International Journal of Preventive Medicine
Volume:13 Issue: 4, Apr 2022

The use of Complementary and Alternative Medicine (CAM) is on the increase globally and found to be more pronounced among those with chronic illnesses even in the face of insufficient scientific evidence to support its efficacy. Hence, this study was conducted to assess the level of use of CAM and its predictors among patients on long term care in tertiary health institution.

This was a cross‑sectional study conducted among 176 patients accessing treatment for chronic medical conditions in Jos University Teaching Hospital using quantitative method of data collection. Epi Info statistical software version 7 was used for data analysis and a value of P < 0.05 was considered statistically significant.

The median age of respondents was 50 (IQR 30–84) years with 83 (47.2%) being 51 years and above. Utilization of CAM was reported among 72 (40.9%) with herbal preparation ranking highest among 56 (77.8%) the respondents. Absence of side effects (AOR = 2.23; 95% CI = 1.6918–3.2135) and consistency with culture (AOR = 4.46; 95% CI = 1.4695–6.1851) were identified predictors of CAM use.

This study has demonstrated a relatively high level of CAM use with perceived absence of side effects, peer influence, and consistency with culture predicting its use.

Travelers are at higher risk of developing health‑related problems, especially travel‑related diseases, and this remains a major public health burden.

To assess pretravel health behavior‑seeking factors, knowledge of vaccine, and travel health attitudes. A cross‑sectional design among Malaysian travelers.

An online survey was conducted from December 2017 till March 2018 among 226 participants. Demographic data, pretraveling health behaviors, knowledge of vaccine‑preventable diseases, and travel health were asked. Independent t‑test and ANOVA were performed using SPSS version 20.

Among travelers, 51.3% and 63.7% used health‑related information on their destination before departure and collected information on possible travel hazards at their destination. Participant age (P = 0.02), monthly income (P = 0.01), predeparture health information (P = 0.03), information on possible hazards (P = 0.04), and travel health advice from medical professionals (P = 0.03) have been reported as a major predictor of knowledge of vaccine‑preventable disease. Travelers’ gender (P = 0.01), household income (P = 0.01), and travel health advice from professionals (P = 0.002) were significantly associated with travel health attitude.

Sociodemographic and pretravel health‑seeking behavior influence knowledge of vaccine‑preventable disease and attitudes towards travel health which requires a public health need for community outreach programs targeting this group.

Evidence suggests that there is some relationship between circadian clock gene variants and obesity. However, there are few examinations supporting this observation in human subjects. This study was aimed to investigate the interaction between Cry1 circadian gene polymorphism and major dietary patterns on obesity measurements.

Healthy overweight and obese women aged 18–53 years old were recruited from health centers in Tehran, Iran by a multistage cluster random sampling method (n = 377). Major dietary patterns were elicited after assessing the intake of 16 food groups using a valid and reliable 147‑item food frequency questionnaire (FFQ). Anthropometric measurements were performed for each and every participant. Body composition was analyzed using bioelectrical impedance analysis (BIA). Socio‑demographic and physical activity data were also collected by a validated Farsi demographic questionnaire and the international physical activity questionnaire (IPAQ). The Cry1 rs2287161 polymorphism were genotyped using polymerase chain reaction‑restriction fragment length polymorphism (PCR‑RFLP). Generalized linear models were used for interaction analysis.

Two major dietary patterns, including healthy and unhealthy dietary pattern (HDP and UDP, respectively) were determined using factor analysis. Our study showed a significant higher weight (P = 0.003), body mass index (BMI) (P = 0.042), hip circumference (P = 0.052), and body fat mass (P = 0.028) in carriers of C allele compared with G allele. Moreover, a significant gene‑diet interaction was observed between being a carrier of C allele and BMI (P = 0.099 for CC genotype; P = 0.1 for CG genotype) and fat mass (P = 0.1 for CG genotype).

The current study suggests a significant interaction of Cry1 rs2287161 gene polymorphisms in people following a healthy dietary pattern on BMI and fat mass among carriers of C allele compared to carriers of G allele.

