International Journal of Preventive Medicine
Volume:3 Issue: 2, Feb 2012

The socioeconomic (SE) status is considered tobe one of the most important health risk factorsnowadays. A simple search showed that onlyin 2011, more than 1100 articles were cited inPubmed about the relationship of health and SEstatus. However, there are many inquiries aboutthis association. The SE status is a complex andmultidimensional issue, and there is no goldstandard method to measure it, [1]More importantly,the impact of SE status on different aspects ofhealth is not clear.[2]The SE status is a broad and multidimensionalterm.[3] The first component of the SE statuscovers the social class of subjects; which means,it considers if the person has an acceptable socialposition. Usually, education is measured as aproxy of a social class of people; unfortunately,the other aspects of the social class of people aremuch more complex to be approached.[1] However,the educational level of people is measured withdifferent scales, from a very simple binary scale(literate / illiterate) up to a numeric scale (year ofeducation).

Evaluating the tuberculosis (TB) status of theEconomic Cooperation Organization (ECO) member countriesrelation to goal 6-c of the third millennium, which includes thatTB incidence, prevalence, and death rates should be halved by2015, compared with their level in 1990. In 2009, we have critically reviewed the countries’Millennium Development Goals (MDGs) reports and extracted thedata from the surveillance system and published and unpublisheddata. The main stakeholders, from both governmental andinternational organizations in the country have been visited andinterviewed by the research team as part of the data validationprocess. The TB incidence is very heterogeneous among ECOcountries, which differ from 21.7 in Iran to 230.7 per 100,000in Tajikistan. TB incidence (per 100,000) is more than 100 in sixcountries and is from 50 to 100 in two countries and is less than 30in two countries. Only in two countries the crude death rate (CDR)is higher than 70%. In seven countries the death rate is higherthan 10 per 100,000. Two countries are among the 20 top worldcountries with the highest tuberculosis burden. There are some signs and signals indicating the badcondition of an ECO member including: incidence of more than50 per 100000, CDR of less than 70%, death rate more than 10 per100,000, and rating two member countries among 20 top countrieswith the highest burden in the world. Iran and Turkey could achieveMDGs by 2015, but if other countries do not prepare urgentintervention programs, they will not be able to fulfill the goals.Keywords: Evaluation, incidence, tuberculosis

This article is a report of psychometric testing ofthe Farsi version of Resources and Support for Chronic IllnessSelf‑management (RSSM) scale. In this cross‑sectional study, a convenience sampleof 160 patients with type 2 diabetes, registered with the CharityFoundation for Special Diseases’ team‑focused diabetes clinic,were recruited (response rate=83.7%; n=134). Participantsolder than 18 years who had active medical files in the systemcompleted the questionnaire. Content validity was establishedusing translation and back‑translation procedures, pilot testing ofthe instrument, and getting views of the expert panel. Constructvalidity was determined using explanatory factor analysis. Internalconsistency was ascertained using Cronbach’s alpha. The stabilitywas confirmed using intra‑class correlation coefficients. Using exploratory factor analysis, a five‑factor modelemerged, which explained 75.24% of the total variance. Internalconsistency reliability was sufficient (α=0.70; range=0.66 – 0.87).The intra‑class correlation coefficient was 0.74 – 0.81 for individualitems. The RSSM‑Farsi seems to be a valid and reliableinstrument to measure outcomes of diabetes self‑managementeducation programs in Farsi. The RSSM‑Farsi version scale couldbe a useful, comprehensive, and culturally sensitive scale forassessing resources and support for self‑management betweentype 2 diabetic patients.

A Public health course has an important role in theundergraduate education of pharmacy and dentistry in termsof emphasizing preventive care. The purpose of this study is toevaluate the views of pharmacy and dentistry students on a publichealth course and preventive health care. 173 students enrolled at Ege University, Facultiesof Pharmacy and Dentistry completed a SWOT (Strengths,Weaknesses, Opportunities, and Threats) analysis and replied to18 Likert type question to determine their perceptions on a publichealth course and preventive health care. The comments of thestudents were reviewed and categorized into key themes. SWOT analysis and the results of quantitative Likerttype questions supported each other. According to the quantitativeresults, there was no significant difference between the scores ofstudents from both schools in terms of their statements about thepublic health course and preventive care. Both groups of studentsmentioned the contribution of the public health course to theirprofessions in the future. They also appreciated the importance ofpreventive care in the health services.

