Iranian Journal of Public Health has been continuously published since 1971, in two languages (English and Persian). From 2001 issue, the Journal is published only in English language.

Iran J Public Health is published by Tehran University of Medical Sciences (TUMS). It is the official Publication of the Iranian Public Health Association and the School of Public Health, TUMS, Iran.

Current Issue

Vol 54 No 3 (2025)

Review Article(s)

  • XML | PDF | downloads: 8 | views: 36 | pages: 454-464

    Background: We aimed to appraise and compare the impact of inadequate nutrition in lung transplant recovery.
    Methods: Based on the inspection of the meta-analysis data, the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were derived by dichotomous random or fixed effect models. 6 papers with 1399 lung transplant who were available between 2020 and 2024 were comprised in this meta-analysis.
    Results: Frail had significantly higher hospital length of stay (MD, 2.80; 95% CI, 1.80-3.80, P< 0.001), and all-cause mortality (OR, 2.33; 95% CI, 1.40-3.87, P=0.001) compared to non-frail in subjects with lung transplant. However, no significant difference was found between frail and non-frail in intubation post-lung transplant (MD, 7.00; 95% CI, -17.52-31.52, P=0.58), and intensive care unit length of stay (MD, -1.70; 95% CI, -4.53- 1.14, P=0.24) in subjects with lung transplant.
    Conclusion: Using frail had significantly higher hospital length of stay, and all-cause mortality, however, no significant difference was found in intubation post-lung transplant, and intensive care unit length of stay compared to non-frail in subjects with lung transplant However, given that comparisons comprised a small number of studies, attention ought to be given to their values.

  • XML | PDF | downloads: 7 | views: 14 | pages: 465-477

    Background: The oral health-related quality of life in diabetic patients is regarded as a significant factor for assessing their dental health. This study aimed to examine the current research state, frequently utilized research instruments, and factors impacting the oral health quality of life in individuals with diabetes.
    Methods: Our review was conducted according to the PRISMA extended guidelines for scoping review. We conducted a literature review on the oral health and quality of life of diabetic patients using PubMed, Embase, and additional databases. This research proposal has been formally submitted to the Open Science Framework.
    Results: Out of 3827 materials, merely 17 publications satisfied the review requirements for our study. The search period extended from the inception of the library until Feb 5, 2024. The research encompassed seven countries, including China, the United States, and Iran, utilizing the Oral Health Evaluation Index for the Elderly and the Oral Health Impact Scale as prevalent assessment instruments. The quality of life connected to oral health was predominantly low among diabetic patients, influenced by socio-demographic characteristics, oral health status, biochemical indicators, psychosocial elements, lifestyle choices, and oral-related factors.
    Conclusion: The oral health-related quality of life among diabetic patients is typically diminished. Oral health care professionals must devise strategies to promptly identify, assess, and manage the factors influencing the oral health-related quality of life in diabetic patients, while incorporating necessary preventive measures and screenings to enhance oral disease prevention in routine evaluations.

  • XML | PDF | downloads: 8 | views: 15 | pages: 478-488

    Background: We aimed to evaluate the effectiveness and safety of Shaoyao Tang in treating ulcerative colitis (UC) through a randomized controlled meta-analysis.
    Methods: Computer searches were conducted between Jan 2000 and Mar 2023 using the databases of CNKI, VIP, PubMed, the Cochrane Library, Wanfang and Web of Science in search of trials with randomization and control including Shaoyao decoction in UC. After quality assessment, The Revman 5.3 was applied.
    Results: Overall, 23 articles were selected for the study totally. Shaoyao decoction improved clinical effective rate (P<0.001) and effective rate of syndrome (P<0.001), IBDQ (P<0.001), interleukin-4 (P<0.001) and interleukin-10 (P<0.001), reduced adverse reactions (P=0.004), recurrence rate (P=0.03), DAI (P<0.001), tumour necrosis component α (P<0.001), interleukin-1β (P<0.001), interleukin-6 (P<0.001), and extremely sensitive C-reactive protein (P=0.02).
    Conclusion: Shaoyao decoction has certain advantages and good safety in the treatment of UC; however the findings still need to be supported by excellent studies.

