Epidemiology and Health System Journal
Volume:3 Issue: 2, Spring 2016

Brucellosis is one of the most important common diseases among man and livestock which are considered as the major problem in the health of the humans and livestock. The Importance of this disease isn’t limited to its physical problems and consequences, but it is considered as a major challenge of economic development in most countries. The aim of this study was to evaluate the effect of some regional parameters on the prevalence of this disease because of its high prevalence in Chaharmahal and Bakhtiari.
This study was a descriptive- analytical and the registered statistics about those affected by Brucellosis in Chaharmahal and Bakhtiari from 2008-2011 abstracted from Center of Public Health of the province. Based on it, spatial distribution maps of Brucellosis were provided by Geographic Information System (GIS). Then, the relationship between this parameter and some regional parameters was studied by using software SPSS.
Extent of Brucellosis prevalence wasn’t consistent in Chaharmahal and Bakhtiari and Koohrang had the more prevalence and Lordegan, Farsan and Kiar regions had less risky. There is a meaningful relationship between increase in Brucellosis and temperature in the year 2008, 2010 and 2011 (P Environmental factors influence disease prevalence.

Cardiovascular diseases are the main cause of mortality among men and women so that the difference in acute myocardial infarction (AMI) symptoms between men and women can affect diagnosis and time of decision making for treatment and consequently disease outcomes. Therefore, knowledge of different symptoms affects the prognosis of the disease according to the gender. This study was conducted to determine the difference in clinical manifestations of MI between men and women.
In this cross-sectional, descriptive-analytical study all patients with primary diagnosis of AMI (n: 33831) in Iran in 2014-2015 were included. Data analysis was done by Stata. For descriptive data, central indices and distribution were used, and for investigation of the association among the variables, independent t-test and logistic regression were used.
Overall, 33831 patients were included in this study, of whom, 24532 (51.72%) were male and the rest were female. Mean age at MI incidence was 80.0 7.59 years in men and 13.66 13.0 in women. Being female increased the likelihood of dyspnea by 3.1 times, vomiting by 31.1 times, and jaw pain by 21.1 times. No significant difference was seen in left arm pain, chest pain, nausea, and sweating between men and women (P>0.05).
Atypical symptoms, particularly in women, may cause the delay in referring the patients and also delay in decision making for diagnosis and treatment by the medical team. Hence, staff and patients of ICUs need more special information about AMI symptoms, especially with regard to gender.

The main cause of many problems in developing countries is related to the provision of safe drinking water. Since the health of drinking water is important in the busy centers such as hospitals, clinics and health centers, this study was done to investigate the role of water coolers connected to the municipal system in microbial quality of drinking water in Behbahan city.
In this study, the samples were provided from all influent and effluent
30 water coolers located in hospitals, clinics and health centers in the Behbahan. They were carried out and transferred to the laboratory. Then, the amounts of total coliforms and fecal coliforms, residual chlorine, pH and temperature were measured. Collected data were analyzed using SPSS and Excel software.
The results showed that the average residual chlorine in input and output of the mentioned water coolers is significantly more than the standard values. Total and fecal coliforms in the input and output of water coolers are also more than the standard values. At the same time, both indicators in the output of water cooler were increased rather than the input one. By using paired t-test, a significant relationship was found between the amount of total coliform, fecal coliform and residual chlorine before and after of water cooler.
The results showed negative effects of water coolers on microbial quality of water. If constant control, monitoring and inspections proceedings were done, these contaminations would be reduced significantly.

Obesity and overweight is a major public health problem and, alongside hypertension, is one of the risk factors of cardiovascular diseases incidence. The aim of this study was to determine the prevalence of overweight and its association with hypertension in the patients referred the healthcare center in Jandaq.
This cross-sectional study was conducted on 400 patients (168 men and 232 women) referring to urban healthcare centers in Jandaq. By means of necessary instruments, the individuals’ weight and height were measured, and body mass index (BMI) was calculated. Also, the individuals’ blood pressure was measured and classified in accordance with the standard manual, and after filling out the questionnaires, the data analysis was done by SPSS.
The prevalence of overweight was 29.3% in men and 35.7% in women. The prevalence of hypertension was 29.1% in men and 35.3% in women. Family history of hypertension and cardiovascular disease was effective on the individuals’ acquiring hypertension. With the increase in the patients’ age, both BMI (P The prevalence rate of overweight and obesity in Jandaq is high. There was an association among the individuals’ BMI, blood pressure and age. Therefore, it is necessary to develop health education programs and to inform the public regarding the increase of mobility and improvement of the nutrition, and to implement effective interventions in health planning in this center.

