فهرست مطالب

  • Volume:10 Issue: 9, 2020
  • تاریخ انتشار: 1398/11/20
  • تعداد عناوین: 37
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  • Won Sriwijitalai*, Viroj Wiwanitkit Page 1
  • Mohammadreza Zarei, Negin Larti, Homayoun Tabesh, Mohammad Ghasembandi, Akram Aarabi* Page 2
    Background

    The aim of this study was to compare the PID with bare skin (without PID) regarding bacterial recolonization and bacterial regrowth of the adjacent skin of surgical incision in lumbar spine surgery patients.

    Methods

    This quasi‑experimental study was conducted from February to May 2018 on 88 patients who were candidate for lumbar spine surgery. Patients were assignedto one of two groups, treatment (with PID) and control (without PID). Skin sampling (adjacent of surgical incision) for bacterial culture was done in two steps, immediately after surgical skin prep (IASSP) and immediately after surgical wound closure (IASWC) by researcher. Finally, samples were sent to the laboratory. </span

    Results

    The mean total bacterial count of patient’s skin in stage IASSP was not significantly different between treatment and control groups (0.34 vs 0.27, P = 0.68). However, mean total bacterial count in stage IASWC in treatment group wassignificantly higher than control group (2.2 vs 0.93, P = 0.03). The frequency distribution of S. aureus (P = 0.04) and S. epidermidis (P = 0.02) was significantly higher in treatment group compared with control group in stage IASWC.

    Conclusions

    The results showed that using PID is unable to reduce recolonization and regrowth of bacteria on patients’ skin adjacent to surgical wound in clean lumbar spine surgeries. However, making a definite decision about using or notusing of PID requires further studies.

    Keywords: Bacteria, lumbar vertebrae, surgical drapes, surgical wound
  • Ghazi Bashamakha, Hesham bin Sumait, Mohamed Bashamakha, Abdulwahed Al Serouri, Yousef Khader* Page 3
    Background

    The incidence of breast cancer is on rise in low‑ and middle‑income countries as populations increasingly adopt western lifestyles. Studies on risk factors of cancers including breast cancer are lacking in Yemen. Therefore, this study aimed to determine the risk factors of breast cancer among women registered at Hadramout Valley and Desert Oncology Center (HVDOC).

    Methods

    A case–control study was conducted at HVDOC, Yemen. All women who were registered in HVDOC and diagnosed with breast cancer and confirmed by histopathology during 2011– 2015 were selected as cases. Age‑matched controls were selected from women who underwent mammography in HVDOC during 2011–2015 and were confirmed to be free of breast cancer. Data were collected using semi‑structured questionnaire and clinical data were abstracted from themedical records.

    Results

    A total of 105 patients and 210 controls were included in this study. About70.5% of cases and 72.4% of control were 50 years old or younger. Compared with married women, divorced women had higher odds of breast cancer [odds ratio (OR) = 2.2]. The odds of breast cancer was higher for women who had never breastfed a child (OR = 1.7). Having hypertension (OR = 2.5), family history of malignancy (OR = 2.4), and postmenopausal status (OR = 2.0) were significantly associated with higher odds of breast cancer in multivariate analysis.

    Conclusions

    The main risk factors for breast cancer among women in Yemen are divorced marital status, never breastfed a child, having hypertension, family history of malignancy, and postmenopause. Regular screening especially among women with high risk is needed.

    Keywords: Breast neoplasm, case–control study, risk factors, Yemen
  • Fatemeh Bakhtari Aghdam, Ziba Delangiz Alamdari, Haidar Nadrian, Mohammad Asghari Jafarabadi, Reza Dehghanzadeh* Page 4
    Background

    Disposal and release of plastic bags in the environment can cause environmental, economic, and social problems. The aim of this study was to explore the determinants of the behavior of plastic bag use (BPBU) among residents using socioecological approach (SEA).

    Methods

    In this cross‑sectional study, multistage random sampling was employed to enroll 400 residents in Hadishahr County, North West of Iran. A valid and reliable instrument based on SEA variables was used.

    Results

    Hierarchical multiple linear regressions were performed with SEA and BPBU as outcome variables. Predictors of outcome variables were classified into four different blocks. Demographic characteristics and SEA constructs explained 50% of the observed variance in BPBU. In the first block, age (P = 0.03) and purchase frequency (P = 0.902) were significant predictors of BPBU (R2 = 0.34), and in the third block, access to alternatives in environment (P = 0.01) wassignificant predictor for BPBU (R2 = 0.49). The majority of residents (47%) were taking home 6 to 10 plastic bags and more than 10 freezer bags after their shopping per week.

    Conclusions

    Health‑care providers may consider purchase frequency and SEA as a framework for developing educational, environmental, and social interventions aiming at reducing the consumption of plastic bags.

    Keywords: Environmental factor, personal factor, plastic bag, social support
  • Mina Minaie, Khadijeh Mirzaei, Ramin Heshmat, Ariyo Movahedi, Ahmadreza Dorosty Motlagh, Mahboubeh Parsaeian, Soori Soghra Raghebi, Abolghasem Djazayery* Page 5
    Background

    Overweight, obesity, and underweight are common child health problems in Iran. Child‑feeding practices are one of the major factors affecting children’s weight through eating behavior and dietary intake. The Comprehensive Feeding Practices Questionnaire (CFPQ), a 49‑item measure comprising 12 subscales, assesses parental child‑feeding practices. It is used to determinefactors that may affect the development of overweight, obesity, and underweight and therefore, helps us plan appropriate preventive action. The aim of this study was to revise and adapt CFPQ to be used for 2–5‑year‑old children.

    Methods

    This study including, 300 mothers selected by simple systematic random sampling, was conducted in the rural and urban areas of Birjand city, Iran. Health workers interviewed the mothers and completed questionnaire according to the standard protocol. Exploratory factor analysis (EFA), tests for internal consistency, and test–retest reliability were conducted.

    Results

    EFA resulted in a final questionnaire with 39 items distributed overseven factors, including Healthy Eating Guidance, Modeling, Parent Pressure, Monitoring, Emotion Regulation, Child Control, and Restriction. The internal consistency reliability for the proposal scales was acceptable for five out of the seven factors and all of the seven factors demonstrated excellent test–retest reliability.

    Conclusions

    The revised CFPQ is a valid tool for determining the variousaspects of parental feeding practices aiming to prevent overweight, obesity, and underweight among 2–5‑year‑old children.

    Keywords: Comprehensive Feeding Practices Questionnaire, feeding behaviors, feeding practices, validation studies
  • Reza Dehnavieh, Sajad Khosravi*, Mohammad Hossein Mehrolhassani, AliAkbar Haghdoost, Saeed Amini Page 6
    Background

    Primary healthcare system in Iran has played an extensive role in promoting people health in the past decades. However, regarding universal developments in the different global aspects effective on health, the performance of this system has been influenced significantly. The aim of the present research is to identify the future trends of the primary health care in Iran.

