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 43 No 7 (2014)
Articles
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Epidemiology studies have demonstrated inconsistent associations between type 2 diabetes mellitus and the risk of malignant melanoma. To this end, the aim was to perform a meta-analysis of cohort studies.Medline, PubMed, Embase and the Cochrane Library were searched up to February 2014. Cohort studies addressing the relative risk of type 2 diabetes mellitus on malignant melanoma were included in this meta-analysis. The Newcastle-Ottawa Scale was applied for quality evaluation. The pooled relative risks with the corresponding 95% confidence intervals (95% CIs) were calculated by using random-effects or random-effects model. Heterogeneity and publication bias were evaluated by I (2) and funnel plot analysis, respectively. Data was analyzed using STATA 11.0.A total of 9 independent cohorts from 8 manuscripts were entered this meta-analysis. Type 2 diabetes mellitus was slightly associated with an increased risk of malignant melanoma, and the pooled relative risk was 1.15 (95% CI, 1.00-1.32) in diabetes compared with non-diabetes with significant evidence of heterogeneity among these studies (P=0.016, I (2) =57.6%). For the studies adjusted for age, gender and obesity, the relative risks were 1.21 (95% CI, 1.03-1.42), 1.17 (95% CI, 1.01-1.35) and 1.11 (95% CI, 1.00-1.24), respectively. For the population-based studies in which case cohort established, the relative risk was 1.85 (95% CI, 1.31-2.62).Type 2 diabetes might be an independent risk factor for malignant melanoma. Further studies are needed to specifically test the effect, and fully elucidate the underlying pathophysiologic mechanisms.
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In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination.The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers' perspectives by conducting survey with an application of structural equation modelling approach.In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model.In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services.
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The association between β2-adrenergic receptor (ADRB2) -16Arg/Gly polymorphism (rs1042713) and chronic obstructive pulmonary disease (COPD) risk has been investigated in many published studies. However, the results were inconclusive. A meta-analysis was performed to make a more precise estimation of the relationship.The PubMed, EMBASE, ISI web of science, the Cochrane Database of Systematic Reviews, and Chinese databases (CNKI, Wanfang Data, CBM, VIP) were searched for published literature. Odds ratios (OR) with 95% confidence interval (CI) were used to assess the strength of association.Eleven studies, comprising 1,128 COPD patients and 1,182 controls, were included in the meta-analysis. Overall, there was no significant association between the ADRB2-16Arg/Gly polymorphism and COPD risk in general population. In the stratification analysis by potential confounding variables, significant associations were observed between the ADRB2-16Arg/Gly polymorphism and COPD risk among smoking Asians under the dominant genetic model and allele model (Arg vs. Gly) (dominant model: OR = 1.45, 95% CI = 1.04-2.01, P = 0.311 for heterogeneity, z = 2.22, P = 0.026 for OR; allele model: OR = 1.27, 95% CI = 1.03-1.57, P = 0.209 for heterogeneity, z = 2.20, P = 0.028 for OR), but not in other subgroups.This meta-analysis suggested that the ADRB2-16Arg/Gly polymorphism might be a potential risk factor for the development of COPD in smoking Asian populations, but not in European descendents, and tobacco smoking probably increased the genetic susceptibility. More studies with larger sample sizes are needed to validate the results.
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Food safety issues are not a new issue in science, but due to the dynamic changes in the modern world it is as equally important as decades ago. The aim of the study was to address the efforts in the development of a comprehensive food safety system in Serbia, and make specific recommendations regarding the improvement of epidemiological investigation capacity as a useful tool which contributes to improving the public health by joint efforts of epidemiologists and law enforcement.We used the methodology appropriate for social sciences.The findings show the current state-of-affairs in the area of food safety and health care system and present some most important weaknesses which have to be overcome. Policy makers need timely and reliable information so that they can make informed decisions to improve the population health in an ongoing process of seeking full membership in the European Union.Serbia has to apply significant changes in practice because the current state-of-affairs in the area of food safety and health care system is not so favourable due to numerous both objective and subjective factors. Hence, the policy-makers must work on the development of epidemiological investigation capacities as a firm basis for greater efficiency and effectiveness. Epidemiologists would not stay alone in their work. Law enforcement as well as many other stakeholders should recognize their new role in the process of the development of epidemiological investigation capacity as a tool for the development of a comprehensive food safety system in Serbia.
