Iranian Journal of Public Health
Volume:43 Issue: 4, Apr 2014

This systematic review was conducted to develop a conceptual framework that addresses various factors associated with return to work among cancer survivors. Databases Medline, EMBASE, ProQuest, PubMed and ScienceDirect were systematically searched using medical subject headings [MeSH] for studies published in English from 1990 to 2013. Studies that described adult cancer patients’ self-reported data or patients’ point of view on factors associated with return to work or employment status following cancer diagnosis were included. Articles selection was conducted in three steps: selection based on title and abstract, retrieval of full text and additions of articles from reference lists and recommendations from experts. Disagreement in data extraction was solved by consultation of third reviewer. Out of twenty seven articles, breast cancer was the most studied type of cancer (30%) while colorectal cancer was studied independently in two articles (7.4%). Conceptual framework on return to work identifies factors under environmental, personal, work demand, work ability, health status and financial factors. Extensive search of scientific databases over last 24 years and the development of the conceptual framework are the strength of this review. Conceptual framework reveals the various factors including non-medical factors associated with return to work upon cancer diagnosis. It serves as a reminder to the policy makers to focus on modifiable factors as potential areas for intervention to assist cancer survivors return to work, especially those with little financial assistance and health insurance.

Nowadays, medical tourism reports impressive growth in terms of number of persons, income and number of countries involved in cross-border flows. So this study was undertaken to clarify entrepreneurship opportunities and bioethics boundaries in medical tourism. For tourism entrepreneurs, these outgoing flows related to medical procedures and tourism become an opportunity that cannot be ignored, so a wide range of tourist services related to health care are provided on a private, entrepreneurial basis. However, social and economic boundaries are omnipresent (impaired health services in receiving (incoming) countries, the crisis of the health care systems in emitting (outgoing) countries, over-consumption of medical and tourism services), and, not least, ethical considerations. Transforming medical care in a market tool, reducing human attributes to the status of commodity that can be bought, sold or negotiated, seriously challenges contemporary bioethics principles. It is a significant entering in the area (which is essentially un-ethic) of market transactions, where libertarianism and consumer-oriented attitudes dominates the spectrum of rational choice. So tourism comes to provide an organized and comfortable framework for all these choices, but many issues still remain controversial and may worsen if national health systems and national and international regulations would not identify their problems and would continue to leave medical tourism to market mechanisms. Market will efficiently allocate the resources, but not always in an ethical manner.

Traditional survey methods may cause refusals to respond or untruthful replies when encounter the sensitive questions. The Randomized Response Technique (RRT) is designed to decrease social desirability bias and obtain reliable estimates. This study aimed to apply these new methods on the sensitive questions survey. Simmons model was applied in the survey of issues relevant to commercial sex among men who have sex with men (MSM) in Beijing, China. Stratified two-stage sampling and stratified random sampling were applied. During July to December 2010 in Beijing, the commercial sex proportion among MSM was 0.051(95% CI: 0.017, 0.085), its estimated variance was 3.01×10-4. The last male condom use rate during commercial sex was 0.778(95% CI: 0.746, 0.810), its estimated variance was 2.6×10-4. We have introduced new approaches for the sensitive question survey among MSM. The new approaches are proved to be reliable and valid.

The aim of this study was to evaluate the ability of 15 serotypes of Salmonella to form biofilm on polystyrene, polyvinyl chloride (PVC) and glass surfaces.. Initially slime production was assessed on CRA agar and hydrophobicity of 20 Salmonella strains isolated from poultry and human and two Salmonella enterica serovar Typhimurium references strains was achieved by microbial adhesion to n-hexadecane. In addition, biofilm formation on polystyrene, PVC and glass surfaces was also investigated by using MTT and XTT colorimetric assay. Further, distribution of Salmonella enterotoxin (stn), Salmonella Enteritidis fimbrial (sef) and plasmid encoded fimbrial (pef) genes among tested strains was achieved by PCR. Salmonella strains developed red and white colonies on CRA and they are considered as hydrophilic with affinity values to n-hexadecane ranged between 0.29% and 29.55%. Quantitative biofilm assays showed that bacteria are able to form biofilm on polystyrene with different degrees and 54.54% of strains produce a strong biofilm on glass. In addition, all the strains form only a moderate (54.54%) and weak (40.91%) biofilm on PVC. PCR detection showed that only S. Enteritidis harbour Sef gene, whereas Pef and stn genes were detected in S. Kentucky, S. Amsterdam, S. Hadar, S. Enteritidis and S. Typhimurium. Salmonella serotypes are able to form biofilm on hydrophobic and hydrophilic industrial surfaces. Biofilm formation of Salmonella on these surfaces has an increased potential to compromise food safety and potentiate public health risk.

