Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 1 7 AA Haghdoost A Mirzazadeh S Alikhani 2015 10 03 Background: Iran, a low- to middle-income country, has experienced considerable socioeconomic changes in 20th century, which their impacts on the adult heights has not been assessed deeply by now. This article aims to quantify the temporal varia­tions of height (with respect to shrinkage of height due to aging) and its deterministic factors in Iranian population born be­tween 1940 and 1984. Methods: We analyzed the data of a large-scale national population- based survey that recruited 89,532 healthy subjects aged from 15 to 64 in 2005. Having used the Baltimore Longitudinal Study of Aging formulae, the shrinkage of height due to aging was adjusted. We modeled the estimated maximum height using multivariate regression analysis based on year of birth, sex, residing area and literacy. Moreover, we generated series of country maps showing the average of height classi­fied by decades and provinces. Results: On average, the height of Iranian population has increased around 1.28 cm per decade (1.17cm in females; 1.53cm in males). The most prominent jumps of male and female heights are observed in 1970s. However, the jump of height in women has occurred around 3.5-10 years later than in men. Conclusion: We found a very sharp and clear increasing trend in height among those who were born between 1940 and 1984. Our findings support the fact that the socio-economical variations have had considerable impact on the maximum height of people; this can prove the population height measure as a good historical determinant for socio-economical de­velop­ment trend. https://ijph.tums.ac.ir/index.php/ijph/article/view/2066 https://ijph.tums.ac.ir/index.php/ijph/article/download/2066/2047

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 8 19 M Mohebbi K Nourijelyani M Mahmoudi K Mohammad H Zeraati A Fotouhi B Moghadaszadeh 2015 10 03 Background: Previous studies indicate a high incidence of digestive cancers along southern parts of Caspian Sea including Ma­zandaran Province. The present study was conducted to further investigate time to occurrence, age distribution and pos­sible risks associated with the incidence time of digestive cancers in the above regions. Methods: For this purpose the data of digestive cancer incidence of 3723 cases during a five-year period of 2001 to 2005 col­lected from Babol Cancer Registry Center in Iran. Almost all cancer cases residence of Mazandaran Province is included in this study and so the results could be considered a population-based conclusion. In order to modify the mortality due to other causes before digestive cancers, and to adjust the effect of digestive cancers correlations, a competing risks model was used. The Cox regression model was used for study of risk factors on cancer incidence. Results: Although incidence of colorectal cancer was relatively low, however, unfortunately the age of onset was at the age cate­gory of 15-19, much sooner than occurrence of stomach cancer which was at 20-24 yr (P< 0.0001), and esophageal can­cer at age category of 30-34 yr (P< 0.0001). Conclusion: Life tables of all digestive cancer, esophageal cancer, stomach and colorectal cancers were presented in this pa­per. Risks related to these cancers are significantly higher in men and residences of urban areas than their baseline coun­terparts. (P< 0.0001) More studies needed to identify risk factors and high risk cases for screening and prevention programs. https://ijph.tums.ac.ir/index.php/ijph/article/view/2067 https://ijph.tums.ac.ir/index.php/ijph/article/download/2067/2048

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 20 30 H Karimzadegan M Rahmatian DD Farhud M Yunesian 2015 10 03 Background: Air pollution in Tehran, capital of Iran is responsible for several diverse negative effects. It has been estab­lished that air pollution can affect human health. These health effects include increased hospital admissions due to the ex­acerba­tion of cardiac and respiratory diseases, as well as symptoms such as headache, cough, eye irritation, nausea, sputum and even death in the most vulnerable individuals. In evaluating any policy that would reduce air pollution, it is useful to com­pare the policy's costs to its benefits expressed in monetary units. Methods: Since there is no market available that places value on the benefits of improved air quality, we must undertake non market valuation methods. In this paper we used direct medical cost (DMC), contingent valuation (CV) and value of sta­tisti­cal life (VOSL) approaches and household production model of health. According to this study marginal health dam­age costs for the following type of pollutants impacts: sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter (PM10) and carbon monoxide (CO) are quantified using exposure response functions(ERF) which relate pollutant con­centra­tion to the resulting impact on a receptor(health). ERFs for health impacts are derived from epidemiological studies. Results: Health damage costs has been estimated at 16224 US$ per each unit increase of PM10, 28816 US$ per each unit in­crease of CO, 1927 US$ per each unit increase of NO2 and 7739 US$ per each unit increase of SO2. Conclusion: Substituting economic incentives for command and control approach to regulating air quality. https://ijph.tums.ac.ir/index.php/ijph/article/view/2068 https://ijph.tums.ac.ir/index.php/ijph/article/download/2068/2049