Measles is an infectious childhood disease with some death annually. The expansion of the coverage of vaccination plan has significantly reduced the mortality rate of this disease. Given that the endemic measles virus is not transmitted in the country and based on Regional Verification Commission (RVC) for Measles and Rubella Elimination has declared that measles and rubella have been eliminated in three countries of Eastern Mediterranean Region including Islamic Republic of Iran, Bahrain, and Oman. Therefore, to continue and preventing from reemerging of measles in Iran, it is essential to maintaining the immunization programs, diagnose, and investigate all suspicious cases and outbreaks. This article investigates the challenges facing to measles after elimination declaration in Iran. However, the elimination of these diseases to be sustainable needs a vigorous case identification protocol and contact follow up.

Adverse effects related to treatment negatively affect the quality of life of patients with thyroid cancer. The current study aimed to evaluate the psychometric properties of the Persian version of the thyroid‑cancer‑specific health‑related quality of life (TC‑specific HRQoL) questionnaire among patients with thyroid cancer in Kerman province, Iran.

This research was a cross‑sectional study conducted on 240 patients with thyroid cancer in Kerman province from 2000 to 2015. The patients were selected through the census method and were asked to complete the thyroid‑cancer‑specific quality of life questionnaire. Data were analyzed by SPSS version 19.0 and LISREL version 8.80. The reliability of the Persian version was determined by Cronbach’s a coefficient and the intraclass correlation coefficient (ICC). Exploratory and confirmatory factor analysis (CFA) was also conducted.

The Cronbach’s a and ICCs were determined as 0.92 and 0.88, respectively. Five factors were extracted in the exploratory factor analysis with a total of 55.76% explained variance. Acceptable goodness of fit indices were found in CFA.

The Persian version of the TC‑specific HRQoL has sufficient psychometric properties and can be used to assess HRQoL among patients with thyroid cancer.

Mobile health intervention shows the positive effects on the management of chronic diseases. Therefore, the study was planned to study the effectiveness of a mobile‑based application promotion of physical activity among newly diagnosed patients with type II diabetes.

The present study was a parallel‑design randomized controlled trial conducted over 2 years. The participants were type II diabetes patients between 18 and 60 years within 3 months of diagnosis who attended the endocrinology outpatient department having knowledge of using smart phone. The sample size was calculated to be 66 and 33 for each arm. The block random design method was adopted for allocation into different arms. A pretested interview schedule was used for the collection of data. Outcomes included body mass index, waist circumference, body fat percentage, and changes in the physical activity was obtained by global physical activity questionnaire (GPAQ). The information thus collected were processed and analyzed using SPSS v 20.

The study included 66 patients aged between 18 and 60 years, out of which 33 were enrolled into control and 33 into intervention group. The mean age of the participants was 42.29 ± 9.5 years ranged from 25 years to 59 years, 65.2% were males and 34.8% were females. It was observed that a higher proportion of intervention participants met WHO recommendations of physical activity level. Total metabolic equivalent of task (MET) value per minute (Mean ± SD) was 1347.27 ± 1028.5 in the control group and 1223.03 ± 584.87 in intervention group at baseline and was not different (P = 0.538). The total MET value per minute was found to be higher among the intervention group in all follow‑ups. There was a significant decrease in weight, BMI, waist circumference, hip circumference, body fat percentage, and systolic blood pressure (SBP) in the intervention group.

Cost‑effective, simple mobile applications may help in routine clinical practice to encourage the patients for the promotion of physical activity.

Recently, the importance of chemokines and their receptors in carcinogenesis and the protective role of aerobic exercise in primary cancer development and progression is highlighted. Based on the facts that endurance exercise may result in hypoxia condition, and in addition, the effect of exercise therapy on the levels of CCL2, CCR2, and their related receptors in breast cancer (BC) model has not been investigated so far, therefore we aimed to evaluate the effect of eight‑week noncontinuous aerobic training on the levels of CCL2, CCL5, and their related receptors; CCR2 and CCR5 in female BALB/C mice with BC.

Thirty‑two BALB/C mice (4–5 weeks old) were randomly divided to four 8‑member groups of control and experimental. The experimental group received 8 weeks of noncontinuous aerobic exercises (AEs) while the control group did not receive any exercises during these 8 weeks. After last of experiment, 5 ml of blood was taken from each rat’s lower inferior vein. The plasma levels of CCL2 and CCL5 were measured by ELISA and CCR2 and CCR5 by western blot. Tumor volume also measured in each step. Data were analyzed using the ANOVA test and the SPSS v. 0.24 Software.

