclerosis is a common and chronic neurologic disorder. This disorder imposes physical, economic, and psychosocial burden on individuals, their families and society. This study aims to analyze the costs of multiple sclerosis disease based on the severity of disability. We performed a cross‑sectional cost of illness study. This study was conducted in 332 patients of Khuzestan province of Iran. Data were included: Patient’s characteristics, disability status, medical, and nonmedical costs and were gathered by using the questionnaire during 3 months period. Costs analysis was performed in the basis of expanded disability status scale (EDSS). Data were analyzed by using SPSS 18 software. Mean age of the patients was 33.5 (standard deviation [SD]: 9.1) and 70.5% of patients were female. Mean EDSS score of the patients was 2.2 (SD: 1.6). Most patients (92.1%) had relapsing remitting multiple sclerosis (MS) form of the disease. Costs mean per patients was 8.6 ± 7.9 million Rial. The direct and indirect costs were 93.1% and 6.9% of total costs, respectively. The major cost of the disease belongs to the pharmaceutical treatment (22% of costs). The majority costs (approximately 62%) attributed to EDSS of 6-7 and >7. Furthermore, there was strong significant relationship between cost of illness and disability severity of patients (P < 0.05). Cost mean per MS patients was relatively high. Furthermore, the results showed that cost of disease had positive and significant relationships with EDSS score that is, progression of disability increase costs of patients.

Psychiatric illnesses are an important group of co‑morbidities that can occur among patients with non‑communicable diseases (NCDs). Both these chronic conditions have an important implication in terms of quality of life, general well-being and cost of treatment and general longevity of the patient. The objectives of our study were to assess the burden of psychiatric co‑morbidities among patients with select NCDs and to identify the determinants associated with them. A cross‑sectional study was conducted at the outpatient departments (OPDs) of Government District Hospital, Mangalore. The study was conducted among patients with select NCDs viz. diabetes mellitus, hypertension, ischemic heart diseases and their combinations attending OPDs of Government District Hospital, Mangalore. Participants were interviewed using Patient Health Questionnaire‑Somatic, Anxiety and Depressive Symptoms. Data analysis was performed using SPSS version 11.0 (SPSS Inc., 233 South Wacker Drive, 11th floor, Chicago, IL 60606‑6412). Bivariate and logistic regression analyses were performed to test the association between different variables. Among the 282 study participants, psychiatric illnesses observed were somatization (n = 99, 35.1%), anxiety (n = 54, 19.1%) and depression (n = 82, 29.1%). Bivariate analysis showed significant negative association (P <0.05) between psychiatric illness and factors such as education, marital status, age <60 years, duration of illness of <10 years. However, on multivariate analysis only marital status (odds ratio [OR]: 0.500, confidence interval [CI]: 0.321‑0.777, P = 0.002) and duration of illness (OR: 0.651, CI: 0.439‑0.967, P = 0.032) were found to be significantly associated negatively with depression and anxiety.