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 31 34 MR Razavi SR Naddaf JLe Bras A Raesi AR Esmaeili M Assmar 2015 10 03 Background: Point mutations in the genes, Pfcrt and Pfdhfr, have been identified elsewhere as strongly associated with re­sistance to chloroquine (CQ) and pyrimethamine, respectively.  Methods: Using a restriction digestion method, we report the frequency of two important mutations, T76 and Asn108, re­spon­sible for conferring resistance to chloroquine and pyrimethamine, respectively, in patients residing in malarious areas of southeastern Iran. Results: Ninety eight and 84% of the patients were found to harbor chloroquine resistant (theronine-76) and pyrimethamine resis­tant (aspargin-108) mutants, respectively. Conclusions: Despite the high frequency of T76 and Asn 108 mutations in Iranian patients, combination of CQ and pyrimethamine-sulfadoxine (SP) was shown to be quite successful with 100% adequate clinical and parasitological re­sponses. https://ijph.tums.ac.ir/index.php/ijph/article/view/2069 https://ijph.tums.ac.ir/index.php/ijph/article/download/2069/2050

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 35 41 E Nasseri M Djalali SA Keshavarz M Hosseini AR Dorosty M Chamari 2015 10 03 Background: Adiponectin is an anti-inflammatory and antiatherogenic protein that has a protective effect against athero­sclero­sis and diabetes. It is exclusively secreted by adipose tissue. Serum adiponectin levels are inversely associated with pa­rame­ters of overall adiposity including body mass index (BMI), fat mass, and percentage of body fat. Methods: In a cross-sectional study of 76 women we sought to evaluate if adiponectin is associated primarily with central adi­pos­ity rather than overall adiposity. We also assessed adiponectin changes after weight loss in a subgroup of 42 obese sub­jects. Results: Waist to hip ratio (WHR), an index of central obesity, was the only variable independently associated to adi­ponectin (Beta= 0.25, P< 0.05). A mean increase of 8.2±24.2% in adiponectin concentration was observed in response to the dietary restriction and weight loss (P= 0.03). Our findings provide evidence for association of serum adiponectin level with visceral fat, represented by waist to hip ratio index. Conclusion: Moderate weight loss result in significant improvements in adiponectin concentration and provide another bio­logi­cal explanation for the beneficial effect of body weight loss on reducing cardiovascular and diabetes risks in obese pa­tients. https://ijph.tums.ac.ir/index.php/ijph/article/view/2070 https://ijph.tums.ac.ir/index.php/ijph/article/download/2070/2051

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 42 47 A Karami KH Naghavi R Sorouri R Ranjbar A Khalilpour 2015 10 03 Background: Enterobacteriaceae are a large group of bacteria widely distributed in nature. Escherichia coli is the most com­mon cause of urinary tract infection. Two amino acid substitutions, in GyrA, are commonly responsible for quinolone re­sistance in E. coli. The aim of this study was molecular survey of nalidixic acid resistance E.coli isolated from patients in the codones of 83 and 87 gyrA genes. Methods: During 5 months (January to June 2005) of Molecular Survey of Nalidixic Acid Resistance, one hundred and twenty-one E. coli isolates from urine samples of patients referred to clinical laboratory of Baqiyatallah Hospital were cul­tured. Differential tests were done for diagnosis of E.coli. An economical and time-efficient mismatch amplification muta­tion assay (MAMA) PCR was developed to detect mutations in the chromosomal gyrA gene causing these substitutions. Results: In nalidixic acid antibiogram test, 55 cases (45.5%) were sensitive, 63 cases (52%) were resistant and 3 cases (2.5%) were intermediate. Results of PCR and MIC were similar to antibiogram. There was not any mutation in the sensi­tive samples but there were performed five mutations on the 85, 81, 107, 97 and 87 codones of resistance samples. The codone number 87s mutation is one of the main mutations of nalidixic acid resistance. Conclusion: Depending on results of this study and comparison with other studies, trend of resistance of E.coli is increas­ing. Therefore, we recommend control of antibiotic misusage and application of MIC and PCR tests (if possible) prior to treat­ment for suitable selection of antibiotic and prevention of microbial resistance. https://ijph.tums.ac.ir/index.php/ijph/article/view/2071 https://ijph.tums.ac.ir/index.php/ijph/article/download/2071/2052

