2023 Impact Factor: 1.3
2023 CiteScore: 2.2
pISSN: 2251-6085
eISSN: 2251-6093
Chairman & Editor-in-Chief:
Dariush D. Farhud, MD, Ph.D., MG.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE). 
Vol 39 No 3 (2010)
Articles
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Background: Understanding the nature and causes of medical adverse events may help their prevention. This systematic review explores the types, risk factors, and likely causes of preventable adverse events in the hospital sector.
Methods: MEDLINE (1970-2008), EMBASE, CINAHL (1970-2005) and the reference lists were used to identify the studies and a structured narrative method used to synthesise the data.
Results: Operative adverse events were more common but less preventable and diagnostic adverse events less common but more preventable than other adverse events. Preventable adverse events were often associated with more than one contributory factor. The majority of adverse events were linked to individual human error, and a significant proportion of these caused serious patient harm. Equipment failure was involved in a small proportion of adverse events and rarely caused patient harm. The proportion of system failures varied widely ranging from 3% to 85% depending on the data collection and classification methods used.
Conclusion: Operative adverse events are more common but less preventable than diagnostic adverse events. Adverse events are usually associated with more than one contributory factor, the majority are linked to individual human error, and a proportion of these with system failure. -
Globalisation has given birth to medical tourism. Health and medical tourism are the fastest growing segments in not only developed nations but in developing countries too. India has become a hot destination, as the Indian medical standards match up to the highly prescribed international standards at a very low cost. However, it is an unmixed blessing; along with advantages, it has many unintended side effects also.
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Background: Mortality refers to the death that occurs within a population. It is linked to many factors such as age, sex, race, occupation and social class. The incidence and prevalence of mortality could affect the population's standard of living and health care. The aim of this study was to explore the pattern of mortality trends in Iran, south-south west Asia and the world in 1970-2010.
Methods: A descriptive study was conducted on the registered data in the Statistical Center of Iran and National Organization of Civil Registration. The data were analyzed using statistical methods and graphs. Finally, the analyzed data were compared with the world and south-south west Asia data.
Results: In Iran, 61.1% of all the registered deaths were in male and 60.4% were in urban areas. Crude death rate, infant mortality rate and under five mortality rate decreased from 13, 164 and 281 per 1000 in 1970-75 to the estimated values of 5, 25 and 35 per 1000 in 2005-2010, respectively.
Conclusion: The results showed that similar to other countries, the trends of all mortality indicators in Iran have been changed and decreased, which is related to many factors such as improvement health situation and medical interventions. -
Background: Gastric cancer is a common and lethal disease throughout the world. In Iran with 7300 new cases annually, it is the first cause of cancer related death in both sexes. Regarding the high incidence (10.5/100000 individuals) of gastric cancer and priority of prevalence index in cancer management, in this study we tried to determine 1, 2-3 and 4-5 year point prevalence of the disease according to survival data.
Method: Survival and incidence data were used for determination of cancer prevalence. Incidence data were extracted from cancer registry in Iran and survival data were determined in a descriptive study by following up 3439 gastric cancer patients in Cancer Research Center (CRC). 1, 2-3 and 4-5 year prevalence was estimated from incidence rates in different years and the proportion of patients surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years from the time of diagnosis.
Results: patients with survival of 0.5, 1.5, 2.5, 3.5 and 4.5 years from the time of diagnosis were 46.38%, 26 %, 19.36%, 15.47% and 12.8% respectively. The prevalence of 1, 2-3 and 4-5 year was 3392, 3118and 1824 respectively. The cumulative 5 year prevalence was 8334 cases.
Conclusion: These estimates of the point prevalence of gastric cancer at 1, 2-3 and 4-5 years are applicable to the evaluation of initial treatment, clinical follow-up, and point of cure. Therefore 1, 2-3 and 4-5 year point prevalence estimates, are necessary in health service planning for gastric cancer management and should be considered by public health managers. -
Background: IgE is an antibody class that regarded as an important factor in the pathogenesis of allergic diseases, asthma, immune responses to parasitic infection and it could be responsible for the late- phase allergic response. The objective of this study was to evaluate total IgE in healthy Iranian adults, establishment of reference range of total IgE and assess helpfulness of this value in clinical diagnosis atopic and allergic diseases.
