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 42 No 12 (2013)
Articles
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Electronic Health Record (EHR) is a repository of patient health information shared among multiple authorized users. As a modern method of storing and processing health information, it is a solution for improving quality, safety and efficiency of patient care and health system. However, establishment of EHR requires a significant investment of time and money. While many of healthcare providers have very limited capital, application of open source software would be considered as a solution in developing national electronic health record especially in countries with low income. The evidence showed that financial limitation is one of the obstacles to implement electronic health records in developing countries. Therefore, establishment of an open source EHR system capable of modifications according to the national requirements seems to be inevitable in Iran. The present study identifies the impact of application of open source software in developing national electronic health record in Iran.
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Background Maternal lifestyle and behaviors during pregnancy have been associated with future health outcomes for mothers and babies. Iranian Traditional medicine, which is a holistically-oriented medical discipline, has special attitudes towards pregnancy. The purpose of the study is the investigation of maternal health in medical books of ancient Iran. This study is a systematic review scrutinizing issues concerning lifestyle during pregnancy based on "Avicenna's Canon medicine" and "Rhazes Al-Havi" and for complete discussion, other reliable sources in traditional medicine which was conducted following the categorization and analysis of the gleaned data. Based on approaches by Iranian Traditional Medicine, the most important topics in lifestyle habits during pregnancy are divided into four main groups: Nutrition, physical exercise, sexual activity and psychological stress. Then special recommendations are suggested which include a regimen to facilitate labor. Eating behaviors and other lifestyle habits have a major role in optimizing the health of women in pregnancy. Regarding to traditional medicine viewpoints paying special attention to correcting diet, life style and preventive attitude with effective and simple therapeutic procedures, it seems that traditional medicine can offer efficient managements to alleviate some pregnancy complications.
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The purpose of the present study was to examine differences in lifestyle factors such as physical activity among homosexual (gay or lesbian), bisexual, and heterosexual Korean adolescents.The sample consisted of 74,186 adolescents from grades 7-12 (ages 12-18) who participated in the 8(th) annual Korea Youth Risk Behavior Web-based Survey in 2012. Of this sample, only 11,829 provided enough information regarding their romantic and sexual experiences to define them as gay, lesbian, bisexual, or heterosexual. From this information, males were divided into gay (n = 323), bisexual (n = 243), and heterosexual (n = 6,501) groups, and females were divided into lesbian (n = 208), bisexual (n = 113), and heterosexual (n = 4,441) groups. Differences in lifestyle factors according to sexual orientation were analyzed using one-way analysis of variance.Males showed significant differences by sexual orientation group in terms of frequency of smoking (P = 0.029), alcohol consumption (P < 0.001), muscular strength exercises (P = 0.020), and walking for at least 10 minutes per week (P < 0.001). Females showed significant differences by sexual orientation group in terms of frequency of smoking (P < 0.001), alcohol consumption (P < 0.001), vigorous physical exercise (P < 0.001), moderate physical exercise (P < 0.001), and muscular strength exercises (P < 0.001), as well as for self-reported mental stress (P < 0.001).We concluded those gay and bisexual males and lesbian and bisexual females had significant lifestyle differences as compared with heterosexual adolescents. This effect was stronger for females than for males.
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This study is concerned with understanding the impact of demographic changes, socioeconomic inequalities, and the availability of health factors on life expectancy (LE) in the low and lower middle income countries.The cross-country data were collected from 91 countries from the United Nations agencies in 2012. LE is the response variable with demographics (total fertility rate, and adolescent fertility rate), socioeconomic status (mean year of schooling, and gross national income per capita), and health factors (physician density, and HIV prevalence rate) are as the three main predictors. Stepwise multiple regression analysis is used to extract the main factors.The necessity of more healthcare resources and higher levels of socioeconomic advantages are more likely to increase LE. On the other hand, demographic changes and health factors are more likely to increase LE by way of de-cease fertility rates and disease prevalence.These findings suggest that international efforts should aim at increasing LE, especially in the low income countries through the elimination of HIV prevalence, adolescent fertility, and illiteracy.
