Vol 46 No 11 (2017)

Review Article(s)

  • XML | PDF | downloads: 425 | views: 621 | pages: 1454-1464

     Background: Data on the questionnaire-based prevalence of food insecurity are needed to develop food and nutrition security studies and policies. The present study aimed to assess the questionnaire-based prevalence of food insecurity in Iran.

    Methods: A systematic search of cross-sectional studies were conducted on databases including PubMed, Google Scholar, Scopus, Magiran, Iranmedex, SID and Medlib up to 29 Oct 2015. Estimation of food insecurity prevalence was according to the instruments including 9-items-HFIAS, 18 and 6-items USDA (US-HFSSM) and Radimer/Cernel food security questionnaires. Pooled effect was estimated using random-effect model and heterogeneity was assessed by Cochran’s Q and I2 tests.

    Results: Thirteen articles included in the study based on screening and assessment of eligibility. The questionnaire-based prevalence of food insecurity was 49.2% (CI95%: 43.8-54.6). The according to sub-groups analysis, the food insecurity without and with hunger was 29.6% (CI95%: 25.7-33.6) and 19.2% (CI95%: 16-22.3), respectively.

    Conclusion: The about half of the population were food insecure. The food insecurity without hunger was more than the food insecurity with hunger. An ongoing food insecurity assessment system is needed to support evidence-informed policy and to plan interventions to increase the food security in different areas.



  • XML | PDF | downloads: 411 | views: 605 | pages: 1465-1474

    Background: The implication of health literacy is the ability of individuals to find, understand, and use their required health information from reliable sources. It is an indicator of the individuals’ participation in their own medical decision-making. Deaf individuals have limited health literacy and poor health status due to low literacy. Hence, this review was conducted to understand barriers and facilitators influencing health literacy among deaf community.

    Methods: We searched the ISI Web of Sciences, Scopus, and Medline from 1987 to 2016. Seventy-three papers were analyzed thematically.

    Results: We found three primary themes, including inadequate health literacy, barriers, and facilitators to accessing health information and health care services among deaf individuals. Facilitators were composed of four sub-theme including legal activities protecting the right of deaf patients to accessing health services, training health professionals about effective communication with deaf patients, providing sign language interpreter services, and developing deaf-tailored educational health programs and materials.

    Conclusion: Closing the deaf cultural gap and their limited access to health information are achievable through the removal of the communication barriers, allowing deaf individuals with more access to health learning opportunities, and informing the hearing community about the communicative skills of deaf individuals.



  • XML | PDF | downloads: 336 | views: 768 | pages: 1475-1485

    Background: Cancer is a genetic disease and mainly arises due to a number of reasons include activation of oncogenes, malfunction of tumor suppressor genes or mutagenesis due to external factors.

    Methods: This article was written from the data collected from PubMed, Nature, Science Direct, Springer and Elsevier groups of journals.

    Results: Oncogenes are deregulated form of normal proto-oncogenes required for cell division, differentiation and regulation. The conversion of proto-oncogene to oncogene is caused due to translocation, rearrangement of chromosomes or mutation in gene due to addition, deletion, duplication or viral infection. These oncogenes are targeted by drugs or RNAi system to prevent proliferation of cancerous cells. There have been developed different techniques of molecular biology used to diagnose and treat cancer, including retroviral therapy, silencing of oncogenes and mutations in tumor suppressor genes.

    Conclusion: Among all the techniques used, RNAi, zinc finger nucleases and CRISPR hold a brighter future towards creating a Cancer Free World.



Original Article(s)

  • XML | PDF | downloads: 310 | views: 388 | pages: 1486-1494

    Background: We tried to investigate the effect of PM2.5 on daily counts of outpatient visits in the Guang’anmen Hospital to determine if short-term PM2.5 exposure with extremely high concentration affects cardiopulmonary function of Beijing residents.

    Methods: Outpatient visits and PM2.5 data from 01/11/2011 to 03/31/2013 were extracted from the Guang’anmen Hospital and the American Embassy in Beijing, respectively. Followed by using a semi-parametric generalized additive model (GAM) with time dependent covariates, we analyzed the association between PM2.5 concentrations and daily count of outpatient visits on Day 0, 1, 2, 3, 4 and 5 of PM2.5 exposure.

