Iranian Journal of Public Health
Volume:51 Issue: 5, May 2022

Post-exposure prophylaxis (PEP) is an effective method for preventing rabies, a highly fatal infection in exposed persons. Malaysia is currently using the purified Vero cell rabies vaccine (PVRV). Nonetheless, there are other commercially available vaccine types and regimens. This systematic review aimed at comparing the effectiveness of the different PEP vaccines, regimens and routes of administration among Asian populations.

We systematically reviewed the PubMed and Web of Science databases for articles reporting on the effectiveness of PEP vaccination against rabies among Asian populations between 2015 and 2019.

Our search identified 11 relevant studies. Majority of study either used PCECV or PVRV type of vaccine, with different regimes and method. All are non-inferior to the other. Most of the studies recorded adequate response by Day 14 of vaccination. Nonetheless, the intradermal (ID) vaccination used minimal volume of vaccine used in all settings, thus cost less and the concurrent administration of RIG to the wound(s) doesn’t affect the RVNA GMT response.

PCECV, using either the Essen or Zagreb regimen, might be a useful alternative for the healthy population in the context of PVRV shortage, especially during an outbreak. Use of the Zagreb or Thai Red Cross (TRC) regimens can be considered (either PVRV or PCECV), as both demonstrate good immunogenic outcomes in Asian populations.

Nurses comprise the majority of the healthcare workforce, and their job satisfaction can have a substantial impact on patient health.

This study aimed to provide a comprehensive overview of studies that performed statistical analyses focused on the job satisfaction of nurses and relevant factors, as well as synthesizing existing data. Overall, 144 studies published between 1986 and 2018 were reviewed for qualitative synthesis.

The most frequently measured variable was job stress, followed by burnout and turnover intention. Overall, 53 studies published between 1994 and 2018 were reviewed for quantitative synthesis. In the meta-analysis, the weighted mean effect size using a random-effects model was moderate for all variables: -0.539, -0.484, and -0.395 for burnout, turnover intention, and job stress, respectively.

The results revealed a long history of variables related to job satisfaction among Korean nurses since data retrieval was not subject to any restrictions. These findings can be used as evidence for the formulation of policies to enhance the retention of nurses committed to their profession. Further, they can facilitate stable workforce management in healthcare.

Patients with temporomandibular disorder (TMD) often have orofacial pain and may use medication without professional prescription. Self-medication and inappropriate drug intake may cause serious health problems. This cross-sectional study evaluated the self-medication profile of TMD patients, the most used medications and their effect, and the relation between self-medication and socioeconomic factors.

A non-representative sample (n=358) consisted of consecutive adult patients seeking TMD treatment in specialized referral centers for orofacial pain of two universities in São Paulo city, Brazil. A standardized questionnaire was used to collect the study variables before the TMD treatment: self-medication history, TMD pain intensity, sex, age, ethnicity, marital status, schooling and socioeconomic levels. Data were analyzed by descriptive statistics, chi-square test, and logistic regression models at the 0.05 significance level.

Almost 60% of 358 TMD patients reported self-medication. Patients with severe TMD were 4.7 times more likely to self-medicate when compared to patients with low TMD intensity (O=5.7; 95% CI=2.4; 13.3; P=0.043), as well as female patients were 30% more likely to self-medicate compared to male patients (OR=2.3; 95% CI=1.1; 5.1; P<0.001). The other independent variables were not associated with self-medication. The frequencies of moderate and severe TMD in women were larger than in those in men (P<0.001). Analgesics and anti-inflammatory drugs were the most used medications. Regarding medication efficacy, 82% of patients reported some improvement after use, but 9% reported side-effect sickness.

Self-medication is common among TMD patients attending specialized clinics, and this inappropriate practice is more likely to occur in women and in patients with severe signs and symptoms of TMD.

We aimed to investigate the high-risk factors of stroke through logistic regressive analysis and using LightGBM algorithm separately. The results of the two models were compared for instructing the prevention of stroke.

