فهرست مطالب

Preventive Medicine - Volume:9 Issue: 1, 2018
  • Volume:9 Issue: 1, 2018
  • تاریخ انتشار: 1396/11/17
  • تعداد عناوین: 10
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  • Izet Masic, Zijo Begic, Nabil Naser, Edin Begic Page 1
    Pediatrics is defned as the science of a healthy and sick child from birth to end of adolescence. Diseases of the cardiovascular system are the leading causes of mortality in adults, with frequent onset in childhood. The cardiologic examination starts with anamnesis in a pleasant atmosphere, refned space, enough time and patience, detailed measurements, and preferably a noncrying child. Anamnesis, regardless of the development of diagnostic procedures, still constitutes the basis of every clinical examination. The basic characteristics of pediatric cardiac anamnesis are comprehensiveness, that is, details, clarity, concurrency, and chronology. Proper and conscientiously taken anamnesis with a thorough clinical examination of a sick child is a solid protection against dehumanizing the relationship between a physician and patient. Pediatric cardiac anamnesis can be variable, completely negative, but very rich. Anamnesis should, frst of all, clarify whether only a child is sick or it is perceived like that be his or her environment. Preschool and school-age children are normally attending anamnesis. High-quality, comprehensive medical history can keep the patient at one level of health care, with a strict focus primarily on the diagnostic processes, reduce crowds in specialist and subspecialist institutions, and make economic savings. A large number of patients in specialist and subspecialist clinics can be reduced by proper screening and by developing primary health-care system (from the local health-care center). Taking patient’s medical history with thoroughness has a strong educative character for young doctors at the beginning of their careers.
    Keywords: Cardiology, pediatrics, prevention
  • Izet Masic Page 2
    Why did I recall the details about public health aspects of global population and well‑being in the 21st century regarding the determinants of health? Most of all because today, at the end of 2017, we are talking about the same principles from the “Declaration on Primary Health Care” from 1978, and the same goals as those in “Health for all” which are still current or perhaps even more current than when they were published for the frst time in scientifc and professional literature. This is a notorious fact, even though we are talking about “Global Health” and its determinants, in all countries of the world, regardless of their social wealth, and all existing resources, especially those, intended to organize health care. In the feld of practice, public health has advanced in knowledge and methodology. Biomedical scientists have identifed many causes of infectious diseases and developed methods to put them under control. Epidemiologists have identifed risk factors that favor many chronic illnesses and information that can be used to reduce the risk of disease. Efforts to cleanse the environment have resulted in air and water that are far safer than half a century ago. Intensive educational efforts have convinced the health‑care organizers to improve their health behavior that is to quit tobacco use, and a combination of drinking and driving. The ability to assess the populations’ health behaviors and assess the share of health interventions has also signifcantly improved the availability of health‑care databases and computer software capable of analyzing them. However, much of the targets from the World Health Organization declarations are not improved or in some countries provided by offcial institutions responsible for public health activities.
    Keywords: Global health, public health, public health determinants
  • Kambiz Soltaninejad, Shahin Shadnia Page 3
    Substance abuse and its consequences are major health hazards in the world. Opium addiction is a common form of substance abuse in Iran. Adulteration of illegal substances in the process of production and distribution of the drug in black market with many types of materials have been reported. One of the main goals of the adulteration of illegal substances is cutting of the substance for deal and increase of the weight for more beneft. However, adding of adulterating agents to illegal drugs could be considered as a cause of nonspecifc and rare toxicity during substance abuse. Although the presence of lead in street‑level heroin, marijuana, and amphetamines has been reported from some countries previously, recently, several reports suggested lead poisoning in Iranian opium addicts. Adulteration of opium with lead is a new source of lead poisoning in Iran in which the opium abuse is frequent and it could be a new health problem in the future. In this regard, evaluation of blood lead level would be important for early diagnosis of lead poisoning in opium addicts.
    Keywords: Iran, lead, opioid‑related disorders, opium, poisoning
  • Hamid Reza Mohammadi, Mohammad Sadegh Khoshnam, Ebrahim Khoshnam Page 4
    Background
    Previous studies have indicated that exercise training improves body composition and cardiovascular disease risk factors. The aim of the present study was to investigate the effect of 12 weeks of aerobic, strength and combined training on body composition, intercellular adhesion molecule‑1 (ICAM‑1), vascular cell adhesion molecule‑1 (VCAM‑1), and C‑reactive protein (CRP) in sedentary middle‑aged men.
    Methods
    Forty‑seven male aged 40–60 years voluntarily participated in this study and were divided in four groups: aerobic (n = 12), strength (n = 12), combined (n = 11), and control (n = 12) groups randomly. Body composition, ICAM‑1, VCAM‑1, and CRP were measured before and after 12 weeks. Data were analyzed using paired t‑test and analysis of variance statistical methods.
