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 51 No 6 (2022)

Review Article(s)

  • XML | PDF | downloads: 140 | views: 122 | pages: 1201-1209

    Background: This study intends to increase awareness on the clinical and laboratory diagnosis as well as health care of newborns with trichomoniasis from infected mothers, to introduce this organism as a respiratory pathogen with lower prevalence in other areas, and to outline its manifestations and symptoms.

    Methods: All case report articles in English language regarding the presence of T. vaginalisin unusual areas among infants, which were available in Scopus, PubMed, Science Direct, Google scholar, and Web of Science published between 1980 and 2021 were searched and reported by two independent researchers. Titles and abstracts of all articles were reviewed for initial screening.

    Results: After searching the articles and evaluating their quality, 9 full text articles were selected. All reported cases were from 8 different cities (4 countries) in the world. In most cases, the parasite was in the respiratory tract, but it was also reported in the brain and urogenital tract. The most common clinical symptom was respiratory distress.

    Conclusion: Although the possibility of trichomoniasis infection in unusual areas such as genitals is low, according to the reports collected from around the world, this parasite can also be present outside the genitals. Perhaps, reviewing trichomoniasis along with other diagnoses in these cases may lead to early diagnosis and treatment of the affected neonates.

  • XML | PDF | downloads: 92 | views: 86 | pages: 1210-1222

    Background: Contact dermatitis (CD) is a common inflammatory disease of the skin. CD has a complex and multifaceted treatment, and one of the main components of CD treatment is inflammation management. We summarized the clinical trials exploring the effects of herbal medicine on patients with CD.

    Methods: A systematic review was performed by searching four databases. Clinical trials in English investigating the effect of herbal medicines on CD prevention and treatment published from 2010 to 2020 were reviewed. This study was conducted based on the PRISMA guidelines.

    Results: Nine clinical trials examining the effects of herbs on CD were identified. A total of 450 patients participated in these studies. Herbal medicines used in the reviewed studies were in various forms. Almost all the studies showed that these herbs were useful in preventing and treating CD. Regarding the side effects of the herbal medicines, few complications such as erythema and papules as well as positive chronotropic effects were reported.

    Conclusion: Evidence showed that herbal medicines were effective in preventing and treating CD by reducing the inflammation level and increasing antioxidant defense. However, the number of clinical trials was low to draw definitive conclusions. Moreover, the studies were not homogeneous and differed regarding methodology, evaluation tools, and quality. Also, in these studies, the interactions and safety of the herbal medicines were not considered adequately. Therefore, well-designed evidence is required to draw definitive conclusions in this regard.

  • XML | PDF | downloads: 50 | views: 76 | pages: 1223-1231

    Background: Irritable bowel syndrome (IBS) is a highly prevalent disorder of the gut interaction characterized by abdominal discomfort and pain associated with altered bowel habits in the absence of structural abnormalities. In spite of IBS' high prevalence and disease burden across the globe, no explanations have been given as to its underlying pathophysiology. As for the treatment of IBS, there is no specific medication, and the most beneficial treatment is usually supportive therapy. Recent animal and human studies have demonstrated the therapeutic potential of curcumin or turmeric in the treatment of IBS.

    Methods: We systematically reviewed all available evidence supporting curcumin and turmeric's therapeutic potential in relieving IBS symptoms in the present study. For this purpose, a database search was performed using curcumin, turmeric, and IBS and all their equivalents as of the search terms in Web of Science, PubMed, Scopus, Ovid, Embase, and Google Scholar from1990 up to Feb 2021. The investigation was then limited to clinical trials, and then nine articles were collected for data analysis.

    Results: The findings of the included literature showed that curcumin and turmeric alone or in combination with other medications could improve the severity of IBS as well as the quality of life among people who suffer from IBS symptoms.

    Conclusion: Overall, medications containing curcumin and turmeric extract due to these compounds' anti-inflammatory effects may improve IBS symptoms, particularly abdominal pain and life quality.


  • XML | PDF | downloads: 50 | views: 31 | pages: 1232-1244

    Background: The End Stage Renal Disease (ESRD) is irreversible impairment of renal function, to the extent that the patient becomes permanently dependent on alternative therapies, especially in children. We aimed to evaluate the graft and patient survival rate among iranian pediatric recipients of kidney transplantation through a systematic review and meta-analysis.

