فهرست مطالب

Iranian Journal of Public Health
Volume:49 Issue: 10, Oct 2020

  • تاریخ انتشار: 1399/08/07
  • تعداد عناوین: 31
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  • Dariush D. FARHUd* Page 0
  • Bingqing Lu, Xingyi Zhang, Jin Wen* Pages 1813-1826
    Background

    The application of information and communication technologies (ICTs) in disaster relief is increasingly widespread, but it is still unclear whether ICT can reduce casualties and economic losses in disaster response phase.

    Methods

    We searched studies in the databases of Scopus, EI, MEDLINE and EMBASE from Jan 1, 1990, to Mar 22, 2019. Excel 2016 and VOSviewer (version 1.6.11) were used to analyze the extracted data and visualize the network diagram.

    Results

    We included 169 eligible articles. The number of ICTs-related disaster-relief articles published annually shows an overall trend of growth since 1990. The United States has the greatest influence in this field. The 169 articles reported twenty-four technologies and the top three reported most frequently were remote sensing, social media, and geographic information system (GIS). The main roles of ICTs in natural disaster rescue included information dissemination, post-disaster image collection and damage assessment. However, of the 169 articles, only five reported that ICTs reduced casualties or economic losses in disaster response phase, two concluded that rescue robot was ineffective in mudslide rescue, and the remaining 162 (95.86%) did not evaluate the effect of ICTs on the rescue.

    Conclusion

    ICTs have the potential to reduce casualties and economic losses, but some technologies are not applicable to all rescue scenarios. In addition, most studies did not pay attention to the effect of technology on the rescue.

    Keywords: Information, communication technologies (ICTs), Natural disaster, Disaster relief
  • Seyyed Reza SOBHANI, Mina BABASHAHI* Pages 1827-1838
    Background

    Demographic, socioeconomic, and environmental determinants are important to population health status in all countries and diet is the main way that these factors could affect health. We aimed to conduct a systematic review of recent research evidence about these determinants of household food basket composition.

    Methods

    The PRISMA guideline was used to the reproducibility of this systematic review. Three databases including PubMed, Scopus and Google Scholar were systematically searched from 1991 to Dec 2017.

    Results

    Thirty four studies were included. Most studies were done in the United States. Three categories of determinants including the demographic, socioeconomic, and environmental define the contribution of different food groups in the household food basket. These factors determine the healthiness of family dietr.

    Conclusion

    Many determinants affect household food basket. Comprehensive consideration of policymakers to these factors is essential to creating and maintaining a healthy society.

    Keywords: Socioeconomic factors, Household, Food
  • Negar BIZHANI, Saeideh HASHEMI HAFSHEJANI, Neda MOHAMMADI, Mehdi REZAEI, MohammadBagher ROKNi* Pages 1839-1847
    Background

    Cysticercosis in among the neglected tropical disease caused by eating the egg of parasite Taenia solium. In this review, we aimed to verify the prevalence of human cysticercosis in different countries of Asia using systematic review and meta-analysis approach.

    Methods

    Based of the protocol, reliable databases including PubMed, SCOPUS, Science Direct, Embase, and Cochrane Library from 1990-2018 were searched using a panel of keywords. Overall, 48 countries of Asia were searched in turn and data were analyzed using a category of statistical tests.

    Results

    Out of 28 included studies, 586175 samples were collected and included in the data analysis. Based on the meta-analysis results, the overall pooled percent of cysticercosis was estimated 3.8% (95% CI: [2.0, 7.0]). According to the result of heterogeneity statistics including I-squared, chi-square, and tau-squared, it was statistically significant (Tau2 = 2.94, chi2 = 12733.31, P value <0.001, I2 = 100%) therefore a random effect model was used to handle the heterogeneity of studies. To evaluate the trend of cysticercosis over the time, Cumulative meta-analysis was performed and the result showed that there was a minor upward tendency in the prevalence of cysticercosis over the time.

    Conclusion

    Although, considering the religious culture and food habits in Asia, we might have expected to witness a low prevalence of human cysticercosis, but we noticed more or less significant infection in some countries of the region. Regarding the new feature of immigration and travel between countries, all authorities are advised to take measures on controlling and monitoring the disease.

