International Journal of Preventive Medicine
Volume:5 Issue: 6, Jun 2014

During recent years, there have been many advances in different types of pharmacological and non‑pharmacological tobacco control treatments. In this study, we aimed to identify the most effective smoking cessation methods used in quit based upon a review of the literature. We did a search of PubMed, limited to English publications from 2000 to 2012. Two trained reviewers independently assessed titles, abstracts and full texts of articles after a pilot inter‑rater reliability assessment which was conducted by the author (GH). The total number of papers and their conclusions including recommendation of that method (positive) or not supporting (negative) was computed for each method. The number of negative papers was subtracted from the number of positive ones for each method. In cases of inconsistency between the two reviewers, these were adjudicated by author. Of the 932 articles that were critically assessed, 780 studies supported quit smoking methods. In 90 studies, the methods were not supported or rejected and in 62 cases the methods were not supported. Nicotine replacement therapy (NRT), Champix and Zyban with 352, 117 and 71 studies respectively were the most supported methods and e‑cigarettes and non‑Nicotine medications with one case were the least supported methods. Finally, NRT with 39 and Champix and education with 36 scores were the most supported methods. Results of this review indicate that the scientific papers in the most recent decade recommend the use of NRT and Champix in combination with educational interventions. Additional research is needed to compare qualitative and quantitative studies for smoking cessation.

Community‑based health programs (CBHPs) with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation‑friendly policies in the community, academy and funding organizations. In this qualitative study, 13 CBHPs, which were active for last 5 years have been assessed using semi‑structural in‑depth interviews with programs principal and managers and focus group discussions with volunteers and service users. Data analysis was based on the deductive‑inductive content analysis considering the participatory approaches in these programs. The results show that, the main category of participation was divided to community participation and intersectional collaboration. The community participation level was very different from “main,” “advisory” or “supporting” level. The process of recruitment of volunteers by the governmental organization was centralized and in non‑governmental organizations was quite different. According to respondents opinion, financial and spiritual incentives especially tangible rewards, e.g., learning skills or capacity building were useful for engaging and maintaining volunteers’ participation. For intersectional collaboration, strong and dedicated partners, supportive policy environment are critical. It seems that maintaining partnership in CBHP takes considerable time, financial support, knowledge development and capacity building.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive women. Nearly 10% of young women in this period involved. Although factors such as Insulin Resistance, hyper insulinemia, obesity and dietary are suggested to be associated with PCOS, cause of PCOS is not completely understood. Dairy products (a key component of the usual diet) of participants can also affect the factors of this disease and may have beneficial effects on treatment of PCOS. However, research in this area is scarce. The purpose of this study was to evaluate the relationship between dairy products consumption and PCOS. This descriptive cross‑sectional study of 400 women was conducted in Shahid Beheshti Hospital of Isfahan University of Medical Science, Iran. Dietary intake was evaluated by validated food frequency questionnaire. Other variables such as ovarian disease, inherited predisposition, age at menarche, physical activity and history of other diseases were evaluated using questionnaire. Data analysis was performed by a logistic regression test using SPSS software version 15 Predictive analytics software and solutions. There were a significant association between PCOS and ovarian disease (P < 0.001), age (P < 0.001) and using medication (P = 0.001). Body mass index (BMI) was inversely associated with PCOS, but it was not significant (P = 0.068). There was a significant direct relationship between milk consumption and risk of PCOS after adjusting for confounding factors (P = 0.028). The findings of this study indicated that ovarian disease and medication use is directly linked to PCOS. Dairy consumption was not significantly correlated with PCOS. However, after adjustment for confounders, there was an direct relationship between milk consumption and risk of PCOS.