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 48 53 S Hosseini N Nayebi B Amirkalali N Seyedkhoei R Heshmat 2015 10 03 Background: Primary prevention status and goals in 2010 are promoting healthy weight and eating habits and dietary ma­nipula­tion considered in all reports to be the cornerstone of prevention and management of chronic diseases. Since in de­velop­ing countries physicians are in the front line of responding patients' questions regarding their diet, we decided to evalu­ate their necessary nutritional knowledge for accomplishing this mission and to identify consideration for improving the paucity of nutrition education and the nutrition literacy in medical training program, we did the same education in medi­cal students. Methods: Applied nutritional knowledge of 150 general, specialist and sub specialist physicians and 202 medical students was evaluated by structured self administrative questionnaire. Eighteen questions which could be self completed in less than 5 minutes were filled by each subject. Results: The percentage of physicians who gave dietary recommendations to their patients was 73% but the mean correct re­sponds to questions were 3.73±2.15 and 5.87±2.14 out of 14 questions in physicians and medical students respectively. Conclusions: Our data show deficient applied nutritional knowledge of physicians is one of   the main problems of hospital mal­nu­trition. As the same results were shown in medical students, this can not be due to forgetting what was learned but can be related to the quality of nutrition training.   https://ijph.tums.ac.ir/index.php/ijph/article/view/2072 https://ijph.tums.ac.ir/index.php/ijph/article/download/2072/2053

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 1 2008 03 15 54 60 E Kazemi-Rad M Mohebali H Hajjaran S Rezaei S Mamishi 2015 10 03 Background: Direct identification of Leishmania species in Giemsa-stained slides without parasite cultur/web_url> https://ijph.tums.ac.ir/index.php/ijph/article/download/2055/2036

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 59 63 A Farahnak N Dabagh 2015 10 03 Background: Cercariae (larva of helminth parasites) are covered by a thick glycocalyx coat, which serves as an osmotic pro­tection during their free existence, and contain carbohydrates conjugated as glycoproteins, glycolipids and mu­co­polysaccharides. Although, limited studies have been made on life cycle of cercariae from fresh water snails, however, car­bo­hydrate studies on cercariae have not been done in Iran so far. This study was made to determine the cercariae speci­fica­tions from Lymnaea gedrosiana and evaluation of surface carbohydrates as receptors for host lectins in a host-parasite rela­tionship system as a model in human schistosomiasis including cercarial dermatitis in Khuzestan Province. Methods: For this purpose, snails were collected from Dezful region in Khuzestan Province and cercariae were obtained by shed­ding method and identified by valuable keys. Experimental infection was established in the Culex pipiens (Culicidae mos­quitoes) larvae for further identification and mode of adhesion. To detect the mode of adhesion, surface carbohydrates of cercariae were detected by lentil (Lens culinaris) lectins. Results: Examined snails were infected with xiphidiocerceria of trematodes and metacercariae were obtained from Culex pipiens. Also, Mannose monosaccharides- CH2OH (CHOH) 4CHO - were detected particularly on the glands of cercariae. Conclusion: Adhesion of cercariae to their host by lectins-carbohydrates bonds is the first stage of host-parasite relation­ship. This phenomenon could be happened for animal schistosome's cercaria in cercarial dermatitis. https://ijph.tums.ac.ir/index.php/ijph/article/view/2056 https://ijph.tums.ac.ir/index.php/ijph/article/download/2056/2037

