Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 155 69 Jiabi Qin Division of Medical Genetics, Maternal and Child Health Hospital of Hunan Province, Hunan, China AND Skate Key Laboratory of Medical Genetics, Central South University, Hunan, China. Tubao Yang Dept. of Epidemiology and Health Statistics, School of Public Health, Central South University, Hunan, China. Hua Wang Division of Medical Genetics, Maternal and Child Health Hospital of Hunan Province, Hunan, China. Tiejian Feng Dept. of Dermatology and Venereal Disease, Shenzhen Center for Chronic Disease Control and Prevention, Shenzhen, China. Xiaoying Liu Caimao Hospital of Hunan Province, Hunan, China. 2015 10 14 Background: Several studies have been conducted in China in order to investigate the potential predictors of serofast state after treatment among syphilitic patients. However, there is a remarkable diversity among the results. This metaanalysis was conducted to assess potential predictors of serofast among syphilitic patients in China. Methods: International and national electronic databases were searched up to September 2013. Reference lists of retrieved articles were also reviewed. Cohort or case-control studies addressing risk factors of serofast among syphilitic patients were included in this study. Results: We assessed 27 separate studies involving overall 6682 HIV-negative participants with syphilis of which 1962 remained in the serofast state. The serofast was positively associated with older age(Ptrend=0.001), female(summary risk ratio[sRR]=1.50, 95%CI:1.34-1.68), latent syphilis(sRRlatent vs primary=3.17, 95%CI: 2.66-3.77; sRRlatent vs secondary=2.00, 95%CI: 1.48-2.69) as well as non-penicillin treatment(sRR =2.99, 95%CI:2.45-3.67), but negatively associated with higher baseline titers(sRR>1:32 vs ≤1:32=0.63, 95%CI: 0.54-0.75). Compared with healthy group and serological cure group, respectively, the levels of CD4 (+), IL-2, and IL-6 among serofast patients were decreased (standardized mean difference[SMD]<0, P<0.05), but the levels of CD8(+) and IL-10 were increased(SMD>0, P<0.05). Some studies also hinted the serofast was associated with subtypes i of treponema pallidum(TP) repeat gene (RR i vs d=4.67,95%CI: 1.31- 16.69) and TP occult infection. Conclusion: The age, gender, stage of infection, baseline titers, treatment drug, cellular immune suppression and disorders, TP occult infection and subtypes i of TP repeat gene should be considered as important predictors of serofast. However, until now the definition and mechanism of serofast has still been not clear. https://ijph.tums.ac.ir/index.php/ijph/article/view/3704 https://ijph.tums.ac.ir/index.php/ijph/article/download/3704/3378

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 170 5 Khalid M Almutairi Dept. of Community Health Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia. 2015 10 14 Background: In this study, we investigated the causes behind increase trends in smoking and extent of tobacco use in Saudi Arabia. We also explored the issues related to and its impact tobacco control research and policy in the Kingdom. Methods: Data were collected from various published articles, public data based such as WHO, Geneva and CDC Atlanta. Data were also obtained from surveys conducted by various institutions under The Global Youth Tobacco Survey (GYTS) for high school students and Global Adult Tobacco Survey (GATS) for medical student. Tobacco importation data and death rates were estimated by various International Organizations. Results: Tobacco importation in Saudi Arabia increased from 1996 to 2012. The proportion of smokers in the KSA almost doubled especially in males from 21% in 1996 to 37% in 2012. Mortality attributable to tobacco in the KSA was estimated to account for 280, 000 premature deaths over the same period (without accounting for smuggled tobacco). The economic burden of tobacco consumption over the last 10 years (2001–2010) in the KSA was 20.5 billion US dollars (based on 2011 prices). Anti-tobacco measures in KSA have been reinforced by the enactment of antitobacco laws and collaboration among different government agencies and ministries. Conclusion: If effective tobacco control strategies are not enacted, serious consequences, increasing premature mortality rates among them, will continue to threaten the KSA. https://ijph.tums.ac.ir/index.php/ijph/article/view/3702 https://ijph.tums.ac.ir/index.php/ijph/article/download/3702/3376