    Keywords: : Cysticercosis, Taenia solium, Human, Neglected tropical disease, Prevalence, Asia
  • Ling ZHANG*, Benxian YAO, Xiaodan ZHANG, Hao XU Pages 1848-1856
    Background

    The global COVID-19 pandemic caused great impacts and influences to human psychology. As a result, youths who are kept at home for a long time easily develop irritability and problematic behaviors. However, relatively little attention has been paid to the relations among irritability, coping style, and subjective well-being of the youth.

    Methods

    Overall, 1,033 youth respondents (aged 18–30 yr) from seven provinces in China were investigated in 2020 using the irritability, depression, and anxiety scale, coping style scale, and well-being index scale.

    Results

    Among the dimensions of irritability of the youth, anxiety received the highest score, followed by introversion irritability, extroversion irritability, and depression. Irritability had significant regional differences. The total score of irritability among rural youth was significantly higher than that of urban youth (P<0.05). The irritability level of youths with parents’ emotional status was harmonious and good relations with family members and peers was far lower than those of youths who have poor relations between parents, family members, and peers (P<0.05). The irritability level of youths with a lower monthly household income was higher (P<0.05). Irritability of the youth had significantly negative correlations with positive response and SWB, and it had a significantly positive correlative with negative response. Coping style can mediate the relationship between irritability and SWB of the youth to some extent.

    Conclusion

    Significant correlations exist among irritability, coping style, and SWB of the youth. Irritability can be used to predict SWB indirectly through positive response.

    Keywords: Youth, Irritability, Coping style, Subjective well-being
  • Xiao SONG, Qiqi SHI, Chongxing ZHANG, Xiangli KONG, Yeyuan LV, Haifang WANG, Hongmei LIU, Lijuan LIU, Xiuxia GUO, Jingxuan KOU, Xiaodan HUANG, Huaiwei WANG, Peng CHENG, Maoqing GONG Pages 1857-1867
    Background

    We aimed to conduct a retrospective analysis of the epidemiological changes and prevention effects for malaria in Weifang, Shandong Peninsula, China from 1957 to 2017.

    Methods

    The malaria data from a web-based reporting system were analyzed to explore malaria epidemiological characteristics and prevention effects in Weifang.

    Results

    Overall, 1, 704, 890 malaria cases were reported in Weifang from 1957 to 2017, of which two major malaria epidemics occurred in 1961 (827.28/10, 000) and 1971 (366.14/10, 000). Prior to 1997, all malaria patients (1, 704, 829) were infected with Plasmodium vivax (P. vivax). After 2007, the cases of Plasmodium falciparum (P. falciparum) showed an upward trend (76.8%). The reported cases after the 21st century were mainly imported cases, and the last indigenous case was a patient that infected with P. vivax in 2006. Overall, 36 imported cases were reported from 2010 to 2017, of which 88.9% were acquired in Africa. Except for one 32-year-old woman, the rest were male (97.2%), in which laborers and farmers represented the vast majority (66.6%). From 1987 to 2017, there were 1, 224, 474 cases of fever with blood tests, and the average blood test rate was 4.9%. From 1957 to 2017, a total of 1, 704, 890 malaria patients were treated, 96 cases were treated during resting phase from 1987 to 2017.

    Conclusion

    Weifang should continue to strengthen the management of the migrant population, making blood tests for fever patients and patient treatment as important means of malaria control and monitoring

    Keywords: Malaria, Epidemiology, Prevention measures, Elimination, Weifang
  • Şükran GÜZEL*, Eda GÜRÇAY, Ebru KARACA UMAY, Serdar MERCİMEKÇİ, Aytül ÇAKCI Pages 1868-1877
    Background

    To evaluate the nutritional status of patients with neurological diseases during the rehabilitation process and to investigate the relationships between the nutritional status and disease severity and clinical evaluation outcomes.

    Methods

    In this prospective trial, 109 patients with a disease duration of <6 months, hospitalized for neurological rehabilitation in Physical Medicine and Rehabilitation Clinic, Ankara, Turkey were enrolled from 2014-17. All patients were assessed with the Mini Mental State Examination (MMSE) test, European Quality of Life Scale (Euro-QoL), Hospital Anxiety and Depression Scale (HADS), Pittsburg Rehabilitation Participation Scale (PRPS), and Functional Ambulation Category (FAC). Nutritional status was analyzed by biochemical and anthropometric parameters. The patients received a conventional rehabilitation program and a nutritional support according to clinical and laboratory findings for 4 weeks. The outcome data were evaluated at baseline and at the end of 4-week treatment.

