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 50 No 10 (2021)

Review Article(s)

  • XML | PDF | downloads: 88 | views: 107 | pages: 1935-1943

    Background: Regularly performed physical activity promote proper development and prevent health risk factors in children and adolescents. Pandemic crisis has been limiting the scope of movement with social distancing for participation of physical activity for health promotion. This study aimed to review studies on promoting physical activity to prevent health risks for children and adolescents since the onset of COVID-19.  

    Methods: Three major online databases (PubMed, Medline, and Scopus) were searched for ‘physical activity,’ ‘intervention’ for children and adolescents. Seven articles were selected from 1,761 articles through the inclusion and exclusion processes.

    Results: All studies were conducted through online. One study showed that streaming services and online apps majorly promoted MVPA (moderate-to-vigorous physical activity), MSE (muscle-strengthening exercise), or combined (MVPA, MSE) by 2.4, 3.1, and 4.3 folds, respectively. Another study showed that greater duration of physical activity (PA) prevented depressive symptoms during exposure to outbreak. Five intervention studies which used digital platforms to promote PA significantly encouraged PA along with the physiological, psychosocial, and academic achievement outcomes.

    Conclusion: Internet-based digital platforms may assist to promote physical activity for improved psychosocial and academic achievement in children and adolescents during the untack period. Structured PA promotion platforms with various health outcomes for children and adolescents should be developed and scientifically evaluated.

Original Article(s)

  • XML | PDF | downloads: 44 | views: 68 | pages: 1944-1952

    Background: Rapid maxillary expansion (RME) is the standard treatment for correcting lateral maxillary defects commonly used in orthodontics. It is the most effective approach to increase maxillary width in clinical practice. At present, there are few studies on the level of molecular biology of periodontal tissue remodeling during RME. We aimed to investigate changes in matrix metalloproteinase (MMP)-8, interleukin (IL)-6 and tumor necrosis factor (TNF)-αin gingival crevicular fluid during RME.

    Methods: Patients admitted to Department of Stomatology, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China between Dec 2016 and Dec 2018 were enrolled, and randomly divided into the observation group (76 cases) and control group (62 cases). Periodontal clinical indicators were recorded. Gingival crevicular fluid was collected and the periodontal clinical indicators were recorded. The levels of MMP-8, IL-6 and TNF-α were determined by ELISA, and the contents of the two groups were compared.

    Results: The plaque index of the observation group was significantly higher than that of the baseline T0 (P< 0.05) from T4, and the increase in the control group started from T5. The general clinical data of the two groups showed that the white blood cell count of the observation group was higher than that of the control group. The levels of MMP-8, IL-6 and TNF-α were the highest at T2, followed by T3, and gradually decreased at T4, and T5, and the differences were significant (P<0.05).

    Conclusion: The changes in levels of MMP-8, IL-6 and TNF-α in adolescent patients during RME were related to the remodeling of periodontal tissue after RME.

  • XML | PDF | downloads: 35 | views: 65 | pages: 1953-1962

    Background: Although the motivation to set goals and taking steps to achieve them is essential for athletes wishing to progress to a professional level, motives for participating in sports vary depending on personal and physical characteristics. We aimed to investigate the effect of motivation to participate in sports on achievement goal orientation and achievement behavior in high-school basketball players.

    Methods: The study included 256 female high-school basketball players from Busan, Korea, and was conducted between September and October 2020. The questionnaires obtained data regarding motivation to participate in sports, achievement goal orientation, and achievement behavior. Structural equation modeling was used for data analysis.

    Results: Motivation to participate in sports exhibited a significant positive correlation with achievement goal orientation (P<0.05). Specifically, motivation related to the development of technical skills and achieving a sense of fulfillment, amusement, and health exerted a positive effect on task-goal orientation. Greater motivation related to technical skill development, attaining a sense of accomplishment, and improving health was associated with greater self-goal orientation. Additionally, achievement goal orientation exerted a significant positive effect on achievement behavior (P<0.05).

    Conclusion: Given the relative unpopularity of basketball in Korea, it is crucial for players to develop high achievement goal orientation and engage in real efforts to translate such motivation into action. This goal- and achievement-oriented attitude should precede motivation for participating in basketball.

