International Journal of Preventive Medicine
Volume:4 Issue: 11, Nov 2013

The effects of early life conditions and diseases in later life have been studied in several studies. Little experience exists on the possible impact of early life circumstances on trends in mortality from atherosclerotic cardiovascular diseases within national populations. We observed a strong relationship between cohort-trends in stroke mortality and cohort-trends in IMR in European low-mortality countries. The Barker’s hypothesis can explain well the trends of stroke mortality; however, it is not appropriate for IHD. It seems that for IHD, another hypothesis can explain much better. For instance, the ‘accumulation of risk’ model assumes that health at old ages is the result of exposures to risk factors not only in early life but also across lifetime, which could explain the IHD mortality trends

Vinca alkaloids are a subset of drugs obtained from the Madagascar periwinkle plant. They are naturally extracted from the pink periwinkle plant, Catharanthus roseus G. Don and have a hypoglycemic as well as cytotoxic effects. They have been used to treat diabetes, high blood pressure and have been used as disinfectants. The vinca alkaloids are also important for being cancer fighters. There are four major vinca alkaloids in clinical use: Vinblastine (VBL), vinorelbine (VRL), vincristine (VCR) and vindesine (VDS). VCR, VBL and VRL have been approved for use in the United States. Vinflunine is also a new synthetic vinca alkaloid, which has been approved in Europe for the treatment of second-line transitional cell carcinoma of the urothelium is being developed for other malignancies. Vinca alkaloids are the second-most-used class of cancer drugs and will stay among the original cancer therapies. Different researches and studies for new vinca alkaloid applications will be carried out in this regard.

Context: one of the serious occupational concerns in health care workers (HCWs) is exposure to blood/body fluids that can transmit blood borne pathogens such as human immunodeficiency virus and hepatitis B and C viruses. We are reporting the effects of training course and surveillance on the rate of needle stick injuries (NSIs) among HCWs at an educational hospital in Iran. To evaluate the effects of training course on the rate of NSIs and its reporting. Settings and Design: we selected two hospitals (A&B) based on their similarities in wards and facilities then asked the managers of these two hospitals to participate in our study.Methods and Material: We established a new occupational health center and conducted a training course at hospital A on 2010 and compared it with control group (hospital B). The data from 2009 to 2011 was collected, analyzed to compare pre and post intervention rates. Statistical analysis used:We used SPSS for windows and statistical significance was observed using Chi-square and independent T-test. During study period nurses sustained the highest number of injuries (hospital A: n=80; 66.1%& hospital B: n=64; 35.4%). The incidence rate of NSIs in hospital A was 7.16 NSI/100FTE/YEAR before the intervention which was increased to 12.06 after the intervention. In hospital B This rate was 6.05 during three years. The study revealed remarkable increase in the incidence rate of NSIs after the intervention. This is being achieved by meticulous surveillance, training course and improving awareness.

Close interaction between retinal pigment epithelium (RPE) and photoreceptors plays an essential role in visual function. The objective of this study is to determine the effects of RPE cells in the differentiation of progenitor derived human embryonic stem cells (hESC) into retinal cells; we developed in vitro co-culture models and compare these models to investigate in which model the expression of photoreceptor markers is superior. It seems the effects of RPE cells on differentiation of retinal progenitor cells (RPCs) through the cell-to-cell contact or with the use of insert and compare of these methods has not been reported yet. Initially, retinal progenitors (RPs) were differentiated from hESC. After isolation of RPE sheet from rabbit eyes, demonstrated these cells maintains the integrity and feature after 2 weeks. Next, we examined the induction of photoreceptors by the co-culture of RPE through insert in 1 week and 2 weeks (indirect) or without insert by the cell-to-cell contact (direct). The differentiation of retinal cells was verified by protein and gene expression in these three methods. The adherent cells were morphologically examined using phase contrast microscopy and characterized by immunofl uorescent staining and reverse transcription-polymerase chain reaction (RT-PCR) Evaluation of immunostaining showed that hESC, highly (>80%) can be directed to the RPs fate. Upon co-culture of RPCs with RPE sheet using insert for 2 weeks or by the cell-to-cell contact, these cells differentiated to neural retina and expressed photoreceptor-specific markers. However, in direct co-culture, some mature photoreceptor markers like arrestin expressed in compare with indirect co-culture. The expression of late photoreceptor marker could be improved when RPE cells seeded on RPCs in compare with the use of insert.