Method: Three hundred sixty six healthy adults from blood transfusion volunteers (18 to 60 years) were selected in this study. A specific questionnaire (including demographic factors, smoking status and ...) was filled out for each person. Also, we evaluated effect of race and education on total IgE. These adults had no history of allergic disease. The total serum IgE level using a commercial enzyme immunoassay and CBC (Eosinophil count) was determined in them.
Results: Mean of age was 37.32± 10.93 yrs and 219 cases were males and 147 females. The geometric mean of total IgE was 20.84 IU/ml (2-373 IU/ml) (95% percentile= 250) (95% confidence interval=46.27-62.70). No differences was observed between mean of IgE log in males and females (P= NS) but mean of total IgE log in females is more than males.
Conclusion: Normal range of serum total IgE obtained in this study could be helpful for diagnosis of IgE-dependent allergic disease, as reference ranges in Iranian healthy adults. -
Background: This study examined the relationship between lifestyle factors and hypertension in Korean women.
Methods: The subjects were 8,836 women, aged 20 to 81 yr, who visited a health promotion center for a medical check up during 2004-2008. The diagnosis of hypertension was defined in the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) report. Statistical significance was set at α<0.05 and SPSS ver. 12.0 software (SPSS, Chicago, IL, USA) was used.
Results: The prevalence of hypertension was 12.8% in this study population. Multivariate logistic regression demonstrated that the odds ratio (95% CI) of hypertension across age groups were 3.43 (1.68-7.02) for forties, 7.13 (3.48-14.60) for fifties, 12.97 (6.27-26.81) for sixties, and 24.28 (11.09-53.14) for over seventies compared to the twenties. In addition, compared with the normal weight group, the odds ratio (95% CI) of hypertension in the over-weight and obese groups were 2.41 (2.00-2.89) and 3.50 (2.95-4.16), respectively. The odds ratio (95% CI) of hypertension in those who consumed more than 3 drinks per week was 1.88 (1.29-2.76, P=0.001) compared with non-drinking group.
Conclusion: The significant risk factors of hypertension were age, BMI, and alcohol drinking among Korean women and that smoking, exercise, and diet were not related to the risk of hypertension. -
Background: The prevalence of vitamin D deficiency and its causative factors has been estimated more frequently in elder population, women, and patients with osteoporosis in different countries, but this issue is less defined in male population within different age groups especially in Asian countries. Therefore, we studied the role of effective factors in vitamin D deficiency and its prevalence in Iranian healthy men.
Methods: This study was a multi center and carried out in five metropolitans in Iran. Serum 25 Hydroxy vitamin D and other biochemical variables were determined in 2396 healthy men in late winter of 2001.
Results: 68.8% of participants suffered from vitamin D deficiency. Vitamin D levels were the highest in Bushehr (n= 111, 40.3%) (P< 0.05) and between Shiraz and Tabriz, Shiraz had the better values (P< 0.05). Tehran had the highest prevalence of vitamin D deficiency (n= 380, n= 85.7%). Geographical zone independently predicted vitamin D status (P< 0.05). There was not any association among age (r= 0.035, P> 0.05), physical activity (r= 0.023, P> 0.05), and exposure of face & hands to sunlight (r= 0.022, P> 0.05) with vitamin D levels.
Conclusion: Prevalence of vitamin D deficiency in Iranian male population is high, considering Iranian cultural and geographical zones, food fortification and life style modification is recommended. -
Background: Leber hereditary optic neuropathy (LHON) is an inherited form of bilateral optic atrophy leading to the loss of central vision. The primary cause of vision loss is mutation in the mitochondrial DNA (mtDNA), however, unknown secondary genetic and/or epigenetic risk factors are suggested to influence its neuropathology. In this study folate gene polymorphisms were examined as a possible LHON secondary genetic risk factor in Iranian patients.
Methods: Common polymorphisms in the MTHFR (C677T and A1298C) and MTRR (A66G) genes were tested in 21 LHON patients and 150 normal controls.
