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Epidemiology and Health System Journal - Volume:4 Issue: 2, Spring 2017

Epidemiology and Health System Journal
Volume:4 Issue: 2, Spring 2017

  • تاریخ انتشار: 1396/03/04
  • تعداد عناوین: 12
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  • Rouhullah Dehghani, Masoud Amiri Pages 91-93
    Zika virus is an Arbovirus identified first time in 1947 in Uganda. Zika epidemic is a threat far greater than the Ebola outbreak. The World Health Organization has urged Asian countries to be vigilant about the risk of spreading Zika virus and preventive measures to control it. In Iran, 64 species of mosquitoes from Culicidea family have been reported three of which belong to the Aedes genus, and one of which is Aedes albopictus. Iran also has suitable climate for endemic transmission of Zika virus. Immigrants from neighboring countries for economic reasons, could increase the risk of disease transmission in Iran. The destination countries of Iranian passengers, especially in East Asia, are at risk or have been reported to have cases of Zika. So, traveling to areas where active Zika virus exists and its transmission is common, could potentially increase the risk of transmission of Zika. Close supervision alongside the borders is necessary when foreign people arrive in the country.
    Keywords: Zika virus, Epidemiology, Iran
  • Mohammad Shokrzadeh, Amir Hajimohammadi, Reza Hoseinpoor, Azam Delaram, Yaghoub Shayeste Pages 94-103
    Background And Aims
    Acute drug poisoning is a major public health problem in the world.The aim of this study was to investigate the trends and characteristics of acute drug poisoning and to compare that with other poisonings in Gorgan, Iran.
    Methods
    This descriptive cross-sectional study was done from March 2008 to march 2015. Data were obtained from medical records. Stata software and Pearson's chi-squared test were used for data analysis.
    Results
    A total of 800 poisoning cases, 573 cases were due to drug poisoning. The majority of the 573 patients (50.8% male) were in the age range of 20-29 years (47.8%) and 78% of them were living in urban areas. The maximum number of poisoning occurred during summer season (27%). The most common agents involved in acute drug poisoning were sedatives-hypnotics drugs, especially BZDs (37.2%), followed by Tramadol (17.3%) and Cardiac drugs (13.1%). Poisoning most commonly occurred as ingestion of single drug (55%). More than half (77.1%) of the cases were intentional poisoning (suicide), followed by overdose (63.1%), drug abuse (51.9%) and accidental poisoning (17.3%). Moreover, the most common drug involved in intentional poisoning was BZDs (44%).9 patients (1.6%) died, of which 3(33.3%) were due to Narcotic drugs.
    Conclusion
    Drugs were the most common cause of poisonings and the majority of acute drug poisoning in Gorgan was associated with suicide attempts. So, easy access to the most prominent methods of suicide i.e. consumption of drugs particularly BZDs should be restricted.
    Keywords: Drug, Poisoning, Intention, Epidemiology
  • Zahra Shamekhi, Mahtab Keshvari Pages 104-110
    Background And Aims
    It is well known that dyslipidemia is related to cardiovascular disease, dietary aspect and obesity play an important role in CVD risk factor. In the present study, we investigated the relationship between calorie intake, anthropometrical parameters and serum lipids in apparently healthy women.
    Methods
    The subject were 90 healthy women aged between 20-55 who were taken part in diabetes screening plan of Shiraz University of Medical Sciences in 2011 anthropometric measurement were done by standard methods. Lipid profile was measured after 10 to 12 hours overnight fasting. Dietary calorie intake was assessed using 24h food recall. The bivariate associations between variables were examined with the Pearson correlation analysis and comparison of the calorie groups was done by t-test. Significance was accepted at P
    Results
    No significant relationships were seen between calorie intake, anthropometric measurements and serum lipids. Although TG level was positively correlated with BMI (r=0.4, P=0.000), WC (r=0.408, P=0.00) and WHR (r=0.33, P=0.003).
    Conclusion
    Higher calorie intake was not significantly correlated with cardiovascular risk factor including Higher BMI,WC,WHR and abnormal serum lipids, but higher BMI,WC,WHR were directly associated with TG in healthy people. Although the association between these parameters and TG may be explained by insulin resistance, the lack of a significant association between anthropometric measurements and LDL in healthy people and limited studies in relation to net calorie and these variables remains an unexpected finding requiring further investigation.