This study aimed to investigate the moderating effect of ethnicity on the effects of multiple psychiatric disorders on serious suicidal thoughts among a nationally representative sample of Black adults in the United States. For this study, we used data of 5,181 Black adults (3,570 African Americans and 1,621 Caribbean Blacks) who participated in the National Survey of American Life, 2001-2003. Five lifetime psychiatric disorders (i.e., major depression disorder, general anxiety disorder, alcohol abuse disorder, drug abuse disorder and posttraumatic stress disorder) were considered as independent variables. Lifetime serious suicidal ideation was considered as the dependent variable. Logistic regressions were used to determine if ethnicity modifi es the effects of each psychiatric disorder on serious suicide ideation. Ethnicity was conceptualized as the possible moderator and socio-demographics (i.e., age, gender, education level, employment, marital status and country region) were control variables. Among African Americans, major depression disorder, general anxiety disorder, posttraumatic stress disorder and alcohol abuse disorder were associated with higher odds of suicidal thoughts. Among Caribbean Blacks, major depression disorder and drug abuse disorder were associated with higher odds of suicidal thoughts. In the pooled sample, the interaction between ethnicity and anxiety disorder was statistically significant, while the interaction between ethnicity and drug abuse disorder was marginally significant. Based on our study, ethnicity shapes vulnerability of United States Black adults’ suicidality due to psychiatric disorders. General anxiety disorder seems to be a more important risk factor for suicidal ideation among African Americans while drug abuse disorder might contribute more to the risk of suicidal thoughts among Caribbean Blacks.

The current study aimed to determine preventive effect of 2 percent topical xylocaine on oculocardiac reflex in ophthalmological surgeries except strabismus, including retinal detachment and vitrectomy with scleral buckling under general anesthesia. A randomized controlled clinical trial was carried out on 150 patients aged 18-90 years undergoing ophthalmological surgeries under general anesthesia. Samples randomly divided into the experimental group (received four drops of 2 percent topical xylocaine instilled in desired eye) and control group (received 0.5 mg atropine sulfate injection). Systolic, diastolic and mean arterial blood pressure of patients and baseline heart rate were recorded. They were compared regarding the incidence of bradycardia, heart rate less than 60 beats/minute, hypotension and blood pressure less than 90 mm/Hg. Data were analyzed by Statistical Package for the Social Sciences software version 20 using Chi-square and ANOVA. The difference between two groups was not statistically significant regarding demographic and basic variables. The incidence of bradycardia in both groups was respectively (90.7 percent vs. 17.3 percent), heart rate less than 60 beats/ minute (40 percent vs. 13.3percent), hypotension (76 percent vs. 32percent) and blood pressure less than 90 mmHg was (28percent vs. 8 percent). Accordingly, the differences between both groups were statistically significant (P > 0.001). The preventive impact of topical xylocaine upon oculocardiac reflex in ophthalmological surgeries such as retinal detachment and vitrectomy with scleral buckling under general anesthesia was less effective than that of atropine injection. Therefore, to avoid this reflex in high-risk patients, injecting atropine would be safer.

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder associated with cardiovascular disease (CVD) risk factors and metabolic disturbances and a genetically heterogeneous disease. Intima-media thickness (IMT) is an indicator of atherosclerosis. This study aimed to determine the relation between IMT and PCOS in women. This cross-sectional study was performed on 44 PCOS patients and 44 healthy women. Data collection included lipid profiles, blood pressure, waist circumference, body mass index (BMI), and common and internal IMT of carotid artery which were measured in studied subjects. IMT was measured by a radiologist using a linear 12 MHz ultrasound probe (LOGIC S6, GE) in carotid setting. IMT of common carotid artery (56.8 ± 7.6 in cases versus 49.8 ± 7.3 in controls), internal carotid artery (56.9 ± 6.03 in cases versus 49.6 ± 6.9 in controls), and both common and internal carotid artery (56.6 ± 6.7 in cases versus 49.7 ± 6.9 in controls) were significantly higher in PCOS patients than healthy women (P < 0.001). In summary, results demonstrated that carotid artery thickness as a risk for premature atherosclerosis in patients with PCOS is higher than healthy subjects. And hence care and monitoring of PCOS women with these risk factors sounds to be important and necessary.

Congenital hypothyroidism (CHT) is one of the most common congenital endocrinal disorders. The prevalence of CHT is estimated about 1 in 3,000 newborns. The prevalence, etiology and associated disorders of abnormal thyroid screening tests are reported in different ranges. In this study, we assessed the pre-term newborns for CHT and associated factors that influence thyroid function. One hundred newborns with the gestational fewer than 35 weeks were investigated. Baseline serum thyroid stimulating hormone (TSH) and free thyroxin (FT4) levels were measured during the first 5 days of life and were repeated during the first 5 weeks. We analyzed the effects of demographic factors and the presence of respiratory distress syndrome on the alteration of thyroid function tests during the first 5 weeks of life. The mean gestational age (GA) at delivery was 32.35±1.97 (range 28 to 35) weeks. CHT was observed in 13(13%) preterm infants. GA was the only factor which affect the FT4 changes over the two weeks follow-up (P < 0.001, b: -2.783, Power: 70.2%) although the differences between baseline and followup amount of TSH were not signifi cantly infl uenced by GA (P = 0.062, power: 46%). However, the adjusted TSH and FT4 serum level changes during follow-up were signifi cantly different between two groups (between CHT and normal, P = 0.006, 0.000, respectively). It seems that thyroid function tests should be repeated in preterm infants, especially for patients with lower gestational age, to confirm the diagnosis of CHT. Also, CHT should be considered among the newborns that are affected by RDS.