After 8 weeks of participation in noncontinuous AEs, a statistically significant decrease was made between the control and experimental groups in terms of CCL2, CCL5, and CCR2 levels, as well as tumor volume. However, there was no significant difference between groups in terms of CCR5 level.

It can be concluded that the 8 weeks of noncontinuous AEs did not result in CCR5 reduction while resulting in a statistically significant decrease in CCL2, CCL5, CCR2, and tumor volume.

Despite the reduction of mortality secondary to cardiovascular diseases observed in the last decades, ischemic heart disease remains the most common cause of death worldwide. Among the spectrum of ischemic heart disease, myocardial infarction accounts for most deaths. Since the introduction of the coronary care units in the 1960s, and until the latest antithrombotic drugs, myocardial infarction survival improved by 40–50%. However long-term mortality after myocardial infarction has not improved as short-term mortality. Moreover, the decline of mortality has apparently reached a “plateau” in the past 15 years. In this review we describe the steps of the improvement in ischemic heart disease mortality, from the bed rest to the possible future of treating microcirculation. In fact, coronary artery disease is not only a disease of large vessels that can be visualized with coronary angiography. The small network of pre-arterioles and arterioles that supply the myocardium can be also affected in ischemic heart disease. Thus, despite the introduction of effective recanalization strategies for epicardial coronary arteries such as thrombolysis and, more recently, primary percutaneous intervention, some patients may not achieve effective myocardial reperfusion due to microvascular dysfunction or damage after myocardial myocardial infarction. This phenomenon is named no reflow. We believe that no reflow, through the incomplete reperfusion that can account for a higher rate of adverse event in the follow up, should be regarded as one of the open issues in the modern treatment of myocardial infarction.

Little observational studies have been conducted on the association between diet and sleep. We conducted a cross-sectional study to evaluate the associations of dietary patterns with sleep duration in an Iranian population.

This study was conducted on the baseline data of two population-based Iranian cohorts: the YaHS-TAMYS and Shahedieh studies. Dietary intakes were assessed in 10451 Yazdi people aged 20–75 years. Dietary habits were derived from answers to a food frequency questionnaire, and a factor analysis using principal component analysis (PCA) was used to identify dietary patterns. The reported sleep duration was categorized as short (<6 h), normal (6–8 h) or long (>8 h). Multivariable logistic regression was used to determine the relationship between dietary patterns and the odds of short and long sleep duration.

Four major dietary patterns were identified: “healthy,” “western,” “traditional,” and “high-carbohydrate, high-fat.” In the Shahedieh study, participants in the top quartile of the western dietary pattern had greater odds of short (<6 h) and long (>8 h) sleep duration (OR = 1.49; 95% CI: 1.17, 1.90; P trend <0.001 and OR = 1.46; 95% CI: 1.12, 1.90; P trend = 0.014, respectively) than those in the bottom quartile. Also, participants in the highest quartile of the high-carbohydrate, high-fat pattern had higher odds of long sleep duration compared with those in the lowest quartile (OR = 1.36; 95% CI: 1.05, 1.75; P trend = 0.005). Pooling the two studies revealed that the western dietary pattern was significantly associated with short sleep duration (OR = 1.31; 95% CI: 1.08, 1.59).

The western dietary pattern might inversely be associated with sleep duration. Future prospective studies are recommended to confirm these results.

Seizure and syncope have similar clinical symptoms but different etiologies. Hence, differential diagnosis is crucial prior to intervention. This study evaluates the diagnostic importance of neuron specific enolase (NSE), creatine phosphokinase (CPK), and serum lactate dehydrogenase (LDH) for admitting patients with seizure medical history to emergency department (ED) in order for differential diagnosis between syncope and seizure.

Patients with a short‑lasting loss of consciousness admitted to the ED were recruited. All patients with a short‑lasting loss of consciousness were eligible and EEG was conducted several times and was taken over a long period. Patients were then divided into two groups of seizure and syncope. The biochemical markers levels of all the eligible patients were measured by a reputable laboratory.

In order to define specificity and sensitivity of different levels of biomarkers and the optimal cut‑off points, ROC curves for each biomarker of syncope and seizure patients admitted to ED were performed. AUC for NSE, CPK, and LDH were 0.973 ± 0.023, 0.827 ± 0.047, and 0.836 ± 0.043 respectively in 95% confidence level. Cut‑off points for NSE, CPK, and LDH were determined 25.12, 218.09, and 193.88 respectively.