    Results
    There were signifcant differences in body weight between aerobic and strength training (P = 0.004) and aerobic and control groups (P = 0.018), body mass index between combined and strength training (P = 0.004) and combined and control groups (P = 0.001), fat percentage between aerobic training and control group (P = 0.017) and combined training and control groups (P = 0.004), and fnally, fat‑free mass between aerobic and strength training (P = 0.024),aerobic and combined training (P = 0.0001), strength and control groups (P = 0.035), and combined and control groups (P = 0.0001).
    Conclusions
    The results indicated that 12‑week workout, 20–60 min/session, 3 days a week of moderate intensity exercise improved body composition, ICAM‑1, VCAM‑1, and CRP compared to those who did not participate in any training. However, all three types of exercises had small benefts on body composition, ICAM‑1, VCAM‑1, and CRP in sedentary middle‑aged men, and the importance of combined training required further investigations.
    Keywords: Body composition, cardiovascular risk factors, exercise training, middle‑aged men
  • Mohammad Reza Salahshoor, Arman Vahabi, Shiva Roshankhah, Ahmad Shabanizadeh Darehdori, Cyrus Jalili Page 5
    Background
    Morphine is a pain medication .It is mostly processed in liver and reasons disturbing effects. It can increase the production of free radicals. Thymoquinone is a phytochemical compound found in the plant Nigella sativa. It has diverse pharmacological properties such as antioxidant and anticancer. This study was intended to assess the effects of thymoquinone against morphine damages on the liver of mice.
    Methods
    In this study, various doses of thymoquinone (4.5, 9,
    and 18 mg/kg) and thymoquinone plus morphine wasadministered (once a day) intraperitoneally to 48 male mice for 20 consequent days. These mice were randomly assigned to eight groups (n = 6). Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, serum nitric oxide (NO) levels, liver weight, and histology have been studied.
    Results
    The results indicated that morphine administration signifcantly increased the mean diameter of central hepatic vein and hepatocyte, blood serum NO level, liver enzymes level, and decreased liver weight compared to saline group (P
    Conclusions
    It seems that antioxidant effect of thymoquinone could protect damage of liver parameters against morphine toxicity.
    Keywords: Liver, mice, morphine, thymoquinone
  • Fatemeh Rezaei, Mohmmad H. Yarmohammadian, Abbas Haghshenas, Ali Fallah, Masoud Ferdosi Page 6
    Background
    Methodology of Failure Mode and Effects Analysis (FMEA) is known as an important risk assessment tool and accreditation requirement by many organizations. For prioritizing failures, the index of “risk priority number (RPN)” is used, especially for its ease and subjective evaluations
    of occurrence, the severity and the detectability of each failure. In this study, we have tried to apply FMEA model more compatible with health‑care systems by redefning RPN index to be closer to reality.
    Methods
    We used a quantitative and qualitative approach in this research. In the qualitative domain, focused groups discussion was used to collect data. A quantitative approach was used to calculate RPN score.
    Results
    We have studied patient’s journey in surgery ward from holding area to the operating room. The highest priority failures determined based on (1) defning inclusion criteria as severity of incident (clinical effect, claim consequence, waste of time and fnancial loss), occurrence of incident (time ‑ unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) then, (2) risks priority criteria quantifed by using RPN index (361 for the highest rate failure). The ability of improved RPN scores reassessed by root cause analysis showed some variations.
    Conclusions
    We concluded that standard criteria should be developed inconsistent with clinical linguistic and special scientifc felds. Therefore, cooperation and partnership of technical and clinical groups are necessary to modify these models.
    Keywords: Failure Mode, Effects Analysis, health system, risk assessment, risk priority number
  • Pragya Verma, Ratan K. Srivastava, Dharmendra Jain Page 7
    Background
    Approximately 20%–25% of the world adult population and nearly 30% of Indians have metabolic syndrome disorder. Our objective was designed to fnd out the association between important nutrients and potential lifestyle risk factors such as diet, physical inactivity, and smoking and alcohol consumption with the number of metabolic syndrome components.
    Methods
    This was a cross‑sectional study. A total of 205 patients of metabolic syndrome were enrolled for this study. Diagnosis of metabolic syndrome was done on the basis of National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP ATP III 2004). Dietary data were collected with the validated food frequency questionnaire and 24 h dietary recall method, and the nutrient intake was calculated with the specially designed software.
    Results
    Unhealthy dietary habits were seen more among the participants who had more than 3 risk factors. Results showed the odds of taking >5 times junk foods was 3 times higher (odds ratio [OR]: 2.97; 95% confdence interval [CI]: 1.61–5.47), and sweet dishes was 2.3 times higher (OR: 2.33; 95% CI: 1.28–4.24) among the participants who had 4–5 risk factors. However, milk and dairy products > 4 servings/ day (OR: 0.54; 95% CI: 0.175–1.67) and pulses and legumes more than 2 servings/day (OR: 0.57; 95% CI: 0.25–1.29) was protective against hypertension. Mean carbohydrate, saturated fat, and sodium intake was signifcantly higher in the participants who had 4–5 metabolic risk factors compared to 3 risk factors (P
    Conclusions
    It was concluded that low intake of fruits, vegetables, and higher intake of flesh food and inadequate physical activity signifcantly associated with the metabolic syndrome risk factors.
