International Journal of Preventive Medicine
Volume:4 Issue: 10, Oct 2013

Cigarette Smoking is a recognized cause of systemic disorders such as bronchogenic, carcinoma, and cardiovascular diseases and hence prompt and effective interventions are required for its elimination. Thus, This Meta‑analysis was carried out for an adult population of west of Iran in order to estimate of prevalence smoking in this area. We examined related to documentation by searching in published and non‑electronic databases. Data were extracted based on variables such as the year of the study, sex, age group, and the prevalence of smoking. Based on the results of heterogeneity, we used fixed or random effects model to assessment the overall prevalence of cigarette smoking. All analyses were accomplished via STATA 11 software. Totally, 25,990 subjects (13005 males) were investigated. Meta‑analysis in men and women indicated prevalence of 22.9 (20.6‑25.2) and 0.6 (0.3‑0.9) respectively. It was found that more than one‑fifth of men from 15 year to 64‑year‑old of west of Iran smoked cigarette. Providing an education on harmful effects of smoking to the adult population would be a valuable means for reducing destructive consequences of smoking.

The aims of this study included: Determination of the most common driver behavior in drivers and also analyzing the relationship between trait anxiety (TA) with subscale of driving behavior (lapses, errors, ordinary and aggressive violations). This cross‑sectional study was conducted on 168 drivers that having crash. The self‑reporting of the drivers was determined by using Manchester driving behavior questionnaire (DBQ) and Spielberger State‑Trait Anxiety Inventory. Independent t‑test showed that violations factor (ordinary and aggressive) are the most common behavior in drivers, Pearson correlation revealed that TA had a significant direct positive relation with all DBQ subscales especially error and lapses factor (P < 0.01) also Pearson correlation showed that age had a negative significant relation with factors of DBQ. It can be concluded from the results (according to the relation between TA with error and lapses factor) that the rate of TA is destructive effective on the memory performance and process in the drivers and cause absent minded and memory imperfect function and process in these people during the driving.

Cancer is a major health problem in the developing countries. Variations of its incidence rate among geographical areas are due to various contributing factors. This study was performed to assess the spatial patterns of cancer incidence in the Fars Province, based on cancer registry data and to determine geographical clusters. In this cross sectional study, the new cases of cancer were recorded from 2001 to 2009. Crude incidence rate was estimated based on age groups and sex in the counties of the Fars Province. Age‑standardized incidence rates (ASR) per 100,000 was calculated in each year. Spatial autocorrelation analysis was performed in measuring the geographic patterns and clusters using geographic information system (GIS). Also, comparisons were made between ASRs in each county. A total of 28,411 new cases were diagnosed with cancer during 2001‑2009 in the Fars Province, 55.5% of which were men. The average age was 61.6 ± 0.5 years. The highest ASR was observed in Shiraz, which is the largest county in Fars. The Moran’s Index of cancer was significantly clustered in 2004, 2005, and 2006 in total, men, and women. The type of spatial clustering was high‑high cluster, that to indicate from north‑west to south‑east of Fars Province. Analysis of the spatial distribution of cancer shows significant differences from year to year and between different areas. However, a clear spatial autocorrelation is observed, which can be of great interest and importance to researchers for future epidemiological studies, and to policymakers for applying preventive measures.

Brewer’s yeast may have beneficial effects on insulin receptors because of itsglucose tolerance factor in diabetic patients. This study was conducted to investigate the effects of brewer’s yeast supplementation on glycemic indices in patients with type 2 diabetes mellitus. In a randomized double‑blind controlled clinical trial, 84 adults (21 men and 63 women) aged 46.3 ± 6.1 years old with type 2 diabetes mellitus were recruited and divided randomly into two groups: Supplement group receiving brewer’s yeast (six 300mg tablets/day, total 1800 mg) and control group receiving placebo (six 300mg tablets/day) for 12 weeks. Body weight, height, body mass index, food consumption (based on 24h food record), fasting blood sugar (FBS), glycosylated hemoglobin, insulin sensitivity, and insulin resistance were measured before and after the intervention. Data analysis was performed using the Statistical Package for Social Sciences (version 18.0). The changes in FBS, glycosylated hemoglobin, and insulin sensitivity were significantly different between the two groups during the study (respectively P < 0.001, P < 0.001, P = 0.02 independent sample t‑test). There was a significant difference in FBS, glycosylated hemoglobin, and insulin sensitivity at the end of the study between the two groups after removing the effects of baseline values (respectively P = 0.002, P < 0.001, P = 0.02, analysis of covariance). Changes in body mass index, 24h food record, insulin resistance were not significant. Dietary supplementation with brewer›s yeast besides the usual treatment of diabetes can ameliorate blood glucose variables in type 2 diabetes mellitus.