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The aim of this study was to examine whether formal and informal social activities are associated with a lower risk of depression. Besides, we investigated which type of social activities may protect against late-life depression by gender using data from a population-based study of older Korean adults.Data for analysis were drawn from the 2010 Korean Longitudinal Study of Aging. Study sample included 3968 Korean adults aged ≥ 65 years. Depression was measured using the 10-item Center for Epidemiological Studies. Depression scale. Multivariate logistic regression analyses were used.Among the informal activities, frequent contact by phone or letters with adult children is significantly associated with a lower risk of depression among older Korean adults, even after adjusting for potentially confounding factors. Face to face contact with close friends was negatively associated with depression in women, but not in men. Face to face contacts with adult children were not significantly associated with depression. All of formal social activities (attending religious activities, volunteering, and participating in alumni society or family councils, political or interest groups) were not significantly associated with depression in both men and women.Informal social activities (contact by phone/letters with children and contact with friends) may have a greater impact on geriatric depression than formal social activities in this population. Researchers need to consider gender differences when examining the relationship between social activity and depression. More research is warranted to examine the direction of associations between particular types of social activities and late-life depression across time.
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The aim of this study was to analyze the association between overweight prevalence and socioeconomic status (SES) measured by complex SES index and single SES factors in Polish adolescents in respect to age and sex.This cross-sectional study was conducted in 2010-2011. A total of 1,176 adolescents aged 13.0-18.9 years were included. The respondents were students of junior-high and high schools from northern, eastern and central Poland. Quota sampling by sex and age was used. The SES was determined by: place of residence, self-declared economic situation, and parental education level. Respondents with low, average or high SES index (SESI) were identified. The level of overweight was assessed using Polish and international standards.The odds ratio (OR) for overweight prevalence in the oldest girls (aged 17.0-18.9 years) with high SESI was 0.34 (95%CI:0.13-0.92; P < 0.05) by Polish standards and 0.22 (95%CI:0.05-0.95; P < 0.05) by international standards, in comparison to the reference group (low SESI). In total girls who had mothers with higher education level, the OR adjusted for age was 0.44 (95%CI:0.21-0.90; P <0.05) by Polish standards and 0.35 (95%CI:0.15-0.81; P < 0.05) by international standards, in comparison to the reference group (maternal elementary education). The other single SES factors were not significant for overweight prevalence.The relationship between socioeconomic status and prevalence of overweight was related to sex and age. The high socioeconomic status strongly lowered the risk of overweight prevalence in the oldest girls, but not in boys, irrespective of age. Maternal education level lowered risk of overweight prevalence in girls.
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Solving the dilemma of the organ shortage in Malaysia requires educating Malaysians about organ donation and transplantation. This paper aims at exploring the average Malaysian households ' preferred channels of campaigns and the preferred campaigners in a family setting, targeting at the dialysis family members.We analyzed the responses of 350 respondents regarding organ donation campaigns. The respondents are 2 family members of 175 dialysis patients from 3 different institutions. The information on respondents' willingness to donate and preferred method and channel of organ donation campaign were collected through questionnaire.Malaysian families have a good tendency to welcome campaigns in both the public and private (their homes) spheres. We also found that campaigns facilitated by the electronic media (Television and Radio) and executed by experienced doctors are expected to optimize the outcomes of organ donation, in general. Chi-square tests show that there are no significant differences in welcoming campaigns among ethnics. However, ethnics preferences over the campaign methods and campaigners are significantly different (P <0.05).Ethnic differences imply that necessary modifications on the campaign channels and campaigners should also be taken under consideration. By identifying the preferred channel and campaigners, this study hopes to shed some light on the ways to overcome the problem of organ shortage in Malaysia.
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The purpose of this study was to determine whether a 45 bp insertion/deletion (I/D) polymorphism in human uncoupling protein 2 (hUCP2) gene was associated with changes in several cardiovascular risk and physical fitness factors in response to combined exercise during 12 weeks in Korean middle-aged women. The changes in physiological parameters after combined exercise during 12 weeks were compared between each genotype subgroups of hUCP2 gene to clarify the inter-individual differences in exercised-induced changes according to genetic predisposition.A total of 185 women aged over 40 years living in Seoul, Korea were participated in this study, and analyzed before and after 12 weeks on combined exercise including aerobic exercise and strength training for body composition, hemodynamic parameters, physical fitness and metabolic variables. A 45 bp I/D polymorphism in hUCP2 gene was genotyped by polymerase chain reaction (PCR) amplification and agarose gel electrophoresis method.Combined exercise program during 12 weeks indicated the significant health-promoting effects for our participants on multiple body composition, hemodynamic parameters, physical fitness factors and metabolic parameters, respectively. With respect to a 45 bp I/D polymorphism in hUCP2 gene, this polymorphism was significantly associated with baseline %body fat of our participants (P <.05). Moreover, this polymorphism was significantly associated with the changes in %body fat and serum triglyceride(TG) level after combined exercise program during 12 weeks(P <.05).Our data suggest that a 45 bp I/D polymorphism in hUCP2 gene may at least in part contribute to the inter-individual differences on the changes in some clinical and metabolic parameters following combined exercise in middle-aged women.
