Iranian Journal of Public Health
Volume:40 Issue: 2, Summer 2011

To investigate the prevalence of metabolic syndrome (MetS) in young Chinese population and assess the as­sociation between HOMA-IR and different components of MetS in young Chinese men. Overall 5576 young Chinese subjects (age range [19-44 yr], 3636 men) were enrolled in, who visited our Health Care Center for a related health checkup from March to December 2008. The international diabetes federation (IDF) definition for MetS was used. The SPSS statistical package, version 11.5 was used for the statistical analysis. The prevalence of MetS was 21.81% in young men and 5.62% in young women. According to suffering from dif­ferent numbers of MetS components, the male subjects were divided into four groups. Numbers of MetS components were more and HOMA-IR values were significantly higher. In this male population, the quartile of HOMA-IR was higher, values of triglyceride (TG), fasting plasma glucose (FBG), systolic blood pressure(SBP), diastolic blood pres­sure(DBP) and waist circumference (WC) were all significantly higher, as well as high density lipoprotein cholesterol (HDL-C) value was significantly lower (P= 0.000). In Spearman's correlation analysis, HOMA-IR was positively corre­lated with TG, FBG, SBP, DBP and WC, and negatively correlated with HDL-C (r= 0.460, 0.464, 0.362, 0.346, 0.586, -0.357, respectively, all P value= 0.000). The prevalence of MetS in these young Chinese men was obviously high. Insulin resistance played an impor­tant role in occurrence and development of MetS. Waist circumference was the best correlation with HOMA-IR among all components of MetS.

Molecular components of the dopamine receptor (DRD3) play an important role in the pathophysiology of schizophrenia (SCZ). Previous studies have demonstrated an association between the DRD3 Ser9Gly polymorphism and SCZ but the results have been inconclusive. In this study, we investigated this controversial association between the Ser9Gly (A/G) polymorphism and SCZ using Malay cases-control (261 cases/157 controls) samples. PCR-RFLP was performed to genotype the distribu­tion of the DRD3 Ser9Gly polymorphism. Both healthy control and SCHZ patient groups were in of Hardy-Weinberg equilibrium for the analyzed ge­netic variability. There was a significant association between the genotype distribution DRD3 polymorphisms and SCZ (χ2= 9.359; df= 2; P= 0.009). We believe that further studies are required to examine the association between others dopamine-related genes and the behavioral phenotypes of SCZ.

The study was conducted to evaluate the knowledge, attitudes and practices of breast-feeding in the West re­gion of Cameroon. A cross sectional descriptive study was conducted in two health facilities on 195 mother-infant pairs, seen at the out patient and vaccination units of the Bafoussam Regional Hospital over a period of one month from 1st to 30th Septem­ber 2008. The socio-demographic characteristics of mothers, knowledge on breastfeeding and the practice of breastfeed­ing were studied. Data was analyzed using the SPSS software. The chi square and student t- test were used for com­parison and results considered significant for P< 0.05. Breastfeeding was practised by 99.48% of the mothers. Only 33.8% of the mothers knew that they had to exclu­sively breastfeed up to 6 months, and 20% effectively breastfed up to 6 months. The mean duration of breastfeeding was 5.06 months and negatively correlated with the number of children and the profession of the mother. In 69.74% of the women, nothing was given to the baby before the first breastfeed. Discontinuation of breastfeeding was done averagely around 15.24 months and earlier in married women and in those with a higher educational level. Although the majority of parents practised breast feeding, only a minority understood its benefits, so more should be done to educate the community on the benefits of exclusive breast-feeding for up to six months.

Osteoporosis is a major public health concern around the world. It has been shown that bone mineral den­sity is correlated to anthropometric measures like height and weight, but this association may vary depending on ethnic and environmental factors. The aim of this study was to identify probable relations between anthropometric measures and bone mineral density. In this population-based study, we compiled the data collected from Iranian Multicenter Osteoporosis Study to assess the possible associations between different anthropometric indices and bone mineral density at femur and lumbar spine. The gathered data was analyzed using t-test and one way ANOVA. Data was available for 4445 subjects, consisting 1900 males (42.7%) and 2545 females (57.3%). We observed statistically significant correlations between bone mineral density and height, weight, waist circumference, hip circumfer­ence, waist to hip ratio and body mass index (BMI). Based on the result of linear regression modeling studies, BMI could be considered an independent predictor of bone mineral density. Iranian population shows similar measures compared to analogous studies in other populations. Lower weight should be carefully considered as a predisposing factor for bone loss and osteoporosis.