    Methods

    The participants of this qualitative case study were experts in primary healthcare, which were selected and interviewed through purposive sampling method. The interview process was saturated after 25 interviews, so we stopped the process at this point. Framework analysis based on STEEP model used to analysis the interviews.

    Results

    The most important social/value, technological, economic, environmental, and political future trends of primary healthcare in Iran included demographic transition, epidemiological transition, social and cultural changes, emergence of modern and advanced technologies, internet and cyberspace, budgeting limitations, resource management, changing paradigm from volume to value in providing health services, environmental pollutions, natural disasters, health governance, intellectual paradigm of senior officials, regional security, international development, and other internal factors of the health system.

    Conclusions

    The identified factors can be turned into opportunities for Iran primary healthcare system if health planners and policymakers have a deep and accurate look at these influential factors and manage them properly.

    Keywords: Forecasting, Iran, primary healthcar
  • Shirin Hasani‑Ranjbar, Shahrzad Jafari‑Adli*, Moloud Payab, Mostafa Qorbani, Farzaneh Ahanjideh, Abbasali Keshtkar, Bagher Larijani Page 7
    Background

    Osteoporosis and obesity are two major public health problems worldwide. Considering the conflicting results about the association between anthropometric measurement and bone mineral density (BMD) and also differences between various races, this study was designed to examine the relationship between anthropometric measurements and BMD in a sample of Iranian adults.

    Methods

    This cross‑sectional population‑based study was conducted on 2625 Iranian adults aged 18 and above who were selected using multistage, cluster sampling method from Sanandaj and Arak (two cities of Iran). The evaluated variables included age, sex, height, weight, body mass index (BMI), BMD, and waist and hip circumferences. The correlations between anthropometric measures and BMD in three bone areas (total hip, femoral neck, and spine) were observed in four sex/age groups (men <50 years, men ≥50 years, and pre‑ and postmenopausal women).

    Results

    Of all the 2625 participants in the Iranian Multicenter Osteoporosis Study, 2022 (1303 women and 719 men) entered into our survey and were stratified into four sex/age groups. According to the results, increasing BMI was directly associated with BMD increase, while an inverse association was observed between waist‑to‑hip ratio (WHR) and total hip BMD. In a similar analysis on the femoral neck and WHR, the correlation coefficients in premenopausal women and men ≥50 years were reported as being the highest and the lowest, respectively, among the four groups.

    Conclusions

    Our results showed that high BMI is a protective factor (positive correlation), and high WHR is a risk factor for osteoporosis, although it should be reminded that we could not specifically define which factors including lean tissue mass, fat mass, and total weight are really affecting BMD increase in the overweight/obese participants.

    Keywords: Abdominal obesity, body mass index, bone mineral density, obesity, osteoporosis, waist‑to‑hip ratio
  • Esfandiar Heidarian*, Mahnaz Keloushadi Page 8
    Background

    One of the most effective parameters in the progression of the prostate cancer is interleukin (IL)‑6 through affecting pSTAT3, pERK1/2, and pAKT cell signaling proteins. Carvacrol is an herbal antioxidant with antitumor effects. The purpose of this study was to investigate the effects of carvacrol on IL‑6 gene expression, pSTAT3, pAKT, pERK1/2 cellular signaling proteins, and invasion in human prostate cancer PC3 cells.

    Methods

    PC3 cell viability was evaluated by MTT assay with different concentrations of carvacrol (0–800 µM). IL‑6 gene expression and cellular concentration of pSTAT3, pERK1/2, and pAKT were investigated using the real‑time reverse transcription quantitative polymerase chain reaction (RT‑qPCR) and western blotting technic, respectively. PC3 cell invasion was determined by invasion assay test.

    Results

    Carvacrol IC 50 for PC3 prostate cancer cells was 360 µM. Carvacrol led to a significant reduction (P < 0.05) for IL‑6 gene expression in a dose‑dependent manner compared to control. IL‑6 protein reduced 41.5% and 52.7% when compared with control cells at 360 and 420 µM of carvacrol, respectively.Carvacrol led to a decline in pSTAT3, pAKT, and pERK1/2 above 360 µM compared to control. PC3 potential invasion was significantly reduced after treatment with carvacrol in a dose‑dependent manner.

    Conclusions

    Decreased IL‑6 protein level by carvacrol resulted in diminishing of pSTAT3, pERK1/2, and pAKT signaling proteins, which leads to the reduction of the cell survival, proliferation, and invasion in PC3 cells.

    Keywords: Cell survival, interleukin‑6, prostatic neoplasms, STAT3 protein, terpenes
  • Hossein Faraji, Sanaz Jamshidi, Gholamreza Askari* Page 9
    Background

    Nutrient deficiency such as antioxidants is a common problem in the elderly; itcan result in different diseases such as cancer. Accordingly, assessment of the dietary intake ofantioxidants is necessary to design a specific plan for solving this problem.

    Methods

    This case–control study was conducted on 152 old people (≥60 years) with and without nursing care innursing care centers in Isfahan, Iran, in 2017. Nutritional assessment was performed by an expertnutritionist using semi‑quantitative validated Food Frequency Questionnaire. Nutrition IV softwarewas used as food analyzer. Analysis of covariance and independent t‑test were used for data analysis.

    Results

    The mean age of the participants was 68.6 ± 4.9 and 68.9 ± 6.1 years in case and controlgroups, respectively, and the percentage of male/females in these groups was 46.3%/53.7% and51.4%/48.6%, respectively. Dietary intake of energy, vitamin E, and selenium was significantlyhigher (P = 0.041; 0.007; 0.017) while beta‑carotene intake was significantly lower in the elderlyunder nursing care than in the control (P = 0.002).

    Conclusions

    The findings indicated that nursingcare leads to improved intake of energy, vitamin E, and selenium, while diminished beta‑caroteneintake in the elderly. Intake of vitamin E, A, C, zinc, and selenium was high among elderly peoplewith and without care, compared with the dietary reference intake. It seems that further studies arerequired to confirm these findings.

    Keywords: Antioxidants, diet, elderly, energy intake, Iran
  • Abdolmehdi Baghaei*, Mohammad Hassan Emami, Peyman Adibi, Hamid Tavakkoli, Hamed Daghaghzadeh, Babak Tamizifar, Mohammad Javad Akbarpour, Badri Hojjatpour Page 10
    Background

    Inflammatory bowel disease (IBD) incidence has been increased in Iran as a developingcountry. Surveillance is a standard method for accessing valid data about disease epidemiology tomake relevant decisions for disease control, prevention, and management. We designed IsfahanIBD Surveillance Project (IISP) to make a surveillance system in this area.

