Iranian Journal of Public Health
Volume:44 Issue: 7, Jul 2015

Alzheimer''s disease (AD) is one of the most common problems for old peoples. Etiology of AD is not clear, but genetic factors play a major role in determining a person''s risk to develop AD. Twin and family studies confirm that AD has a genetic basis.AD genetics has been split into two broad categories: early-onset and late-onset. EOAD cases are inherited in an autosomal dominant pattern. In this form, dominant mutations in genes like APP, PSEN-1 and PSEN-2 associated with AD. This study aimed to consider the role of genetic in AD. At the first, most of the references in relation with genetic basis of AD searched from the following websites: PubMed, Science direct, Wiley & Sons (1995-2014). Then, the most common genes and their affects described briefly. Aging is the most obvious risk factor for developing AD. There is a genetic basis for AD, of course this relation is not complete but it is significant. More than thousand genes studied in relation with Alzheimer''s disease. Against the improvements in understanding different aspects of AD, the accurate genetic foundation of AD remain unclear.

Discharge against Medical Advice (DAMA) is a problem for hospitals which may result in increasing readmissions, morbidities, inabilities, deaths and health care costs. This study, aimed to investigate the rate and causes of DAMA in Iranian hospitals. A systematic review and meta-analysis study was conducted in 2014. Required data were collected through searching for key words included: «Discharge Against Medical Advice», «Leaving against medical advice», «causes*», «hospital» and their Persian equivalents, over databases including PubMed, OVID, Google Scholar, Embase, Scopus, Magiran, scientific information database (SID). The reference lists of the articles, certain relevant journals and web sites in this field were also searched. Out of 913 articles initially retrieved, finally 17 articles were incorporated into the study. There were 244858 individuals studied in the articles. Using a random effects model, the rate of DAMA in Iranian hospitals was estimated at 7. 9% (6. 3%-9. 8%). While the highest rate of DAMA was associated with patients in departments of psychiatry (12%), the lowest rate was related to patients in departments of pediatrics (3. 7). DAMA was in men more than women (P<0. 05) Patient''s perception of feeling of wellbeing, financial problems, family problems, the lack of attention from physicians and nurses, inappropriate behavior with patients by hospital team and the lack of timely care were mentioned as main causes for DAMA. The rate of DAMA in Iranian hospitals is relatively high. Thus effective initiatives in this area are required.

This study was to investigate the health literacy and influencing factors of older population in pension institution of Xinjiang, China. Elderly people were selected from 44 pension institutions in Urumqi, Changji, Karamay and Shihezi and from September 2011 to June 2012 using random layer sampling method. The investigation was carried out by Chinese citizen health literacy questionnaire prepared by the China Health Education Center. Data were analyzed by One-way ANOVA, multiple linear regression and Pearson correlation analysis. A total of 1396 elderly people met the inclusion criteria and their average age was (77.37 ± 8.48) years. Their average health literacy score was (77.37 ± 8.48) points, which was at a low level. There was significant difference in health literacy score among the factors of age, gender, race, education, household income, marital status and occupation (P<0.05). The independent influencing factors of health literacy were education, race, occupation, household income, age and marital status (P < 0.05). Correlation analysis was conducted between the scores of health knowledge, health belief, health behavior, health skill and total scores of health literacy. Health knowledge scores and total scores had highest correlation (r=0.95), followed by health belief scores and total scores (r=0.81). The correlation between health behavior scores and health skill scores was the lowest (r=0.33). The major factors that lead to low health literacy in elderly people are femininity, minority and low levels of education.