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 64 74 S Nasseri-Moghaddam H Razjouyan R Habibi K Rafaat-Zand B Ahrari M Nouraie R Majdzadeh H Vahedi R Malekzadeh 2015 10 03 Background: Gastroesophageal reflux disease (GERD) is prevalent in the West. Mayo-GERQ is one of the most widely used questionnaires for screening GERD. We validated GERQ in an Iranian population. Methods: The Mayo-GERQ was translated into Persian (P-GERQ) and reviewed and commented by two gastroenterolo­gists. Eleven lay-people filled it in and commented on it. Reliability was assessed by test-retest within 2-6 wks in 53 hos­pital staff. Concurrent-validity was checked in another 53, comparing the results of the self-administered questionnaire with the questionnaires filled in by a gastroenterologist interviewing them. Weighted-kappa (kw) statistics was used. Time needed to complete the questionnaire, practicability of the directions and linguistic eloquence were checked (feasibility indi­ces). Results were used to modify P-GERQ. The modified P-GERQ was tested in another 99 hospital employees in the same man­ner. Results: Phase-one; One-hundred seventeen subjects were enrolled (46 men). Mean time for completion was 23.7 minutes. Mean kw for reliability was 0.47 and that for validity 0.26. Sources of poor performance were sought, P-GERQ was revised and underwent validation again (2nd phase). Phase-two: Ninety-nine individuals were enrolled (37 men). The modified P-GERQ took 15.8+/-11.9 min to complete. k-values for concurrent-validity of major symptoms (acid-regurgitation, heart­burn) were 0.70 and 0.67 respectively. Corresponding k-values for reliability were 0.57 and 0.80. Conclusions: P-GERQ was not valid initially. After making appropriate technical and linguistic changes, it achieved accept­able validity, reliability and feasibility. In addition to making available a useful tool for population-based studies, our re­sults underscore the importance of validation before adopting a translated questionnaire. https://ijph.tums.ac.ir/index.php/ijph/article/view/2057 https://ijph.tums.ac.ir/index.php/ijph/article/download/2057/2038

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 75 82 Z Babaei H Oormazdi L Akhlaghi S Rezaie E Razmjou SK Soltani- Arabshahi AR Meamar R Hadighi 2015 10 03 Background: This study was conducted to determine of molecular epidemiology of the Giardia lamblia by PCR-RFLP method in Tehran, capital of Iran. Methods: Thirty eight stool samples were randomly selected from 125 patients diagnosed with giardiasis using microscopy in Tehran. DNA extraction of some samples were performed by phenol/chloroform/isoamyl alcohol method and to raise the sen­sitivity of the PCR assay, the genomic DNA of the others were extracted using glass beads and the QIAamp Stool Mini Kit in order to effectively remove the PCR inhibitors. A single step PCR-RFLP assay, targeting the glutamate dehydro­genase (gdh) locus, was used to differentiate within and between assemblages A and B that have been found in humans. Results: Of the 38 isolates, 33 samples (87%) were found as G. lamblia (genotype AII), 3 (7.8%) belonged to assemblage B, genotype BIII, the mixed of genotype AII and B were detected only in two samples (5.2%). Conclusions: PCR-RFLP is a sensitive and powerful analytical tool that allows effective genotype discrimination within and between assemblages at targeting gdh gene, and makes it possible to identify the presence of mixed genotypes. Our data sug­gest that there is an anthroponotic origin of the infection route, assemblage A group II, in Tehran so it seems that the main reservoir of Giardia infection is humans in the area studies. https://ijph.tums.ac.ir/index.php/ijph/article/view/2058 https://ijph.tums.ac.ir/index.php/ijph/article/download/2058/2039