Results: Strong associations were observed between the LHON syndrome and C677T (P= 0.00) and A66G (P= 0.00) polymorphisms. However, no significant association was found between A1298C (P =0.69) and the LHON syndrome.
Conclusion: This is the first study that shows MTHFR C677T and MTRR A66G polymorphisms play a role in the etiology of the LHON syndrome. This finding may help in the better understanding of mechanisms involved in neural degeneration and vision loss by LHON and hence the better treatment of patients. -
Background: Medical journals are scientific resources where utilization of knowledge is availed and create an environment of competitiveness. To speed up the growth and increase scientific production and in order that the rank of Iranian journals be defined regionally and globally, journal standardization is necessary. This study was done to evaluate the country's medical journals from 2004-2006.
Methods: This is a descriptive/analytical study. Evaluation was based on the following; scientific credibility, registry and year of service, journal management, technical quality and accessibility. The number of journals evaluated during 2004-2006 were 86, 103 and 93, respectively and the process involved 3 phases 1) defining the journal's structural indicators and designing the evaluation form 2) collection, sharing and final confirmation of information with the publication staff 3) data entry, analysis and ranking
Results: Improvement and growth of publication depends largely on 5 parameters and its development were based on the following; publication management (61.62 points), scientific credibility (43.80 points), quality of accessing the journals (37.05 points), quality of publication (14.80 points) and registry and year of service (0.02 points). Based on the study, an upward developmental trend of the country's medical journals can be seen and the tools were sufficient in terms of validity and reliability. A revised and more comprehensive checklist that would evaluate all aspects of a publication basing on latest indicators is developed.
Conclusion: Evaluations of the country's medical journals not only promote compliance to international standards but also led to more indexing of journals in accredited international indices. -
Background: In general, measurements of solar ultraviolet (UV) radiation are related to horizontal surfaces. While the humans walking and standing outdoors expose to the natural solar UV radiation, their eyes, cheeks, extremities, trunks, or many other anatomical sites are close to vertical plane and random orient to different directions. In this study, we characterized the diurnal variations in solar UV on horizontal and vertical plane which may be helpful to obtain more relevant information on UV exposure of humans.
Methods: The were measured using Solar-UV Sensors in Shenyang (41°51′N, 123°27′E) and Sanya (18°19'N, 109°42'E), PR China.
Results As the well known, the diurnal variations in solar UV on horizontal plane in a sunny day exhibited unimodal distributions, reached a single UV peak exposure at around solar noon. However, the diurnal variations on vertical plane presented bimodal distributions, with two peaks in summer in Shenyang and Sanya, and a unimodal distribution in winter in Shenyang. In spring and autumn in Shenyang, the UV exposure around noon were slightly flat with no significant peaks but relative high. When the Solar Elevation Angle (SEA) is about 40°, the vertical plane may potentially receiving maximal unweighted total solar UV radiation exposures.
Conclusion: The results potentially showed that the protection of some vertical and near-vertical anatomical sites of human body from high UV exposure should not only focused on the periods of before and after noon especially in high SEA places. -
Background: Diabetes mellitus is associated with chronic changes in peripheral arteries because of oxidative stress and insufficient antioxidative defense mechanism. Omega-3 fatty acid supplementation could be effective in some diabetes complications; however, polyunsaturated fatty acids may increase lipid peroxidation. This study aimed to determine whether eicosapentaenoic acid alone or in conjunction with vitamin E had differential effects on serum antioxidants and peroxidation indices.
Methods: This double-blind, placebo-controlled trial was carried out on 136 patients with type II diabetic mellitus (age 48.8±4.4 yr, BMI 27.8±1.7 kg/m²). The four groups of the study either received two grams of omega-3 fatty acids, 400 IU of vitamin E, a combination of the two or placebo for three months. Their serum total antioxidant capacity, enzymatic antioxidants and peroxidation indices were assessed.
