Shiraz Emedical Journal
Volume:20 Issue: 9, Sep 2019

Leishmaniasis contains a group of zoonotic diseases that is caused by infected phlebotomine sandflies with flagellate protozoa of the genus Leishmania. The aim of this study was to determine some epidemiological aspects of patients with cutaneous leishmaniasis referring to Marvdasht health center, Fars Province, Iran. Demographic and clinical data of all patients recorded in Marvdasht Health Center, the Infectious Diseases Unit from 2010 to 2016. 7418 confirmed cases of cutaneous leishmaniasis referred to health centers for receiving treatment. The mean age of the patients was 32.9 ± 26.9 year and the incidence of disease in men was higher than women. The age group was 21 to 30 years old (22.9%) had the most cases. The average duration of exposure to detection of the disease was 4.9 ± 1.38 months. The prevalence of wet lesions was significantly higher than dry lesions, and the average size of the lesions was 4.27 cm. The average number of lesions was 1.58 per person, and most of them were in hands (39.6%) and feet (21.4%). The incidence of disease was higher in the autumn than other seasons and it occurred more in rural areas. Marvdasht city is an endemic area of cutaneous leishmaniasis in Iran. Our results showed that the number of cases reported has fluctuated in recent years. Therefore, it is very important for the health system to implement an accurate and effective continuous monitoring strategy for this important vector-borne disease in this part of the country.

Parental adjustment with the birth of a preterm baby is often associated with stress, anxiety, and concern. This study aimed to compare mental health and self-efficacy of mothers with preterm and term infants. This case-control study was conducted on 108 women visiting the healthcare centers of Tabriz (36 mothers with preterm infants as the case group and 72 mothers with term infants as the control group) in 2018. The participants were selected by clustering sampling. The general health questionnaire-28 (GHQ-28) and the maternal self-efficacy questionnaire (MSQ) were used to collect data. The multivariate linear regression model was used for data analysis. The mean self-efficacy score was 30.5 ± 5.6 in the case group and 29.1 ± 4.1 in the control group from the attainable score of 10 to 40. The mean total score of mental health was 27.5 ± 7.5 in the case group and 26.1 ± 8.2 in the control group ranging from 28 to 84. Moreover, 69.4% of the mothers in the case group and 66.7% in the control group had mental health disorder with no significant difference between them (P = 0.771). There was no significant difference between the groups in terms of self-efficacy (0.168) and mental health (0.930) based on the multivariate linear regression model with adjusting the variables of mother and spouse’s age and gestational age. The results showed a high prevalence of mental health disorder in both groups without significant difference between the groups. This shows the importance of taking measures to improve the mental health of mothers with preterm and term infants.

Health literacy is the capacity of individuals to obtain, understand, and interpret basic health information that is necessary to make appropriate health-related decisions.

This study aimed to investigate the association between oral health literacy and the decayed, missing, and filled teeth (DMFT) index, which was conducted in Mashhad dental clinics in 2016.

In this cross-sectional study, 380 patients referred to private and public clinics in Mashhad filled out the oral health literacy adult’s questionnaire (OHL-AQ). The questionnaire contained 4 sections: reading, numeracy, listening, and decision making. Each correct answer was assigned a score of 1 and incorrect or no response were assigned with zero score. The DMFT index was evaluated based on decayed, missing, and filling teeth. Data analysis was performed using chi-square and linear regression tests.

The mean score for oral health literacy was 10.6 ± 3.4. Among patients 46.8% had favorable oral health literacy level, 19.7% were with relatively favorable, and 33.4% were with unfavorable health literacy levels. The average of the DMFT index in the studied group was 8.3 ± 4.9 and was higher among males than females. A significant correlation between the health literacy level and the DMFT index was observed; however, the correlation was negative and weak (R= - 0.127).

The average of oral health literacy level for the entire study population was relatively appropriate, and the majority of the subjects (46.8%) represented a good oral health literacy level. Furthermore, education, economic status, and collecting information from different sources of oral health are important factors affecting the level of oral health literacy.

The rapid growth of health expenditures is a great concern for governments at present.

The present study aimed to determine the main factors affecting health care expenditures in countries with different types of the healthcare system.

We studied 25 countries with different types of healthcare systems, including national health insurance, traditional sickness insurance, national health services, and mixed systems. Health expenditure per capita was estimated as a function of health care price, out-of-pocket health expenditure, income, and other exogenous factors. A random-effects model was selected instead of a fixed-effects model based on the Hausman test to assess the effect of different factors on health expenditures.

