International Journal of Preventive Medicine
Volume:5 Issue: 1, Jan 2014

So far several animal and case-control studies have confirmed this hypothesis that dietary fat increases the risk of breast cancer. However, cohort studies have not shown this relationship. The aim of this study was to review the studies on the relationship between dietary fat intake and breast cancer risk among women. Electronic database PubMed and Google Scholar were searched using the key words: Breast cancer, dietary fat, serum estrogen, saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs). The evidence of the studies regarding to the association of total and subtypes of fat intake with breast cancer risk are inconsistent. Several studies have shown that, among several types of fat, SFAs and w-3 PUFA intake are associated with an increased and reduced risk of breast cancer, respectively. The relationship between MUFAs intake and breast cancer risk is conflicting. Narrow ranges of fat intake among populations, measurement errors, high correlation between specific types of dietary fat, the confounding variables like body fatness and high-energy intake and other dietary components such as fiber and antioxidants might be probable explanations for these inconsistent results. Although we are not at a stage where we can justifiably advise women to reduce their fat intake to decrease the risk of developing breast cancer, it seems the current guidelines to lower total fat consumption and recommendation to consumption of unsaturated fats such as MUFAs and w-3 fatty acids and also reduction of SFAs (meat and dairy products) intake to avoid heart disease is also useful for breast cancer risk.

Fertility pattern has some influence on health of mother and child as well as it can resist population growth. A cross sectional study on fertility perception among married women of reproductive age group, was carried out in 3 blocks and 2 municipality areas of Howrah District of West Bengal, India, covering 12 villages and 4 wards, selected by stratified multistage random sampling, for a period of 6 months from April to September 2009. Two thousand married women were the respondents. Respondents were mainly belonged to poor and BPL groups (86.7%), one third (33.4%) were illiterate and just literate group, 66.8% of the respondents belonged to Hindu by religion and 63.4% had history of teen age pregnancy and more than 50% of the respondents were married early (below 18 years). The study revealed that perception about age of marriage, interval between marriage and 1st pregnancy and spacing were incorrect in case of 45.8%, 37.6% and 23% of the respondents, respectively. 22.3% and 13.1% of the respondents had no proper idea regarding desired no of children and Family Planning methods, respectively and their knowledge varied with literacy status, age and religion. Majority (67.5%) of the study population received information about family planning methods from health personnel. Correct Knowledge regarding different components of fertility among Eligible Couples to be enhanced by intervention through Information, Education and Communication (Interpersonal Communication and Mass Media).

Nutrition in childhood has a significant role in current and adulthood health. Recent studies have shown that the mother’s life-style has an important role in the methods used by mother to feed child, child’s diet and body mass index (BMI). This study paper aimed to investigate the association between mother’s weight efficacy life-style (WEL) with feeding practices and diet in children aged 3-6 years. In this cross-sectional study, which was carried out in 18 Primary Schools of Rasht (Iran) in 2012, 165 mothers with children aged 3-6 years were participated. Mothers reported their own and their child’s demographics. Aspects of mother’s WEL and mother’s control practices were assessed using WEL questionnaire and Comprehensive Feeding Practices Questionnaire respectively. Height and weight of mothers participated in the study were measured. Child’s dietary intake was measured using Food Frequency Questionnaire (FFQ). The role of mother’s weight efficacy in predicting child’s feeding practices and child’s diet was assessed using the linear regression. Statistical significance for allP values was set at 0.003.The results were showed that mother’s weight efficacy was related to child feeding practices and child’s dietary intake. The mothers with similar WEL applied similar methods in child nutrition. Mothers with better weight efficacy used more encourage balance and variety (β= 1.860), environmental control (β= 0.437), child involvement (β=0.203) and less emotion regulation using foods (β= −0.213) and their children eat fewer snacks (β=−0.318) (PV= 0.003).The result of this study showed that maternal life-style was associated with feeding practices and child’s intake. There was no significant relation between the maternal self-efficacy and child BMI.

Earlier forms of food frequency questionnaire (FFQ) used in Iran have extensive lists of foods, traditional categories and food-based design, mostly with the interviewer-administered approach. The aim of the current paper is to describe the development of a dish-based, machine-readable, semi-quantitative food frequency questionnaire (DFQ).Within the framework of the Study on the Epidemiology of Psychological, Alimentary Health and Nutrition project, we created a novel FFQ using Harvard FFQ as a model. The following steps were taken to develop the questionnaire: Construction of a list of commonly consumed Iranian foods, definition of portion sizes, design of response options for consumption frequency of each food item and finally a pilot test of the preliminary DFQ. From a comprehensive list of foods and mixed dishes, we included those that were nutrient-rich, consumed reasonably often or contributed to between-person variations. We focused on mixed dishes, rather than their ingredients, along with foods. To shorten the list, the related food items or mixed dishes were categorized together in one food group. These exclusions resulted in a list of 106 foods or dishes in the questionnaire. The portion sizes used in the FFQ were obtained from our earlier studies that used dietary recalls and food records. The frequency response options for the food list varied from 6-9 choices from “never or less than once a month” to “12 or more times per day”.The DFQ could be a reasonable dietary assessment tool for future epidemiological studies in the country. Validation studies are required to assess the validity and reliability of this newly developed questionnaire.