    Results: Overall, 284354 subjects were collected. There were significant associations of short-term PM2.5 exposures with outpatient visits for cardiopulmonary diseases (P<0.05). Specifically, a 10 µg/m3 increase in PM2.5 was positively associated with a 0.74% of increase in angina visit on the first day and 0.50% increased visit on the second day (P<0.05). With an increase in PM2.5, the cough and respiratory visits significantly decreased by 0.17% and 0.30% on the first day, respectively (P<0.05). However, there were significant positive associations of PM2.5 with increased cough and respiratory visits (increased by 0.17% and 0.10%, respectively) on the fifth day (P<0.05).

    Conclusion: Our association studies showed an instant effect of PM2.5 level on cardiovascular outpatient visit in the Guang’anmen Hospital in Beijing while a lag effect on respiratory outpatient visits.



  • XML | PDF | downloads: 217 | views: 262 | pages: 1495-1501

    Background: Determining the role of genetic markers in individual sensitivity to chemical exposures raises a possibility of risk assessment of occupational diseases and their prevention. This paper focuses on the results of the identification of molecular-genetic markers associated with occupational skin cancer susceptibility. This study aimed to explore an association between polymorphisms of the TP53 tumor suppressor gene and a risk of developing occupational skin neoplasms.

    Methods: This case-control study was conducted on 71 workers with occupational skin neoplasms, 99 healthy workers, and 100 healthy population-based controls in Bashkortostan Republic, Russia in 2015. Genotyping of TP53 polymorphisms (rs1042522, rs1625895, and rs17878362) was performed by restriction fragment length polymorphism analysis of genomic DNA extracted from peripheral blood. Odds ratios and 95% confidence intervals were calculated to measure the strength of the association.

    Results: Subjects carrying allele C of rs1042522 were associated with an increased risk of occupational skin neoplasms [P=0.027, odds ratio (OR)=1.97, 95% confidence intervals (CI) 1.08-3.63]. An increased risk was also associated with allele 16bp of rs17878362 (P=0.010, OR=3.32, 95 % CI=1.31-8.78) and allele A of rs1625895 (P=0.003, OR = 5.45, 95 % CI = 1.72-19.15).

    Conclusion: The polymorphic variants rs1042522, rs1625895 and rs17878362 of the ТР53 gene are related to increased risks of occupational skin cancer. This study suggests the potential use of molecular-genetic data to assess increased individual risks of the development and prognosis of occupational skin neoplasms.



  • XML | PDF | downloads: 310 | views: 348 | pages: 1502-1511

    Background: Heart rate variability (HRV) represents the sympathetic nervous system activity induced by apnea or hypopnea events among OSAS patients. However, few studies have been conducted to clarify the association between HRV parameters and polysomnography (PSG) diagnostic indices. In our study, we postulate that the prevalence of cardiac arrhythmias is associated with OSAS, and HRV parameters may be an effective method for OSAS screening.

    Methods: Overall, 168 participants had been collected from 2011 to 2016 in the Second Affiliated Hospital of Soochow University. By apnea-hypopnea index (AHI), patients were separated into three subsets: AHI < 5 as control group, 5≤AHI<30 as mild-moderate OSAS group and AHI≥30as severe OSAS group. HRV and PSG parameters were collected based on electrocardiography and polysomnography system. Correlation analyses between standard deviation of R-R intervals (SDNN), SDNN index, RMSSD, PNN50, low frequency (LF), high frequency (HF) and LF/HF ratio and the AHI, ODI and MI were performed by Spearman's correlation analysis.

    Results: Compared with control group (64.5%) or mild-moderate OSAS group (67.3%), the prevalence of arrhythmias was considerably greater in severe OSAS group (P<0.05). Moreover, we demonstrated that LF/HF was greater in two OSAS groups than the normal group.

    Conclusion: Correlation analyses revealed a significant and positive relation between the LF/HF and AHI, ODI and MI in OSAS patients. Severe OSAS could be attributed to enhanced danger of incident arrhythmia. LF/HF ratio as a relevant feature may be an effective parameter for detecting OSAS.



  • XML | PDF | downloads: 261 | views: 320 | pages: 1512-1520

    Background: This cross-sectional study examined the association between types of living arrangements, quality of life, and mental health of the Korean elderly.