    Methods

    The projectis designed in 3 phases. At the first phase, a model of step‑wise approach (core, expanded core, andoptional variables) for IBD surveillance was designed and implemented among IBD patients registeredat a major referral gastrointestinal diseases clinic in Isfahan. Data bank program and its softwarewere designed with suitable and multifunctional features. A total of 352 IBD cases were registered todata bank and analyzed as a pilot study of IISP.

    Results

    A total of 352 IBD patients, including 245ulcerative colitis (UC), 80 Crohn’s disease (CD), and 27 indeterminate colitis, were registered to thedata bank. Bloody stool and abdominal cramp were the most common presentation symptom amongUC and CD, respectively. Extensive pancolitis was the most prevalent phenotype (40%) of UC. Overtwo‑thirds of our IBD patients were in remission states. Biologic agents had been prescribed in about10% of patients during disease. Primary sclerosing cholangitis was detected in about 7% and 10% ofCD and UC patients, respectively.

    Conclusions

    Valid data from a standard surveillance system area relevant, trustworthy tool for making decision by health policy‑makers. Integrated comprehensiveinterventional programs for disease control and management is the second phase of IISP.

    Keywords: Colitis, Crohn’s disease, inflammatory bowel diseases, Iran, registries, ulcerative
  • Nastaran Eizadi‑ Mood, Maliheh Ghandehari, Marjan Mansourian, Ali Mohammad Sabzghabaee, Shiva Samasamshariat, Erfan Sadeghi Page 11

    Many studies have focused on the relationship between naloxone and seizurein tramadol poisoning but the results are in conflict. We performed a meta‑analysis study to see whether naloxone prevents or increase the risk of seizure in tramadol poisoning. Bibliographic literature searches were conducted in the ISI Web of Science, Excerpta Medica Database (EMBASE), PubMed, and Cochrane from January 1990 to December 2017 for relevant articles. Pooled data were analyzed by calculating odds ratios (ORs) with 95% confidence intervals (CIs). The outcome includes seizure. To investigate the publication bias, Begg’s and Egger’s tests were used along with funnel plot as a graphical test. Seven studies met the inclusion criteria. The meta-analysis showed I2, 27%, (P value, 0.23) indicating no significant heterogeneity. As a result, using the fixed effect, the OR was 1.14 (95% CI = 0.60–2.18, P value, 0.69) which was not significant, means naloxone did not increase the risk of seizure. Naloxone therapy did not increase the risk of seizure significantly in the treatment of acute tramadol poisoning. We suggest considering the risk/benefit when administration naloxone, especially for the seizure risk factors including previous history of seizure, tramadol misuse, and co-ingestion.

    Keywords: Meta‑analysis, naloxone therapy, poisoning, review, tramadol overdose
  • Seyed Abdol Reza Mortazavi Tabatabaei, Jalal Ghaderkh, Ali Nazari, Kourosh Sayehmiri, Fatemeh Sayehmiri, Iraj Pakzad* Page 12
    Background

    Urinary tract infection (UTI) is one of the most common infectious diseases ranking next to upper respiratory tract infections. UTIs are often significantly associated with morbidity and mortality. The inappropriate administration of antibiotics to treat these infections increased infection
    resistance to antibiotics. The aim of this study is to determine the frequency of antibiotic resistance pattern in UTIs.

    Methods

    We searched several databases including PubMed, Web of Science, Scopus, Google Scholar, Iran Medex, Magiran, IranDoc, MedLib, and Scientific Information Database to identify the studies addressing antibacterial resistance patterns of the most common uropathogenic bacteria in UTIs in Iran. A total of 90 reports published from different regions of Iran from 1992 to May 2015 were involved in this study.

    Results

    It is shown that the most common pathogen causing UTIs is Escherichia coli with 62%. The resistance among the isolates of E. coli was as follows: ampicillin (86%), amoxicillin (76%), tetracycline (71%), trimethoprim‑sulfamethoxazole (64%), cephalexin (61%), and cefalothin (60%). The highest sensitivity among isolates of E. coli was as follows: imipenem (86%), nitrofurantoin (82%), amikacin (79%), chloramphenicol (72%), and ciprofloxacin (72%).

    Conclusions

    The results of this study showed that the most common resistance are antibiotics that are commonly used. The most effective antibiotics for E. coli were imipenem, nitrofurantoin, amikacin, chloramphenicol, and ciprofloxacin. Considering this study, it had better, use less gentamicin, second‑generation cephalosporins, and nalidixic acid in the initial treatment of infections caused by E. coli, and no use penicillins, tetracyclines, cotrimoxazole, and first-generation cephalosporins.

  • Mohammad Bagherniya, Firoozeh Mostafavi Darani, Manoj Sharma, Ramesh Allipour‑Birgani, Ali Taghipour, Mohammad Safarian* Page 13
    Introduction

    Childhood obesity has become a global endemic public health problem. Emotional distress has been proposed to be a strong mediator of unhealthy lifestyle behaviors among youth.
    The aim of this study was to explore the sources and role of stress on developing unhealthy lifestyle practices pertaining to diet and physical activity among overweight and obese adolescents.

    Methods

    This qualitative study was conducted in 2016–2017 in two large cities of Iran, Mashhad and Isfahan. Fifty‑two overweight and obese adolescents were selected through purposeful sampling. In‑depth semi‑structured interviews and focus group discussions were conducted to obtain perceptions and experiences regarding underlying factors of obesity and the sources and role of stress in inducing unhealthy lifestyle. Ten parents were also interviewed. Data were analyzed using conventional content analysis with MAXQDA software. Study rigor was verified using criteria proposed by Lincoln and Guba.

    Results

    After analyzing the data, two main categories which triggered emotional overeating and physical inactivity among adolescents were: “school originated stress” and “family originated stress.” Three subcategories of school originated stress were “Too much homework,” “Frequent exams” and “Priority for studying at both school and home” and family originated stress subcategories were “Parental destructive conflicts,” “Divorce” and “Socio‑familial issues.”

    Conclusions

    Our findings highlighted the sources and role of stress in emerging unhealthy lifestyle practices including emotional overeating and physical inactivity among adolescents which could lead
    to weight gain. Therefore, to improve lifestyle behaviors of students and prevent childhood obesity, addressing school, and family stressors is a crucial subject.

    Keywords: Adolescent, emotional eating, obesity, physical activity, qualitative research
  • Abdolhalim Rajabi, Masoud Arefnezhad, Saeed Erfanpoor, Firooz Esmaeilzadeh, Masoumeh Arefnezhad, Jalil Hasani* Page 14
    Background

    Associations between smoking and health‑related quality of life (HRQoL) in the general population remain unclear. The aim of the study was to quantify the independent associations between smoking and HRQoL.

