Vol 46 No 6 (2017)

Review Article(s)

  • XML | PDF | downloads: 140 | views: 363 | pages: 724-732

    Background: Glaucoma is the major ophthalmic public health issue and a leading basis of blindness. Elevated intraocular pressure (IOP) is still a foremost risk factor in development and progression of glaucoma. Central corneal thickness (CCT) may play as the risk factor for the progression of glaucoma, closely associated with IOP especially in pediatric age group. This study performed a pioneering investigation combining the outcomes of multiple studies using a meta-analytic approach.

    Methods: Nineteen published articles between 1980 and 2015 were designated by searching Scopus, PubMed, and Google Scholar and analyzed with random effects model while I² statistics employed to find out heterogeneity. Subsequently, the information statistically analyzed by Stata software ver. 11.20.

    Results: The mean IOP has been documented to 16.22 mmHg (95% CI: 15.48-16.97) in all races subgroups. Analyzing the data by race-based subgroups revealed the lowest IOP of 12.02 mmHg (95% CI: 11.40-12.64) in Indian children while IOP of 17.38 mmHg (95% CI: 15.77-18.98) documented in black children as the highest measurement. The mean CCT was 553.69 micrometer (95% CI: 551.60-555.78) among all races. Lowest CCT of 536.60 mm (95% CI: 531.82-541.38) has been documented in mixed Malay-Indian children whereas Chinese children ought to the highest CCT value of 557.68 mm (95% CI: 553.10-562.25).

    Conclusion: Findings of published studies were inconsistent when considered independently; however, meta-analysis of these results showed a significant correlation between CCT and IOP. Owing to non-uniform methods used to measure IOP and CCT in studies, data were stratified into various subgroups according to the instruments used to measure IOP and CCT.



  • XML | PDF | downloads: 200 | views: 594 | pages: 733-743

    Background: Congenital anomalies are considered as main causes of disability and mortality among children in developing and developed countries. Expenditures of hospitalization and treatment procedures for these children impose a large burden on health system and their families. This study aimed to review the prevalence of congenital anomalies among infants in Iran.

    Methods: The review of studies was conducted through searching databases including IranMedex, SID, Magiran, Scopus, and PubMed. Descriptive and cross-sectional studies investigating on the prevalence of congenital anomalies among infants were included into the study. Hand search for some related journals and websites was done. The list of studies' references was reviewed. The data were analyzed using the CMA 2 software.

    Results: Of 455 studies, 27 studies were included into the meta-analysis study. The studies were conducted between 1992 and 2014.The overall prevalence of congenital anomalies among infants was estimated to be 2.3%. The overall prevalence rates, in terms of gender, were estimated to be 3% in boys and 2% in girls. While the highest prevalence rates were related to musculoskeletal anomalies (27.5%), skin anomalies (19.7%) and genitourinary system anomalies (15.8%), the lowest prevalence rate was related to respiratory system (1.82%)

    Conclusion: The prevalence of congenital anomalies among infants in Iran is high. In order to reduce the rates of these anomalies and complications resulted from them, coping and preventive strategies such as the necessity of genetic counseling particularly in consanguineous marriages seem to be appropriate solutions.



Original Article(s)

  • XML | PDF | downloads: 244 | views: 471 | pages: 744-754

    Background: We aimed to apply collaborative business intelligence (BI) system to hospital supply, processing and distribution (SPD) logistics management model.

    Methods: We searched Engineering Village database, China National Knowledge Infrastructure (CNKI) and Google for articles (Published from 2011 to 2016), books, Web pages, etc., to understand SPD and BI related theories and recent research status. For the application of collaborative BI technology in the hospital SPD logistics management model, we realized this by leveraging data mining techniques to discover knowledge from complex data and collaborative techniques to improve the theories of business process.

    Results: For the application of BI system, we: (i) proposed a layered structure of collaborative BI system for intelligent management in hospital logistics; (ii) built data warehouse for the collaborative BI system; (iii) improved data mining techniques such as supporting vector machines (SVM) and swarm intelligence firefly algorithm to solve key problems in hospital logistics collaborative BI system; (iv) researched the collaborative techniques oriented to data and business process optimization to improve the business processes of hospital logistics management.  

    Conclusion: Proper combination of SPD model and BI system will improve the management of logistics in the hospitals. The successful implementation of the study requires: (i) to innovate and improve the traditional SPD model and make appropriate implement plans and schedules for the application of BI system according to the actual situations of hospitals; (ii) the collaborative participation of internal departments in hospital including the department of information, logistics, nursing, medical and financial; (iii) timely response of external suppliers.