  • XML | PDF | downloads: 9 | views: 21 | pages: 489-498

    Sugar sweetened beverages (SSBs) have become a cause of concern because of their growing consumption levels across age groups and associated chronic diseases such as diabetes mellitus, cardiovascular diseases and cancers. The aim of this review was to provide a detailed profile of the SSBs trends and associated health risk, with special focus on its role in breast cancer development. A review of current literature has depicted increased intakes of SSBs across the globe with servings ranging from 3 to 11 per day in different countries, while children, adolescents and young adults report the highest intake levels. These increased intakes further contribute to different metabolic diseases via increased body adiposity, blood glucose and insulin levels, and increased post-menopausal estrogen levels, all of which contribute to chronic diseases, including cancers. Nutrition interventions including ones that target SSBs reduction seem to have a positive impact on reducing the development of these non-communicable diseases and are also associated with better prognosis and survival chances in cancer patients. However, the implementation of SSBs taxation and mass awareness campaign interventions remains poor due to lack of policy development and regulation for these beverages. The control of SSBs intake across the world requires rigorous research to construct efficient and practical policies to reduce the accessibility and marketing of SSBs while simultaneously increasing awareness in the public regarding the health risks of these beverages. To achieve this, a coordinated approach involving different public and private sectors is needed. 

  • XML | PDF | downloads: 5 | views: 15 | pages: 499-508

    Background: Tuberculosis (TB) control programs confront a significant challenge in ensuring patients fully adhere to their treatment regimens. Video-observed therapy (VOT) is an alternative digital technology for monitoring tuberculosis treatment that may potentially improve adherence and clinical outcomes. However, there is limited evidence supporting the effectiveness and acceptability of VOT. This scoping review aimed to summarize the characteristics of existing evidence-based VOT for tuberculosis treatment monitoring and to describe the evidence for their effectiveness and acceptability.
    Methods: This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review protocol in Jan 2023. Three databases, namely PubMed, Web of Science, and SCOPUS, were used in this review.
    Results: The search identified 170 articles, and after the identification and screening process, 22 articles were included in this review. The findings were categorized into effectiveness and acceptability.
    Conclusion: There is a progressively growing body of evidence, particularly in treating and monitoring TB using VOT, which has a positive impact on improving effectiveness regarding health outcomes and is widely accepted to implement. Future studies, such as non-inferiority trials and cost-effectiveness evaluations, will help improve tuberculosis strategies and management.

  • XML | PDF | downloads: 9 | views: 15 | pages: 509-520

    Background: Anemia is a significant public health problem worldwide in rich and poor countries. Anemia among teenagers can be seriously almost entirely caused by a lack of substance iron, which is closely related to the level of severity of anemia. The most visible effect of anemia is a decline in achievement studying in school. This article briefly introduces anemia, etiology, pathophysiology, impact, and preventive measures.
    Methods: Major databases, including Scopus, Pubmed, Proquest, Google Scholar, and Science Direct, were researched to obtain articles related to anemia in adolescent girls. The keywords used in the literature search were “ anemia and teenage girls "and " anemia prevention. " The time frame of the articles obtained ranged from 2012 to 2023.
    Results: Enhancement observed prevalence​ during several final years will cause prevalence to exceed​ the agreed target level. The most visible impact of anemia is a decline in achievement studying in school. Not only that, teenage women who suffer from anemia are at risk of experiencing anemia during pregnancy, which can hurt the growth and development of the fetus in Content. Apart from that, there is the potential to experience complications during pregnancy and childbirth.
    Conclusion: Identifying and understanding the etiology of anemia is critical to developing effective prevention strategies with screening. An integrated approach to early prevention of anemia involves collaboration between the health, education, and community sectors. 