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 176 84 Sadaf Raana Dept. of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan. Aqeel Javeed Dept. of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan. 2015 10 14 Background: Epidemiological evidence shows that cancer and diabetes are major causes of death in the world. Type2 diabetes increases the risk of cancer-specific mortality. This review relates diabetic therapies, diabetes and cancer. Method: All published papers in this field were searched, looking into such databases as Science Direct, ISI Web of Knowledge, PubMed and Scopus. Results: In cancer patients, metformin improves patient outcome and reduces cancer risk. Sulfonylureas may increase risk of cancer, but decreased risk of cancer is associated with thiazolidinediones in type2 diabetic subjects. Metformin lowers circulating insulin and it may be important for treatment of hyperinsulinemia-associated cancers, such as colon and breast cancer. Conclusion: However, laboratory investigations and large-scale population based studies are required for further investigation of association of cancer-preventive, anti-cancer and cancer-mortality of noninsulin antidiabetics. https://ijph.tums.ac.ir/index.php/ijph/article/view/3700 https://ijph.tums.ac.ir/index.php/ijph/article/download/3700/3374

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 185 93 Yongmei Yin The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China AND The Hospital for Infectious Diseases of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China. Jie Qin The Mental Health Center of Wuxi, Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China. Yaping Dai The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China AND The Hospital for Infectious Diseases of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China. Fanwei Zeng Dept. of Basic Medical Sciences, Medical College, Xiamen University, Xiamen, Fujian, China. Hao Pei The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China AND The Hospital for Infectious Diseases of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China. Jun Wang The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China AND The Hospital for Infectious Diseases of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China. 2015 10 14 Background: The ratio of CD4+/CD8+ has been used as a clinically index to evaluate patients’ immunity. Numerous researchers have studied CD4+/CD8+ ratio in pulmonary tuberculosis (PTB) patients. However, the change of CD4+/CD8+ ratio remains controversial. We present a meta-analysis of 15 case-control studies to identify the change of CD4+/CD8+ ratio in PTB patients. Methods: We assessed heterogeneity of effect estimates within each group using I2 test. Subgroup analysis was performed to explore the potential source of heterogeneity. To investigate further the potential publication bias, we visually examined the funnel plots. For robustness of results, we performed sensitivity analysis by removing studies. Data entry and analyses were carried out with RevMan 5.2 (The Nordic Cochrane Centre). Results: Twelve peripheral blood studies were categorized into two subgroups. Eight studies presented a significant decrease of CD4+/CD8+ ratio in PTB cases compared to healthy subjects (SMD: -0.45; 95% CI -0.65–-0.25; I2 = 7%). Other four studies researched on the newly diagnosed patients presented a more seriously and significantly decrease (SMD: -2.17; 95% CI -2.61–-1.74; I2 = 37%). The pooled analysis of bronchoalveolar lavage fluid (BALF) studies showed a significant increase of CD4+/CD8+ ratio using Flow Cytometry (FCM) (SMD: 4.75; 95% CI 3.44–6.05; I 2 =0%). Conclusion: The present meta-analysis indicated that there was a synthetic evidence for the reduced CD4+/CD8+ ratio in peripheral blood of PTB patients, especially newly diagnosed cases. However, the CD4+/CD8+ ratio in BALF was increased using method of FCM. https://ijph.tums.ac.ir/index.php/ijph/article/view/3698 https://ijph.tums.ac.ir/index.php/ijph/article/download/3698/3372