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Diarrheal diseases can be caused by viral, bacterial and parasitic infections. This paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in Tunisian children less than five years of age.Overall, 124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. All stools were examined for the presence of enteric pathogens.In diarrheagenic children, 107 pathogenic bacteria were isolated (12 Salmonella spp. (9.7%) and 95 diarrheagenic Escherichia coli strains (76.6%): 29 enteroaggregative E.coli (EAEC) (23.4%), 15 enteroinvasive E.coli (EIEC) (12.1%), 17 enteropathogenic E.coli (EPEC) (13.7%), 26 enterotoxigenic E.coli (ETEC) (21%) and 2 enterohemoragic E.coli (EHEC) (1.6%). However, in the control group, 23 pathogenic E.coli strains were isolated (42.6%): 8 EAEC (14.8%), 12 EIEC (22.2%) and 3 EPEC (5.5%). Among diarrheagenic E.coli (DEC), only ETEC strains were significantly recovered from diarrheagenic children than from healthy controls (P < 0.0003). Group A rotavirus was identified in 33.9% (n=42) of diarrheagenic children and in 11.1% among the control group (n=6). Concerning norovirus, 8.9% (n=11) of the samples collected from diarrheagenic children and 9.2% (n=5) from the control group were positive. The prevalence of rotaviruses and Salmonella spp were also significantly higher in patients with diarrhea than in controls (P = 0.002 and P < 0.019, respectively). Finally, enteropathogenic parasites (Entamoeba coli and cryptosporidium Oocystes) were isolated from 4.8% and 9.2% of diarrheagenic and control children, respectively.These results provide baseline data about the relative importance of different enteropathogens in Tunisian children.
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The aim of this study was to determine the trend of changes in Cataract Surgical Rate (CSR) in the provinces of Iran during 2006 to 2010 and identify high risk areas.This report is part of the national Iranian CSR Study. The percentage change in CSR in 2010 compared to 2006 was conducted in each province, retrospectively. One hundred and ten centers were chosen from all provinces, to determine CSR in each, the weight of major (>3,000 annual surgeries) and minor (3,000 annual surgeries or less) centers was calculated based on the number of selected centers, and multiplied by the number of surgeries in each province.In eight provinces, CSR was decreased by 1-60%. One province (Booshehr) showed no change. Eighteen provinces had 2-79% increase. No 2006 data was available in three provinces. North Khorasan had the most decrease while Kerman had the most increase in CSR. Six of these 8 provinces had CSR>3,000 despite a decrease in 2010, but North Khorasan had CSR<3,000 over the whole 5 year period. In 4 provinces, CSR had a gap from 3,000 despite an ascending trend, and in two, the gap was quite considerable.Although CSR has an improving trend in most provinces in Iran, it is decreasing in some provinces, and despite an already low CSR, the exacerbation continues. The growing population of over 50 year olds calls for prompt measures in such provinces. Even in improving provinces, some lag behind the minimum recommended by WHO, and the growth rate of the over 50 population reveals the necessity of immediate planning.
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Knowledge Translation is a process that includes synthesis, dissemination, exchange and application of knowledge to improve the health, services and products In this study we have attempted to examine the knowledge translation practice and its perceived barriers on the universalities and research institutes (research sector) in Iran.Both qualitative and quantitative approaches were used. In the quantitative section, a questionnaire had prepared for this study was completed by 88 authors country wide from randomly selected papers. In the qualitative section 13 in-depth interviews and 6 focus group discussions were held with managers and policy makers, clinical and health service providers, and researchers.Twenty four percent of the authors had no interaction whatsoever with the target audience. Lack of expectation toward creating change in the target audience, researchers' incentives, low level of trust among researchers and decision makers, absence of a predefined mechanism for delivery of research results and inappropriate research priorities were among the most important barriers identified in the qualitative section.Translation of research findings into some concrete outputs which can affect health of people is not in mandate of researchers and subsequently they are not prepared for this as well. Based on the barriers identified, it seems that the following interventions are necessary: cooperation among policy makers at macro and meso (organizational) level and the research sector; establishing networks for researchers and decision makers in choosing the research topic, priority setting, and building trust among researchers and policy makers.