    Results

    Linear regressions analysis revealed that the significant independent predictors that associated positively with baseline insulin (P=0.010) and negatively with baseline cortisol (P=0.020) levels were Brunnstrom upper and hand stages. Additionally, the significant independent predictor that associated positively with baseline insulin (P=0.041) was Brunnstrom lower stage.

    Conclusion

    Insulin and cortisol levels may be predictors in motor function recovery of stroke patients in rehabilitation process. Early detection and treatment of malnutrition both during hospitalization and follow-up might be important for the improvement of outcomes.

    Keywords: Stroke, Malnutrition, Function, Rehabilitation
  • Haemi JEE Pages 1878-1884
    Background

    Increased exercise repetitions and intensities need to be compared between dominant and non-dominant sides to prevent asymmetrically conducted movements for possible dyskinesia.

    Methods

    A total of 20 participants were enrolled from Inha University, Incheon, Korea in 2019. They were assessed for comparisons of asymmetrical motion between the dominant and non-dominant arms during the abduction and adduction lateral raises during more than fifteen repetitions and low and high exercise intensity by giving different weight loads based on 1-RM.

    Results

    Repetition led to significant reductions in range of motion for both dominant and non-dominant sides. In addition, increased repetitions led to significant greater reductions in range of motion especially toward the last phases of repetitions. Moreover, the dominant side showed significantly increased accelerations with increased intensities.

    Conclusion

    Increased repetitions and exercise intensity led to reduced range of motion and increased accelerations especially for the dominant sides. Dispersing kinematics should be considered to minimize possible dyskinesia between the symmetric sides when performing repetitive and loading physical activity.

    Keywords: Repetition, Exercise intensity, Asymmetry, Dyskinesia
  • Huawei LIN, Jing CHANG, Jun Li* Pages 1885-1893
    Background

    To investigate the effects of docetaxel combined with icotinib on tumor markers in serum and quality of life of patients with advanced non-small cell lung cancer (NSCLC).

    Methods

    Overall, 121 patients with advanced NSCLC, admitted to the Third Affiliated Hospital of Shandong First Medical University, China from 2017- 2018 were selected as subjects. Among them, 58 patients treated with docetaxel combined with icotinib for chemotherapy were considered as study group, and 63 patients treated with paclitaxel combined with carboplatin as control group. The clinical efficacy, adverse reactions, and ECOG scores of the two groups were observed. CEA, CA125, and SCC (Tumor markers) levels of the two groups before and after treatment were detected by chemiluminescence immunoassay (CLIA).

    Results

    The leukopenia, oral mucosa ulcer and mild numbness in the control group were significantly higher than those in the study group (P<0.05). After treatment, ECOG scores of both groups decreased (P<0.05), and the ECOG score of the study group was significantly higher than that of the control group (P<0.05). The serum CEA, CA125 and SCC levels of the study group and the control group after treatment decreased significantly compared with that before treatment (P<0.05).

    Conclusion

    Application of docetaxel combined with icotinib for chemotherapy of patients with advanced NSCLC can effectively reduce the serum levels of CEA, SCC, and the CA125. Docetaxel combined with icotinib can significantly reduce adverse reactions and better improve the quality of life of patients compared with paclitaxel combined with carboplatin, which is worthy of clinical promotion.

    Keywords: Docetaxel, Icotinib, Paclitaxel, Carboplatin, Cancer
  • Ji-Hoon CHO, Ki-Hyuk LEE, Seung-Taek LIm* Pages 1894-1901
    Background

    The purpose of this study was to find the basic data of medical and exercise therapy by indexing lumbar extension muscle strength of low back pain (LBP) patients.

    Methods

    In this cross-sectional study, 3078 chronic LBP participants from The J hospital, Seoul, Republic of Korea, from 2003 to 2010 were enrolled. Maximum muscle strength was measured at maximum flexion angle and maximum extension angle according to range of motion (ROM) results. For each isometric test, participants were seated and secured in the MEDX (medx lumbar extension machine, Ocala, FL, USA) machine.

