Vol 42 No 1 (2013)

Articles

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    The evolution of human blood groups, without doubt, has a history as old as man himself. There are at least three hypotheses about the emergence and mutation of human blood groups. Global distribution pattern of blood groups depends on various environmental factors, such as disease, climate, altitude, humidity etc. In this survey, the collection of main blood groups ABO and Rh, along with some minor groups, are presented. Several investigations of blood groups from Iran, particularly a large sampling on 291857 individuals from Iran, including the main blood groups ABO and Rh, as well as minor blood groups such as Duffy, Lutheran, Kell, KP, Kidd, and Xg, have been reviewed.

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    This study is to report characteristics of people killed in road traffic crashes and to describe major patterns of traffic crashes in China.Descriptive and inferential statistical analyses were conducted. Road traffic death national data, population denominator data and motor vehicles data of 2009 were obtained from the Bureau of Traffic Management at Ministry of Public Security and National Bureau of Statistics. The association between the fatalities from road traffic crashes and selected demographic factors, the time distribution, crash patterns, crash causes, and road user category were assessed in χ(2) analyses.ROAD TRAFFIC CRASHES IN CHINA DISPROPORTIONABLY AFFECTED THE FOLLOWING POPULATIONS: males, persons 21-65 yr of age and adults aged more than 65 yr, persons living in rural areas, pedestrians, passengers, motorcyclists and bicyclists. Approximately 50% of fatalities of road traffic crash occurred in Eastern regions. The number of road traffic deaths was higher in daytime than in nighttime. Road traffic deaths in frontal crashes, side-to-side crash and crashes with an object or a person were more common than in rear-end crashes. In about 92% of road traffic deaths, auto drivers were believed to be responsible for the fatal crash. Major crash causing factors were speeding, careless driving, driving without a license, driving in the wrong lane, and driving after drinking alcohol.Road traffic deaths accounted for about 70,000 premature deaths in China which should be taken into account.

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    Color blindness is a common X-linked genetic disorder. However, most of color blinds remain undetected due to absence of proper screening. Our study was to determine the prevalence of red-green color vision defects among Manipuri Muslim males and females. The study could help in decreasing birth of children with this disorder as Muslims commonly perform consanguineous marriage among themselves.Unrelated individuals of both sexes (Male-1352, Female-1302) belonging to six different populations were randomly selected and screened for red-green color vision defects using the Ishihara (pseudo-isochromatic plates) test from the area of Imphal East and Imphal west districts of Manipur, which is a small hilly state, situated in the north eastern extreme corner of India sharing an international boundary with Myanmar (Burma).About 8.73% of males and 1.69% of females were found to be color blind. Among six different populations studied the males of Meitei population shows the highest frequency i.e. 14.93% while Naga population shows the least frequency of 3.75%. Among females, Meitei population again shows the highest frequency of 2.5% and least frequency is shown by Mughal and Naga populations 0.00% as not a single female color blind was found.Present study shows higher prevalence rate of color blindness as compared to other reported rates of India. Deuteranomaly cases occur in higher percentage than other types of color blindness. The higher prevalence rate observed in Muslims may be due to the hidden effect of consanguineous marriages.

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    The purpose of this study was to examine whether the frequency of breakfast consumption was related to academic performance in healthy Korean adolescents.We analyzed data from the seventh Korea Youth Risk Behavior Web-based Survey conducted in 2011, in which 75,643 adolescents from school grades 7-12 participated. We assessed the association between the frequency of breakfast consumption (per week) and academic performance using multivariate logistic regression analysis after adjusting for covariates such as age, body mass index, frequency of smoking, frequency of drinking, parents' education level, family economic status, frequency of vigorous physical activity (PA), frequency of moderate PA, frequency of muscular strength exercises, and level of mental stress.For male adolescents, the odds ratios (ORs) for achieving average or higher academic performance according to the breakfast frequency per week were once per week, 1.004 (P=0.945); twice per week, 0.915 (P=0.153); 3 days per week, 0.928 (P=0.237); 4 days per week, 1.087 (P=0.176); 5 days per week, 1.258 (P<0.001); 6 days per week, 1.473 (P<0.001); and every day, 1.700 (P<0.001), compared to no breakfast per week. For female adolescents, the ORs for achieving average or higher academic performance according to the breakfast frequency were once per week, 1.068 (P=0.320); twice per week, 1.140 (P=0.031); 3 days per week, 1.179 (P=0.004); 4 days per week, 1.339 (P<0.001); 5 days per week, 1.449 (P<0.001); 6 days per week, 1.768 (P<0.001); and every day, 1.922 (P<0.001), compared to no breakfast per week.The frequency of breakfast consumption is positively correlated with academic performance in both male and female healthy adolescents in Korea.