Health status of children and adolescents is determined to a larger extent by their nutritional status. There are no published studies available on the influence of thinness on childhood morbidity using new World Health Organization‑body mass index (WHO‑BMI) for age criteria. This cross‑sectional study was conducted in primary, high schools, pre‑university and degree colleges at southern Karnataka for a period of 1 year. Majority 6924 (53.6%) were in the age group of 15‑19 years with the mean age of 14.2 ± 3.1 years. 6167 (47.7%) were males and 6749 (52.3%) were females. As per WHO growth standards for children between 5 and 19 years, taking BMI for age criteria into account, 9092 (70.4%) subjects were found to be normal, 3660 (28.3%) thin and 164 (1.3%) overweight/obesity. 8224 (63.7%) subjects were suffering from some sort of morbidities. Mean morbidities rank for subjects with thinness was found to be significantly higher compared with normal and overweight/obese subjects. Thinness was found to be the major predictor of morbidity age, sex and residing in rural areas. Magnitude of thinness among children and adolescents was 28.3%. BMI for age criteria was found to be a significant predictor of childhood and adolescent morbidity.

The aim of the current study was twofold: To investigate the effect of veteran status on risk of developing heart disease over a period of 20 years in the United States and to test if socio‑economic characteristics, chronic conditions, health behaviors, body mass index (BMI) and depressive symptoms explain the association between veteran status and risk of heart disease. Data came from the Health and Retirement Study, a 20 year national cohort from 1992 to 2012. The study enrolled a representative sample of Americans over the age of 50. We included 8,375 individuals who were older than 50 years at entry, did not have heart disease at baseline and provided data on heart disease over the next 20 years. Veteran status was considered to be the independent variable. Self‑reported data on physician diagnosis of heart disease, which was measured on a biannual basis, was the outcome. Baseline socio‑economic data (i.e. age, gender, race, marital status and education), chronic conditions (diabetes and hypertension), health behaviors (i.e. drinking, smoking, and exercise), BMI and depressive symptoms (modified Center for Epidemiologic Studies Depression Scale) were entered into logistic regressions. Logistic regression was used for data analysis. Veterans were at higher risk of having a new onset of heart disease (unadjusted relative risk [RR] = 1.996, 95% confidence interval [CI] =1.694‑2.351), compared with non‑veterans. Logistic regression confirmed the association between veteran status and heart disease (adjusted RR = 1.483, 95% CI = 1.176‑1.871) after controlling for all covariates. Veterans may be at higher risk for heart disease over time and this link may be independent of baseline socio‑economic characteristics, chronic medical conditions, health behaviors, BMI and depressive symptoms. Veterans may require more rigorous cardiovascular prevention programs.

The effect of high‑legume hypocaloric diet on metabolic features in women is unclear. This study provided an opportunity to find effects of high‑legume diet on metabolic features in women who consumed high legumes at pre‑study period. In this randomized controlled trial after 2 weeks of a run‑in period on an isocaloric diet, 42 premenopausal women with central obesity were randomly assigned into two groups: (1) Hypocaloric diet enriched in legumes (HDEL) and (2) hypocaloric diet without legumes (HDWL) for 6 weeks. The following variables were assessed before intervention and 3 and 6 weeks after its beginning: Waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting serum concentrations of triglyceride (TG), high density lipoprotein cholesterol, fasting blood sugar (FBS), insulin, homeostasis model of insulin resistance (HOMA‑IR), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). We used multifactor model of nested multivariate analysis of variance repeated measurements and t‑test for statistical analysis. HDEL and HDWL significantly reduced the WC. HDEL significantly reduced the SBP and TG. Both HDEL and HDWL significantly increased fasting concentration of insulin and HOMA‑IR after 3 weeks, but their significant effects on insulin disappeared after 6 weeks and HDEL returned HOMA‑IR to basal levels in the subsequent 3 weeks. In HDEL group percent of decrease in AST and ALT between 3rd and 6th weeks was significant. In HDWL group percent of increase in SBP, DBP, FBS and TG between 3rd and 6th weeks was significant. The study indicated beneficial effects of hypocaloric legumes on metabolic features.