    Results

    The relative ROM (P=0.012) differed significantly among the aged groups in all participants. In addition, mean of strength (P<0.001), maximal of strength (P<0.001), mean of strength %BW (P<0.001) and maximal of strength %BW (P<0.001) are significant differences in all participants. The results of multiple regression analysis was the ‘model A’, maximal of strength for 32.1% of the variance in weigh, body mass index and range of motion. In addition, ‘model B’ was 30.4%, ‘model C’ was 28.8%, ‘model D’ was 28.5%, ‘model E’ was 21.7%, and ‘model F’ was 23.5% of the variance in weigh, body mass index and range of motion.

    Conclusion

    We found the three predictor (weight, BMI, and ROM) variables accounted for 32.1% of the variance in maximal of strength %BW, the highest in < 29 yr groups. Our data indicate the basic data of medical and exercise therapy by indexing lumbar extension muscle strength of LBP patients.

  • Ummavathy PERIASAMY, Sherina MOHD SIDIK*, Mehrnoosh AKHTARI ZAVARE, Lekhraj RAMPAL, Siti Irma Fadhilah ISMAIL, Rozi MAHMUD Pages 1902-1911
    Background

    We aimed to assess whether “Managing Patients on Chemotherapy” book is effective to improve quality of life (QOL) of cancer patient via counselling by pharmacist.

    Methods

    A randomized control trial study was run among 2120 cancer patients in public hospitals in Peninsular Malaysia, from Apr 2016-Jan 2018. The treatment group received counselling regarding chemotherapy by using developed module. The data were collected at three time-points: baseline, 1st, 2nd and 3rd follow-ups after counseling by Validated Malay version of the WHOQOL-BREF of questionnaire. Data analyses were done using χ2 and two-way repeated measure ANOVA.

    Results

    The treatment group improved significantly as compared to control group in physical health, psychological health, social relationship, environment and overall QOL (P<0.00).

    Conclusion

    The “Managing Patients on Chemotherapy” book along with repetitive counselling by pharmacists is a useful intervention for improving QOL of cancer patients undergoing treatment.

    Keywords: Quality of life, Cancer patients, Pharmacist, Counselling, Malaysia
  • Xiaohong YU*, Dongjin FENG, Guangmeng WANG, Zhongmao DONG, Qi ZHOU, Yuan ZHANG Pages 1912-1920
    Background

    To analyze the correlation between Helicobacter pylori infection and digestive tract symptoms in children and other related factors, and to explore the risk factors of H. pylori infection in children and the expression of inflammatory factors in H. pylori-positive and H. pylori-negative children.

    Methods

    Overall, 234 children with H. pylori test in Xuzhou Children's Hospital, Xuzhou Medical University (Xuzhou, China) were enrolled. Among them, 73 children were H. pylori-positive and 161 were H. pylori-negative. The expression levels of cytokines interleukin-8 (IL-8), interleukin-18 (IL-18) and interferon-γ (IFN-γ) in H. pylori-positive and H. pylori-negative children were determined by ELISA. The correlation between H. pylori-positive and general data, digestive tract symptoms, other clinical symptoms, living habits, eating habits, family history and other related factors was statistically analyzed. Multivariate Logistic regression analysis was used to analyze the independent risk factors of H. pylori infection in children.

    Results

    Family monthly income, inattentive eating, sharing toothbrushes and cups, gnawing fingers, eating fried food, drinking raw water, eating smoked and pickled food, father suffering from gastropathy and mother suffering from gastropathy were independent risk factors for H. pylori infection in children. The most common digestive tract symptoms of children with H. pylori infection were abdominal pain, accompanied by one or more clinical symptoms. The expression levels of IL-8, IL-18 and IFN-γ in H. pylori-positive children were significantly higher than those in H. pylori-negative children.

    Conclusion

    Prevention of H. pylori infection in children is helpful for healthy growth of children, and cytokines IL-8, IL-18, IFN-γ have the potential to be used as biomarkers for diagnosis of H. pylori-positive children.

    Keywords: : Helicobacter pylori, Infection, Digestive tract symptoms, Risk factors, Cytokines
  • Noor Hamzani FARIZAN, Rosnah SUTAN*, Kulanthayan KC MANI Pages 1921-1930
    Background

    We aimed to assess the effectiveness of the health educational booklet intervention in improving parents/guardian’s knowledge on prevention of child drowning and, the perception of drowning risk and water safety practice. 

    Methods

    A quasi-experimental study was conducted in year 2017 in Selangor, Malaysia among 719 parents/ guardians of primary school children. The parent/guardians were randomly assigned as the intervention groups and were given a health educational Be-SAFE booklet on drowning prevention and water safety. The pretest was conducted before the intervention and posttest was done one month of intervention. The data collection tool was using a validated questionnaire on knowledge, attitude and practice for drowning prevention and water safety.