    Methods

    A cross‑sectional population‑based study was conducted on a total sample of 2197 participants obtained by multistage sampling to investigate the associations between smoking and HRQoL in the general population of southeast and southwest of Iran, aged 18–100 years in 2012–2013. Data were collected using a self‑administrated of the 36‑ Item Short Form Survey (SF‑36) questionnaire. Linear regression analyses were used to evaluate the associations between HRQoL and smoking while adjusting for various socioeconomic variables. In this study, P < 0.05 was considered a significant difference.

    Results

    Out of the total of 2197 participants, current smokers and never smokers accounted for 13% and 87%, respectively. The mean HRQoL indices were for the current smokers 66.66 ± 17.86, and never smokers 71.35 ± 18.47 (P < 0.001). Independent associations between smoking and HRQoL were found, including negative associations (P < 0.001). The multivariate associations between smoking status and HRQoL, male smokers had a lower physical functioning, mental health, and total SF‑36 score.

    Conclusions

    Smoking was independently related to HRQoL, with large differences according to the gender. This study showed that there is a significant difference in the quality of life related to health
    in male smokers compared to male nonsmokers.

    Keywords: Cigarette smoking, Iran, quality of life, sex
  • Zeinab Samadi, Effat Bambaeichi*, Mahboubeh Valiani, Zahra Shahshahan Page 15
    Background

    Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder in women of reproductive ages which will lead to infertility. This study is aimed to determine changes in levels of hyperandrogenism, hirsutism and menstrual regulation after a period of aquatic high intensity interval training (AHIIT) in women with PCOS.

    Methods

    Thirty patients with PCOS having age between 20 and 35 and body mass index (BMI) ≥30 kg/m2 in obstetrics and gynaecology clinics in Isfahan were selected based on Rotterdam Diagnostic Criteria. They were randomly divided into experimental (AHIIT + metformin, N = 15) and control groups (metformin, N = 15). The exercises were done for 12 weeks, three sessions of 20 minutes. Metformin (1500 mg) was taken daily for 3 consecutive days for 12 weeks. Kolmogorov–Smirnov test, t‑test, Covariance and Wilcoxon were applied (P value < 0.05).

    Results

    After 12 weeks, no significant difference was observed in waist‑to‑hip ratio (WHR), but in AHIIT, the BMI and fat mass significantly decreased and levels of follicle‑stimulating hormone (FSH), free testosterone (FT) and sex hormone binding globulin (SHBG) increased compared to control group (P < 0.05). While levels of improvement of total testosterone (TT), dehydroepiandrosterone sulphate (DHEAS), FT, luteinising hormone (LH) and free androgen index (FAI) were not significant between the two groups (P > 0.05). Furthermore, there was a significant decrease in homeostatic assessment of insulin resistance (HOMA‑IR) and hirsutism severity in experimental group (P < 0.05). In both groups, the order of menstrual cycles
    improved significantly (P < 0.05).

    Conclusions

    Doing AHIIT besides drug therapy can be effective for PCOS patients.

    Keywords: AHIIT, hyperandrogenemia, hirsutism, menstrual, PCOS
  • Mohammadreza Rajabalipour, Hamid Sharifi, Nouzar Nakhaee, Abedin Iranpour* Page 16
    Background

    The growing supply and prevalence of waterpipe (WP) smoking among Iranian adolescents have become a concern for both families and policymakers. The aim of this study was to determine the factors underlying WP use and also to design an intervention program based on social cognitive theory (SCT) aimed to reduce the demand for WP smoking among male adolescents.

    Methods

    This quasi‑experimental study involved 189 high‑school students in Kerman, Iran, who were split into two groups, an intervention group and a control group. A validated questionnaire
    based on SCT constructs was used to collect data. The intervention was performed over four sessions with a focus on preventing WP smoking.

    Results

    Before intervention, the lifetime and current‑use prevalence of WP smoking across both groups was 48.5% and 20.2%, respectively. In the intervention group, the most change was related to knowledge score from 10.70 ± 4.38 to 16.52 ± 3.89 (P < 0.0001) and outcome values score from 12.40 ± 3.81 to 13.53 ± 4.23 (P = 0.007); however, in the control group, no significant changes were seen in posttest scores. The scores for self‑efficacy (P = 0.21), outcome expectations (P = 0.09), and environment constructs (P = 0.06) did not show any statistically significant changes after the intervention in both groups. Overall, there was no significant difference in the rate of WP smoking after the intervention.

    Conclusions

    Based on the results of this study, although some construct scores showed significant differences after the intervention, there was no significant change in the prevalence of WP smoking. More effective educational interventions based on this theory but with a greater focus on self‑efficacy and environmental influences may be warranted.

    Keywords: Adolescent, social cognitive theory, student, waterpipe smoking
  • Shirin Amini, Saeed Shirali, Sima Jafarirad*, Hajar Ehsani, Houra Mohseni, Mehdi Sayah Bargard Page 17
    Background

    Depression and obesity are among the increasingly publicized health problems,both being related to critical complications, and increasing the risk of substantial morbidity andmortality. An increasing number of documents indicate that obesity affects mental status, lowserum cholesterol levels, and is related to depressive symptoms. The purpose of the present studywas to evaluate the possible significant difference in lipid profile levels, body mass index (BMI),waist circumference (WC), and blood pressure (BP), between depressive and nondepressive olderadults.

    Methods

    This was a case–control study where 107 patients, over 65‑year‑old, were enrolled in this study. Serum total cholesterol, high‑density lipoprotein‑cholesterol, low‑densitylipoprotein‑cholesterol (LDL‑C), triglycerides (TG), BP, and fasting blood sugar were measured.Data were analyzed using the statistical SPSS software version 22. Independent t‑test was usedto compare the results between the two groups and the Chi‑square test was used to comparecategorical variables. In addition, nonparametric Mann–Whitney test was used to evaluate the data.

    Results

    The depressive group showed significant lower BMI, WC, LDL‑C, and TG (P < 0.001,P < 0.001, P < 0.016, and P < 0.014). Furthermore, the findings showed significantly higher systolicand diastolic BP in participants who had shown depressive symptoms (P < 0.035 and P < 0.024).

    Conclusions

    The findings suggest that a low BMI, serum LDL‑C, and TG are related to depressivesymptoms the Iranian elderly.

    Keywords: Aged, blood pressure, body mass index, cholesterol, depression
  • Amir Almasi‑Hashiani, Mahmoud Abbasi, Mohammad Tavakol, Vali Baigi, Mehri Mohammadi, Javad Nazari, Esmaeil Khedmati Morasae, Yahya Shadi, Majid Taheri Page 18
    Background

    Health literacy is a major factor for health promotion and well‑being. In spite of several researches on health literacy, information on the subject of the status of health literacy in
    Asian countries such as Iran is inadequate. Therefore, this study aimed to assess the inequality of health literacy in an Iranian population and its influencing factors.