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Previous literature has implicated that there might be an individual susceptibility difference in terms of race/ethnicity and gender in response to second hand smoke (SHS) exposure. This study was done to examine the effect of SHS exposure on lung function in non-smoking Korean women.This cross-sectional study was conducted using the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008-2011. A total of 2,513 female participants, age 40 yr and older, with no respiratory symptoms or prior lung diseases, were included in this study. Participants' smoking status was examined using both self-reported history and measurement of urinary cotinine level. Lung function was assessed using spirometry data, including FVC and FEV1. T-test and Chi-square tests were performed to compare diverse variables between groups. Analysis of covariance (ANCOVA) adjusted for age, height, alcohol consumption, and level of exercise was used to see any statistical differences in lung function parameters between non-SHS exposed and SHS-exposed groups.Among 2,513 non-smoking females, 767 (30.5%) were SHS-exposed. The urinary cotinine levels clearly distinguished SHS exposure, and the mean urinary cotinine levels were 7.1±0.4 and 11±0.7 in non-SHS exposed group vs. SHS-exposed group, respectively (P < 0.001). Urinary cotinine levels were correlated with duration of SHS exposure. However, both groups had normal lung function and there was no significant difference between the two groups in lung function.Urinary cotinine is a valuable marker of SHS exposure. Korean women may have higher tolerance for SHS exposure-induced lung function decline.
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Neurotoxicants present in water supply may affect human functions in terms of attention, response speed and perceptual motor speed. Neurobehavioural performance can be influenced by gender, age and education levels. This study aims to assess the neurobehavioral performance of palm oil estate residents with private water supply in southern Peninsular of Malaysia.A total of 287 and 246 participants from estates with private (PWS) and public water supply (PUB) were recruited to complete a demographic and subjective symptom questionnaire followed by the Neurobehavioral Core Test Battery (NCTB).PWS participants who consumed privately-treated water performed poorly in all NCTB tests compared to PUB participants except for Santa Ana test. Significant group differences in neurobehavioral performance were found for Digit Span Backward (P=0.047), Benton Visual Retention (P=0.006) and Trail Making B tests (P<0.05); which measures the function of memory, attention and visual perception-conceptual. Gender, age and years of education influenced the NCTB scores (P<0.05). Female participants performed poorly in tests measuring latency but excellently tackled those tests that determined association. Younger participants from both PWS and PUB performed better on NCTB tests when compared to other age groups (P<0.05). PWS and PUB participants in this study who received a longer duration of education excelled in the NCTB tests (P=0.000).Poor neurobehavioral performance is associated with low water supply quality which affects neurofunctions in terms of attention, memory, response and perceptual motor speed.
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The purpose of this study was to analyse the prevalence of postmenopausal osteoporosis risk factors and to analyse the T-score variability in spine and hip according to the associated risk factors.This is a retrospective study (2003-2007) including 177 female patients with postmenopausal osteoporosis. The patients were separated in seven groups according to the number of risk factors per case. The T-score was compared between this groups using unpaired t-Student test.The most frequent risk factor was early menopause (44.63%), followed by low consumption of dairy products (37.29%), coffee consumption (25.99%), sedentary lifestyle (20.9%), smoking (19.21%), delayed menarche (15.25%), low body mass index (10.71%), nulliparity (7.91%), alcohol consumption (0.56%). The maximum number of risk factors per case was six. The T-score decreased with increasing number of risk factors. T-score differences are statistically significant when comparing cases with 6 risk factors to cases with 5 risk factors (P=0.0315 in spine; P=0.0088 in hip), 4 risk factors (P=0.0076 in spine; P=0.043 in hip), 3 risk factors (P<0.0001 in spine; P=0.0205 in hip), 2 risk factors (P=0.0012 in spine; P<0.0001 in hip), a single risk factor (P<0.001 in spine and hip) and no risk factor (P=0.0075 in spine; P=0.0006 in hip).Association of several risk factors leads to decrease of T-score so being able to avoid any such factors may contribute to a better bone mineral density. This could be achieved by the education of female population regarding postmenopausal osteoporosis risk factors, followed by adopting an appropriate lifestyle and diet.