    Keywords: Calorie intake, Obesity, Lipid Profile, Anthropometric measurement
  • Seyed Mehdi Hosseini, Masoud Parvin, Masoud Bahrami, Manoochehr Karami, Meysam Olfatifar Pages 111-117
    Background And Aims
    One of the most common approach to understanding spatial and temporal trends of event data is to break it up into a series of time snapshots. Therefore space-time cube method applied in order to portray the likely trend in occurrence of the pulmonary tuberculosis (TB) cases.
    Methods
    In this study, information of all patients with pulmonary TB recorded in surveillance system of Hamadan University of Medical Sciences from 2005 to 2013 years were studied. After geocoding the residence location address of pulmonary TB cases and converted to point layer, the space-time cube was used to detect likely trends in occurrence of tuberculosis. Then, based on the space-time cube results the Emerging Hot Spot Analysis was run to clustering hot and cold spots.
    Results
    There was significant increasing trend in occurrence of pulmonary TB cases. The statistic trend was 2.1871 and P-value was 0.0287, as well as 36 hot spots locations was detected that have been form approximately in central areas of province.
    Conclusion
    Significantly increasing trend in occurrence of TB cases and existence of hot spot, especially intensifying hot spots in central areas of province can represent pay more attention to this disease in mentioned areas in order to detect the change in epidemiological face and to implement suitable prevention programs.
    Keywords: Trend, Space time cube, Pulmonary Tuberculosis, Hamadan
  • Iman Alavi, Maryam Zahedi, Mahshid Zahedi, Abdollah Ghasemi Pirbalouti, Ebrahim Rahimi, Hassan Momtaz Pages 118-124
    Background And Aims
    In Iran herbal water and dried herb are as traditional medicinal and are consumed widely. Therefore, microbial evaluation of these products in term of public health is important. The aim of the present study was to study the contamination of some dried medical plants and distillates in the groceries of Shahrekord city.
    Methods
    In this descriptive study, 35 samples of herbal waters and 35 samples of 7 species (lavender, lemon balm, valerian, savory, borage, mint and thyme) dried medicinal plant (total samples=70) distributed in Shahrekord during spring to summer of 2012 were purchased and transferred to laboratory. Then, microbial tests such as total aerobic bacterial count mold and yeast count, total coliforms, and detection were evaluated based on national standard of Iran.
    Results
    Contamination to mesophilic bacteria and yeast was observed in the 100% of distilled samples, based on the national standard of Iran. Additionally, none of the medicinal dried plant was contaminated according to the national standard of Iran.
    Conclusion
    According to contamination of all distilled, It is proposed that producers of herbal distillates consider the hygiene conditions, using correct and suitable pasteurization, considering the structural condition of workshop and also appropriate packaging in order to reduce the secondary contamination and increase the quality of the finished product.
    Keywords: Medicinal dried plants, Distillates, Microbial load, Coliforms, Escherichia coli
  • Fatemeh Mehravar, Mohammad Ali Mansournia, Moussa Abolhassani, Kourosh Holakouie-Naieni, Ensie Nasli-Esfahani Pages 125-133
    Background And Aims
    Dyslipidemia is one of the major factors implicated in the development of the vascular complications of diabetes. In this study, it was evaluated the association between serum lipids profile and Hemoglobin A1c (HbA1c) in type 2 diabetes mellitus.
    Methods
    In this cross-sectional study, the serum lipid profile and HbA1c was studied on 562 Iranian patients who were older than 30 years and had type 2 diabetes identified from the diabetes and metabolic diseases clinic of endocrinology and metabolism research institute. A Multiple Linear Regression analysis was also done with the HbA1c as outcome variable and serum lipids profile as predictor variables; adjusted for potential confounders (age, sex, diabetes duration and Body Mass Index (BMI)).
    Results
    In 1966, 6.34% of the national total population was over 60 years compared to mean age of the participants that was 61.6±10.4 years, with a range of 32 to 89 years. The results confirmed that the Triglyceride (TG) (β: 0.11, 95% CI: 0.000-0.004, P=0.01) and cholesterol (β: 0.13, 95% CI: 0.000-0.009, P=0.04) were correlated with the HbA1c value but there were no significant association between HDL and LDL.
    Conclusion
    This study demonstrated that in persons with type 2 Diabetes Mellitus (DM), HbA1c value is a good predictor of lipid profile. Therefore, lipid profiling for all persons with type 2 DM should be a routine test.