Samples of residents older than 40 years of age were collected from two medical examination centers in Jiaxing, China from 2018 to 2019. Among the total 2124 subjects, 1059 subjects were middle-aged people (40-59 years old) and 1065 subjects were elder-aged people (≥60 years old). Their demographic characteristics, medical history, family history, eating habits etc. were recorded and separately input into logistic regressive analysis and LightGBM algorithm to build the prediction models of high-risk population of stroke. Four values including F1 score, accuracy, recall rate and AUROC were compared between the two models.

The risk factors of stroke were positively correlated with age, while negatively correlated with the frequency of fruit consumption and taste preference. People with low-salt diet were associated with less risk of stroke than those with high-salt diet, and male had higher stroke risk than female. Meanwhile, the risk factors were positively correlated with the frequency of alcohol consumption in the middle-aged group, and negatively correlated with the education level in the elder-aged group. Furthermore, the four values from LightGBM were higher than those from logistic regression, except for the recall value of the middle-aged group.

Age, gender, family history of hypertension and diabetes, the frequency of fruit consumption, alcohol and dairy products, taste preference, and education level could as the risk predictive factors of stroke. The Model of using LightGBM algorithm is more accurate than that using logistic regressive analysis.

The study aimed to provide basic data about the changes in the Korean elementary schools’ Physical Activity Promotion System (PAPS) amidst the COVID-19 pandemic and to present future direction for school and physical education.

Data were collected for 2019–2021 from the PAPS, conducted by the Korea Ministry of Education. Participants were fifth and sixth level students from 1,214 Korean elementary schools, with 124,871, 126,396, and 117,953 participants in 2019, 2020, and 2021, respectively. Five physical fitness variables were evaluated—cardiopulmonary endurance, flexibility, muscle strength, power, and obesity—and graded from 1 (highest physical fitness level) to 5 (lowest physical fitness level). Data were analyzed using repeated measures analysis of variance and Bonferroni for multiple comparisons for computing confidence intervals.

The findings indicated significant changes in the ratios of grades 1, 2, 4, and 5 according to the year (P<0.05). Grades 1 and 5 decreased and increased in 2021 from 2019 and 2020, respectively (P<0.001). Grades 2 and 4 continuously decreased and increased from 2019 to 2020 (P=0.001, P<0.001, respectively) and further in 2021 (P<0.001), respectively. Moreover, significant changes were identified in the grade ratio by year according to sex (P<0.05). Male students reported higher grade 1 ratios than female students in 2019 (P=0.018) and 2021 (P<0.001). However, for all 3 years, female students reported higher grade 2 ratio (P<0.001), while male students reported higher grade 4 and 5 ratios (P<0.001). Lastly, male students reported higher grade 3 ratios than female students in 2019 (P=0.003), but this finding was reversed in 2021 (P=0.004).

The pandemic decreased students’ physical activity and weakened their health, and this reduced fitness was greater pronounced in male students. In the future, physical educators should plan and present solutions to tackle reduced physical activity post the pandemic.

We started to design and test health education Apps for self-management among patients to provide a rich source of clinical support and information for patients to increase their ability of self-management.

First, a multidisciplinary research team worked together to design and conduct the research. With their help, we redesigned an apps to incorporate some personalized changes for patients’ needs. Second, we chose a questionnaire from the Comprehensive Service Platform for the Elderly self-designed by CHENYu. Finally, a purposive sample of 34 users were tested experiences and satisfaction of users in Jul 2021.

This research was successfully conducted in 22 wards among 23159 patients and 40440 chapters about healthy information sent to patients from Mar 2019 to January 2021 by smartphone. The data showed that 91.2% of participants resolved that the evaluation effect of the proposed application was better, in comparison with the paper version as routine verbal instruction. Additionally, 85.3% of participants wanted to continue to receive medical education information after discharge from the hospital. The top four most popular medical education information that they would like to receive included drug administration, disease prevention, nursing, and home care. Moreover, the top four most popular types of user suggestions were one-on-one online Q & A, continue to see every session, accelerate the speed of browsing and page updated, and free Wifi. The user satisfaction of the application was considerably high.

The apps was welcomed by patients who wanted to increase their knowledge level of disease and perform self-management better.

We assessed risk factors, antenatal and intrapartum complications associated with early-onset Gestational diabetes mellitus (GDM) in comparison with late-onset GDM.