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Infertility is one of the most significant medical, as well as social problems that affect psychological health of families and societies. Determining the prevalence of infertility is important for evaluating the potential of fertility. There are different reports on the prevalence of infertility in Iran, but the current research employs fertility history in order to provide an unbiased estimation of primary infertility.Data from a national survey of Iranian women aged 20-40 years was used in this study in year 2011. Totally, 1011 clusters were randomly selected according to post office codes, proportional to the population of the province. We evaluated the history of fertility as the basis for gathering information. Accordingly, we designed a questionnaire. Subsequently, we recruited and trained nurses and obstetricians to call on married women to fill the questionnaires. Primary infertility refers to a condition in which couples have not been able to conceive a child after one year of un-protected intercourse.In this research, we questioned 17187 women in 1011 clusters. The mean age of the women at the time of their marriage was 20.1, and that of their husbands was 25.4 years. The mean age of women at the time of their first pregnancy was 21.1. This research revealed the prevalence of primary infertility to be 20.2% in Iran.The prevalence of primary infertility in Iran seems to be higher than the world average. Therefore, it is crucially important to support the large number of couples who face this problem.
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Appraisal of clinical guideline, especially at the national level, has two potential benefits; one is the improvement of quality of care and the second is assessing the impact of researches on an applied setting. On the other hand, Tuberculosis (TB) is a major infectious disease which has national guideline in many countries. The present study was performed to assess sources of information and level of evidence in Iran's national TB guideline. This could explore the impact of national researches on day by day practice in the health system.A list of main "recommendations" of the guideline was explored. Then, in cases that the cited study for any decision was available, the type of study and its evidence level was specified using a standard tool. In addition, the source of information (national/international) was determined. In other cases that no any specific citation was found, the data source of the recommendation was determined by the senior experts in the Center for Communicable Disease Control.Fifteen (48.3%) recommendations of the national guideline, out of 31 reviewed, had clearly cited at least one study. There was just one single national study which was utilized as the basis for the recommendations. All other sources were international guidelines, mainly World Health Organization's, and or international researches.While, the methodology of the guideline development was not clear enough appropriately; the share of national researches in development of the national guideline was insignificant.
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Dietary notifications have been introduced recently for Alzheimer Disease (AD). In Iranian old medical manuscripts, there are some nutritional recommendations related to Nesyan (AD equivalent). The aim of this article was to compare dietary recommendations of Iranian traditional medicine (ITM) with novel medical outcomes.1) Searching for dietary recommendations and abstinences described in ITM credible manuscripts; 2) Extracting fatty components of ITM diet according to the database of the Department of Agriculture of the USA; 3) Statistical analysis of fatty elements of traditionally recommended foods via Mann-Whitney Test in comparison with elements of the abstinent ones; 4) Searching for AD dietary recommendations and abstinences which currently published in medical journals; 5) Comparing traditional and new dietary suggestions with each other.1) Traditionally recommended foods are fattier than abstinent ones (P<0.001). There are meaningful differences between unsaturated fatty acids (UFAs) (P<0.001), saturated fatty acids (P<0.001), and cholesterol (P<0.05) of recommended foods and abstinent ones. 2) Traditionally recommended diet is also fattier than the abstinent diet (4.5 times); UFAs of the recommended diet is 11 times more than that of the abstinent one; it is the same story for cholesterol (1.4 times); 3) Recent studies show that diets with high amounts of UFAs have positive effects on AD; a considerable number of papers emphasizes on probable positive role of cholesterol on AD; 4) Traditional recommended diet is in agreement with recent studies.ITM recommended diet which is full of unsaturated fatty acids and cholesterol can be utilized for complementary treatment of AD.