The purpose of the present study was to evaluate the inequality of geographical distribution of non-cardiac intensive care beds in Iran using the Gini coefficient. The population information of Iran's provinces in 2006 was obtained from The Statistical Center of Iran and the number of non-cardiac intensive care beds (including ICU, PostICU and NICU beds) in all provinces was taken from published information of Ministry of Health and Medical Education of Iran in the current year. The number of beds per 100,000 populations of each province and the Gini coefficients for each bed were calculated. Iran's population was 70,495,782. The total number of ICU, PostICU and NICU beds were 3720, 291 and 1129, respectively. Tehran had the highest percentage of each bed among all provinces. The number of each bed was 5.3, 0.4 and 1.6 per 100,000 populations of country, respectively. The calculated Gini coefficients for each bed were 0.17, 0.15 and 0.23, respectively. The findings of this study showed that, according to the Gini coefficients, non-cardiac intensive care beds have an almost equal geographical distribution throughout the country. However, the numbers of beds per population are less than other countries. Since such studies can be used as a base for health systems planning about correction of ine­quality of health services distribution, similar studies in other health care services are recommended which can be con­ducted at the national or provincial level.

Hearing loss (HL) is the most frequent sensory birth defect in humans. Autosomal recessive non-syn­dromic HL (ARNSHL) is the most common type of hereditary HL. It is extremely heterogeneous and over 70 loci (known as DFNB) have been identified. This study was launched to determine the relative contribution of more frequent loci in a cohort of ARNSHL families. Thirty-seven Iranian families including 36 ARNSHL families and 1 family with Pendred syndrome each with ≥ 4 affected individuals, from seven provinces of Iran, were ascertained. DFNB1 contribution was initially studied by DNA sequencing of GJB2 and linkage analysis using the relative STR markers. The excluded families were then sub­jected to homozygosity mapping for fifteen ARNSHL loci. Sixteen families were found to be linked to seven different known loci, including DFNB1 (6 families), DFNB4 (3 families +1 family with Pendred syndrome), DFNB63 (2 families), DFNB2 (1 family), DFNB7/11 (1 family), DFNB9 (1 family) and DFNB21 (1 family). DNA sequencing of the corresponding genes is in progress to identify the pathogenic mu­tations. The genetic causes were clarified in 43.2% of the studied families, giving an overview of the causes of ARNSHL in Iran. DFNB4 is ranked second after DFNB1 in the studied cohort. More genetic and epigenetic investiga­tions will have to be done to reveal the causes in the remaining families.

The recent devastating earthquake of December 26 in Bam, 2003 created various risk factors; caused a sharp increase in incidence of anthroponotic cutaneous leishmaniasis (ACL) cases and reached to an epidemic proportion. The objective of this study was to evaluate the status of ACL cases five years before the earthquake compared to the cases occurred five years after the earthquake (1999-2008). Status of disease was assessed retrospectively for the five years before the earthquake and prospectively for the five years after the earthquake. Identification was confirmed by smear and polymerase chain reaction (PCR). The mean annual incidence of ACL for the period from 1999 to 2003 was 1.9 per 1000 comparing to post earthquake period, which was 7.6 per 1000. Most of the infection was in individuals of <20 years, more frequently in females before the earthquake, whilst in contrast, there was a progressive rise in the number of cases, significantly in male individuals of >20 years (P< 0.0001) in post earthquake era. The anatomical distribution of lesions considerably changed during the two periods. Most of the cases were limited to three zones within the city prior to the earthquake, whereas it was spread throughout different zones after the earthquake. PCR indicated that the CL was due to Leishmania tropica in the city. The results strongly suggest that in natural disasters such as earthquakes various precipitating factors in favor of disease will be created, which in turn provide a suitable condition for propagation of the vector and the transmis­sion of the parasite

