Vol 46 No 3 (2017)

Review Article(s)

  • XML | PDF | downloads: 186 | views: 559 | pages: 281-285

    Background: Due to embargoes and sanctions from 1979 until 2015, impact on scientific research in Iran may be critical. Public health is the main example of this burning point. In this paper, the aim was to map the scientific research in public health in Iran until 2014 with area studies as well as networks of countries involved.

    Methods: We used bibliographic analyses using VOS viewer software for network analysis during the period 1975-2014. Two databases were used: Web of Science and PubMed. We performed analyses of journals, authors, publication years, organizations, funding companies, countries, keywords and Web of sciences Categories.

    Results: We accessed 862 articles published between 1991 and 2014, the majority of published after 2008. The main countries of research were Iran, the United States of America, England, and Sweden and represented the main network collaboration. The main Web of Sciences categories was public, occupational and environmental health, medicine general internal and parasitology. We accessed 25462 publications on PubMed database from 1950 to 2014. The majority of published after 2004. The main area studies were prognosis, wounds and injuries, soil solutions and biological markers.

    Conclusion: Public health research in Iran has been developed since 2004. The chief field was emerging cardiovascular diseases and communicable diseases. Other biotechnological fields were emerging such as biological markers research. Iran provides structures to face up with its new challenges using networks of countries such as the USA, England, and Sweden. End of embargoes could provide new perspectives for public health research and more largely scientific research in Iran.



  • XML | PDF | downloads: 401 | views: 389 | pages: 286-292

    Background: This paper examined the political and social implications of the Compendium de epidemia prescription written by the Masters of the Faculty of Medicine of the University of Paris in the mid-14th century during the Black Death. This study aimed to examine how the effects of power as a discourse owned by medical knowledge are revealed.

    Methods: This paper outlines the composition of the contents based on the 1888 edition edited and translated by Émile H. Rébouis and notes the features of the prescription examined by the existing study of medical history rather than the causes of diseases.

    Results: Compendium de epidemia seems to have been written primarily for the royal family and nobles who ordered them when looking at prescription-related technologies. At the same time, under the influence of Islamic-Arabic academia, it clearly distinguishes the world of faith and the world of academia (intelligence), explaining the pathogenesis and infection pathways based on causality. The onset substrate is due to heat and humidity, and the prescription is to prevent the two from overdoing in the body. In particular, issues related to heat are criticized in connection with the value of life of knight-noblesse. This is in response to political criticism of the ineffectual French royal family and nobility at the beginning of the Hundred Years' War and shows why this tract sets the utilitas publica at the forefront as an important purpose.

    Conclusion: The conclusion has shown how medical knowledge produced on the Black Death pandemic how they function as discourses that have a sort of power effect on the value of life of knight-noblesse. It is necessary to conduct if these phenomena can be found in other contemporary medical writings.



Original Article(s)

  • XML | PDF | downloads: 139 | views: 356 | pages: 293-300

    Background: Air pollution has been a serious public health threat worldwide. It has been linked to pulmonary and cardiovascular diseases but is also believed to contribute to air-pollution-mediated cardiometabolic disease such as diabetes. We investigated the relationship between type 2 diabetes mellitus (DM2) and air pollution in densely developed urban settings in South Korea, using national epidemiologic data.

    Methods: The analysis focused on examining gender-related differences in the relationship between DM 2 and air pollutants, specifically particulate matter ≤ 10μm (PM10) and sulfur dioxide (SO2). To assess the relationship between DM and exposure to PM10 and SO2, multivariate logistic regression models were developed using the 2012 Korea Community Health Survey data and the ambient air pollution data in South Korean cities at both Gu- and Si levels.

    Results: The commonly encountered levels of PM10 and SO2 may be associated with DM 2 prevalence in South Korea but it appears there may be gender differences. In particular, exposure to either PM10 or SO2 was significantly related to the prevalence of DM 2 among women but not among men.

    Conclusion: These findings provide new evidence of an association between air pollution and the risk of diabetes in urbanized areas of South Korea.