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In the area of youth health, peers education is an approach to health promotion. Assess the training needs of peers educators clarifies the components, values, and quality of training protocols. Aim to that we conducted a participatory educational needs assessment of youth peer educators.Involving youth and key informants in direct collaboration with research team, a qualitative approach was planned based on grounded theory. For data collection a semi-structured guide questioning was designed. Sixteen focus group discussions and 8 in depth interview were held.The majority of participants emphasized on the importance of mental health, life skills, AIDS prevention, contraception methods, and healthy nutrition as the main training topics. They were extremely interested into the comprehensive educational material among their participatory role in peer programs.The training programs should be well defined based on the knowledge, skills and behavior of peers. During the implementation, training programs should be followed to meet the ongoing educational needs of service providers.
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Starting in 1990 many programs were initiated to prevent and control the spread of HIV/AIDS in prisons in accordance with the policies of the Ministry of Health. This study attempts to evaluate the effectiveness of harm reduction programs vis-à-vis drug abuse and dependency in 7 prisons in Iran.The methodology used is Before-After testing and the sample population is incarcerated prisoners in 7 large prisons in 7 provinces with diverse geographical, criminal, and numerical factors and the population sample is estimated at 2,200 inmates.Findings show that Drug addiction tests conducted on prisoners, right after their admittance indicated that 57% used at least one of the three drugs of morphine, amphetamines, and hashish (52% morphine, 4.5% ampheta-mines, and 3.9% hashish). Two months later, on the 2nd phase of the study, test results indicated that only 10% of subjects continued using drugs (P =0.05). Heroin and opium were the two most prevalent drugs. Smoking, oral in-take, and sniffing were the three most popular methods. Of those who continued to use drugs in prison, 95% admitted to drug use records.Intervention policies in prisons resulted in reduction of drug consumption, from 57% of the newly admitted inmates to 10% after two months of incarceration.
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The primary health care has notable effects on community health and accreditation is one of the appropriate evaluation methods that led to health system performance improvement, therefore, this study aims to developing of national accreditation model for rural health centers in Iran Health System.Firstly the suitable accreditation models selected to benchmarking worldwide via systematic review, the related books and medical university's web site surveyed and some interviews hold with experts. Then the obtain standards surveyed from the experts' perspectives via Delphi technique. Finally, the obtainedmodel assessedvia the experts' perspective and pilot study.The researchers identified JCAHO and CCHSA as the most excellent models. The obtained standards and their quality accepted from experts' perspective and pilot study, and finally the number of 55 standards acquired.The designed model has standards with acceptable quality and quantity, and researchers' hopeful that its application in rural health centers led to continues quality improvement.
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In the absence of dysphagia-oriented food products, rheological characterization of available food items is of importance for safe swallowing and adequate nutrient intake of dysphagic patients. In this way, introducing alternative items (with similar ease of swallow) is helpful to improve quality of life and nutritional intake of esophageal cancer dysphagia patients. The present study aimed at rheological characterization and cluster classification of potentially suitable foodstuffs marketed in Iran for their possible use in dysphagia diets.In this descriptive study, rheological data were obtained during January and February 2012 in Rheology Lab of National Nutrition and Food Technology Research Institute Tehran, Iran. Steady state and oscillatory shear parameters of 39 commercial samples were obtained using a Physica MCR 301 rheometer (Anton-Paar, GmbH, Graz, Austria). Matlab Fuzzy Logic Toolbox (R2012 a) was utilized for cluster classification of the samples.Using an extended list of rheological parameters and fuzzy logic methods, 39 commercial samples (drinks, main courses and desserts) were divided to 5 clusters and degree of membership to each cluster was stated by a number between 0 and 0.99.Considering apparent viscosity of foodstuffs as a single criterion for classification of dysphagia-oriented food products is shortcoming of current guidelines in dysphagia diets. Authors proposed to some revisions in classification of dysphagia-oriented food products and including more rheological parameters (especially, viscoelastic parameters) in the classification.