  • XML | PDF | downloads: 7 | views: 13 | pages: 521-529

    Pneumoconiosis, an occupational lung disease that arises from the inhalation of harmful dust, often coexists with multiple chronic diseases that aggravate its prognosis and complicate treatment. These chronic diseases can include pulmonary and cardiovascular conditions, as well as cerebrovascular, renal, endocrine, and rheumatic comorbidities. The underlying pathogenesis, which involves inflammatory responses, blood vessel damage, and immune system compromise, is rooted in the persistent presence of inhaled dust particles within the pulmonary alveoli and the systemic circulation. Management emphasizes preventive measures, notably through regulatory oversight to reduce exposure, and is coupled with vigilant chronic disease monitoring and lifestyle interventions. This article reviews the mechanisms, research status, and management strategies for pneumoconiosis patients complicated by the aforementioned chronic diseases. We aimed to bridge the gap between understanding the complexities of pneumoconiosis combined with chronic conditions and translating this insight into practical and effective management strategies to enhance patient care.

  • XML | PDF | downloads: 4 | views: 14 | pages: 530-541

    Abstract

     

  • XML | PDF | downloads: 11 | views: 25 | pages: 542-553

    Background: This study investigated the impact of climate variables on the prevalence of malaria, a climate-sensitive infectious disease.
    Methods: A systematic review was conducted on articles published from Mar 2000 to Aug 2023 in Persian and English languages. Overall, 10,731 articles were retrieved, and 58 studies were included in the analysis.
    Results: Climate variables such as temperature, rainfall, and humidity play a significant role in predicting malaria outbreaks, with inconsistencies observed in different regions, including Iran. The study highlights the need for tailored preventive.
    Conclusion: Strategies and interventions to address the impact of climate change on malaria transmission. Enhanced health system resilience is essential to combat the anticipated rise in malaria cases in the future.

  • XML | PDF | downloads: 4 | views: 10 | pages: 554-566

    Background: Access to health care, or ultimately health care utilization, by all groups of population is a critical goal of health systems around the world. Several studies have examined factors affecting preventive health services utilization among middle-aged population none of systematic review exist. Therefore, we aimed to explore the factors affecting the preventive health services utilization by middle-aged population.
    Methods: Drawing on PRISMA protocol, this scoping review explored articles in PubMed, Scopus, Web of Science, and Cochran by using combinations of relevant keywords. All studies that have investigated factors affecting health service utilization among middle-aged population (40–60 yrs. old), published from 1990 to 2024, were included. The identified studies were screened and narratively synthesized.
    Results: Overall, 3314 articles were retrieved, of which 16 met the inclusion criteria. The factors were categorized into three main groups including personal, institutional and social factors. Such factors as the aboriginal status, ethnicity, age, religious salience, employment status, having chronic disease, disabilities, numeracy skill levels, knowledge regarding the services, housing insecurity, and urbanization of the residence areas affected the preventive health services utilization by middle-aged population.
    Conclusion: Various factors appeared to affect the utilization of middle-aged groups from preventive services, which need to be addressed vigorously in an effort towards universal health coverage. Policymakers ought to understand and bring to the fore these correlated factors in their health system as these de facto signify the place on which the potentially effective interventions should focus and target.

  • XML | PDF | downloads: 1 | views: 8 | pages: 567-577

    Background: Hirschsprung disease (HSCR) is a congenital life-threatening intestinal disorder characterized by the absence of nerves in the myenteric and submucosal plexuses in the distal bowel. There are several studies on the association of rs2435357 polymorphism in the proto-oncogene RET gene and HSCR susceptibility. However, some of the results remain controversial. Therefore, we conducted this updated meta-analysis to estimate the association of this polymorphism and HSCR risk.
    Methods: We searched PubMed, Scopus, Web of Science and Google Scholar according to PRISMA guidelines to assess the association of RET rs2435357 with HSCR up to Jan 2024. We included case-control/cohort studies to perform meta-analysis conducted using genotype models. Odd ratios (ORs) with 95%CI were utilized to determine the susceptibility to HSCR. Q-test and I2 were used to evaluate heterogeneity, and Egger’s/ Begg’s tests were used to assess publication bias.