It was concluded that NSE, CPK and LDH levels were different significantly in seizure patients compared to syncope ones. The seizure group showed an increase in NSE, CPK and LDH level. Determining biomarkers level for differential diagnosis of seizure and syncope can be applied as a supplementary test in addition to tests like EEG.

Cigarettes Smoking is a major social and global health problem. Cigarette smoking continues to be a major contributor to deteriorated health status across different age categories. Clarifying the impact of the cigarette smoking on young adults’ lungs health and functional aspects can serve eliminating further deterioration in health status and establishing proper management regimens. This study aimed to investigate the impact of cigarette smoking on lung health (age and functions) and functional performance in the university smoker students.

One hundred and Thirty eligible volunteer, current smoker students participated in this study to objectively evaluate their pulmonary functions (including forced vital capacity “FVC”, forced expiratory volume in one second “FEV1”, FEV1/FVC, peak expiratory flow rate “PEFr”), lung age and functional performance (via the 6‑minutes’ walk test “6MWT”) and compare “the observed” with “the predicted normal” mean values. Data were analyzed via SPSS program using the student t‑test.

There were significant differences (P < 0.05) between the “observed” and the “predicted normal” FVC, FEV1 , FEV1/FVC, PEFr, lung age, and the 6MWT mean values. The “observed” and the “predicted normal” FVC, FEV1 , FEV1/FVC, PEFr, lung age and the 6MWT mean values were [(4.47 ± 0.53, 4.77 ± 0.5 liter), (3.95 ± 0.42, 4.08 ± 0.4 liter), (88.74 ± 7.17, 85.59 ± 4.91%), (550.75 ± 114.96, 572.72 ± 53.02 liter/minute), (32.77 ± 9.44, 21.55 ± 1.37 year), (387.06 ± 56.47, 466.82 ± 18.45 meter)], respectively.

Cigarette smoking negatively impacts the lung age, functions, and functional performance of the university smoker students; the concept that can be used to encourage prevention and early smoking cessation.

Inflammatory markers of blood are critical predictors of chronic diseases as well as exacerbating risk factors. Exercise is a well‑known strategy to reduce the risk of inflammation and chronic disease. The present study aimed to investigate the anti‑inflammatory effects of a period of aerobic training and vitamin D supplementation (AT + Vit D) in postmenopausal women with metabolic syndrome.

This quasi‑experimental research was performed on forty‑six patients with metabolic syndrome who were selected according to the available sampling method, and were randomly divided into four groups: AT + Vit D (50,000 IU), AT, Vit D (50,000 IU), and control (C). The training protocol consisted of 40–60 min of AT 60–75% of maximal heart rate, three times a week, for 8 weeks. One‑way Analysis of variance (ANOVA) and t‑test were used to compare the between and within groups; the Bonferroni post hoc test was used if significant differences were found.

The combination of exercise and vitamin D significantly reduced C‑reactive protein (CRP) (P = 0.001), interleukin‑6 (IL‑6) (P = 0.001), and improved the metabolic syndrome indices (P = 0.001 in all indices). The results also show that the improvement in the metabolic syndrome indices, CRP, and IL‑6 was more significant in AT + Vit D, compared to AT or Vit D alone.

The findings from the present study suggested that a sedentary lifestyle and vitamin D deficiency accelerated the occurrence of metabolic syndrome probably by increasing the anti‑inflammatory. Additionally, adequate levels of plasma vitamin D are necessary to achieve the beneficial metabolic effects of AT.

Turner syndrome is a common genetic disorder in females. It is a disorder characterized by variable number of clinical features, so it needs a multidisciplinary approach for care. Therefore, we aimed to define the cutoff of gonadotropins for close evaluation of cardiometabolic risk factors in Turner syndrome.

This is a case‑control study on 31 patients with Turner syndrome and 31 healthy individuals. Clinical examination including blood pressure measurement and systems evaluation was performed. Laboratory testing, which included 12‑h fasting, assessed lipid profile, glucose, and serum gonadotropin.

Turner syndrome had a higher BMI, systolic, and diastolic blood pressure than the normal group (P < 0.001) Patients with Turner syndrome had significantly higher total cholesterol, low‑density lipoprotein, triglyceride, and TG‑to‑high‑density lipoprotein ratio compared to the healthy individuals (P < 0.05). With increasing LH and FSH, BMI values, systolic blood pressure, and total cholesterol increased significantly (P < 0.001). Serum TG levels in Turner syndrome were only positively correlated with LH and not correlated with FSH. The cutoff point of LH and FSH for triglyceride in upper 75 percentile were 31 (sensitivity = 38.1%, specificity = 80%) and 48 (sensitivity = 61.9%, specificity = 70%), respectively.