Result: Fasting serum TAC increased in EPA+E (10.7%, P< 0.001) and E groups (7.5%, P< 0.05). SOD, G-PX and G-RD increased in EPA group (7.3%, 5.1%, and 8.4%, P< 0.05, respectively). MDA and protein carbonyl decreased in EPA and E groups (respectively, 12.5%, 7.6% P< 0.05, P< 0.05; 13%, 15.3% P< 0.001, P< 0.05). After adjustment for baseline values, age, sex, BMI and duration of diagnosed diabetes, protein carbonyl decreased in EPA+E and E group (30.7%, 15.3%; P< 0.05 respectively) relative to the placebo group.
Conclusion: EPA, by itself has a statistically significant effect on serum total antioxidant capacity, enzymatic antioxidants and peroxidation indices in diabetic patients compared to EPA+E or E alone.Trial registration: ClinicalTrials.gov NCT00817622
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Background: Given the increasing prevalence of obesity among Iranian adolescents and the role of consumption of unhealthy snacks in this issue, interventions that focus on factors influencing food choice are needed. This study was designed to delineate factors associated with unhealthy snack use among female Iranian adolescents.
Methods: The theory of Planned Behavior served as the framework of the study. Qualitative data were collected via nine focus group discussions in two middle schools (6th to 8th grades) in a socio-economically diverse district in the city of Tehran in spring 2008. The study sample included 90 female adolescents aged 12-15 years. The sampling strategy was purposive method. Data analyzed using the "framework" method.
Results: Major factors identified by the respondents were taste, peer pressure, parental influence, easy access to unhealthy snacks, limited availability of healthy snacks, appeal of snacks, habit, high price of healthy snacks, and media advertisements. Nutritional value and healthiness was not one of the first priorities when buying snacks, as adolescents thought it was too early for them to worry about illness and adverse consequences of eating junk foods.
Conclusions: For developing culturally sensitive evidence-based interventions that can motivate adolescents to choose healthy snacks, a broad range of factors should be taken into account. -
Background: To compare the effectiveness of 3 commercial gel bait formulations containing fipronil (Goliathã Cockroach Gel 0.05% AI), chlorpyrifos-A (Clean Baitã Gel, 2% AI), and chloropyrifos-B (Serpaã Gel 2% AI) against German cockroaches (Blattella germanica) when stored at 23°C and 30° C after treatment.
Methods: Laboratory bioassays consisted of placing groups of fifteen cockroaches (a random combination of adult, mixed sex and large nymphs-stage 6) into a 5 L cylindrical plastic container with one drop of product (avg 0.10 g ± 0.01 g) applied to a 76 mm x 26 mm glass microscope slide affixed to the bottom of each container (one product tested per container). Cumulative mortality was assessed at 6 h, 1, 2, 3, 4, and 5 d after application. To determine the further effects of storage temperature after treatment on residual activity of the gels, a drop of each product was applied to separate glass microscope slides and stored at either 23º C (warm) or 30º C (hot) under dark conditions for 0, 1, 7, 14, 30, 45, 60 and 90 d after application.
Results: Freshly applied baits (day 0) containing fipronil provided complete cockroach mortality (100%) within 5 d whereas chloryrifos-A and chlorpyrifos-B provided »72% and 88% mortality, respectively. Generally, cockroach mortality was greater when gels were stored at 30°C compared with 23º C.
Conclusion: The fipronil gel formulation proved to be as efficacious as the chlorpyrifos gels and in some instances surpased the latter formulations depending on storage time and temperature by providing »90% mortality at 90 d post treatment. -
Background: Cockroaches have been recognized as a powerful indoor allergen. Cockroach allergy can be a major factor in serious asthma and nasal allergy. Bioinformatics tools have been developed to identify potential allergens. The present study was conducted to identify potential allergens in Periplaneta americana (Linnaeus).
Methods: The study focused on the identification of potential allergens among the characterized proteins of P. americana using web-based and publicly available allergen prediction tools that follow the FAO/WHO guidelines for prediction of allergenic proteins. P. americana protein sequences were retrieved from UniProtKB. The sequences obtained were analyzed using AlgPred. The potential allergens obtained were further analyzed by SDAP for confirmation.