  • XML | PDF | downloads: 45 | views: 68 | pages: 1963-1972

    Background: We aimed to provide information for health practitioners and other related people about the association between ambient air quality and adverse health outcomes in the general population of Nigde, a central Turkish city, within the context of current health data epidemiological evidence.

    Methods: The present study highlights the connection between health problems and time series of particulate matter (PM10) and sulphur dioxide (SO2) in Nigde, Turkey between 2011 and 2017. Significant morbidity is linked to ambient air pollution, resulting in a significant economic cost to society.

    Results: We found that the required funds to treat cancers and chronic obstructive pulmonary disease triggered by ambient air pollution in Nigde, exceed 9 million US dollars per year, even when only the city center is taken into account.

    Conclusion: As Turkish cities grow and urban population density increases, air pollution issues need to be given priority in order to protect the health of the public and support sustainable development for future generations. It is recommended that particulate matter concentration in this urban center should be significantly reduced to minimize health problems.

  • XML | PDF | downloads: 13 | views: 33 | pages: 1973-1982

    Background: This research was designed to probe into the role of miRNA-21 in the pathogenesis of childhood asthma and its correlation with the severity.

    Methods: Fifty-four children with bronchial asthma admitted to the Third Affiliated Hospital of Qiqihar Medical University from Jun 2018 to Dec 2019 were included. Forty nine healthy children underwent physical examination at this time period were also enrolled. The miR-21 expression in peripheral blood serum was analyzed by qRT-PCR. The relationship between the expression and severity of asthma in children was explored by Spearman correlation analysis and ROC curve. Bronchial epithelial cell lines were cultured in vitro and divided into blank control group, negative control group and miR-21 inhibition and activation group. The changes of cell proliferation after treatment were detected by CCK-8 test in different groups. The expression of TGF-β1/Smad signaling pathway protein in cells was assessed by Western blot (WB).

    Results: Compared with that of healthy children, the miR-21 expression in peripheral blood serum of asthmatic children was higher (P<0.001). MiR-21 expression was positively correlated with the severity of illness (r=0.853, P<0.001). The results of cell experiments in vitro signified that miR-21 can promote the proliferation of bronchial epithelial cells, and may be involved in regulating the expression of TGF-β1/ Smad3 signaling pathway, thus affecting cell proliferation.

    Conclusion: miRNA-21 regulates the proliferation of bronchial epithelial cells by activating TGFβ1/Smad signaling pathway. And it is positively correlated with the severity of asthma in children.

  • XML | PDF | downloads: 27 | views: 57 | pages: 1983-1992

    Background: We aimed to explore the effect of education levels on self-rated health and physical activity (PA) and to provide basic data for developing interventions based on physical education to improve the quality of life among Koreans.

    Methods: The 2019 Community Health Survey data were selected through primary and secondary phylogenetic extraction. The survey was conducted among Korean adults aged ≥19 years (n=229,099), in 2019, using an electronic questionnaire. The education levels were classified into eight groups: uneducated, Seodang/Hanhak (traditional Korean school), elementary school, middle school, high school, college (2 or 3 years), university (4 years), and post-graduate or higher. In this study, the effect of participants’ education levels on self-rated health levels and PA was investigated (the PA subdimensions were: the number of days of vigorous PA, moderate-intensity PA, walking, and flexibility exercises).

    Results: 1) Regarding self-rated health, significant differences according to education level were recorded (P<0.001), with higher education levels leading to higher averages. 2) Regarding PA, significant differences according to education level were revealed, and the number of days of vigorous PA, walking, and flexibility exercise (P<0.001) increased with higher education levels. Moreover, the university (4 years) group reported the highest average. However, the middle school group reported the highest average for the number of days of moderate-intensity PA (P<0.001), and the average number of days decreased as the education level increased after middle school.

    Conclusion: Education plays an important role in maintaining health, and practicing appropriate PA contributes to one’s quality of life.

  • XML | PDF | downloads: 11 | views: 34 | pages: 1993-2001

    Background: We aimed to analyse the impact of elevated systolic blood pressure (SBP) levels on mortality and life expectancy among ≥25 yr adults in the municipality of Ningbo, China.

    Methods: The death cause data were collected from the Internet-based Comprehensive Chronic Disease Surveillance System in Zhejiang Province in 2015, and SBP level data were obtained from the Ningbo Adult Chronic Disease Surveillance survey. According to the comparative risk assessment theory, the population attributable fraction (PAF) of elevated SBP levels by gender and urban-rural regions has been calculated. The deaths and life expectancy loss due to elevated SBP levels were estimated.

