International Journal of Preventive Medicine
Volume:13 Issue: 11, Nov 2022

One billion worldwide population is living in slum areas that mostly accompanied with high rates of poverty, illiteracy, unemployment, unhealthy situation, and inappropriate health‑care services. The prediction of enormous growth of slums by 2030 led to a raise to address the “plight of slums” in Sustainable Development Goals (SDGs).

To address evidence‑based health‑related priorities, we conducted a systematic review to summarizing evidences on health situations of slums population in Iran. Six electronic databases were systematically searched for published studies without any restriction on age, sex, and language to assess health situations of slums in Iran reported by following the  Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. All identified articles were screened, quality assessed, and data extracted by two authors independently.

The finding of this systematic review in addition to overall view categorized in five categories: health system, reproductive health, infectious diseases, noncommunicable diseases and their risk factors, social issues besides overall situation of Slums.

Community‑based participatory interventions with socioeconomic approach on modifiable risk factors; active response of health system; establishment new health care centers in slum areas; augmenting the quality of care; active case finding; and elevating health knowledge, attitude, and practice is crucial to achieve SDG’s in Slum area.

Malnutrition is a major public health issue worldwide. It has significant consequences, including weakened immune systems, which may lead to increased incidences of infectious disease and higher mortality, particularly in children. A systematic review and meta‑analysis were conducted to estimate the overall prevalence of malnutrition (wasting, underweight, and stunting) among children of 6–14 years of age in Iran.

Data were collected in 2018 based on searches of the PubMed, Science Direct, Scopus, Google Scholar, Science Information Database (SID), Magiran, Irandoc, and Iranmedex databases using the following keywords: childhood, childhood malnutrition, children, nutrition, malnutrition, wasting, underweight, stunting, child, student, boy, girl, cause, prevalence, and Iran, in order to identify studies eligible for inclusion in the review. Comprehensive Meta‑Analysis, version 2 (CMA: 2) was used to estimate the overall prevalence of malnutrition.

Nine out of 328 articles were included in our analyses. The overall of wasting among children of 6–14 years of age in Iran based on the random‑effects model (according to nine studies and 18,296 participants) was 12.5% (95% Confidence Interval, 7.1‑21.2). The overall prevalence of underweight based on the random‑effects model (according to 10 studies and 19,185 participants) was 19% (95% CI, 8.1‑38.6). Also, the overall prevalence of stunting based on the random‑effects model (according to 10 studies and 19,185 participants) was 20% (95% CI, 9.4‑37.8).

The results of this study show that the prevalence of malnutrition among 6–14‑year‑old children in Iran is similar to the global average. We need solutions that can be used for both prevention and reduction of malnutrition, especially in areas with middle or low socioeconomic status. It is necessary to identify factors associated with malnutrition in various geographic regions in order to implement appropriate programs based on factors with the highest impact in each region.

Background

This meta-analysis was performed to investigate the effect of serum lipids on the risk of breast cancer incidence.

PubMed, Web of Science, Scopus, and EMBASE were searched systematically from January 1998 to April 2019. Inclusion criteria were English observational studies (cohort or case-control) and the concentration of at least one of the lipid profile components (total cholesterol/triglycerides/low‑density lipoprotein cholesterol/high‑density lipoprotein cholesterol) measured before a diagnosis of breast cancer (BC). The studies were included in which the relative risk (RR) had been reported with 95% confidence intervals (CIs). A random-effects model was used.

Results:

 A total of 25 studies were found, including 2,882,789 participants in cohort studies with 45,481 cases with BC, and 1983 BC cases and 2963 case-control studies. Combined RR of cohort studies for the highest versus lowest for the BC was LDL-C: 0.95 (95% CI: 0.89–1.01), triglycerides (TG): 0.95 (95% CI: 0.91–0.99; P = 0.02), total cholesterol (TC): 0.98 (95% CI: 0.91–1.05), and HDL-C: 0.86 (95% CI: 0.63–1.18). Combined RR of case-control studies for the highest versus lowest was LDL-C: 1.08 (95% CI: 0.78–1.48), TG: 1.73 (95% CI: 0.94–3.18), TC: 1.02 (95% CI: 0.80–1.29), and HDL-C: 0.79 (95% CI: 0.65–0.97).

Conclusions:

 Based on the results, it can be concluded that only TG but not TC and/or LDL‑C had a significant inverse association with the risk of BC incidence. HDL‑C showed a significant protective effect against breast cancer in postmenopausal women and case-control studies.