Sleep apnea is associated with increased risk ofdiabetes mellitus. However, no studies have compared sleep apneasymptoms in diabetic patients and their first degree relatives.The purpose of our study was to investigate high risk for sleepapnea syndrome, in diabetics and their first degree relatives forprevention of diabetes in family. As a part of a cohort study, all of diabetic and their firstdegree relatives who came for glucose control in diabetes clinicwere invited to take part in the survey. Two thousand, four hundredand sixty‑two individuals (82% of invited) agreed to fill out theBerlin and Epworth sleep questionnaire. Participants consisted of2462 subjects of 15–70 years of age, both males and females withdiabetes and family history of type 2 diabetes mellitus. A total of1234 participants had diabetes and 11,231 were relatives of diabeticpatients. High risk for sleep apnea regarding Berlin questionnaire andEpworth sleepiness scale, diabetic and relative were analyzed. Prevalences of high risk for sleep apnea were higheramong diabetics than relatives (P‑value<0.001). In a multipleregression analysis, ‘‘age, body mass index, education, high bloodpressure’’ were risk factor for sleep apnea symptoms while isolatedblood glucose level was not by Berlin questionnaire. By Epworthsleep scale only education level was a risk factor for sleep apneasymptoms while isolated blood glucose level was not risk factor. Sleep apnea symptoms may not have significantdifference between diabetics and their relatives. We need morestudy on sleep apnea in the family of diabetic patients. We hopethat more studies on mentioned field may help prevention ofdiabetes in their family.

Thus study aimed to test the hypothesis that positiveemotion can quell or undo the lingering worry and ruminationfollowing induced negative emotion. 32 female students in grade 1 of high school wererandomly recruited and assigned in two experimental and controlgroups. They completed questionnaires in a pretest that are listedherewith: (1) Rumination questionnaire; (2) Two scales of the bigfive factorial questionnaire (extraversion – introversion; (3) MMPI2;(4) Penn-state worry questionnaire. Then for the first group a sadmovie, for the second group a cheerful movie, and for the thirdgroup a neutral movie was played, and the fourth group remainedwithout intervention. Next day, all the group members completedthe worry and rumination questionnaire again. Research findingswere analyzed using covariance analysis and multivariate analysisof variance (MANOVA). Those participants whose attention was turned towardthe cheerful movie recovered from negative emotions (ruminationand worry) more than those who saw either a neutral or sad movieor remained without intervention. Positive emotion is effective on negative emotionlike worry and rumination. This effect is called the undoing effectof positive emotions.

Most patients with superficial bladder cancer whoundergo transurethral resection of bladder tumor show recurrenceof the disease. So far, there have been numerous studies on waysto decrease bladder cancer recurrence, including the intake ofvitamins and antioxidants. The goal of this study was to investigatethe effect of vitamin E on the recurrence of non‑invasive bladdercancer. In this randomized controlled trial, 46 patients witha single, low‑grade, superficial bladder cancer, less than 3 cm indiameter, were randomly divided into two groups of vitamin Eintake (400 IU daily) and no intake of vitamin E. Ultrasound andurinalysis were performed every three months to detect bladdercancer recurrence. There was no significant difference between the groupsin age, tumor size, mean time to recurrence, and follow‑up time.There recurrence rate was 28.3% throughout the follow‑up period(19% in the study group and 36% in the controls) (CI=0.19 – 0.92,RR=0.53, CI=0.11 – 0.94, OR=0.42, P=0.04). In both groups,most (69.2%) of the recurrences occurred during the first year.The rate of recurrence decreased in smokers from 50% in thestudy group to 25% in the control group (P=0.06) and from 26.7%to 15.4% in the non‑smokers in the control and study groups,respectively (P=0.15). Intake of vitamin E significantly decreased bladdercancer recurrence, especially among smokers, possibly due tohigher levels of oxidants, which vitamin E may target in smokers.

Maternal mortality (MM) is an avoidable death andthere is national, international and political commitment to reduceit. The objective of this study is to examine the relation of MM tosocioeconomic factors and its inequality in Iran’s provinces at anecologic level. The overall MM from each province was considered for3 years from 2004 to 2006. The five independent variables whoserelations were studied included the literacy rate among men andwomen in each province, mean annual household income per capita,Gini coefficients in each province, and Human Development Index(HDI). The correlation of Maternal Mortality Ratio (MMR) to theabove five variables was evaluated through Pearson’s correlationcoefficient (simple and weighted for each province’s population) andlinear regression – by considering MMR as the dependent variableand the Gini coefficient, HDI, and difference in literacy rate amongmen and women as the independent variables. The mean MMR in the years 2004–2006 was 24.7 in100,000 live births. The correlation coefficients between MMRand literacy rate among women, literacy rate among men, themean annual household income per capita, Gini coefficient andHDI were 0.82, 0.90, −0.61, 0.52 and −0.77, respectively. Basedon multivariate regression, MMR was significantly associated withHDI (standardized B=−0.93) and difference in literacy rate amongmen and women (standardized B=−0.47). However, MMR was notsignificantly associated with the Gini coefficient. This study shows the association betweensocioeconomic variables and their inequalities with MMR in Iran’sprovinces at an ecologic level. In addition to the other directinterventions performed to reduce MM, it seems essential toespecially focus on more distal factors influencing MMR.