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Social determinants, similar to equity, have been considered by policymakers in many countries. However, there is not a correct and complete understanding of them. This study aimed to analyze the systematic relationships among social determinants of health (SDH) and identify their prioritization in Iran.This cross-sectional descriptive-analytical study was conducted in 2012. The target population consisted of 30 experts on SDH. Required data was collected using a questionnaire, as well as, nominal group technique (NGT). Then collected data were analyzed using MATLAB 7.9.0 and SPSS 18.0.Determinants of early life (EL), social gradient (SG), unemployment (U), stress (S) and addiction (A) were certainly affecting determinants on the system, which were placed in the cause group and ranked as the first to fifth priorities, respectively. While social exclusion (SE), food (F), social support (SS), work (W) and transport (T) were partially affected determinants and were placed in the effect group and ranked as the sixth to tenth priorities, respectively. Early life and transport were identified as the most affecting and affected determinants with the coordinates (2.16 and 0.75) and (1.68 and -0.47) on the SDH diagram, respectively.Improving the social and economic status, considering the early life, increasing the quality of education, and reducing unemployment and stress have effects on the other social determinants of health and provide opportunities for increasing equity.
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In April, 2013, a Suzhou Hospital reported a nitrite intoxication patient in coma as well as 2 family members with the similar symptom 5 days ahead. We investigated the event to identify the cause, source and possible pollution ways of the contamination.We defined case as any person living in YSHY community who has cyanosis and with at least one of the following symptoms: dizziness, headache, fatigue, tachycardia, drowsiness, nausea, vomiting, abdominal pain or diar-rhea during April 15 to April 25, 2013. We searched for case by interviewing community residents and reviewing clinics' medical records; information was then retrospectively collected on the patient's food history, cooking procedures and food sources.We identified 3 nitrite intoxication cases, 1 male and 2 female from a family. The interval time between dinner and onset was < 1 hour. Retrospective survey showed 'sugar stir and mix asparagus' on April 17 and 'scrambled asparagus' on April 21 were suspected foods. Both suspected dishes had 'sugar' added, sourced from a clean-up of a neighboring rental house. Nitrite was detected in a vomitus sample, the 'sugar' and two leftover food samples.This family clustered nitrite intoxication was induced by using unidentified nitrite as sugar to cook dishes. We recommend sodium nitrite should be dyed with bright colors to avoid mistaking it for plain salt or sugar, health departments strengthen food hygiene propaganda to improve people's recognition of food safety, and to alert them the dangerous of eating unidentified or unknown source food.
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Background Cutaneous leishmaniasis is the most common form of leishmaniasis caused by flagellate protozoa of the genus Leishmania transmitted by sand fly bites. Old World leishmaniasis is endemic in the Mediterranean Sea and the neighbouring countries. We believe, that this case is interesting by the fact that we had a very rear disease case that can be observed in nonendemic area. We present a case of a 22-year-old man with a cutaneous leishmaniasis in a localised form of ulcers on the right cheek and the right part of the neck. Histopathological examination showed diffuse dermal infiltrate predominantly of macrophages with admixture of few lymphocytes, eosinophils and plasma cells. In a very small number of macrophages amastigotes were seen. On their surface and occasionally extracellularly rod-shaped kinetoplasts were noticeable. It should be stressed that both clinical and laboratory data were not peculiar for this disease. Adults in endemic areas have stable immunity for protozoal infections. This made diagnostication and timely management of the disease very difficult. But clinical effect of drug therapy which is specific for cutaneous leishmaniasis treatment proved, in spite of the absence of ulcer soft tissues, blood and cerebrospinal puncture Leishmania, that our diagnosis was correct. The case, described by us, may be interesting for dermatologists, parasitologists, surgeons and other medical specialists. Because of higher rate of travel and work abroad increased number of sporadic cases of cutaneous leishmaniasis in non-endemic areas should be taken into account. Cutaneous leishmaniasis is a rare disease in Kazakhstan, especially in the north region. Because of higher rate of travel and work abroad increased number of sporadic cases of cutaneous leishmaniasis in non-endemic areas should be taken into account.
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