BRCA1 and BRCA2 genes have been recognized to be responsible for 20-30% of hereditary breast can­cers and approximately 50% of familial breast and ovarian cancers. Therefore, the demand for BRCA1 and BRCA2 muta­tion screening is rapidly increasing as their identification will affect medical management of people at increased risk. Because of high costs involved in analysis of BRCA1 and 2 genes, contribution of different mutation types in BRCA1 and 2 and not knowing who should be tested has hampered wide spread use of molecular testing of high -risk fami­lies. There is a need to identify the genes and types of mutations involved in breast or ovarian cancers at different age of onsets and polymorphism and polymorphic variations in our population. Twenty-seven patients with either early onset breast cancer (at age≤ 35 years) or a personal and/or family his­tory of breast or ovarian cancer and 50 control subjects participated in this study. After collecting blood samples and extract­ing DNA, BRCA1 and BRCA2 genes were fully sequenced. Thirteen missense substitutions in BRCA1 and BRCA2 (9 and 4, respectively) were revealed. Two nucleotide substitu­tions were novel (Gly1140Ser in BRCA1 and Glu1391Gly in BRCA2). The Glu1038Pro and Gly1140Ser were found in large series of breast and ovarian cancer and matched controls. Some nucleotide substitutions were seen only in single families and other in several. In other cases, muta­tions were seen in both BRCA1 and BRCA2 genes. Clinical significance of these mutations was evaluated comparing with normal controls.

To determine the prevalence of malnutrition and depression in free-living elderly people and their relationships (If any) in Razavi Khorasan, Iran 2007. To evaluate nutritional status, we used Mini Nutritional Assessment (MNA) method in free-living elderly people (n=1565 using cluster sampling, 720 males and 845 females, aged≥ 60 yr) and their relationship to Socio Economic Conditions (SECs). Based on the final scores, our patients were classified into three groups: score 17-23.5 (at risk for malnutrition), score less than 17 (with malnutrition), and score 24-30 (well nourished). To determine the mood status (here depression), we used Geriatric Depression Score (GDS). According to this score our participants turned out to be in two distinct groups: depressed (score ≥8) and non-depressed (score< 8). From the total subjects entered the study (1495), 22.07% were depressed and 11.5% and 44% were malnour­ished or at risk of malnutrition respectively. In depressed group, the prevalence of malnutrition was 14.5% (48 out of 330) and the prevalence of "at risk of malnutrition" was 45.8%, whereas the prevalence of malnutrition and at risk of malnutrition in non-depressed population were 10.6% and 43.3% respectively. From the aforemen-tioned information we have concluded that there is a significant statistical difference between the prevalence of malnutrition in depressed and non-depressed individuals (P= 0.047). With respect to the high rate of vegetative symptoms in elderly depressed individuals, malnutrition would have a higher prevalence in the depressed people.

Nitrous oxide (N2O) is the oldest anesthetic in routine clinical use and its occupational exposure is under regulation by many countries. As studies are lacking to demonstrate the status of nitrous oxide levels in operating and recovery rooms of Iranian hospitals, we aimed to study its level in teaching hospitals of Tehran University of Medical Sciences. During a 6-month period, we have measured the shift-long time weighted average concentration of N2O in 43 op­erating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences. The results show that the level of nitrous oxide in all hospitals is higher than the limits set by different countries and anesthetists are at higher risk of exposure. In addition, it was shown that installation of air ventilation could reduce not only the overall exposure level, but also the level of exposure of anesthetists in comparison with other personnel. The high nitrous oxide level in Iranian hospitals necessitates improvement of waste gas evacuation systems and regular monitoring to bring the concentration of this gas into the safe level.

The aim of this study was to predict the survival rate of Iranian gastric cancer patients using the Cox proportional hazard and artificial neural network models as well as comparing the ability of these approaches in predicting the survival of these patients. In this historical cohort study, the data gathered from 436 registered gastric cancer patients who have had surgery between 2002 and 2007 at the Taleghani Hospital (a referral center for gastrointestinal cancers), Tehran, Iran, to predict the survival time using Cox proportional hazard and artificial neural network techniques. The estimated one-year, two-year, three-year, four-year and five-year survival rates of the patients were 77.9%, 53.1%, 40.8%, 32.0%, and 17.4%, respectively. The Cox regression analysis revealed that the age at diag-nosis, high-risk behaviors, extent of wall penetration, distant metastasis and tumor stage were significantly associated with the survival rate of the patients. The true prediction of neural network was 83.1%, and for Cox regression model, 75.0%. The present study shows that neural network model is a more powerful statistical tool in predicting the survival rate of the gastric cancer patients compared to Cox proportional hazard regression model. Therefore, this model recommended for the predicting the survival rate of these patients.