    Results: In 2015, the average SBP level among ≥25 yr adults in Ningbo was 129.01 ± 17.73 mmHg, which was higher in men (131.67 ± 16.89 mmHg) than in women (126.24 ± 18.15 mmHg) and was higher among adults in rural regions (130.55 ± 18.75 mmHg) than among adults in urban regions (127.15 ± 16.19 mmHg). A total of 6181 deaths were attributed to elevated SBP levels among adults in Ningbo. The PAF of deaths caused by elevated SBP levels among adults was 16.14%, which was higher in women (18.73%) than in men (14.31%). The overall loss of life expectancy caused by elevated SBP levels among adults was 1.76 yr, which was higher in women (1.99 yr) than in men (1.53 yr) and was higher in rural regions (1.91 yr) than in urban regions (1.49 yr).

    Conclusion: Elevated SBP levels had a serious impact on the death and life expectancy loss of residents in Ningbo.

  • XML | PDF | downloads: 23 | views: 45 | pages: 2002-2009

    Background: We aimed to provide the baseline data of nursing intervention for promoting the health promotion and promotion of growth and development for elementary students.

    Methods: By subjecting the 887 elementary students from 20 elementary schools located in the northern area of Gyeonggi-do Province, South Korea, data were gathered from April 10-May 30, 2017. The SPSS was used for analysis of data.

    Results: Some elements of emotional intelligence were found to differ depending on the gender and family type of lower-grade children, and depending on gender, sleep time, family type, and physical activity experience of higher-grade children. Some factors of stress were found to have differences according to sleeping time of the lower grades, and according to gender, sleeping time, family type, and whether they have experience in physical activity of higher-graders.

    Conclusion: It is possible to improve emotional intelligence and solve the stress of elementary students. This study will be the baseline data on developing the Health Promotion Education Arbitration Program for elementary students.

  • XML | PDF | downloads: 20 | views: 55 | pages: 2010-2016

    Background: To investigate the relationship between different dietary patterns and the levels of bone mineral density (BMD) in middle-aged and aged people, and to provide references for the nutritional prevention of osteoporosis.

    Methods: A total of 476 residents aged 45 yr or more in Qiqihar City were enrolled from Aug 2018 to Feb 2019. They took a Food Frequency Questionnaire for dietary survey. Their dietary patterns were analyzed using the factor analysis method, and BMD were detected using ultrasound bone densitometer, to explore the relationship between different dietary patterns and BMD levels.

    Results: Four dietary patterns were obtained in the survey: relatively balanced, oil-salt, milk-tuber, and aquatic. Among them, the prevalence of osteoporosis reached 21.8%. High-level relatively balanced dietary pattern (OR=0.588, 95%CI= 0.363-0.951) and high-level dairy-potato food dietary pattern (OR=0.668, 95%CI= 0.370-0.983) were associated with lower risk of osteoporosis.

    Conclusion: A balanced diet and a high intake of dairy-potato food dietary pattern were associated with a lower prevalence of osteoporosis. It is recommended that middle-aged and aged people should have a balanced diet with more dairy products and potatoes to protect bone health.

  • XML | PDF | downloads: 32 | views: 52 | pages: 2017-2027

    Background: Patients with oncological diseases often have mental disorders in the form of comorbidity. The aim of this study was to research the association of cancer with the presence of symptoms of depression and anxiety in primary health care patients.

    Methods: This prospective observational study done in 2020 included adult users of health care at the Health Center Trstenik, Central Serbia, aged 19 and over, both sexes, with a diagnosis of oncological disease. A research instrument to assess depressive symptoms is used PHQ-9 (The Patient Health Questionnaire) questionnaire, derived from PRIME MD- and (The Primary Care Evaluation of Mental Disorders), and the Beck Anxiety Scale (BAI) to register the presence of certain anxiety symptoms.

    Results: The largest percentage of patients had symptoms of mild (27.2%) or moderate depression (22%), while 18% reported symptoms of major depression. The level of depression was higher in older subjects, in the presence of chronic diseases with greater limitations of activity and the presence of difficulties in performing daily activities, with a more pronounced effect of pain on activity, the presence of stress. All subjects were characterized as persons with severe anxiety (score 26-63). The level of anxiety was higher in older respondents, in the presence of long-term illness, with greater limitations of activities and difficulties in performing daily activities, with a more pronounced influence of pain on performing activities and the influence of the media.

