Background: As a DNA repair protein, flap endonuclease 1 is a key enzyme in maintaining genomic instability and preventing carcinogenesis. Two single nucleotide polymorphisms (SNPs), -69G>A and 4150G>T are associated with DNA damage. This meta-analysis is to evaluate the genetic effects of FEN1 gene SNPs (-69G/A and 4150G/T) and the susceptibility to diseases, including glioma risk, breast cancer, lung cancer, keratoconus (KC) and fuchs’ endothelial corneal dystrophy (FECD).

Methods: A literature search of PubMed and Embase was conducted to identify all eligible published studies. Five case-control studies were included with a total of 5612 cases and 6703 controls in this meta-analysis. Crude odds ratios (ORs) with their corresponding confidence intervals (95%CI) were used to assess the strength of the association.

Results: The FEN1 -69G/A and 4150G/T polymorphisms were significantly associated with the disease risk. Our meta-analysis showed the FEN1 -69GG genotype was correlated to increase risk for the contained diseases compared with the -69AG genotype (OR=0.77, 95%CI=0.71~0.83). Moreover, the FEN1 4150GG genotype could increase diseases risk compared with the 4150TG genotype (OR=0.81, 95%CI=0.75~0.87).

Conclusion: The variant genotypes of the FEN1 -69G/A and FEN1 4150G/T polymorphisms may be associated with diseases susceptibility. However, more studies are needed to detect the disease risk in different ethnic populations.

Background: Nowadays self-medication is one of the most common public health issues in many countries, as well as in Iran. According to need to epidemiological information about self-medication, the aim of this study was to systematic review and meta-analysis of prevalence and cause of self-medication in community setting of Iran.

Methods: Required data were collected searching following key words: medication, self-medication, over-the-counter, non-prescription, prevalence, epidemiology, etiology, occurrence and Iran in Google Scholar, PubMed, Scopus, Magiran, SID and IranMedex (from 2000 to 2015). To estimate the overall self-medication prevalence, computer software CMA: 2 applied. In order to report the results, forest plot was employed.

Results: Out of 1256 articles, 25 articles entered to study. The overall prevalence of self-medication based on the random effect model was estimated to be 53% (95% CI, lowest= 42%, highest=67%). The prevalence of self-medication in students was 67% (95% CI, lowest=55%, highest=81%), in the household 36% (95% CI, lowest=17%, highest= 77%) and in the elderly people 68% (95% CI, lowest=54%, highest=84%).The most important cause of self-medication was mild symptoms of disease. The most important group of disease in which patients self-medicated was respiratory diseases and the most important group of medication was analgesics.

Conclusion: The results show a relatively higher prevalence of self-medication among the Iranian community setting as compared to other countries. Raising public awareness, culture building and control of physicians and pharmacies’ performance can have beneficial effects in reduce of prevalence of self-medication.

Keywords: Self-medication, Prevalence, Cause, Community setting, Iran

Background: Prehypertension frequently progresses into hypertension and is related to an increased risk of cardiovascular disease. We studied the prevalence of prehypertension and their determinants by gender and age.

Methods: The study used nationally representative data from 11,754 participants aged 20–91 years collected between 2010–2012 Korea National Health and Nutrition Examination Surveys (KNHANES).

Results: Prehypertension was more prevalent in men than women (aOR = 2.48, CI = 2.11–2.92). Aging was positively associated with prehypertension (40-59 vs. 20-39, aOR = 1.79, CI = 1.55–2.05; 60+ vs. 20-39, aOR = 2.89, CI = 2.35–3.56). In women aged ≥60, prehypertension was associated with WC (aOR = 1.04, CI = 1.00–1.07), whereas in both men and women aged 20–39, it was associated with BMI (men, aOR = 1.14, CI = 1.04–1.24; women, aOR = 1.08, CI = 1.01–1.16). In subjects aged 40–59, age (men, aOR = 1.03, CI = 1.01–1.06; women, aOR = 1.05, CI = 1.02–1.07) was the significant factor increasing the risk of prehypertension, whereas smoking (men, aOR = 0.55, CI = 0.38–0.80; women, aOR = 0.43, CI = 0.24–0.76) showed an inverse association with prehypertension. Alcohol intake showed a positive association with prehypertension in only men aged 40-59.