    Results

    There were 719 respondents (response rate of 89.9%) participated at baseline and 53.7% at end line (after the intervention). Significant differences found in knowledge, attitudes and practice on drowning prevention and water safety for the intervention and control groups after the intervention (P<0.001). There was a significant difference in mean scores for knowledge and attitude before and after the intervention, whereas no significant findings noted for practices (P<0.001).

    Conclusion

    Be SAFE booklet contributed to the increase in parents/guardian’s knowledge and attitudes towards drowning prevention and water safety to prevent the risk of child drowning.

    Keywords: Health education, Drowning, Prevention, Knowledge, Attitude, Practice
  • Jun WANG *, Jingxin CHEN, Gang JING, Daoquan DONG Pages 1931-1939
    Background

    To study the effects of long non-coding ribonucleic acid (lncRNA) HOX transcript antisense intergenic RNA (HOTAIR) on the proliferation and apoptosis of malignant melanoma cells, and to explore its specific regulatory mechanism through the nuclear factor-κB (NF-κB) signaling pathway.

    Methods

    LncRNA HOTAIR small-interfering RNAs (siRNAs) were designed and synthesized, and the effects of si-HOTAIR transfection on the proliferation and apoptosis of malignant melanoma cells were detected via cell counting kit-8 (CCK-8) assay, 4',6-diamidino-2-phenylindole (DAPI) staining assay and flow cytometry, respectively. The gene expressions were determined using quantitative reverse transcription-polymerase chain reaction (qRT-PCR), the changes in NF-κB pathway-related proteins and apoptosis-associated proteins after interference in lncRNA HOTAIR were detected via Western blotting, and the level of NF-κB in each group was determined via ELISA.

    Results

    The results of CCK-8 assay revealed that the cell proliferation rate significantly declined gradually in si-HOTAIR group compared with that in si-NC group and control group (P<0.05). The results of Western blotting and ELISA showed that the activity of NF-κB in si-HOTAIR group was weakened (P<0.05), suggesting that down-regulation of HOTAIR can suppress the activity of NF-κB. Compared with si-NC group and control group, si-HOTAIR group had remarkably increased gene and protein expressions of pro-apoptotic Bax, and remarkably decreased gene and protein expressions of anti-apoptotic Bcl-2 (P<0.05), demonstrating that down-regulation of HOTAIR can promote apoptosis.

    Conclusion

    Down-regulation of lncRNA HOTAIR can inhibit the proliferation and promote the apoptosis of malignant melanoma cells and suppress the NF-κB pathway.

    Keywords: LncRNA HOTAIR, Malignant melanoma cells, NF-κB pathway
  • Ahmad Ali NOORBALA, Armita SALJOUGHIAN, Seyed Abbas BAGHERI YAZDI, Elham FAGHIHZADEH, Mohammad Hadi FARAHZADI, Koorosh KAMALI, Soghrat FAGHIHZADEH, Ahmad HAJEBI, Shahin AKHONDZADEH, Mir Taher MOUSAVI Pages 1940-1946
    Background

    Drug addiction is known as one of the health, medical and social problems of the present century. Beyond the harmful physical and mental consequences for addicts, drug abuse can cause serious social problems. The aim of this study was to evaluate drug and alcohol abuse in individuals aged 15 yr and over in Iran in 2015.

    Methods

    This descriptive cross-sectional study was done on individuals aged 15 yr and older who lived in urban and rural areas of Iran. Overall, 36,600 individuals were selected by systematic and cluster random sampling. The postal code was used to access the samples in 31 provinces of Iran. In each province 1200 individuals (50% men, 50% women) were evaluated. The used instrument was the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and data were analyzed using SPSS software.

    Results

    The results showed 4.6% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.4% used Amphetamine stimulants, 6.1% used Sedative drugs, and 2.6% used Alcoholic beverages on a regular basis. Within the last 12 months, 3.9% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.3% used Amphetamine stimulants, 5.8% used Sedative drugs, and 1.9% used Alcoholic beverages. With the exception of Sedatives drugs men used more drugs than women and residents of rural areas used more opium and its derivatives than other groups of drugs. Based on the provincial distribution, Kerman and Qom used the highest and lowest prevalence percentage of Opium and its derivatives respectively.