  • XML | PDF | downloads: 157 | views: 303 | pages: 301-307


    Background: The control of spread of HIV takes concerted efforts at both national and international levels. Education is an important component of preventing the spread of HIV. This study aimed to assess the attitudes of parents, teachers and students towards informing children about HIV/AIDS, attitudes concerning 'proper' age to learn about HIV/AIDS, possible differences in attitudes relating to gender of child and what they should learn and ideas about the most 'adequate' person/institution to be responsible for provision of HIV/AIDS education.

    Methods: This study was conducted in Amman, Jordan in April 2015. Descriptive correlational design was used; a sample of school students, university students, school teachers and parents, a stratified random sample was used. Data was collected by using a questionnaire.

    Results: All groups asserted the importance of HIV/AIDS education and awareness rising for all. 62.0% of respondents thought that school was the main source of information. About 82% of respondents believed that HIV/AIDS education should be integrated into different disciplines of school curricula, 84% of respondents believed that HIV/AIDS education should be part of university curricula. Nobody believed that HIV/AIDS education should be restricted to boys only.

    Conclusion: As HIV/AIDS is a scary matter to all, stigmatization and shame may be behind potentially bigger numbers of infected or ill people who do not come forward for treatment or care. Attitudes of their kin care providers need to be addressed as well as those of the official health care providers.



  • XML | PDF | downloads: 185 | views: 507 | pages: 308-317

    Background: The increase in breast cancer incidence has enhanced attention towards breast cancer risk. The aim of this study was to determine the risk of breast cancer and risk perception of women, factors that affect risk perception, and to determine differences between absolute risk and the perception of risk.

    Methods: This cross-sectional study was carried out among 346 women whose score in the Gail Risk Model (GRM) was > 1.67% and/or had a 1st degree relative with breast cancer in Bahçeşehir town in Istanbul, Turkey between Jul 2012 and Dec 2012. Data were collected through face-to-face interviews. The level of risk for breast cancer has been calculated using GRM and the Breast Cancer Risk Assessment Form (BCRAF). Breast cancer risk perception (BCRP), has been evaluated by visual analogue 100-cm-long scale.

    Results: Even though 39.6% of the women considered themselves as high-risk carriers, according to the GRM and the BCRAF, only 11.6% and 9.8% of women were in the “high risk” category, respectively. There was a positive significant correlation between the GRM and the BCRAF scores (P<0.001), and the BCRAF and BCRP scores (P<0.001). Factors related to high-risk perception were age (40-59 yr), post-menopausal phase, high-very high economic income level, existence of breast cancer in the family, having regular breast self-examination and clinical breast examination (P<0.05).

    Conclusion: In women with high risk of breast, cancer there is a significant difference between the women’s risk perception and their absolute risk level.





  • XML | PDF | downloads: 171 | views: 383 | pages: 318-325

    Background: We aimed to describe morphological and morphometrical characteristics of Fasciola spp. in livestock from Ardabil Province, Northwest Iran.

    Methods: Forty adult flukes were collected from different definitive hosts (cattle and sheep). Previously specimens were identified as F. hepatica or F. gigantica based on PCR-RFLP of the ITS-1 region with RsaI enzyme.  We identified Fasciola spp. based on morphological and metric assessment of external features of fresh adults, morphological and metric assessment of internal anatomy of stained mounted worms. Statistical analysis was conducted using the Student’s t-test implemented in SPSS 15.0 (SPSS, Chicago, Illinois). Then the morphometric criteria of Fasciola samples were compared with PCR-RFLP data. The results of PCR-RFLP were confirmed by COI gene sequence.

    Results: The differences between the body length, area of the body, peripheral of the body, succer area, cone length, cone width, in two species were significant (

  • XML | PDF | downloads: 258 | views: 385 | pages: 326-332

    Background: Happiness is a drive and constructive force of life. A person feels wellbeing under different effective factors. Religious dogmatism that has an influence on the entire world is one of the depreciatory factors of happiness or wellbeing. The current study decided to analyze the relation between dogmatism and wellbeing, and according to a model, answer the following question: how does religious dogmatism decrease wellbeing?

    Methods: This study is a correlation research. Population of study includes all people with 30-50 yr old who live in Tehran, Iran, in 2015. Among all, 180 subjects were selected as in access sample. The Oxford happiness questionnaire and Rokeach dogmatism scale were used. Data were analyzed by Pearson correlation test.

    Results: There is a significant negative correlation between dogmatism and happiness (α=0.05).