  • XML | PDF | downloads: 173 | views: 443 | pages: 755-761

    Background: The aim of this study was to compare the effects of the ingestion of either the caffeine (CAF) or the placebo (PLA) on performance of repeated modified agility test (RMAT), some cardiovascular factors, metabolic and notes of perceived exertion (RPE) in young males and females.

    Methods: In a randomized double-blind study, we enrolled 18 active students (10 males and 8 females) in Sport Sciences pursuing degrees in Exercise Science and Physical Education at the University of Sports of Kef (Tunisia), during the academic year 2013-2014. All participants were ingested CAF (5 mg.kg-1) or PLA 60 min before performing an RMAT. Total times (TT), peak time (PT) and fatigue index (FI) were identified as the RMAT indices. Heart rate (HR), arterial pressures (PA), blood glucose (BG) and RPE were assessed before, during and after the RMAT.

    Results: Taking caffeine had been improved the performance by the significant decreased of TT on male gender better than female gender and the entire group. In addition, there was a significant improvement on HR during and after RMAT in both genders and the whole group, except after RMAT among male gender. However, the repeated measurement results had demonstrated no effect of caffeine on PA, BG and RPE.

    Conclusion: Caffeine supplement had a beneficial effect on agility performance and HR in male better than in female, although, there was no improvement in PA, BG and RPE.



  • XML | PDF | downloads: 128 | views: 263 | pages: 762-770

    Background: The aim of this study was to explore the relationship between nutritional status and expression of RUNX3 in gastric cancer cells and to investigate the effects of nursing strategies on the nutritional status of elderly patients with advanced gastric cancer.

    Methods: Forty-eight elderly patients admitted at Affiliated Hospital of Qingdao University with advanced gastric cancer and 30 healthy controls were selected as subjects from 2014-15. The correlation between RNX3 gene expression and nutritional status of the gastric cancer patients was investigated. The patients with advanced gastric cancer who had low expression of RUNX3 gene were treated with holistic nursing while routine nursing was taken for those patients who had normal or high expression of RUNX3 gene. The nutritional statuses of these patients were evaluated after 3 months of nursing. After a follow-up of 1 year, the influence of different nursing methods on the survival time was evaluated.

    Results: Compared with normal gastric tissue, the expression of RUNX3 gene and protein in tissues of advanced gastric cancer were significantly decreased (P<0.01). Compared with patients with normal or high expressions of RUNX3, the nutritional statuses of advanced gastric cancer patients with low expressions of RUNX3 were lower (P<0.01). The nutritional statuses of patients with low expressions of RUNX3 were notably improved after holistic nursing, becoming equivalent to those with normal or high expression of RUNX3 who received routine nursing (P>0.05). The survival time of patients with low expression of RUNX3 who received holistic nursing were similar to patients with normal or high expression of RUNX3 who received routine nursing (P>0.05).

    Conclusion: RUNX3 is correlated with the occurrence and development of advanced gastric cancer. The low nutritional status of elderly advanced gastric cancer patients with low expressions of RUNX3 can be significantly enhanced by holistic nursing, thereby prolonging survival time.


  • XML | PDF | downloads: 173 | views: 414 | pages: 771-781

    Background: Self-Management is a crucial regimen for patients with diabetes mellitus. Many factors have affected patients' self-management practice including psychosocial factors. Literature revealed contradictory results concerning the psychosocial correlates of patients' self-management practices. Therefore, this study assessed the psychosocial correlates of diabetes self-management practices among Jordanian diabetic patients.

    Methods: A descriptive, cross-sectional, correlational design was utilized to collect data (conducted in the middle region of Jordan in 2015) from 341 Jordanian outpatients with diabetes using self-reported questionnaires (Social Support Scale, CES-D, and Summary of Diabetes Self-Care Activities) and chart review.

    Results: Participants reported practice rate of 2.85/ 7 (SD=1.3), with diet practice the most (M=3.66, SD=1.5) and exercise the least (M=1.53, SD=2.1). Participants reported receiving social support (M=3.23, SD=1.3) less than needed (M=3.39, SD=1.3). High levels of depressive symptoms were reported (M=17.1, SD= 11.4). Diet practices had significant positive correlation with family support attitude (r= .266, P= .000) and negative correlation with depressive symptoms (r= - .114, P= .037). Testing blood sugar significantly correlated with both support needed (r= .144, P= .008) and support received (r= .166, P= .002).