Quality of life (QOL) is increasingly recognized as an important outcome measure in dermatology. Psoriasis has a great impact on QOL of patients, and has a strong effect on social relations, psychological status, and daily activities. This study describe and compare the impact of different grades of severity of psoriasis on QOL of patients in north of Iran. This cross‑sectional study was performed on 55 patients diagnosed with psoriasis and 55 healthy controls. The patients were selected by consecutive sampling from April to December 2006. The controls were recruited by simple random sampling among patient escorts. After obtaining written informed consent, all the members were included into the study. The Psoriasis Area and Severity Index (PASI) standard questionnaire was used to determine the severity of the disease. In addition, the short‑form‑36 questionnaire, which is validated for use in Iran, was employed. The gathered data were analyzed using the Stata (V 8.0, SE) (Copyright 1984-2003, Stata Corporation, 4905 Lakeway Drive Special Edition, College Station, Texas 77845 USA) and analyses of covariance (ANCOVA) test. Overall, The mean PASI scores was 5.4 ± 6.7, total QOL scores had a significant difference between patients and controls (61.1 ± 17.0 vs. 71.9 ± 22.4) (P < 0.05), especially in three domains: Role‑physical (58.5 ± 23.3 vs. 70.8 ± 26.2), general health (43.8 ± 21.6 vs. 61.5 ± 27.3), and social functioning (62.7 ± 26.7 vs. 79.5 ± 27.5) (P < 0.01). Physical activities were affected in >50% of the cases. This figure significantly increased with the increasing severity of psoriasis. In addition, social relationships were disrupted in more than half of the patients, but with no significant difference between different grades of severity (P > 0.05). There is no significant difference between adjusted score of multiple domains of QOL in psoriatic patients according to PASI levels (ANCOVA, P > 0.05). The physicians’ awareness of the importance of patients’ QOL in both physical and emotional aspects could improve and enhance the psychological evaluation of the psoriatic patient, which will promote his/her positive outcome. And, PASI score can’t to predict the QOL really.

Oligodendrocytes, the myelinating glial cells of central nervous system, are highly vulnerable to ischemic‑induced excitotoxic insult, a phenomenon in which calcium overload triggers cell death. Berberine is an alkaloid extracted from medicinal herbs as Coptidis Rhizoma with several pharmacological effects like inhibition of neuronal apoptosis in cerebral ischemia. We examined the effects of berberine (0.5-4 μM) and glutamate receptors antagonists (MK‑801 [10 μM] and NBQX [30 μM]) on OLN‑93 cell line (a permanent immature rat oligodendrocyte) during (30, 60, 240 min) oxygen‑glucose deprivation (OGD)/24 h reperfusion. The cells were cultured in 12-well plates. The cells were exposed to glucose‑free medium and hypoxia in a small anaerobic chamber. Cell viability was evaluated by MTT (3-[4,5‑Dimethylthiazol‑2‑yl]-2,5‑diphenyl‑tetrazolium bromide) assay. The intracellular calcium levels also were evaluated by Ca2+‑sensitive indicator Fura-2/AM in presence or absence of berberine (2 μM) during 30 min chemical OGD by NaN3 (20 mM). Student’s t‑test and ANOVA were used for statistical analysis. Berberine, MK‑801and NBQX significantly increased oligodendrocyte viability in all 3 time‑scheduled oxygen‑glucose deprivation/reperfusion. Berberine at 2 μM produced peak of protection, and increased cell viability to 83%, 77%, and 79% during 30, 60, 240 min ischemic experiments, respectively (P < 0.001). Berberine significantly attenuated intracellular Ca2+ rise induced by chemical ischemia, and this effect of berberine was significantly stronger than MK‑801 and NBQX (P < 0.001). We concluded that berberine protected OLN‑93 oligodendrocyte against ischemic induced excitotoxic injury. Attenuation of intracellular Ca2+ overload by berberine may be the key mechanism that saved OLN‑93 from excitotoxicity damage.

Vitamin D deficiency is a pandemic problem mostly diagnosed in elderly. Few studies are available exclusively done on the topic among young adults. Specific professions such as medical students may have higher risk for developing hypovitaminosis D. We aimed to assess the vitamin D status in medical students of Iran University of Medical Sciences; and to define a cut‑off point for 25‑hydroxyvitamin‑D (25(OH)D) level based on secondary hyperparathyroidism. This was a cross‑sectional study on 100 medical students conducted during October 2012. Serum 25(OH)D, intact parathyroid hormone (iPTH), and calcium were measured. Age, sex, body mass index, daily dietary fish and egg consumption, sun exposure, and sunscreen usage were recorded. The association between serum 25(OH)D and iPTH was assessed. Receiver operating characteristics curve analysis was performed. 25‑hydroxyvitamin‑D level was <30 ng/ml in 99% of all participants, and <20 ng/ml in 77%. Mean serum 25(OH) D level was 16.8 ± 4.7 ng/ml. iPTH level in the group with 25(OH)D level of <10 ng/ml was significantly higher than in those with serum 25(OH)D level of 10 to <20 ng/ml and 20 to <30 ng/ml (109 ± 47 pg/ml, 47 ± 27 pg/ml and 46 ± 19 pg/ml, respectively; P = 0.0001). There was a significant linear inverse correlation between serum iPTH and 25(OH)D (r = -0.36, P = 0.0001). 25(OH) D level of 15.4 ng/ml was determined as the optimal cut‑off point in detecting possible secondary hyperparathyroidism. To improve the community vitamin D status, in addition to population‑based food fortification programs, educational programs seem essential; not only for general population, but also for the more educated groups.