    Conclusion: Dogmatism is one of the factors that have a negative effect on wellbeing. Religious dogmatism is the most dangerous factor against wellbeing. Dogmatic individuals have an inflexible cognitive system that emerges as a stable personality trait and decreases their adjustment with environment. Affective well-being and cognitive wellbeing are affected by individual adjustment. Therefore, in dogmatic individuals with low adjustment, the decrease of affective well-being and cognitive wellbeing is inevitable. This process will result in decrease of happiness and increase of aggression.



  • XML | PDF | downloads: 197 | views: 485 | pages: 333-341

    Background: Worldwide, infertility affects 10%-15% of couples and most of them seek medical help including Assisted Reproductive Technology (ART) treatments. Undergoing ART treatments create many physical and emotional burdens. This study examined the psychological consequences of infertility in Iranian infertile males and females as well as their spouses, unlike previous studies that examined mainly females with infertility.

    Methods: Subjects in this descriptive analytical design were recruited from the IVF Department of Mirza Koochak Khan Hospital and the Rouyesh Infertility Treatment Center of Tehran, Iran between Aug 2014 and Sep 2015. Overall, 256 couples (64% response rate), consisting of 78 infertile male and their spouses and 50 infertile female and their spouses, were included in this research. The psychological disorders were measured by the Persian version of Symptoms Checklist-90-Revised and Cattle Inventory.

    Results: Psychological disorders of infertile couples are significantly associated with increasing age, higher education, longer duration of infertility and unemployment (P<0.05). Prevalence of anxiety, depression, hypochondriasis and paranoia in infertile females and spouses of infertile males were significantly higher than husbands of infertile females (P<0.05). Obsession was more sever in infertile females was significantly greater than infertile males (P=0.01). Depression was significantly lower in infertile males than their spouses (P=0.016).

    Conclusion: Iranian infertile females and spouses of infertile males experienced more psychological disorders than infertile males and spouses of infertile females. These results may be due to the impact of cultural beliefs and gender roles in Iranian society. Anxiety, depression, obsession, paranoia and hypochondriasis should be addressed before any ART treatments.



  • XML | PDF | downloads: 177 | views: 451 | pages: 342-350

    Background: Primary immunodeficiency diseases (PID) are heterogeneous group of inherited disorders mainly characterized by recurrent infections leading to several times hospital admissions. The economic impact of PID is a challenging issue; therefore, this study was designed to determine the medical costs of hospitalizations in this group of patients as an indicator of the direct cost of these diseases.

    Methods: One hundred and ten children with PID hospitalized in the Children’s Medical Center Hospital, Tehran, Iran were included in this study during Jan 2011 and Jan 2012. All direct costs during the admission period were calculated, using the hospital information system.

    Results: Medical cost was 7.090$ per patient per admission. Among them, about 1.580$ belong to drug consuming during hospitalization. Anti-infective drugs for systemic use were the most cost-consuming group of drugs, followed by alimentary tract and metabolism and blood and blood forming organs agents. Investigation of anti-infective group internally showed that immune sera and immunoglobulin and antiviral agents for systemic use consisting the most important medication for PID patients during hospital admission.

    Conclusion: Although the results of economic evaluations in a region cannot necessarily be applied to other regions, having an overall estimation of hospital admission costs and types of drugs used during admission could be helpful in health policy system.



  • XML | PDF | downloads: 156 | views: 310 | pages: 351-356

    Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant challenge to the burn patient. The implementation of proper monitoring programs and prompt identification of epidemic MRSA strains are critical to consequently control and eradicate potential outbreaks. This study aimed to define the genetic relatedness of MRSA strains isolated from burn patients by analyzing the large fragments of DNA.

    Methods: In this cross-sectional study, 126 pus/wound swabs from skin and soft tissue infections (SSTIs) were collected from inpatients of Shahid Motahari Burn Center (Tehran, Iran) in 2013. Then, molecular typing of MRSA was achieved by Pulsed-Field Gel Electrophoresis (PFGE).

    Results: The PFGE analysis of MRSA indicated 31 single types and 5 common types. There was a significant diversity in the chromosomal digestion pattern of the MRSA strains explained by the acquisition of MRSA from various sources.

