International Journal of Preventive Medicine
Volume:4 Issue: 2, Feb 2013

The recognition of seasonal patterns in infectious disease occurrence dates back at least as far as the hippocratic era, but the mechanisms underlying these fluctuations remain poorly understood. Many classes of mechanistic hypotheses have been proposed to explain seasonality of various directly transmitted diseases, including at least the following; human activity, seasonal variability in human immune system function, seasonal variations in vitamin D levels, seasonality of melatonin, and pathogen infectivity. In this short paper will briefly discuss the role of these factors in the seasonal patterns of infectious diseases.

The concentration of adiponectin, a hormone which is secreted from adipose tissue, is inversely correlated with body fat mass. This hormone has anti inflammatory and anti atherogenic properties. Its concentration reduces in metabolic syndrome and cardiovascular diseases. This study reviews the evidence on the relationship between serum adiponectin concentration and lipid profile. In this study former clinical trials, cross sectional and prospective studies have been reviewed. The PubMed search engine has been used to find related research for the topic by considering dyslipidemia, total cholesterol (TC), high and low density protein (HDL and LDL), triglyceride (TG), lipid profile (LP) and adiponectin as the key words. Finally, 25 articles were recruited to review in the present article. Serum adiponectin level was positively correlated with plasma HDL cholestrol concentrations. There was a significant inverse relationship between plasma triglyceride and serum adiponectin. An inverse correlation between very low density lipoprotein (VLDL) and LDL levels and adiponectin was reported from the studies. So, Adiponectin has an important role in the metabolism of lipid profile including HDLc.

In recent years, outcome assessment related to orthopedic surgeries has increasingly focused on patient‑reported questionnaires. The Oxford Hip Score (OHS), self‑administered questionnaire, is a reliable, valid, and responsive instrument for assessing hip in patients undergoing Arthroplasty. The study involved 105 adult Persian‑speaking patients admitted for primary Total Hip Arthroplasty in two hospitals in Isfahan in Iran from September 2009 until April 2011. All of them filled out their scales (Persian OHS, WOMAC, and SF12) in preoperative examination. Mean scores of OHS in first administrations was 42.7 ± 12.7. The Persian OHS overall score demonstrated high reproducibility (ICC,0.93, P < 0.001) and internal consistency (CA, 0.94). PersianOHS had high correlations with WOMAC total score (r = 0.86), function score (r = 0.86), and pain score (r = 0.79), the relationship between the Persian OHS and the WOMAC stiffness subscale was somewhat lower (r = 0.69). The correlation coefficient between the Persian OHS and the PCS of the SF‑12 in our study was moderate (r = 0.58). Persian OHS had low correlation with MCS of the SF‑12 (r = 0.40). Persian OHS had high correlations with WOMAC total score, function score, and pain score. It had moderate correlation with PCS of the SF‑12 and low correlation with MCS of the SF‑12. Our study demonstrated the trans‑cultural adaptation and validation of the Persian OHS is a reliable and practicable instrument for assessment of function and pain in Iranian patients with hip osteoarthritis.

To evaluate predictive factors of adolescents’ appraisal of their health. The nationwide study, entitled “Childhood and Adolescence Surveillance and Prevention of Adult Non‑communicable Diseases (CASPIAN) study,” was conducted in 2010 among Iranian school students, aged 10‑18. In addition to demographic factors and physical examination, variables as family structure, nutrition habits, physical activity, smoking, hygienic habits, violence, school attachment, family smoking, and family history of chronic diseases were assessed. The dependent variable is the self‑rated health (SRH) and it was measured by 12 items, which had already been combined through latent class analysis. We had taken a dichotomous variable, i.e. the higher values indicate better SRH. The dependent variable was regressed on all predictors by generalized additive models. 75% of adolescents had a good SRH. The linear and smooth effects of independent variables on SRH were observed. Among all the variables, physical activity had a positive linear effect on SRH (β = 0.08, P value = 0.003). Smoking, violence, and family history of disease associated to SRH non‑linearly (P value < 0.05). Family smoking (β = –0.01) and hygienic habits (β = 0.27) related to SRH both linearly and non‑linearly. Physical health and high risk behavior, either of linear or non‑linear effect, are factors, which seem to shape the adolescents’ perception of health.

