فهرست مطالب

Preventive Medicine - Volume:6 Issue: 11, Nov 2015

International Journal of Preventive Medicine
Volume:6 Issue: 11, Nov 2015

  • تاریخ انتشار: 1394/09/09
  • تعداد عناوین: 11
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  • Suneela Garg, Ritesh Singh, Deeksha Khurana Page 1
    Loss or impairment of auditory sense is the most prevalent deficit of all the sensory organs. With virtually no mortality, hearing impairment causes huge impact on one’s social, educational and economic well-being. There are 5-6 infants who are hard of hearing out of 1000 neonates. They will not be identified till they attain 2 or more years of age, by then irreversible damage would have been done. Universal screening for hearing of new-borns is the only way to decrease the burden of deafness in our society. There are tools available which can be administered by health workers after initial training for screening the infants for hearing impairment. Under the aegis of National Programme for Prevention and Control of Deafness (NPPCD) of India universal screening can and should be applied. The programme would entail additional financial burden for the initial purchase of screening machines and rehabilitating the identified children.
    Keywords: Deafness, hearing, impairment, India, new, born, universal screening
  • Keshava Abbayya, Sameer Anil Zope, Sanjay Naduwinmani, Apurva Pisal, Nagraj Puthanakar Page 2
    Periodontitis is a disease of the periodontium, characterized by loss of connective tissue attachment and supporting the alveolar bone. Therefore, to regenerate these lost tissues of the periodontium researchers have included a variety of surgical procedures including grafting materials growth factors and the use of barrier membranes, ultimately resulting into regeneration that is biologically possible but clinically unpredictable. Recently a newer approach of delivering DNA plasmids as therapeutic agents is gaining special attention and is called gene delivery method. Gene therapy being considered a novel approach have a potential to channel their signals in a very systematic and controlled manner thereby providing encoded proteins at all stages of tissue regeneration. The aim of this review was to enlighten a view on the application involving gene delivery and tissue engineering in periodontal regeneration.
    Keywords: Gene, growth factors, periodontal regeneration, stem cells, tissue engineering, vectors
  • Mahmoud Rafieian‑, Kopaie Rafieian‑, Kopaie, Hamid Nasri Nasri Page 3
    On February, 2014 World Cancer Day (WCD) was established to raise alertness of cancer and to encourage its prevention, detection, and treatment. In fact, WCD is celebrated every year on the 4th of February all over the world to commemorate all the accomplishments of the WHO. In this paper, we aimed to present the scientific evidence for the role of antioxidants in cancer. Damage to cells by reactive oxygen species, especially the damage to DNA, has been found to play a crucial role in the development of cancer. Exogenous antioxidants can prevent free radical damage associated with cancer development. However, whether or not taking dietary antioxidants can prevent or reduce the risk of developing cancer in humans is not clear. Some researchers have suggested that antioxidants counteract with drugs or toxins, which induce oxidative stress and hence prevent damage to cells or body organs.
    Keywords: Antioxidant, cancer, herbs
  • Ali Ahmadi, Hamid Soori, Yadollah Mehrabi, Koorosh Etemad, Homeira Sajjadi, Mehraban Sadeghi Page 4
    Background
    Regarding failure to establish the statistical presuppositions for analysis of the data by conventional approaches, hierarchical structure of the data as well as the effect of higher‑level variables, this study was conducted to determine the factors independently associated with hospital mortality due to myocardial infarction (MI) in Iran using a multilevel analysis.
    Methods
    This study was a national, hospital‑based, and cross‑sectional study. In this study, the data of 20750 new MI patients between April, 2012 and March, 2013 in Iran were used. The hospital mortality due to MI was considered as the dependent variable. The demographic data, clinical and behavioral risk factors at the individual level and environmental data were gathered. Multilevel logistic regression models with Stata software were used to analyze the data.
    Results
    Within 1‑year of study, the frequency (%) of hospital mortality within 30 days of admission was derived 2511 (12.1%) patients. The adjusted odds ratio (OR) of mortality with (95% confidence interval [CI]) was derived 2.07 (95% CI: 1.5–2.8) for right bundle branch block, 1.5 (95% CI: 1.3–1.7) for ST‑segment elevation MI, 1.3 (95% CI: 1.1–1.4) for female gender, and 1.2 (95% CI: 1.1–1.3) for humidity, all of which were considered as risk factors of mortality. But, OR of mortality was 0.7 for precipitation (95% CI: 0.7–0.8) and 0.5 for angioplasty (95% CI: 0.4–0.6) were considered as protective factors of mortality.
    Conclusions
    Individual risk factors had independent effects on the hospital mortality due to MI. Variables in the province level had no significant effect on the outcome of MI. Increasing access and quality to treatment could reduce the mortality due to MI.