    Methods

    In this cross‑sectional study, 736 families were selected by cluster random sampling. A validated questionnaire was used to measure the health literacy of participants. Socioeconomic status (SES) was calculated by asset‑based approach, and principal component analysis (PCA) was performed to estimate the families’ SES. Concentration index and curve were used to measure SES inequality in health literacy, and after that decomposed into its determinants. The data were analyzed by Stata software.

    Results

    The mean age of the participants was 34.81 years (standard deviation = 5.98 years). The value of concentration index for health literacy equals 0.2292 (95% confidence interval = 0.168–0.283), and this value indicates that there is inequality in distribution of health literacy in Iran and the inequality disfavors the poor.

    Conclusions

    The results of this study revealed that there is inequality in distribution of health literacy in Iran, and people of higher economic status in Iran enjoy from better health literacy levels.

    Keywords: Healthcare disparities, health literacy, health status disparities, socioeconomic factors
  • Shervin Assari*, Masoumeh Dejman Page 19
    Background

    To test whether gender moderates the effects of baseline depressive symptoms and chronic medical conditions (CMCs) on risk of receiving subsequent psychiatric diagnosis among
    older adults.

    Methods

    Data came from ten waves of the Health and Retirement Study, a nationally representative longitudinal study. We followed 9794 individuals older than 52 years without any diagnosed psychiatric disorder at baseline for up to 18 years. Baseline depressive symptoms and CMC were the predictors, time to receiving an emotional diagnosis was the outcome, baseline
    demographics and socioeconomics were controls, and gender was the moderator. We used Cox proportional hazards models for data analysis.

    Results

    In the pooled sample, female gender increased the effect of baseline depressive symptoms (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.26–2.00) and reduced the effect of baseline CMC (HR, 0.78; 95% CI, 0.63–0.97) on time to receiving a psychiatric diagnosis. Among men, baseline depressive symptoms (HR, 2.36; 95% CI, 1.87–2.97) increased and baseline CMC (HR, 0.81; 95% CI, 0.69–0.95) decreased time to receiving a psychiatric diagnosis. Among women, depressive symptoms (HR, 1.49; 95% CI,
    1.21–1.83) but not CMC (HR, 1.06; 95% CI, 0.91–1.23) were associated with time to receiving a psychiatric diagnosis over time.

    Conclusions

    Men and women differ in how depressive symptoms and CMC influence their risk of receiving a psychiatric diagnosis over time. Depressive symptoms are more salient promotor for men than women while CMC is only a barrier for men.

    Keywords: Chronic medical conditions, depressive symptoms, gender
  • A. Suguna, A. Surekha* Page 20
  • Chidiebere Emmanuel Okechukwu Page 22
  • Mohammad Reza Tamadon, Samaneh Tirom, Farahnaz Ghahremanfard*, Azar Baradaran, Raheb Ghorbani Page 23
    Introduction

    Cisplatin is a widely used anti‑cancer drug that is commonly administered for the treatment of various cancers. However, nephrotoxicity is the most important side effect of this drug which limits its use. This study aimed to investigate the protective effect of Cystone against nephrotoxicity induced by Cisplatin in patients with cancer.

    Methods

    This pilot clinical trial study was conducted on 43 cancer patients treated with Cisplatin (75 mg/m2 for a period of six months). The subjects were divided into treatment group (receiving Cystone, two per 8 hours; n = 21) and control group (n = 22). The two groups were compared with each other in terms of demographic and laboratory variables.

    Results

    In the intervention group receiving Cystone, serum creatinine‑based GFR level (P = 0.453) and 24‑hour urine creatinine‑based GFR level (P = 0.397) did not change significantly during the studied period, but in the control group, serum creatinine‑based GFR level (P = 0.013) and 24‑hour urine creatinine‑based GFR level (P = 0.016) significantly changed. Serum creatinine‑based GFR level increased by 2.3 units in the intervention group and 10.5 units in the control group (P = 0.005) in the six months of the study. At the end of the sixth month, 24‑hour urine creatinine‑based GFR level increased by 2.2 units in the intervention group and 0.8 unit in the control group (P = 0.008).

    Conclusions

    The use of Cystone resulted in more stable kidney function indices in the intervention group, as compared with the control group. Therefore, Cystone seems to have a protective effect against nephrotoxicity induced by Cisplatin in cancer patients.

    Keywords: Cisplatin, cystone, neoplasm, nephrotoxicity
  • Maryam Javadi, Atena Jamalzehi, Hadis Gerami*, Seyed Kianoosh Hosseini, Mohammad Bagher Maljaei, Mina Eslami, Asma Bahreini Page 24
    Background

    Coronary artery disease (CAD) is one of the major causes of mortality that is related to the nutritional habits and lifestyle. The aim of this study was to examine the association between tea, coffee, and soft drink consumption and coronary artery stenosis in patients undergoing coronary angiography.

    Methods

    Out of all the patients, 208 cases (101 Female) with 57.81 ± 12.18 (mean ± SD) were assigned to participate in this cross‑sectional study. In total, 168‑items, semi‑quantitative food frequency questionnaire collected for assessments of dietary intakes of black tea, coffee, caffeine, and soft drinks and record demographic and clinical questionnaire.

    Results

    There were negative association between arteries with stenosis of more than 50% number with dietary intakes of tea (P = 0.011, r = – 0.187), coffee (P = 0.069, r = – 0.098) intakes, and dietary caffeine intake (P = 0.043, r = –0.118). The high consumptions of soft drinks (P = 0.005, r = 0.387) were associated with an enhancement in arteries with stenosis of more than 50% number. In addition, dietary consumption of black tea have a negatively significant association with the history of previous angiography (P = 0.044, r = –0.121), the history of previous
    Stanton (P = 0.035, r = –0.132), and coronary artery bypass graft surgery nomination (P = 0.008, r = –0.216). Coffee consumption showed a significant negative relationship with engagement for coronary artery bypass graft surgery (P = 0.004, r = –0.598).

    Conclusions

    Dietary intakes of tea, coffee, and caffeine may have a negative relationship with CAD and cardio vascular diseases. Healthy dietary lifestyle is an important issue for the prevention of chronic diseases.

    Keywords: Caffeine, carbonated beverages, coffee, coronary stenosis, tea
  • Corey H. Basch*, Sarah A. MacLean Page 25
    Background

    Breast cancer has an impact not only on those who are diagnosed, but also on their social network, creating an even greater need for the availability of reliable information and support.

    Methods

    The purpose of this study was to document the content of posts on the highly popular social media platform, Instagram. Posts were garnered and analyzed from Instagram using the hashtag #breastcancer. Data were collected at three different points in time in 2018 and were then aggregated.

