International Journal of Preventive Medicine
Volume:3 Issue: 1, Jan 2012

Childhood obesity is a major public health crisis nationally and internationally. The prevalence of childhood obesity has increased over few years. It is caused by imbalance between calorie intake and calories utilized. One or more factors (genetic, behavioral, and environmental) cause obesity in children. Physical, psychological, and social health problems are caused due to childhood obesity. Hence, effective intervention strategies are being used to prevent and control obesity in children. The purpose of this manuscript is to address various factors infuencing childhood obesity, a variety of interventions and governmental actions addressing obesity and the challenges ahead for managing this epidemic. In order to collect materials for this review a detailed search of CINAHL, MEDLINE, ERIC, Academic Search Premier databases was carried out for the time period 1999‑2011. Some of the interventions used were family based, school based, community based, play based, and hospital based. The effective school‑based interventions were seen targeting physical activity along with healthy diet education. The major challenges faced by these intervention programs are financial, along with stigmatization of obese children. Governments along with other health care organizations are taking effective actions like policy changing and environmentally safe interventions for children to improve physical activity. In conclusion, childhood obesity can be tackled at the population level by education, prevention and sustainable interventions related to healthy nutrition practices and physical activity promotion.

To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation.

Limited studies have demonstrated that the Theory of Planned Behavior (TPB) may be able to help in explaining the variation in physicians’ behavior. We selected the management of asthma as the tracer topic because asthma had nationally known clinical guidelines, and the main medicinal therapies used for asthma had limited applications for the treatment of other diseases, and hence, it was possible to trace the relevant prescribing from routine data. In this study we used the TPB to explain general practitioners (GPs) intentions and prescribing in accordance with asthma clinical guidelines. We surveyed a stratified random sample of 122 GPs in England. The GPs demographic and prescribing data were obtained from routine sources. The participants completed a TPB questionnaire that was developed based on qualitative interviews and had been tested in a pilot study. Regression methods were utilized for data analysis. Forty‑three percent of variance in prescribing intentions was explained by direct TPB measures. Perceived controls were the main predictors of variation in intentions. TPB belief item variables contributed to regression analysis that explained up to 34% of variation in the efficiency prescribing indicators. Effective prescribing indicators were unrelated to TPB variables. Using TPB was helpful in understanding the prescribing intentions of GPs. This could help in promoting the prophylactic usage of inhaler corticosteroids and prevent chronic asthma symptoms and side‑effects. However, further empirical and methodological researches are required.

Colorectal cancer (CRC) is the third most common malignancy in Iran. Limited data are available on knowledge and barriers in regard to CRC and screening tests in Iran. The aim of the study was to characterize knowledge, practice, and barriers toward CRC and its screening tests among an Iranian at‑risk population. This cross‑sectional study was conducted with participation of 200 individuals of both genders aged 50 years or older in a teaching hospital in Tehran, Iran. Data were collected via face‑to‑face interviews. A questionnaire containing demographics; knowledge about CRC and screening tests; screening practice; and reasons for not being screened was administered. The reliability alpha for knowledge items was 0.52. The age of the participants ranged from 50 to 83 years (mean 60.13). Overall, 11% of the respondents reported prior screening by either fecal occult blood test (6.5%) or colonoscopy (4.5%). The majority of individuals had poor knowledge although respondents with prior screening obtained slightly higher score in comparison with nonparticipants in screening (26.74 vs. 23.24; P<0.05). Four commonly cited reasons for not having CRC tests were “doctor did not recommend the test,” “did not think it was needed,” “never think of the test,” and “no symptoms/problems” which were reported by 29%, 26%, 20%, and 17% of the participants, respectively. It is necessary to design appropriate educational interventions to increase the general population’s knowledge about CRC and screening before implementing preventive programs in Iran.

Prevention of suicide is one of the most important issues of community medicine in the world. Because of high accessibility of people to different drugs in our society, one of the easiest ways of suicide is intentional self‑poisoning. In this study, demographic factors and health status of the patients with intentional self‑poisoning were evaluated. A cross‑sectional study was conducted in the poisoning referral center on 384 patients aged 15–40 years who committed intentional self‑poisoning. Information was gathered using two questionnaires about demographic characteristics and the general health status of the patients. 70.5% of the patients had easy accessibility to drugs. Most of the patients were women (62.5%) and single (51%). History of psychological disease was demonstrated in 82.5% of patients. In terms of general health status, the most common problems were social dysfunction (97.57%) and depression (88.9%). Easy accessibility to drugs and psychological problems may increase the risk of intentional self‑poisoning. Being religious and the consequent hopefulness may have a positive protecting effect for the prevention of intentional self‑poisoning.

An article with a clear message can transfer research knowledge better. However, this is the case when the message suits the type of study methodology (research design) and its results. The objective of this study was to assess the presence of message articles and the type of study methodologies. Articles published between 2001 and 2006, on maternal care, diabetes, and tuberculosis, which were based on studies performed on the Iranian population were investigated. A systematic search was performed in foreign databases ‘Pubmed, Medline, and Embase’, and national databases ‘Iranmedex, SID (Scientific Information Database), and Iranpsych’. Seven hundred and ninety‑five articles were examined for the type of study methodology and presence of an actionable message (one that specifies what and how an action should be carried out). Among the 795 articles accessed, cross‑sectional studies were the most frequent (50.9%) and systematic reviews were the least frequent (0.4%). Cohort cases were observed in 6.9% of the cases. Actionable messages were observed in 22.1% of all the cases and 24.7% of the cross‑sectional studies. Cohort studies increased from 5% in 2001 to 6.9% in 2006, but the shortage of systematic reviews represented a major weakness in the country’s knowledge production process. Studies with a higher level of evidence such as systematic reviews, and cohort and interventional studies should be among the priorities of knowledge production in the country.