    Conclusion: Jordanian DM patients were found to practice less than optimum DM self-management practices, and to consider diet practices than exercise practices. This study confirmed that the subcategories of DM self-care management should be considered rather than considering the general plan.


  • XML | PDF | downloads: 167 | views: 370 | pages: 782-791

    Background: Chinese medical workers suffer from a high incidence of mental health problems, resulting in reduced efficiency, increased medical malpractice, rising medical costs, and other issues. The effective alleviation of mental health problems among medical workers is therefore an important focus of research and social attention.

    Method: The mental health of 842 medical workers from the First Affiliated Hospital of Fujian Medical University and the Second Affiliated Hospital of Fujian Medical University in Fuzhou, China was evaluated between February 2016 and March 2016. Sixty-two workers with positive SCL-90 screening results were selected as the subjects to be investigated in the intervention experiment, with 31 in the intervention group and 31 in the control group. The control group did not participate in any regular physical exercise activity for the 4-month duration of the study, whereas the exercise–psychology adjustment mode was applied to the intervention group.

    Results: Medical workers had a higher total SCL-90 score and number of positive items than the national norm (P < 0.05). After the intervention, the SCL-90 score, number of positive results, somatization, obsessive-compulsive symptoms, sensitivity, depression, anxiety, and hostility of the intervention group were significantly lower than they were before the intervention (P < 0.05) and lower than those of the control group (P < 0.05).

    Conclusion: The alleviation of mental health problems, which are increasingly serious among medical workers, should be a matter of societal focus. The exercise–psychology adjustment is an effective intervention mode for the mental health of medical workers.


  • XML | PDF | downloads: 178 | views: 341 | pages: 792-795

    Background: Along with the newly emergence of paleoparasitology research in Iran, findings of parasites from Northern part of the county have not been reported so far. In this study tracking for the lancet liver fluke dates back 250 BC is addressed.

    Methods: Samples were taken from grave crypts of the soil layers attached to the pelvic bones from above-mentioned site in 2015. The laboratory examinations were conducted in the Dept. of Medial Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Current rehydration technique using TSP 0.5% was utilized for examining the samples.

    Results: Out of 10 burial soil samples examined, one individual was seen parasitized with a Dicrocoelium egg. The burial belonged to an adolescent male 20-22 yr old. The egg was in brown color and the length/width parameters of 36×22/5 µm. Parthian coins found in nearby the burials in Kiasar Cemetery, declared the time of the skeleton about 247 BC – 224 AD confidently.

    Conclusion: Although the possibility of transit infection with D. dendriticum is high, yet the environmental and geographical conditions in that time are in favor of a normal human transmission in northern Iran.



  • XML | PDF | downloads: 151 | views: 276 | pages: 796-803

    Background: Unpleasant health outcomes are common in deprived communities and have been shown a direct connection between socioeconomic status and wellbeing but, the effect of the socioeconomic status on suicide is currently controversial. This study explored the relationship of the socioeconomic status and addiction and mental disorders in suicide attempts and decomposed inequalities into its determinants to calculating share of contribution to the inequality.

    Methods: This cross-sectional study recognized 546 suicide deaths and 6818 attempted suicides from 1 Jan 2010 to 31 Dec 2014 in Ilam Province, West of Iran. Inequality measured by concentration index (CI) and decomposing contribution in inequality. All analysis was performed by standard statistical software, Stata (Ver. 11.2).

    Results: The pooled rate of death in people with suicide attempts was 8.0% and that of having a history of suicide was 5.2%. The overall CI for addiction was -0.233 (95% CI= -0.383 to -0.084), and the CI for mental disorders was 0.0006 (95% CI = -0.009 to 0.010). The more amount of contribution to socioeconomic inequality in suicide attempts because of age group of < 25 yr (26%), socioeconomic level (23%), and marital status (22%).

    Conclusion: Addiction and mental disorders were distributed among suicide attempters unequally and gap between advantaged and disadvantaged attempted suicide confirmed by our results. Addiction prevention-related policies and programmers’ should be focus on disadvantaged groups.


  • XML | PDF | downloads: 135 | views: 294 | pages: 804-810

    Background: Latex agglutination test for Kala-azar (KAtex) is an easy, inexpensive, and field-applicable antigen detection test. However, the main drawback of this method is the boiling step applied to remove false positivity of the test. This study was conducted to survey false positivity results of latex agglutination test for KAtex without boiling process in urine of some autoimmune patients.