    Methods: National (SID, MagIran, IranMedex, IranDoc) and international (Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science) databases of, were searched to find studies published electronically from 1985 until Nov 2019. Heterogeneity between the collected studies was determined using the Cochran’s test (Q) and I2. Meta-regression was used to investigate the factors affecting statistical heterogeneity in 1, 5, and 10-year survival of kidney transplantation in addition to subgroup analysis based on cities.

    Results: Ten studies were qualified to enter the meta-analysis. The total participants in the study were 2673 people with an average age of 13.71±3.65 years. In the random-effects model, the survival rate of 1, 3, 5 and 10 yr of kidney transplantation were 91, 88, 81 and 70%, respectively.

    Conclusion: By providing the documented and comprehensive evidence, can be the basis of many plans, policies, and decisions of various sectors of development. These sectors include the evaluation of treatment programs and health interventions in the pediatric kidney transplantation. The results of the present study can provide an acceptable estimate of the survival rate of transplanted children in Iran and will be useful for planning prevention and treatment programs.

Original Article(s)

  • XML | PDF | downloads: 90 | views: 73 | pages: 1245-1250

    Background: Data on the association between suicide and kidney function in the general population are scarce. This study evaluated albuminuria across suicidal ideation in Korean adults.

    Methods: We performed a cross-sectional study using data from the 2011 to 2013 Korean National Health and Nutrition Examination Survey. Overall, 14,101 adults were included in an examination of the amount of albuminuria associated with suicidal ideation. Suicidal ideation was measured using a self-reported questionnaire and albuminuria was assessed using the urinary albumin-to-creatinine ratio (ACR).

    Results: Various factors, including suicidal ideation, were associated with ACR. Multivariate regression analyses were stratified by age group and type 2 diabetes due to their strong relation to ACR. In the non-diabetic young group, individuals with suicidal ideation presented ACR 11.4 mg/g higher than those without suicidal ideation (P=0.038).

    Conclusion: In healthy young people, suicidal ideation is associated with increased albuminuria.

  • XML | PDF | downloads: 44 | views: 44 | pages: 1251-1258

    Background: To investigate the effect of dapagliflozin combined with cognitive behavior training on quality of life and cognitive function in elderly patients with type 2 diabetes mellitus (T2DM) complicated with mild cognitive impairment.

    Methods: Ninety-six elderly patients with T2DM and mild cognitive impairment treated in Shenzhen People’s Hospital, Guangdong Province China from June 2019 to December 2020 were selected and equally randomized into control group (CG) and experimental group (EG). The CG received conventional intervention, while the EG received dapagliflozin combined with cognitive behavior training based on the CG. The clinical observation indexes of both groups were compared to assess the clinical intervention effect of dapagliflozin combined with cognitive behavior training on elderly patients with T2DM complicated with mild cognitive impairment.

    Results: After intervention, the blood glucose levels of both groups decreased, and compared with the CG, the blood glucose level of the EG was markedly lower (P<0.05). The scores of C-DMSES, ADL and MMSE of both groups were higher than those before intervention, and compared with the CG, the scores of the EG were obviously higher (P<0.05). The QOL-AD scores of both groups gradually increased, and compared with the CG, the QOL-AD scores of the EG were higher at 3 and 6 months after intervention (P<0.05).

    Conclusion: For elderly patients with T2DM complicated with mild cognitive impairment, dapagliflozin combined with cognitive behavior training intervention can obviously improve their cognitive function, self-efficacy of diabetes management and quality of life, which should be promoted in clinic.


  • XML | PDF | downloads: 42 | views: 46 | pages: 1259-1264

    Background: Glaucoma is a main cause of blindness despite the effectiveness of treatments, and adherence to treatment is a critical aspect of glaucoma management. We aimed to identify the factors associated with non-adherence to treatment among Korean glaucoma patients.

    Methods: Data were collected from 4,833 glaucoma patients during the Korea Community Health Survey (KCHS) in 2008 and 2011 regarding current treatment for glaucoma, demographics, comorbidities, perceived health status, and health-related behaviors were subjected to analysis. A multivariable regression model was applied to identify factors related to non-treatment for glaucoma.

    Results: Approximately, half of the 4,883 patients failed to adhere to treatment. Compared to the treatment group, the non-treatment group had lower social status, fewer comorbid conditions, were more optimistic about their health statuses, and more likely to adopt unhealthy behaviors. Stepwise regression analysis showed that poor social status (low level of education and unmarried), self-perception of a satisfactory health status, and unhealthy behaviors (smoking and no flu-vaccination) were significantly associated with non-adherent to treatment.