The present study designed to test effects of defatted soy-fortified wheat bread on the organoleptic properties as well as influences on rat growth rate.Defatted soy flour (DSF) was blended with wheat flour with extraction rate of 82-84% at 3, 7, and 7% levels plus 3% sugar. Bread produced with these blends compared with regular Taftoon bread and was tested for chemical and organoleptic characteristics. The organoleptic characteristics of blends consist of taste and flavor, crust texture, fragrance and aroma, appearance, bendability, and overall acceptability were determined through taste panel by 213 judges. Forty Sprague Dawley rats were randomly given codes and allocated to different groups via tables with random numbers to feed on three DSF-fortified bread blends and control bread for 30 days.The blending of wheat flour with DSF altered the organoleptic properties of breads. Addition of DSF increased significantly the protein and ash content of the bread (P< 0.05). Organoleptic test indicates that the best formulation is between 3 and 7% fortifications of DSF blends. In biological evaluation, rats fed the control diet had the lowest body weight gain and their food efficiency ratio was significantly different (P< 0.05) in compare with 7% DSF-fortified blend.It was concluded that overall acceptability score significantly decreased with increasing DSF substitution level. Rats fed 7% DSF-fortified blend showed privileged food efficiency ratio. Then, the best formulation is between 3 and 7% DSF bread. This formulation can nourish all human at risk of malnutrition.

A key challenge for equality evaluation and monitoring, mainly in developing countries, is assessing socioeconomic status of individuals (SES). This difficulty along with low technical competency, have resulted in many health information collected in these countries to be devoid of suitable SES indices. However, simplifying data collection requirements for estimating economic parameters seems to guarantee their wide adoption by survey and health information system (HIS) designers, resulting in immediate production of equity-oriented policy-relevant information. The goal of this study is obtaining adequate number of variables, combination of which can provide a valid assessment of SES in Iranian population.The data source was Living Standards Measurement Study of Iran (2006). Data of 27,000 households on the ownership of 33 household assets was used for this analysis. Households of this study were put into 5 groups in terms of SES status using principle component analysis. Then selection was made among 33 variables so that a combination with minimum necessary number for obtaining SES status is reached. Agreement of the new combination (including minimum number of variables) was assessed with full variable combination (including all 33 variables) using weighted kappa.A minimum set of six variables including having kitchen, bathroom, vacuum cleaner, washing machine, freezer and personal computer can successfully discriminate SES of the population. Comparing these 6 item-index with the whole 33 item-index revealed that 65% of households were in the same quintiles, with a weighted kappa statistics of 0.76. For households in different quintiles, movement was generally limited to one quintile, with just 2% of households moving two or more quintiles. The proposed simple index is completely applicable in current Iran’s society. It can be used in different survey and studies. The development is quite simple and can be done on a yearly basis using the updated National level data. Having such standardized simplified and up to date SES indices and incorporating them into all health data sources can potentially ease the measurement and monitoring of equity of health services and indices.

Internalizing and externalizing disorders in children and adolescents have been known in many countries. This study was performed to find out effect of culture on emotion regulation and its aim was to identify relationship between emotion regulation and psychopathology in children. Participants were 269 children from Iran and Germany who voluntarily agreed to participate. Groups were defined by cultural background, thus we select them by available method. In order to data gathering, we used children emotion management scale, cognitive emotion regulation and youth self‑report (YSF) questionnaires. For data analysis, we used Multivariate Analysis of Variance (MANOVA). Finally, in order to realize variables that are significant in Iran or Germany groups, we used post hoc Scheffe test.The results showed significant relationship in main effect of country (P< 0.001) and main effect of sex (P= 0.003). In addition results indicated no significant relations in interaction effect between country and sex. Main effect of country was significant (P ≤0.001). But findings in sex, country and sex interactions were not significant. MANOVA analyses for internalizing and externalizing YSF indicated main effect of country and sex was significant and main effect of country and sex interaction was not significant statistically (P= 0.088).The results imply that students in Iran showed more internalizing and externalizing symptoms. We concluded that culture and emotion expressions are explaining differences between Iranian and German students. It is difficult for young children to express themselves because they have to cope with situation and respect to reserve harmony in family.

