فهرست مطالب

International Journal of Preventive Medicine
Volume:3 Issue: 12, Dec 2012

  • تاریخ انتشار: 1391/10/10
  • تعداد عناوین: 15
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  • Zoya Tahergorabi, Majid Khazaei Pages 827-838
    Type 2 diabetes mellitus is a complex disease and a chronic health‑care problem. Nowadays, because of alteration of lifestyle such as lack of exercise, intake of high fat diet subsequently obesity and aging population, the prevalence of diabetes mellitus is increasing quickly in around the world. The international diabetes federation estimated in 2008, that 246 million adults in worldwide suffered from diabetes mellitus and the prevalence of disease is expected to reach to 380 million by 2025. Although, mainly in management of diabetes focused on hyperglycemia, however, it is documented that abnormalities of angiogenesis may contribute in the pathogenesis of diabetes complications. Angiogenesis is the generation of new blood vessels from pre‑existing ones. Normal angiogenesis depends on the intricate balance between angiogenic factors (such as VEGF, FGF2, TGF‑β, angiopoietins) and angiostatic factors (angiostatin, endostatin, thrombospondins). Vascular abnormalities in different tissues including retina and kidney can play a role in pathogenesis of micro‑vascular complications of diabetes; also vascular impairment contributes in macrovascular complications e.g., diabetic neuropathy and impaired formation of coronary collaterals. Therefore, identifying of different mechanisms of the diabetic complications can give us an opportunity to prevent and/or treat the following complications and improves quality of life for patients and society. In this review, we studied the mechanisms of angiogenesis in micro‑vascular and macro‑vascular complications of diabetes mellitus.
    Keywords: Angiogenesis, diabetes mellitus, diabetic complications, macro‑vascular, micro‑vascular
  • Mehrdad Askarian, Najmeh Maharlouie Pages 839-845
    Objective
    The main aim of this study was to assess knowledge, attitude, and practice of university faculty members and high school teachers regarding irrational antibiotic use and self‑medication.
    Methods
    In this cross‑sectional survey, 320 university teaching staff and 150 high school teachers received a questionnaire that assessed their knowledge, attitude, and practice regarding the use of antibiotics and self‑medication. The reliability of the questionnaire was assessed with Cronbach’s alpha internal consistency coefficient and the results were analyzed with the Mann‑Whitney U test. Spearman’s correlation coefficient was used to determine the correlation between knowledge, attitude, and practice.
    Results
    The questionnaires were completed by 134 university faculty members and 308 high school teachers, among whom 35.8% and 47.1%, respectively, reported self‑medication with antibiotics during the previous year, mostly to relieve sore throat. High school teachers were significantly better than university teaching staff in their knowledge about the effects of antibiotics and in their usage practices. In both the groups, a weak direct linear relationship was detected between attitude and practice (r=0.243, r=0.238, P<0.01) and a weak inverse linear relationship was seen between knowledge and practice (P=0.22) in the high school teacher group.
    Conclusions
    Our results showed that self‑medication and the irrational use of antibiotics were common among highly educated people in a community population sample in Shiraz, Iran. The rational use of antibiotics may be favored by improving knowledge about these drugs.
    Keywords: Academic staff, antibiotic, attitude, knowledge, practice, self‑medication
  • Peter Schwandt, Arnold Von Eckardstein, Gerda-Maria Haas Pages 846-852
    Background
    Age‑ and gender‑specific percentiles of body mass index in children and adolescents are a cornerstone categorizing overweight and obesity in youths worldwide. Since corresponding worldwide growth curves of percent body fat (% BF) are missing, the purpose was to contribute smoothed percentiles of percentage body fat from a large urban sample of German youths and to include them in actual national and international percentile curves.
    Methods
    We estimated % BF in 22 113 German youths aged 3 to 18 years participating in yearly cross‑sectional surveys of the PEP Family Heart Study Nuremberg between 1993 and 2007. Percentage body fat was calculated from skinfold thickness using Slaughter equations. Ten smoothed percentile curves were constructed for % BF using the LMS method significant.