Social support is a complex and multifaceted construct. Thus, It is important that a given social support scale be theoretically grounded and its purview clearly defined. The purpose of this study was to examine the reliability, validity and factor structure of the Iranian version of the Multidimensional Scale of Perceived Social Support (MSPSS). The sample study included 176 consecutive myocardial infarction (MI) patients admitted to the coronary care unit (CCU) ward of nine hospitals in Isfahan, Iran, and 71 consecutive subjects from the general population. They all fi lled out the fi nal Iranian version of the MSPSS and also 71 participants fi lled out the MSPSS twice over a 2-month period. Factor analysis, Cronbach’s α coeffi cient and Pearson’s correlation coeffi cient correlation were used to analyze data. Factor analysis of the scores of the patient and healthy samples yielded a three-factor structure, including family, friends and signifi cant others. The percentage of variance explained by the three factors in the patient sample and healthy sample were 77.87% and 78.55%, respectively. Cronbach’s α coeffi cient has been found to be 0.84 for the scale and 0.90, 0.93 and 0.85, respectively, for the friends, signifi cant others and family subscales from the patient sample, and 0.92 for the scale and 0.89, 0.92 and 0.87, respectively, for the friends, signifi cant others and family subscales from the healthy sample. Test–retest stability over a 2-month period yielded 0.84 for the scale and 0.73, 0.78 and 0.84, respectively, for the friends, signifi cant others and family subscales from the healthy sample. The fi ndings proved the three-factor structure of the Iranian version of the MSPSS and indicated that the Iranian version of the MSPSS is a reliable, valid and acceptable measure of perceived social support.

The present study focuses on comparing the effects of home-based (HB) and group-based (GB) physical activity on mental health in a sample of older adults in Shahr-e-kord. In this quasi-experimental study, a twice-weekly physical activity program for 2 months was provided either individually at home or in a group format for 181 people who were divided into two groups (HB and GB). The outcome, mental health, was measured with the 28-item General Health Questionnaire (GHQ-28). Mental health status improved after participation in the physical activity program. The decrease in GHQ-28 total score in GB group, 3 months after intervention, was 3.61 ± 2.28 (P < 0.001). In HB group, this reduction was 1.20 ± 2.32 during the same period (P < 0.001). The difference of these “before–after differences” between the two groups in the GHQ-28 and all its subscales was statistically significant (P < 0.001). Also, the effects of GB physical activity on mental health compared with HB physical activity, adjusted for related baseline variables, were significant. These findings reveal the probable effects of GB rather than HB physical activity on mental health among the elderly.

This study assesses self-reported tobacco use prevalence (cigarette, water-pipe, and medwakh) among applicants to Abu Dhabi’s Premarital Screening program during 2011. Premarital Screening data reported to the Health Authority – Abu Dhabi from April to December 2011 were utilized to estimate tobacco use prevalence among applicants. Smoking prevalence was examined by nationality, age group and gender. Overall, 24.7% of Premarital Screening Program applicants were current smokers; 11.5% smoked cigarettes, 5.9% smoked medwakh (hand-held pipe), 4.8% smoked water-pipe and 2.5% smoked a combination (more than one type). Men (19.2%) were more likely than women (3.5%) to be current cigarette smokers. Women were much less likely to smoke medwakh (0.1%) than men (11.5%), with male UAE Nationals having the highest medwakh smoking prevalence (16.1%). The overall prevalence of water-pipe smoking was 6.8% among men and 2.8% for women with the highest water-pipe smoking prevalence (10.2%) among Arab expatriate men. Variations in tobacco use prevalence among Premarital Screening Program applicants refl ect preferences for different modes of tobacco consumption by nationality, age group and gender. Enforcement of tobacco control laws, including implementation of clean indoor air laws and tobacco tax increases, and targeted health education programs are required to reduce tobacco consumption and concomitant tobacco-related morbidity and mortality.