    Conclusion: The permanent import of novel types of MRSA strains despite the rigorous infection control measures carried out within the center. The importance of PFGE in understanding the epidemiology of MRSA may serve as a basis for the development of rational control strategies.



  • XML | PDF | downloads: 167 | views: 320 | pages: 357-367

    Background: High temperatures have destructive effects on cancer cells by damaging proteins and structures within cells. Gold nanoparticles (AuNPs) can act as drug delivery vehicles, especially for cancer therapy. Due to the selective intake of asparagine molecules into malignant cells, AuNPs were coated with asparagine; and CCRF-CEM human T-cell leukemia cells were treated with the new combination, Asn-AuNPs, at 39 °C.

    Methods: The co-authors from a number of collaborative labs located at Tehran University of Medical Sciences, Tehran, Iran, have initiated the idea and preliminary design of this study in 2011. Hydroxyl surfaced AuNPs were preliminary prepared by tannin free ethanol extract of black tea leaves. These biogenic AuNPs were further capped with asparagines to form asparagine-gold nanoparticle conjugates (Asn-AuNP conjugates). Then CCRF-CEM human T-cell leukemia cells were separately treated with different concentrations of AuNPs and Asn-AuNP conjugates (3, 30, 300 µg/mL). MTT assay and zymography analysis were carried out, and the apoptotic and necrotic effects of Asn-AuNPs were determined in comparison with AuNPs, using flow cytometry assay.

    Results: Asn-AuNP conjugates at 300 µg/mL significantly inhibited MMPs at 39 °C, compared to AuNPs. In terms of cytotoxicity, a remarkable decrease was observed in the percentage of viable cells treated with Asn-AuNP conjugates, rather than AuNPs. Moreover, the AuNPs and Asn-AuNP conjugates enhanced the level of apoptosis at almost similar rates.

    Conclusion: AuNPs are coated with asparagine molecules and the temperature is slightly increased by 2 °C, the apoptosis is not only enhanced among cells but also shifts to necrosis in higher concentrations of Asn-AuNP conjugates. More investigations should be carried out to explain the exact mechanism underlying the necrotic effects of Asn-AuNPs.



  • XML | PDF | downloads: 152 | views: 379 | pages: 368-379

    Background: Normal standard references of blood pressure (BP) for children and adolescents should be constructed according to anthropometric indices. Therefore, we aimed to produce BP reference percentiles by body mass index (BMI).

    Methods: Data on demographic characteristics, anthropometric indices and BP values of 16246 3-18-year-old children and adolescents from 3 cross-sectional studies conducted in Tehran were included. To justify the need for BMI adjustment, quantile regression model was applied for different percentiles of systolic and diastolic BPs with age, sex, and the corresponding BMI percentiles. Then, Age- and sex-specific BP nomograms were constructed according to BMI.

    Results: All regression coefficients for BMI percentiles were significant in quantile regression of BPs, confirming the necessity for BMI-adjusted nomograms of BP. The BP percentiles for each gender by age and BMI are presented. All the BP percentiles rose steadily in all BMI percentiles with minor discrepancies between the two genders. As observed, the prevalence of hypertension is estimated to be lower among the lean subjects and higher among overweighs when the BMI-adjusted BP curves are considered.

    Conclusion: The reference database constructed in this survey is the first Iranian BP reference by age and BMI in children and adolescents, from it concluded that BMI-adjusted BP curves depict a more precise picture of the hypertension prevalence and present a more reliable classification standard for hypertension.



  • XML | PDF | downloads: 494 | views: 1001 | pages: 380-388

    Background: Technical, human, operational and organizational factors have been influencing the sequence of occupational accidents. Among them, organizational factors play a major role in causing occupational accidents. The aim of this research was to understand the Iranian safety experts’ experiences and perception of organizational factors.

    Methods: This qualitative study was conducted in 2015 by using the content analysis technique. Data were collected through semi-structured interviews with 17 safety experts working in Iranian universities and industries and analyzed with a conventional qualitative content analysis method using the MAXQDA software.

    Results: Eleven organizational factors’ sub-themes were identified: management commitment, management participation, employee involvement, communication, blame culture, education and training, job satisfaction, interpersonal relationship, supervision, continuous improvement, and reward system. The participants considered these factors as effective on occupational accidents.