    Methods: Ninety-two urine samples from autoimmune patients including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), scleroderma, autoimmune vasculitis, vitiligo, pemphigus and Wagner cases and 20 urine samples from healthy individuals were collected from Kerman Province in Southeastern Iran in 2010-2011. All urine samples were checked by KAtex after boiling for 5 min false positivity rate of the test was surveyed in different healthy and patients groups while boiling process was removed. Rheumatoid factor (RF) then was checked in sera of all cases to evaluate the relationship between RF and KAtex false positivity.

    Results: All samples represented negative results with KAtex when boiling was performed (100% specificity). Then, 20% positivity was evident in healthy cases. False-positive reactivity was more prominent observed in patient groups than healthy individuals, except in vitiligo. However, a significant difference was only observed in RA group (P<0.05). RF was related to KAtex false positivity.

    Conclusion: RA was described as the autoimmune disease in which KAtex false positivity was higher than normal population. RF or its metabolic products may have role in false positivity of KAtex but this finding needs to be confirmed by more reliable and improved experiments. Overall, immune system products should be considered in attempts for modification of KAtex for boiling process removal.



  • XML | PDF | downloads: 153 | views: 310 | pages: 811-819

    Background: A significant role of Renin-angiotensin system (RAS) genetic variants in the pathogenesis of essential hypertension and cardiovascular diseases has been proved. This study aimed to develop a new, fast and cheap method for the simultaneous detection of two missense single nucleotide polymorphisms (T207M or rs4762 and M268T orrs699) of angiotensinogen (AGT) in single-step Multiplex Hexa-Primer Amplification Refractory Mutation System - polymerase chain reaction (H-ARMS-PCR).

    Methods: In this case-control study, 148 patients with coronary artery disease (CAD) and 135 controls were included. The patients were referred to cardiac centers in Afshar Hospital (Yazd, Iran) from 2012 to 2015. Two sets of inner primer (for each SNP) and one set outer primer pairs were designed for genotyping of rs4762 and rs699 in single tube H-ARMS-PCR. Direct sequencing of all samples was also performed to assess the accuracy of this method. DNA sequencing method validated the results of single tube H-ARMS-PCR.

    Results: We found full accordance for genotype adscription by sequencing method. The frequency of the AGT T521 and C702 alleles was significantly higher in CAD patients than in the control group (OR: 0.551, 95% CI: 0.359-0.846, P=0.008 and OR: 0.629, 95% CI: 0.422-0.936, P=0.028, respectively).

    Conclusion: This is the first work describing a rapid, low-cost, high-throughput simultaneous detection of rs4762 and rs699 polymorphisms in AGT gene, used in large clinical studies.


  • XML | PDF | downloads: 129 | views: 299 | pages: 820-826

    Background: Permanent artificial pacemaker is one of the important therapies for treatment of cardiac conduction system problems. The present study aimed to determine the association between some predictive variables and all-cause and cause-specific mortality in the patients who had undergone pacemaker implantation.

    Methods: This study was conducted on 1207 patients who had undergone permanent pacemaker implantation in the hospitals affiliated with Shiraz University of Medical Sciences, Iran, from Mar 2002 to Mar 2012. The variables that existed in the patients’ medical records included sex, diabetes mellitus, obesity, cerebrovascular accident, cardiomegaly, smoking, hypertension, ischemic heart disease, congenital heart disease, sick sinus syndrome, and atrial fibrillation. Competing risks model was used to assess the association between the predictive variables and cause-specific (i.e., cardiac and vascular) mortality.

    Results: The patients’ mean age was 66.32±17.92 yr (70.62±14.45 yr in the patients with single-chamber pacemakers vs. 61.91±17.69 yr in those with two-chamber pacemakers) (P<0.001). Sick sinus syndrome and age increased the risk of all-cause mortality, while two-chamber pacemaker decreased this risk. Obesity increased the risk of cardiac death, and diabetes mellitus and heart valve disease increased the risk of vascular death.

    Conclusion: The variables predicting mortality in all-cause model were completely different from those in cause-specific model. Moreover, death in such patients may occur due to reasons other than pacemaker. Therefore, future studies, particularly prospective ones, are recommended to use competing risks models.


  • XML | PDF | downloads: 162 | views: 359 | pages: 827-834

    Background: The aim of this study was to determine the prevalence of overweight and obesity and their associated factors in the middle-aged population of Shahroud, North of Iran.

    Methods: In a population-based cross-sectional study with random cluster sampling, 300 clusters of Shahroud (north of Iran) were randomly selected from the 40-64 yr old population of the city, during 2009 and 2010. Upon enrollment, participants were weighed on digital scales and their heights were measured under standard conditions. Overweight and obesity were defined as a body mass index (BMI) of 25-29.9 kg/m2 and a BMI ≥30 kg/m2, respectively.