Conclusion: Our findings suggest that different gender/age groups may have different patterns of risk factors associated with prehypertension. Thus, healthcare providers should consider both gender and age when designing community-based interventions for controlling BP and reducing prehypertension.

Keywords: Prehypertension, Risk factor, Gender, Age, Korea

Background: We aimed to evaluate the levels of social support in patients with postoperative esophageal carcinoma and potential effect of social support on generic and EC-specific quality of life.

Methods: Overall, 803 Chinese patients with EC were recruited in the high-incidence region- Linzhou in Henan, China for the observation study. We obtained data on European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), disease-specific score of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-OES18 (The QLQ-OES18), and social support evaluation score at home visits by a specially trained research team.

Results: Aging and low education were negatively predicted total social support scores. A significant correlation (P = 0.000, 9 = 0.000) was found between QOL physical function and either the subjective or the objective dimensions in social supportive system. OES18 eating difficulty was significantly associated with objective support including family intimacy, friendship and community support (P = 0.016, P = 0.001).

Conclusions: The social support team should endorse quality care as integrating community-care management in post-esophagus recovery and meet the need of individual health quality of life. The elders, educational levels and rural farmers are significant to challenge the social supportive delivery in the current model of esophagus cancer care.

Keywords: Esophageal cancer, Quality of life, Social support, Community

Background: Violence against women is a serious social problem and affects mainly young women. This study aimed to evaluate sexual violence against women in Campina Grande, Brazil.

Methods: A retrospective study with analysis of 886 forensic medical reports of sexual violence from the Institute of Legal Medicine of Campina Grande, Brazil, was conducted between January 2005 and December 2009. Sociodemographic variables related to victims, offenders and aggressions were analyzed. Significance level of 5% was adopted.

Results: Two hundred and ninety-one cases of rape (32.8%) were confirmed, the majority of victims aged between 0 and 19 years (89.9%), were single (98.8%) and had low educational level (86.9%), with association with marital status (P = 0.02). The sex offender was known to the victim in 84.2% of cases and in 93.8% of cases, he acted alone. There was an association between rape and the relationship with the offenders (P = 0.01) and the age of the offenders (P = 0.03). The rape occurred in most cases at the home of victims (49.3%), with the use of violence in 72.3% of cases, but only 5.7% of the victims exhibited physical injuries. There was an association between rape and variables date of occurrence (P = 0.001), previous virginity (P = 0.001) and violence during practice (P = 0.001).

Conclusion: Over one third of women were victims of rape, predominantly adolescents, unmarried and with low educational level. The offenders were known to the victims, and acted alone in most situations, making use of physical violence.

Keywords: Sex offenses, Rape, Domestic violence, Brazil

Background: This study aimed to evaluate the perception of lay people regarding determinants of health at global level and factors affecting it.

Methods: Data was collected from International Social Survey Program (ISSP) and World Bank website. Multilevel regression analysis was done and lay people’s perception regarding health behavior, environment, poverty and genes as health determinants was assessed. Various socio demographic factors were used as independent variables.

Results: The highest percentage of people agreed environment as determinant of health. An inverse relationship was observed between GNI quartiles and an individual’s agreement with poverty, health behavior, and environment as health determinant. There was a significant negative association of females with health damaging behavior (P<0.05) and positive association with environment and genes (P<0.05) as health determinants. Elderly people agreed with poverty as determinant of health (P<0.05). GNI was negatively related to environment (P<0.05) and poverty (P<0.05) as health determinant.

Conclusion: The common public is now becoming aware of a broadened concept of health and people belonging to different backgrounds have different perceptions regarding determinants of health. Our results show that highest percentage of people agreed with environment as determinant of health, which is consistent with scientific view of increased burden of disease, caused by environmental factors. Thus, tailored health programs and policies that address an individual's specific problems are likely to induce a change in behavior and attitude, hence decreasing the disease burden.