    Results: Overall, 89 eligible studies meeting the inclusion criteria were retrieved with 2690 cases and 5408 controls from online databases. Finally, 17 studies were used for meta-analysis. RET rs2435357 showed a statistically significant association with HSCR under allelic model (OR = 4.50, 95%CI: 3.78-5.36, P<0.05), additive model (OR=2.02, 95%CI: 1.54-2.63, P<0.05), recessive model (OR=4.39, 95%CI: 3.33-5.78, P<0.05) and dominant model (OR=8.66, 95%CI: 6.96-10.76, P<0.05).
    Conclusion: The polymorphism rs2435357 in RET gene provides substantial susceptibility in all inheritance models and to HSCR. However, more research is needed to clarify its specific role in prognosis and the interaction with other genetic and environmental factors affecting HSCR.

Original Article(s)

  • XML | PDF | downloads: 11 | views: 13 | pages: 578-588

    Background: This randomized and controlled pre- and post-test experimental study investigated the effects of a nonviolent communication education program on empathy, interpersonal relationships, stress, and resilience among Korean nursing students.
    Methods: We included 51 Korean nursing students from a university in Busan Metropolitan City, Republic of Korea, with 26 in the experimental group and 25 in the control group. Data were collected from May to August 2024, and the nonviolent communication education program was conducted for 8 hours daily. To confirm program effectiveness, the participants were asked to practice nonviolent communication during the 5 weeks of participation in the program, and a reflection journal was to be written daily. The collected data were analyzed using descriptive statistics, χ2-tests, independent t-tests, and a repeated-measures analysis of variance.
    Results: The over-time change in empathy and interpersonal relationship scores in the experimental group was significantly different from those in the control group (F=8.540, P<0.001 and F=3.654, P=0.029, respectively). However, the over-time change in stress and resilience scores in the experimental group was not significantly different from those in the control group (F=0.366, P=0.851 and F=0.256, P=0.775, respectively).
    Education programConclusion: The nonviolent communication education program was effective in promoting empathy and interpersonal relationships among nursing students. However, its effects on stress and resilience were not significant. Periodic implementation of the program coupled with stress-relief strategies may be effective. A long-term program must be implemented to verify changes in nursing students’ self-understanding. Moreover, further research is needed on the sustainability of the program’s effects.

  • XML | PDF | downloads: 8 | views: 14 | pages: 589-597

    Background: Due to economic development and lifestyle changes, childhood obesity and psychological problems are becoming increasingly prominent. However, only a few studies have investigated the available psychological interventions for obese children. In this study, an eight-week empirical research on obese children was conducted where rational-emotive therapy was combined with group exercise.
    Methods: A total of 110 obese children from 2 public primary schools in Fujian Province, China were selected via cluster random sampling. They were randomly divided into an experimental group and a control group, with 55 children in each group. The experimental group received an integrated intervention dominated by rational-emotive therapy, while the control group did not receive any intervention. After eight weeks of intervention, a comparative measurement was conducted on both groups.
    Results: The decrease in BMI observed in the experimental group was significantly greater than that observed in the control group, and such difference was statistically significant (P<0.05). The decrease in depression observed in the experimental group was greater than that observed in the control group, and such difference was statistically significant (P<0.05). The experimental group reported reductions in all eight factors of metal health after the intervention, and the differences were statistically significant (P<0.001).
    Conclusion: The proposed intervention model can effectively reduce obese children’s BMI and depression levels and improve their mental health. The results of this study provide scientific basis for the timely prevention of childhood obesity and negative psychological problems.