    Results
    The age‑ and gender‑specific reference curves demonstrate a continuous age‑dependent increase of percentage body fat from age 3 to 18 years in girls; whereas in boys, the percentile curves steeply increase from 5 to 11 years and thereafter slightly decrease. The shape of the percentile curves, the maxima among boys at puberty and the median % BF at age 18 years are consistent with most of the current growth curves. % BF in urban studies seems to be lower than in national surveys.
    Conclusions
    More than these nine studies should contribute to worldwide-standardized growth charts for % BF to better define overweight and obesity in youth.
    Keywords: Youths, Germany, international comparison, percentage body fat, reference curves
  • Amir Musarezaie, Tahereh Momeni Ghalae Ghasemi, Homayoon Naji Esfahani Pages 853-859
    Background
    This study was performed to examine quality of life’s dimensions and its relationship with some clinical and demographic characteristics on women with breast cancer under chemotherapy referred to the oncology hospital, Isfahan University of medical sciences, Iran.
    Methods
    This Cross sectional study was conducted among 330 a descriptive‑analytic one breast cancer patients with simple sampling methodology. Data collection instrument included a questionnaire contains 2 parts (clinical and demographic characteristics information and version 2.0 of the SF‑36 questionnaire (the international version). The data were analyzed with 99% confidence by carried out using SPSS18 with using descriptive and analytic statistics.
    Results
    The majority of subjects’ quality of life was moderate (53.93%). there was a statistically significant relationship between quality of life among breast cancer patients with chemotherapy sessions (P < 0.05, df =4, χ2 = 16.37). One way Analysis Of Variance (ANOVA) suggested the absence of any significant relationship between quality of life with marital status (f = 0.21; P = 0.92) and employment status (f = 0.26; P = 0.77). Also, Spearman test showed the absence of any significant relationship between quality of life with age (P = 0.60), and the elapsed duration from diagnosis (P = 0.68), however Spearman test showed significant relationship between quality of life and education status (P = 0.002, r = ‑0.84).
    Conclusion
    This study shoed a direct correlation with regard to results of this study, there was a direct correlation between the number of chemotherapy sessions and patients quality of life. The attitude of the population toward chemotherapy is usually inhibiting and negative, so patients, students and nurses should be trained about chemotherapy efficacy to improve their attitude about chemotherapy, which in turn would lead to improvement of the patients’ quality of life..
    Keywords: Breast neoplasms, demography, drug therapy, quality of life
  • Mahnaz Ashoorkhani, Jaleh Gholami, Reza Majdzadeh, Fariba Akbari, Hamed Hosseini Pages 860-866
    Background
    Timely notification is of great importance in health emergencies. So identifying the most important sources of information used by people in emergencies seems necessary. The objective of this study was to assess peoples’ level of awareness concerning the symptoms, routes of transmission, prevention, and treatment of H1N1 at the time of the pandemic and also to identify their most important source of information.
    Methods
    Two telephone surveys were performed at the beginning of levels five and six of the pandemic at a four‑month interval on two populations. Using a questionnaire, random phone numbers were called and 662 and 701 individuals from Tehran were surveyed at the two phases, respectively.
    Results
    Peoples’ level of awareness concerning the disease, symptoms, its routes of transmission, prevention, and treatment of H1N1 had increased in the second phase of the study. At the same time, people were less afraid of the disease in the second phase. The most important sources of information used were TV, newspapers, and radio, respectively.
    Conclusions
    Mass media including TV and newspapers were recognized as the most important sources of information used by the people in emergencies. It seems that designing educational programs and synchronizing the media’s policies with health authorities can help fight future health emergencies and prevent delays in notifying people.