    Methods: We used secondary data analysis from the data of 4248 elderly people aged 65 yr or older that completed the Korea National Health and Nutrition Examination Survey (2010–2012). Data concerning participants’ demographic characteristics, living arrangements, quality of life, and mental health were used. Data were analyzed using the SAS survey procedure.

    Results: The living arrangements were as follows: living alone=18.3%, living with a spouse only =44.5%, living with family without a spouse =13.4%, and living with family including a spouse=23.8%. Mobility, self-care, usual activity, pain/discomfort, and anxiety/depression significantly differed by living arrangement. In the final model corrected for covariance, for the elderly living with their families without a spouse compared to the elderly living with a spouse only, the odds ratios were the following: stress =1.40 (95% CI: 1.03–1.91), depression=1.48 (95% CI: 1.07–2.04), and suicidal ideation=1.48 (95% CI: 1.10–2.00). The odds ratio of suicidal ideation of elderly living alone compared to the elderly living with a spouse only was 1.32 (95% CI: 1.01–1.72). Finally, the elderly living with family without a spouse or living alone had an increased risk of stress, depression, and suicidal ideation. In addition, they had decreased health-related quality of life.

    Conclusion: Health-related quality of life and mental health differ by living arrangement in elderly adults. Therefore, interventions to improve quality of life and mental health for the elderly who are living without a spouse are necessary.


  • XML | PDF | downloads: 208 | views: 234 | pages: 1521-1527

    Background: To analyze and summarize the effect of continuous care on the life quality and control of asthma of pediatric patients with asthma discharged from multiple hospitals.

    Methods: Retrospective analysis was carried out on 172 pediatric patients with asthma aged between 6 and 11 yr old randomly selected from those admitted to five hospitals between January 2014 and December 2015. Among these 172 patients, only 86 (intervention group) received the continuous care between January 2015 and December 2015, while the rest (control group) did not receive from January 2014 and December 2014.

    Results: After the patients in the intervention group were discharged from the hospital, the ratio of practical forced expiratory volume in one second (FEV1) to the expected FEV1 at the 12th month was (90.28±10.35)%, and the ratio of peak expiratory flow to the expected value was (84.24±3.43)%, respectively higher than those [(82.73±8.86)% and (75.80±4.67)%] in the control group. Regarding pediatric asthma quality of life questionnaire (PAQLQ) between the intervention group and the control group, the difference had statistical significance (Z=-7.254, P<0.05). Childhood asthma control test (C-ACT) comparison between the intervention group and the control group indicated that the difference had statistical significance (Z=-7.918, P<0.05).

    Conclusion: Continuous care can improve the pediatric patient’s pulmonary function and life quality, and effectively control the asthmatic symptoms.


  • XML | PDF | downloads: 184 | views: 261 | pages: 1528-1534

    Background: The purpose of this study was to compare the effects of the phytoestrogens in relieving and/or suppressing the specific somatic-vegetative symptoms of menopause with those of the hormone therapy, administered in small doses.

    Methods: The study was conducted in the County Clinical Emergency Hospital Oradea - Obstetric-Gynecological Ambulatory, and in private obstetrics-gynecology cabinets from Bihor County (NW Romania), from November 2011 to January 2014. Overall, 325 patients clinically diagnosed with specific postmenopausal symptomatology and not previously treated with phytoestrogens or hormone replacement therapy (HRT), were divided into 3 groups. Symptom assessment was performed with a standardized questionnaire named Menopause Rating Scale (MRS) in three phases: beginning of the treatment, after six months, and after one year. The administered doses for three different groups were as follows: 1 mg estradiol and 0.5 mg norethisterone acetate (NETA) p.o. daily (i.e. for the HRT group); 40 mg of isoflavones p.o. daily - i.e. 2 capsules of 40% standardized extract containing 20 mg of pure isoflavones: Genistein, Daidzein, and Glycitein (i.e. for the group with phytoestrogens); and no trreatment for the control group.

    Results: The evolution of the somatic-vegetative symptoms was better in both groups treated either with phytoestrogens or HRT (P<0.001) as opposed to the higher percentage of patients with stationary symptoms in the control group (i.e. 37.74% for control group, 16.13% for the group treated with phytoestrogens, respectively 18.95% for the group treated with HRT).