Results: Protein sequences (233 cases) of P. americana were obtained from UniProtKB out of which 25 were known allergens. Out of the remaining 208 proteins, 102 potential allergens were predicted by AlgPred. However, only 9 were found to be potential allergens after screening with SDAP. Arginine kinases, RNA polymerase II subunit, parcxpwnx02, peptidyl-prolyl cis-trans isomerase, hemocyanin subunit type I and type II, homologue of Sarcophaga proteinase and alpha amylase were confirmed to be potential allergens by SDAP.
Conclusion: We have identified nine potential allergens in P. americana that may be used as preliminary support for further laboratory experiments. -
Background: Neural tube defects (NTD) are one of the leading causes of infant mortality worldwide. This study was designed to determine the prevalence of NTDs among native Fars ethnic groups during 1998-2005, and to identify maternal and demographic factors associated with NTDs.
Methods: We performed a descriptive cross-sectional hospital-based study in Dezyani Hospital, Gorgan, North of Iran, since January 1998 until December 2005. The design was based on a sample of 30,639 births of native Fars ethnic groups. Data were analyzed by using spss V13.5 software and were compared with the chi-square test.
Results: The prevalence of NTDs in Native Fars during the 8-year period was 25.4 per 10000 births (95% confidence interval: 20.1-31.8). The prevalence of NTDs was 20.6/10000 and 30.6/10000 in males and females respectively but this difference was not significant. The prevalence of spina bifida, anencephaly and encephalocele were 12.7, 11.4 and 1.3 per 10000 respectively. The rate of NTD was 48.9/10000 in newborns with mothers aged > 35 years. The highest rate of NTDs and spina bifida was in 2002. The highest and lowest rate of anencephaly was in 2005 and 2003 respectively. Twenty eight percent of the parents had consanguineous marriages. Degree relatedness 3, 4, 5 and 6 of consanguineous marriages were 12.8%, 9%, 3.8%, 2.5%, respectively. Also 47.5% of the parents resided in rural areas.
Conclusion: This investigation showed that the rate of NTDs in Native Fars was higher in Iran. In addition, this rate is higher than the Canada and Ukraine and lower than Chinese people. -
Background: Using public swimming pools during different seasons and poor health behavior could be responsible in transmission of fungal disease through pool water and its environment. Therefore, this research was conducted to investigate fungal agents of indoor public swimming pools of Ahwaz, capital city of Khouzestan Province, south-west of Iran.
Methods: Ten indoor swimming pools of Ahwaz were investigated during two seasons for 6 months. Water specimens were collected by pump and environment samples including shower-bath area, margin of pool walls, dressing rooms, and slippers, by sterile carpet pieces. All specimens were cultured in SC and SCC culture media and fungal agents identification were based on macroscopic, microscopic characteristic and complement tests when it was necessary. Data analyzing was performed using SPSS version 13 for descriptive analyzing.
Results: A total of 593 samples were collected from different parts of pools. Interestingly in 13 samples from environmental places, dermatophytes were isolated as follows: Trichophyton mentagrophytes, T. rubrum, T. verrucosum and Epidermophyton floccosum 5, 4, 3 and 1 cases respectively. Ten cases of dermatophytes were isolated from floor of dressing area. Three hundred seventy two saprophytic fungi species and 32 yeasts were recovered from water and environment surfaces samples. Aspergillus, Penicillium and Mucor were the most common isolated saprophytic fungi.
Conclusion: Existence of saprophytic fungi and yeast in pools water seems to be an indicator of their resistance to detergent agents. In addition, yeast water contamination could be from swimmers. Dermatophytes isolation from pools environment areas and foot washing sink, reveals the importance of public swimming pools in disease transmission. Because dressing places are being used by all of the swimmers, take care of hygienic discipline in these places should be noted by health policy markers. -
Ardabil Province, northwestern Iran, is endemic for visceral leishmaniasis of Mediterranean type from many years ago. This situation might cause to underestimate other important diseases, which occur sporadically within the same area. In this case, a 6-year-old male patient in this area was treated as infected with visceral leishmaniasis initially with seropositive result for visceral leishmaniasis. Afterwards, histopathological study of crashed material and tissue sections surprisingly revealed numerous liver fasciolid fluke eggs. This case demonstrates that in an area endemic for a given parasitoses, other important infectious diseases must be considered as well.