To assess the effectiveness of tuberculosis awareness program amongst school students. Settings and Design: School‑based interventional type of study. The study was done on 135 secondary school students of 8th and 9th standard of randomly selected private English medium school, in field practice area of Urban Health Training Center (UHTC) of a private medical college in Pune city. Health awareness session on tuberculosis was conducted by using various visual and audiovisual aids by the medical college undergraduate students. A pre‑test and post‑proforma was filled before and after the session. Paired t‑test was used to assess the effectiveness of awareness program. There was a highly significant (P = 0) increase in the knowledge of school students after the tuberculosis awareness program by medical undergraduate students. The mean pre‑test scores were 6.31 (52.58%), and the mean post‑test scores were 10.20 (85%). This activity also helped medical undergraduate students to acquire skills related to communication, working in a team, preparation and presentation of various visual aids for health awareness program; they also gained knowledge of research methodology. Health education program by medical students helped significantly to improve the knowledge of school students regarding tuberculosis. Thus, medical college students can be involved to some extent for conducting health‑related behavioral change communication (BCC) activities in schools during their Community Medicine morning posting. Collaboration of private medical colleges, schools, and district tuberculosis units (DTUs) can be ideally achieved under public private partnership (PPP) for health awareness programs.

There is only little information about the effects of GABA receptors agonist and antagonist on morphine self‑administration. Present study was designed to assess role of GABAB receptors in the regulation of morphine‑reinforced self‑administration. This study was performed in four groups of rats: (1) Saline group, which received saline in the self‑administration session. (2) Morphine group, which received morphine in saline solution in the self‑administration session. (3) Baclofen + Morphine group, which received both baclofen 20 min before self‑ administration test and morphine in the self‑administration session. (4) Phaclofen + Morphine group, which received both phaclofen 20 min before self‑ administration test and morphine in the self‑administration session. The number of lever pressing and self‑infusion were recorded. Morphine significantly increased the number of active lever pressing dose dependently in self‑administration session in comparative with saline group. Administration of baclofen, 20 min before morphine self‑administration produced significant decrease in the initiation of morphine self‑administration during all session. Conversely, pre‑treatment of phaclofen increased the number of active lever pressing and self‑infusion in this test. Our results indicated a short‑term treatment by baclofen, reduced morphine‑maintenance response in a dose‑dependent manner, suggesting that GABAB receptor agonists could be useful for reversing the neuroadaptations related to opiates.

Sleep disturbances are common among uremic patients; however, limited data are available on predictors of sleep quality in this population. We assessed sleep quality in patients on hemodialysis (HD) and peritoneal dialysis (PD) and investigated predictors related to sleep quality. Patients on maintenance HD and PD were consecutively included from two medical centers in Isfahan city (Iran). They completed the Pittsburgh sleep quality index (PSQI) and hospital anxiety and depression scale. Laboratory tests were done for iron state, kidney function, and electrolytes. Univariate and multivariate analyses were performed to find predictors of sleep quality. About 90 patients were evaluated (53 males, age = 54.2 ± 15.2 years, disease duration = 5.3 ± 4.5 years). Poor sleep quality was frequent in 86.6% of the cases in each group of HD and PD patients. Patients on HD had poorer sleep quality in terms of total PSQI scores and two dimensions of sleep latency and sleep efficiency (P < 0.05). Anxiety (β = 0.232, P = 0.027), depression (β = 0.317, P = 0.004), and being on HD (β = 2.095, P = 0.009) were independent predictors of overall poor sleep quality. Poor sleep quality is highly frequent in patients on maintenance dialysis and mood disorders and being on HD are predictive factors. Further studies are required for better understanding of risk factors associated with poor sleep quality and thus possible treatments in these patients.

Limited data are available indicating associates of stunting among Iranian c hildren. This study was conducted to investigate determinants of stunting in first grade primary school children of Tehran in 2007. In this case‑control study, 3147 school children were selected by multistage cluster random sampling method from 5 districts of Tehran. Anthropometric measurements were done and stunting was defined as height for age less than the 5th percentile of CDC2000 cut‑off points. Eighty six stunted children were identified and considered as case group. After matching for age, sex and residence area, 308 non‑stunted children were randomly selected as control group. Required data were collected by trained nutritionists using que stionnaires. Stunting was prevalent among 3.7% of the study population (girls 4.4% vs. boys 2.8%, P < 0.05). Mean age of the studied children was 82.3 month. Children with a birth weight of >3000 g were less likely to be stunted (OR: 0.25: 95% CI: 0.11‑0.54) compared with those with a birth weight of <3000 g. Being born to older mothers (>35 years) was associated with greater odds of being stunted (3.01; 1.19‑7.60) compared with being born to younger mothers (<35 years). Those with fathers’ height of >160 cm were less likely to be stunted (0.04; 0.005‑0.37) than those whose fathers’ height was less than 160 cm. We found that birth weight, maternal age and fathers’ height are the major contributing factors to stunting in this group of Iranian children. Taking into account the determinants of stunting might help policy makers designing appropriate interventions.