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The aim of this study was to investigate the prevalence of hepatitis B, hepatitis C, HIV and syphilis infections in blood donors referred to Tehran Blood Transfusion Center (TBTC), and determine any association between blood groups and blood- borne infections between the years of 2005 and 2011.This was a retrospective study conducted at TBTC. All of the donor serum samples were screened for HBV, HCV, HIV and syphilis by using third generation ELISA kits and RPR test. Initial reactive samples were tested in duplicate. Confirmatory tests were performed on all repeatedly reactive donations. Blood group was determined by forward and reverse blood grouping. The results were subjected to chi square analysis for determination of statistical difference between the values among different categories according to SPSS program.Overall, 2031451 donor serum samples were collected in 2005-2011. Totally, 10451 were positive test for HBV, HCV, HIV and syphilis. The overall seroprevalence of HBV, HCV, HIV, and syphilis was 0.39%, 0.11%, 0.005%, and 0.010%, respectively. Hepatitis B and HIV infections were significantly associated with blood group of donors (P <0.05) ; percentage of HIV Ag/Ab was higher in donors who had blood group "A" and percentage of HBs Ag was lower in donors who had blood group O. There was no significant association between Hepatitis C and syphilis infections with ABO and Rh blood groups (P>0.05).Compared with neighboring countries and the international standards, prevalence of blood-borne infections is relatively low.
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Understanding of the natural history of chronic HBV infection is useful for presenting the optimal management of chronic HBV infection. The aim of this study was to evaluate the natural history of chronic hepatitis B infection.In this cross sectional study, 219 untreated chronic hepatitis B patients from Jan. 2010 to Aug. 2012 were included. The subjects were classified in four groups based on serological, biochemical and molecular testing, Serological tests for HBeAg and HBeAb were performed by ELISA method. HBV DNA viral loads were detected by using Light Cycler instrument and ALT/AST levels were assessed by automatic analyzer.The majority of subjects (94.1%) were HBeAg negative. Of 13 HBeAg positive patients, 5 (2.3%) and 8(3.7%) were considered as immunetolerant and immune reactive, respectively. Of 206 HBeAg negative patients, there were 142 (64.8%) patients in inactive or low replicative phase and 64(29.2%) were in HBeAg negative chronic hepatitis B phase.The lowest rate of subjects were in immunetolerant phase and most of them had above 20 years old that confirmed successful neonatal vaccines in our country. The highest rate of chronic HBV infected patients were in low replicative phase of chronic hepatitis B infection. Although, it is not recommended to treat these patients, but liver function and also liver biopsy should be considered in patients above 40 years of age.
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The aim of this study was to detect the Glutathione S-Transferase(GST) enzyme activity of healthy / cystic liver as a diagnostic biomarker for hydatidosis. In order to compare with liver tissue, the level of the GSTs enzyme activity of parasite was also determined.Parasites were collected from sheep liver tissue with hydatid cysts at a local abattoir and washed with PBS buffer. Collected parasites and liver tissues were sonicated or homogenized respectively. Extract solution samples were centrifuged and stored at - 20°C. GST enzyme activities were measured in the extract of parasite and liver tissue samples (healthy and infected livers). Protein amounts and protein bands were detected using Bradford and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) methods respectively. To determine significant difference between two groups, two-sample t-test was performed.GST specific activities of healthy / infected livers and parasites were estimated 304, 1297 and 146 U/ml/mg respectively. Significant higher GST specific activities in cystic liver than healthy liver was observed (P <0.05). T-test analysis showed GST activity of parasite was lower than healthy liver tissue. SDS-PAGE showed GST protein bands with 24 kDa in parasite samples and25 kDa in liver tissues.GST activity incystic liver tissue could be concerned as a biomarker for hydatid cyst diagnosis with other hydatid disease parameters.
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P A twin pregnancy with a complete hydatidiform mole with a coexistent foetus (CHMF) is a rare condition that typically results in poor pregnancy outcomes. For patients with refractory vaginal bleeding, termination of pregnancy is more appropriate. However, unified methods for termination remain to be explored. In the present study, we reviewed the termination measures in four cases of twin pregnancy with CHMF. Additional understanding of this condition will aid in the treatment of women with this condition and improve their pregnancy outcomes.
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