    Conclusion: More attention should be paid to glaucoma patients with low social status or that are overconfident about their health. Future prospective studies that more comprehensively assess treatment compliance, are needed to confirm our findings.


  • XML | PDF | downloads: 61 | views: 77 | pages: 1265-1273

    Background: Generally, violence against women, especially during pregnancy, can increase the risk of pregnancy and childbirth complications. Besides, multiple trauma may occur because it affects not only the woman but also the fetus. The present study analyzed the factors associated with violence against pregnant women in Indonesia.

    Methods: This cross-sectional study involved participants consisted of 2,553 pregnant women (aged 15-49) from the 2017 Indonesian Demographic and Health Survey data. The dependent variable was violence, while the independent variables included the characteristics of the households, respondents, and husbands/partners. In the final stage, the author calculated determinants using binary logistic regression.

    Results: The higher the wealth status of pregnant women, the lower the likelihood of domestic violence. The pregnant women who jointly owned a house with their husbands/partners were more likely to be violated than those who did not. Pregnant women in the high parity category were at greater risk of experiencing violence than those in the primiparous category. A husband/partner at a younger age increased the likelihood of violence among pregnant women. Finally, the pregnant women whose husbands/partners had primary/secondary education were more likely to experience violence than those whose husbands/partners had no education.

    Conclusion: The study concluded five variables were statistically and significantly associated with violence against women in Indonesia: wealth status, homeownership, parity, husband/partner’ age, and the education level of the husbands/partners.

  • XML | PDF | downloads: 33 | views: 29 | pages: 1274-1282

    Background: To study the association between indoor environment (MiE), blood trace elements (BTE), and immune globulin (PRO) among workers from vegetables plastic greenhouse, and to assess the mediate effects on MiE and PRO by BTE.

    Methods: Overall, 168 practitioner and corresponding sheds were included from cross-sectional study in 2016. BTE and PRO were determined by physical test and MiE data from field and laboratory measurement. The association was assessed using canonical correlation analysis. The direct and indirect effects between MiE, PRO and BTE were conducted by structural equation model. 5000 times bootstrap methods were performed to estimate coefficient and 95% confidence interval.

    Results: MiE was moderately correlated with BTE (canonical coefficient = 0.439), and BTE was strongly correlated with PRO (canonical coefficient = 0.514 and 0.481). No statistical evidence was found for the overall impact of MiE on PRO, and BTE as an intermediary affecting its relevance was not confirmed. Only the path way of the BTE impact on PRO had a significant positive effect (P=0.012).

    Conclusion: BTE was positively associated with PRO, therefore, reducing exposure in greenhouse is a pathway to remain blood trace elements, and further effect the immune protein in human body.


  • XML | PDF | downloads: 36 | views: 40 | pages: 1283-1294

    Background: The purpose of this study was to determine the influence of some eating habits on body mass index (BMI) using a regression model created via the classification and regression tree method (CART).

    Methods: The study was conducted using a questionnaire specially developed for the study, evaluated for reliability and validity. In addition to demographics (age and sex), the questions concern the timing of the meals and the type of food consumed. The data contains records for 533 people (322 women and 211 men) aged 18 to 65 years. The survey was conducted in the period 2019-2021 in Stara Zagora, Bulgaria. Data were processed using descriptive statistics, and regression and classification data mining method CART.

    Results: A CART model with a dependent variable BMI and predictors Sex, Age, Breakfast type, Breakfast time, Lunchtime, Lunch type, Dinner time, Dinner type have been created. The obtained model is statistically significant at a significance level of P<0.0001 and a coefficient of determination R2 = 0.495. The normalized importance of the factors that affect the BMI is as follows: Sex (100%), Age (61.4%), Lunch type (26. 0%), Lunchtime (18.8%), Dinner time (13.9%), and Breakfast type (13.2%). Women have a lower BMI than men. BMI increases with age.

    Conclusion: The CART method allows to make a classification by the predictors used and gives opportunities for a more in-depth analysis of the reasons for the increase in BMI. The level of influence of diet and eating habits (type of food, time of consumption) on BMI was determined.


  • XML | PDF | downloads: 25 | views: 26 | pages: 1295-1302

    Background: To research effective prevention and treatment strategies for pressure sores in geriatric patients and examine the results from application of a three-level linkage system.