This retrospective study included 161 GDM women having singleton pregnancies, without previous medical disorder and delivered at a tertiary care Hospital in Ha’il City, KSA from Dec 2020 till Jun 2021. Women diagnosed at < 24 weeks of pregnancy were grouped as early-onset GDM (n=71) and those diagnosed at ≥ 24 weeks as late-onset GDM (n=90). Both groups were matched for background variables. Chi-square and binary logistic regression analysis were applied with P-value significance at 0.05.

Past history of GDM, macrosomia and stillbirth were significant predictors for early-onset GDM (P value 0.000, 0.002 and 0.040 respectively). Regression analysis showed early-onset GDM significantly increases the risk for recurrent urinary tract infections (AOR 2.35), polyhydramnios (AOR 2.81), reduced fetal movements (AOR 2.13), intrauterine fetal demise (AOR 8.06), macrosomia (AOR 2.16), fetal birth trauma (2.58), low APGAR score at birth (AOR 8.06), and neonatal ICU admissions (AOR 2.65). Rate of preterm birth, hypertensive disorders, labor onset (natural vs. induced) and cesarean section and intrapartum maternal complications were same in both groups.

Early-onset GDM significantly increases certain maternal (recurrent urinary tract infections, polyhydramnios and reduced fetal movements) and fetal complications (intrauterine fetal demise, macrosomia fetal birth trauma, low APGAR score at birth and neonatal ICU admissions). Most of these adverse pregnancy outcomes can be prevented through early registration and screening, close follow up, growth ultrasounds, and provision of efficient emergency and neonatal care services.

To analyze the effect of continuous nursing model based on WeChat public health education on self-management level and treatment compliance of stroke patients.

  Overall, 98 stroke patients admitted to the Second Affiliated Hospital of Chongqing Medical University, ChongQing,400000,China from Feb 2018 to Feb 2019 were enrolled as the research objects. They were randomly and equally divided into experimental group and control group. The control group received routine nursing management model while the experimental group received continuous nursing model based on WeChat public health education to compare the self-management level, treatment compliance, life quality and other indexes between the two groups.

The overall self-management level in the experimental group was significantly higher than that in the control group (P<0.05). The life quality scores in both groups after nursing intervention increased, and the scores in the experimental group after nursing intervention were significantly higher than those in the control group (P<0.001). The total treatment compliance rate in the experimental group was higher than that in the control group (P=0.001). After nursing intervention, the readmission rate and complication rate in the experimental group were significantly lower than those in the control group (P<0.05).

The implementation of continuous nursing model based on WeChat public health education for stroke patients can significantly enhance the self-management level, improve the cognitive level on stroke related-health knowledge, improve treatment compliance of patients in the nursing process, promote their physical and mental health, improve the life quality and effectively reduce the complication rate and readmission rate.

The COVID-19 pandemic and social distancing measures have limited outdoor activities for many people, including university students who live inside the campus and far from their families. We investigated if and how the fear of COVID-19 had impacted visiting green areas and consequently the quality of life.

The assessments were taken through a questionnaire-based survey of the university students living inside the campus in two universities (Konkuk and Sejong universities) in Seoul, South Korea in 2021 (n=255). Measuring three variables, the participants were asked to self-estimate their fear of COVID-19 and quality of life during the pandemic, and the time and frequency of the park visit. Structural equation modeling (SEM) and confirmatory factor analysis (CFA) were conducted to explore the potential relationship between the three main observed variables.

In the case of the campus students, visiting the green area cannot play a mediating impact on the effect of the COVID-19 fear and quality of life. Likewise, the data did not support the effect of COVID-19 fear on the quality of life for this group of students, however, significant correlations were found between the COVID-19fear and visiting green spaces (P<0.05) (positive effect on visiting, and negative effect on the time of visit).

Students perceived not a considerable improvement in their quality of life after visiting green areas. It might be due to the fear of staying outdoor for a long time (frequency) during the pandemic, and students’ lifestyles. However, the quality of life for the students is likely to be influenced by other factors, rather than the fear of COVID-19.

A tertiary-hospital-based retrospective study (2011-2019) was conducted to determine the mediating role of hypertensive disorders of pregnancy and abnormal placentations between advanced maternal age and adverse neonatal outcomes.