    Conclusion: Caring for the mental health of cancer patients must occupy a significant part of each country's national health policy.

  • XML | PDF | downloads: 19 | views: 47 | pages: 2028-2037

    Background: A good level of physical fitness helps teenagers maintain a good state in daily study and life and enables them to cope well with emergencies. We aimed to explore the influences of physical exercise motives on the physical health and aerobic fitness of teenagers.

    Methods: A total of 982 teenagers aged between 13 and 16 years in the four districts of Guangzhou City, China from January to December 2019 were selected randomly with the assistance of communities. Their physical exercise motives and exercise behaviors were investigated using a questionnaire survey, and their physical health indexes and aerobic fitness were assessed. The relationships of physical exercise motives and behaviors with physical health and aerobic fitness were analyzed.

    Results: Teenagers who have higher physical health scores show significantly increasing trends in their scores in exercise motives and different dimensions, exercise behaviors, and aerobic fitness scores (P<0.05). Physical exercise motives show significant correlations with exercise behaviors, physical health, and aerobic fitness. Moreover, exercise behaviors show significantly positive correlations with physical health and aerobic fitness (P<0.05). Physical exercise motives have a positive effect on exercise behaviors, physical health, and aerobic activities, and exercise behaviors have a positive effect on physical health and aerobic activities (P<0.05).

    Conclusion: The physical exercise motives of teenagers have positive and prediction effects on exercise behaviors, physical health, and aerobic fitness. Exciting physical exercise motives can promote the physical exercise behaviors of teenagers and improve their physical health and aerobic fitness.

  • XML | PDF | downloads: 10 | views: 37 | pages: 2038-2045

    Background: The main objective was to investigate the relationship between Health-Related Quality of Life (HRQL) and Body Mass Index (BMI) status according to gender in a representative sample of Greek urban population.

    Methods: In this cross-sectional study, data were collected from 1060 participants (mean age 47.10 yr, 95%CI 46.09–48.07, 52.7% females) in a stratified sample of representative urban population during 1-20 Apr 2016 in Athens, Greece. Socio-demographic characteristics and medical history were involved. BMI (kg/m2) was calculated, based on reported height and weight. HRQL was assessed by using the Greek version of SF36. Parametric tests and multiple logistic regression analysis were applied to identify whether socio-demographic characteristics differed across BMI groups. Mann–Whitney test was used to detect significant differences in SF36 scales between men and women across different BMI and age groups. Μultivariate stepwise linear regression analyses were performed to investigate the influence of sociodemographic variables on HRQL.

    Results: The effect of being overweight or obese differs by age and gender and that this negative impact in HRQL was greater in women than in men. More vulnerable were overweight young and obese middle-aged woman both in terms of physical and mental health. On the other hand, HRQL of normal weight men and women did not differ in almost all age groups.

    Conclusion: Gender differences on HRQL observed in the general population were mediated by the different way that the two genders affected by increases in body weight.

  • XML | PDF | downloads: 11 | views: 36 | pages: 2046-2054

    Background: Autism significantly affects mental health and lowers subjective well-being (SWB). The rehabilitation therapy of autism is attracting widespread attention. We aimed to explore the effects of image-sandplay therapy on the mental health and SWB of children with autism.

    Methods: A total of 90 children with autism treated in Changchun Women and Children Health Hospital from Jan 2019 to Jun 2020 were enrolled by convenient sampling method. They were randomly divided into control (n=45) and observation (n=45) groups. The observation group had a 12-week image-sandplay therapy based on conventional rehabilitation therapy. In the image-sandplay therapy, the one-to-one intervention was provided once a week, 60 min in each. Autism treatment evaluation checklist (ATEC), autism behavior checklist (ABC), Conners parent symptom questionnaire (PSQ), satisfaction with life scale (SWLS), and positive and negative affect scale for children (PANAS-C) of the two groups were assessed.

    Results: After intervention, the observation group showed lower scores in ATEC scale and ABC scale than the control group, and the difference show statistical significance (P<0.05). Meanwhile, the observation group showed significantly lower scores in PSQ scale than the control group, showing a significant difference (P<0.05). The observation group shows higher scores in SWLS scale and positive affect scores than the control group, as well as significantly lower negative affected scores than the control groups, showing a significant difference (P<0.05).