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 83 87 R Ranjbar MR Pourshafie N Sadeghifard A Karami M Hamidian M Izadi M Parzadeh N Jonaidi 2015 10 03 Background: Epidemic and endemic cholera is a major public health problem for many   countries. Aim of this study was to evaluate AP-PCR for investigation of clonal relatedness among the strains of Vibrio cholerae recovered from an out­break occurred in different parts of Iran in 2005. Methods: The study was conducted during the cholera outbreak occurred in some of provinces in Iran in summer 2005. Bac­terial isolation and identification was carried out according to the standard bacteriological methods. Arbitrarily primed PCR (AP-PCR) used to study the genetic relatedness between the V.cholerae isolates. Results: Thirty-nine isolates of V.cholerae O1 were identified. All isolates belonged to serotype Inaba. AP-PCR could dif­ferentiate the isolates into five groups. AP-PCR cluster types 1 and 2 were the most prevalent groups, accounting for 36% and 41%, respectively, of V.cholerae isolates. Conclusion: The most of epidemic strains of V.cholerae O1 isolated in the year 2005 could be attributed to two pre­dominant clusters including AP-PCR cluster types 1 and 2 accounting for more than 77% of isolates. In conclusion, a few epidemic clones were responsible for the apparently epidemic occurrence of cholera in provinces studied. https://ijph.tums.ac.ir/index.php/ijph/article/view/2059 https://ijph.tums.ac.ir/index.php/ijph/article/download/2059/2040

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 88 92 L Giahi A Djazayery A Rahimy M Rahmany B Larijani 2015 10 03 Background: Adiponectin is a protein produced exclusively by adipose tissue; the reduced level of which has been shown to be involved in a variety of obesity-related disorders, such as insulin resistance and diabetes, in different eth­nic groups. This cross-sectional study was conducted to determine adiponectin level and its association with insu­lin sensitivity in 20 adult overweight type-2 diabetic and 20 healthy over-weight non-diabetic Iranian men for the first time. Methods: Body fat mass (Bio-electric impedance), serum level of adiponectin (ELISA), fasting blood sugar and fasting in­sulin were measured. Insulin sensitivity was calculated using QUICKI. Results: As expected, the mean adiponectin concentration was lower in diabetics (7.7 ±3µg/ml) than non-diabetics (8.1 ± 2µg/ml); however, the difference did not achieve statistical significance (P= 0.5). Adiponectin negatively cor­related with fat mass. This correlation was stronger in diabetics with a higher fat mass (r= -0.3 in diabetics vs. r= -0.01 in non-diabetics; p: N.S.). Adiponectin positively related with insulin sensitivity in both groups, although this rela­tion was only statistically sig­nificant in non-diabetics (r= +0.5; P= 0.04). The relation between insulin sensitivity and mean of adiponectin level was mar­ginally significant even after adjustment for group (diabetic and non-dia­betic), age and fat mass. Conclusion: Our findings are consistent with the studies on different ethnic groups which have indicated lower adi­ponectin lev­els in diabetics. Also our results confirm the relationship between a low adiponectin level and insulin sen­sitivity reported in earlier studies. https://ijph.tums.ac.ir/index.php/ijph/article/view/2060 https://ijph.tums.ac.ir/index.php/ijph/article/download/2060/2041

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 93 100 B Attarbashi Moghadam H Bagheri MR Hadian K Tavakol M Salarifar M Nejatian 2015 10 03 Background: Strengthening exercises are not favored in the rehabilitation of patients after coronary artery bypass grafts (CABG) for concerns over potential adverse effects. However, patients often present with weakened skeletal muscles post CABG due to disuse. Methods: We studied the effects of aerobic and strengthening exercises on the serum C-reactive protein (CRP) levels and blood pressure in 79 post CABG patients aged 40-60 years.  Patients were randomly assigned to one of four programs five days per week, consisting of either aerobic exercises alone (controls) or combined with strengthening exercises (experimen­tals) at moderate intensity. The serum CRP levels were quantified at the beginning, 12th and 24th sessions, and at 3-month fol­low-up. Patients' blood pressure was measured before and after each exercise session.  Patients were re-evaluated at 3-month follow-up. Results: There was a mild but significant increase in the CRP levels at 12th session in all groups.  Patients systolic blood pres­sures declined by 2%-7% at 12th and 24th sessions, respectively. There was no significant difference in changes of blood pres­sure among the groups. Conclusion: The results suggest that the four exercise programs were equally safe in low-risk, post CABG patients. Exer­cises did not promote a systemic inflammatory response. These beneficial effects were still evident at 3-month follow-up. https://ijph.tums.ac.ir/index.php/ijph/article/view/2061 https://ijph.tums.ac.ir/index.php/ijph/article/download/2061/2042