Data from a tertiary-hospital-based retrospective study (n= 23051) was used and conducted regression-based mediation analysis to assess the mediating role of hypertensive disorders of pregnancy and abnormal placentation between the advanced maternal age and adverse neonatal outcomes.

After adjusting for confounding factors, the indirect effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight mediated by hypertensive disorders of pregnancy was [aOR 4.95 (95% CI: 4.05, 5.85)], [aOR 2.82 (95% CI: 1.78, 3.86)], and [aOR 5.90 (95% CI: 4.93, 6.87)], respectively. The indirect effect of advanced maternal age on preterm births and low birth weight mediated by abnormal placentation was [aOR 6.83 (95% CI: 5.70, 7.97)] and [aOR 4.18 (95% CI: 3.26, 5.11)].  About, 23%, 37%, and 17% of the effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight was mediated by hypertensive disorders of pregnancy, respectively. Furthermore, abnormal placentation mediates the association between advanced maternal age and preterm births by 18% and low birth weight by 23%. 

Hypertensive disorders of pregnancy and abnormal placentation partially mediate the association between advanced maternal age and adverse neonatal outcomes.

We aimed to investigate the clinical effect of low molecular weight heparin (LMWH) combined with magnesium sulfate in patients with severe pre-eclampsia (PE).

A total of 70 patients with severe PE admitted in Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, China from Jun 2020 to May 2021 were enrolled and randomized into observation and control groups. The control group was treated with magnesium sulfate only, and the observation group was treated with small-dose LMWH combined with magnesium sulfate. The clinical effects and artery blood flow index were analyzed.

The observation group had higher coagulation function than that in the control group. RI, S/D, and PI in the observation group after treatment were lower than those in the control group, with statistically significant differences (P <0.05). In serum and placental tissues, both kininase expression and TGF-1 levels of the observation group were higher than those of the control group, with lower PAPP-A, VCAM-1 and E selectin levels than those in the control group.

Small-dose LMWH combined with magnesium sulfate can promote the expression of endogenous kallikrein, weaken the infiltration of cytotrophoblast, and improve the maternal blood clotting state in patients with severe PE. It also improves placental microblood flow and effectively prolong pregnancy, promotes fetal growth, and improves the clinical effects.

This study was determined to describe the patterns of lifestyle behaviors and their associations with metabolic profiles among Chinese urban and rural adults.

This was a cross-sectional study set in the Nanjing (5,824) and Hefei (20,269) Community Cardiovascular Risk Surveys from 2011-2013, using random cluster sampling. Questionnaires were completed via face-to-face interview, and data on lifestyle behaviors including daily night sleep duration, nap duration (if any) and sitting time, and weekly physical activity (measured using the International Physical Activity Questionnaire, in metabolic equivalents of task × minutes, and separated into walking and moderate-to-vigorous physical activity (MOVPA) according to intensity) was collected. The patterns of physical activity in Chinese urban and rural populations and the metabolic profile in each pattern were identified by the latent class analysis.

Six distinct clusters were determined, with the sizes ranging from 45% to 5% of the total population. For example, the most common cluster was associated with a sufficient night and nap sleep duration, a long sitting time, and above WHO recommended physical activities for both walking and MOVPA, and the smallest cluster was featured by its huge amount of MOVPA and limited amount of walking activity. Difference in proportion of each cluster was observed between the two survey sites. No obvious abnormal blood measures were seen in any cluster.

Common lifestyle behavior clusters were described, leading to a better understanding of people’s routine activities.

Medullary Thyroid Cancer (MTC) is a very aggressive type of thyroid carcinoma. Mutation in RET proto-oncogene is demonstrated in MTC development. We aimed to knock-out of RET-oncogene using CRISPR/Cas9 genome editing method in MTC cell-lines.

This research was conducted in Shahid Beheshti University of Medical Sciences, Tehran, Iran during 2019-2020. Four different sgRNAs were designed to target exons one, two, and four of RET-oncogene in TT and MZ-CRC-1 cell-lines using bioinformatics tools, then the CRISPR/Cas9 constructs was made. About 72-hours after cell transfection, T7EI method and DNA sequencing were used to confirm the knock-out of RET-oncogene. Expression of RET, Calcitonin genes and RET protein were evaluated by Real-time PCR and ELISA, respectively.