Keywords: ISSP, Determinants of health, Multilevel analysis, Tailored approach

Background: The humbug gene is a truncated isoform of Aspartyl β-hydroxylase (ASPH) gene that is overexpressed in many human malignancies. In recent years, since humbug has received increasing attention, it is considered as a potential therapeutic molecular target. Therefore, it is necessary for preparing humbug protein and its monoclonal antibody to investigate its structure and function.

Method: The optimized humbug gene, synthesized by Genscript in Nanjing, China on December 21st 2013, was expressed in Pichia pastoris cells that were cultured in a 10-L bioreactor. The recombinant protein was further obtained and purified by using ion exchange chromatography and Sephadex G75. The humbug protein was used to immunize Balb/c mice to generate the monoclonal antibodies. The specificity and sensitivity of the monoclonal antibodies were assessed by indirect enzyme-linked immunosorbent assay. Finally, the humbug monoclonal antibodies were used to detect the expression of humbug in several tumor cell lines via indirect immunofluorescence.

Results: Firstly, the recombinant humbug was expressed in P. pastoris successfully and efficiently by using a gene-optimized strategy. Secondly, the purification process of humbug was established via multiple chromatography methods. In addition, four monoclonal antibodies against humbug were obtained from the immunized Balb/c mice, and the result of indirect immunofluorescence was indicated that the humbug monoclonal antibody showed the high affinity with humbug protein, which expressed in several tumor cell lines.

Conclusion: The over-expression of recombinant humbug provides adequate sources for its structural study and the preparation of the humbug-specific monoclonal antibody can potentially be used in tumor initial diagnosis and immunotherapy.

Keywords: Humbug, Fermentation, Pichia pastoris, Monoclonal antibody, Tumor diagnosis

Background: The aim of this study was to assess the predictive capacity of body composition estimated by bioelectrical impedance analysis (BIA) to identify abnormal blood pressure in physical education and sport teaching students in the city of Ankara.

Methods: Data for this cross-sectional study were obtained in the city of Ankara in 2014. A total of 133 students aged 20-35 yr participated in this study. Anthropometric measurements were measured. Body composition was assessed by BIA. Physical activity level (PAL) and usual dietary intake were assessed. Pre-hypertension and hypertension were defined, respectively, as BP ≥120 and/or 80, and ≥140 and /or 90 mmHg.

Results: More overweight students showed abnormal BP especially SBP (P=0.005 and 0.002, respectively). Age adjusted regression showed sig­nificant association between arm circumference (β= 0.176, P 0.044), mid arm muscle circumference (MAMC) (β= 0.235, P 0.007), lean body mass (LBM) (β= 0.238, P 0.006), basal metabolism rate (BMR) (β= 0.219, P 0.012) and SBP and, also, MAMC (β= 0.201, P 0.022), LBM (β= 0.203, P 0.021), BMR (β= 0.189, P 0.030) and DBP. Fat intake was associated with DBP (β= 0.14, P =0.040). Multivariate regression models adjusted for age, BMI, WC and fat intake/kg body weight showed positive association of SBP with MAMC, BMR and LBM (P<0.05).

Conclusion: The relationship between blood pressure and body composition in young adults may be associated to LBM and MAMC. LBM or MAMC in this population may be indirect indicators of heart muscle mass and heart pumping power.

Keywords: Lean body mass, Body mass index, Hypertension, Young adults, Turkey 

Background: Previous studies have revealed significant differences between populations for genotypic frequencies of glutathione S-transferase T1 (GSTT1) and M1 (GSTM1) polymorphisms. In order to find the frequency of the null genotypes of GSTM1 and GSTT1 in Iranian populations, the present study was carried out.

Methods: The total study subjects consisted of 1340 unrelated healthy Muslims/Iranian. From these 297, 200, 123, 168, 152, 200, and 200 individuals from Tabriz (East Azerbaijan Province; belong to Azaris), Yasuj (Kohgiluyeh-va-Boyerahmad Province; belong to Lurs), Abarku (Yazd Province; belong to Persians), Zahedan (Sistan-va-Balouchestan Province; belong to Balouchis), Zahedan (Sistan-va-Balouchestan Province; belong to Sistanis), Kermanshah (Kermanshah Province; belong to Kurds), and Gorgan (Golestan Province; belong to Turkmen) respectively. The genotypes were detected by multiplex PCR.