Neck and shoulder pains are the prevalent complaints among computer office workers. The purpose of this study was to assess the relationship of somatization tendency, expectation of pain, mental health and beliefs about causation of pain with persistence of neck/shoulder pains among computer office workers. This research is a kind of prospective cohort study with 1‑year follow‑up. It has done among all eligible computer office workers of Shahroud universities (n = 182) in 2008-2009 and 1‑year later. Data were collected using the Cultural and Psychosocial Influences on Disability questionnaire. Statistical Analysis: Multiple logistic regression analysis was used to analyze the data through SPSS (P < 0.05). At the baseline 100 (54.9%) of participants reported neck/shoulder pains and at follow‑up 34.3% of them reported persistence pains. Significant relationships were found between persistence of neck/shoulder pains and negative expectation about pain in next 1‑year P = 0.002, (odds ratio [OR] =8.3, 95% confidence interval [CI]: 2.1-32.9) and somatization tendency P = 0.01, (OR = 6.5, 95% CI: 1.6-27.4). Pain expectation and somatization tendency recognized as associated risk factors of persistent neck/shoulder pain among computer operators. This confirmed some other similar studies on work‑related musculoskeletal disorders in Europe countries in recent years.

Men, much like women, are faced with age-related menopause-like symptoms as they age. In recent years, increasing attention has been drawn to clinical research into elderly men and their health-related quality of life. The Aging Male Scales (AMS) questionnaire is an international tool for assessing the health-related quality of life in elderly men. Hence far this questionnaire has not been subjected to psychometric assessment in Iran. This study aims to evaluate the validity and reliability of the Persian version of the AMS questionnaire specific to the health of elderly men in Iran. To validate this instrument, a cross-sectional study was conducted on 521 healthy Iranian men aged 40-65 years old, who attended the blood transfusion center clinic between February 2011 and June 2012. The English version of the AMS questionnaire was translated to Persian and then back-translated. To determine the reliability of the AMS questionnaire, internal consistency was evaluated and test-retest was done. The questionnaire was validated using convergent and structural validity methods. To assess the factor structure of the questionnaire, a correlation matrix of questions and domains was used. Cronbach’s alpha was higher than 0.7 (0.73-0.88) in all domains. A Pearson’s correlation coefficient of 0.87 between pretest and posttest indicated a high correlation and an acceptable reliability. The convergent validity of the questionnaire was found acceptable by calculating the correlation between the domains and items-total correlation ranging 0.40-0.85, except for question 14 that had a 0.28 correlation with the whole test. The criterion-related validity of the questionnaire in the psychological domain was confirmed with the “two-item Patient Health Questionnaire” (r = 0.63, P < 0.001). According to the results, the Persian version of the AMS questionnaire has high validity and reliability and may be used to assess the health-related quality of life of men between 40 and 65 years old.