The results of T7E1, and DNA sequencing of transfected cells confirmed RET gene knock-out by CRISPR/Cas9. There was a significant decrease in RET gene expression and RET protein in transfected TT and MZ cells compared to controls. The rate of cell apoptosis in transfected cells was significantly increased. Calcitonin gene expression was also significantly reduced in transfected cells. p-RET, p-PI3K, p-AKT, p-MEK, p-ERK protein levels were significantly reduced in TT and MZ transfected cells.

For the first time, knock-out of RET gene was performed and confirmed using CRISPR/Cas9. Inhibition of this gene leads to inhibition of the tyrosine kinase RET signal transduction pathway. Therefore, it can be one of the most effective and specific therapeutic goals in the field of Personalized Medicine in the treatment of diseases caused by over activity of RET molecular pathway.

Silver nanoparticles (AgNPs) were phyto-synthesized using Typha azerbaijanensis aerial part and root extracts, and their biological activities were investigated.

This study was conducted in the Science and Research Branch, Islamic Azad University, Tehran, Iran in 2019. In this experimental study, silver nanoparticles (AgNPs) were phyto-synthesized and the physicochemical properties of AgNPs were determined using UV-Vis (UV-Vis) spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Fourier transform infrared (FTIR) spectroscopy. Antibacterial and anticancer activity of synthesized AgNPs was determined using microdilution assay, and MTT 3- (4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) methods, respectively. The apoptotic effects of AgNPs were investigated using Real-Time PCR and flow cytometry techniques.

Morphological analysis of the synthesized AgNPs confirmed the spherical shape of AgNPs with an average size of 10.67 to 16.69 nm. The FTIR spectrum confirmed the presence of phytochemicals from T. azerbayenensis extract at the AgNP surface. Antibacterial experiments showed that phyto-fabricated AgNPs had significant antibacterial activity against Gram-negative bacteria. The AgNPs were significantly cytotoxic against breast cancer cell line (MCF-7) through induction of apoptosis.

The phyto-synthesized AgNPs had biological activities could be useful in pharmaceutical applications.

There is no official and representative information on certain health-risk behaviors in Iran. This national survey was performed to determine the prevalence of five high-risk behaviors among the adult population and underlying factors.

This cross-sectional study was performed in 23 provinces of Iran in 2019 involving 10,957 participants. The following five risky behaviors were evaluated: (a) using illicit drugs in the past month, (b) drinking alcohol in the past month, (c) having extramarital sex in the past year, (d) having suicidal thoughts in the past month, (e) and attempting suicide in the past year. The logistic regression model was used for analyses and associations were reported using odds ratio (OR) with its 95% confidence interval (CI).

The prevalence of health-risk behaviors was as follows: illicit drug use 10.4%, drinking alcohol 16.8%, extramarital sex 9.9%, suicidal thoughts 8.8%, and suicide attempt 5.4%. Almost 27.6% of the participants were involved in at least one risky behavior. There was a strong association between illicit drugs use and male gender 2.51 (2.11-2.98) and using psychiatric medications 2.96 (2.46-3.55); between drinking alcohol and male gender 2.23 (1.93-2.58); between extramarital sex and divorced/widowed status 2.43 (1.72-3.44) and having an intimate friend of the opposite sex 3.75 (3.13-4.51); between suicidal thoughts and using psychiatric medications 2.23 (1.83-2.72); between suicide attempt and a history of running away from home 2.10 (1.64-2.68).

More than one-fourth Iranian adult population is involved in at least one risky behavior. Engaging in any risky behavior may increase the possibility of engaging in other high-risk behaviors.

Congenital anomalies are one of the major public health problems and one of the leading cause of infant mortality and morbidity. We aimed to investigate some factors associated with infant mortality due to congenital anomalies in several provinces of Iran.

This case-control study was conducted on 2199 women referring health centers of nine provinces of Iran 2015-2018. Cases were defined as mothers with infant death due to congenital anomalies, and control group comprised of mothers with live birth or infant deaths due to other causes (n=1986). The descriptive data were expressed as percentage and frequency. Factors associated with infant death due to congenital anomalies were evaluated and analyzed at 95% confidence level by logistic regression analysis.