Income and health care price had the greatest impacts on health expenditures in countries with national health insurance and countries with mixed health care systems, respectively. Among the variables, mortality and life expectancy had the greatest impacts on health expenditure in all types of the healthcare system. The out-of-pocket health expenditure had the most and least impacts on health expenditures in countries with mixed health care systems and countries with national health insurance systems, respectively.

The study showed that health condition and out-of-pocket health expenditure are the most important determinants of health expenditures in all health care systems, especially the mixed health care system.

Cataracts is the most common cause of blindness worldwide. Factors that influence the development of cataracts in middle-aged people have not been thoroughly investigated.

The purpose of this study was to explore risk factors associated with cataracts among middle-aged patients attended an outpatient clinic in Shiraz, Iran.

This was a case-control study of patients aged 40 to 59 years who were attended Motahari outpatient clinic from February to June 2017. The case subjects were 140 patients who were found to have incident cataracts and controls were 140 age- and sex-matched healthy patients with a normal eye examination. Data were collected by an interviewer-administered questionnaire, an ophthalmologic examination, and the measurement of HbA1c levels. Univariate and conditional logistic regression analyses were used to identify factors that independently predicted the risk of middle-aged cataracts.

Our findings showed that a middle-aged cataracts was associated with myopia (odds ratio [OR] = 2.66, P = 0.001), a history of cataracts before age 60 years in patient’s first degree relatives (OR = 2.12, P = 0.009), a low educational level (OR = 1.89, P = 0.020), and overweight or obesity (OR = 1.80, P = 0.039). Prediabetes and diabetes status were not independently associated with the outcome of interest in this age group.

A hereditary predisposition may play a primary role in the development of cataracts in middle-aged people. Myopia and cataracts may share a genetic predisposition in this age group. Further genetic studies are recommended to elucidate the possible role of specific genes in the development of middle-aged cataracts.

Chest pain is one of the most frequent causes of a child’s referral to a cardiologist.

The present study aimed at determining whether treatment of constipation in 4 - 17-year-old children with idiopathic chest pain stops their chest pain.

The current descriptive study was conducted on all patients aged 4 - 17 years old with idiopathic chest pain referring to the Pediatric Cardiology Clinic of Hejazi Hospital, Shiraz, Iran in 2016. A diagnosis of idiopathic chest pain is established after a thorough history taking, physical examination, and appropriate laboratory investigations in patients with no abnormality in the heart, lung, musculoskeletal system, psychological condition, and upper gastrointestinal tract. The study patients were divided into two groups: 36 patients with constipation as cases and 27 patients without constipation as controls. Patients with constipation were supported with toilet training programs and pharmacological treatment. Relief of chest pain was evaluated in the two groups after four months.

There were no significant differences in terms of age, gender, weight, and height between the patients with idiopathic chest pain with and without constipation. The number and length of chest pain were significantly different between the case and control groups (P < 0.001 and 0.047, respectively). After medical treatment of constipation, chest pain was significantly stopped in patients with constipation compared with the ones without constipation (P < 0.001).

The current study showed that resolution of constipation stopped chest pain in the patients with idiopathic chest pain and constipation. Physicians should consider treatment of constipation as a first modality in each patient with idiopathic chest pain and constipation due to its easy assessment.

Some studies show tuberculosis (TB) seasonal pattern. There are only two reports addressing TB seasonal pattern in Iran.

The current retrospective analysis aimed at determining the seasonal distribution pattern of all registered pulmonary TB cases over the recent six years in Fars province of Iran.

All patients with pulmonary TB in Fars province diagnosed from 2006 to 2011 were investigated in terms of gender, age, and the month of definitive diagnosis. Patients with clinical symptoms suggestive of pulmonary TB with at least one documented positive culture or smear for acid-fast bacilli were included.

A total of 934 patients with pulmonary TB with a mean age of 44.3 ± 21 years were studied, of whom 319 (42.2%) were male. The highest proportion of patients were diagnosed in May (10.7%) and June (10.2%) (P = 0.033). More than 29% of the TB incidents occurred during spring. The proportion of patients presenting in spring decreased from 39.7% in 2006 to 28.4% in 2011. Similarly, percentage of patients recorded in summer significantly decreased during the study (P = 0.008).

Pulmonary TB is a seasonal disease in Fars province with peak incidence in warm seasons independent of patients’ age and gender though seasonal fluctuations decreased over the study period.