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 101 105 F Mojarrad P Bakianian Vaziri 2015 10 03 Background: Since the earliest days of medicine, the tongue has been considered a good reflection of systemic disease. Hip­pocrates, Galen and others considered the tongue to be barometer of health. In addition, the early diagnose of tongue le­sions help to recognize the some systemic diseases. The purpose of this study was to determine the frequency of different mor­phological variations (anomaly) of the tongue in a population of school children aged 6-12 years in Hamadan, Iran. Method: This cross sectional study was held with questionnaires and face-to-face interview among 1600 schoolchildren 6- 12 years old (800 girls, 800 boys) with cluster randomize method were selected and examined. Each school was considered as a cluster that was selected by randomized selections in view of the total sample size. Results: Tongue lesions were found in 39.7% of the children. Overall, the most frequent condition was geographic tongue (27%) and fissured tongue (12.9%). Microglosia and median rhomboid glossitis were in 0.2% of cases. Conclusion: The present study indicates a higher frequency of tongue abnormalities specially geographic tongue than previ­ous studies however further investigation are required to indicate if hereditary and congenital factors play a vital role or if the environmental factors in this region vary with those in their regions. On the other hand the findings from this survey should serve as a baseline for future studies. https://ijph.tums.ac.ir/index.php/ijph/article/view/2062 https://ijph.tums.ac.ir/index.php/ijph/article/download/2062/2043

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 106 111 P Derakhshandeh-Peykar H Hourfar M Heidari M Kheirollahi M Miryounesi 2015 10 03 Background: β-thalassemia is a common autosomal recessive disorder resulting from over 200 different mutations of beta glo­bin genes. The aim of the present study was to identify the distribution and frequency of the most com­mon β-thalassemia mu­tations among the population of Isfahan Province in central Iran. Methods: The data presented here were derived from a total of 114 β-thalassemia chromosomes of 18 affected pa­tients and 78 unrelated carriers identified in our screening program. Furthermore, 23 pregnant women were analyzed among couples with a PND request for β-thalassemia. Allele identification was carried out using routine Reverse Dot Blot, ARMS, and ge­nomic sequencing. Results: The most common mutation, IVS-II-I, followed by FSC-36-37, IVS-I-5, FSC-8-9, IVS-I-110, IVS-I,3'-end; -25bp, IVS-II-745, FSC-8, Cd-39, FSC-22-24, IVS-I-1, Cd-44, IVSII-2,3 (+11/-2), IVS-I-6, and FSC-16, respectively. The pre­sent study not only provides a guide for distribution and frequency of both recurrent and uncommon mutations, but also for the first time, reports a rare b-thalassemia mutation, IVSII-2, 3 (+11/-2), in the Isfahan province of Iran. Conclusion: The information presented here could greatly facilitate screening for β-thalassemia and prenatal diagno­sis in the prov­ince of Isfahan. https://ijph.tums.ac.ir/index.php/ijph/article/view/2063 https://ijph.tums.ac.ir/index.php/ijph/article/download/2063/2044

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 112 119 H Ozden O Elcioglu 2015 10 03 There are various ethical approaches in the history of philosophy. Beauchamp and Childress introduced four basic principles which were acceptable in all communities: beneficence, non-maleficence, respect for autonomy and jus­tice. Yusuf Khass Hajib is the first author of the Islamic Turkish Literature whose work was found out. This study aims to reveal the existence of four principles of bioethics in this work, in Kutadgu Bilig, presented to the prince of Karakhanids, Tavgach Bugra Khan, by Yusuf Khass Hajib in 1069-1070. It was found out in this study that all these principles were included in Kutadgu Bilig in different forms. The principles that Beauchamp and Childress argued to be acceptable in all communities and all cultures have already existed in different communities in different ages. Yusuf Khass Hajib's work, Kutadgu Bilig, constitutes a good example of this reality. https://ijph.tums.ac.ir/index.php/ijph/article/view/2064 https://ijph.tums.ac.ir/index.php/ijph/article/download/2064/2045

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 37 2 2008 06 15 120 122 Gh Mowlavi