This study was conducted to determine the total expenditure and out of pocket payment on pregnancy complications in Tehran, the capital of Iran. A cross-sectional study conducted on 1172 patients who admitted in two general teaching referral Hospitals in Tehran. In this study, we calculated total and out of pocket inpatient costs for seven pregnancy complications including preeclampsia, intrauterine growth restriction (IUGR), abortion, ante-partum hemorrhage, preterm delivery, premature rupture of membranes and post-dated pregnancy. We used descriptive analysis and analysis of variance test to compare these pregnancy complications. The average duration of hospitalization was 3.28 days and the number of visits by physicians for a patient was 9.79 on average. The average total cost for these pregnancy complications was 735.22 Unites States Dollars (USD) (standard deviation [SD] = 650.53). The average out of packet share was 277.08 USD (SD = 350.74), which was 37.69% of total expenditure. IUGR with payment of 398.76 USD (SD = 418.54) (52.06% of total expenditure) had the greatest amount of out of pocket expenditure in all complications. While, abortion had the minimum out of pocket amount that was 148.77 USD (SD = 244.05). Obstetrics complications had no catastrophic effect on families, but IUGR cost was about 30% of monthly household non-food costs in Tehran so more financial protection plans and insurances are recommended for these patients.

This study aims to introduce an appropriate instrument for measurement of smoking stages in adolescents and to examine its validity using latent class analysis (LCA) model. We designed an algorithm to measure the smoking stages. The relevancy and clarity of the algorithm was examined by experts and lay experts. We assessed the reliability of our algorithm using test-retest method. Moreover, using the LCA, we studied the validity of the stages measured by the designed algorithm in 4903 students (ages 14-19), who were randomly selected from grade 10 high school students in Tabriz (North-West of Iran). The algorithm content validity indicates high relevancy and clarity percentages. Intra-class correlation of 0.929 was found in the assessment of the reliability of smoking stages (9 stages) in 154 students within a two-week interval. The LCA model revealed nine interpretable classes (G2 = 0.051, df = 1, P = 0.821) for the measurement of smoking stages. Examination of the smoking cessation stages in a sample of 218 students in the cessation stage demonstrated that the results for five classes could be interpreted (G2 = 0.001, df = 1, P = 0.975). The results suggested that this algorithm is clear, valid, and reliable.

Tobacco smoke is the leading cause of preventable death world-wide. Unfortunately, the risk is not limited to smokers. It is dangerous for non-smokers particularly women, kids and elderly. Despite the remarkable reduction of tobacco exposure in public places, it is still continuing at homes as the most common places. Interventions to create a smoke-free home are needed, but little is known about them. The aim of this study is to explain the field randomized controlled trial that is designed to examine the role of non-smoker women to create a smoke-free home through establishing complete agreement on ban smoking at home. In this field randomized controlled trial, the effectiveness of women’s education will be evaluated in primary health-care centers. A total of 136 non-smoker women who exposed to second-hand smoke by their husbands at home will be included (68 intervention/non-intervention group). The intervention arm will receive an educational package including a consultation visit individually, a peer group session, a booklet, a “no smoking” sign. The primary outcome is the frequency of smoke-free home (no exposure to second-hand smoke at home). Mediator outcomes include a complete agreement to ban smoking at home, second-hand smoke exposure rate and self-assertiveness rate. All measurements will be conducted on baseline, 1 and 3 months after intervention. Outcomes will present the effects of implementing multi-component women’s education intervention program to ban smoking at home. If the effectiveness of the trial is confirmed, it will be suggested to merge this package to routine care in primary health-care centers.

Nephrolithiasis, obstructive renal failure, essential hypertension, and chronic tubulointerstitial nephritis have been considered as the renal complications of hyperuricemia. Massive proteinuria has been rarely reported as the primary manifestation of increased serum uric acid. This is the report of a child presented with proteinuira, hypertension, and glomerular scelrosis secondary to hypouricosuric hyperuricemia, who was treated by uric acid lowering management.

Primary perianal tuberculosis is a rare form of extra pulmonary tuberculosis. We present a case of perianal tuberculosis without any pulmonary or gastrointestinal involvement in a diabetic patient. Histopathological examination of perianal lesion demonstrated loose granulomas and positive staining for (EZN) stain.

The main objective of this study was predicting student’s mental health using social problem solving- ability. In this correlational- descriptive study, 369 (208 female and 161 male) from, Mazandaran University of Medical Science were selected through stratified random sampling method. In order to collect the data, the social problem solving inventory-revised and general health questionnaire were used. Data were analyzed through SPSS-19, Pearson’s correlation, t test, and stepwise regression analysis. Data analysis showed significant relationship between social problem solving ability and mental health (P < 0.01). Social problem solving ability was significantly associated with the somatic symptoms, anxiety and insomnia, social dysfunction and severe depression (P < 0.01). The results of our study demonstrated that there is a significant correlation between social problem solving ability and mental health.