    Keywords: Mortality, multilevel analysis, myocardial infarction
  • Hajar Pourgheysari, Yaghoub Hajizadeh, Mohammad Javad Tarrahi, Afshin Ebrahimi Page 5
    Background
    High concentrations of elements such as aluminum (Al) and silicon (Si) in drinking water can affect human health. It is suggested that high daily intake of Al is associated with increased risk of neurodegenerative disorders. Si, as an antidote of Al, may decrease Al bioavailability. The study was conducted to estimate Al and Si concentration and correlation in water and evaluate their health risk.
    Methods
    In this cross‑sectional study, water samples were collected from 20 points of water distribution system and the water treatment plant of Isfahan in spring and summer. Samples were analyzed using DR‑5000. The health risk was evaluated via calculating chronic daily intake (CDI) and hazard index (HI).
    Results
    Significant negative correlation was documented between Al and Si (R = −0.482, P = 0.037 in spring, and R = −0.452, P = 0.049 in summer). These values were approximately similar in all types of Al and Si. The amounts of CDI for Al in spring and summer were 6.67E‑04 and 0.002 mg/kg/day, respectively. The Al HI values were below 1 in both seasons.
    Conclusions
    The significant correlation between Al and Si concentrations suggests that Si can eliminate Al in water, and probably it might do the same in the body. The health risk of Al intake from tap water was negligible, it was assessed in an acceptable range with an HI value of less than the standard levels. The health risk of Si remained unknown due to lack of information regarding its toxicity and adverse health effects.
    Keywords: Aluminum, chronic daily intake, correlation, hazard index, silicon
  • Ali Fathi‑, Ashtiani, Ahmad Ahmadi, Bagher Ghobari‑, Bonab, Mohammed Parsa Azizi, Sayeh Moosavi Saheb, Alzamani Page 6
    Background
    The current study was conducted to examine the effect of cognitive behavior therapy on the reduction postpartum mood disorder and increasing the self‑esteem of at‑risk Iranian mothers.
    Methods
    In this quasi‑experimental study, 135 at‑risk mothers were selected from the population by means of cluster sampling and randomly assigned into one of two groups: Intervention (n = 64), or control (n = 71). The control group received usual medical care, and the intervention group received an eight sessions’ cognitive behavior program during pregnancy. Assessments were administered at two time points (pretest at the beginning of the third trimester and posttest at 2 weeks postpartum). Beck anxiety, beck depression, Edinburgh postpartum depression, (PPD) Coopersmith self‑esteem, and religious attitude questionnaire were used to collect data.
    Results
    The mean age of participants was 25.8 ± 3.7 years. One‑third of them had either bachelor or higher degrees in education (33%). About two‑third of participants were unemployment with similar distribution in both the groups (intervention = 80%, control = 83%). The majority (70%) of the participants had cesarean section deliveries. There were no statistically significant differences respects to sociodemographic characteristics between the control and intervention groups (P > 0.05). The multivariate analysis of covariance results showed that the average scores of PPD were reduced significantly in the intervention group (P < 0.001). Also while the mean score of anxiety in the intervention group decreased from 23.31 (standard error [SE] =12.11) to 16.64 (SE = 8.33) and self‑esteem increased from 29.09 (SE = 3.51) to 31.81 (SE = 2.76), no change was statistically significant in comparison to the control group.
    Conclusions
    According to the findings of the present study, cognitive behavior intervention is effective in reducing PPD in at‑risk mothers.
    Keywords: Anxiety, cognitive behavior intervention, postpartum depression
  • Shirin Djalalinia, Sahar Saeidi Moghadam, Niloofar Peykari, Amir Kasaeian, Ali Sheidaei, Anita Mansouri, Younes Mohammadi, Mahboubeh Parsaeian, Parinaz Mehdipour, Bagher Larijani, Farshad Farzadfar Page 7
    Background
    The prevalence of obesity continues to rise worldwide with alarming rates in most of the world countries. Our aim was to compare the mortality of fatal disease attributable to excess body mass index (BMI) in Iran in 2005 and 2011.
    Methods
    Using standards implementation comparative risk assessment methodology, we estimated mortality attributable to excess BMI in Iranian adults of 25–65 years old, at the national and sub‑national levels for 9 attributable outcomes including; ischemic heart diseases (IHDs), stroke, hypertensive heart diseases, diabetes mellitus (DM), colon cancer, cancer of the body of the uterus, breast cancer, kidney cancer, and pancreatic cancer.
    Results
    In 2011, in adults of 25–65 years old, at the national level, excess BMI was responsible for 39.5% of total deaths that were attributed to 9 BMI paired outcomes. From them, 55.0% were males. The highest mortality was attributed to IHD (55.7%) which was followed by stroke (19.3%),and DM (12.0%). Based on the population attributed fractions estimations of 2011, except for colon cancer, the remaining 6 common outcomes were higher for women than men.
    Conclusions
    Despite the priority of the problem, there is currently no comprehensive program to prevention or control obesity in Iran. The present results show a growing need to comprehensive implications for national and sub‑national health policies and interventional programs in Iran.