Results: The frequency of GSTM1 null genotype among Azaris, Lurs, Persians, Balouchis, Sistanis, Kurds, and Turkmen was 43.8, 50.0, 52.0, 50.0, 51.3, 56.0, and 53.0%, respectively. There was no significant difference between these populations for the genotypic distribution of the GSTM1 polymorphism (c²=8.47, df=6, P=0.206). The frequency of GSTT1 null genotype among Azaris, Lurs, Persians, Balouchis, Sistanis, Kurds, and Turkmen was 18.2, 17.0, 29.3, 20.8, 17.8, 18.5, and 23.0%, respectively. There was very similarity between Azaris, Kurds and Lurs for the frequency of GSTT1 genotypes (c²=0.17, df=2, P=0.916).

Conclusion: By comparing the frequency of GSTT1 genotypes among Iranian populations, Caucasians and Asians, it is concluded that Azaris, Kurds and Lurs were similar to each other. Taken together, it is suggested that although Azaris are Turkish speaking belong to Caucasians.

Keywords: Iran, GSTT1, GSTM1, Population genetics

Background: The high prevalence and potential side effects of anabolic-androgenic steroids (AAS) misuse by athletes has made it a major public health concern. Epidemiological studies on the abuse of such drugs are mandatory for developing effective preventive drug control programs in sports community. This study aimed to investigate the prevalence of AAS abuse and their association with some psycho-socio-demographic factors in Iranian male recreational body-builders.

Methods: Between March and October 2011; 906 recreational male body-builders from 103 randomly selected bodybuilding clubs in Tehran, Iran were participated in this study. Some psycho-socio- demographic factors including age, job, average family income, family size, sport experience (months), weekly duration of the sporting activity (h), purpose of participation in sporting activity, mental health as well as body image (via General Health Questionnaire and Multidimensional Body-Self Relations Questionnaire, respectively), and history of AAS use were obtained by interviews using questionnaires.

Results: Participants were all recreational male body-builders [mean age (SD): 25.7 (7.1), ranging 14-56 yr]. Self-report of AAS abuse was registered in 150 body-builders (16.6%). Among different psycho-socio-demographic factors, only family income and sport experience were inversely associated with AAS abuse.

Conclusion: Lifetime prevalence of AAS abuse is relatively high among recreational body-builders based on their self-report. Some psycho-socio-demographic factors including family income and sport experience may influence the prevalence of AAS abuse.

Keywords: Anabolic agents, Ergogenic, Doping, Iran, Body-building, Sports, Athlete

Background: The emergence and spread of Ebola outbreak is a growing problem worldwide, which represents a significant threat to public health. Evidence has shown that the level of knowledge, attitude, and practice of people in the society play major roles in controlling the spread of Ebola virus disease. This study was designed to determine knowledge, attitude and practice of students at School of Public Health, Tehran University of Medical Sciences towards Ebola.

Methods: A cross-sectional survey was performed in Tehran, Iran in 2014 using a pretested self-administered questionnaire on a stratified sample of 400 students. Descriptive and multivariate analyses were used for statistical analysis.

Results: All-in-all, 385 students returned the completed questionnaires making a response rate of 96.3%., 239 (62.2%) were females and 145 (37.8%) were males. The mean age of female and males were 28.44 and 30.3 years respectively. Of the 385students, 83 (21.7%) were studying at PhD level, 210 (55.0%) at Masters Level (including MPH) and 89 (23.3%) at Bachelors level. knowledge of the students regarding EVD transmission was lowest among students of Department of Occupational Health (50.0%), followed by Health Education and Promotion Department (33.3%). Virology Department recorded the highest percentage of students who had selected correct answers regarding EVD prevention (100.0%)

Conclusion: These findings will aid in the assessment of the adequacy of current students’ educational curriculum. Also, it will provide further insight in designing future multifaceted interventions to promote specific messages to change attitude and improve practice.