This study aimed to analysis the inequalities of mortality of children under 5 years in West Africa by examining the determinants and contributing factors to the overall inequality concentration in these countries. Data used came from the DHS surveys conducted in the six countries in West Africa: Burkina Faso (2010), Benin (2006), Cote d''Ivoire 2011), Ghana (2008), Mali (2006), Nigeria (2008) and Niger (2012). The concentration index (CI) and Generalized Linear Model (GLM) with logit link were used to access inequality. The results show that in all countries, the poorest Q1 have the highest proportions of deaths: Nigeria (31.4%), Cote d''Ivoire (30.4%) and Ghana (36.4%), over 30% of deaths of children under 5 years are among the children of the poorest (Q1) and the absolute differences of proportions Q1-Q5 are more than 20 points (25.8 in Ghana and 23.6 in Nigeria). The contributing factors of inequalities of child mortality were birth order, maternal age, parity and household size. Our findings also showed that the intensity of inequality varies from one country to another. The most important conclusion of this study is to reduce mortality in children under 5 years, it is needed to reduce economic and social inequalities and improve the country''s economic and social condition. There is a need for monitoring and assessment inequalities by leading causes of death and morbidity among children in the region in order to advance in understanding the gaps and finding a way to reduce them in West Africa countries.

Occupational stress is a psychosocial dimension of occupational health concept on social determinants of health, especially, job & environmental condition. Recently, staff network of different government universities of Thailand have called higher education commission, and Ministry of Education, Thailand to resolve the issue of government education policy (e.g. wage inequity, poor welfare, law, and job & environment condition) that leads to their job insecurity, physical and mental health problems from occupational stress. The aim of this study was to investigate a causal relationship of occupational stress among the academic university employees. This cross sectional research was conducted in 2014 among 2,000 academic university employees at Thai government universities using stratified random sampling. Independent variables were wage, family support, periods of duty, and job & environmental condition. Dependent variable was stress. Job & environmental condition, as social and environmental factor, and periods of duty as individual factor had direct effect to stress (P< 0.05). Family support, as family factor, and wage, as individual factor had direct effect to stress (P < 0.05). Both family support and wage were the causal endogenous variables. Job & environmental condition and periods of duty were increased so that it associated with occupational stress among academic university employees at moderate level.

The aim of this study was to demonstrate similarities and differences between mothers and daughters regarding dietary and non-dietary risk factors for bone fractures and osteoporosis. The study was carried out in 2007-2010 on 712 mothers (29-59 years) and daughters (12-21 years) family pairs. In the sub-sample (170 family pairs) bone mineral density (BMD) was measured for the forearm by dual-energy x-ray absorptiometry (DXA). The consumption of dairy products was determined with a semi-quantitative food frequency questionnaire (ADOS-Ca) and calcium intake from the daily diet was calculated. The presence of risk factors for bone fractures in mothers and daughters was significantly correlated. The Spearman rank coefficient for dietary factors of fracture risk was 0.87 (P<0.05) in whole sub-sample, 0.94 (P<0.05) in bottom tercile of BMD, 0.82 (P<0.05) in middle tercile of BMD, 0.54 (P>0.05) in upper tercile of BMD and for non-dietary factors of fracture risk was 0.83 (P<0.05) in whole sub-sample, 0.86 (P<0.05) in bottom tercile of BMD, 0.93 (P<0.05) in middle tercile of BMD, 0.65 (P<0.05) in upper tercile of BMD. Our results confirm the role of the family environment for bone health and document the stronger effect of negative factors of the family environment as compared to other positive factors on bone fracture risk.

Patients undergoing pacemaker implantation often experience anxiety and fear. As such, studies have focused on the mechanisms that relieve the negative emotions caused by the intervention. Continuous nursing is a safe and effective nursing mode. In this study, continuous nursing intervention was provided for elderly patients undergoing pacemaker implantation and an empirical investigation was performed to determine the effects of their negative emotion and disease-coping ability. Overall, 114 (68 males and 46 females) elderly patients who were undergoing pacemaker implantation from Harbin City (China), were enrolled in the study. The patients were divided into two groups, namely, the control group and the intervention group, based on different nursing methods. Routine nursing was applied to the control group; continuous nursing support was provided for the intervention group from January 2014 to January 2015. The nursing results of the two groups were compared. These results were also evaluated using self-rating depression scale, self-rating anxiety scale, and trait coping style questionnaire. The effects of depression and anxiety intervention were significant in the intervention group (P<0.05). Compared with the control group, the intervention group did not significantly differ. The coping style of the intervention group elicited significant effects. Compared with the control group, the intervention group was significantly different (P < 0.05). Continuous nursing can relieve the negative emotion and improve the negative coping style of patients undergoing pacemaker implantation.