Postpartum care at home is a post delivery care method that can be provided by public health nurses, trained health workers, or midwifery nurses. A study conducted to compare effect of two midwife visits at home to usual postpartum care on the healthy behaviors of low-risk Iranian mothers. A randomized controlled trial conducted on 200 mothers at a reference center for screening for infant hypothyroidism in Tehran. Mothers were randomized to either home-based (n= 100) or routine-based postpartum care (n= 100). Each mother and her neonate received two cares. Home-based cares were provided by a midwife in the intervention group. Postpartum cares in the control group were provided by care providers of primary health care system. Healthy behavior was measured using a validated and reliable researcher made instrument. The data were analyzed using independent sample t-tests, paired t-test, and χ2-test. The data showed that a significant number of subjects in the control group did not receive their postpartum care (P< 0.001). The mean score of maternal healthy behaviors in the intervention group increased from 120.5 (SE= 0.76) to 148.9 (SE= 1.02) (P< 0.001) and in the control group from 119.9 (SE= 1.06) to 140.9 (SE= 1.08) (P< 0.001). The mean score of maternal healthy behaviors in the intervention group had significant differences with that in the control group at the end of study (P< 0.001).Early postpartum care at home by trained midwives can be positively effective for improving maternal healthy behaviors in less developed countries.

Training medical students in tobacco prevention and cessation skills is critical to have competent physicians who are prepared to address the grave levels of morbidity and mortality associated with tobacco use. Medical students should possess adequate knowledge of the risks of tobacco use and acquire appropriate skills for helping their patients in smoking prevention and cessation. However, in India, enough attention has not been given to elicit the active participation of physicians in tobacco control. Particularly, the medical students have remained an unexplored potential and the missed opportunity. Keeping this in view, a program was undertaken to develop the skills and competence of medical students with the objective of improving medical student inquiry into smoking and the delivery of advice accordingly for patients in their clinical year’s routine consultations. The targeted learners were 149 1st-year medical and dental students of SCB Medical College, Cuttack, Orissa, India, who had appeared the second semester examination; 84 of the participants were male. We attempted to determine whether a curriculum on tobacco intervention could improve relevant knowledge, attitudes and self-confidence and be applied in students’ early clinical experience.

Low birth weight (LBW) is considered as an important outcome of birth and pregnancy, which is associated with long-term consequences and health-care problems. Maternal lifestyle and health care during pregnancy are powerful predictors of BW of infants. The purpose of this study was to assess the effect of a self-care educational program based on the Health Belief Model (HBM) on reducing LBW among a sample of pregnant Iranian women.In this randomized controlled trial, we recruited 270 pregnant women referred to prenatal clinics in the south of Tehran, Iran. The participants were randomly allocated to two intervention and control groups. Women in the intervention group received an educational program to promote self-care behaviors during pregnancy. The control group received routine care. BW was compared between the two groups. Baseline demographic characteristics and knowledge and attitude scores before the intervention in both groups were compared using the Chi-square test for categorical variables. Logistic regression analysis was conducted to control the effect of demographic variables on BW. The results showed that LBW was reduced significantly in the intervention group at the follow-up measurement (5.6 vs. 13.2%,P = 0.03). After controlling for demographic characteristics, we found a significant decrease in the risk of LBW in the intervention group [odds ratio (OR): 0.333; 95% confidence interval (CI): 0.12-0.88,P = 0.02].Implementation of a self-care educational program designed on the basis of an HBM on pregnant women was effective in reducing the rate of LBW.

Pain and limited range of motion (ROM) are the crucial subsequent results of joint hemorrhages in individuals with bleeding disorders and hemophilia. Exercise interventions are particularly recommended in treatment of such patients. The purpose of this study was to detect the influences of conventional exercise therapy and hydrotherapy on the knee joint complications in patients with hemophilia.A total of 40 patients engaging hemophilia A were randomized into one of three groups: Therapeutic exercise (N= 13), hydrotherapy (N= 14) or control (N= 13). While the first two groups followed their specific programs for 4 weeks, routine life-style was maintained by subjects in the control group in this period. To evaluate the pain level and knee ROM the visual analog scale and standard goniometer were utilized,respectively. The outcome was measured at baseline and after completing the prescribed protocols. Data analysis was performed using one-way analysis of variance and Scheffe statistical tests (P< 0.05).Both experimental groups experienced more significant decreasing in pain level (P< 0.001) and knee flexion and extension ROM (P< 0.001) in comparison to the control group. Although the pain was significantly (P< 0.01) more alleviated in participants treated through hydrotherapy in comparison to exercise therapy, the difference in ROM improvement was not statistically significant (P> 0.05).Using hydrotherapy in addition to usual rehabilitation training can result in beneficial effect in terms of pain and knee joint ROM. However, it appears that hydrotherapy is more effective in reducing pain.