Keywords: Ebola, Outbreak, Tehran, Iran, Knowledge, Attitude, Practice, Students

Background: Breast cancer (BC) is the second most commonly diagnosed cancer after lung cancer. Survival of BC patients is affected by intermediate events. This study was aimed to investigate the disease course of primary non-metastatic BC patients with first recurrence of the tumor (FRT) as the intermediate event using the illness- death model.

Methods: This retrospective cohort study was conducted on 529 Iranian females with BC underwent surgery, from 1995 to 2013. Patients, tumor and treatment characteristics were collected from medical records of the patients. The illness-death model were used to investigate the relationship between these factors and survival time. Data were analyzed using version 3.1.1 of R software.

Results: The risk of FRT in patients who had tumors size in the range of 2-5 cm and >5 cm was 1.3 and 3.5 times higher than that of patients with tumor size ≤2 cm, respectively (P<0.001). Furthermore, risk of death in patients aged ≥50 years was 1.6 times higher compared to patients aged less than 50 years (P =0.012). Risk of death after metastasis in patients with tumor size >5 cm was 2.1 times higher than patients with tumor size ≤2 cm (P =0.019).

Conclusions: The stage of the disease and tumor size have statistically significant effects on patients’ survival before occurrence of the FRT. Furthermore, illness-death model was found to be a useful tool in modeling the disease course of BC patients.

Keywords: Breast cancer, Intermediate events, Illness- death model, Survival analysis

Background: This study investigated the interaction between heterotrophic bacteria and coliform, fecal coliforms, fecal streptococci bacteria in water supply networks.

Methods: This study was conducted during 2013 on water supply distribution network in Aq Qala City, Golestan Province, Northern Iran and standard methods were applied for microbiological analysis. The surface method was applied to test the heterotrophic bacteria and MPN method was used for coliform, fecal coliform and fecal streptococci bacteria measurements.

Results: In 114 samples, heterotrophic bacteria count were over 500 CFU/ml, which the amount of fecal coliform, coliform, and fecal streptococci were 8, 32, and 20 CFU/100 ml, respectively. However, in the other 242 samples, with heterotrophic bacteria count being less than 500 CFU/ml, the amount of fecal coliform, coliform, and fecal streptococci was 7, 23, and 11 CFU/100ml, respectively. The relationship between heterotrophic bacteria, coliforms and fecal streptococci was highly significant (P<0.05). We observed the concentration of coliforms, fecal streptococci bacteria being high, whenever the concentration of heterotrophic bacteria in the water network systems was high.

Conclusion: Interaction between heterotrophic bacteria and coliform, fecal coliforms, fecal streptococci bacteria in the Aq Qala City water supply networks was not notable. It can be due to high concentrations of organic carbon, biofilms and nutrients, which are necessary for growth, and survival of all microorganisms.

Keywords: Heterotrophic bacteria, Coliform, Fecal coliforms, Fecal streptococci, Water networks

Background: Driver fatigue is one of the major implications in transportation safety and accounted for up to 40% of road accidents. This study aimed to analyze the EEG alpha power changes in partially sleep-deprived drivers while performing a simulated driving task.

Methods: Twelve healthy male car drivers participated in an overnight study. Continuous EEG and EOG records were taken during driving on a virtual reality simulator on a monotonous road. Simultaneously, video recordings from the driver face and behavior were performed in lateral and front views and rated by two trained observers. Moreover, the subjective self-assessment of fatigue was implemented in every 10-min interval during the driving using Fatigue Visual Analog Scale (F-VAS). Power spectrum density and fast Fourier transform (FFT) were used to determine the absolute and relative alpha powers in the initial and final 10 minutes of driving.

Results: The findings showed a significant increase in the absolute alpha power (P = 0.006) as well as F-VAS scores during the final section of driving (P = 0.001). Meanwhile, video ratings were consistent with subjective self-assessment of fatigue.

Conclusion: The increase in alpha power in the final section of driving indicates the decrease in the level of alertness and attention and the onset of fatigue, which was consistent with F-VAS and video ratings. The study suggested that variations in alpha power could be a good indicator for driver mental fatigue, but for using as a countermeasure device needed further investigations.

Keywords: Driver mental fatigue, F-VAS, Video rating, EEG alpha power.

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