The aim was to compare the predictive power for Type 2 Diabetes mellitus (T2DM) using dynamic change (Difference) of metabolic syndrome (MS), Difference of fasting plasma glucose (FPG), baseline MS and FPG in cohort study. Overall, 3461 subjects were recruited from Prevention of Multiple Metabolic disorders and MS in Jiangsu of China Study with 3.8 years follow-up. Cox proportional-hazards regression and receiver operating characteristic were used to evaluate the predictive power for T2DM using Difference MS, Difference of FPG, baseline MS and FPG. Adjusted relative risk (aRR 5.24, 95% CI 4.28-6.42) of Difference of FPG to T2DM was highest than other. Difference of FPG owns the largest AUC (0.89, P<0.05), the highest sensitivity (96.25%) and specificity (80.49%) demonstrating that Difference of FPG can provide strongest predictive information to T2DM, Difference of MS comes second. Between FPG related tools, sensitivity of Difference of FPG almost was twice than baseline FPG(96.25% vs. 54.38%) suggesting that using baseline FPG would missed found 46% T2DM patients. Among MS related indicators, sensitivity of Difference of MS almost was twice than baseline MS (sensitivity 66.25% vs. 39.38%) suggesting that using baseline would missed found 61% T2DM patients. Dynamic change of FPG had the highest predictive power for T2DM in Chinese than Dynamic Change of MS, baseline MS and FPG.

The ability to taste Phenylthiocarbamide (PTC), a bitter organic compound, described as a bimodal autosomal trait is widely used to know the heritable trait in both genetic and anthropological studies. The present study was carried out to analyze the prevalence of PTC taste sensitivity and to determine the gene frequencies among some Muslim populations of Uttar Pradesh, India. This study has some physiological relevance to highlight the adaptability of endogamous groups to behavioral traits in the same place. Unrelated, healthy individuals of both sexes (Male-403, Female-418) belonging to different populations of Uttar Pradesh, India were randomly selected with the age range of 16-45 years observed for phenylthiocarbamide to taste sensitivity. PTC tasting ability was measured by using a serial dilution method of Harris and Kalmus. The phenotypic frequency of tasters was higher as compared to non-tasters, and the same is statistically significant (χ2= 11.92, df = 5, P = 0.036). There were more females among tasters (67.94%) than males (64.76%). This observation was statistically significant (χ2 = 14.79, df = 5, P= 0.011). The frequency of PTC tasters is greater than non-tasters and the females have lower non-taster phenotypes as compared to males. This type of study will provide background information about genetic structure of population and serves as useful interaction of genetics, food preferences and dietary patterns.

The TP53 gene is one of the most frequently mutated genes amongst human malignancies, particularly TP53 codon 72 polymorphism. Furthermore, an association between the TP53 codon 72 variants and prostate cancer has been reported in several studies. Although some studies have indicated an association between the TP53 Arg/Arg variant and an increased risk for prostate cancer, other studies have shown a positive correlation between the TP53 Pro/Pro genotype instead. Therefore, to clarify if this polymorphism is associated with an increased risk of prostate cancer in Iranian men, we conducted a case-control study of 40 sporadic prostate cancer patients and 80 benign prostate hyperplasia cases. The TP53 codon 72 was genotyped using an allele specific PCR. A significant association between the TP53 codon 72 genotype and prostate cancer risk was found (OR = 6.8, 95% CI = [1.8-25.1], P = 0.005). However, the results of this study did not support an association between age, the Gleason score nor TP53 genotype at codon 72 in prostate cancer patients. TP53 codon 72 polymorphism may have a great impact in the development of prostate cancer.