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    Typhoid fever is one of the most important infectious diseases transmitted by contaminated food and water. This study aimed at epidemiological features of disease during the last five decades, over the period from 1962-2011.A retrospective cross-sectional study was conducted using typhoid fever national surveillance data.The highest incidence of typhoid fever was registered in 1965 with 133.4 /100,000 cases/year and the lowest in 2011 with 0.52/100,000 cases/year. Typhoid fever incidence in Iran had three phases. Before the year 1969, with high incidence >100 (phase 1), the period between 1969-1996 with medium (10-100), (Phase 2) and the phase 3 has inaugurated from 1996 until now with low incidence rate less than 10 /100,000. Kermanshah Province was the most infected area. Most cases were occurred in warm months in 2010. Of 196 (31%) cases were under 15 years old whom were more affected. 53.6% of total cases in 2010 were female and 56.6% stayed in rural area. In 2010, 27.8% cases were confirmed. Among positive cases, the sources of culture were 46.8% stool, 37.2% blood, 14.6% urine and 1.2% bone marrow. Following treatment, 97.8% of cases were recovered completely and in 1.6% of cases had experienced complications and only 0.6% of confirmed cases have been died.As a result of development in socio-economic condition in Iran, the typhoid fever incidence has been dramatically declined from high (133.4/100,000 cases/year) in 1965 to low (0.52/100,000 cases/year) in 2011.

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    We aimed to evaluate the timeliness of reporting of malaria surveillance system and understanding the existing problems.The timeliness of malaria surveillance system of Iran was evaluated in four provinces of Iran including Sistan & Baluchistan, Hormozgan, Kerman (as provinces with local malaria transmission) and Khuzestan (without local malaria transmission). In this descriptive-analytic cross-sectional study two levels of Primary Health Care service providers including first level (Health Houses) and second level (Urban or Rural Health care units) were evaluated with regard to reporting of malaria surveillance system.Forms number 1 (87% reported within one day) and number 2 (reporting median: 2 days) are reported from first level to second level, and forms number 4 (median: 4 days), number 3 (median: 6 days), number 7 (median: 9 days), number 5 (median: 11 days) and number 6 (median: 19 days) are reported from second level to the third level respectively in a shorter time. Independent variables such as distance, local malaria transmission level, and case finding type, are the factors affecting the reporting delay.Reporting in the first level compared to the second level is done with lower delay. In the areas where there is a deadline set for reporting, reporting is done more timely. Whatever number of malaria cases is decreased, sensitivity and subsequently timeliness reduced. It is recommended that the studies of timeliness be done with sensitivity and usefulness analysis of surveillance system.

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    The cognitive behavioral interventions based on the transdiagnostic approach for emotional disorders have received useful empirical supports in recent years. Most of the researches on this area have been conducted without any control group. Moreover, little information about comparative effectiveness has reported. The current study was compared transdiagnostic group therapy with classical cognitive group therapy.Thirty three collages students with anxiety and depressive symptoms participated in eight two-hour sessions in Akhavan Hospital, Tehran, Iran during May and June 2011. The results were analyzed by The Depression, Anxiety, and Stress Scale, and Work and Social Adjustment Scale in pre and post intervention.Both groups showed the significant difference in research variables pre and post test. However, there was no significant difference in the results analysis using ACOVAs except for anxiety symptoms.The effectiveness of transdiagnostic group therapy was confirmed in reducing anxiety and depressive symptoms. Implications of the study are discussed.

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    In this paper the real role and place of human resource (HR) in health system reform will be discussed and determined within the whole system through the comprehensive Human Resource Management (HRM) model.Delphi survey and a questionnaire were used to 1) collect HR manager ideas and comments and 2) identify the main challenges of HRM. Then the results were discussed in an expert panel after being analyzed by content analysis method. Also, a deep focus study of recorded documents related to Health Human Resource Management was done. Then based on all achieved results, a rich picture was drawn to illustrate the right place of HRM in health sector. Finally, the authors revitalize the missed function of HRM within the health sector by drawing a holistic conceptual model.The most percentage of frequency about HR belongs to "Lack of reliable HR information system" (91%) and the least percentage of frequency belongs to "Low responsibility of HR" (28%). The most percentage of frequency about HR manager belongs to "Inattention to HR managers as key managers and consider them in background" (80%) and the least percentage of frequency belongs to "Lack of coordination between universities' policies" (30%). According to the conceptual framework, human resources employed in health system are viewed from two comprehensive approaches: instrumental approach and institutional.Unlike the common belief that looks HRM through the supportive approach, it is discussed that HRM not only has an instrumental role, but also do have a driver role.

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    Location-allocation is a combinatorial optimization problem, and is defined as Non deterministic Polynomial Hard (NP) hard optimization. Therefore, solution of such a problem should be shifted from exact to heuristic or Meta heuristic due to the complexity of the problem. Locating medical centers and allocating injuries of an earthquake to them has high importance in earthquake disaster management so that developing a proper method will reduce the time of relief operation and will consequently decrease the number of fatalities.This paper presents the development of a heuristic method based on two nested genetic algorithms to optimize this location allocation problem by using the abilities of Geographic Information System (GIS). In the proposed method, outer genetic algorithm is applied to the location part of the problem and inner genetic algorithm is used to optimize the resource allocation.The final outcome of implemented method includes the spatial location of new required medical centers. The method also calculates that how many of the injuries at each demanding point should be taken to any of the existing and new medical centers as well.The results of proposed method showed high performance of designed structure to solve a capacitated location-allocation problem that may arise in a disaster situation when injured people has to be taken to medical centers in a reasonable time.