  • XML | PDF | downloads: 53 | views: 28 | pages: 598-606

    Background: Smartphone addiction, a growing issue affecting Generation X, Y, and Z, is characterized by excessive use of applications, leading to counterproductive behaviors like virtual shifting. This study aimed to investigate the moderating role of generation differences (X and Y) in the effect of smartphone addiction on cyberloafing behaviors.
    Methods: Participants included 423 bank employees and volunteers, with 214 from the X generation and 209 from the Y generation, from three provinces in Turkey. Participants were selected through simple random sampling, and data were gathered using Google Forms between February and Mar 2024. The data were analyzed using SPSS 25 and AMOS 25 software.
    Results: The analysis indicated that a significant positive correlation between smartphone addiction and cyberloafing behaviors. Furthermore, smartphone addiction was found to have a positive impact on cyberloafing behaviors, with no generational differences in this association.
    Conclusion: The study results highlight the importance of smartphone addiction in the workplace, as it leads to an increase in cyberloafing behavior. 

  • XML | PDF | downloads: 5 | views: 12 | pages: 607-614

    Background: A number of important problems remain unresolved in the field of assisted reproductive technologies (ART) using germ cells from a single donor. We aimed to assess attitudes about the use of sex gamete donation in ART in different social groups including medical workers, oocyte recipients, and oocyte donors.
    Methods: To achieve this goal, we surveyed 286 participants from seven countries. Of them, 190 were medical workers from ART clinics (respondents from seven countries), 45 were oocyte recipients, and 51 were oocyte donors.
    Results: The main motive for oocyte donation was financial compensation, which draws attention to the social disadvantage of the donor population. Medical workers with more than 5 years of work experience (79.7%) supported the use of programs tracking donor sex cells and limiting the use of oocyte donors.
    Conclusion: The willingness and consent of the surveyed medical workers and oocyte recipients to use the donor material and create a unified registry of donor sex cells demonstrates the importance of this issue.

     

  • XML | PDF | downloads: 9 | views: 12 | pages: 615-623

    Background: The prevalence of sexually transmitted infections in men who have sex with men (MSM) is higher than in other communities. We aimed to Uncovering the risk of sexually transmitted infections in MSM in Indonesia.
    Methods: We adopted a cross-sectional design carried out in 24 provinces in Indonesia from March-May 2023, using secondary data from the 2018-2019 Integrated Biological Behavior Survey (IBBS). The population consisted of MSM who had sex with men totaling 6,000 people. A total of 4,290 samples were selected using Respondent Driven Sampling (RDS). The data obtained were analyzed with chi-square and logistic regression models of risk factors.
    Results: The prevalence of STIs in MSM was 20.9%. Marital status, consistency of condom use (P<0.01), how to get condoms (P<0.001), and STIs examination (P<0.001) had a significant association with the incidence of STIs among MSM from 2018 – 2019. Meanwhile, the use of lubricant during sex association had no significant relationship with the incidence of STIs. Vaginal and anal sexual intercourse had a significant relationship with the incidence of STIs, where MSM who CI95% (had their first anal sex between the ages of 25-49 years (P<0.001), AOR=2.26 and vaginal sex at the age of ≥50 years were more at risk of experiencing STIs (P<0.017), AOR=1.33.
    Conclusion: Marital status, consistency of condom use, how to get condoms, and STIs examination, vaginal and anal sexual intercourse had a significant association with the incidence of STIs among MSM.