Characteristics of differentiated osteoblasts from adipose derived stem cells (ADSCs) in compared with isolated osteoblasts from normal bone such as calvaria are unknown. The aim of this study was determination and comparison of phenotypic characterization between differentiated osteoblasts from stem cells and calvaria osteoblasts in vitro. In this study, mesenchymal stem cells were isolated from adipose tissue of human by enzymatic digestion and were differentiated into osteoblasts using osteogenic medium. Characteristics of these cells at first, second, third and fourth weeks were comprised with calvaria osteoblasts that were isolated from human calvaria by explanation culture method. To screen the characteristics of both calvaria and the differentiated osteoblasts, we used western blot to identify protein levels, von Kossa staining for mineral matrix detection and alkaline phosphatase (ALP) assay kit (Sigma) for ALP activity measurement. Difference between calvaria and differentiated osteoblast cells were analyzed by one‑way ANOVA and P < 0.05 was considered as statistically significant. Alkaline phosphatase activity, collagen and mineral material production in differentiated osteoblasts at third week were more significantly than calvaria cells (P < 0.05). Our results indicated that there was no significant different in osteocalcin (OC) production between differentiated osteoblast at first, second and third weeks and calvaria cells but declined at fourth week (P < 0.05). Our survey showed that cellular traits of differentiated osteoblasts presented better than calvaria osteoblasts in vitro conditions. Therefore, we suggest that ADSCs could be used in next studies for bone tissue engineering.

Alzheimer’s disease was known as a progressive neurodegenerative disorder in the elderly and is characterized by dementia and severe neuronal loss in the some regions of brain such as nucleus basalis magnocellularis. It plays an important role in the brain functions such as learning and memory. Loss of cholinergic neurons of nucleus basalis magnocellularis by ibotenic acid can commonly be regarded as a suitable model of Alzheimer’s disease. Previous studies reported that exercise training may slow down the onset and progression of memory deficit in neurodegenerative disorders. This research investigates the effects of treadmill running on acquisition and retention time of passive avoidance deficits induced by ibotenic acid nucleus basalis magnocellularis lesion. Male Wistar rats were randomly selected and divided into five groups as follows: Control, sham, Alzheimer, exercise before Alzheimer, and exercise groups. Treadmill running had a 21 day period and Alzheimer was induced by 5 μg/μl bilateral injection of ibotenic acid in nucleus basalis magnocellularis. Our results showed that ibotenic acid lesions significantly impaired passive avoidance acquisition (P < 0.01) and retention (P < 0.001) performance, while treadmill running exercise significantly (P < 0.001) improved passive avoidance learning in NBM‑lesion rats. Treadmill running has a potential role in the prevention of learning and memory impairments in NBM‑lesion rats.

Anemia has been a very important nutritional disorder in the world. India has reported high prevalence of anemia in pregnancy. Most of the articles have reported an adverse pregnancy outcome related to anemia. Of late, reports are emerging suggesting anemia could be indeed beneficial. Apart from that, there was no consistency in the timing of hemoglobin considered for analysis. Hence, we designed an observational study to look into these aspects. 1000 mothers admitted for delivery were recruited and their hemoglobin was measured. Hemoglobin in previous trimesters was noted from their antenatal record. We followed up these mothers till delivery and looked into the gestation and birth weight of the babies. Descriptive statistics was used for baseline characteristics. Comparison of means was done using Student’s t-test. Qualitative variables were compared using Fisher’s exact test. More than 50% of the mothers were anemic at some point of time during their pregnancy and 39% of the mothers were anemic throughout. Mean birth weight of babies born to anemic mothers was marginally lower compared to that of babies born to nonanemic mothers. This difference was statistically significant. There was 6.5% increase in the incidence of low birth weight babies and 11.5% increase in preterm deliveries in mothers who were anemic in their third trimester. The incidence of low birth weight babies was significantly more in mothers who were anemic in their third trimester. Preterm deliveries occurred more frequently in mothers who were anemic in their second and third trimesters. Higher hemoglobin did not show any effect on either birth weight or gestation in our study.