Depression is a growing public health problem in the world. In this study we investigated the relationship between dietary patterns and depression in adults aged 20-50 years living in Shiraz, Iran.
In a cross-sectional study, 416 subjects (180 men and 236 women) aged 20 to 50 years were selected by stratified multistage random sampling. Dietary intakes were assessed using a semi-quantitative food frequency questionnaire. Depression information was collected by Depression, Anxiety and Stress Scale (DASS) questionnaire. Three major dietary patterns were extracted by factor analysis: vegetable, Western, and Mediterranean-type dietary patterns. Regression analysis was used for association between dietary pattern and depression.
A strong positive significant association was observed between Western dietary pattern and depression. Also there was a negative significant association between Mediterranean-type dietary pattern and depression. These associations remained statistically significant even after adjustments for demographic characteristics, physical activity, smoking, body mass index, and energy intake. No association was found between vegetable dietary pattern and depression.
The results showed that there was a relationship between dietary patterns and depression. However, clinical trials are needed to clarify whether a causal relationship between diet and mood disorders can be established.

Diabetes affects all physical, emotional, and psychological aspects of patient’s health. Postmenopausal diabetic women are more susceptible due to their crucial conditions. The emotional regulatory role of vitamin D may be because of the existence of its receptors distributed in brain areas involved in emotional processing and affective disorders. The aim of this study is to assess the effect of 3-mounth regular consumption of vitamin D-fortified low fat yogurt on QOL indices in diabetic postmenopausal women.
Fifty nine postmenopausal diabetic women randomly allocated to the ‘FY’ (received vitamin D-fortified low fat yogurt, containing 2000 IU vitamin D in 100 g) or ‘PY’ (received plain low fat yogurt without additive) treatment groups. The quality of life questionnaire SF-36 which is the most widely used method to assess the QOL was used before and after the intervention.
After the 3-month intervention, physical performance, vitality, and mental health scores significantly increased and the score of physical pain decreased in the FY group. In the PY group, physical performance, vitality, and emotional role scores significantly decreased. Final scores of physical performance and vitality significantly increased in the FY group compare to the PY group while physical?
Three months daily consumption of 2000 IU vitamin D fortified low-fat yogurt improved physical performance, physical pain, and vitality while the other domains of QOL assessments did not show significant changes.

Complaints of obstetrics and gynecology specialist are on the top of complaint from doctors and these have been increasing with increased population and births. In this regard, parallel to industrialization of life, tendency to cesarean against vaginal delivery has been increased in patients. All the cases of complaint increased from 1995 until 2010. In multiple studies and evaluation of complications of cesarean and vaginal delivery conducted in legal authorities like forensics due to patient and her relatives complains can have an effective role on selecting delivery method in specialists by creating virtue of working. Limited information is available on this study. We aimed to investigate the effect of selecting delivery method on medical malpractice incidence in the specialized field of obstetrics and gynecology.
This is a descriptive-analytic study, and 913 cases of 2011 to 2012 who referred to Tehran forensics organization have been assessed and computer software SPSS was applied for data analysis. Our study was approved by the Ethical Committee of Forensic Medicine.
Of the total referred cases, 12.8% were in the field of obstetrics and gynecology in which 691 cases were obstetric and 222 cases related to gynecological. In 44.5% of cases, medical malpractice was confirmed and 2.3 of them were due to caesarian surgery. The rate of maternal injuries was more prevalent than babies and children, and most of complains were related to inexperience surgeons.
As in our study, 2.3 of complaints were associated with cesarean patients and the rate of approved malpractice in cesarean was almost double the vaginal delivery. Furthermore, the rate of complains associated with mother in cesarean delivery has been twice the vaginal birth. The type of medical malpractice associated with type and method of delivery. In this study cesarean surgery delivery is pioneer.
Considering the patient and fetus situation and patients’ education selecting the type and method of delivery has an important role in prevention of patients’ complaint to surgeons from forensic view and creation of more awareness among obstetrics and gynecology specialists about medical mistakes and special training that should be given to those joining with these specialties.

Needle stick injuries are a common and serious occupational hazard in the medical settings. So, this study was aimed to assess the incidence of needle stick injury among medical students at Tabriz Imam Reza Hospital in 2014.
This is a cross-sectional study which its data was collected from 211 medical students in Tabriz Imam Reza Hospital. The study was done using valid and reliable researcher's made questionnaire in December 2014 with getting inform consent from participants. The mentioned tool has two main parts; the first part studies the demographic and background variables and the second part focuses on the phenomenon of needle stick injuries and its relevant parameters. The data were firstly analyzed descriptively and the obtained results reported the qualitative variables in form of frequency (percentage) and for the quantitative variables the mean (standard deviation) was reported. Further on, the statistical relationship between demographic and background with Needle stick injuries parameters were assessed using Chi-square test. All these analyses were conducted using SPSS software and in all cases the significance of P was considered as less than 0.05.
Obtained findings showed that 36% of the medical students have experienced needle stick injuries in the last year (with Confidence Interval of 95%) and the mean annual frequency is equal to 3.11 times per person. Moreover, the study findings indicated that there is a statistical relationship between needle stick exposure and age (P=0.019), educational level (P=0.001) and the hospital ward (P=0.004) which students older than 30, medical research fellows and students working in the surgery and pathology wards experience needle stick injuries more than others significantly.
This study showed the high incidence of needle stick injuries in medical students and highlighted the need for implementing precise interventions.