    Results

    The most common attributes were highlighting an individual story (n = 76), discussing support for those with breast cancer (n = 75), discussing treatment (n = 55), or promoting an alternative treatment or product (n = 24). Posts that contained images of people were more likely highlight an individual story (P = 0.001) and discuss treatment (P = 0.046).

    Conclusions

    Future research can focus on best practices for developing breast cancer‑related information on social media.

    Keywords: Breast cancer, Instagram, social media
  • Ashraf Pirasteh, Hamed Pouraram, Nahid Kholdi, Mitra Abtahi* Page 26
    Background

    Since women’s readiness for dietary behavioral change can be one of the most effective fundamental measures for reducing dietary salt intake in line with preventing chronic diseases in developing countries, the present study is aimed to determine the readiness for behavioral change in discretionary salt intake among women living in Tehran.

    Methods

    The present cross‑sectional study was conducted on 561 women referring to the women care units across city of Tehran. The self‑administered questionnaire included assessment of nutrition‑related knowledge on salt intake and its association with diseases, discretionary salt intake, stages of change, and self‑efficacy of women. In addition, the logistic regression test was used to determine the predictors of women’s readiness for behavioral change in discretionary salt intake.

    Results

    40% women had someone in the family who had such a limitation (salt intake‑limited exposure group), while 81.6% always or often added salt to their foods. Moreover, one‑third of the participants were in the stage of pre‑contemplation and 41.2% were in the stage of preparation for reducing salt intake. Self‑efficacy and salt intake‑limited exposure were the two most important determinants of the women’s readiness for behavioral change in discretionary salt intake, respectively: (OR = 1.1 95% CI: 1.06‑‑1.14 P < 0.001; OR = 1.58, 95% CI: 1.03‑‑2.42 P < 0.03).

    Conclusions

    Results of the present study showed that increased self‑efficacy is associated with higher levels of behavioral change among women. Since self‑efficacy is very important for initiating and maintaining the behavioral change, women’s empowerment for reducing salt intake necessitates putting the emphasis on increased self‑efficacy as well as community‑based nutritional interventions.

    Keywords: Behavior, readiness, salt
  • Taher Doroudi, Mahtab Alizadeh‑Khoei, Hadi Kazemi, Sakar Hormozi, Fahimeh Taati, Mehdi Ebrahimi, Pirhossein Koulivand, Hossein Fakhrzadeh, Iran Davoudi, Farshad Sharifi Page 27
    Background

    The aim was to determine validity, reliability, and cutoff of full‐mini nutritional assessment (MNA) and MNA‐short form (SF) also which one was better for the screening of malnutrition in the Iranian hospitalized elderly.

    Methods

    In this cross‐sectional validation study, 96 hospitalized elderly ≥60 years selected from two hospitals in Tehran. Anthropometric measures (body mass index [BMI], mid‐arm circumference [MAC], calf circumference [CC], abdomen, and waist skinfold thickness) and laboratory tests (albumin and hemoglobin levels, and red blood cell count were performed. Nutrition tools (full‐MNA and MNA‐SF), cognition tool (mini‐mental state examination, depression scale (Geriatric Depression Scale15 and activities of daily living (ADL) index (Modified Barthel‐ADL) were administered.

    Results

    The full‐MNA scores were significantly correlated to measures of MAC, BMI, waist, and CC. The MNS‐SF scores were significantly related to measures of MAC, waist, and CC. Serum albumin showed a poor correlation with both tools. At cutoff 24 in full‐MNA had a sensitivity 75% and specificity 77.8% and the MNA‐SF considered 62.5% sensitivity and 65.3% specificity at cutoff 10.50 to detect well‐nourished from malnourished subjects. The internal consistencies of both tools were >90%. In exploratory factor analysis, six components found for full‐MNA and two components for MNA‐SF. Known group validity of full‐MNA was reflected significant differences between geriatric patients with expected higher full‐MNA scores and patients with expected lower scores (BMI ≥24 vs. BMI <24 or bed ulcer or assisted food intake).

    Conclusions

    It seems the Persian version of full‐MNA is more appropriate in comparison to MNA‐SF for screening malnutrition in the Iranian hospitalized elderly patients.

    Keywords: Aged, nutrition assessment, psychometrics
  • Katayoun Falahat, Arash Mirabzadeh, Monir Baradaran Eftekhari*, Homeira Sajjadi, Meroe Vameghi, Gholamreza Ghaedamini Harouni, Golnaz Feizzadeh Page 28
    Background

    Based on the World Health Organization definition, mental health is the absence of mental disorders and presence of positive mental health (PMH). As the social determinants of mental disorders and PMH are not the same in different cultures and in order to promote community mental health, social determinants of PMH should be identified, which is the aim of this study.

    Methods

    This was a qualitative study conducted in Tehran. Data were collected through eight focus group discussions with the general population aged between 30 and 60 years and ten semi‑structured interviews with mental health professionals from Tehran. Data were analyzed through directional content analysis using Dedoose software.

    Results

    Fifty‑one lay people and ten mental health professionals participated in this study. The process of content analysis resulted in two main themes: (a) structural determinants of PMH which consist of socioeconomic and political context and socioeconomic position and (b) intermediary determinants of PMH which consist of working condition, living condition, family factors, lifestyle, psychosocial factors, and health system.

    Conclusions

    Improvement of living conditions, with emphasis on working conditions as one of the intermediary social determinants, will play an important role in

    Keywords: Iran, positive mental health, qualitative research, social determinants of health
  • Behnam Honarvar, Morteza Banakar*, Nazi Hassani, Yasaman Movahednezhad, Zahra Gheibi, Kamran Bagheri Lankarani Page 29
    Background

    Delay in diagnosis of diabetes mellitus (DM) in older adults is more catastrophic than other age groups. This study investigated the prevalence of pre‑diabetes, DM, and glycemic control in the elderly.

    Methods

    In this cross‑sectional study, a sample of 412 older adults >60 years from Shiraz, Iran, were recruited through a multistage cluster random sampling. Demographic, clinical, and laboratory information were collected by interview, physical examination, and reviewing the medical records. Data were analyzed using SPSS 20.

    Results

    Mean age was 68.1 ± 6.2 years and female‑to‑male ratio was 1.1. Out of all, 137 (33.2%) were diagnosed as diabetic including 128 (31%) as known cases and 9 (2.2%) as new cases of DM, whereas 275 (66.7%) were diagnosed as new cases of pre‑diabetes. Multivariable analysis showed that low level of education (OR = 5.2, 95% CI: 1.5–16.6), hyperlipidemia (OR = 3.5, 95% CI: 2.1–5.8), liver disease (OR = 3.1, 95% CI: 1.4–6.9), and hypertension (HTN) (OR = 1.9, 95% CI: 1.1‑3.2) were the most common predictors of DM in the elderly, respectively. Out of all diabetics, 33.6% had FBS >130 mg/dL and 25.5% had HbA1c >8%, whereas these figures were ≥100 mg/dL and ≥5.7% in 36.7% and 21.4% of pre‑diabetics, respectively.