Vitiligo is an acquired, idiopathic disorder characterized by circumscribed depigmented macules and patches. The exact etiology and pathogenesis of vitiligo is not clear. Many theories have been presented regarding this subject among them aautoimmune theory is the most important one. The association of vitiligo with other autoimmune disorders has been reported, but the relationship between vitiligo and celiac disease is controversial. The aim of this study was to study the frequency of celiac autoantibodies in a group of vitiligo patients compared with control. This was a cross sectional case control study that involved 128 individuals, 64 vitiligo patients and 64 individuals as control group. The means age of participants was 30.3 ± 14.4 years. IgA anti Endomysial antibody and IgA anti‑glutaminase antibody were measured by ELISA method in the serum of all participants. Data were analyzed by SPSS software version 15. The serum of two vitiligo patients (3.1%) was positive for antibodies. All control groups were seronegative for these antibodies (P < 0.05). There may be a relationship between celiac disease and vitiligo. This may indicate a common basic autoimmune mechanism that is an explanation for few case reports that gluten free diets were effective in the treatment of vitiligo patients.

Photorefractive keratectomy is a popular mean to correct refractive errors of the eye and haze formation is one of the most important complications of the surgery. Although standard dose of intraoperative Mitomycin C has shown to be effective in reduction of this complication, potential side effects of Mitomycin C promote us to show if the lower concentration of Mitomycin C has t he same effect. 170 eyes of 85 patients enrolled in our prospective interventional study. In each patient one eye randomly assigned to be treated by low dose intraoperative MMC (LDMMC) and other eye by standard dose MMC (SDMMC). Then the patients were followed up to 6 months and refraction, Uncorrected Distant Visual Acuity (UCDVA), Best Corrected Distant Visual Acuity (BCDVA) and haze formation submitted in each postoperative exam. The results from two arms of the study compared by means of statistical methods to reveal if there was a significant difference between two groups. The mean preoperative refraction in LDMMC eyes was –3.08 (SD 1.65) sphere and 0.92 (SD 0.88) cylinder. These values for SDMMC eyes were –3.25 (SD 1.80) sphere and 0.81 (SD 0.84) cylinder. Mean postoperative sphere in LDMMC group was –0.132 (SD 0.503) and –0.138 (SD 0.484) in 3 and 6 months after PRK. These results was –0.041 (SD 0.501) and –0.076 (SD 0.489) for SDMMC group. Mean postoperative cylinder 3 and 6 month after PRK was 0.435 (SD 0.218) and 0.423 (SD 0.255) In LDMMC group and 0.435 (SD 0.247) and 0.426 (SD 0.261) in SDMMC group. In third month 14 eyes in LDMMC group presented with grade 1 score of clinical haze. From these eyes only 2 still had this haze after 6 month. 7 eyes in SDMMC group had grade 1 clinical haze at third month‑ but no clinical haze was seen at the end of 6th month. Findings of this study show no meaningful differences in postoperative rate of haze formation by use of standard and low dose intraoperative Mitomycin C. regarding these results low dose Mitomycin C with its lower side effects seems to be superior to standard dose in photorefractive keratectomy.

To test if social support and ethnicity mediate/moderate the association between religion involvement and subjective health in the United States. This is a secondary analysis of National Survey of American Life, 2003. Hierarchical regression was fit to a national household probability sample of adult African Americans (n = 3570), Caribbean Blacks (n = 1621), and Whites (n = 891). Frequency of church attendance, positive/negative church‑based social support, ethnicity, and subjective health (overall life satisfaction and self-rated mental health) were considered as predictor, mediator, moderator and outcome, respectively. Frequency of church attendance had a significant and positive association with mental health and life satisfaction among all ethnic groups. Frequency of church attendance was also correlated with positive and negative social support among all ethnic groups. Church‑based social support fully mediated the association between frequency of church attendance and overall life satisfaction among African Americans but not among Caribbean Blacks, or Whites. Church‑based social support, however, partially mediated the association between frequency of church attendance and overall mental health among African Americans but not among Caribbean Blacks or Whites. Ethnicity shapes how church‑based social support mediates the association between religious involvement and subjective health. Our results showed a moderating mediation effect of ethnicity and social support on the religious involvement-subjective health linkage, in a way that it is only among African Americans that social support is a pathway for the beneficial health effect of religious involvement.