A selective and sensitive high performance liquid chromatography-electrospray ionization mass spectrometry method has been established for determination of methotrexate in human plasma.
Methotrexate was extracted from plasma with acetonitrile. The mobile phase consisted of acetonitrile-water-formic acid 74: 25: 1(v/v). Twenty µl of sample was chromatographically analyzed using a repacked ZORBAX-XDB-ODS C18 column (2.1mm×30mm, 3.5 micron). The mode of mass spectrometry was selected-ion monitoring (SIM).
Standard curve was linear (r= 0.998) over the concentration range of 0.1–100.0 ng/ml and showed a suitable accuracy and precision. The limit of detection (LOD) was 0.05ng/ml.
The method is quick, easy, very steady and precise for the partition, assignment and evaluation of methotrexate in human plasma.

One of the most common injuries around the world is the traumatic injury of the spine and spinal cord with unknown worldwide situation of traumatic spinal cord injury (TSCI) affecting on the effectiveness of preventive policy programs. In addition, because of possibility of making paralysis, the potential injury to the spine could be one of the most important traumas and a major cause of disability.
This research is a review study. Initial studies had focused on the descriptive epidemiology, considering incidence rates, age, gender, race, etiology and level and completeness of injury, but the recent researches are focusing on identifying of the high-risk groups, making awareness, establishing trends, predicting the needs, and thus contributing to effective health care planning of this condition.
An important part of the prognosis, diagnosis and management of acute and chronic spinal trauma could be diagnostic medical imaging. While spinal cord and soft-tissue injuries could be evaluated better by magnetic resonance imaging (MRI); spine fractures could be characterized better by computed tomography (CT).
Imaging using CT and MRI is essential in the management of acute/chronic spinal cord injuries. The problem could be that due to fear of clinicians from missing occult spine injuries, they ask radiographs for almost all injured patients. It is recommended that a National Registry for spinal cord injuries be established by the national Ministry of Health, so that the etiological pattern of spinal cord injuries in the world can be known.

Nowadays, hypnosis has opened its position in the medical community. Based on controlled trials, hypnosis has been superior compared to other interventional procedures to reduce acute pain. This investigation aims to determine the effectiveness of hypnosis in the treatment of pain and enhancing mental performance in Iran, using the meta-analysis method.
The search has been conducted in international database such as: ISI, Scopus, Pubmed, Google Scholar, and Iranian databases such as: Medlib, SID, Magiran, and Iran Medex. The data have been analyzed using meta-analysis method (random effects model). Heterogeneity between articles was assessing using I2 index and “Dersimonia and Lardi” statistics. In all studies, hypnotic effect size was expressed as a dichotomous (yes or no) variable. Relative Risk (RR) was used to show effect size.
Among the 45 articles, 6 of them had eligibility to inter to meta-analysis. Sample size of 6 articles was 546. The effectiveness of hypnosis in the case group has been 20% more than the control group RR=1.20 (Confidence interval 95%: 0.97 to 1.46), But, there was no significant difference between test and control groups.
There was not statistical significance evidence in effectiveness of hypnosis in pain and reduction of psychological tensions, but 20% of effectiveness can be important from medical view of point. So, this method can be used as a routine procedure in the treatment of pain and enhancing mental performance.

Neurofeedback is a relatively new therapy focusing on the core symptoms of inattention, impulsivity and hyperactivity.We undertook a meta-analysis to estimate the effectiveness of neurofeedback on attention deficit disorder in Iran.
International databases of Pubmed, Scopus, ISI, Google Scholar, and national databases of Sid, Med lib, Iranmedex, Magiran were searched using the terms of neurofeedback, attention deficit and hyperactivity. The standardized effect size (SMD) of the control group’s mean difference was calculated by the standard deviation integration. Data were analyzed using meta-analysis (random effects model). Heterogeneity of studies was assessed using I2 index and the DerSimonian-Laird method.
9 studies were reviewed with a sample size of 204 individuals during 1997 to 2005 and Neurofeedback’s overall standardized effect size (SMD) on attention deficit disorder was significant in the experimental group before and after the intervention (SMD = 1.14; 95% CI, 0.91-1.38, P = .000). The SMD was not significant in the control group before and after the intervention (SMD = .09; 95% CI, .07-.24). Meta-regression showed no statistically significant relationship between the year of study, sample size and SMD.
Although international randomized clinical trials have shown that neurofeedback is not effective in ADHD treatment, In Iran, results of the studies showed that neurofeedback was effective in the treatment of some ADHD’s indicators and ineffective in some other ADHD’s indicators. Overall, neurofeedback was effective in the treatment of ADHD.