    Conclusion

    Overall, 2340000 individuals were addicts used Opium and its derivatives in 2015, therefore, medical and health officials should take all necessary measures to deal with these serious social problems.

    Keywords: Drug, alcohol abuse, Smoking, Iran
  • Sedigheh KHEIRANDISH, Nosratollah ESHGHYAR, Farzad YAZDANI, Pouyan AMINI SHAKIB, Ali HOSSEINI-BERESHNEH, Zahra NOURI, Ali KHEIRANDISH, Fatemeh KARAMI Pages 1947-1953
    Background

    Oral squamous cell carcinoma (OSCC) is one of the most important types of oral malignancies. DKK gene family members as well as DKK2/4 have critical roles in regulation of Wnt signaling as one of the main determining pathway in oral carcinogenesis. This study aimed to identify promoter methylation status of DKK2/4 genes to provide possible biomarkers for early detection and treatment of OSCC patients.

    Methods

    A case control study was performed on 31 fresh tissues obtained from oral cavity of patients affected by OSCC and 31 fresh corresponding tissues from normal healthy controls in Tehran and, between the years of 2016-2018. Purified DNA from tissue samples was subjected to bisulfite treatment and then methylation specific polymerase chain reaction (MSP-PCR) was carried out on treated DNA samples.

    Results

    DKK4 promoter was methylated in none of OSCC samples while it was methylated in 16.1% of healthy controls. 16.1% of OSCC samples were detected to be semimethylated and 22.6% of healthy normal samples were methylated for DKK2 promoter gene. Meaningful difference was found in DKK4 promoter methylation among OSCC patients and healthy controls. Significant correlation was found between DKK4 promoter methylation and tumor grade. The age of all enrolled samples was demonstrated to have strong effect on promoter methylation of studied genes.

    Conclusion

    Hypomethylation of DKK2 and DKK4 genes in higher grades of OSCC samples may indicate the pivotal role of their expression in tumor cells invasion and progression through modulation of Wnt signaling pathway. Further study required to determine simultaneous expression of those genes and Wnt signaling elements at mRNA and protein levels.

    Keywords: Methylation, Oral squamous cell carcinoma, Methylation-specific polymerase chain reaction
  • Amin SABERINIA, Anna ABDOLSHAHI, Saeed KHALEGHI, Yaser MORADI, Hossein JAFARIZADEH, Ali SADEGHI MOGHADDAM, Mohsen AMINIZADEH, Mehdi RAEI, Alireza KHAMMAR, Mohsen POURSADEQIAN Pages 1954-1958
    Background

    One of the major causes of various work-related health problems among nurses is occupational stress. Hence, the main purpose of the present research was to find association between occupational stress of nurses and risk factors of cardiovascular disease.

    Methods

     In this cross-sectional study, the Osipow job stress questionnaire was employed to assess the occupational stress among the 250 nurses in Emam Khomeini hospital of Tehran in 2018. Based on stress score for participants, subjects divided into two groups: Scoring of group one was 60-179 (mild and average stress) and group two between 180 and 300 (average to acute and acute stress). Systolic and diastolic blood pressures were recorded for subjects after 10hrs fasting. Then the blood samples were collected to measure cholesterol, triglyceride and glucose levels. For determining the association between education level, job experience and study groups, the Chi-square test and for comparing job stress between two groups of study the Mann–Whitney U test was used.

    Results

    Subjects with job stress in group one was 70(28%) and group two was 180(72%). The association between level of education and two study groups was not significant (P=0.129) while between job experience and two study groups was significant (P=0.004). Mean of Blood glucose levels for group I (98.0± 37.5), was higher than group II (82.5±12.0) and statistically significant (P=0.001). No significant difference was found between two groups of study for other parameters.

    Conclusion

    High level of work-related stress among subjects affected the values related to blood glucose level, but no significant relationship was found between other risk factors of cardiovascular diseases and occupational stress among nurses.

    Keywords: Cardiovascular diseases, Occupational stress, Nurses
  • Mirhojjat NAJAFINASAB, Lotfali AGHELI, Hossein SADEGHI, Sajjad FARAJI DIZAJI Pages 1959-1969
    Background

    The present study aimed to identify and prioritize strategies for medical tourism improvement in the Social Security Organization (SSO) of Iran.