Echinococcosis or hydatidosis is a chronic, zoonotic worldwide infection caused by the larval stage of the dog taeniid tapeworm Echinococcus granulosus. Vaccination has been considered as one of the ways to prevent of hydatidosis in recent decades. The aim of this study was to construct a pcDNA3.1 eukaryotic expression vector containing the subunit 8-kDa antigen B (Hyd1) of E. granulosus (G1 strain) and investigate its capability to induce protein expression in mammalian cell line, as a basis toward developing a DNA vaccine against hydatidosis. The coding sequence of HydI was amplified by PCR with the specific PCR primers from pQE/HydI, and then was sub-cloned into pcDNA3.1 plasmid as expression vector. The pcHyd1 plasmid was digested by restriction enzymes and amplified with the specific PCR primers to confirm cloning of this gene in pcDNA3 plasmid. In last step, the sub-cloned gene was expressed in mammalian cell line (NIH 3T3 cells). The subunit 8-kDa antigen B (Hyd1) was successfully sub-cloned in pcDNA3.1 and Hyd1 protein was expressed in eukaryotic cell confirmed by SDS-PAGE and Western blot. Recombinant plasmid of pcDNA3.1 was successfully constructed and express of recombinant Hyd1 protein was confirmed. That is promising step for forthcoming measures on providing vaccine against human and animal hydatidosis.

Twin pregnancies are commonly associated with low birth weight (LBW) infants. Most studies focus on growth of LBW compared with normal infants in singleton. However, there has not been any study on twins to compare LBW with normal birth weight (NBW) infants as a match control of the same twin. This cohort study was conducted at Healthcare centers of Kashan, in 2013. Twins differing in birth weight (one with LBW and the other with NBW) were assessed using the care charts in Well Care program in regard to weight, height and head circumference measurements at birth and after 6, 12, 24 months of age and were compared separately between all matched pairs and in four sex-twin subgroups which was defined according to the sex of each twin in pairs; SF(Same-sex: Female), SM(Same-sex: Male), LF(LBW: Female) and LM(LBW: Male). Incidence of dissimilar twins in birth weight was 28.4%. The weight of LBW was significantly lower than the NBW cohort in SF and LF subgroups up to 24 months. The height of LBW was not significantly different from NBW cohort in SM and LM subgroups up to 24 month. Head circumference was significantly higher in LBW compared to NBW cohort in LM subgroup up to 24 month. However, these indices were significantly lower in LBW compared to NBW cohort in all pairs. Although LBW cohort was significantly lower than the NBW in growth indices at birth to 2 years old in all twins, however, highly variable results was observed in four subgroups of sex-twin.

Research on sensitive topics, such as sexuality, could raise technical, methodological, ethical, political, and legal challenges. The aim of this paper was to draw the methodological challenges which the authors confronted during sexuality research with young population in the Iranian culture. This study was an exploratory mixed method one conducted in 2013-14. We interviewed 63 young women aged 18-34 yr in qualitative phase and 265 young women in quantitative phase in (university and non-university) dormitories and in an Adolescent Friendly Center. Data were collected using focus group discussions and individual interviews in the qualitative phase. We employed conventional content analysis to analyze the data. To enhance the rigor of the data, multiple data collection methods, maximum variation sampling, and peer checks were applied. Five main themes emerged from the data: interaction with opposite sex, sexual risk, sexual protective, sex education, and sexual vulnerability. Challenges while conducting sex research have been discussed. These challenges included assumption of promiscuity, language of silence and privacy concerns, and sex segregation policy. We described the strategies applied in our study and the rationales for each strategy. Strategies applied in the present study can be employed in contexts with the similar methodological and moral concerns.