The present study was aimed to evaluate the efficacy of acetaminophen plus dexamethasone on post‑operative emergence agitation in pediatric adenotonsillectomy. A total of 128 patients were randomized and assigned among four groups as: Intravenous (IV) dexamethasone, oral acetaminophen, IV dexamethasone plus oral acetaminophen, placebo. Group 1 received 0.2 mg/kg dexamethasone plus 0.25 mg/kg strawberry syrup 2 h before surgery. Group 2 received 20 mg/kg oral acetaminophen (0.25 ml/kg) with 0.05 ml/kg IV normal saline. Group 3 received 20 mg/kg acetaminophen and 0.2 mg/kg dexamethasone intravenously. Group 4 received 0.25 ml/kg strawberry syrup and 0.05 ml/kg normal saline. Agitation was measured according to Richmond agitation sedation score in the post anesthetic care unit (PACU) after admission, 10, 20 and 30 min after extubation. Pain score was measured with FACE scale. Nurse satisfaction was measured with verbal analog scale. If agitation scale was 3 ≥ or pain scale was 4 ≥ meperidine was prescribed. If symptoms did not control wit in 15 min midazolam was prescribed. Patients were discharged from PACU according Modified Alderet Score. Data were analyzed with ANOVA, Chi‑square, and Kruskal‑Wallis among four groups. P < 0.05 was considered statistically significant. A total of 140 patients were recruited in the study, which 12 of them were excluded. Thus, 128 patients were randomized and assigned among four groups. The four treatment groups were generally matched at baseline data. Median of pain score in 0, 10, 20 and 30 min after extubation were different between each study group with the control group (<0.001, 0.003 respectively). Also median of agitation score in 0, 10, 20 and 30 min after extubation were different between each study group with the control group (<0.001). Incidence of pain and incidence of agitation after extubation were not statistically identical among groups (P < 0.001 and P = 0.002 respectively). Mean of recovery time, duration of agitation and 1st time to agitation appearance, meperidine and midazolam consumption, nurse satisfaction and complication frequency were not statistically identical among groups (P < 0.001). Acetaminophen, dexamethasone and combination of them are superior to placebo for prevention of agitation after adenotonsillectomy in children. Furthermore combinations of both drugs are superior to acetaminophen or dexamethasone separately.

Eurycoma longifolia Jack (ElJ) has been shown to elevate serum testosterone and increased muscle strength in humans. This study investigated the effects of Physta® a standardized water extract of ElJ (400 mg/day for 6 weeks) on testosterone: epitestosterone (T:E) ratio, liver and renal functions in male recreational athletes. A total of 13 healthy male recreational athletes were recruited in this double blind, placebo‑controlled, cross‑over study. The participants were required to consume either 400 mg of ElJ or placebo daily for 6 weeks in the first supplementation regimen. Following a 3 week wash‑out period, the participants were requested to consume the other supplement for another 6 weeks. Mid‑stream urine samples and blood samples were collected prior to and after 6 weeks of supplementation with either ElJ or placebo. The urine samples were subsequently analyzed for T:E ratio while the blood samples were analyzed for liver and renal functions. T:E ratio was not significantly different following 6 weeks supplementation of either ElJ or placebo compared with their respective baseline values. Similarly, there were no significant changes in both the liver and renal functions tests following the supplementation of ElJ. Supplementation of ElJ i.e. Physta® at a dosage of 400 mg/day for 6 weeks did not affect the urinary T:E ratio and hence will not breach any doping policies of the International Olympic Committee for administration of exogenous testosterone or its precursor. In addition, the supplementation of ElJ at this dosage and duration was safe as it did adversely affect the liver and renal functions.