    Keywords: Dietary pattern, hypertension, lifestyle risk factors, metabolic syndrome, physical activity
  • Youkhabeh Mohammadian, Behzad Mahaki, Mahmoud Dehghani, Mohammadkazem Atef Vahid, Fahimeh Fathali Lavasani Page 8
    Background
    The investigation of personality characteristics and emotional experiences of the people suffering from anxiety disorders is one of the most important issues which are considered by researchers and clinicians. Perfectionism, sensitivity to interpersonal rejection, and anger are personality traits related to social anxiety. In social anxiety disorder, it has also been focused on anger as a personality characteristic and as an emotional condition. The main purpose of this work is to investigate the role of these variables in predicting social anxiety among a nonclinical group of Iranian students.
    Methods
    In this cross‑sectional study, 131 students completed the self‑report version of Liebowitz Social Anxiety Scale Self‑Report version (LSAS‑SR), Frost Multidimensional Perfectionism Scale (FMPS), Interpersonal Sensitivity Measure (IPSM), and State and Trait Anger Expression Inventory. Multiple linear regressions were conducted to examine the concurrent associations between perfectionism, interpersonal sensitivity and quality of emotional experience, and expression of anger with severity of self‑report social anxiety.
    Results
    Greater levels of FMPS total were signifcantly associated with a greater level of LSAS total, fear, and avoidance of social and functional situations (P = 0.022, P = 0.024, and P = 0.006). Moreover, a signifcant positive correlation between IPSM total (P = 0.015) with fear and also between anger expression index (P = 0.009) with avoidance subscale were found.
    Conclusions
    In accordance to the previous researches, we found that perfectionism, interpersonal sensitivity, anger experience, and anger expression skills are related to social anxiety. How these personality traits are related to fear and avoidance of social situations and their concurrent effects on predicting social anxiety were discussed.
    Keywords: Anger, interpersonal sensitivity, perfectionism, social anxiety
  • Ahdieh Chinekesh, Seyed Ali Hoseini, Farahnaz Mohammadi Shahbolaghi, Mohammad Esmael Motlagh, Monir Baradaran Eftekhari, Gelayol Ardalan, Shirin Djalalinia Page 9
    Background
    Factors affecting lifestyle become one of the most priorities of the research feld, especially in adolescents and youth. Using a qualitative approach, this study aimed to understand what factors are affecting young people’s healthy lifestyle.
    Methods
    Using the conventional content analysis, and used the semi‑structured in‑depth interviews, we conducted a qualitative study to elicit the youth opinion considering their lifestyle affecting factors. Initially, purposeful sampling method was considered for data collection. Participants were selected from volunteered youths 18–30 years whom were selected from the Tehran city. Inclusion criteria for the participants were; (a) willingness to participate in the study, and (b) ability to express experiences.
    Results
    According to fndings, although the majority of participants agreed on the important role of lifestyle related behaviors in their healthy life, the lack of essential motivation and the pressure of educational assignments remove it from their daily program priorities. The most important barrier to observing the healthy lifestyle was expressed as; the acceptance of the concept by the individual and the social and economic potential of the individual. It was also suggested that practical interventions should focus on improving more participator engagement of all of the related stakeholders.
    Conclusions
    We proposed the participatory strategies for youth healthy lifestyle promotion. Through which based on a specifc needs the assessment of different target groups, designing, development, and implementation of health programs led to more effective interventions.
    Keywords: Iran, lifestyle, qualitative study, youth
  • Fatemeh Rajabi, Leila Mounesan, Azadeh Sayarifard, Laleh Ghadirian Page 10
    Background
    Women play a central role in the health of the whole family, but they are faced with more barriers while taking part in physical activities.
    Methods
    This study was composed of two main phases. In the frst phase, the status of physical activity among young and adolescent in Iran and global evidence of effective interventions were searched. In the second phase, Focused Group Discussion (FGD) sessions were held with the key stakeholders in Tehran to investigate the results obtained from the frst phase.
    Results
    Physical activity among young and adolescent in Iran is inadequate. Based on the results obtained from the evidence and analysis of the FGDs, solutions defned as supporting policies, supporting environment, and supporting programs for physical activities.
    Conclusions
    Multilevel cooperation among schools, families, and society is necessary to develop and implement policies and supporting programs, with an emphasis on combined interventions.
    Keywords: Adolescent, girls, physical activity, young