Women suffer more from obesity than men in Iran do. In this study, we compared obesity risk and its con­tributors regarding the job categories as housewives (HWs) or employees to deeply explore the risk of obesity in house­wives in Iran. Based on WHO stepwise approach, in 2005, 33472 women aged 15 to 65 years old (excluding all men) were ex­amined for the major risk factors for non-communicable diseases. Obesity was determined by Body Mass Index>30kgm-2 in adults (>20 years) and by girl BMI percentiles according to WHO 2007 Growth Reference 5-19 years in adolescents. We modeled obesity by logistic regression and entered all the known/potential predictors, including job categories. The participation rate was more than 99%. The weighted prevalence of overweight and obesity in HWs were 34.5% and 24.5% respectively. Employed women were about 4% and 10% less overweight and obese than the HWs, respec­tively (P< 0.01). HWs vs. employed women had the adjusted OR 1.39 (CI95%, 1.18-1.63) for obesity. Older women, with higher educational level and socioeconomic status, lower physical activities and those living in urban areas were at risk of obesity. In comparison to HWs, working as an Official Clerk (OR=0.66) associated with a decrease in odds of obe­sity significantly, while others did not. Being as HW is an independent significant factor for obesity in women. Preventive health care programs to re­duce risk of obesity in women should be applied, considering their occupation for achieving more effectiveness.

To determine relationships between healths related quality of life and body mass index in children aged 9-11 years old. This cross sectional study was conducted on 240 children 9-11 year olds who were selected via multi stage cluster sampling design from primary schools in the Shahre Qods of the Tehran, Iran in 2007. Pediatric Quality of Life inventory was completed by child self report with measured height and weight used to determine body mass index percentile/weight classification. Obesity was defined as body mass index (BMI) ≥95th percentile for age and gender and one way analyses of variance (ANOVA) was used for data analyses. Physical, social and school functioning was significantly lowered for obese when compared to normal weight children (P<.05). The impairment in QOL in the community-based sample of elementary school children was less marked than clinical sample of obese. Obese children maintain emotional health. These results highlight the importance in considering dimensions of quality of life at further understanding obesity in children.

Many studies have investigated the possible role of reactive oxygen species in the etiology and patho­gene­sis of Rheumatoid Arthritis (RA). The aim of this study was to investigate the activities of some antioxidants in RA patients. In this case-control study, 59 RA patients and 60 healthy sex and age-matched controls were selected. Vitamin E and Beta-carotene were determined using HPLC. Erythrocytes glutathione reductase (GR) activity was meas­ured spec­trophotometrically, and malondialdehyde (MDA) was determined by colorimetric method. Aryles­terase activity (AEA) was measured by Phenylacetate. The clinical data were determined by a rheumatologist, medical history and filling the questionnaire by interview. Statistical analyses were carried out using the SPSS software. In patients with RA, serum MDA level was significantly higher and plasma concentration of vitamin E, Beta-carotene and GR activity, were significantly lower than healthy control (P<0.001). AEA activity differences between two groups were non-significant. Oxidative stress may play an important role in the inflammation and pathogenesis of RA

Annually millions of Muslims depart to Saudi Arabia for performing a religious pilgrimage called "Hajj". In this ceremony, pilgrims face numerous health hazards and injuries such as pressing in overcrowding, sliding, burning, fal­ling down, traffic accidents etc. The main purpose of this study was to determine the prevalence of injuries in Hajj period across 2004 to 2008. This study was conducted on 253808 Iranian pilgrims on five consecutive years of Hajj ceremonies, from 2004 to 2008. We used a report sheet with 13 types of injuries and 13 mechanisms of these injuries. SPSS V13.5 soft ware was used for analyzing the data. ANOVA and independent sample t- test was conducted, and relationships were considered signifi­cant at P< 0.05. The most common injuries was "tissue contusions and ruptures "(about 76/10000), and "tendon lesions" (about 62/10000). In addition, the most common mechanism of injuries was "ankle sprain" (69/10000) during the five consecu­tive years. The prevalence of all fractures was about 49/10000 and the proportion of burning with hot water or fire was about 40/10000. Changes of all causes of the injuries were significant in this study (P< 0.05). We have suggested some directions for preventing of injuries and related Injuries in Hajj, in this study.