    Conclusion: The mentioned 11 organizational factors are probably involved in occupational accidents in Iran. Naturally, improving organizational factors can increase the safety performance and reduce occupational accidents.



  • XML | PDF | downloads: 271 | views: 432 | pages: 389-395

    Background: Pabon Lasso model was applied to assess the relative performance of hospitals affiliated to Kurdistan University of Medical Sciences (KUMS) before and after the implementation of Health Sector Evolution Plan (HSEP) in Iran.

    Methods: This cross-sectional study was carried out in 11 public hospitals affiliated to KUMS in 2015. Twelve months before and after the implementation of the first phase of HSEP, a checklist was used to collect data from computerized databases within the hospitals' admission and discharge units. Pabon Lasso model includes three indices: bed turnover, bed occupancy ratio, and average length of stay.

    Results: Analysis of hospital performance showed an increase in mean of bed occupancy and turnover ratio, which changed from 65.40% and 86.22 times/year during 12 months before to 69.97% and 90.98 times/year during 12 months after HSEP, respectively. In line with Pabon Lasso model, before the implementation of HSEP, 27.27% and 36.36% of the hospitals were entirely efficient and inefficient, respectively, whilst after the implementation of HSEP, their condition changed to 18.18% and 27.27%, in order.

    Conclusion: Indicators of bed occupancy and turnover ratio had a 4% increase in the studied hospitals after the implementation of HSEP. Number of the hospitals in the efficient zone reduced because of the relative measurement of efficiency by Pabon Lasso model. Since more than 50% of the hospitals in the studied province have not yet reached their optimal bed occupancy ratio (more than 70%), short-term and suitable strategy for improving the efficiency is to stop further expansion of hospitals as well as developing the number of hospital beds.

  • XML | PDF | downloads: 196 | views: 390 | pages: 396-407

    Background: Weather and climate play a significant role in human health. We are accustomed to affects the weather conditions. By increasing or decreasing the environment temperature or change of seasons, some diseases become prevalent or remove. This study investigated the role of temperature in cardiovascular disease mortality of city of Mashhad in the current decade and its simulation in the future decades under conditions of climate change.

    Methods: Cardiovascular disease mortality data and the daily temperatures data were used during (2004-2013) period. First, the correlation between cardiovascular disease mortality and maximum and minimum temperatures were calculated then by using General Circulation Model, Emissions Scenarios, and temperature data were extracted for the next five decades and finally, mortality was simulated.

    Results: There is a strong positive association between maximum temperature and mortality (r= 0.83, P-value<0.01), also observed a negative and weak but significant association between minimum temperatures and mortality. The results obtained from simulation show increased temperature in the next decades in Mashhad and a 1 °C increase in maximum temperature is associated with a 4.27% (95%CI: 0.91, 7.00) increase in Cardiovascular disease mortality.

    Conclusion: By increasing temperature and the number of hot days the cardiovascular disease mortality increases and these increases will be intensified in the future decades. Therefore, necessary preventive measures are required to mitigate temperature effects with greater attention to vulnerable group.




  • XML | PDF | downloads: 214 | views: 372 | pages: 408-413

    Background: Hepatitis C Virus (HCV) infection is one of the major blood-borne infections worldwide. HCV carriers may develop chronic hepatitis leading to liver cirrhosis and hepatocellular carcinoma (HCC). There is no overall estimate of the infection prevalence in the northeast of Iran. We have performed this research in order to determine accurately the prevalence and risk factors of HCV infection among general population in Mashhad.

    Methods: During 2009, 1678 people between 1 to 90 yr old with the mean age of 29.1±18.5 yr were selected randomly by multistage sampling from different geographical regions of the city proportionate to sex and age distribution of population in 2006 census. ELISA was used to screen for antibodies and RT-PCR tested the positive samples.

    Results: HCV infection was detected in 7/1654 cases; overall prevalence of the infection was 0.42% (95%CI: 0.17-0.87%), 0.80% and 0.11% among males and females, respectively (P= 0.051). One HCV-infected subject was also positive for hepatitis B surface antigen (HBsAg), however, no cases showed HIV or HTLV seropositivity.

    Conclusion: In comparison with similar studies, the prevalence of HCV infection in Mashhad is low.


Letter to the Editor