    Conclusion: Twelve months treatment study is a favorable evidence for the use of soy derived phytoestrogens in the treatment of somatic-vegetative symptoms at postmenopausal women.



  • XML | PDF | downloads: 179 | views: 260 | pages: 1535-1539

    Background: This study aimed to investigate the guiding effect of serum procalcitonin (PCT) on the antibiotic application to patients with sepsis.

    Methods: Ninety-eight patients with sepsis treated in Renmin Hospital of Wuhan University, China from 2015-2017 were enrolled. They were divided into two equal groups of control group and the observation group. Patients in the observation group received the antibiotic therapy guided by PCT while patients in the control group received the regular antibiotic therapy. The conventional indexes, prognosis and clinical effects of the two groups were compared.

    Results: There were no statistical significance in the differences of the Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores C-reactive protein (CRP) and white blood cell count (WBC) levels between the two groups. The duration of the antibiotic application to patients in the observation group was (7.74±0.61) d which was (10.22±0.78) d shorter than that to patients in the control group. The difference was statistically significant (P<0.05). The Intensive Care Unit (ICU) stay time and the hospital stays of patients in the observation group were shorter than those of patients in the control group. The difference had statistical significance (P<0.05). The difference in 30-day-recurrence rate and 30 day-mortality of the patients in the two groups had no statistical significance. There was statistically significant difference in the comparison of the clinical effects between the two groups.

    Conclusion: Guiding effects of the serum PCT on the application of antibiotics to patients with sepsis shorten the usage time of the antibiotics, ICU stay time and hospital stays.



  • XML | PDF | downloads: 466 | views: 367 | pages: 1540-1545

    Background: Mycotoxins are natural toxins, produced by several fungal species and are associated with morbidity or even mortality in animals, plants, and humans. In this study, 120 samples of herbs and spices in both bulk and packaged forms were prepared in order to measure aflatoxin level in different regions of Iran

    Methods: The aflatoxin was extracted during Mar to May 2015, using 80% methanol and then purified via immunoaffinity column. Measurements were performed, using high-performance liquid chromatography, equipped with a fluorescence detection system at excitation and emission wavelengths of 365 and 435 nm, respectively.

    Results: The highest prevalence of aflatoxin contamination in food products was attributed to aflatoxin B1 (30.8%). In addition, the highest prevalence of aflatoxin contamination was reported in red pepper (100%). Examination of effective factors indicated the substantial impact of moisture on aflatoxin level (P=0.046).

    Conclusion: Even at low levels of aflatoxin, contamination could be a serious threat, given the prevalent use of spices (either raw or not) as ingredients in food preparation. Therefore, regular monitoring of spices, especially chili pepper, is highly recommended.



  • XML | PDF | downloads: 245 | views: 349 | pages: 1546-1554

    Background: The prevalence of overweight and obesity have increased dramatically worldwide and together they constitute a major risk factor for coronary heart disease (CHD). The aim of this study was to assess the repeated measurements of body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR) in predicting CHD incidence.

    Methods: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study between 1999–2011, on 1959 women and 1371 men participants’ ages ≥30 yr, without a history of CVD. A joint modeling approach was utilized for data analysis using R software. The resulting joint model allowed measuring α (quantifies the association between anthropometric indices up to time t and the hazard for CHD event at the same time point).

    Results: About 9% of the participants (7.1% of the women and 11.7% of the men) experienced CHD event during follow-up. The results indicated a significant linear increasing trend in BMI, WC, WHR, and WHtR over time (P<0.001). The increased risk of CHD event in females increases with the values of BMI (α= 0.004, P=0.023), WC (α= 0.018, P=0.009), WHR (α= 0.067, P=0.014) and WHtR (α= 0.106, P=0.002). Furthermore, in males the risk of CHD risk increases by the values of BMI (α= 0.005, P=0.032), WC (α= 0.019, P=0.008), WHR (α= 0.043, P=0.015) and WHtR (α= 0.096, P=0.002).

    Conclusion: By jointly modeling longitudinal data with time-to-event outcomes, our study revealed that WHtR is superior to other indices in predicting CHD incidence.



  • XML | PDF | downloads: 284 | views: 397 | pages: 1555-1562

    Background: This study aimed to identify and prioritize factors affecting the development of military hospital beds and provide a model using fuzzy analytical hierarchy process (Fuzzy AHP).

