International Journal of Preventive Medicine
Volume:1 Issue: 4, Fall 2010

Children are more sensitive to radiation than adults. Computerized tomography (CT) consists of 25 % of all medical imaging. It was estimated that more than 2% of all carcinomas in the USA are due to CT scans. There is an ongoing focus on the reduction of CT scan radiation dose. Awareness about risk-benefits of CT has increased. Reduction of radiological exam is an important issue because the accumulation effects of radiation can be hazardous. In addition, proper protocol should be followed for diagnostic procedures of ionization radiation and computerized tomography. Effective radiation dose should range from 0.8 to 10.5 millisievert. The same protocol should be followed in different hospitals as well. Basic principles of radiation protection should be monitored. As much as possible, both technician and radiologist must be present during computerized tomography for children, and MRI and ultrasound should be replaced if possible.

In this study, we investigated the determinants of poor adherence with anti-tuberculosis therapy among pulmonary tuberculosis (TB) patients in Mumbai, India, receiving Directly Observed Treatment Short Course (DOTS) therapy. A cross-sectional study on 538 patients receiving DOTS I and II regimen was conducted. Patients were interviewed and clinical and laboratory data were collected. Eighty seven patients were considered non-adherent. Multivariable logistic regression was used to determine risk factors associated with non-adherence. Factors associated with non-adherence were found to be different among the newly-diagnosed patients and all the other residual groups. Smoking during treatment and travel-related cost factors were significantly associated with non-adherence in the newly-diagnosed patients, while alcohol consumption and shortage of drugs were significant in the residual groups. An approach, targeting easier access to drugs, an ensured drug supply, effective solutions for travel-related concerns and modification of smoking and alcohol related behaviors are essential for treatment adherence

The purpose of this study was to design a valid questionnaire suitable to the Iranian culture to measure the stress mounted on dementia caregivers. In order to design a valid and reliable tool, the stages of content validation were performed as follows: 1- Development: search of relevant electronic databanks and use of experts and caregivers’ opinions to prepare appropriate content, review and correction of the content through consecutive focus group discussions with experts. 2- Judgment Quantification: determination of inter-rater agreement (IRA), relevancy and clarity of each of the items and the tool as a whole. Reliability was measured with Cronbach’s alpha, and repeatability was measured with intra-cluster correlation through repeated test-piloting at 2-3 week intervals. Using a conservative approach, the IRA for the overall relevancy and clarity of the tool was 87.87% and 81.81%, respectively. Through overall agreement (the items that were recognized as appropriate by 100% of the specialists were divided by the total number of items) the overall relevancy of the tool obtained was 98.62%. The overall clarity of the tool was calculated through the mean clarity of the questions and was 99.3%, and eventually its comprehensiveness was 100%. The overall Cronbach’s alpha was 94% and the intra-cluster correlation that was obtained through comparing the overall score of the questionnaire in the pre-test and test phase was 97%. The new tool has good reliability and validity suitable to Iranian dementia patients and their caregivers’ culture. Researchers can use this tool to monitor the pressure mounted on dementia caregivers and to assess interventions in this group.

The aim of this study was to investigate the relation between C-reactive protein (CRP) with physical fitness, physical activity, obesity, and selected cardiovascular risk factors in schoolchildren. Forty-four boy schoolchildren (mean ± SD: age 10.25 ± 0.75 years, height 144 ± 0.2 cm, body weight 46.1 5± 4.59 kg, body mass index 22.16 ± 2.16 kg/m2) voluntarily participated in this study. Physical fitness and physical activity were assessed using the 20-meter fitness test. Adiposity was estimated using body mass index. Blood samples were taken after an overnight fast and measured for CRP, LDL, HDL and cholesterol. Pearson’s correlation was calculated to determine the relations between these factors. Mean (SD) CRP concentration was 1.07 (0.82) mg/l. A significant correlation was observed between CRP and VO2max (r=-0.45, P= 0.001), body mass index (r=0.55, P=0.000) and cholesterol (r=-0.35, P=0.04). No significant relation was found between CRP and physical activity, LDL and HDL (P> 0.05). Moreover, significant associations were observed between body mass index and VO2max (r=-0.33, P=0.02) and physical activity (r=-0.43, P=0.04). Body mass index was the most powerful predictor of serum concentrations of CRP in schoolchildren. It may be an important factor to control body weight to prevent an increase in serum CRP in children and to help the primordial prevention of chronic diseases.