This is a comprehensive review based on the published papers in the field of COVID‑19 vaccines and vaccination. Many efforts have been made to develop vaccines to combat this pandemic. Since December 2020, more than 200 vaccines have been tested in various research stages and in clinical trials on humans, of which eight vaccines reached phase four clinical trials in humans and approved by FDA and EUA. After the Pfizer–BioNTech vaccine that had the highest efficacy (95%), the efficacy of the other vaccines are as follows: Moderna 94.5%, Sputnik V 91%, Novavax 89.7%, Sinopharm 79.3%, Oxford/AstraZenaca 70.4%, Johnson and Johnson 66.9%, and Sinovac 50.7%. At present, protein‑based vaccines, with 35% of all available COVID‑19 vaccines, are the most common technique in the vaccine production, and then there are vaccines of non‑replicating viral vector (13.3%), mRNA1 (12.1%), DNA (10.2%), replicating viral vector (9.8%), and inactivated vaccines (8.2%). The most frequently recognized adverse effects within 7 days of each vaccine dose involved fever, fatigue, headache, chill, and myalgia. The mRNA‑based vaccines were associated with a higher occurrence of local side effects (78.3 vs. 70.4%; Sig. = 0.064), whereas the viral vector‑based vaccine was associated with a higher prevalence of systemic side effects (87.2 vs. 61%; Sig. < 0.001). Based on the evidence and articles in the field of vaccination, AstraZeneca‑Oxford and Sinopharm vaccines reported the highest and lowest side effects, respectively. Because of being emerging, pathogenicity, and high infectivity of COVID‑19, vaccination against the disease to prevent its incident rate and decrease the prevalence rate is recommended immediately. Being informed of various aspects of the existing vaccines such as efficacy, effectiveness, safety, etc.can accelerate to make effective and useful choices and consequently have a vaccinated community against the epidemic.

Some circulating microRNAs, such as miR15b, are predictors of diseases associated with adulthood obesity. This study aimed to evaluate the effect of two selected school‑based and high‑intensity interval training (HIT) on miR15b expression and lipid profile of obese adolescents.

Thirty‑eight adolescent males (12 ± 1 years) with obesity (body mass: 74.7 ± 13.2 kg, body mass index (BMI): 26.0 ± 2.3 kg/m2 , and body fat (BF): 27.2 ± 3.6%) were randomly assigned to the following based on the age‑related body mass index: (i) HIT (n = 13), (ii) school‑based exercises (SBE, n = 13), and (iii) control (n = 12) groups. Mir15b was extracted using the RT‑PCR system, and lipid profile was studied using the enzymatic colorimetric method before and after 12 weeks. Three training sessions were held each week during the course.

Following the exercise interventions, in both training groups, miR15b (HIT: –63.8 vs. SBE: –56. 7%; P = 0.001), cholesterol (HIT: –8.8 vs. SBE: –9.2%; P = 0.025), and low‑density lipoproteins levels (SBE: –13.1 vs. –20.8%; P = 0.48) decreased; however, the peak oxygen uptake of subjects increased (HIT: 4.0 vs. SBE: 4.0%; P = 0.003). However, there were no significant differences in triglyceride (HIT: –16.9 vs. SBE: –8.3%; P = 0.134), and high‑density lipoprotein (HIT: 3.1 vs. SBE: 4.8%; P = 0.479) levels between both intervention and control groups (P > 0.05).

The results showed that both types of exercises had almost similar effects on reducing miR15b expression and improving the lipid profile. Hence, based on the difficult nature of HIT for children with obesity, further use of school‑based exercises is suggested.

The role of anti‑phospholipid antibodies (aPLs) in the prognosis of COVID‑19 patients is controversial. In order to prove the role of this factor, the necessary measures such as early initiation of anticoagulants should be started even in the early stages of the disease and in outpatients or the use of other drugs in addition to anticoagulants. We decided to investigate the role of these antibodies in ICU admission outcomes in critically ill COVID‑19 patients.

The case‑control study was carried out in Isfahan, Iran, from March to September 2021. One hundred nine patients in the case group were selected, including patients admitted to the ICU with a COVID‑19 diagnosis. The 140 patients in the control group were selected from hospitalized and outpatients with COVID‑19 with PCR + and pulmonary involvement, similar to the case group without the need for ICU hospitalization. The anti B2GP1 (IgM, IgG) and anti‑cardiolipin (IgM, IgG)) were compared in two groups.

The frequency percentage of patients in the abnormal group of anti‑phospholipid antibodies was about 10% in total. No statistically significant difference in these aPLs in continued measures was observed between the two groups of patients admitted to the ICU and those outside the ICU. Also, in the logistics regression analysis, no significant association was observed.

Therefore, the cause of coagulation in patients admitted to the ICU is not related to these aPLs. This means that aPLs could not be a good predictor of patient admission to the ICU.

The first need of any society is to have a healthy life that can be achieved through preventive education. Despite providing training in the prevention of risk factors for noncommunicable diseases in the country’s educational programs, we are witnessing an increase in the incidence of these diseases. We aimed to summarize the views of experts in the field of health and education on improving the effectiveness of these trainings.