    Keywords: Epidemics, emergency, health promotion, mass media, swine flu
  • Mohammad Reza Maracy, Farhad Moradpour, Sayed Mohsen Hosseini, Maryam Tirani Pages 867-874
    Background
    The aim of this study was to show up‑to‑date estimates of incidence and prevalence in Isfahan for all cancers, except non‑melanoma skin cancer over the period 2001‑2010 to provide projections up to 2015, based on a statistical method that uses mortality and cancer patients’ survival data.
    Methods
    Mortality data in Isfahan province were collected from various sources such as hospitals, medical forensic, cemetery, and health centers. In addition, population data by sex, age, location, and calendar year in the period of 2001‑2010 were acquired from the Statistical Center of Iran. Relative survival probabilities for all cancers combined and for selected specific cancers were estimated based on observed cancer death and expected mortality data. Incidence and prevalence estimates were computed with Mortality‑incidence Analysis Model (MIAMOD) method.
    Results
    The estimated age‑standardized cancer incidence rate had higher increase rate for urban females than for males. Also, the number of prevalent cancers was higher among females, which was mostly due to better cancer survival rates in women. Age‑adjusted incidence was estimated to increase by 6.9 and 8.7 per 100000 annually, between 2001 and 2015, in males and females, respectively. The prevalence is to increase by 24 and 40 and mortality by 2.8 and 2.5 per 100000 between 2001 and 2015.
    Conclusion
    The present study does not only shows the incidence and prevalence estimates of all cancers combined, but also gives information about cancer burden, which can be used as a bases for planning healthcare management and allocating recourses in public health.
    Keywords: Cancer, incidence, mortality, prevalence, relative survival
  • Reza Chaman, Ali Alami, Mohammad Hassan Emamian, Kourosh Holakouie Naieni, Majid Mirmohammadkhani, Elham Ahmadnejhad, Rasool Entezarmahdi, Mohsen Shati, Mohammad Shariati Pages 875-879
    Background
    The aim of the study was to evaluate potential risk factors of children mortality between 1‑59 months of age.
    Methods
    This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow‑up data available in household health records.
    Results
    Mortality was significantly associated with breastfeeding duration (OR: 0.87, 95% CI: 0.81‑0.93), total health care visits (OR: 0.90, 95% CI: 0.83‑0.98) and low birth weight (LBW) (OR: 7.38, 95% CI: 1.37-39.67).
    Conclusion
    In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1‑59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5‑year‑old children, so combined efforts would be necessary to improve child health indicators.
    Keywords: Childhood, Iran, mortality, nested case‑control study, risk factors
  • Asghar Mohammadpoorasl, Saharnaz Nedjat, Kamran Yazdani, Ali Fakhari, Abbas Rahimi Foroushani, Akbar Fotouhi Pages 880-886
    Background
    Intention to smoking is a strong predictor of future smoking behavior. The aim of this study is identifying the personal, environmental, and psychological factors relating to intention to smoking in adolescents of Tabriz city (Northwest of Iran).
    Methods
    Four thousand nine hundred and three (4903) students were randomly selected and completed a self‑administered questionnaire about cigarette smoking, intention to smoking, and the related risk factors through multi‑stage sampling. The association of independent variables with intention to smoking was evaluated using the multi‑variable logistic regression model.
    Results
    The mean age of student was 15.7 ア 0.73 years, and 42.9% of the samples were male. The results showed that 95.0% of students were in committer stage (students who had never smoked and were sure never start smoking). Having general risk‑taking behavior (OR = 2.90; 95% confidence interval [CI]: 1.21‑6.97), smoker in the family (OR = 2.60; 95% CI: 1.20‑5.61), and positive attitude towards cigarette smoking (OR = 1.30; 95% CI: 1.18‑1.43) had statistically significant association with intention to start smoking in future.
    Conclusion
    Majority of non‑smokers have firm decision to not start smoking in the future. Having general risk‑taking behavior, smoker in the family, and positive attitude towards smoking are associated with intention to smoking in adolescents.