The purpose of this study was to determine the effects of cardiac rehabilitation program (CRP) on exercise capacity and rate pressure product (RPP) in Iranian female patients undergoing coronary artery bypass grafting (CABG) in Hamadan, Iran. Sixty women after CABG were assigned into an exercise group (n = 30, mean age 58.5 ± 10.8 years), who performed physical training for 12 weeks, or a control group (n = 30, mean age 59.3 ± 8.6 years) who received usual care. Functional capacity and RPP were evaluated by six minute walking test (6MWT) and exercise test. In comparison to before training, significant increases of estimated exercise capacity (10.72 ± 1.30 vs. 7.72 ± 1.6 METs, respectively) as well as 6MWT (556 ± 66.1 vs. 375.2 ± 28.1 meters, respectively) were observed in exercise group after 12 weeks training (P<0.001). Women increased their exercise duration time (464.6 ± 107.3 vs. 311.2 ± 101.7 seconds, respectively) by 49.2% and RPP (22361 ± 3206 vs. 20270 ± 2704.1, respectively) by 10.3% after training (P<0.001). However, no significant differences were found before and after CRP in the control group. Women referred for rehabilitation have similar levels of compliance and improvement in exercise capacity and supply of oxygen to cardiac muscles (measured by peak myocardial oxygen consumption). After CRP, women demonstrated significant improvements in exercise duration time, 6MWT, RPP and supply of oxygen to cardiac muscles. CRP can play an important role in improving functional independence in women.

An estimated 150-200 million people worldwide are infected with hepatitis C. Only limited information about the epidemiology of Hepatitis C virus (HCV) infection is available. The aim of this study was to determine the prevalence of anti-HCV antibodies and the possible factors for transmission in the female population of a largely urban city, Islamabad, Pakistan. A cross-sectional study was conducted from May to August 2006 in Islamabad. The city is divided into forty union councils. Five union councils were selected randomly and then, we randomly selected 252 female households (n = 252) of age ranges between 15-50 years who were able to read and write the self-administered questionnaires. Those with severe debilitating disease, physical or mental handicapped or those who did not give consent and known cases of HCV were excluded. The primary outcome variables were HCV seropositivity and factors as history of major surgical procedure, blood transfusion and intravenous drug use. The mean age of participants was 33.21 (9.95) years and HCV seropositivity prevalence was 62 (24.6%). Final forward stepwise multiple logistic regression showed blood transfusion [OR, 10.09; 95% CI: 1.95-52.25], dental procedure [OR, 5.38; 95% CI: 2.31-12.50] and dilation and curettage [OR, 3.86; 95% CI: 1.86-8.01] were significantly associated with HCV seropositivity. The study highlights the poor quality of care provided and a massive need to educate general population including patients as well as health professionals and allied health workers for controlling, combating and preventing the wild epidemic of HCV

Left ventricular (LV) dysfunction heart failure is one of the causes of morbidity and mortality following ST elevation myocardial infarction (STEMI). This study was done to determine the clopidogrel effect in preventing reduced LV function in patients with STEMI. In this study, 144 patients with STEMI admitted to the Isfahan University of Medical Sciences hospitals were followed in two groups for one month. The case group received Clopidogrel, 300 mg, on admission and then, 75 mg daily, while the control group received routine therapy for STEMI without Clopidogrel. Left ventricular ejection fraction (LVEF) on the 4th day and one month after STEMI was measured by echocardiography. The results of LVEF were compared within and between groups. The mean LVEF in the case group on the 4th day and one month after STEMI were 45.92 and 52.15%, respectively (P<0.001). The mean LVEF in the control group on 4th day and one month after STEMI were 44.72 and 42.71%, respectively. We suggest that Clopidogrel is effective in prevention of LVEF reduction in patients with STEMI.