    Conclusions

    The pre‑diabetic elderly were mostly undiagnosed, while one‑third to one‑fourth of DMs had poor glycemic indices. These figures show the need for pre‑diabetes and diabetes screening in the elderly, especially in those with low level of education, hyperlipidemia, liver disease, or HTN. Furthermore, regular monitoring of glycemic indices in the diabetic and pre‑diabetic elderly is recommended.

    Keywords: Diabetes mellitus, diabetic, elderly, glycemic index, pre‑diabetes
  • Mina Minaie, Ariyo Movahedi, Ahmadreza Dorosty Motlagh, Zahra Abdollahi*, Abolghasem Djazayery Page 30
    Introduction

    Child nutrition status is very important in all societies, which is influenced by the interaction of multiple factors including food security and socioeconomic status in both genders. The aim of this study was to examine the relationship between food security and socioeconomic status with anthropometric indices among 2–5‑year‑old urban children in eight different cities in Iran.

    Materials and Methods

    In this cross‑sectional study, anthropometric Z scores of 7028 children of urban area were measured by using World Health Organization (WHO) Anthro software based on WHO 2007 standards. Family food security was assessed by using HFIAS 9‑item questionnaire. Socioeconomic status as well as health factors were analyzed using the SPSS.

    Results

    Based on the present study, significant correlation was observed between sleep time, birth weight, and food security (P < 0.05) with body mass index (BMI), while the rest of the variables including age, family size, number of children, parents’ education, breastfeeding duration, watching TV, playing computer games, playing outdoors, number of main eating, and number of snacks showed no significant
    relation (P > 0.05).

    Conclusion

    It was shown that 2–5 years old children’s life are the most vital and vulnerable to the hazards of undernutrition or overweight and obesity, which could affect the whole health of the person. As food security affects BMI, it is important to focus more on this issue in order to improve child’s health status.

    Keywords: Body mass index, malnutrition, obesity, overweight, thinness
  • Yaser Mohammed Al Eryani, Nawal Nooradain, Kakob Alsharqi, Abeer Murtadha, Abdulwahed Al Serouri, Yousef Khader* Page 31
    Background

    The aim is to determine the incidence rate of unintentional injuries and its associated factors and determine the pattern of these injuries among laboratory staff in three reference laboratories in Sana’a, Yemen.

    Methods

    A cross‑sectional study was conducted among laboratory staff in the three reference laboratories in Sana’a, Yemen. A pretested structured questionnaire was used to collect data on the unintentional injuries during the past 12 months including the type of injury.

    Results

    A total of 93 technicians responded and filled the questionnaires. Of the 93 technicians, 51 (54.8%) technicians reported that they had been injured in the past 12 months. Of all injuries, 38% of technicians were caused by needle sticks, 21% by sharp materials other than needles, 15% by hot materials, 15% by exposure to chemicals, and 11% of them by other exposures. Only 18% of injuries were reported to safety officer in the laboratory. Those who had an experience of <5 years were more likely to experience injury in the past 12 months than those who
    had 5 years of experience or more (odds ratio = 8.3; 95% confidence interval: 2.2, 27.4; P < 0.005).

    Conclusions

    About half of laboratory technicians in Yemen reported that they had been injured in the past 12 months, with the needle stick being the most common cause of injury. Therefore, there is a need for targeted interventions to laboratory technicians to increase their awareness on the risk of injuries in the laboratory. Bio‑safety training among laboratory technicians deemed very necessary.

    Keywords: Field epidemiology training program, laboratory technicians, medical laboratories, unintentional injuries, Yemen
  • Reza Valizadeh, Leila Vali, Kambiz Bahaadinbeigy, Mohammadreza Amiresmaili* Page 32
    Background

    Incidence and prevalence of type 2 diabetes are one of the major challenges of Iran health system. Despite policies on diabetes prevention and control, Iran is faced with many problems in prevention and control of this disease at the executive level. This study seeks to identify the problems of Type 2 diabetes prevention and control program in Iran.

    Methods

    In this qualitative study, 17 participants were interviewed purposefully. The semi‑structured interview guide was designed based on literature review and four initial in‑depth interviews. Framework analysis method was used for the analysis of qualitative data.

    Results

    Six themes and 29 subthemes explaining the problems of type 2 diabetes prevention and control program were identified: Referral system, human resources, infrastructure, cultural problems, access, and intersectoral coordination issues.

    Conclusions

    Despite the well‑developed policy of type 2 diabetes prevention and control, the implementation is faced with some problems which endangers the effectiveness of the plan. Any attempt to improve the successful implementation of the type 2 diabetes prevention and control program requires effective measures, deep understanding of the problems and solving them.

    Keywords: Diabetes mellitus, health plan implementation, prevention, control, type 2
  • Hassan Ahmadvand, Sina Mahdavifard* Page 33
    Background

    We investigated the effect of thioctic acid (TA) on kidney function, oxidative stress, and inflammatory status in serum and kidney homogenates of a rat subjected to ischemia–reperfusion injury (IRI).

    Materials and Methods

    Thirty male Wistar rats were randomly divided into three equal groups: sham, IR, and IR + TA in 50 mg/kg once‑daily intraperitoneal injection for 2 weeks, before IR induction. The levels of urea and creatinine (Cr) in the serum of rats were measured. Malondialdehyde and nitric oxide (NO) as stress oxidative markers; tumor necrosis factor‑α, interleukin‑6, and myeloperoxidase as inflammatory markers, as well as activities of superoxide dismutase, glutathione peroxidase and catalase, and glutathione (GSH) level in both serum and kidney homogenates were determined.

    Results

    Cr and urea increased in serum of IR group. Furthermore, levels of oxidative stress and inflammatory markers in serum and kidney homogenates of the cited group were higher than the sham group. TA not only decreased the levels of Cr, urea, oxidative stress, and inflammation but also elevated the level of GSH and activities of antioxidant enzymes (P < 0.001).

    Conclusions

    The findings showed that TA protected IR rat against kidney dysfunction and IRI due to reinforcing endogenous antioxidant and subtracting of inflammatory markers.

    Keywords: Antioxidant enzymes, inflammation, renal ischemia–reperfusion, oxidative stress, thioctic acid
  • Akram Ghadiri Anari, Narjes Hazar, Maryam Jalili Sadrabad, Shadab Kharazmi, Khatereh Kheirollahi*, Azra Mohiti, Nasim Namiranian Page 34
    Background<

    Diagnosis of prediabetic stage is very important for prevention of diabetesand complications. This stage may be associated with some oral lesions. Only a few studiesare available on the oral status of prediabetic patients and incidence of oral lesions in thispopulation. This study aimed to compare some oral complications between prediabetic andhealthy control groups.