    Methods: We developed and constructed a three-level linkage intervention system for pressure sores from Jun 2017 to Dec 2018, centered at the geriatrics department of the Ninth People's Hospital of Zhengzhou, China. The changes included improving the organization structure; formulating a unified evaluation system for quantitation of pressure sore risk management; formulating and standardizing the reporting/feedback mechanism; constructing and improving three-level linkage system staff training; and establishing a quality control system for process monitoring guidance and final evaluation feedback.

    Results: The incidence of pressure sores significantly decreased, nursing staff’s knowledge level regarding pressure sore prevention and treatment increased, and pressure sore cure rate and care satisfaction increased.

    Conclusion: Implementation of a three-level linkage intervention system for pressure sores in geriatric patients and standardizing pressure injury assessment helps achieve pressure sore prevention and early intervention, effectively reduces the occurrence of pressure sores in geriatric nursing homes, increases the cure rate, and improves care satisfaction among patients.


  • XML | PDF | downloads: 68 | views: 122 | pages: 1303-1312

    Background: Non-communicable diseases (NCDs) are increasing in Myanmar. There have been limited studies to assess the health service system for NCDs patients at the primary health care (PHC) level. We aimed to assess and compare the health service readiness, availability, and utilization of PHC facilities for NCDs in districts in Myanmar.

    Methods: This cross-sectional study collected data by questionnaires from 242 health care providers working at PHC facilities in three districts in Shan State, Myanmar from January 2020 to January 2021. Differences were calculated with the ANOVA test for NCD capacity readiness and NCD service availability and the Kruskal-Wallis test for NCD service utilization.

    Results: PHC facilities had a mean score of greater than 70% for NCD capacity readiness of health workforces, health information systems, and essential medicines and equipment domains, but there were large gaps for improvement in financing and governance of health. Almost all PHC facilities had NCD services available, and the differences were not significant among the three districts. However, the mean scores of NCD services availability for chronic respiratory diseases and cancers were lower in all districts. Regarding NCD service utilization, the screening and new patient rates had significant differences among districts (P-value < 0.05).

    Conclusion: We revealed the situation and gaps in managing NCDs in Myanmar’s PHC facilities. These findings can inform policymakers at the state and district levels to implement programs for improving health services for NCDs, particularly in rural areas.


  • XML | PDF | downloads: 19 | views: 26 | pages: 1313-1322

    Background: The forecasting of daily outpatient visits has significant practical implications in outpatient clinic operation management, not only contributing to guiding long-term resource planning and scheduling but also making tactical resolutions for short-term adjustments on special days such as holidays. We here in propose an effective genetic programming (GP)-based forecasting model to predict daily outpatient visits (OV) in a primary hospital.

    Methods: In the GP-based model, the holiday-based distance outlier mining algorithm was used to determine the holiday effect. In addition, solar terms were applied as the smallest unit to more accurately determine the impact of a change in the climate on the outpatient volume. A segmental learning strategy also was used to predict the daily outpatient volume for the time series data.

    Results: The GP-based prediction could more effectively extract depth information from a finite training sample size and achieve a better performance for predicting daily outpatient visits, with lower root mean square error (RMSE) and higher coefficient of determination (R2) values, than the seasonal autoregressive integrated moving average (SARIMA) model in the time range of holidays and the holiday effect.

    Conclusion: GP-based model can achieve better prediction performance by overcoming the shortcomings of the SARIMA model. The results can be applied to support decision-making and planning of outpatient clinic resources, to help managers implement periodic scheduling of available resources on the basis of periodic features, and to perform proactive scheduling of additional resources.

  • XML | PDF | downloads: 33 | views: 54 | pages: 1323-1330

    Background: The prevalence of undiagnosed hypertension in Malaysia is 17.2%, which is higher compared to the known case of hypertension (13.1%) reported in 2015. For every two people diagnosed with hypertension, there will be three persons with undiagnosed hypertension; the trend has not changed since 2011. This study aimed to determine the determinants of undiagnosed hypertension among urban community of Kuala Lumpur, Malaysia.

    Methods: This was a cross-sectional study conducted among 206 participants in Kuala Lumpur, Malaysia from the ongoing Prospective Urban Rural Epidemiology (PURE) project. The samples with complete variable data were taken from the second year of follow-up, starting Jan 2014 till Dec 2015, through convenience sampling. Data were analyzed using descriptive analysis, simple logistic regression, and multivariable logistic regression.