Expanding cities with rapid economic development has resulted in increased energy consumption leading to numerous environmental problems for their residents. The aim of this study was to investigate the correlation between air pollution and mortality rate due to cardiovascular and respiratory diseases in Shiraz. This is an analytical cross‑sectional study in which the correlation between major air pollutants (including carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2] and particle matter with a diameter of less than 10 μ [PM10]) and climatic parameters (temperature and relative humidity) with the number of those whom expired from cardiopulmonary disease in Shiraz from March 2011 to January 2012 was investigated. Data regarding the concentration of air pollutants were determined by Shiraz Environmental Organization. Information about climatic parameters was collected from the database of Iran’s Meteorological Organization. The number of those expired from cardiopulmonary disease in Shiraz were provided by the Department of Health, Shiraz University of Medical Sciences. We used non‑parametric correlation test to analyze the relationship between these parameters. The results demonstrated that in all the recorded data, the average monthly pollutants standard index (PSI) values of PM10 were higher than standard limits, while the average monthly PSI value of NO2 were lower than standard. There was no significant relationship between the number of those expired from cardiopulmonary disease and the air pollutant (P > 0.05). Air pollution can aggravate chronic cardiopulmonary disease. In the current study, one of the most important air pollutants in Shiraz was the PM10 component. Mechanical processes, such as wind blowing from neighboring countries, is the most important parameter increasing PM10 in Shiraz to alarming conditions. The average monthly variation in PSI values of air pollutants such as NO2, CO, and SO2 were lower than standard limits. Moreover, there was no significant correlation between the average monthly variation in PSI of NO2, CO, PM10, and SO2 and the number of those expired from cardiopulmonary disease in Shiraz.

Weaning plays a major role in determining the nutritional status of a child. Poor weaning practices during infancy and early childhood, resulting in malnutrition, contribute to impairment of cognitive and social development, poor school performance and reduced productivity in later life. The objective of this study is to know weaning practices of mothers of difficult terrain. Cross‑sectional study was conducted in all villages under Rural Health Training Center, the field practice area of Department of Community Medicine. A total of 500 mothers with children within 3 years of age were included in the study. Pre‑tested pre‑designed semi‑structured questionnaire was used to collect information on weaning practices. Majority of children (51.57%) were weaned at >6 months and were observed to be more under nourished (79.34%) as compared with those between 4 months and 6 months (61.50%). Majority of boys were weaned earlier than girls irrespective of the age of the weaning. Malnutrition was found in majority of those children who were weaned inadequately in terms of both frequency and amount. The present study revealed suboptimal weaning practices among the mothers of hilly region. Thus, appropriate educational strategies should be directed particularly on counteracting various myths related to infant feeding Moreover, promotion of appropriate feeding should target not only on maternal caregivers, but also on other family members, particularly husbands and grandmothers, taking into account the social and cultural situation of the area.

To seek pleasure is man’s innate nature. In his search for gratification, man has discovered a world of substances that intoxicated him. Those who fell within its trap, their life changed, their families aggrieved and they shrank from company. The addiction remained alone in the end. To many death was a relief. A community based cross-sectional study was conducted in the Catchment area of UHTC (Urban Health and training Centre) where all males aged ≥15 years residing in the study area were included. Data was collected by home visit using WHO questionnaire (AUDIT: Alcohol use disorder identification test) Modified Kuppuswamy scale was used to assess the socio-economic status of the families. Data was analyzed by appropriate test using SPSS 20.0 version. Logistic regression was applied to the positively associated results. According to the AUDIT score, Hazardous, Dependent and harmful drinkers were 7.7%, 9.2% and 2.4% respectively. Age, marital status, education of the head of the family, occupation of the respondent, caste, family history of alcohol use had statistically significant association (P < 0.05, 95% confidence interval). Logistic regression was applied and marital status, family history of alcohol use and caste retained their statistical significance (P < 0.05, 95% confidence interval). It can be concluded that being young, being low educated, being married and having a family history of alcohol use are more at risk to it. This indicates the dire necessity to consider the above factors in order to combat with this evil of alcohol use.