This study was conducted with a qualitative approach and conventional content analysis method. Participants were 12 experts in the field of health and 19 employees in education who were selected by purposive and available sampling method with maximum diversity. The data collection method was semistructured interview with note‑taking.

A total of 32 subcategories and 9 main categories were extracted: “Macro health policies,” “Strategic health system,” “The role of education system in health promotion,” “Schools and Lifestyle modification,” “Informal learning,” “Preventive strategies in promoting health,” “ Lifestyle, multifactorial phenomena,” “The impact of stress on health,” and “Factors affecting preventive education.”

Providing preventive education to students is one of the ways to prevent noncommunicable diseases. If these trainings have the necessary attractiveness and support by the authorities (and especially the health system), then it will not only raise students’ awareness, but also change their attitude and improve their performance.

Backround:

 Noise is one of the most important occupational and environmental health hazards. Exposure to loud noise can cause irrevocable hearing damage and loss of hearing. The aim of this study was to determine the efficiency of two samples of earmuff and earplug in low frequency noise reduction in comparison to subjective method.

All the procedures of the work were done using the simulated human ear canal and the required microphone in the eardrum. At the octave frequencies, that is 31.5 and 63.5, 125, 250, 500, 1000, 2000, 4000, and 8000 Hz, and intensities of 85‑90 dB, one stage was done by using the individual’s subjective response relative to the received sound before and after using the ear protector.

The sound levels before and after the protection were significantly different in both the model and humans (P < 0.05). However, at 315 Hz frequency, the rate of attenuation is increased by 4 dB after placing the earplug and 14 dB after placing the earmuff, showing a reduction of 18 dB.

This study verifies the increasing protection by simultaneous application of earplugs and earmuffs. Because of the laboratory evaluation of ear protectors, it is possible not to justify the proficiency of ear protectors in a subjective method.

Type 2 Diabetes Mellitus (T2DM) is the prominent public health issue. Pharmacotherapy and diet modification should be integrated into T2DM management.

To investigate the effects of vegetables consumption before carbohydrates on blood glucose and GLP‑1 levels in T2DM patients.

A non‑randomized quasi experimental study was conducted to recruit T2DM patients who attended at the Gatot Soebroto Central Army Hospital, Jakarta, Indonesia from April to May 2016. The Lemeshow’s formula was used to determine sample size. A total of 12 non‑diabetic and 24 diabetic patients were participated in our study. Glucose levels were measured using a routine hexokinase method while serum GLP‑1 levels were determined using the ELISA. The student t‑test was used to compare two groups with parametric data. The significant difference was at P < 0.05.

Our data showed that T2DM patients who consumed vegetables before carbohydrates, had relatively stable glucose levels at 0, 60 and 120 mins (164.25 ± 86.89 vs 183.5 ± 55.96 vs 167.83 ± 65.53, P = 0.163) and stay lowered within the normal range compared to T2DM patients who consumed vegetables after carbohydrates (165.08 ± 67.89 vs 241.92 ± 68.03 vs 204.92 ± 81.76, P = 0.022). Additionally, GLP‑1 levels remained stable after 60 and 120 min at day 1 (P = 0.816) and day 3 (P = 0.955).

Vegetables consumption before carbohydrate is a promising and simple method of diabetes diet for maintaining blood glucose and GLP‑1 levels and preventing from vascular complication.

Although previous studies have described a positive correlation between physical activity and 25-hydroxyvitamin D levels (25(OH)D), the relationship between participation in school sports and 25(OH)D levels among children has not been well characterized.

The present study analyzed data from participants aged 5 to 15 years in the National Health and Nutrition Examination Survey cycle 2013-2014. General linear models adjusted for potential confounders were assembled to examine 25(OH)D levels according to participation in school sports.

Of 1,670 children in the study sample, 17.9% were defined as having 25(OH)D inadequacy (< 50 nmol/L). Overall, 38% of children reported participation in school sports. In general, 25(OH)D levels were increased among children examined between May 1st and Oct 31st non-Hispanic whites, normal weight, higher income, and daily vitamin D intake ≥ 400 IU/d. After adjusting for potential confounders, 25(OH)D levels were 3.7 nmol/L higher among children who played in any school sports than those who did not. In general, higher 25(OH)D levels were seen among children examined during summer and fall seasons than those during winter and spring seasons, regardless the type of sport activities. Moreover, children who played mixed sports during summer and fall seasons had significantly higher 25(OH)D levels than their physically inactive counterparts.

25(OH)D concentrations were significantly higher in children playing school sports than those who did not. Thus, children’s participation in school sports, particularly during summer and fall seasons should be considered as an effective public health intervention to reach optimal 25(OH)D levels.