    Conclusion: Image-sandplay therapy can improve the symptoms of children with autism and is conducive to promoting mental health and increasing SWB. It is a feasible and effective rehabilitation method.

  • XML | PDF | downloads: 13 | views: 42 | pages: 2055-2064

    Background: Nursing educators commonly adopt simulations to educate nursing students and evaluate their clinical thinking, clinical reasoning, and clinical judgment. We aimed to determine the effectiveness of established nursing care simulations by evaluating, through video, a select number of nursing students in scenarios that simulate nursing care for Increased Intracranial Pressure (IICP) patients.

    Methods: The participants were students in their senior year at a nursing college in South Korea in 2018. We adopted a mixed-method design by first conducting a nonequivalent control group pre-test/post-test research design, then analyzing the experimental group’s simulation videos. The participants consisted of 38 students in the experimental group and 39 students in the control group, and each group consisted of 9 teams. This study measured the level of anxiety (Cronbach’s α=0.780), critical thinking (Cronbach’s α=0.895), performance (Cronbach’s α=0.927), theoretical knowledge (Cronbach’s α=0.970), and analyzed clinical judgments by directly reviewing video from the experimental group. We used a mixed methods appraisal tool (MMAT) version 2018 as its research checklist.

    Results: Confidence (P=0.000), theoretical knowledge (P=0.000), clinical performance (P=0.017) indicated statistically significant increases in the experimental group. We subsequently identified 10 clinical judgment processes, including “Identify the patient’s condition” to “Reassess the condition after symptoms improve” by analyzing the simulation videos.

    Conclusion: Developing a simulation for nursing care is effective in honing students’ clinical judgment and enhancing their theoretical knowledge, confidence, and clinical performance.

  • XML | PDF | downloads: 18 | views: 38 | pages: 2065-2075

    Background: Turner syndrome (TS), also known as 45,X, is a genetic disorder caused by the partial or complete lack of an X chromosome. TS can cause a variety of medical and developmental conditions. We aimed to investigate TS mosaicism and variants pattern and research the presence of a correlation between the different variant’s factors and TS occurrence.

    Methods: From 1984-2018, 100,234 patients referred to the Farhud Genetic Clinic, Tehran, Iran, for karyotyping were studied. TS was determined by the chromosomal assay, and the patients’ karyotype was obtained from amniotic fluid and blood samples. Different variants of the TS diagnosed patients were investigated, including maternal and paternal age at pregnancy, parental consanguinity, and the presence/absence of a family history of the disease.

    Results: Overall, 261/100,234 (0.26%) were diagnosed with TS. These, 150 cases were identified to have the classical 45,X karyotype and 111 cases were identified to have either TS mosaicism or other less common variations of TS karyotyping. Higher parental age at pregnancy and TS data suggested that the occurrence of TS is significantly higher.

    Conclusion: Data suggest parental age at pregnancy is an important factor for TS occurrence. Hence, prenatal screening in these groups of parents recommended. This study also implicates early medical diagnostic testing before the onset of puberty or as soon as symptoms arise is essential for early treatment.

  • XML | PDF | downloads: 14 | views: 27 | pages: 2076-2084

    Background: Graft and patient survival are of great importance after transplantation. This study aimed to determine the long-term survival rate of kidney transplantation and its effective factors among transplanted patients in Mashhad transplantation centers in northeastern Iran.

    Methods: Overall, 618 kidney transplant recipients were examined in different transplantation centers during the years from 2000 to 2015 in a historical cohort study. The Kaplan-Meier method and the Log-rank test were used to calculate the survival rate of the kidney transplant, and to check the difference between survival curves respectively. Modeling of effective factors in survival rate was performed using Cox regression model.

    Results: Overall, 1, 3, 5, 7, 10, and 15-year survival rate of kidney transplantation were 99%, 98%, 97%, 93%, 88 and 70% respectively. The adjusted hazard ratio indicated that variables such as recipient age >40 yr [HR=0.22, 95% CI=(0.071,0.691)], serum creatinine after transplantation >1.6 Mg/dl [HR=3.03, 95% CI=(1.284,7.125)], history of hypertension [HR=6.70, 95% CI=(2.746,16.348)], and BMI [HR (normal weight versus underweight)=0.26, 95% CI=(0.088,0.761), HR (over weight versus underweight)=0.13,95% CI=(0.038,0.442)] were significant factors on kidney transplant survival rate.