Based on dyslipidemia and lower level of ejection fraction, considering cardiometabolic risk factors in lower age groups in Turner syndrome can be recommended.

End‑stage renal disease is one of the most important chronic diseases. Selenium is one of the so‑called rare elements which are essential for our body functions. Here, we aimed to investigate and the effects of selenium supplement therapy on weight gain, physical activity, and triglyceride (TG) and total cholesterol in patients under hemodialysis.

The current study is a double‑blinded clinical trial performed on patients with ESRD under hemodialysis in 2019. In the beginning, serum selenium levels were assessed. All patients were randomly divided into two groups. The first group was under treatments with tablets of selenium 400 μg. Patients received selenium tablets three times after each hemodialysis session (3 times a week) and the other group received placebo tablets. 3 months after the beginning of the study, blood selenium levels, TG and total cholesterol, and weight and physical activities of patients were evaluated again and compared with the beginning.

A total of 78 patients were included. Serum selenium levels at the beginning of our study were 40.06 ± 8.50 in the intervention group and 45.00 ± 8.16 in control groups. Selenium levels and physical activities of patients were increased significantly in intervention group compared to baseline ( P < 0.001 for both). Weight, physical activity, total cholesterol, and TG in both intervention and control groups did not change significantly after interventions (P > 0.05).

We showed that selenium supplement therapies have beneficial effects in patients under hemodialysis. Furthermore, we showed that selenium supplement therapies have positive effects on serum selenium levels but no effects on total cholesterol and TG.

As a psychostimulant agent, methylphenidate (MPH) abuse can cause serious liver damage. Studies have documented the hepatoprotective impacts of curcumin on liver damage. According to this definition, the purpose of this study is to explain the hapatoprotective effects of curcumin against the hepatotoxicity induced by MPH.

Seventy rats were equally divided into seven groups (10 rats per group). Groups 1 and 2 received normal saline (0.7 mL/rat) and MPH (10 mg/kg), respectively for 21 days. Groups 3, 4, 5, and 6 concurrently received MPH (10 mg/ kg) and curcumin (10, 20, 40, and 60 mg/kg, respectively) for 21 days. Group 7 was treated with curcumin (60 mg/kg) alone for 21 days. The hepatic function test key enzymes such as AST, ALP, and histology of liver tissue (ALT), and alkaline phosphatase (ALP) levels was studied in the blood samples, and also, the histopathological changes and cell density changes were evaluated in the liver tissue.

The latest studies have shown that the administration of MPH induces rises in the AST, ALT, and ALP levels and induces degeneration changes in histopathology, whereas curcumin administration at doses of 40 and 60 mg/kg reduced the elevation of MPH‑induced hepatic enzyme and inhibited histopathological degeneration in the MPH‑treated classes. Curcumin alone (60 mg/kg) did not alter the biochemical and histological parameters.

Curcumin can function as a hepatoprotective agent against MPH‑induced hepatotoxicity.

Nutrition‑related factors have been of great interest as one of risk factors of biliary stones. This study evaluated the association of dietary patterns with biliary stone among Iranians.

This is a hospital‑based case‑control study, which was conducted in a general hospital in Tehran, Iran. A total of 110 patients with gallstone or common bile duct (CBD) stone confirmed by Ultrasonography within the last 6 months before collecting data were recruited. Controls were age‑matched patients admitted to the other wards of the same hospital for a broad spectrum of disorders including traumas and orthopedic conditions, or elective surgeries, or throat/ear/nose disease and had no gallbladder disorders, participated in this study. We used a valid and reliable food frequency questionnaire to assess dietary intakes of participants. Dietary patterns were determined by factor analysis.

By design, age was similar in both groups (57.66 ± 16.39 years vs . 56.00 ± 10.64 years in cases and controls, respectively). Two dietary patterns were extracted; “Unhealthy” (high consumption of artificial juice, processed meats, refined grains, sweets and desserts, pickles, snacks, and red meats), and “Healthy” (high consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt). Participants in the highest tertile of “Healthy” dietary pattern were significantly less likely to have the gallstones disease (OR: 0.33, 95% CI = 0.120.89) compared to the reference group (low tertile of “Healthy” dietary pattern) (P = 0.02).

High consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt in context of healthy dietary pattern are inversely associated with risk of gallstones.

Indoor air pollution is an important environmental health problem. Nanotechnology is one of the most important methods to reduce the indoor air pollution. Titanium dioxide (TiO2) is generally accepted as one of the most effective photoinduced catalysts. It is frequently used to oxidize organic and inorganic compounds in the air due to its strong oxidative ability and long‑term photostability. The aim of this study was to determine the effectiveness of nanotechnology in the purification of ambient air by using Saudi myrtle plants treated with TiO2.

Experiments were conducted in two academic departments of the laboratories at the Public Sector University. Concentration of formaldehyde, nitrogen dioxide (NO2), sulphur dioxide (SO2) and other toxic gases was measured in the environment of the laboratories. Myrtus plant was growing in the growth media which contained TiO2. After 8 hours of exposure of the plant, concentration of NO 2, SO2 and other toxic pollutant gases in the air was measured. The total duration of the experiment was 4 days.

It was found that the levels of formaldehyde, volatile organic compounds (VOCs) and other pollutants were significantly reduced the concentration from 10% to 98% in the air. After intervention, air containing the concentration of formaldehyde, TVOCs, NO2 SO2 and carbon monoxide (CO) on the fourth day reduced from 0.251, 401, 0.032, 0.009 and 0.99 to 0.014, 54,0.0003, 0.003 and 0.01 after exposure of Myrtus plant to ambient air.

Significant reduction of air pollutants in the air after application of TiO2 in the green plant (Myrtus communis). It is a novel approach and economically feasible for purification of indoor air.

Obesity and diabetes are common public health issues in Saudi Arabia. The aim of this study is to evaluate the association of maternal obesity and diabetes with exclusive breastfeeding among Saudi Mothers at the Royal Commission Service Primary Health Care Centers in Jubail City, Saudi Arabia.

It is a cross‑sectional study and 360 mothers were selected from primary health center through a simple random sampling. A validated and structured questionnaire was used. Body mass index was used for calculation of obesity and fasting blood sugar to find out the diabetic status. Chi‑square test was used to assessing the difference between obese and nonobese and diabetic and nondiabetic group with respect to exclusive breastfeeding. Logistic regression was used to determine the association of obesity and diabetes with exclusive breastfeeding.

Obesity and diabetic prevalence among study participants were 81.9% and 65.5%, respectively. Exclusive breastfeeding prevalence among total study participants was 36.9%. Among obese, it was 28.8% and diabetes, it was 29.1% and this difference is statistically significant when compared to nonobese and nondiabetic group (P‑value 0.04). The obese [OR1.30 (1.12–4.85) with P value 0.02] and diabetic [OR 1.56 (1.35–3.9) with P value 0.00] mothers were more than one time more likely associated with nonexclusive breastfeeding.

The study concludes that the rate of exclusive breastfeeding decreased among obese and diabetic mothers and the positive association of obese and diabetes with nonexclusive breastfeeding. Intervention is required to reduce the prevalence of obesity and diabetic among breastfeeding mothers

The existing system of outpatient drug provision of citizens allows providing certain categories of citizens and patients with certain types of diseases on a free basis. The purpose of the study is to analysis and evaluate the system of providing preferential categories of citizens with antihypertensive drugs at the level of primary health care.

To determine the level of satisfaction of citizens with drug provision at the outpatient level, 3118 respondents were interviewed using a questionnaire for persons who received free medicines for the treatment of hypertension. The questionnaire consisted of 20 questions. They were distributed by sex and age criterion. The ratio of male and female respondents was 51.7% and 48.7%, respectively.

Thus, the results of a sociological study to study the opinions of the population about the existing system of free outpatient care revealed some organizational and managerial problems. Although that patients with hypertension since 2012 receive drugs for free, 37% noted that they bought at full cost in pharmacies, which should be released free of charge for privileged categories of citizens. Also, 77% of respondents claimed that they were not invited to outpatient organizations to receive drugs.