One of the most common causes of acute kidney injury (AKI) is kidney ischemia/reperfusion injury (IRI). The distant organ injury such as acute lung injury is one of the side effects of AKI or kidney IRI. In this study, we performed bilateral renal IRI in rats and the protective role of N‑acetylcysteine (NAC) in kidney and lung was investigated. Rats (n = 30) were randomly assigned to four experiment groups. The group 1 was assigned as sham‑operated group. Before kidney IRI performance, the others groups were treated with saline (group 2), 150 mg/kg (group 3) or 500 mg/kg (group 4) of NAC, and the treatment were continued daily after IRI for next 3 days. At day 3, the all groups’ animals were subjected for the measurements. The serum level of blood urea nitrogen (BUN) and creatinine (Cr) in the control group increased significantly (P < 0.05), and administration of NAC (150 mg/kg) decreased the serum levels of Cr and BUN. However, only the serum level of Cr decreased significantly (P < 0.05). NAC did not improve kidney weight and damage; however, its low dose (150 mg/kg) attenuated the lung injury score (P < 0.05) when compared with the control group. No significant differences were observed in lung water content and endothelial permeability, serum levels of malondialdehyde and nitrite between the groups. Low dose of NAC as a protectant agent may protect the kidney function and lung tissue damage after kidney IRI.

In hot weather, overweight and obesity are considered as significant risk factors for the incidence of cardiac strain in workers. This study was aimed to compare cardiac strain among overweight and normal‑weight workers in hot, humid conditions in the south of Iran. This cross‑sectional study was conducted on 71 workers in the south of Iran in summer 2010. The heart rate was measured at rest and at actual work. Cardiac strain based on working heart rate (WHR), the relative cardiac cost (RCC), the net cardiac cost (NCC), load relative cardiovascular (CVL), and heart rate reduction was analyzed in 35 normal‑weight people (body mass index (BMI) <25 kg/m2) and 36 overweight people (BMI >25 kg/m2) using descriptive statistics. In 42% of the total workers, BMI was >25 kg/m2. The average of Wet Bulb Globe Temperature Index (WBGT Index) in the two groups was not significantly different. The mean WHR in the two groups was 101 ± 20.3 and 112 ± 18.9, respectively (P = 0.026). Percentages exceeded the acceptable limits in the parameters NCC, RCC, WHR, CVL, and Brouha index, which were significantly higher in overweight people than in those with normal weight. Based on the study results, it is concluded that the severity of cardiac strain was higher in overweight workers compared with that in normal weight workers. Hence, in order to decrease the cardiac strain, selecting overweight individuals for these jobs should be avoided and also some vital intervention for losing weight should be implemented such as nutrition education and encouraging them regarding physical activity.

To compare the level of knowledge, the attitudes, and practices with regards to tobacco use between Iranian students at a public (PBU) and Islamic Azad (IAU) university. A cross‑sectional design was used in this study. As the number of students at the IAU were three times greater than that of the PBU, we selected 150 students from the PBU and 450 students from the IAU using simple random sampling. A 57‑item survey instrument was utilized for this study. The collected data were recorded by SPSS version 15 software and then it underwent statistical analysis using descriptive statistics and ANOVA to compare the difference between means of knowledge, attitude and practice scores. Logistic regression analysis was conducted to identify variables that have an independent association with students smoking and to describe possible variations in these relationships. The P value level for statistical significance was set at 0.05. From participants, 46.8% were females, 10% of 327 students reported being daily smokers; of these, 84% were from the IAU. Totally, among the 107 smokers, 61 (57%) and 29 (27.1%) were water pipe and cigarettes smokers, respectively. Ninety‑three IAU students (21.7%) and 30 PBU students (20.7%) reported smoking during the past 30 days. The mean of the knowledge items between the students of IAU was lower than PBU students. Female gender, smoking in the home, and allowing visitors to smoke in the home were significant predictors of smoking in the past 30 days in PBU, respectively. In IAU, female gender, smoking by friends, and health status were predictors for smoking in the past 30 days. Future studies should assess the factors affecting smoking initiation, as well as effective techniques for the prevention of smoking initiation and substance abuse in Iranian adolescents and young adults.