    Methods

    Using Delphi method in the first step, we identify strengths, weaknesses, opportunities and threats that Social Security Organization of Iran faces in medical tourism during 2017-2018. In the second step we interviewed 100 medical and tourism experts to identify proper strategies using SWOT method and finally prioritize strategies through the Analytic Hierarchy Process (AHP) by using Expert Choice software.

    Results

    The application of SWOT technique indicated that the dominant strategy for the Iranian SSO should be conservative. It should overcome its internal weaknesses and exploit its external opportunities. The Iranian Social Security Organization should arrange appropriate marketing in target countries, invest in international medical/hospital standards, boost the communicative competence of personnel in SSO hospitals and create multilingual web-based information to introduce the capabilities and costs of the hospitals.

    Conclusion

    Since the SSO’s weaknesses are more prominent than its strengths, thus SSO should plan to reduce its weaknesses to boost medical tourism. For this purpose, SSO should design coherent plans for attract medical tourists to the organization’s hospitals, attempt to upgrade hospital and medical centers standards, train the medical staff regarding linguistic and communicative skills, and run a user-friendly website to introduce its medical capabilities.

    Keywords: Medical tourism, Social security organization (SSO), Hybrid analysis, Strategies
  • Najmossadat MUSAVI BAFRUI, Seyed Jamal HASHEMI HAZAVEH*, Mansour BAYAT Pages 1970-1976
    Background

    Dermatophytosis is one of the most common fungal infections in humans. Antifungals such as fluconazole are effectively used for treating dermatophytosis; however, drug resistance was observed in many cases. Therefore, a newer treatment strategy is essential.

    Methods

    This study (Conducted in the Laboratory of the School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in 2018) evaluated the antifungal susceptibility of nano fluconazole compared to conventional fluconazole on dermatophyte isolates using CLSI M38-A2guidelines. Dermatophyte species isolated from clinical cases of dermatophytosis were identified using PCR sequencing techniques. Zeta potential and size of the nano particles containing fluconazole were measured; scanning electron microscope (SEM) was used to determine nano particle structure.

    Results

    The size of liposomal fluconazole obtained was 88.9  12.14 nm with –20.12  3.8 mV for zeta potential. The encapsulation rate for fluconazole was 75.1  4.2%. MIC50 for the three tested species was 32, 16, and 8 μg/ml for Trichophyton interdigitale, T. rubrum, and Epidermophyton floccosum isolates, respectively. The corresponding values for nano fluconazole were 8 μg/ml for the three tested species.

    Conclusion

    MIC value for nano-fluconazole was lower than conventional fluconazole in all dermatophytes species tested; therefore, nano-fluconazole could inhibit the growth of dermatophytes better than fluconazole at a lower concentration of the drug.

    Keywords: Dermatophyte, Minimum inhibitory concentration, Fluconazole, Nano-particle
  • Mojtaba MOHAMMADHOSEINI, Seyedeh Mahdieh NAMAYANDEH, Hosein FALLAHZADEH, Fatemeh MAJIDPOUR, Seyed Mahmoud SADR-BAFGHI, Mohammadhosein SOLTANI, Leila HADIANI, Mohammadtaghi SAREBANHASSANABADI, Hossein NOUGH, Ahmad KARIMI, Maryam ASKARI Pages 1977-1982
    Background

    The population attributable risk (PAR) percent has used widely in public health policy. We aimed to calculate the attribute risk of hypertension due to hyperuricemia by Levin's formulas compare to direct PAR calculation method.

    Methods

    This was a sub-study of Yazd Healthy Heart Cohort (YHHC). Overall, 1256 normotensive individuals were enrolled through multistage randomized cluster sampling and followed up for mean 9.8 years, from 2005-2015. The threshold cutoff point of the hyperuricemia was considered equal and more than 75th percentile that equal to 5.5 mg/dl for men and 4.3mg/dl for women. To calculate the attributable risk of hyperuricemia in developing hypertension, two methods were applied. Levin's formulas and direct PAR estimation by population risk calculation via exposure prevalence weighted formula. Multiple logistic regression was used for estimate of odds ratio (OR) of hyperuricemia in developing hypertension. We calculated Relative Risk (RR) from OR. The data were analyzed using SPSS software version 16. A significant level of 0.05 was considered.