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 194 202 Lela Tsitaishvili Faculty of Medicine. Tbilisi State University of Iv. Javakhishvili, Tbilisi, Georgia. Manana Kalandadze Dept. of Stomatology and Maxillo-Facial Surgery, Tbilisi State University of Iv. Javakhishvili, Tbilisi, Georgia. Vladimer Margvelashvili Dept. of Stomatology and Maxillo-Facial Surgery, Tbilisi State University of Iv. Javakhishvili, Tbilisi, Georgia. 2015 10 14 Background: Georgia is a country with a Human Development Index (HDI) score of 0.733. Significant deterioration in socio-economic conditions in the 1990s caused serious health problems in the population including oral health. Since then, there has not been an epidemiological survey of dental diseases among the adult population in Georgia. Methods: The pathfinder survey- cluster- stratified method derived by WHO was used for sampling. Overall, 2370 adults including 1289 women and 1081 men in nine regions of Georgia including the residents of a city, town and village in each region and the capital, Tbilisi, were examined. Four age groups were investigated including: I- (20-34), II- (35-44), III-(45-64), IV- (65-74). Results: Unhealthy periodontal tissues were observed in 66.9% of men and in 57.5% of women. Bleeding on probing occurred in 44.9% of men and 37.2% of women, with periodontal pockets in 46.8% of men and 40.6% of women. Inflammation was seen in 61.2% of men and 54.8% of women. Healthy periodontal tissues were most common (59.2%) in the first age group (20-34); periodontal pockets (0-3mm) were least common (9.8%) at this age. Pockets of ≥4-5mm depth were observed mostly in the 3rd (9.4%) and 4th (10%) age groups. Conclusion: The high prevalence of periodontal diseases in the adult population of Georgia is explained by a low socio-economic status and low medical education background with a negative attitude towards oral hygiene skills and low levels of dental service accessibility. https://ijph.tums.ac.ir/index.php/ijph/article/view/3696 https://ijph.tums.ac.ir/index.php/ijph/article/download/3696/3370

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 203 10 Ebaa El-Sharouny Botany and Microbiology Department, Faculty of Science, Alexandria University, Alexandria, Egypt. Hossam El-Shazli Botany and Microbiology Department, Faculty of Science, Alexandria University, Alexandria, Egypt. Zakia Olama Botany and Microbiology Department, Faculty of Science, Alexandria University, Alexandria, Egypt. 2015 10 14 Background: The current study aimed to detect the presence of Helicobacter pylori in some water systems in Egypt as well as in blood samples of patients suffering from stomach ulcers. Methods: Fifty-one water samples collected from some Egyptian governorates; Giza, Alexandria, Monofia, Beheira, Minya, Sohag, was subjected to physical and chemical analysis. Urease gene ureC, a highly specific sequence in H. pylori DNA was tracked in tested water samples and then in blood samples of patients’ resident in areas with infected water supply using PCR technique. Data were all fed to the computer using IBM SPSS software package version 20.0. Qualitative data were described using number and percent. Comparison between different groups regarding categorical variables was tested using Chi-square test. Results: Two samples, belonging to Abu El Matamir-Beheira, and Sidi Bishr-Alexandria, showed positive results for presence of H. pylori. These two samples gave a positive result for the second time, on applying PCR technique for the cultures isolated under microaeroplilic conditions. Blood samples (173) were withdrawn from individuals living in the two areas with infected water supply. As diagnosed by ELISA, positive tests for H. pylori were recorded in 33.3% and 33.8% of patients suffering from ulcers in Abu El Matamir-Beheira, and Sidi Bishr-Alexandria, respectively. Conclusion: In developing countries such as Egypt, there is a big possibility for H. pylori to be transmitted via drinking water, hence, causing an epidemic infection, particularly in dense populated areas. https://ijph.tums.ac.ir/index.php/ijph/article/view/3695 https://ijph.tums.ac.ir/index.php/ijph/article/download/3695/3369