    Keywords: Lipid Profile, Diabetes, Dyslipidemia, Triglycerides, HbA1c
  • Priyanka Lahot, D.P. Tiwari Pages 134-144
    Background And Aims
    From the past studies, it has been proved that consumption of heavy metals by humans may cause several chronicle problems like cancer, kidney and liver damage, high blood pressure and low blood pressure problems and etc. So, it has become very crucial to remove these heavy metals from industrial wastewater. The aim of this study was to find out a low cost and easy available adsorbent for adsorption of heavy metals.
    Methods
    Batch removal study of nickel and cadmium metal ions from their salt solutions was used. Preparation of adsorbent was done by following chemical treatment method and finally dried product obtained was characterized through FT-IR and morphological study. Influence of parameters initial metal ion concentration, pH and adsorbent dosage were done by varying one factor remaining others fixed. Equilibrium study at different temperatures while concentration fixed and kinetic study to know efficiency of adsorbent were done.
    Results
    Influence of parameters gives optimum range for adsorption as pH gives 6.8 and 0.2 g for adsorbent dose. Adsorption isotherm well explained by Temkin isotherm as it gives positive value for calculating constants and high correlation coefficient
    0.99. Kinetic behavior well followed by Pseudo second order, Intraparticle diffusion and Elovich second order kinetic models. Further, several thermodynamics parameters like ΔS°, ΔH° and ΔG° were predicted. The value of ΔG° predicted at different temperatures, highlighted the spontaneity.
    Conclusion
    Dalbergia proved as a low cost and efficient adsorbent.
    Keywords: Adsorption, Dalbergia, Nickel ion, Cadmium ion, heavy metals
  • Abbas Rezaianzadeh, Hedayat Abbastabar, Abdolreza Rajaeefard, Haleh Hgaem, Maliheh Abdollahi Pages 145-155
    Background And Aims
    The pandemic of AIDS is a global emergency and one of the biggest challenges in social and individual life. This study aimed to evaluate the survival time of HIV patients and its effective factors.
    Methods
    This historical cohort study was conducted on the individuals infected with HIV in Fars province, south of Iran, during 2006 to 2013. The study data were obtained from information documented in the patients’ records. For statistical analysis, at first, Kaplan-Meier survival analysis was used as univariate method and then, time varying Cox regression model was applied as multiple analyses.
    Results
    The findings of the present study implied that some variables could play the role of risk factors in HIV patients, and shorten the patients’ life span e.g. older age, female gender, unemployment, delay in HIV diagnosis, drug injection, and higher Hemoglobin (HGB) levels.
    Conclusion
    Many factors affect HIV patients’ survival time. Some of these factors, such as gender and genetic factors, are irreversible. However, some others, including drug injection, are preventable. This implies that in order to slow down the speed of HIV conversion to AIDS and delay the occurrence of death, special attention must be paid to these factors and changing the patients’ conditions accordingly.
    Keywords: Survival analysis, Cox regression, HIV, AIDS, Iran
  • Azam Sabahi, Leila Ahmadian, Fatemeh Salehi, Sayed Mahmoud Mirzaee Pages 156-165
    Background And Aims
    Gastric cancer is one of the most common cancers all over the world and is the world's second fatal cancer. This study was done to identify the epidemiological features and risk factors of gastric cancer in different regions of Birjand. Such study can be an effective step in preventing, controlling and curing the diseases.
    Methods
    This descriptive-analytical study was conducted in Birjand educational hospitals. All patients with gastric cancer who were hospitalized in the period 2006-2011 in educational hospitals were recruited through census. Data were collected using researcher-made checklist through examining medical record of patient. Data were analyzed using descriptive and analytical statistics by SPSS software. Ethical approval was received from the Birjand University of Medical Sciences.
    Results
    Results of this study showed that villages around Ghaien had the highest rate of gastric cancer (n=14, 12.6%). In this study, the relationship between histopathology with therapeutic interventions (P=0.006) and diagnostic methods (P=0.005) was significant. In addition, there was a significant relationship between the place of residence (P=0.018) and the type of therapeutic interventions.
    Conclusion
    Findings of this study depicted an accurate and complete image of the epidemiology of this cancer in the region and provided authorities with valuable findings to make decisions about the identification of risk factors of gastric cancer in order to reduce cancer rates. It can also be an alarm for the villagers to change their habits and diet and to have a healthy life.