Dust pollution has become a serious environmental problem especially in recent decades. The present study aim was the investigation of the levels of PM10 concentration in Kermanshah, western Iran and also measured five important heavy metals (Pb, Cd, As, Hg and Cr) in some samples during 2005 to 2011. A total 2277 samples were collected from air pollution measurement station belonging to the Department of Environment in Kermanshah. Furthermore, four samples were collected during dusty days to determine the selected heavy metals concentration. The samples were analyzed statistically using the SPSS Ver.16 The highest seasonal average concentration in spring was recorded in 2008 with 216.63µg/m3, and the maximum values of 267.79 and 249.09µg/m3 were observed in summer and winter in 2009, respectively. The maximum concentration of 127.11µg/m3 was in autumn in 2010. The metals concentration (Pb, Cd, As, Hg and Cr) of samples were 42.32±5.40, 37.45±9.29, 3.51±2.07, 1.88±1.64 and 0µg/g in July, 2009, respectively. According to National Ambient Air Quality of USEPA guidelines, the most days with non-standard, warning, emergency and critical conditions were related to 2009 (120 days) while the least polluted days were recorded in 2006 (16 days). There are concerns about the increasing frequency and intensity trend of dust storms in recent years as a result of special condition in neighboring Western countries which it could endanger public health and environment. All measured heavy metals except mercury was higher than the standard level of WHO and USEPA.

HIV/AIDS epidemic is concentrated among injecting drug users in Iran. Like many other countries with HIV/AIDS concentrated epidemic, prisons are high risk areas for spreading HIV/AIDS. The aim of this paper was to study the trend of HIV/AIDS prevalence and related interventions administered in prisons of Iran during a 13 years period This cross sectional study was conducted using the data collected from the sentinel sites in all prisons in the country and it also used the data about Harm Reduction interventions which has been implemented by Iran Prisons Organization. To evaluate the correlation between the prevalence and each of administered interventions in prisons the Correlation Coefficient Test was used for the second half of the mentioned time period The prevalence of HIV/AIDS in prisons had increased rapidly in the early stages of epidemic, so that in 2002 the prevalence raised to 3.83%. Followed by the expansion of Methadone Maintenance Therapy and development of Triangular Clinics, HIV/AIDS prevalence in prisons declined. There was a relationship between interventions and the prevalence of HIV/AIDS. In regions and countries where the epidemic is highly prevalent among injecting drug users and prisoners, Methadone Maintenance Therapy and development of Triangular Clinics can be utilized to control HIV/AIDS epidemic quickly.

Nowadays mobile phone is very popular, causing concern about the effect it has on people's health. Parotid salivary glands are in close contact to cell phone while talking with the phone and the possibility of being affected by them. Limited studies have evaluated the effect of cell phone use on the secretions of these glands; so this study was designed to investigate the effects of duration of mobile phone use on the total antioxidant capacity of saliva. Unstimulated saliva from 105 volunteers without oral lesions collected. The volunteers based on daily usage of mobile phones were divided into three groups then total antioxidant capacity of saliva was measured by Ferric Reducing Ability of Plasma (FRAP) method. Data were analyzed by SPSS software version 19. ANOVA was used to compare 3 groups and post-hoc Tukey test to compare between two groups. Average total antioxidant capacities of saliva in 3 groups were 657.91 µmol/lit, 726.77 µm/lit and 560.17µmol/lit, respectively. The two groups had statistically significant different (P=0.039). Over an hour talking with a cell phone decreases total antioxidant capacity of saliva in comparison with talking less than twenty minutes.

Smoking and unhealthy diet are two major risk factors for non-communicable diseases. The aim of this study was to investigate the possible association between these two risk factors amongst healthy adults 30-60 years old in Tehran, Iran. Overall, 2602 healthy adults 30 to 60 years old in Tehran were studied. The demographic characteristics, anthropometric and smoking status of the participants were questioned. The frequency of consumption of red meat, white meat, fruits and vegetables, dairy products, bread and cereals and fast food were questioned to be daily, weekly, monthly, once every 6 months or yearly and categorized as “healthy” or “unhealthy”. Of the 2602 participants, 974 (37.4%) had smoked more than 100 cigarettes in their life time and continued daily or smoked occasionally. Smokers significantly consumed more fast food and white meat but less fruit and vegetables and dairy product (P<0.0001). Totally, 586 (22.5%) consumed “unhealthy” diet. A positive association between cigarette smoking and unhealthy diet (OR=1.68; 95% CI: 1.40-2.03) were found. After adjusting the analysis for the effect of age, education and gender, the odds ratio of consuming unhealthy diet for the smoker increased to 1.83 (1.50, 2.25) compared with non-smoker. Our study found a noticeable association between cigarette smoking and unhealthy diet. Smoking cessation and changing diet program for smokers is recommended.