In solving the problems of improving the organization and management, it is necessary to take into account regional peculiarities, which allow, based on the use of a set of methods of analysis and forecasting, to assess the state and trends of development, to identify its strengths and weaknesses, to assess the factors of the external and internal environment

One of the most important occupational and environmental pollutants are biological agents such as various types of viruses. Recently the 2019‑nCoV causes lower respiratory tract disease, called novel coronavirus pneumonia that in addition to causes physical disorders, can lead to mental health problems. This study looks at some of the articles that deal with psychological problems caused by the coronavirus pandemic in different groups of people. For this purpose, a review of the published literature was performed in some databases (PubMed, Google Scholar, Elsevier) and related references were used.

We describe a visual algorithm to help prevent severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) contagion as well as manage COVID‑19 disease according to categories of clinical severity. The algorithm is timely, with multiple countries worldwide declaring repeat surges in SARS‑CoV‑2 infections following the easing of lockdown measures. Its flowchart assimilates key effective interventions in a visual manner that will assist healthcare workers to manage COVID‑19 disease algorithmically, and policymakers to suppress further SARS‑CoV‑2 waves. Importantly, we include the innovative use of topical p‑menthane‑3,8‑diol spray by the British Army for COVID‑19 Support Force personnel, which in light of its coronavirucidal properties, deserves wider dissemination. This algorithm has the potential to be updated as numerous studies are concluded globally.

There was the association between the metabolic syndrome (MS) and obstructive sleep apnea (OSA). Also, the genetic factors have been implicated in the OSA. Our aim was to compare the frequency of MS in first‑degree relatives (FDRs) of OSA patients with healthy controls.

39 FDR (parents, siblings, and children) of patients diagnosed with OSA at Bamdad Respiratory and Research Center as cases and age‑ and sex‑matched healthy controls were included in the current case–control pilot study. The sampling method was convenience sampling based on having inclusion criteria and consent to participate in the study. Demographic characteristics and essential criteria for diagnosing MS included blood pressure, anthropometric [weight (kg), height (cm), waist circumference (cm) and body mass index (BMI) (kg/m2)], and biochemical indices (lipid profile and blood glucose) were assessed based on standard protocols.

In the comparison of the demographic and clinical characteristics of two39 cases and control groups, weight and diastolic blood pressure were significantly higher in case group than controls (P < 0.05). Case and control groups were not significantly different in the frequency of MS (P > 0.05). Although, the frequency of hypertension as an important cardiovascular risk factor was higher in cases than controls (P < 0.05).

The present study demonstrates that the frequency of MS is not significantly different between FDRs of OSA patients and controls. However, further large‑scale studies are warranted to detect the frequency of MS in people with hereditary background for OSA compared to general population

The bacteriological quality of drinking water has become a public health concern according to its association with water‑borne diseases. Nowadays, there are several different types of drinking water, including water cooler dispensers (WCDs), which are becoming a popular device in educational institutions. Therefore, this study aims to determine the bacteriological quality of drinking water from WCDs, and inspect their hygienic conditions in students’ dormitories at a university in Nakhon Si Thammarat, Thailand.

Water samples from 53 WCDs installed in 13 dormitories were collected and analyzed coliform bacteria by using the multiple‑tube fermentation technique. The hygienic inspection form from the Department of Health, Ministry of Public Health, was used for inspection of the sanitary conditions. The hygienic factors of water cooler sanitation were analyzed using the generalized linear model.

Coliform bacteria were found in 10 out of 53 samples; moreover, Escherichia coli was recovered in three samples. Maintenance/cleaning and monitoring were the most two sanitary issues found in 100% (53/53) of the WCDs. Location and features of machine were found the correlation with the prevalence of coliform bacteria in drinking water.

The findings of this study suggest regular monitoring of water quality in educational institutions. Also, the Sanitary Standard and Operational Procedures (S.S.O.P.) should be developed to improve the hygienic conditions of the water cooler dispensers

Today, cardiovascular disease (CVD) is the leading cause of mortality in both sexes. There are several risk factors for heart diseases; some controllable, others not. However, socioeconomic, technological, and environmental factors can impact CVD as well as exclusive risk factors. Accurate identification and assessment of these factors are often difficult. In the present systematic review, we aimed to explore factors affecting CVD.

Multiple databases (MEDLINE, Scopus, ISI Web of Science, and Cochrane) and gray literature were searched. The included studies described at least one determinant of CVD. The framework method was applied to analyze the qualitative data.