Phantom limb pain (PLP) is approximately a common condition after limb amputation, which potentially affects the quality of life. We aimed to evaluate anxiety and depression in patients with amputated limbs suffering from PLP and to compare these psychological dysfunctions with that of patients with non‑phantom chronic pain. A total number of 16 male amputees with PLP and 24 male age‑matched patients with non‑phantom chronic pain were recruited in this study, which was performed at Khatam‑Al‑Anbia Pain Clinic, Tehran, Iran. A validated Persian version of the hospital anxiety and depression scale (HADS) was used to compare two psychological dysfunctions – anxiety and depression – between the two groups of study. The mean of total anxiety score was significantly lower in patients with PLP (8.00 ± 3.93 vs. 11.25 ± 5.23; P = 0.041) and the prevalence of anxiety caseness (HADS‑A score ≥ 11) was also lower in the PLP group (25% vs. 58.3%; P = 0.112, power = 31.7%). The mean of total depression score was 7.69 ± 5.51 and 9.38 ± 6.11 in patients of PLP and chronic pain groups, respectively (P = 0.340, power = 15%).Consequently, the prevalence of depression caseness (HADS‑D score ≥ 11) was lower in PLP patients (37.5% vs. 50%; P = 0.710, power = 8%). Our results indicate that depression and anxiety are not more common in PLP patients, whereas they are more prevalent in subjects with non‑phantom chronic pain. These lower levels of anxiety and depression in PLP compared with chronic pain is a new finding that needs to be evaluated further, which may lead to new insights into the pathogenesis of phantom pain in further studies.

This study compares the Center for Disease Control (CDC) and International Obesity Task Force (IOTF) references in assessment of overweight and obesity among Iranian adolescents. The data of this study was drawn from a cross sectional study of a representative sample of 1200 adolescents aged 12‑17 years in Babol, northern Iran. A standard procedure was used to measure height and weight and the body mass index was calculated. Each subject was classified as overweight and obese based on IOTF cut off values of BMI and CDC references BMI percentile sets by age and sex. The kappa coefficients were estimated for the degree of agreement. In assessment of obesity/overweight prevalence, the CDC and IOTF references produced a similar estimate by age group and sex. The maximum differences was about 1% and the kappa coefficients was 0.96 to 1 (P = 0.001). While for assessment of obesity, the CDC reference produced slightly a higher rate of obesity and the difference in prevalence between the two sets of references was ranged from 1.4% to 3.2% with kappa coefficients: 0.90 to 0.70 (P = 0.001) depending on the age group and sex and a greater difference was observed among younger age group. The findings suggest an excellent agreement between the TOTF and CDC references in assessment of overall overweight/ obesity prevalence among adolescent boys and girls. While in assessment of obesity prevalence alone the degree of agreement between the two sets of references slightly diminished. Overall, the two references are comparable and the agreement varies a little with respect to age and sex.

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder associated with multiple cyst formation in the different organs. Development of pancreatic cyst in ADPKD is often asymptomatic and is associated with no complication. A 38‑year‑old man with ADPKD was presented with six episodes of acute pancreatitis and two episodes of cholangitis in a period of 12 months. Various imaging studies revealed multiple renal, hepatic and pancreatic cysts, mild ectasia of pancreatic duct, dilation of biliary system and absence of biliary stone. He was managed with conservative treatment for each attack. ADPKD should be considered as a potential risk factor for recurrent acute and/ or chronic pancreatitis and cholangitis.

Non‑recurrent laryngeal nerve (NRLN) is a rare anomaly which is reported in 0.3%‑0.8% of people on the right side and in 0.004% (extremely rare) on the left side. Damage to this nerve during the surgical procedure may lead to severe iatrogenic morbidity and should therefore be prevented from being damaged. The best way to avoid this damage to the nerve is to identify the nerve with a systematic diligent dissection based on usual anatomical landmarks and awareness about the possibility of their existence. Hereby, we are going to present a 26‑year‑old woman, a case of NRLN on the right side which was identified during thyroidectomy. The nervous anomaly was accompanied with vascular abnormality which was confirmed by computerized tomography (CT) angiography, post‑operatively.