Acute respiratory infection (ARI) in young children is responsible for an estimated 4.1 million deaths worldwide of which approximately 90% are due to pneumonia. To study the clinical effectiveness of co‑trimoxazole versus amoxicillin in the treatment of non‑severe pneumonia, as defined by WHO, in children in the age group of 02 months to 5 years. Randomized Control Trial study was conducted in out patient department of a large tertiary care hospital after taking consent from parents and ethical committee clearance. Children in study group were treated with amoxicillin (40 mg/kg/day in 3 divided doses) and those in control group were treated with co‑trimoxazole (8 mg/kg/day of trimethoprim in 2 divided doses). All cases were reviewed on second and fifth day. The effectiveness and therapy failure were decided on the basis of clinical, radiological and complete blood count results. Two hundred and four cases of non severe pneumonia were studied. All cases were diagnosed on the basis of clinical criteria, as defined by WHO. Treatment failure was seen in 8.09% cases with amoxicillin and 39.05% cases with co‑trimoxazole. Cost of one complete course with amoxicillin was 2.3 times higher than with co‑trimoxazole. Compliance of therapy to co‑trimoxazole (90.47%) was better than to amoxicillin (83.84%). The response to treatment with amoxicillin is faster, however, compliance is slightly poorer and cost of treatment high. In order to improve the compliance, better counseling and more studies are required to ascertain the efficacy of amoxicillin in higher dosage over a shorter period of time.

This study aims to evaluate the sex hormone binding globulin (SHBG) level as a predictor of response to pharmacological treatment in women with polycystic ovary syndrome (PCOS). This study was conducted in 2009-2012 in Isfahan, Iran. Anovulatory women with a diagnosis of PCOSwere studied. Metformin was started at 500 mg three times a day. If no ovulation occurred, Clomiphene citrate was added. The study comprised273 infertile women with PCOS completed the study, 75 (28%) of them became pregnant 6 months after treatment (7.36% with metformin and 20.14% with metformin and clomiphene citrate). Patients who responded to metformin treatment had significantly lower mean SHBG levels compared to those who did not (0.88+0.32vs. 0.2642+0.44 nmol/L, respectively, P<0.0001). The area under the ROC curve (AUC) for prediction the response to treatment was 0.85. The baseline level of 27was the most appropriate cut of point HSBG for the prediction of conception. HSBG had a sensitivity of 88%, and specificity of 73.6%. It had a false positive level of 26.4% and false negative level of 12%. Its positive predictive value was 56.4% and its negative predictive value was 94%. The chance of conception increased for reducing a unit of fpg (OR = 0.69; 95% CI = 0.54-0.86; P =. 002), as well as reducing of every unit of HSBG (OR = 0.47; 95% CI = 0.39-0.56; P <0.001), and for reducing each unit of insulin in (OR = 0.082; 95% CI = 1.021-0.33; P <0.001). HSBG test is suggested as an appropriate test for predicting pregnancy achievement of PCOs women after pharmacological treatment

We assessed associations between educational achievement and alcohol consumption. We employed five alcohol consumption measures (length of time of and amount consumed during most recent drinking occasion, frequency of alcohol consumption, heavy episodic drinking, problem drinking); and three educational achievement indicators (students’ subjective importance of achieving good grades, students’ appraisal of their academic performance in comparison with peers, students’ actual module mark). Males were positively associated with all five alcohol consumption measures. Age was negatively associated with three alcohol consumption measures. While students´ importance of good grades was negatively associated with three alcohol consumption measures, academic performance in comparison with peers was negatively associated with heavy episodic drinking. Actual module mark was not associated with any alcohol consumption measure. Alcohol consumption showed negative associations with motivation for and subjectively achieved academic performance. University alcohol prevention activities might have positive impact on students’ academic success.

Several health‑compromising behaviors (e.g., smoking, alcohol) as well as health‑enhancing behaviors (e.g., physical exercise, nutrition) are adopted in adolescence and they often persist into adulthood. Thus, there is a definite need to investigate the health behavior of adolescents rather than focus on adults since it will be far more difficult for adults to change their unhealthy habits adopted in their youth. Therefore, the present study was conducted to ascertain health‑promoting behavior and lifestyle of university graduates of Chandigarh. The present cross‑sectional pilot study was conducted in Chandigarh during 2009 among university graduates of Chandigarh aged 17-20 years. A semi‑structured, pretested questionnaire comprising of 28 items was used to get information from students regarding their involvement in diet, physical exercise, spirituality and philanthropy. Height, weight, waist and hip circumference of the respondents were measured using standardized equipments and procedures. Mean score of health‑promoting lifestyle profile of university graduates was found to be 67.5 ± 12.1 (maximum attainable score = 106). Fourteen students were found to be overweight. Frequent intake of fast food and less consumption of fruits and vegetables was reported by the students. Majority of students exercised as part of their daily routine. The result of the study showed that North Indian students had reasonably good orientations toward health behaviors, with a mean score of 67.5. The topics related to diet, physical exercise, spiritual growth and philanthropy promotion should be incorporated within the curriculum of students for their all round personality development.