    Methods

    < The  present two‑group cross‑sectional study was carried outon 302 prediabetic and non‑diabetic (healthy) 20‑ to 60‑year‑old subjects. In this study, dataon age, gender, educational level, medications use, smoking, and some other variables wereextracted through history taking. In addition, orodental examination was carried out by an oralmedicine specialist to diagnose oral lesions including candidiasis, lichen planus, periodontitis,gingivitis, xerostomia, delayed wound healing, geographic tongue, fissured tongue, and burningmouth sensation. Data entry and analysis was performed by SPSS version 22 software, andP value and odds ratio (OR) were calculated to show statistical relationship between variables.

    Results

    < The most common oral lesion in prediabetic subjects was periodontitis (27.2%),followed by gingivitis (14.7%) and xerostomia (11.3%). In the control group, gingivitis (20.5%)followed by periodontitis (11.3%) are common oral lesions. Candidiasis (P = 0.036), periodontitis(P < 0.001), and xerostomia (P < 0.001) in prediabetic subjects were higher than controlgroup that is statistically significant. Regression analysis showed that in the prediabetic group,periodontitis [OR = 2.91, confidence interval (CI): 1.54–5.49] and xerostomia (OR = 18.51,CI = 2.42–141.45) were significantly more prevalent than healthy subjects.

    Conclusion

    < Basedon the results, glucose intolerance stage exhibited a significantly higher oral problems such asperiodontitis and xerostomia than healthy euglycemic stage.

    Keywords: Periodontitis, prediabetes oral lesions, xerostomia
  • Subraham Pany, Sandeep Kumar Panigrahi, E Venkata Rao, Lipilekha Patnaik*, Trilochan Sahu Page 35
    Background

    Anabolic‑androgenic steroids (AASs), when taken in supraphysiologic doses,increase muscle strength and athletic performance. Evidence suggests that long‑term use of AAS insupraphysiologic doses have adverse effects on health. Therefore, the study was conducted to findcrude estimate of the prevalence of AAS use among attendees of the gymnasium, the factors thatcould have influenced them for AAS abuse and to assess the short‑ and long‑term side effects asperceived by them.

    Methods

    A cross‑sectional study was conducted in selected gymnasiums of asmart city of India using a predesigned and pretested questionnaire. Snowball sampling method wasundertaken. The study was from July 2015 to June 2016. Informed written consent was taken. Theanalysis was done using SPSS v. 20.0.

    Results

    Of 84 bodybuilders approached, 74 participants usedAAS. All users were male with mean age of 26.5 + 0.55 years. The mean age of initiation of AASabuse was 23 years, and 66.2% (49) were unmarried. Eighty‑five percent (63) preferred injectable.Seventy percent (52) abusers were influenced by trainers for abuse. Most commonly abused wasNandrolone decanoate (55.4%). Seventy‑three percent were not aware of any legal ban on steroids.Reported benefits include increased strength, muscle size, and power, while harms were increasedacne, deepening of voice, swelling of feet, increased irritability, depressive thoughts, impairedjudgment, panic disorder, and withdrawal effect.</strong>

    Conclusions

    Frequency of ASS use was substantialamong young bodybuilders. Awareness about side effects was not a deterrent factor. Abusers werehighly influenced by coaches. Efforts should be made for preventing easy access to AAS.

    Keywords: Fitness centers, steroids, substance‑related disorders
  • Introduction of a Community‑Based Participatory Model for Women’s Mental Health Promotion in Iran: A‑Z
    Monir Baradaran Eftekhari, Arash Mirabzadeh, Ameneh Setareh Forouzan, Masoumeh Dejman, Katayoun Falahat, Zohreh Mahmoudi, Judy Bass, Amanda J. Nguyen Page 36
    Background

    To address the disproportionate burden of poor mental health among women, we present a community based participatory research (CBPR) model used to develop a women’s mental health promotion program for Iranian women.

    Methods

    This is a multi‑phase interventional study using a CBPR approach among married women age 18–65 living in Tehran. First, participants described the process of women’s mental health. Subsequent steps involved participatory needs assessment, priority setting, intervention design, and evaluation. Finally, a conceptual model of women’s mental health promotion was developed.

    Results

    Seeking comfort” emerged as the core process in women’s mental health. To promote mental health, women prioritized training on coping mechanisms to deal with stress. Women receiving this training used more problem‑based coping methods and reported a higher quality of life than the comparison group.

    Conclusions

    The resulting conceptual model illustrates the utility of using a CBPR approach to develop women’s mental health promotion programs.

    Keywords: Community‑based participatory model, Iran, mental health promotion, women
  • Abolfazl Aslani, Golamreza Asghari, Hossein Yosofi Darani, Mustafa Ghanadian, Fatemeh Hosseini Page 37
    Background

    Trichomoniasis is a common sexually transmitted disease that is caused by infection with protozoan parasite called Trichomonas vaginalis. Metronidazole is the drug of choice for the
    treatment of this infection. In this study, design, formulation, and physicochemical evaluation of vaginal cream containing Eucalyptus camaldulensis, Viola odorata, and Mentha piperita extracts for the prevention and treatment of trichomoniasis has been investigated.

    Methods

    Ethyl acetate extract of E. camaldulensis leaves, water fraction of V. odorata root, and hydroalcoholic extract of M. piperita leaves was prepared and used for anti‑trichomonas experiments. Then, based on results, different formulations of vaginal cream containing mixed extracts were prepared and physicochemical evaluation was conducted. In the next step, anti‑trichomonas effect of selective formulation was tested in vitro.

    Results

    The mixed concentrates containing 2.5 mg/ml E. camaldulensis, 0.06 mg/ml V. odorata, and 1 mg/ml M. piperita showed 100% growth inhibition (GI) during 24 h. Furthermore, the mixture containing 1.25 mg/ml E. camaldulensis, 0.03 mg/ml V. odorata, and 0.5 mg/ml M. piperita showed 92% GI in the first 24 h. The selective formulation passed all of physicochemical test and also showed 100% GI for in vitro anti‑trichomonas experiments in the first
    24 h.

    Conclusions

    The mixed concentrates containing 2.5 mg/ml E. camaldulensis, 0.06 mg/ml of V. odorata, and 1 mg/ml of M. piperita are the mixture which showed the highest percentage of GI (100%) after 24 h. The selective formulation of vaginal cream containing this mixture of extracts  was detected 100% GI in the first 24 h.

    Keywords: Eucalyptus camaldulensis, Mentha piperita, trichomoniasis, vaginal cream, Violaodorata