Dear Editor, Coronavirus‑19 is a novel virus involving humans and animals in the world.[1] According to chest radiography and chest computerized tomography (CT) scan, the lungs of patients with COVID‑19 are infiltrative prone to lung fibrosis that may result in death.[2] Therefore, prevention and early treatment of lung fibrosis are critical.

There has recently been a high increase in the prevalence of adolescent pregnancies, especially in developing countries, because they are considered vulnerable populations. The objective of this study was to determine the risk factors for low emotional intelligence and for depression in pregnant Peruvian Andean adolescents seen in a public health centre.

The study was a correlational analysis of 280 pregnant Peruvian Andean adolescents using logistic regression analysis. Emotional intelligence and depression were considered dependent variables, while independent variables were age, marital status, and education. The instruments used were Beck’s Depression Inventory and the BarOn Emotional Quotient Inventory: Youth version. The threshold of significance was P < 0.05.

Age, marital status, and level of education were not risk factors for lower emotional intelligence, because they had respective ORs of 0.8 (95% CI: 0.5‑1.4), 1.6 (95% CI: 0.8‑3.4), and 0.7 (95% CI: 0.0‑1.1). Nor were they risk factors for depression, showing ORs of 0.8 (95% CI: 0.4‑1.5), 0.6 (95% CI: 0.2‑1.3), and 0.6 (95% CI: 0.3‑1.1), respectively.

Thus, the risk factors studied do not significantly influence emotional intelligence or depression in pregnant Peruvian Andean adolescents.

The objective of this research is to consider the incidence of brain cancers in Iran during the years 2004–2008 to improve reporting, distribution of the disease.

In this cross‑section study, the study population was all brain cancer cases diagnosed in Iran between 2004 and 2008. Age‑standardized rate (ASR) per 100,000 persons and crude rate were calculated using direct standardization. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 16) and Microsoft Office Excel 2010.

During the period 2004–2008, the ASR and crude rate of brain cancers among males were 2.37, 2.46, 2.77, 2.84, 4.16 and 2.13, 2.11, 2.40, 2.49, 3.61, respectively, and among females the ASR and crude rates were (1.64, 1.67, 2.04, 2.17, 3.09) and (1.45, 1.45, 1.76, 1.84, 2.62), respectively.

According to the study results, a significant increase in the incidence of brain cancer was observed over a 4‑year period in Iran. Hence, screening and early detection programs for this type of cancer are highly recommended.

Congenital anomalies are among the causes of disability and death in infants. This study aimed to determine the incidence of major congenital anomalies (MCA) recorded at birth and also their relationship with some related factors in neonates born.

In this cross‑sectional study, all infants born from March 2016 to March 2017 in the hospitals of Chaharmahal and Bakhtiari Province were evaluated for MCA at birth. Information recorded in the medical file including parent and infant characteristics is extracted from the maternal and newborn electronic files. Data were analyzed using Generalized Linear Model with function of Poisson.

Of the 19666 newborns studied, 63 (3.2 per 1000) had MCAs at birth. Variables such as number of pregnancies, parity, gestational age, neonatal birth weight, height, and head circumference were found to be significantly associated with MCA based on the crude model (P value < 0.05). Using adjusted model 1, the incidence of MCA was found to be significantly related to mother’s place of residency and her parity. Finally, in adjusted model 2, the incidence of MCA was found to be related to gestational age, neonatal birth weight, and head circumference.

In some MCA, early diagnosis and treatment can prevent disability. Consequently, the emphasis on public education to consider appropriate gestational age, proper nutrition before and during pregnancy, and prenatal care is necessary to inhibit MCA.

Breast cancer is the most common cancer in the world, which accounts for 21.4% of all kinds of cancers for women in Iran. However, the treatment of breast cancer is costly and given that the budget devoted to the healthcare sector is limited, the present study aimed to investigate the cost‑effectiveness of breast cancer screening for women, who referred to breast clinic located in Shahid Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz city, Iran in 2017‑2018.

This study is a cross‑sectional study analyzing the cost‑effectiveness of breast cancer screening versus no screening. The study was conducted on 3500 women, who referred to the breast clinic in Motahari clinic, at 2017–2018 in Shiraz, Iran. The patients were identified and direct costs, which were correlated to cancer breast screening, were calculated based on the patients’ records with public tariff per person. Tree age pro 2011 used to analyze cost effectiveness.

Based on the results obtained, the expected cost of screening and no screening were 7556 $ppp and 7840 $ppp, respectively. Given their difference in effectiveness (16%), screening was dominant (less costly and more effective) compared to no screening. Tornado diagram showed that the results had the maximum sensitivity to the increase in screening cost.

In general, according to the results obtained from the current study, the screening was more cost effective compared with no screening