    Results: Multivariable logistic regression showed that only four determinants were associated with undiagnosed hypertension which were the age group of 35 to 49 yr old (aOR: 5.9, 95% CI: 1.8; 19.1), secondary education level (aOR: 2.3, 95% CI: 1.1; 4.6), normal BMI (aOR: 5.1, 95% CI: 1.5; 16.6), and non-diabetes mellitus (aOR: 5.5, 95% CI: 2.5; 12.0).

    Conclusion: The determinants of undiagnosed hypertension in this study showed that low-risk groups of hypertension were highly underdiagnosed. The low-risk group of hypertension was easily approached at their working place. Thus, routine health screening and awareness campaigns should be emphasized substantially at the working place to detect undiagnosed hypertension. Early detection will be beneficial as early management can be initiated to prevent further complications.


  • XML | PDF | downloads: 30 | views: 39 | pages: 1331-1338

    Background: There are a large number of psychological problems caused by Internet addiction. We aimed to explore the intervention effect of narrative therapy in combination with Pilates exercise on Internet addiction among adolescents.

    Method: From July 2021 to October 2021, 42 adolescents with Internet addiction selected from four communities in Yiyang City of China were randomly divided into the intervention and control groups with 21 members in each group. The intervention group participated in the intervention of narrative therapy in combination with Pilates exercise eight times, whereas the control group did not receive any intervention. The 12-item General Health Questionnaire, Self-rating Young’s Diagnostic Questionnaire of Internet Addiction, and Positive Affect Subscale were used to measure the psychological indexes of the adolescents before and after the intervention.

    Results: Compared with those in the control group, the adolescents in the intervention group had an obvious decrease in the degree of Internet addiction with a statistically significant difference before and after the intervention (P < 0.001). After the intervention, the intervention group had significantly higher mental health scores and significantly lower scores for anxiety, depression, social dysfunction, and loss of interest than the control group. After the intervention, the intervention group showed an obvious increase in the score for positive affect with a statistically significant difference before and after the intervention (P < 0.001).

    Conclusion: The intervention method proposed in this study could effectively solve the problem of Internet addiction among adolescents.

  • XML | PDF | downloads: 34 | views: 42 | pages: 1339-1347

    Background: Cytokines are protein substances involved in immune response and inflammation regulation, cell growth, tissue repair and natural and adaptive immunity events such as hematopoiesis. Changes in Th1 and Th2 immune responses provide information on the clinical presentation, pathology and diagnosis of diseases.

    Methods: This study was conducted on 142 patients, aged 18-95 yr and applied to Parasitology Laboratory of Van Yuzuncu Yil Hospital between Aug 2018 and May 2019. Fifty-one of the patients were serologically diagnosed with CE, 53 with a diagnosis of fascioliasis, and 38 as the control group. Serum samples were taken from patients and levels of IL-4, IL-10, TNF α and IFN γ parameters were investigated by ELISA method. Results were evaluated by spectrophotometer and observed which immunologic parameters increased in which infections. Cytokine results were also evaluated according to patient age groups and genders. Chi-square and/or Fisher's exact test were used to evaluate the results. IL-4 response was detected in 50.9%; IL-10 in 44.2%; TNF-α in 43.3% and IFN-γ in 43.3% of CE seropositive patients.

    Results: IL-4, IL-10, TNF-α and IFN-responses detected in 50.9%, 44.2%, 43.3% and 43.3% of CE patients, and in 43%, 39.2%, 34.4% and 40.6% of fascioliasis patients, respectively. The presence of Th1 and Th2 responses were detected in both infections. There was a significant relationship between fascioliasis and IL-4 response and between CE and IL-4, IL-10 and TNF-α responses (P≤.05).

    Conclusion: These cytokine levels may provide information about the immune response to infections, and may be useful for early detection of disease and recurrence and monitoring of treatment.

  • XML | PDF | downloads: 30 | views: 48 | pages: 1348-1354

    Background: The increasing trend of obesity prevalence is a serious health warning for people worldwide. Evaluation of anthropometric measures is essential for explaining individual’s health status. Studies have investigated the effect of diet on inflammation. Empirical Dietary Inflammatory Pattern (EDIP) was recently developed to empirically create a score for overall inflammatory potential of diet. This study aimed to investigate the relationship between EDIP with anthropometric measures in women with overweight and obesity.

    Methods: In a cross-sectional study, the EDIP score was calculated for 301 participants from their food frequency questionnaire, who referred to health centers in Tehran, Iran in 2018. Anthropometric measures was assessed through multi-frequency bioelectrical impedance analyzer.