  • XML | PDF | downloads: 12 | views: 30 | pages: 624-633

    Abstract

  • XML | PDF | downloads: 4 | views: 14 | pages: 634-644

    Background: Phenols and parabens have been associated with various adverse health outcomes. However, their relationship with breast cancer remains inconsistent, and the combined effect is still unknown. This study aimed to examine the association between mixed phenols and parabens and breast cancer among female adults.
    Method: Participants for this study were obtained from six cycles of the National Health and Nutrition Examination Survey (NHANES). The weighted logistic regression model was employed to investigate the relationship between individual chemicals and breast cancer. Furthermore, the weighted quantile sum (WQS) regression was used to assess the joint effects of phenols and parabens on breast cancer.
    Results: The study included 4993 participants, with 154 women diagnosed with breast cancer. After adjusting for all potential covariates, triclosan (TCS) showed a positive association with breast cancer (OR for Q3 = 2.12, 95% CI: 1.23-3.65), while propylparaben (PrPB) exhibited a negative association with breast cancer (OR for Q4 = 0.48, 95% CI: 0.23-0.98). The WQS regression mode found no significant difference between mixed chemicals and breast cancer (OR for positive model = 1.09, 95% CI: 0.65-1.84 and OR for negative model = 0.95, 95% CI: 0.57-1.58).
    Conclusion: Exposure to phenols and parabens has distinct effects on breast cancer risk. High-quality research is essential to obtain conclusions that are more reliable and uncover potential underlying mechanisms.

  • XML | PDF | downloads: 6 | views: 11 | pages: 645-653

    Background: Idiopathic granulomatous mastitis (IGM) is a chronic breast disease with unknown pathophysiological and clinical aspects. Therefore, we designed this multi-center prospective case-control study to explore and clarify the risk factors with an acceptable sample size.
    Methods: From March 2021 to December 2023, five hundred-four women with a histologically proven IGM were entered into the IGM group and 504 women with healthy breasts were included in the control group across nine centers. Participants' information was obtained by trained staff. Multivariate binary logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) for the associations between variables and IGM.
    Results: The mean age of all participants was 34.92 ± 7.12 yr. The previous history of diseases as a whole, was significantly higher in the IGM group (33.1%) compared with the control group (26.6%). Logistic regression showed that previous lactation (OR= 7.51, 95% CI= 2.37-23.77) and a positive history of diabetes (OR = 4.23, 95% CI= 1.32-13.51) had a positive association with IGM, while OCP use (OR = 0.70, 95% CI= 0.52-0.93) was associated with IGM reversely.
    Conclusion: The history of breastfeeding and not its duration is associated with a 7-fold increase in the rate of IGM. Furthermore, previous history of diabetes is a risk factor, while OCP use is a protective factor against IGM. We are designing another study to further investigate the relationship between breastfeeding, milk stasis, and IGM, based on our findings.

  • XML | PDF | downloads: 4 | views: 12 | pages: 654-662

    Background: Myocardial infarction (MI) is one of the most common causes of death globally. Since a comprehensive study on the relationship between coagulation factors in AMI patients and opium consumption has not been done, in this study the effect of opium consumption on the number of coagulation factors I, II, VII, IX, and XI in patients with myocardial infarction and ST-elevated (STEMI) was investigated. Furthermore, our results shed light on the relationship between opium and coagulation factors with thrombosis grades.
    Methods: In this case-control study, 80 STEMI patients referred to Razi Birjand Hospital, Iran, between years 2021 to 2022 were divided into two groups of opium addicts and non-addicts based on opium consumption and non-addict use, and the levels of the mentioned coagulation factors in their plasma were measured and compared with the corresponding values in 80 healthy people. Collected data was analyzed using SPSS software. The significance level of all tests was 5%.
    Results: The number of coagulation factors I, II, VII, and IX, unlike factor XI, in the opium addict group was significantly higher than the other two groups. While there was no statistically significant relationship between these coagulation factors with different degrees of thrombosis, most of the studied population were classified as Grade 5. Results also suggest no significant correlation between biochemical parameters and opium consumption.
    Conclusion: Opium consumption can cause thrombosis by increasing the level of some coagulation factors. The findings from this study could have implications for clinical practice and public health interventions related to opium addiction and its impact on cardiovascular outcomes.

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