    Keywords: Adolescents, attitude to smoking, intention to smoking, risk‑taking behavior, smoking stages
  • Majid Davari, Mohammad Reza Maracy, Mohammad Hasan Emami, Diana Taheri, Abolfazl Aslani, Mahshid Givi, Saeid Massah Pages 887-892
    Background
    The Immense cost of cancer treatment is one of the main challenges of health care systems all over the world including Iran. The aim of this study was to analyze the direct treatment costs of colorectal cancer patients in Isfahan, Iran.
    Methods
    In this cross sectional study, the medical records of colorectal cancer (CRC) patients admitted to the Seyyed‑al‑Shohada Hospital “SSH” from 2005-2010 were reviewed. The profiles of 452 patients were examined. However based on inclusion, exclusion criteria a total number of 432 profiles were analyzed. All records including age, sex, treatment processes and treatment costs were extracted from the patients’ profiles and analyzed using Kruskal‑Wallis test.
    Findings
    The results showed that 56.1% of CRC patients were male. The mean age of patients suffering from CRC was 56 ± 13.4. More than Thirty‑six percent of the patients were in stages 1‑3 of CRC and more than half of them (64.4%) were in the 4th stage. The higher the stage of the cancer the higher the percentage of treatments used. 5-Fluorouracil and Leucovorin (5FU/LV) was the most common used chemical treatment protocol. The mean treatment cost for stage one was 10715 (±4927), for stage two 15920 (±3440), stage three 16452 (±2828) and for stage four was 16723 (±2555) US Dollars. The cost of drug treatment was the first cost driven between the medical services.
    Conclusion
    CRC in Iranian population starts in younger age than people in western countries. This imposed considerable direct and indirect economic cost to the society. The direct medical cost of colorectal cancer in Iran is very higher than 38 million $. Screening programs could reduce the economic cost of CRC significantly.
    Keywords: Colorectal cancer, cost analysis, Iran
  • Jui-Tung Chen, Kazuhiko Kotani Pages 893-896
    Background
    Oral contraceptive therapy (OCT) is associated with an increased risk of deep vein thrombosis, venous thromboembolism and stroke. However, the underlying mechanisms have not yet been elucidated. The objective of this study was to investigate the influence of OCT on blood levels of an oxidative stress maker in pre‑menopausal women.
    Methods
    Oxidative stress was determined in 87 pre‑menopausal healthy women (24 with and 63 without OCT) using a blood assay for reactive oxygen metabolites (by the d‑ROMs test). The subjects with OCT received a triphasic preparation consisting of ethinyl estradiol and norethisterone.
    Results
    Subjects with OCT showed significantly higher d‑ROMs levels (median: 380; interquartile range: 328‑502 Carr U) than those without OCT (325 [271‑369]; P < 0.05). The results remained the same after adjusting for potential confounders.
    Conclusions
    The use of OCT may increase oxidative stress levels, independent of traditional cardiovascular risk factors, in pre‑menopausal women, providing new insights to the primary prevention of vascular complications in these subjects.
    Keywords: Contraceptives, d‑ROMs test, ethinyl estradiol, norethisterone, oxidative stress marker
  • Milankumar V. Dharsandia, Sumeeta T. Soni, Mahendra M. Vegad Pages 897-899
    Echinococcosis or Hydatid disease is one of the important zoonotic, as well as occupational disease with worldwide distribution. In India, hydatid disease is endemic. However, hydatid disease of ovary is uncommon condition. We report such a case of ovarian hydatid disease in an 11‑year‑old girl, from rural Gujarat, Western India, presenting with symptoms of urinary obstruction. This case report highlights the rarest location of the Echinococcosis.
    Keywords: Echinococcosis, hydatid disease, ovarian hydatid
  • Ajai Kumar Singh, Ashish Singh, Deepti Singh, Manish Singh, Pratibha Singh, Abhishek Sharma Pages 900-901
  • Saurabh Rambiharilal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy Pages 902-903