The purpose of this study was to determine the level of heat stress to construction workers using Thermal Work Limit (TWL) and Wet Bulb Globe Temperature (WBGT) indices and by measuring Urine Specific Gravity (USG) among construction workers in Iran and comparing the appropriateness of these indices for measuring heat stress in Iran climate. This comparative and experimental study was conducted during September 2012 in Baghe Ketabe Tehran, one of the large size construction sites in Tehran City, Iran. Sixty participants were randomly selected in two groups (exposed to sun and non-exposed) among the construction workers in a construction campus with similar work type, climate and diet. TWL and WBGT and USG were measured in two consequent days and at the beginning, mid and end of the work shift, for both groups. The mean WBGT index was 22.6 ± 0.9 ºC for control group and 27.5 ± 1.2 ºC for exposure group, the mean TWL index measure was 215.8 ± 5.2 W/ m2 for control group and 144 ± 9.8 W/ m2 for exposure group and the mean USG was 1.0213 ± 0.0054 in control group and 1.026 ± 0.005 in exposure group. There was a significant difference in TWL, WBGT and USG between exposed and non-exposed group (P<0.01). workers were at an allowed level of heat stress. TWL, WBGT and USG measures were significantly correlated; however as TWL level enabled classification based on required intervention, it had some merit over WBGT index.

Prematurity is the most common cause of neonatal death. Risk factors of premature birth can be related with ethnicity and genetic. There is no comprehensive high sample size study in Kurdish ethnicity to determine risk factors related to prematurity. This study evaluated risk factors of preterm labor in Kurdish ethnicity. This case-control study was conducted in 200 preterm infants (case group) and 400 term infants (control group), in Besat Hospital, Sanandaj, Iran, in the year 2012. Data was analyzed using SPSS software and analysis was performed by Chi-square, Mann-Whitney and logistic regression tests. In univariate analysis, mother's own prematurity, history of previous preterm labor, prematurity in the first-degree family members, history of dead children, premature rupture of membranes, multiple pregnancies, overt diabetes, chronic hypertension, preeclampsia and eclampsia, infertility and cervical incompetence had significant relationship with preterm labor. However, multivariate analysis results showed that abnormal amniotic fluid, premature rupture of membranes, double and multiple pregnancies, chronic hypertension, family history of premature birth, mothers age over 35 years, and cervical incompetence (P<0.05) had significant relationship with the premature birth. Screening of newborns at risk of preterm labor could be achieved by these risk factors: family history of prematurity, mother's own history of prematurity and previous preterm labor, history of previous neonatal death, decreased amniotic fluid, multiple pregnancies, overt diabetes, hypertension, preeclampsia, infertility and cervical incompetence, however some of these factors are not the direct cause of prematurity. Our study suggests genetic’ s role in preterm labor.

To identify mental disorders and their prevalence in patients with retinitis pigmentosa (RP). This descriptive study was carried out between January 2009 and January 2010 on 417 patients with RP, who were members of Iran RP Center. The necessary data were collected using questionnaires consisting two parts: The background characteristics and questions assessing the mental health and screening personality and psychosocial disorders, which were designed based on the Minnesota Multiphasic Personality Inventory. Data were analyzed using SPSS software with Chi-square test to assess the relationship between background characteristics and each mental disorder. Scores in the range of 30 and 70 were considered normal. Patients with RP suffered from eight mental disorders with the following prevalence: Obsessive compulsive disorder (39.3%), schizophrenia (38.1%), antisocial personality (37.6%), paranoia (36.7%), hypochondrias (35.3%), depression (31.2%), hysteria (26.9%), and hypomania (23.7%). No one had all the eight mental disorders simultaneously. Statistical analysis showed no significant relationship between obsessive compulsive disorder, paranoia, depression, and hysteria and background characteristics. A significant association was found between schizophrenia and onset of RP (P = 0.047). Furthermore, a significant association was seen between hypochondrias and educational level (P = 0.026) as well as income (P = 0.037), and smoking (P = 0.009). There was also a significant association between hypomania and marital status (P = 0.027). The findings showed that RP might lead to various mental disorders, especially obsessive compulsive disorder.

Thyroglossal duct cysts are the most common form of congenital cysts on the neck. The incidence of thyroid papillary carcinoma in thyroglossal duct cyst is less than 1%. In most cases the diagnosis is made postoperatively. We present a 22-year-old female with thyroid papillary carcinoma arising from thyroglossal duct cyst, identified in pathologic study after sistrunk operation. In our case there was neither invasion to adjacent tissue nor lymph node involvement. The patient then underwent total thyroidectomy and bilateral neck dissection. The patient was treated with radioactive iodide and thyroid suppression therapy was given as adjuvant treatment. The patient has been following for two years without any metastasis.