Icter is the most prevalent disease in newborns. Although most of the newborns affiliated with this seem healthy in other aspects, there is always a fear for toxic complication of indirect hyperbilirobinemia in the central nervous system. If the level of indirect Bilirobin increases in the plasma to a level, which denotes the probability of danger, phototherapy must be carried out immediately as the basic intervention. Nowadays phototherapy is the method of decreasing (or avoidance of increase) of total serum bilirobin (TSB) and it is also used widely in neonatal health care centers according to the availably of equipment, but without any defined standard. These light sources utilize different technologies designed to create light beams with the highest efficacy and less complications. In this study, two light sources, quarts halogen incandescent filament lamp (QHIFL) and fluorescent lamp (FL) are compared with each other to find out which method is more useful and efficient. This study is a randomized controlled trial done on 25 newborns with gestational age of 35 weeks or more, with newborn’s icter in the 1st week after birth, at Isfahan Behesti Hospital, February 2012 to March 2013. A group of these newborns was treated with FL and the other with QHIFL and they all were controlled and tested according to their level of TSB at the beginning of phototherapy, at 8th, 12th, and 24th h of treatment and at discharge. The data from the study was analyzed by IBM SPSS Statistics Version 21. According to the findings, the level of TSB before and 8 h after the intervention had no significant difference among the groups. However, at 16th and 24th h of treatment, the TSB level was lower in the FL group and this difference was meaningful (P = 0.002 and P = 0.013 respectively). Furthermore the duration of the treatment was significantly shorter in FL group meaningfully (P = 0.047). According to the findings of this study, the technology used in QHIFL cannot show the capabilities of the FLs. However, more studies are needed to confirm the findings of this study are universal.

Cesarean delivery is a surgery for deliver a baby. Women with previous cesarean delivery (CD) must often choose between a vaginal delivery (VD) and repeat CD. Our aim of this study was to investigate factors associated with preference for CD in Neyshabur pregnant women with previous CD. A cross‑sectional study was conducted on all pregnant women (who had previous caesarean delivery) from February 20, 2011 to March 20, 2011 in Northeast of Iran (Neyshabur). Logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The mean age of pregnant women was 29.95 ± 4.94 years. In this study of the 292 pregnant women, 235 (80.5%) said they prefer CD. There was a statistically significant relation between preference for CD and the following variables: pregnant women’s educational level (P < 0.001; OR = 3.86; 95% CI = 1.85-8.05) and doctor’s advice (P = 0.021; OR = 3.55; 95% CI = 1.21-10.43). The pregnant women with a previous CD presented four‑fold upper chance of choosing CD. As observed in this study, most pregnant women with previous caesarean delivery prefer repeated caesarean delivery rather than VD in their subsequent pregnancy and educational level of pregnant women and doctor’s advice were important factors that influenced this preference. This subject suggests the need to counsel pregnant women with an obstetrician before select delivery type.

Prevalence of obesity in children has been increased during recent decades all over the world. Obesity, particularly, abdominal obesity (AO) is associated with the risk of metabolic syndrome and cardiovascular disease. This study aimed to assess obesity and central obesity within students aged 11-18 of Birjand city. This cross‑sectional and descriptive‑ analytical study was conducted on 2458 secondary and high school students, including 1345 girls (54.8%) and 1113 boys (45.2%), who had been selected from Birjand Middle and high schools through multiple‑cluster sampling in 2012. For determination of AO, waist circumference and the percentage 90 or more regarding age and sex were used. The obtained data were analyzed by using statistical t‑tests and 2 at the significant level P < 0.05. Among the studied students, average 16.3% (20% of boys and 13.2% of girls) had AO. The obtained data about these two groups shows statistical significant difference of P < 0.001. Chance of AO in boys was 1.6 times greater than that of girls. Odds ratio (OR) = 1.6 (confidence interval [CI]: 1.3-2.1). It was 1.9 times more about under 15‑year‑old than over 15 aged subjects. OR = 1.9 (CI: 1.5-2.4). Regarding high prevalence of AO in Birjand adolescents, it is recommended that adolescents and their families should be warned for long‑term outcomes of obesity on quality‑of‑life. Periodic studies are suggested for awareness of obesity trends in the coming years.