India shares the largest burden of under‑nutrition in world. The aim of this study was to conduct follow‑up assessment of under‑nourished children attending anganwadi center (AWC). This was a retrospective cohort study conducted in 50 AWC of Tapi district. Total 529 children aged 1‑6 years diagnosed as under‑nourished before 1 year were included. Pre‑structured questionnaire was used for present day assessment of these children followed by Epi‑info mediated analysis. Children of literate mothers had higher weight gain. Ninety percent of children attended anganwadi regularly, however 25% of children dropped out for more than 1 month. In 1 year, growth had faltered in 20% children and was stagnant in 63% of them. Children who were treated for under‑nutrition; that completed course at Child Development and Nutrition Center; and whose parents were counseled about the under‑nourished status of child had higher weight gain than their counterparts. Parents of under‑nourished children must be counseled about the nutritional status of their child. In cases of under‑nourished child, referral to higher center must be ensured by health worker. Supplementary feeding as a long‑term solution to country’s under‑nutrition problem should be studied in detail with the alternative solutions.

The petal’s hydro‑alcoholic extract of Rosa damascena Mill. on ileum contractions of Wistar rats and its possible mechanism were investigated. Forty‑eight male Wistar rats were divided into six groups. Ileum was placed adjacent to propranolol (1 μM), naloxone (1 μM) and L‑NAME (100 μM) and also under the influence of different doses (2-8 mM) of calcium chloride. Cumulative extract of R. damascena Mill. (100, 500, and 1000 mg/L) decreased ileum contractions induced by KCl (60 mM) in a dose‑dependent manner (P < 0.0001). Propranolol and naloxone significantly decreased the inhibitory effect of the extract on contractions induced by KCl (P < 0.001), but L‑NAME was ineffective. Furthermore, calcium led to the contraction of depolarized tissue through KCI and this contractile effect decreased significantly induced by the cumulative concentrations of the extract (P < 0.001). The results indicate that R. damascena Mill. dose‑dependently (100, 500, and 1000 mg/L) decreases ileum movements of the rat probably through stimulating the β‑adrenergic and opioid receptors and voltage‑dependent calcium channels, and it may be used to treat digestive disorders.

There is no information about the pattern of use of earphones and music players in Iranian adolescents. The aim of this study was to assess the prevalence and pattern of the use of earphone and music player devices as a main risk factor for hearing loss in adolescents of Tabriz city, northwest of Iran. In this cross‑sectional study in November 2011, 2,359 high school students were randomly selected and were asked to complete a 20‑item questionnaire about the pattern of using earphones and music players. The results showed that 44.3% [confidence interval (CI) 95%: 38.3-50.3] of the respondents had a history of hearing problems that was significantly different between males and females (42.2% of males and 47% of females, p: 0.02). Notably, 36.8% of the participants stated that they listened to music without any rest or stop. Almost 49.6% (CI 95%: 44.4-54.4) of the students reported listening to ‘somewhat loud’ (gain setting at 50%) or ‘very loud’ (gain setting more than 50%) volume level of music. In terms of the kind of earphones, 17.1% of the participants used headphones, 34.8% used earbud‑style headphones, 32.3% used supra‑aural headphones, and 15.8% of them did not use any type of earphones. Students have risky patterns of using earphones and music‑listening devices. Planning educational programs in this domain for adolescents especially in high schools is necessary.

Aphasia is prevalent in people following stroke, which can have a significant impact on the quality of life of the patients with stroke. One of the new methods for treatment of patients with aphasia is constraint‑induced aphasia therapy (CIAT). The aim of this study was to investigate the efficacy of CIAT on naming deficits in individuals with chronic aphasia. This study had a prospective, single‑subject study with A‑B‑A design. The CIAT was administered to two patients with chronic aphasia. Participants were a 57‑year‑old male and a 45‑year‑old female and had a stroke 60 and 36 months ago, respectively. In this study, the naming test was used as the outcome measure. The naming test was administered in three baseline sessions with 1 week interval between tests (phase A). Patients received CIAT for four consecutive weeks (3 days/week). Four measurements were taken during the treatment phase (phase B). In follow‑up phase (phase A) two other measurements were performed. Visual analysis consisting of level, regression line, and variability were used to determine the effects of CIAT on naming. Both participants increased scores on naming test after phase A and B. The mean of the naming score improved from the baseline to the intervention phase in both participants. There was a positive trend in naming scores during the treatment phase compared with the trend in the baseline demonstrated by both participants. The results of this study showed that the CIAT can be effective in improving the naming deficit in patients with chronic post‑stroke aphasia.