    Keywords: Gastriccancer, Cancer epidemiology, Histopathology
  • Raziyeh Karami-Eshkaftaki, Fereshteh Ahmadinejad, Shahrzad Aghaei, Hassan Moghim, Morteza Hashemzadeh-Chaleshtori, Mohammad-Saeid Jami Pages 166-172
    Background And Aims
    Hearing loss (HL) happens due to the genetic or environmental causes or both. Risk factors include congenital infections and congenital deformities of auricle and ear duct. The present study was performed to briefly explain the genetics, molecular biology and epidemiology of HL in Middle East especially in Iran.
    Methods
    An intense an comprehensive literature search was prformed through heading journals in the field. All data was organized using Mendeley software and incorporated to the text as required.
    Results
    While the etiology of 25% of HL cases remains indistinct, it is estimated that at least 50% of pre lingual HL cases have a genetic cause. About 70% of genetic HL cases are non Syndromic (NSHL) without anomaly, whereas the remaining 30% are Syndromic. Autosomal recessive non-syndromic hearing loss forms (ARNSHL) are the severest forms of congenital HL with defect in cochlea. In addition to X-linked (DFNX), autosomal dominant (DFNA), autosomal recessive (DFNB) and Y-linked (DFNY) inheritance patterns, HL can be inherited through mitochondrial genes including
    MT-RNR1 and MT-TS. At least 120 genes have been reported to be associated with HL. Among them, mutations in connexin 26 (GJB2) have been shown to play a very important role in developing ARSNSHL in many populations depending on geographical location and ethnicity. In Caucasians and Spainish/Italian populations, 50% and 79% of HL cases have respectively been reported to be occurred due to mutations in GJB2 gene.
    Conclusion
    In the Middle East, the prevalence seems different as an average of 14-20% of the HL in several region of Iran is due to mutation in GJB2 gene. Alternatively similar studies showed the prevalence of GJB2 mutations around 25% and 6.1% in Turkey and Pakistani populations respectively.
    Keywords: Hearing loss, Iranian population, GJB2
  • Mohammad Reza Noormohammadi, Mohsen Arbabi, Hassan Moghim, Masoud Amiri Pages 173-175
    As a temporary emotional situation and a relatively stable state of being happy (subjective happiness level), happiness can be considered. In fact, people with high subjective happiness level think more positively than others.
    There are many factors with potential positive or negative effects on happiness such as: the (dark and milky) chocolate, Yoga, outdoor group walks in the natural environments, personality, social exclusion, negative emotional feelings, normative and subjective oral health status, socioeconomic factors, leisure time program, training like skills for coping with stress, increasing marriage satisfaction, improving economic status, and religion.
    Due to different related factors affecting on each person, it is not an easy task to clarify the methods of raising happiness in the communities . Each part of the world has its own culture and traditions, resulting in the fact that there is no identical way to make happier people. It is recommended to have several studies on happiness worldwide to investigate the specific policy for each region.
    Keywords: happiness, Health, Factors
  • Ali Janati, Mobin Sokhanvar, Edris Hasanpoor, Edris Kakemam, Morteza Arab-Zozani, Elaheh Haghgoshayei Pages 176-181
    Background And Aims
    Public sector in Iran is responsible for providing whole primary health care and approximately 85% of the second and third level services. Following the previous programs, and in order to improve health system performance, Iranian Ministry of Health and Medical Education launched Health Sector Evolution Plan of Iran (HSEP) in 2014 aimed to reduce patients’ cost, improve quality, and provide equal access for all.
    Methods
    We examined the achievement of these objectives through reporting a case and comparing current and past situation. The data related to the case were collected by interview and surveying patient documents. Published articles were considered as a base to compare some indices before and after the plan.
    Results
    Our case was a Ph.D. student who sought out health care for his wound treatment. Total treatment expenses were $ 195 and many medical supplies were used. Waiting time and visit length were calculated 345 minutes and 1 minute, respectively. Paying an amount of money equivalent to almost 57% of his salary and too long waiting time to receiving short visit are in contrast to the primary objectives of HSEP and show no improvement in these indices compared with prior to the plan.
    Conclusion
    With regard to increasing financial resources through HSEP (70%) compared with the same time before HSEP, it is necessary to manage these funds properly to achieve objectives more effective and efficient than the current ones.
    Keywords: Hospital services provision, Health Sector Evolution Plan, Waiting time, Visit time