    Conclusion: The short-term transplant survival rate was good in transplant patients. What's more, through a consideration of variables such as age, creatinine serum after transplantation, history hypertension and body mass index, as well as proper planning to control their effect, it is possible to improve the long-term graft survival rate.

  • XML | PDF | downloads: 21 | views: 42 | pages: 2085-2094

    Background: To study the current trends in Obstetrics–Gynecology (Ob-Gyn) education and workforce in Iran since 1979 and to discuss the consequences and implications.

    Methods: This descriptive-analytical study was conducted to describe the Ob-Gyn residency and fellowship growth and workforce profile in Iran (1979-2017).The first-hand data gathered from MOHME and Iran’s Medical Council. The Obstetrician-Gynecologist (Ob-Gyns) per 100000 populations’ ratio and the percentage changes calculated and the trends analyzed.

    Results: Between 1979 and 2017, the proportion of trained Ob-Gyns at national universities increased by 86.27%, the number of certified Ob-Gyns increased by 333% and, female Ob-Gyns increased by 1142%.The ratio of active gynecologists per 100,000 people was 5.0 in 1979 and 8.05 in 2017, represents an increase of 70%. Since 1979 the number of active gynecologists has increased by 278 and the number of active female gynecologists has increased by 996%. Since 1990 the maternal mortality per 100,000 live births decreased by 79.9% in Iran. However, since 1980 the Cesarean proportion increased by 203% in Iran.

    Conclusion: Ob-Gyn education has undergone remarkable growth. Ongoing research should focus on Ob-Gyn’s geographic distribution, and potential implications of female Ob-Gyns practice pattern and technologies on women’s health.

  • XML | PDF | downloads: 16 | views: 31 | pages: 2095-2104

    Background: Cancer with 13% of all deaths is the third leading cause of mortality in Iran. We aimed to assess the burden of cancer in Iran by acquiring data from the Global Burden of Disease (GBD) study.

    Methods: This study was conducted on the DALY approach to examine the cancer burden in Iran from 1990 to 2016. A list of all cancers was extracted using the International Classification of Disease, tenth revision (ICD-10). Then, the cancer burden was assessed based on the type of cancer. The Percentage change (PC) by Daly’s number and age-standardized DALY rate (ASDR) was estimated. The cause of PC on the DALYs number from cancer was analyzed, and the share of every variable was determined.

    Results: In 2016, cancer caused 781.5 and 564 thousand DALYs for men and women, respectively. In all years, the DALYs number of cancer is higher in men than women. From 1990 to 2016, leukemia, stomach, tracheal, bronchus and lung (TBL) cancers were among the leading causes of cancer burden in Iran. The highest increase in PC of cancer DALYs from 1990 to 2016 happened by multiple myeloma with 302.4% and breast with 283.7%. The lowest increase occurred by Hodgkin lymphoma (-2.1%) and leukemia (18.2%).

    Conclusion: Cancers have grown more than doubled in terms of DALYs from 1990 to 2016. The majority of DALYs were due to Years of Life Lost, suggesting the need for prevention, early detection, and screening programs.

  • XML | PDF | downloads: 17 | views: 34 | pages: 2105-2110

    Background: Phenylketonuria (PKU) is an autosomal recessive disorder that screening and timely control of this disorder can prevent the adverse effects. Regarding the high prevalence of PKU in Iran, the PKU screening program was started in Iran in 2006. This study was conducted to determine the cost-effectiveness of PKU screening in Iran.

    Methods: An economic evaluation was performed among screened and treated individuals compared to no screening in 2013. The study population included 1356132 newborns that screened for PKU diagnosis. Lifetime costs, quality-adjusted life year (QALY) gains and incremental cost-effectiveness ratio (ICER) were calculated from the perspective of government. A discount rate of 3% was considered for both QALYs and costs. A one-way sensitivity analysis was used for assessing the robustness of the results.

    Results: The discounted lifetime cost of intervention and non-intervention were $59528953.8 and $85295501.6 respectively. Therefore, the total estimated cost saving was $25766547.84. PKU screening produces an ICER of $1844420 per QALY gained.