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    Cooperation of all health sectors and early diagnosis of the disease are the key factors for controlling tuberculosis. This study assesses the patterns of reported tuberculosis cases in Iran.This was a cross sectional study. Tuberculosis cases were defined according to World Health Organization and Iran's national TB guidelines. Final data were prepared for analysis using SPSS16 software.Public hospitals, public and private outpatient clinics reported 4111 (39.1%), 3007 (28.6%) and 2839 (27%) cases of TB, respectively. The highest number of reported TB cases was from the public healthcare system. One third of TB cases were reported by private outpatient clinics.It is essential to make a plan such as public-private mix model in Iran. Because of high coverage of private physicians in our country and even in rural areas, it is quite necessary to involve private system in tuberculosis program.

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    Human papilloma virus causes benign and malignant abnormalities in different part of the body. The link between high risk types of HPV and some anogenital and aerodigestive tract cancer is well established. Oral HPV infection plays a role in developing oropharyngeal squamous cell carcinoma. We studied the prevalence of oral HPV in healthy individuals and its relative risk factors.Saliva samples of 114 healthy subjects were collected for HPV DNA analysis. Volunteers completed questionnaires and signed a written consent. For data analysis descriptive statistic, chi square test and odds ratio was used.The frequency of oral HPV in healthy individuals was 6.1 %(seven participant).The most frequent type was HPV-18 in five of them. HPV-6 and HPV-66 each was detected in one case. Relation of oral HPV positivity to demographic features and risk factors was not statistically significant.The prevalence of oral HPV infection in our community is the same as many other communities of developing countries, stressing that HPV-18 were the dominant type.

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    Research background approved weight loss would result in improvement of lipid profile. Nowadays, weight management is attained by modifying psychological mediators, as well as dieting and making individuals do more physical activity. Hence, This research was performed to compare effectiveness of different psychological interventions on lipid profile improvement among individuals with overweight and obesity.Using quasi-experimental design, 68 participants with mean age 26 years and 9 months (ranged from 20 to 43) were randomly assigned into 4 groups (including LEARN, CBT, CT, and MCT), and eventually 61 participants completed the treatment protocols. BMI was calculated by Omron digital body composition instrument, and blood lipids and glucose concentrations were measured prior to and after all interventions.Data analysis by using t-test for dependent groups analysis revealed lipid profile, FBS, and BMI were significantly modified after applying 4 interventions comparing baseline and post treatment mean differences(P<0.05). Furthermore, repeated measure design analysis showed there were significant mean differences (P<0.05) in HDL cholesterol, TG levels and FBS levels among 4 groups. Scheffe test revealed more detailed significant differences among four groups in HDL cholesterol, and FBS concentration varieties (P<0.05).Adding psychological interventions to dietary plans and regular physical activities in overweight management would consider as a valuable step in optimizing physiological outcomes and that's because of correcting mind-body interactional pathways among obese and overweight individuals.

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    In September 2007 national standard manual was finalized and officially announced as the minimal quality requirements for all medical laboratories in the country. Apart from auditing laboratories, Reference Health Laboratory has performed benchmarking auditing of medical laboratory network (surveys) in provinces. 12(th) benchmarks performed in Tehran and Alborz provinces, Iran in 2010 in three stages. We tried to compare different processes, their quality and accordance with national standard measures between public and private hospital laboratories. The assessment tool was a standardized checklist consists of 164 questions. Analyzing process show although in most cases implementing the standard requirements are more prominent in private laboratories, there is still a long way to complete fulfillment of requirements, and it takes a lot of effort. Differences between laboratories in public and private sectors especially in laboratory personnel and management process are significant. Probably lack of motivation, plays a key role in obtaining less desirable results in laboratories in public sectors.

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    Clinical Trial Committee (CTC) has been established in Food and Drug Organization (FDO), in 2003 to assure efficacy and safety of all types of medicinal products which are meant to be registered in Iran Drug List and/or obtain market authorization.All clinical trial files, meeting minutes and databases in CTC secretariat in FDO were reviewed. Relevant information and data extracted, analyzed and reported.Total number of clinical trial (CT) files received by CTC, in 2011, was 76 cases: 21 CT protocols, 45 CT reports and 10 requests for importation of investigational new medicinal products (IMPs). Number of CT files received for herbal and natural products was 8 cases while CT files reviewed for vaccines and biological products was 50; 66% of all CT files received. Local industries sponsored 28 CT studies while 47 studies were supported by multinational/foreign companies. Of all CT files reviewed, 54 cases accounted for phase III CTs and 20 cases for phase IV and periodic safety updated reports (PSUR). With respect to the decisions made by CTC in 2011, 23 out of 45 CT reports were approved and the number of clinical trial authorizations (CTA) issued were 11; 52% of all CT protocols reviewed.Results presented in this report are indicative of a positive trend in compliance of pharmaceutical industries and clinical research groups to national regulations of CTs and IR-GCP. Effective communication with different parties involved in regulatory and industry sides of CTs will further enhance conducting quality CTs.

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