    Results: 49% (95% CI: 40.8 - 57.2) had positive EDIP score. A significant relationship was found between EDIP quartiles with weight (P=0.004), BMI (P=0.012), FM (P=0.013), WC (P=0.003) and WHR (P=0.031). Those individuals in the lowest group of EDIP score had significantly lower weight, Body Mass Index, Fat Mass, Waist Circumference and Waist to Hip Ratio, compared to those with highest inflammation score.

    Conclusion: A significant relationship was found between EDIP with anthropometric measures in women with overweight and obesity, supporting the hypothesis that an anti-inflammatory diet is associated with decreasing trend of weight, Body Mass Index, Fat Mass, Waist Circumference and Waist to Hip Ratio.


  • XML | PDF | downloads: 25 | views: 28 | pages: 1355-1363

    Background: Quality of life is determined by the lifestyle of individuals. If people have a healthy lifestyle, then they have a higher quality of life. What makes a person's lifestyle is the way he thinks. Therefore, if the thinking is healthy, the person's lifestyle will be healthy, and if the thinking is unhealthy, the person's lifestyle will also be damaged, which will reduce the quality of life.

    Methods: The research method was mixed method in two quantitative and qualitative phases. The research method in the qualitative phase was customary qualitative content analysis, in which the data analysis process was based on the approach of Granheim and Ladman. In the quantitative phase, the psychometric properties of the research scale were measured. This research was conducted from 2016 to 2021 in Iran. The statistical population in the qualitative section was all scientific texts in the form of articles, books and dissertations that were extracted from scientific databases such as ScienceDirect, PubMed, Elsevier, Ebsco, Sid, Magiran.

    Results: Indicators of intellectual thinking have been mentioned as research results, which are the main components of the new model of thinking. Moreover, the level of thinking was mentioned and Cognitive distortions, cognitive bias, and perceptual errors were mentioned as sources of harm and error.

    Conclusion: Intellectual thinking has been mentioned as healthy thinking, which is the main factor of a health promotion lifestyle because healthy lifestyle improves the quality of life of people, which is one of the indicators of public health. Therefore, a higher quality of life can be achieved from the model of healthy thinking, which is a new perspective on promoting public health.

  • XML | PDF | downloads: 43 | views: 36 | pages: 1364-1370

    Background: The purpose of this survey was to develop a novel and rapid isothermal nucleic acid based detection assay of Vibrio cholerae by polymerase spiral reaction (PSR) in emergency situations.

    Methods: The current study was conducted in Baqiyatallah University of Medical Sciences, Tehran, Iran in 2021. The conserved ctxA gene sequence of V. cholerae was used as a target of designed two pairs of primers. Amplification of nucleic acids performed under isothermal temperature of 65 oC in 55 min by using Bst DNA polymerase. PSR amplified products were real-time visualized under UV transilluminator and also on agarose gel electrophoresis.

    Results: Seven non- V. cholerae bacteria were negative for detection, which indicated the specificity of PSR assay was 100%. A 10- fold serial dilution of V. cholerae genomic DNA was subjected to conventional polymerase chain reaction (PCR) and real-time PCR to compare their sensitivities with PSR. The detection limit of PSR was 3 × 10-5 ng/ μL within 60 min, which 100-fold higher than that of PCR (3 × 10-3 ng/μL), but the sensitivity of real-time PCR was found as same as it.

    Conclusion: The PSR assay developed in this study can provide a simple, cost-effective, rapid, and precise diagnosis technique in endemic cholera outbreaks, especially in low-income with limited access provinces.


  • XML | PDF | downloads: 31 | views: 46 | pages: 1371-1380

    Background: The aim of this study was to evaluate the predictors of osteoporosis in women in Yazd, Iran.

    Methods: This hospital-based case-control study was performed on 270 women 35-65 yr old (135 case and 135 control) from Mar 2016 to Mar 2017. Case and control were matched in terms of age ± 2 (year) as a group matching. Osteoporosis is defined as a T-score of bone mineral density (BMD) below –2.5 SD. Data were analyzed using SPSS 20 software. Statistical tests included chi-square, student t test and Mann Whitney test .Multiple logistic regression (MLR) which forward method was used for modeling.