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 211 7 Neda Roshanravan Dept. of Biochemistry and Diet Therapy, Student Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran. Mohammad Alizadeh Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Mehdi Hedayati Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Asghari-Jafarabadi Road Traffic Injury Prevention Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran. Naimeh Mesri Alamdari Dept. of Biochemistry and Diet Therapy, Student Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran. Farideh Anari Rohzende Health and Therapeutic Center 2, Shabestar, Iran. Ali Tarighat-Esfanjani Nutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Science, Tabriz, Iran. 2015 10 14 Background: Hyperglycemia and gestational diabetes mellitus are complications of pregnancy. Both mothers and newborns are typically at increased risk for complications. This study sought to determine effect of zinc supplementation on serum glucose levels, insulin resistance, energy and macronutrients intakes in pregnant women with impaired glucose tolerance. Methods: In this clinical trial 44 pregnant women with impaired glucose tolerance, from December 2012 –April 2013 were randomly divided into zinc (n=22) and placebo (n=22) groups and recived 30mg/day zinc gluconate and (n=22), and placebo for eight consecutive weeks respectively. Dietary food intake was estimated from 3-days diet records. Serum levels of zinc, fasting blood sugar, and insulin were measured by conventional methods. Also homeostatic model assessment of insulin resistance was calculated. Results: Serumlevels of fasting blood sugar, insulin and homeostatic model assessment of insulin resistance slightly decreased in zinc group, but these changes were not statistically significant. Serum zinc levels (P =0.012), energy (P=0.037), protein (P=0.019) and fat (P=0.017) intakes increased statistically significant in the zinc group after intervention but not in the placebo group. Conclusion: Oral supplementation with zinc could be effective in increasing serum zinc levels and energy intake with no effects on fasting blood sugar, homeostatic model assessment of insulin resistance and insulin levels. https://ijph.tums.ac.ir/index.php/ijph/article/view/3693 https://ijph.tums.ac.ir/index.php/ijph/article/download/3693/3367

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 218 27 Lyly Nazemi Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ingmar Skoog Dept. of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unite, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden. Ingvar Karlsson Dept. of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unite, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden. Saeed Hosseini Dept. of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Mohammadi Psychiatry Research Center, Rozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Hosseini Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Javad Hosseinzade Dept. of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Seyed Alireza Mesbah-Namin Dept. of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Masoud Baikpour Dept. of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Malnutrition and dehydration are two most common types of ailments residents of nursing homes (NH) prone to. It is very important to assess these problems because they can predispose the residents to severe illnesses. The aim of this study was to gather information on nutritional status and its associated risk factors in elderly residents of NHs in Tehran, Iran. Methods: From 16 NHs in Tehran, 263 residents were randomly selected. Data were collected via questionnaires, including demographic characteristics, past medical history, present health problems and daily routines. The MNA questionnaire was used to gather information regarding their nutritional status. Results: The present study showed that 10.3% of the elderly residents in nursing homes were malnourished. 66.4% of males and 70.8% of females were at risk of malnutrition. Multivariate analysis showed that after adjusting for confounders the following elderly-related factors were the independent risk factors of malnutrition: consuming half or less than of the food (OR=8.0, 95%CI=3.7-17.7), having no teeth or good prosthesis (OR=1.7, 95%CI=1.1-2.7), diabetes (OR=1.6, 95%CI=1.1-2.4), smoking (OR=0.6, 95%CI=0.3-1.2), studying (OR=0.4 95%CI=0.2-0.9) and praying in their free time (OR=1.8 95%CI=1.2-2.6). Conclusion: The subjects’ health-related factors and their free-time activities and nutritional behavior are the most important factors associated with poor nutrition among elderly residents of NHs; however, further investigation is needed to clarify the role of other factors in maintaining a suitable nutritional plan for them. https://ijph.tums.ac.ir/index.php/ijph/article/view/3691 https://ijph.tums.ac.ir/index.php/ijph/article/download/3691/3365