    Keywords: Body mass index, burden, mortality, obesity, population attributed fraction
  • Khandan Shahandeh, Hamid Reza Basseri, Reza Majdzadeh, Roya Sadeghi, Reza Safari, Davoud Shojaeizadeh Page 8
    Background
    Malaria elimination efforts face with substantial challenges and the role of health workers in address this challenge, particularly advocates and mobilizes communities. The aim of the study was to explore perceptions of health workers in relation to eliminating malaria in order to better understand the level their involvement in malaria elimination efforts. A qualitative approach was adopted based on key informant interviews with 26 health workers who workingat community‑level in malaria low endemic areas, southern Iran.
    Methods
    Data were collected through key informant interviews. Data were analyzed using thematic content analysis.
    Results
    Findings reveal that the majority of participants concerned with the imported malaria cases, without to address an effective solution to the issue. Health workers had positive perceptions on their basic knowledge and opinions in relation to their field work with emphases to integrate methods. Participants expressed willingness to contribute to malaria elimination effort. They also emphasized on continuous training, resource mobilization, and support. In addition, theirperceptions on malaria elimination policy such as sustained financial investment to achieve elimination and integrated management of vector control were rather negative.
    Conclusions
    A mechanism should be considered that allow the health workers to feedback positively on their quality of their practice to health providers.
    Keywords: Health worker, individual adjustment, Iran, malaria elimination, qualitative
  • Zeinab Salehi, Mahnaz Roayaei Page 9
    Background
    Peripheral neuropathy is one of the most important limitations of oxaliplatin base regimen, which is the standard for the treatment of colorectal cancer. Evidence has shown that Vitamin E may be protective in chemotherapy‑induced peripheral neuropathy. The aim of thisstudy is to evaluate the effect of Vitamin E administration on prevention of oxaliplatin‑induced peripheral neuropathy in patients with colorectal cancer.
    Methods
    This was a prospective randomized, controlled clinical trial. Patients with colorectal cancer and scheduled to receive oxaliplatin‑based regimens were enrolled in this study. Enrolled patients were randomized into two groups. The first group received Vitamin E at a dose of 400mg daily and the second group observed, until after the sixth course of the oxaliplatin regimen. For oxaliplatin‑induced peripheral neuropathy assessment, we used the symptom experience diary questionnaire that completed at baseline and after the sixth course of chemotherapy. Only patients with a score of zero at baseline were eligible for this study.
    Results
    Thirty‑two patients were randomized to the Vitamin E group and 33 to the control group. There was no difference in the mean peripheral neuropathy score changes(after−before) between two groups, after sixth course of the oxaliplatin base regimen (mean difference [after − before] of Vitamin E group= 6.37 ± 2.85, control group= 6.57 ± 2.94; P = 0.78). Peripheral neuropathy scores were significantly increased after intervention compared with a base line in each group (P < 0.001).
    Conclusions
    The results from this current trial demonstrate a lack of benefit for Vitamin E in preventing oxaliplatin‑induced peripheral neuropathy.
    Keywords: Colorectal neoplasms, oxaliplatin, peripheral nervous system diseases, Vitamin E
  • The Potential for HIV Self‐testing in Iran
    Fatemeh Jahanbakhsh, Ehsan Mostafavi, Aliakbar Haghdoost Page 10
  • Alok Kumar, Keerti Singh, Kandamaran Krishnamurthy, Anders L. Nielson Page 11
    Background
    The major objectives of this study were to evaluate the existing primary health care service provisions in the public and private sector and utilization of the services, and to assess the existing manpower and material resources.
    Methods
    Data were collected through interviews with the primary health care providers. Data were also collected from the records maintained at the polyclinics and the Ministry of Health Statistics. An analysis and discussion of all the available data was conducted to develop a comprehensiveprimary health care service utilization and resources inventory at the polyclinics. Similar data were collected from the primary care providers in the private sector.
    Results
    In the public sector, there are 8 polyclinics that provide primary health care to the children. All the polyclinics have immunization services and curative acute care. Some of the polyclinics have a range of services, including dental care, eye care, and rehabilitative care services that common to both adults and children. In the private sector, primary health care is delivered through the 76 private office and of the individual physicians and 11 grouped private practices. All of the private offices and group practices have curative acute care for children and some of the offices have immunization services. Over all 87.5% of all the immunizations were done at the polyclinics. Over all 60.1% of acute care visits were to the private sector and 39.9% to the public sector. In the public sector, 59.5% were under 5 years children while 40.5% were5 years or older. The corresponding figures in the private care settings were 80.9% and 11.9%.
    Conclusions
    The findings demonstrate the complimentary role of the public and the private sector in the primary health care of children in this country. While the private sector has a major role in the curative acute care of children, the public sector plays a pivotal role in the immunization services.
    Keywords: Children, pluralistic health care setting, primary health care