The aim of this study was to evaluate patterns of students’ snacks habits regarding to their schools’ cafeteria status in Tehran by focus group discussion (FGD) technique. Participants were 240 students (12‑15 years old), selected from12 middle‑schools in Tehran. The field study consisted of 24 FGDs sessions; involving 8‑10 participants. Collected data were coded, categorized and analyzed using constant comparative method. Over half of the students believed that snack consumption is necessary. Although, majority of students believed that their schools’ cafeterias are not acceptable, they noted them as one of the necessary parts of school. Nearly half of the children were complaining of unvaried and expensive food items. The most purchased items were: Cookies, sandwiches with mayonnaise and ketchup, soft drinks and chocolate milk. Most of the students were interested in having roles in their cafeterias. Schools’ cafeteria are significant sources of supplying adolescents’ snacks, so developing hygienic stores containing healthy and nutritious food items is a key element to affect their snack selection positively. Reaching this goal requires a multi disciplinary approach through participation of students, school staff, parents, and the support of community and media.

Suicide is a commonly encountered and stressful event in professional life of any psychiatrist. Suicide risk assessment is a major gateway to patient treatment and management. It is a core competency requirement in training of psychiatry. The present study designed to assesseducational needsfor suicide prevention in residents of psychiatry in two medical schools in Iran, Isfahan University of Medical Sciences (IUMS) and Shahid Beheshti Medical University (SBUMS) inTehran. This was a qualitative triangulation study, conducted in two steps. The first step was based on a phenomenological approach and the second was based on focus groups. The studied population was the psychiatric residents of IUMS and SBUMS. Purposive sampling was implemented until saturation. Interviews were performed. Colaizzi method was used to analyze the data. In the second step, participants attended a session, in which all final codes of the first step were discussed, and regarding the views, educational priorities and needs were listed. A total of 2047 codes, extracted from 31 interviews, analyzed through Colaizzi method, were categorized in three groups: Educational, facilities and processes, human resources. According to defects of current educational program, we suggest regular reevaluations and revisions of clinical training programs according to current needs.

More and more cases of H1N1 influenza are being detected in India and so also the variety of complications this virus can cause. Here, we report a case of symmetric peripheral gangrene following H1N1 infection.

Head trauma and brain injuries are common causes of emergency admission and usually predispose multiple psychiatric complications. In turn, the traumas often occur after some psychiatric disorders. Therefore, the complicated interaction of these factors often causes difficulties in diagnosis and management of the patients. The side‑effects of surgical and medical treatments may also complicate these processes more, as well. In this study, we present a case of a young patient with these complex factors and discuss the diagnosis and management.

The average rural Indian women enter her reproductive life, particularly in pregnancy, suffer from nutritional anemia due to iron deficiency. National program of India had implemented a strategy for supplementation of iron folic acid by means of iron folic acid (IFA) tablets at least 3 months during antenatal period. The study had been conducted to assess the proportion of pregnant mothers consumes the IFA tablets and the factors determine compliance. A cross‑sectional, community‑based study was conducted in rural area of India on 50 antenatal mothers by multistage sampling technique. The data were analyzed by using SPSS 16 (Statistical Package for the Social Sciences, ver. 16), Chicago, considering the level of significance at 95%. The IFA tablet was adequately consumed by 62% mother among the study population. The consumption is more among the mother who were explained properly than those who were not explained by the health worker (χ2 = 4.529, P < 0.05). The compliance of iron folic acid tablets was still far behind to reach the National Goal though the service component are quite strong by the front line workers and health providers. An effort should be given at the level of front line health workers by training and re‑training them to improve the compliance of IFA consumption.

The prevalence of depression especially among youths is increasingly high. The present study is aimed to identify some demographic and psychological factors such as self‑efficacy and perceived stress that may be related to depression among male adolescents. Overall, 402 adolescent were selected for participation in the study using multistage sampling method. The participants completed a questionnaire including demographic, depression, self‑efficacy, and perceived stress data. A multiple regression analysis and the Pearson correlation test were used for data analysis. SPSS version 17 software was used for performing analyses. The mean age of the adolescents was 15.44 (SD = 0.68) years. The total mean score of depression was 16.02 ｱ 9.14 and 153 (38.1%) of participants showed depressive symptoms. Results showed that high levels of depression were associated with low level of self‑efficacy and high level of perceived stress; also some demographic variables such as fathers’ job and academic situation can be related to depression among male adolescents. Self‑efficacy and perceived stress can be related to depression but the role of stress and self‑efficacy in the etiology and forming of depression in adolescent are discussed. Therefore, more studies for approval of these associations should be considered.