Amelogenins are the major components of enamel matrix proteins. Enamel matrix derivatives (EMD) can be used in periodontal diseases to regenerate periodontal tissues. The main aim of this study was to evaluate expression of full-length functional recombinant human amelogenin (rhAm) in Iranian lizard Leishmania (I.L.L.) as an alternative eukaryotic expression system. Human cDNA encoding a 175-amino acid amelogenin expression cassette was sub cloned into a pLEXSY vector. The construct was transferred into Leishmania cells by electroporation. The protein production was surveyed in the transcription and the translation levels. The expressed protein was purified and some of its biological properties were investigated in comparison to EMD and negative control. Expression of rhAm was confirmed by RT-PCR and western blot test in Leishmania cells. Purified rhAm significantly inhibited the formation of tartrate-resistant acid phosphatase positive (TRAP+) multinuclear cells in calcitriol stimulated mouse marrow cultures. Moreover, it significantly promoted proliferation and DNA synthesis in L929 mouse fibroblast cells. Functional rhAm was successfully expressed in I.L.L. Easy handling and post translation modification were the main advantages of this expression system. It is suggested to investigate molecular properties of this rhAm in the future.

This study investigated the in vitro and in vivo antibacterial effects of three mouthwashes on supragingival plaque microbiota. The three mouthwashes under study were 0.2% chlorhexidine (CHX), Listerine®, and Persica (PM). Water was used as negative control. Supragingival plaque samples were collected from 32 patients with gingivitis in the Dental School of Shahid Beheshti University of Medical Sciences in March 2014. Plaque samples were swabbed on agar plates and discs (previously immersed in the three mouthwashes) were placed on the agar. The zone of bacterial inhibition (ZOI) was measured after incubation for 24 hours. For the in vivo testing, the same plaque samples were inoculated on agar and the colony forming units (CFU) were counted. The patients were then instructed to use the mouthwashes (cases) and water (controls) for two weeks, after which plaque samples were again collected, inoculated and the CFUs were counted. For the ZOI test, 0.2% CHX inhibited the growth of bacteria to an average diameter of 18.38 mm, while Listerine®, PM and water caused no inhibition of bacterial growth around the discs after 24 hours. The mean bacterial count after using 0.2% CHX for two weeks decreased by 23.13 CFU. This was followed by Listerine®, with a mean reduction of 19.75 CFU. PM resulted in 13.5 CFU decrease in the mean bacterial count, while water reduced the bacterial count by only 1 CFU. 0.2% CHX inhibits bacterial growth considerably. All three mouthwashes can reduce total bacterial count after 2 weeks although with different mean bacterial count reduction.

Lamellar ichthyosis is one form of congenital autosomal recessive ichthyosis. To date, seven causative genes for ARCI have been identified. To understand further the genetic spectrum of the disease, we analyzed a four-generation Iranian family with ARCI that had observable inheritance. Exome sequencing data for one of the affected individuals with ichthyosis from a consanguineous Iranian family was analyzed. Potential candidate mutations were analyzed in additional family members to determine if the putative mutation segregated with disease status. A novel homozygous mutation (p.D414V) in TGM1 and rs3027232 in ALOXE3 gene in heterozygous form were identified which segregated with disease status in the family. Bioinformatic studies with Polyphen-2 and SIFT showed that these variants are damaging. We identified a possible triallelic inheritance in this study. Moreover, this paper illustrates how advances in genome sequencing technologies could be utilized to rapidly elucidate the molecular basis of inherited skin diseases which can be caused by mutations in multiple disease genes.

Every material that gastrointestinal system cannot digest will make a bezoar. Trichobezoar is the result of hair ingestion whether self-hair or from others and is not a common disorder in humans. It is a hairball, which mostly has been seen in females at teenage, or adolescence. It usually locates in stomach but in rare conditions, it will pass through the intestine, and make the Rapunzel syndrome. Herein we present a 13-year-old girl suffering from gastric trichobezoar presenting with failure to thrive.