A total of 64 studies from 26 countries were included. The contextual determinants of CVD were categorized into 45 determinants, 15 factors, and 4 main social, economic, technological, and environmental categories. The 15 potentially reversible factors were identified as sociodemographic, violence, smoking, occupation, positive childhood experience, social inequalities, psychological distress, eating habits, neighborhood, family income, rapid technology, environmental pollution, living environments, noise, and disaster.

Devolution and more efficient health policies are required to achieve further sustained reduction in CVD mortality, increase life expectancy, and reduce its associated risk factors. Policymakers should fully address the value of social, economic, technological, and environmental factors. In fact, a prevention agenda should be developed and updated collaboratively in terms of the determinant factors.

 Fractional exhaled nitric oxide can be used as a biomarker of some respiratory diseases.

This study was conducted to compare exhaled nitric oxide in cigarette and water‑pipe smokers with nonsmokers.

This cross‑sectional study was conducted on 549 adult subjects as a sub‑study of Shahedieh cohort in Yazd. Participants were divided into 5 groups according to their smoking habits: non‑smokers (n = 202), cigarette smokers (n = 121), water‑pipe smokers (n = 129), cigarette ex‑smokers (n = 58), water‑pipe and cigarette smokers (n = 39). The smokers were also categorized into heavy and light smokers. Fractional exhaled nitric oxide was compared between the groups. Statistical Analysis Used: The data were analyzed by SPSS (ver. 20) using Kolmogorov‑Smirnov, Kruskal‑Wallis, and Mann‑Whitney U tests.

Fractional exhaled NO was lower in all smokers than nonsmokers, but cigarette smokers showed the least level of NO than other groups. Fractional exhaled NO was not significantly lower in water‑pipe smokers than nonsmokers.

Cigarette smoking significantly affect fractional exhaled NO, but water‑pipe smoking did not significantly affect exhaled NO level.

Most of the aged women experience the deterioration of bone due to the gradual decrease in bone mineral density (BMD). According to different studies, a continuous progressive decline in bone density results in risks of fractures.

The study aimed to identify the fracture risk factors among post‑menopausal women with the deterioration of bone density. Settings and Design: Cross‑sectional study design was used, and was conducted clinic at Hospital Tengku Ampuan Afzan (HTAA) Kuantan, Pahang, Malaysia.

In total, 116 post‑menopausal women were selected as a sample from a public hospital in Malaysia. An assessment checklist on fracture risks; including age, menopause year, BMD, serum calcium level, balance and gait score, body mass index (BMI) was used to collect data. Descriptive statistics and Pearson correlation were used to analyze data.

Findings showed that 87.1% participants confidently performed daily activities. Normal TUG score was revealed for 76.7%, and Fall Free Prevention Questionnaire (FFPQ) findings show that no risk of falling prevailed. Pearson correlation showed negative weak correlation between BMD with the age of respondents, year of menopause and TUG (r = –.373), (r = –. 284) and (r = –.237). Moderate correlation was found between BMD in BMI status ( r = .343) and weak correlation was found between BMD and ABC scale (r = .200).

The study emphasized on instigation of the intervention to improve population literacy related to menopause and bone density deficiency.

This study was designed and performed to investigate the relationship between fetal chromosome aberrations and screening markers in the first trimester of pregnancy in order to prevent the birth of infants with chromosome aberrations with early prenatal diagnosis.

We conducted an analytic cross‑sectional study on result of chromosomal culture of 762 pregnant women with high‑risk combined screening test from December 2018 to June 2020 and analyzed by SPSS program.

There was a significant relationship between chromosome structural abnormalities with free beta‑human chorionic gonadotropin (free β‑hCG) values equal to and higher than 1.5 multiples of the median (MoM) (P: 0.05). The highest incidence of disorder in number of chromosomes with abnormal nuchal translucency (NT) percentiles (≥99%) was seen (P < 0.001). It also shows that the cumulative number of chromosome aberrations of 25 (78.12%) occurred in individuals with a NT less than 99th percentile and at the same time a risk of 1/50≤ risk <1/10.

According to the results, Comparative Genomic Hybridization (CGH) array method is recommended to detect structural abnormalities in chromosomes in samples with NT ≥3.5. In addition, it is noteworthy that chromosomal structural abnormalities occur in free β‑hCG ≥1.5 MoM.

Due to the frequency of chromosomal structural disorders and its effect on the incidence of fetal abnormalities, the study of chromosomal structural disorders is recommended.