    Conclusion: Screening and early treatment for PKU is highly cost-effective. Therefore, the screening can improve quality of life of the patients and increase financial saving in health system.

  • XML | PDF | downloads: 35 | views: 43 | pages: 2111-2120

    Background: Photodynamic therapy (PDT) is alternative treatment of cutaneous leishmaniasis (CL), and phenolthiazine dyes such as Toluidine Blue O (TBO) have the potential role in PDT and notably affect parasites inactivation. This study aimed to evaluate the effectiveness of PDT by using TBO and a light-emitting diode (LED) in the treatment of zoonotic CL (ZCL).

    Methods: The study was conducted in Iran University of Medical Sciences, Tehran, Iran in 2018-2020. Different concentration (7.8 µg/ mL up to 500 µg/ mL) of TBO as a photosensitizer and a 630 nm LED light as a source of light were used for antileishmanial activity against both forms of Leishmania major promastigotes and intracellular amastigotes. Effective concentration (EC50) and cell cytotoxicity (CC50) were calculated in both infected and non-infected J774.A1 macrophages, respectively. As well as inhibitory concentration (IC50) was quantified in L. major promastigotes for 2 h, 24 h, and 48 h after incubation using a MTT colorimetric assay.

    Results: TBO dye in combination with the PDT significantly decreases the L. major promastigotes and intracellular amastigotes viability when compared with TBO alone. Both TBO dye in combination with the PDT and TBO alone had no toxic effects on the mice macrophages; however, it significantly killed the entered parasites inside the cells. Our results in the current study established satisfactory findings in clearing intracellular L. major parasites in in-vitro conditions.

    Conclusion: TBO dye in combination with the PDT can be considered as a harmless, effective and importantly perfect treatment against L. major, causative agent of ZCL, in an in-vitro situation without any negative toxicity to the mice macrophages.

  • XML | PDF | downloads: 34 | views: 48 | pages: 2121-2131


    Background: Close contact tracing is an essential measure that countries are applying to combat the epidemic of COVID-19. The purpose of contact tracing is to rapidly identify potentially infected individuals and prevent further spread of the disease. In this study, based on the factors affecting the COVID-19 transmission, a scoring protocol is provided for close contact tracing.

    Methods: First, the factors affecting the COVID-19 transmission in close contacts were identified by a rapid review of the literature. Data were gathered by searching the Embase, PubMed, Google Scholar, and Scopus databases. Then, by formulating and scoring the identified factors with two sessions of the expert panel, close contact transmission risk score determined, and a protocol for contacts tracing was designed.

    Results: Close contact transmission risk depends on the contact environment characteristics, the infectivity (virus shedding) of the sentinel case, and contact characteristics. Based on these factors, the close contact transmission risk score and contact tracing protocol were prepared.  

    Conclusion: The close contact transmission risk scores will provide the ability to contact classifications and developing specific tracing strategies for them. Given that there are not any specific treatments for COVID-19 and lack of universal vaccination, applying nonpharmaceutical measures such as contact tracing along with physical distancing is very crucial. Therefore, we recommended this model to the evaluation of exposure risk and contact tracing.

  • XML | PDF | downloads: 22 | views: 67 | pages: 2132-2138

    Background: Provided that COVID-19 pandemic has led to mental wellbeing disorders for city dwellers, and given that there is a significant association between outdoor activities and mental health, this paper investigated how the frequency of walking during the pandemic contributes to the immediate and subsequent ‘mood’.

    Methods: A longitudinal data collection method was adopted to verify the ‘mood’ of the participants before and after walking. The survey was conducted with 100 participants in a walking path in Shiraz, Iran, on Jan 2021. The quantitative analysis methods were performed in SPSS to examine the mental wellbeing outcomes of walking in the outdoor walking path when considering the psychological impacts of the pandemic and the quantity. 

    Results: The result affirms the positive contribution of walking in the improvement of mental-wellbeing-mood during the pandemic; though, such a mood boost is in a direct relationship with the quantity of the activity within a week. Moreover, other factors can play a significant role, including the ‘mood before walking’, and the age of the participants.

    Conclusion: It is likely that encouraging people to consider walking as their routine activity can lead to several positive consequences on mental wellbeing since walking as a basic outdoor activity during the pandemic can contribute on the mood. 

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