Chronic arsenic toxicity (Arsenicosis) due to drinking of arsenic contaminated ground water is a global problem. However, its treatment is unsatisfactory. Methylation of arsenic facilitates its urinary excretion. Persons with relatively lower proportion of urinary dimethyl arsenic acid (DMA) are found to have at greater risk of developing symptoms of arsenicosis including its complications. The biochemical pathway responsible for methylation of arsenic is a folate-dependent pathway. Studies in rodents and humans suggest that folate nutritional status influences the metabolism of arsenic.The present study compares the effect of giving folic acid on 32 arsenicosis patients during a 6-month period and comparing the results with clinical effect of taking only arsenic-free safe water on 45 age and sex-matched arsenic-affected people for the same period.There was significant improvement of arsenical skin lesion score of both patients treated with folic acid (2.96 ± 1.46 to 1.90 ± 0.90, P< 0.001) and arsenic free safe water(2.91 ± 1.26 to 1.62 ± 1.05, P< 0.001) for a period of 6 months. Significant improvement in systemic disease score was also observed from the baseline systemic score in folic acid treated group (4.78 ± 3.43 to 1.00 ± 1.56, P< 0.001) and the group treated with arsenic-free water (1.87 ± 2.11 to 0.82 ± 1.62, P< 0.001).However, there was a significant increased improvement of systematic disease score in the folic acid treated group compared to the control group taking arsenic free water (P< 0.001).This study provides evidence that folic acid treatment in arsenicosis cases could help in reducing clinical symptoms of arsenicosis.

This study aims to assess the relationship of serum Mg and vitamin D levels in a nationally-representative sample of Iranian adolescents.The study participants consisted of 330 students, aged range from 10 to 18 years, consisting of an equal number of individuals with and without hypovitaminosis D. The correlation between serum 25 hydroxy vitamin D (25(OH) D) and magnesium (Mg) concentrations was determined.The mean age of participants was 14.74 ± 2.587 years, without significant difference between those with hypovitaminosis D and those without it. The mean 25(OH) D level was 6.34 ± 1.47 ng/ml in the group with hypovitaminosis D and 39.27 ± 6.42 ng/ml in the group without it. The mean Mg level was 0.80 ± 0.23 mg/dl with lower level in the group with hypovitaminosis D than in others (0.73 ± 0.22 mg/dl vs. 0.87 ± 0.22 mg/dl, respectively) and according to t-test analysis, significant lower levels in the deficient group was observed (P= 0.0001). The linear regression analysis showed the meaningful relationship between Mg and 25(OH) D serum levels (P= 0.0001).Our study revealed significant associations between serum Mg and 25(OH) D levels. This finding may be of use for further studies on the prevention and management of hypovitaminosis D in children and adolescents. Further longitudinal studies shall evaluate the underlying mechanisms and the clinical significance of the current findings.

Context: Sepsis is one of the major causes of death in intensive care units. Oxidative stress and hyper-inflammation has been shown to be major cause of mortality and morbidity in septic cases. Pomegranate is a fruit considered for its antioxidant and anti-inflammatory properties. The aim of this study is to evaluate the effect of a standard pomegranate fruit liquid extract (POMx), on mortality and peritoneal bacterial load in cecal ligation and perforation (CLP) sepsis model. Settings and Design:Male wistar rats were divided into four groups of 24 each: sham; CLP; prevention (consumed POMx [250 mg of polyphenols/kg/day] for 4 weeks before CLP); treatment(received a single drink of POMx [250 mg of polyphenols/kg] after CLP). Each group was divided in to three subgroups, each containing eight animals, for bacterial load and survival (with and without antibiotics) studies.Sepsis was induced by CLP surgery. Ten day survival rate were recorded. Peritoneal bacterial load was also assessed. Statistical Analysis Used:Log-rank and Kruskal-Wallis tests.There was no significant difference in survival rate of CLP, prevention and treatment groups, in subgroups without antibiotics. However, in subgroups with antibiotics, the prevention group had significantly lower survival rate than sham group (P< 0.05). Conversely, the bacterial load of prevention and treatment group were significantly higher than sham group (P< 0.01).Our study demonstrates for the first time that pomegranate extract could increase mortality rate via increasing peritoneal cavity bacterial load, in CLP sepsis model. More studies to assess mechanisms of this effect are warranted.