    Results: Odds ratio (OR) of osteoprosis were menarche age>12 yr (OR=3.37, CI:2.29-15.89), history of hysterectomy (OR=13, CI:3.81-44.82), rheumatoid arthritis (RA) (OR=6.58, CI:2.29-18.91) calcium supplements (OR=0.14, CI:0.04-0.41), menopause age <40 (OR=11.84, CI:1.54-90), second smoking (OR=3.38, CI:1.16-9.81) and increase of weight (OR=0.86, CI:0.80-0.94).

    Conclusion: Predictors of osteoporosis was menarche age >12 yr (3 times), history of hysterectomy (13 times), RA (6.5 times), menopause age <40 (12 times), second smoking (more than 3 times), calcium supplements and weight (protective).


  • XML | PDF | downloads: 29 | views: 39 | pages: 1381-1388

    Background: Premenstrual Syndrome (PMS) is the experience of some physical and psychological symptoms periodically in the last days of the menstrual cycle that interferes with academic, social and family functioning. We aimed to evaluate the effectiveness of Transdiagnostic Treatment Program (TTP) on clinical symptoms and emotion regulation in girl’s adolescents with PMS.

    Methods: This experimental trial study was carried out on 32 girls adolescents with PMS referred to two medical centers located in Tehran, Iran from Mar 21, 2019, to Oct. The patients randomized in 2 groups, 1-intervention (n=16, 8 sessions, 90-minute weekly‎) and 2-control (n=10).The PMS Screening Tool (PSST) and Emotion Regulation Questionnaire (ERQ) before and after treatment were filled out by participant. The SPSS software and P<0.05 considered for data analysis and as significant levels respectively.

    Results: The study sample was 32 girls adolescents with PMS (mean age intervention and control were 16.30±2.02 and 16.40±1.6, P=0.915). The score of two questionnaires, PSST (symptom, effect) and ERQ (cognitive reappraisal, suppression) between two groups in before treatment were the same. After intervention the change of variable symptom (-1.05 vs -0.02, P<0.001), effect (-0.53 vs -0.04, P<0.001), cognitive reappraisal (0.67 vs 0.02, P<0.001) and suppression (-0.64 vs -0.07, P<0.001) were significant between two groups.

    Conclusion: TTP is an effective technique for controlling clinical symptoms and emotion regulation in girl’s adolescents with PMS.

  • XML | PDF | downloads: 32 | views: 40 | pages: 1389-1399

    Background: It is necessary to study the predictors of life quality in the early postpartum period. Early diagnosis, timely care and intervention can improve the health of mother and baby. We aimed to evaluate the predictors of the quality of life in the postpartum period.

    Methods: This cross-sectional study was conducted on 407 eligible women aged 18 to 47 yr, in the postpartum period, selected from clinics affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Tehran, Iran in 2018. Data were collected using a demographic and obstetric questionnaire and Maternal Postpartum Quality of Life (MAPP-QOL) with Cronbach's alpha coefficients of 0.96 to assess personal details and postpartum quality of life. Data analyzed using SPSS. Linear regression analysis was performed to examine the relationship between maternal predictors and quality of life in the postpartum period.

    Results: The postpartum quality of life had a significant relationship with income status (P<0.001), Number of Children (P=0.031), mother's education(P=0.009) and maternal complications (P<0.001).

    Conclusion: This study confirmed the relationship between maternal predictors and the postpartum quality of life. It could facilitate clinicians and educators to improve the quality of life for postpartum women.


  • XML | PDF | downloads: 34 | views: 45 | pages: 1400-1410

    Background: Identification of freshwater snails and possible trematodes transmission sites are essential to continue monitoring the potential for disease outbreaks in areas with a history of parasitic infections. We aimed to search some areas in the margin of the Caspian Sea, northern Iran to identify the snail fauna of this area and verify the contamination of vector snails.

    Methods: More than 5,308 snails from 51 diverse and permanent habitats were studied from April 2019 to October 2021. Snails were collected randomly and identified using shell morphology. Trematode infection in snails was investigated by the release of cercariae and dissection methods.

    Results: Five families of freshwater snails including Lymnaeidae, Physidae, Planorbidae, Bithyniidae, and Viviparidae were investigated in the Caspian Sae Litoral of Iran. Physidae were found as the most prevalent snails (55.1%) followed by Lymnaeidae (29.4%). The parasitize rate was observed as 20% using releasing cercaria technique. Echinostomatoidea (31%), Schistosomatoidea (8%), and Diplostomoidea (21%), and Plagiorchioidea (40%) were seen as detected parasites. Meanwhile, 60% of the studied snails illustrated the other stages of trematodes.