The multiple logistic regression analysis reveal that history of cesarean delivery [OR:2.13 ;95%CI (1.58-2.87)], maternal age [OR:1.94 ;95%CI (1.31-2.86)])], area of living [OR: 1.69;95%CI (1.22-2.33)], maternal smoking during pregnancy [OR: 1.41; 95%CI (1.02-1.95)], consanguineous marriage [OR:1.53;95%CI (1.12-2.08)], also low birth weight [OR: 3.09; 95%CI (2.23-4.30)] were significantly associated with infant death due to congenital anomalies.

Identification of factors associated with congenital anomalies has been shown to reduce treatment costs and medical complications of neonates. Therefore, genetic counseling and educational programs for high-risk women, and prenatal screening are essential to identify and prevent factors contributing to congenital abnormalities.

Nurses play a key role in increasing the efficiency of healthcare systems. Given the 24-hour performance of hospitals and the small number of nurses in the field of treatment, it is quintessential to re-shift them in the hospital. This study set out to achieve coherence in nursing shift planning and justice in the order of shifts in hospital.

This applied and a developmental study was performed from 2019 to 2020. We used genetic algorithm to provide operational solutions and define flexible shifts and plan nurses' working hours in Yas Hospital, Tehran University of Medical Sciences Hospital, Tehran, Iran.

Based on the selection of each nurse and determining the approved shifts of each ward, the possibility of appropriate planning was provided to determine the required shifts per month and to estimate the needs of each department.

Using genetic algorithm and nursing shift in office automation console provides useful tools for managers at all organizational levels, according to which a good balance between the hospital's need for nurse and nurses’ demands in different time periods.

We aimed to investigate the antibacterial activity of Persian Gulf microalgae extracts on some Gram-positive and negative bacterial species in order to find new compounds with antibacterial activity.

After sampling microalgae from December 2020 to April 2021 from the northernmost part of Qeshm Island in Persian Gulf, the antibacterial activity of methanolic and ethyl acetate extract of microalgae were tested in three concentrations of 125, 250, and 500 mg/ml on Gram-positive bacteria including Staphylococcus aureus, Bacillus cereus, and Gram-negative bacteria including Pseudomonas aeruginosa and Escherichia coli by disk-diffusion assay and the results were compared with two standard antibiotics including ciprofloxacin and streptomycin. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were assessed spectrophotometrically using microplate and enzyme-linked immunosorbent assay (ELISA) reader.

Methanolic and ethyl acetate extracts had antibacterial effects against Gram-positive and negative bacteria. Compared to ethyl acetate extract, the methanolic extract showed stronger effects on both Gram-positive and negative bacteria. The most antibacterial effect was related to methanolic extract with a concentration of 500 mg/ml on S. aureus by 14.6 mm inhibition zone. Evidence from MIC also confirmed that the lowest MIC was belonged to methanolic extract by 0.75 mg/ml against S. aureus. Interestingly, both of these extracts showed more antibacterial activity on Gram-positive bacteria than Gram-negative bacteria.

The investigation proved the efficacy of microalgae extracts isolated from Persian Gulf as natural antimicrobials and suggested the possibility of employing them in medicines as antimicrobial agents.

Visfatin is known as one of the adipokines associated with the development of inflammation, but its role in the pathogenesis of nonalcoholic fatty liver is less known so far. We aimed to investigate the association between visfatin gene polymorphism rs4730153 and insulin resistance and non-alcoholic fatty liver disease (NAFLD).

This case-control study was performed on 80 patients with NAFLD as well as 80 healthy participants as controls referred to Amir Al-Momenin and Bouali hospitals in Tehran. Genotyping was performed using PCR-RFLP method. Plasma concentrations of visfatin and insulin were measured using ELISA kit. The fasting blood glucose, TC, TG, LDL-C, HDL-C, ALT, AST, SBP, DBP, and BMI levels were measured using the standard methods. Statistical analysis was also performed using SPSS software.