Different vasoactive factors can modulate cardiovascular adaptation to hemorrhagic shock including Nitric Oxide (NO). In this study we investigated the effect of the NO synthase inhibitor for treatment of decompensated hemorrhagic shock in normotensive and hypertensive rats. Twenty‑four male Wistar rats were divided into two groups: The normotensive and hypertensive groups. Hypertension was induced by the DOCA‑Salt method for eight weeks. Then, the animals were given hemorrhagic shock by continuously withdrawing blood until the mean arterial pressure (MAP) reached to 40 mmHg. The animals were maintained in the shock state for 120 minutes. Subsequently, they were randomly assigned to L‑NAME‑treated and non‑treated groups and monitored for 60 minutes. The survival time was recorded. Blood samples were taken before and after the shock and 60 minutes after L‑NAME administration. Infusion of L‑NAME caused a significant increase in MAP in normotensive animals, however, slightly increased MAP in hypertensive animals. The heart rate did not significantly alter. Hemorrhage caused a marked increase in serum nitrite levels in both groups (P<0.05). L‑NAME treatment significantly reduced the serum nitrite concentration in the normotensive group (P<0.05), without any change in the hypertensive group. All animals who received L‑NAME treatment survived at the end of experiment. Fifty percent of the hypertensive animals died four hours after the experiment. The 72‑hour survival rate was similar in the L‑NAME treated groups. L‑NAME infusion during decompensated hemorrhagic shock plays a protective role in the improvement of hemodynamic responses and short‑term survival rate in normotensive animals.

Iodine deficiency disorder (IDD) creates major public health problems in India, including Gujarat. The Bharuch district is a known iodine deficiency endemic area. This study was conducted to estimatethe prevalence of goiter in primary school children; to determine the median urinary iodine concentration; to assess the level of iodine in salt samples at the household and retail shop levels; and to study the profile of salt sold at retail shops. This study was carried out by using the 30‑cluster survey method in the primary schools of the rural areas in Bharuch district. A total of 70 students, including five boys and five girls from the first to seventh classes, who were present in class on the day of the visit were selected randomly for goiter examination from each village. Urine samples were collected from one boy and one girl from each class in each cluster. From each community, a maximum of two boys and two girls from each standard in the same age group were examined and also salt samples were tested from their households. From each village, one retail shop was visited and the salt purchased from those shops was immediately tested for iodine with spot kits. We found a goiter prevalence of 23.2% (grade 1 – 17.4% and grade 2 – 5.8%). As the age increased, the goiter prevalence decreased except in nine‑year‑olds. The median urinary iodine excretion level was 110 µg/L. An Iodine level > 15 ppm was found in 93% of the salt samples tested at the household level. The present study showed moderate goiter prevalence in primary school children in the Bharuch district of Gujarat and an inadequate iodine content of salt at some household levels.

In Iran, diarrheal disease is the fourth cause of under five‑year mortality. Proper care‑seeking behavior and system‑based disease management in the national field will have a great effect in reducing morbidity and mortality. This nationwide study was performed on a target population of rural and urban communities; in all 31 provinces of the Islamic Republic of Iran. One lakh three thousand three hundred and thirty one (103331) families were sampled by multi‑stage stratifed random sampling and were interviewed with a standard data collection form. The collected data was entered into the Stata 8.0 software and analyzed by the survey analysis method. Of the 14625 (10.1%) children who were reported to have diarrheal diseases two weeks prior to the interview, 8.8% were cured and 1.5% were not. About 70% of them had at least one visit for health seeking the most of patients were seen by a rural health worker (Behvarz) in the rural and by a general pediatrician in the urban areas. About 62% of the patients in urban and 57% in the rural areas had been treated with antibiotics and these rates for ORS were 51% and 65%, respectively. The factors most related to a care‑seeking pattern were the level of routine preventive well‑child care, number of siblings, child age, and living area. According to this national survey, our health system needs to integrate all the levels of prevention, especially the Integrated Management of Child Illnesses (IMCI) programs with a family physician project. Futher more, there is a great need for empowering the referral system and gate keeping in all referral levels, to make efficient national integrated programs.

Through a clinical trial we evaluated statin therapy benefits over stroke outcome. All patients with moderate stroke in Middle Cerebral Artery (MCA) were registered during February 2006 to February 2008, in Al Zahra Hospital, Isfahan, Iran. Among 55 patients who were enrolled in the present study, 25 subjects received 20 mg lovastatin daily, for 90 days after stroke attack (group 1) and 30 patients received no treatment (group 2). Patients were assessed at admission, 7 and 90 days after stroke. National Institutes of Health Stroke Scale (NIHSS) score was recorded in the day 1 and 7 in the hospital with a questionnaire and BARTHEL index was estimated 90 days after stroke incidence by a telephone survey or in an outpatient visit. Data were analyzed by means of χ2, ‘t’ test and Independent ‘t’ test. NIHSS score measured in first day immediately after stroke attack and following 7 days, did not differ significantly in two groups. Moreover, BARTHEL index recorded within 90 days was not also different comparing group 1 and 2. After 90 days, no mortality was recorded in group 2, while one patient expired in group treating with statins (P‑value>0.05). We did not find statins administration to play any role in stroke recovery and consequent long‑term prognosis. More researches with larger samples are needed to establish the possible favorable outcome of statins when administered in cerebrovascular diseases.