    Results

    Hypertension developed in 44.7% of individuals with uric acid level ≥ 75th percentile vs. 35.6% of other individuals (P=0.024). Attributable risk (AR) of hyperuricemia in hypertension incidence was 9.1%. PAR of hyperuricemia for hypertension incidence by using two methods mentioned before was 6%, 5.8% respectively.

    Conclusion

    The results of the study confirmed the noticeable contribution of hyperuricemia as an independent other risk factor for the occurrence of hypertension. PAR of hyperuricemia for hypertension incidence by using two methods almost near was 6%, 5.8% respectively.

  • Ahmad HOSSEINI-SAFA, Saeedeh SHOJAEE, Seyed Alireza SALAMI, Mehdi MOHEBALI, Sedigheh HANTOUSHZADEH, Parisa MOUSAVI, Seyed Ali DEHGHAN MANSHADI, Hosein KESHAVARZ VALIAN Pages 1983-1991
    Background

    Toxoplasma gondii is an obligate intracellular protozoan with worldwide distribution. Diagnosis of toxoplasmosis is a very critical issue, especially in pregnant women and immunocompromised patients. The aim of this study was rapid detection of T. gondii DNA in peripheral blood samples (PBS) employing HRM technique and using RE gene.

    Methods

    Totally, 242 samples from pregnant women and human immunodeficiency virus (HIV) patients were collected from different hospitals and medical centers of Tehran during Oct 2017 to Dec 2018. High resolution melting analysis (HRM) using partial sequences of repetitive element (RE) gene was done and compared with ELISA test.

    Results

    Overall, 51 were positive for acute toxoplasmosis that among them, 12 and 20 reported as positive in pregnant women and HIV+ patients, respectively using HRM technique. Among 70 patients in chronic phase of disease, 10 and 3 samples were reported as positive for pregnant women and HIV+ patients respectively. From 121 negative control, 3 (4.62%) samples associated with HIV+ patients, showed positive real-time PCR and HRM analysis results.

    Conclusion

    For the first time, HRM technique via employing RE gene was used for detection of T. gondii infection in PBS. This method is suitable, helpful and in parallel with serological methods for early diagnosis of acute as well as active form of toxoplasmosis in pregnant women and HIV+ patients. The use of techniques based on melt curve and through employing next-generation dyes for diagnosis of T. gondii would be accessible for patients in developing countries.

    Keywords: High-resolution melting (HRM), Toxoplasmosis, Pregnant women, HIV+ patients
  • Bojan MASANOVIC*, Stevo POPOVIC, Dusko BJELICA, Jovan GARDASEVIC Pages 1992-2000
    Background

    We aimed to focus on a review of the literature on physical activity and physical fitness for children and adolescents in Montenegro, to identify and evaluate the current situation and provide a better basis for the creation of a future monitoring system.

    Methods

    The Montenegrin Research Team (MRT) has set up a specific methodology that is reflected in the assessment of physical activity and physical fitness of Montenegrin children and adolescents through ten separate indicators. Grades were awarded based on data found in available scientific articles that were published up to 2018, as well as in the grey literature, such as government and nongovernment reports and online content from the same period.

    Results

    All indicators averaged 3.7 on a six-point scale. It is interesting to note that two indicators were rated as excellent, three more indicators were rated with above-average, four indicators were rated as below-average and, lastly, one indicator was rated as “unfinished”.

    Conclusion

    Children’s and adolescents’ physical activity and physical fitness for Montenegro might be good, especially if compared to other countries from the region.

    Keywords: Children, Adolescents, Physical activity, Physical fitness, Monitoring, Montenegro
  • Jung Hun LEE, Jeong Ho JEON, Sang Hee LEE* Pages 2003-2005
  • Marjan MOHAMMADZADEH, Hamidin AWANG, Cheah Yt JUN, Nor Fauziah HASHIM, Archana PREMKUMAR Pages 2006-2008
  • Maryam KHEIROLLAHPOUR, Mahmoud DANAEE, Amir Feisal MERICAN, Asma Ahmad SHARIFf* Pages 2011-2013
  • Sain SAFAROVA* Pages 2014-2015
  • Ali AMINIAN, Seyde Sedighe YOUSEFI* Pages 2016-2017
  • Maryam ASKARI*, Seyedeh Mahdieh NAMAYANDEH Pages 2018-2019
  • Amirhossein MEMARI, Ardalan SHARIAT*, Joshua CLELAND Pages 2020-2021