A significant difference was found in Visfatin level in the patients with NAFLD compared to this level in healthy individuals. The levels of HDL-C and LDL-C in healthy individuals and triglyceride in patients for GG, AG, and AA genotypes carriers also were significantly different. There was a significant relationship between rs4730153 polymorphism and insulin resistance; however, no association was found between this polymorphism and NAFLD. Notably, Visfatin showed a significant association with age (all individuals), body mass index (healthy individuals), insulin, and HOMA (in patients).

Visfatin levels reduced in patients with NAFLD. Moreover, rs4730153 polymorphism was indicated to be associated with both lipid metabolism and insulin resistance, but no association was found between this polymorphism and nonalcoholic fatty liver disease.

Coronary heart disease (CHD), a major cause of death worldwide, is defined as a narrowing or blockage of the coronary arteries that supply oxygen and blood to the heart. We aimed to find potential biomarkers for coronary artery disease, by comparing the expression profile of blood exosomes of both normal and CHD samples.

Datasets of 6 CHD and 6 normal samples of blood exosomes were downloaded, and differentially expressed RNAs, with adjusted P<0.01 and log2FoldChange≥1 were achieved. Moreover, gene ontology (GO) and pathway analysis were accomplished by PANTHER database for datasets.

Our data analysis found 119 differentially expressed genes between two datasets. By comparing transcriptome profiles, we candidate the highest downregulated gene, ACSBG1, and the highest upregulated one, DEFA4, as specific biomarkers for CHD. Furthermore, GO and pathway analysis depicted that aforementioned differentially expressed genes are mostly involved in different molecular metabolic process, inflammation, immune system process and response to stimulus pathways which all cause cardiovascular diseases.

We have provided new potential biomarkers for CHD, though experimental validation is still needed to confirm the suitability of the candidate genes for early detection of CHD.

Medical sociology is concerned with the relationship between social factors and health, and with the application of sociological theory and research techniques to questions related to health and the health care system. Considering the wide range of studies in the field that each examined different aspects, to promote health in community, bibliometrics analysis in this area is felt.

In this descriptive-analytical study with a scientometric approach, the data about “medical sociology” were retrieved from PubMed in MEDINE format, including 1226 records over the period 1945-2018. By using Co-word analysis, clustering methods, and strategic diagram with the help of SPSS, UcInet 6 software the data were analyzed.

The keyword “Attitude to Health” and two pairs of frequently used keywords, namely “Power (Psychology)*Professional Autonomy” were the most frequent in medical sociology. The results shaped the concepts of medical sociology in 7 clusters. The clusters “Attitude of health personnel”, “Health Policy” and “Sociology of Medical Education” are topics that may be emerging or disappearing. The “Physicians", "Models of Social Determinants of Health" and "medical philosophy" are immature clusters.

This research used co-word networks that indicate the important links between keywords of research areas. Considering the frequency of keywords along with the clusters obtained, it seems that the most research approach was seen on the medical aspect rather than the sociological aspect. Despite the importance of sociological aspects such as social rooting of disease, sociability, medicine as a social institution and etiological studies, these subjects have not been sufficiently considered.

In the classification of road accidents, type 2 traffic accidents and non-traffic accidents are not considered and in Iran so far no special study has been done in the field of type 2 traffic accidents and non-traffic accidents, so we aimed to investigate the incidence of type 2 traffic accidents and non-traffic accidents in Iran.

This cross-sectional was conducted on all individuals referred to Forensic Medicine Organization (FMO) from all over Iran who suffered from non-traffic accidents and type 2 traffic accidents during 2013-2018. Demographic information, accident information and other information including the location of the impact, the final cause of death and the date of the accident were examined. The information received from the FMO was first checked and then analyzed using Stata 11 statistical software.

During the 6-year study period, 10882 people lost their lives in type 2 traffic accidents (4779 people) and non-traffic accidents (5287 people). In terms of age, the highest incidence of type 2 traffic accidents and non-traffic accidents was observed in the age group over 65 years. The incidence of type 2 traffic accidents has not been increasing, while the trend of non-traffic accidents has been increasing.

With respect to the high rate of deaths due to traffic accidents, including type 2 traffic accidents and non-traffic accidents, it is necessary for the national media and relevant agencies to educate the people about first aid and also inform about free relief services, timely presence is important.