A 24‑year‑old, unmarried woman diagnosed of pulmonary tuberculosis (PTB) visited our hospital out‑patient department in the month of August‑2013. Patient came with the complaint of sever cough with expectoration; evening raise of temperature; gradual loss of appetite and weight since 2‑weeks. We referred the patient to our hospital’s Revised National Tuberculosis Program, direct observed treatment short‑course center for sputum fluorescence microscopic examination (FME). FME report suggested the new smear positive, 2+ PTB. Our patient received yogic breathing techniques (YBT) for 45‑min daily under the supervision for three alternate‑days/week with anti‑tuberculosis treatment (ATT) for the period of 8‑weeks. After intervention our result showed better improvement in weight gain, body mass index, symptom scores, pulmonary function and health related quality of life with conversion of positive to negative FME for acid fast bacilli. It suggests YBT with ATT are effective in treating PTB and further studies required to warrant this effect.

Worldwide, breast cancer is the most common cancer among women. In India and other developing countries, breast carcinoma ranks second only to cervical carcinoma among women. Although studies have been done globally, to find the association between breastfeeding and breast cancer, very few studies in India document such a benefit. A case–control study was done from August 2009 to July 2010 in the wards of General Surgery and Oncosurgery at Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India. A total of 128 histopathologically confirmed new cases of breast cancer during the study period were taken as cases. Equal numbers of controls were selected by simple random sampling. Controls were matched for age with a range of ± 2 years. Subjects were interviewed using a pretested questionnaire after obtaining written informed consent. The categorical data were analyzed statistically using the Chi‑square test and odds ratio with a 95% confidence interval. Continuous variables were analyzed using an independent t‑test. All the analysis was done using SPSS, version 17. The age group of the cases was 25‑78 years, while that of the controls was 24‑79 years. The proportions of cases (56.3%) and controls (63.3%) living in rural areas were more than those living in urban areas. A significant association of breast cancer cases was found with caste, age at marriage, age at the first pregnancy, number of live births, and lifetime duration of breastfeeding. Breastfeeding has a significant role in reducing breast cancer, and so information, education, and communication activities for the promotion of breastfeeding and creating awareness about this fatal disease are the need of the hour.

Vitamin D deficiency is a public health concern even in sunny areas, so we decided to assess the prevalence of vitamin D deficiency and its related factors among university students in Shiraz. This cross‑sectional study was carried out on 254 (128 male and 126 female) university students. Demographic questionnaires and a questionnaire on exposure to sun light and sun protection were completed by the participants. Serum 25OH‑vitamin D was measured using a radioimmunoassay kit. Data analysis was done using Statistical Package for Social Sciences (SPSS) software # 16. A P value less than 0.05 was considered as significant. Mean ± standard deviation (SD) of serum 25OH‑vitamin D was 49.29 ± 12.87 (nmol/l) and 27.46 ± 10.37 (nmol/l) among male and female students, respectively. 51.2% of female students were vitamin D insufficient and 44% of them had vitamin D deficiency. Prevalence of vitamin D insufficiency and marginal status among male students were 49.5 and 48%, respectively. Serum vitamin D of female students was significantly less than the males (P < 0.001). Serum vitamin D was negatively correlated to sun protection score (P < 0.001, r = 0.50), but there was no correlation between serum vitamin D and sun exposure. Vitamin D deficiency especially among female students is alarmingly prevalent. Increasing use of sunscreen lotion and clothing style could be the main factors inhibiting endogenous vitamin D synthesis which results in its deficiency.