    Results: Of the 6311 selected people, 5190 people (82.2%) participated in the study. Their mean age was 50.9±6.2 yr, and 2977 of them were women (57.4%). Age and gender standardized mean BMI in the study population were 28.1 kg/m2 (95% CI: 27.9-28.2). Age and gender-standardized prevalence of BMI≥25 was 74.4% (95% CI: 73.0-75.8); 43.4% (95% CI 44.8-42.0) were overweight and 31.0% (95% CI 32.5-29.6) were obese. Overweight, Obesity and a BMI ≥25 prevalence's were significantly higher in women (P<0.001). In the multiple logistic regression models, female gender and higher economic status were significantly correlated with BMI≥25. In addition, people over the age of 54 yr were more likely to have BMI≥25 than those in the 40-44 yr age range (P<0.001).

    Conclusion: The prevalence of overweight and obesity in the present study, especially in women, was higher than that reported from previous studies in Iran. Considering prevention, programs for overweight and obesity-related are suggested as a priority for the health system in this population.


  • XML | PDF | downloads: 159 | views: 240 | pages: 835-842

    Background: Cutaneous leishmaniasis (CL) is an important vector-borne disease in Iran. The present study aimed to evaluate the efficacy of Deltamethrin treated nets in comparison to Indoors Residual Spraying (IRS) for the control of leishmaniasis in a new focal area of Iran.

    Methods: The study was carried out in 5 villages in the west of Iran during 2012-2013. One village was selected to the application of Insecticide Treated Nets (ITNs, 25 mg/m2 deltamethrin) among residents. Four other villages were considered for IRS using deltamethrin emulsion, 2.5% EG and Aicon 10WP. Spraying was repeated after 3 month. Other control methods e.g. environmental managements, and treatment of positive cases were carried out in all villages.

    Results: After 1 yr of trial, the cases of disease reduced from 50 to 2 and 128 to 5 for ITNs distributed nets and use of IRS in the villages, respectively.

    Conclusion: Reduction of CL cases in both methods were significant (P<0.001).


  • XML | PDF | downloads: 143 | views: 270 | pages: 843-847

    Background: Creating healthy cities promotes socio-economic development, thus, the creation of such cities has been receiving more attention from the Chinese government and the Chinese people. In the current study, the intention was to conduct a comprehensive evaluation of the creation of healthy cities in Henan province in central China.

    Methods: We randomly selected 18 cities (7 healthy cities and 11 non-healthy cities) in middle regions of China in 2013 and established evaluation indices to evaluate the beneficial effects by horizontal and vertical comparison analyses.

    Results: Creating the healthy cities promoted health service, economic development, spiritual and ecological success. This was achieved by constructing cities and changing work style among the officials and establishment of patriotic health organizations.

    Conclusion: This is the first comprehensive, in-depth, appraisal of the healthy cities in China. We suggest that creating the healthy cities should be promoted a larger extend world-wide since it is beneficial at many levels.


Case Report(s)

  • XML | PDF | downloads: 142 | views: 296 | pages: 848-851

    Trisomy 13 (Patau syndrome) is the third most common autosomal trisomy with a prevalence between 1 in 10,000 - 20,000 live births. Robertsonian translocations represent the largest number of chromosomal aberrations in human population with an incidence of 1.23 in 1000 live birth and translocation 13;14 is one of the most frequent Robertsonian translocations (approximately 75%). We sampled umbilical vein blood from a 27-yr-old woman whose ultrasonography findings revealed congenital heart defects, single ventricle, polycystic kidney, median cleft lip and palate and holoprosencephaly at gestational age of 23+6 weeks for karyotype and sequencing during intra-amniotic cavity injection of acrinol for labor induction. Next-generation sequencing indicated 47,XN,+13 and karyotype was identified as 46,XN,+13,rob (13;14). An unexpected problem becomes more and more obvious in human cytogenetics – it seems to become difficult to decide how and when to use the “molecular cytogenetics” or “traditional karyotype analysis”. Molecular cytogenetics, such as next-generation sequencing and array-based comparative genomic hybridization (array-CGH), can detect microdeletions and micro-duplications, but it cannot detect balanced translocations. For this case, we cannot find balanced translocations by Molecular cytogenetics. The purpose of this case is that molecular cytogenetics cannot replace the traditional karyotype analysis, but can serve as a useful complement for G-banding to be used in the clinical cytogenetic diagnosis.



Letter to the Editor