    Methods: This applied study was conducted in 2016 in Iran using a mixed method. The sample included experts in the field of military health care system. The MAXQDA 10.0 and Expert Choice 10.0 software were used for analyzing the collected data.

    Results: Geographic situation, demographic status, economic status, health status, health care centers and organizations, financial and human resources, laws and regulations and by-laws, and the military nature of service recipients had effects on the development of military hospital beds. The military nature of service recipients (S=0.249) and economic status (S=0.040) received the highest and lowest priorities, respectively.

    Conclusion: Providing direct health care services to the military forces in order to maintain their dignity, and according to its effects in the crisis, as well as the necessity for maintaining the security of the armed forces, and the hospital beds per capita based on the existing laws, regulations and bylaws are of utmost importance.



  • XML | PDF | downloads: 224 | views: 292 | pages: 1563-1571

    Background: Breast cancer is one of the most common cancers with a high mortality rate among women. Prognosis and early diagnosis of breast cancer among women society reduce considerable rate of their mortality. Nowadays, due to this illness, try to be setting up intelligent systems, which can predict and early diagnose this cancer, and reduce mortality of women society.

    Methods: Overall, 208 samples were collected from 2014 to 2015 from two oncologist offices and Javadalaemeh Clinic in Kerman, southeastern Iran. Data source was medical records of patients, then 64 data mining models in MATLAB and WEKA software were used, eventually these measured precision and accuracy of data mining models.

    Results: Among 64 data mining models, Bayes-Net model had 95.67% of accuracy and 95.70% of precision; therefore, was introduced as the best model for prognosis and diagnosis of breast cancer.

    Conclusion: Intelligent and reliable data mining models are proposed. Hence, these models are recommended as a useful tool for breast cancer prediction as well as medical decision-making.



Short Communication(s)

  • XML | PDF | downloads: 198 | views: 228 | pages: 1572-1578

    Background: Arrangement of effective management aimed at improving dermatological services and consistent care of patients with skin diseases depends on understanding the epidemiological situation.

    Methods: This retrospective study presents an epidemiological assessment of non-neoplastic skin and subcutaneous tissue diseases in Kazakhstan registered in 2003-2015.

    Results: The yearly incidence rate of the diseases among the whole population was in average 3,341.8±121.1per 100000 population. This represents 4835.0±156.1 for children, 5503.2±141.8 for adolescents and 2646.6±106.7for adults per 100000 inhabitants.Space and time incidence rate was evaluated according to the administrative division. The overall trend decreased to 3.5% in children to 2.8% in adolescents to 1.9%, and in adults to 3.9%. Considerable variation in rates was seen across the country, with highest rates in East Kazakhstan, Mangystau and Aktobe regions, the lowest – in Atyrau and South-Kazakhstan regions.

    Conclusion: Non-neoplastic diseases of skin and subcutaneous tissue continue to be an urgent public health problem, especially among children in many regions of Kazakhstan.



Case Report(s)

  • XML | PDF | downloads: 191 | views: 241 | pages: 1579-1582

    Vascular lesions of the central nervous system are one of the most important and topical problems in modern neuropathology. Bulgaria is among the first in morbidity and mortality from cerebrovascular diseases. Because of the significant medical and social importance of this pathology resulting in severe disabling of most survivors, we aimed to explore the effectiveness of kinesitherapeutic methodology applied in the recovery of a patient with ischemic stroke. We present a case of a 69-old patient admitted in the Neurological Ward of “St. George Hospital in Plovdiv in 2015, Bulgaria with right hemiparesis due to ischemic stroke in the basin of the left middle cerebral artery. The applied Kinesitherapeutic methodology included various techniques like Kabat’s Bobath’s methods as well as training in equilibrium and walking. The patient obtained satisfactory results in terms of movement of the body and preserving the equilibrium, improvement of voluntary movement of the upper and lower right limb achieved via the help of some compensatory mechanisms. Despite the applied Kinesitherapy, the patient failed to gain independence in daily activities. We ascribe this satisfactory recovery only to the short period of application of kinesitherapeutic methodology. For a better recovery of patients with cerebrovascular disease, a continuous multidisciplinary approach is needed.



Letter to the Editor