Tissue iron deposition may disturb functions of the organs. In many diseases like thalassemia, the patients suffer from iron deposition in kidney and heart tissues. Deferoxamine (DF) is a synthetic iron chelator and silymarin (SM) is an antioxidant and also a candidate for iron chelating. This study was designed to investigate the effect of DF and SM combination against kidney and heart iron deposition in an iron overload rat model.Male Wistar rats were randomly assigned to 5 groups. The iron overloading was performed by iron dextran 100 mg/kg/day every other day during 2 weeks and in the 3 rd week, iron dextran was discontinued and the animals were treated daily with combination of SM (200 mg/kg/day, i.p.) and DF (50 mg/kg/day, i.p.) (group 1), SM (group 2), DF (group 3) and saline (group 4). Group 5 received saline during the experiment. Finally, blood samples were obtained and kidney, heart and liver were immediately removed and prepared for histopathological procedures.The results indicated no significant difference in kidney function and endothelial function biomarkers between the groups. However, combination of SM and DF did not attenuate the iron deposition in the kidney, liver and heart. DF alone, rather than DF and SM combination, significantly reduced the serum level of malondialdehyde (P< 0.05). Co-administration of SM and DF significantly increased the serum level of ferritin (P< 0.05).DF and SM may be potentially considered as iron chelators. However, combination of these two agents did not provide a protective effect against kidney, liver and heart iron deposition.

Myxomas, the most common primary cardiac tumors, are known as a source of cardiogenic emboli. The possibility of their early detection has made them of great importance for emergency medicines. Detection of the disease is probable at early stages using echocardiography and associate complications such as syncope, cerebral embolic ischemic strokes, and sudden death. We report experience of a rare case of juvenile acute stroke in a patient with cardiac myxoma affecting all cardiac chambers presenting to the emergency department. In young stroke patients with signs and symptoms compatible with cardiovascular involvement, cardiogenic emboli should be taken into consideration; early echocardiographic studies are highly recommended. Prompt myxoma resection is required in both asymptomatic and stroke patients in whom intravenous thrombolysis course has not been implemented due to any limitations.

The aim of the present study was to determine the prevalence and prognosis of cerebrovascular accident(CVA) and its subtypes among Iranian patients with systemic lupus erythematosus (SLE).In a cross-sectional study, medical records of 575 SLE patients were reviewed. The patients developing CVA in their course of disease were extracted. In these patients, data about demographic features, lupus anti bodies, duration of the disease until CVA, CVA manifestation(s) and follow-up duration were gathered. In the next step, patients with any kinds of CVA were summoned to Neurology clinic to identify the grade of disability in each patient with CVA.We identified 38 patients with CVA of which 6 (15.8%) were men and 32 (84.2%) were women. The most common subtype of CVA was small vessels thrombosis (21.05%)among the study patients and hemi paresis was the most prevalent initial presentation (39.47%). In 11 (28.9%) patients, SLE was initiated with CVA and in 3 (7.9%) patients CVA had happened in the 1st year of SLE. Anti-phospholipid antibodies (APLA) were positive in 29 (76.3%) patients. Mean modified Rankin Scale in patient with positive and negative serology for APLA was 0.93 ± 1.11 and 0.22 ± 0.66 respectively (P= 0.006).Our study shows that 6.6% of Iranian SLE patients have CVA during their course of the disease. Small vessels thrombosis is the most common CVA subtype and hemi paresis is the most prevalent initial presentation. Moreover, we showed that the prognosis of CVA in Iranian SLE patients is not unfavorable.

Although cardiovascular disease (CVD) is typically associated with middle- or old-age, the atherosclerotic process often initiates early in childhood and is occurring at an increasing rate. There is a consensus that changes in life-style have driven the current epidemic. Adverse changes in physical activity, nutrition, and sleep behavior have been strongly linked to the development of a host of cardio-metabolic conditions, including obesity, dyslipidemia, hypertension, and type 2 diabetes mellitus. These conditions independently and additively increase CVD risk, even in children and adolescents. The result is that today’s children and adolescents are not only becoming pre-conditioned for CVD, but are also, due to developmental issues, unable to achieve the level of health achieved by their parents. Such early development of the disease risk factors also means that by simply focusing on the clinical manifestations of CVD that is “reactive” medicine, we are tackling the problem too late. Public health-care policy needs to place a stronger focus on paediatric “preventive” medicine, not only for the well-being of children, but to alleviate the increasing economic cost that is being placed on society through the prolonged burden of disease.