    Conclusion: The rate of infection of snails with different cercaria in northern Iran is significant. It needs further deep studies to clarify the situation of zoonoses transmitted by snails in the region. Policy makers should pay attention more to this area in terms of monitoring the snail-transmitted diseases.

  • XML | PDF | downloads: 25 | views: 50 | pages: 1411-1418

    Background: To determine the seroprevalence of human cystic echinococcosis/hydatidosis which is one of the most important zoonotic diseases by ELISA using native antigen B in Semnan and Sorkheh, Semnan province, Iran, where no significant information about human infection exists.

    Methods: Overall, 957 human serum samples were randomly prepared from Semnan, Sorkheh, and its 13 surrounding villages in different seasons from 2017 to 2018. Antigen B was prepared from native hydatid cyst fluid of domestic sheep. All serum samples were evaluated by ELISA while the suspected cases were rechecked. The cut-off was calculated as the X̄±2SD.

    Results: Overall, 48(5%) out of 957 (422 males and 535 females) were positive for hydatidosis. The seropositivity based on sex showed 20(2.1%) out of 422 in males and 28(2.9%) out of 535 in females. The distribution of seropositive samples based on residence area showed 41 (4.3) out of 882 in urban and 7 (0.7) out of 75 in rural areas. The highest seroprevalence cases was among housewives (2.1%) followed by employers (1.5%). Based on education, source of drinking water, and age groups the highest seropositivity was observed in high school and less, in the plumping water consumers, and 50 to 59 yr old age group, respectively. There was a significant difference between seropositivity with occupation, literacy, and age group (P<0.05). Semnan with 4% seropositivity had the highest prevalence followed by Sorkheh, county.

    Conclusion: High prevalence of the disease in this area emphasizes the importance of increasing people's awareness about hydatidosis.


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    Background: We aimed to elucidate the pathogenic bacterial and fungal profiles of specimens obtained from suspected ocular infections at Farabi Eye Tertiary Referral Hospital, Tehran, Iran.

    Methods: In this cross-sectional study, we collected data from ocular specimens taken during the seven-year period of 2011 to 2018, and the results were then retrospectively analyzed. Samples had been obtained from patients who were investigated for ocular infections.

    Results: Overall, 16,656 ocular samples were evaluated. The mean patient age was 48.31 ± 26.62 years. Most patients were men (60.33%), and men in the 7th decade of life were the largest represented group. The seasonal distributions of specimen collection sites followed the overall distribution of collection sites by year. Specimens obtained from the cornea were the most common (49.24%), also representing the largest number of specimens in all seasons. The most commonly isolated fungal microorganisms were Fusarium spp., followed by Aspergillus spp. and Candida albicans. Of the 6,556 specimens with positive bacterial cultures, 59% produced gram-positive bacteria, while the remainder produced gram-negative pathogens. The most commonly isolated bacteria were Pseudomonas aeruginosa (17.77%), Staphylococcus epidermidis (13.80%), Streptococcus pneumoniae (13.27%), S. viridans (12.23%), and S. aureus (11.18%).

    Conclusion: Most submitted specimens were obtained from the cornea. The most commonly isolated fungal microorganisms were Fusarium spp., followed by Aspergillus spp. and C. albicans. The most commonly isolated bacteria were P. aeruginosa, followed by S. epidermidis and S. pneumoniae.

Case Report(s)

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    Fumigation of grain cargoes in the ship holds with phosphorus hydrogen-based substances has been widely introduced into the daily practice of the fleet. We present a case of mass occupational phosphine poisoning in the crew of the cargo ship. On October 18, 2018, the “Nazmehr” cargo ship transporting grain from Kazakhstan to Azerbaijan by the Caspian Sea has sent a SOS signal. The Azerbaijani patrol ship was found with 12 seafarers on board with signs of poisoning and evacuated them onshore. Upon admission to the hospital the patients were diagnosed with "phosphine poisoning" based on clinical symptoms and positive chemical-toxicology test. Because phosphine has no antidote, supportive care and symptomatic therapy was administered. In 36 hours, all patients were discharged without complications. Three seafarers died on board before the patrol ship arrived. The autopsy showed that death occurred due to profound shock, acute myocarditis, pulmonary edema and multi-organ failure. The cause of this mass poisoning in seafarers was the failure in the ship safety requirements, decrepitude of the vehicle and the lack of tightness of the holds. The incident showed the necessity for strengthening of control over the observance of safety rules during transportation of fumigated goods.

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