This study aimed to investigate the impact ofinternet addiction on some psychiatric symptoms among universitystudents. This cross-sectional study was conducted among 250students selected via quota sampling from universities in Isfahan,Iran. Participants completed demographic questionnaire, YoungDiagnostic Questionnaire, Internet Addiction Test and SymptomChecklist‑90‑Revision (SCL‑90‑R). Finally, the means of psychiatricsymptoms of internet addicted and non‑addicted subjects werecompared. Also, t‑test and multivariate analysis of covariance wereused through SPSS16 software for data analysis. The mean±standard deviation (SD) of psychiatric symptomssuch as somatization, obsessive–compulsive disorder, interpersonalsensitivity, depression, anxiety, aggression (hostility), phobic anxiety,paranoid ideation and psychoticism in the addicted group were11.27 ± 6.66, 14.05 ± 7.91, 10.5 ± 6.20, 15.61 ± 8.88, 10.77 ± 5.52,6.77 ± 4.88, 6.05 ± 4.47, 7.61 ± 4.28, and 9.66 ± 6.87, respectively, andin the non‑addicted group were 6.99 ± 6.42, 7.49 ± 5.23, 5.46 ± 4.95,9.27 ± 7.92, 6.35 ± 6.69, 3.57 ± 3.35, 2.41 ± 2.79, 5.47 ± 4.1, and5.29 ± 4.95, respectively. There were significant differences betweenthe means of psychiatric symptoms in all SCL‑90‑R subscales andGlobal Severity Index, Positive Symptom Distress Index, PositiveSymptom Total in the addicted and non‑addicted individuals (P<0.05).Also, internet addiction (with controlling sex variable) seemed to affectpsychiatric symptoms. Psychiatrists and psychologists involved in the fieldof mental health need to be well informed about mental problemsdue to internet addiction, such as anxiety, depression, aggression,and job and educational dissatisfaction.

Considering the role of maternal thyroid stimulatinghormone (TSH) receptor blocking antibody (TRAb) in the etiology ofcongenital hypothyroidism (CH), this study aimed to determine TRAbamong patients with CH in Isfahan, Iran. In this case–control study, patients with CH and their motherswere compared with a group of healthy neonates and their mothers.Venous blood samples were obtained for measurement of TRAb usingenzyme-linked immunosorbent assay (ELISA) method among mothersand their neonates. TSH of mothers was also determined. The case group consisted of 65 patients with CH and theirmothers; controls were 148 healthy neonates and their mothers. Theprevalence of positive TRAb in patients with CH and their motherswas higher than in the control group (81.5% vs. 1.3% in mothers and80% vs. 0% in neonates, respectively, P<0.05). The relationship betweenthe TRAb and occurrence of CH was significant (P<0.05), whereas thecorresponding figure was not significant for TRAb and the level ofmaternal and neonatal TSH in case and control groups (P>0.05). It seems that autoimmunity has an important role inthe etiology of CH. Further studies are necessary to determine otherautoantibodies in CH patients.

White matter lesions (WMLs) are commonly observed in strokepatients with small vessel disease (SVD) and are thought toresult from a progressive, irreversible disease process followingarteriolosclerosis. In this study, we report a case of partialdisappearance of WMLs 1 year after a lacunar stroke in a69-year-old man with evidence of SVD. We also discuss possiblemechanisms associated with this observation.Keywords: Brain white matter hyperintensities, leukoaraiosis,stroke

Recently, I have read with interest the article byMosayebi et al.[1] entitled “The Effects of CardiacTertiary Prevention Program after CoronaryArtery Bypass Graft Surgery on Health andQuality of Life” in your esteemed journal. Thecardiac rehabilitation (CR) program significantlyimproves the functional capacity in postmyocardialinfarction patients, especially those revascularizedby coronary artery bypass graft surgery (CABG)or percutaneous coronary intervention (PCI).[2]I would like to attract the authors’ and readers’attention to some points that can be helpful inhaving high quality research.

In 2004, Klastersky et al. reported that fever isa common finding in patients with hematologicmalignancies, occurring in more than 80% of thepatients during or after chemotherapy.[1] He andhis colleagues also reported that the most fearedinfection in neutropenic patients is bloodstreaminfection (BSI), which significantly increases themortality rate of these patients.[2] In 2009, Viscoliet al.[3] and 10 years later Bodey[4] came into thesame conclusion that the identification of the BSIby clinical means is complicated due to the factthat in neutropenic patients, the common signs ofinfection are usually absent and the only clinicalsign of BSI is fever.