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 228 37 Alireza Ostadrahimi Dept. of Nutrition, Biochemistry and Diet Therapy, School of Nutrition, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Akbar Taghizadeh Dept. of Animal Science, School of Agriculture, University of Tabriz, Tabriz, Iran. Majid Mobasseri Dept. of Internal Medicine, School of Medicine, Bone Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Nazila Farrin Dept. of Nutrition, Biochemistry and Diet Therapy, School of Nutrition, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Laleh Payahoo Dept. of Nutrition, Biochemistry and Diet Therapy, School of Nutrition, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Zahra Beyramalipoor Gheshlaghi Dept. of Animal Science, School of Agriculture, University of Tabriz, Tabriz, Iran. Morteza Vahedjabbari Dept. of Nutrition, Biochemistry and Diet Therapy, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 14 Background: Diabetes is a global health problem in the world. Probiotic food has anti-diabetic property. The aim of this trial was to determine the effect of probiotic fermented milk (kefir) on glucose and lipid profile control in patients with type 2 diabetes mellitus. Methods: This randomized double-blind placebo-controlled clinical trial was conducted on 60 diabetic patients aged 35 to 65 years.Patients were randomly and equally (n=30) assigned to consume either probiotic fermented milk (kefir) or conventional fermented milk (dough) for 8 weeks. Probiotic group consumed 600 ml/day probiotic fermented milk containing Lactobacillus casei, Lactobacillus acidophilus and Bifidobacteria and control group consumed 600 ml/day conventional fermented milk.Blood samples tested for fasting blood glucose, HbA1C, triglyceride (TG), total cholesterol, HDL-C and LDL-C at the baseline and end of the study. Results: The comparison of fasting blood glucose between two groups after intervention was statistically significant (P=0.01). After intervention, reduced HbA1C compared with the baseline value in probiotic fermented milk group was statistically significant (P=0.001), also the HbA1C level significantly decreased in probiotic group in comparison with control group (P=0.02) adjusting for serum levels of glucose, baseline values of HbA1c and energy intake according to ANCOVA model. Serum triglyceride, total cholesterol, LDL-cholesterol and HDL- cholesterol levels were not shown significant differences between and within the groups after intervention. Conclusion: Probiotic fermented milk can be useful as a complementary or adjuvant therapy in the treatment of diabetes. https://ijph.tums.ac.ir/index.php/ijph/article/view/3688 https://ijph.tums.ac.ir/index.php/ijph/article/download/3688/3362

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 238 43 Arash Hemmati Dep. of Microbiology, Rasht Branch, Islamic Azad University, Rasht, Iran. Elham Hooshmand Dep. of Veterinary, Rasht Branch, Islamic Azad University, Rasht, Iran. Mohammad Javad Hosseini Molecular Biology Research Center, School of Medicine, Baqiyatallah University, Tehran, Iran. 2015 10 14 Background: This study was conducted with the aim of determining surface water contamination with cysts of Entamoeba histolytica using PCR in Rasht City, Northern Iran. Methods: In this cross-sectional study, 49 water samples including 18 rivers and 6 wetlands were collected from different regions near the city of Rasht in autumn of 2012. After filtration using 0.22 µm nitrate cellulose membrane filters, the samples were examined using microscope and PCR method. Results: In microscopic examination, four samples of the 49 samples were positive for cysts of E. (histolytica / dispar / muschkovskii). By using PCR method and molecular analysis, one sample was positive for E. histolytica. Conclusion: In the molecular analysis, contamination by E. histolytica was proved in the waters of Rasht City. Further investigations including more samples and necessary preparations must be applied to prevent contamination. https://ijph.tums.ac.ir/index.php/ijph/article/view/3687 https://ijph.tums.ac.ir/index.php/ijph/article/download/3687/3361

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 244 53 Mohammad Hassan Abolhassani Dept. of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Fariba Kolahdooz Aboriginal and Global Health Research, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Canada. Reza Majdzadeh School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran. Mohammadreza Eshraghian School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran. Mahboubeh Shaneshin National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran. Se Lim Jang Aboriginal and Global Health Research, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Canada. Abolghasem Djazayery Dept. of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Food security is a multi-dimensional phenomenon. The objective of this study was to identify and prioritize major indices for determining food insecurity in Iran. Methods: Descriptive study using the Delphi method was conducted through an email-delivered questionnaire. Fortythree senior experts at national or provincial level were selected based on their work experience and educational background through study panel consultation and snowballing from Tehran and other cities of Iran. During two rounds of Delphi, participants were asked to identify priority indicators for food security at provincial level in Iran. Results: Sixty five percent of Delphi panel participated in the first round and eighty-nine percent of them participated in the second round of Delphi. Initially, 243 indices were identified through review of literature; after excluding indictors, which was not available or measurable at provincial level in Iran, 103 indictors remained. The results of study showed that experts identified “percentage of individuals receiving less than 70% of daily energy requirement” with a median score of 90, as the most influential index for determining food insecurity. “Food expenses as a proportion of the overall expenses of the family”, “per capita of dietary energy supply”, and “provision of micro-nutrient supply requirement per capita” with median of 80 were in the second rank of food security priority indicators. Conclusion: Out of 243 identified indicators for food security, 38 indicators were selected as the most priority indicators for food security at provincial level in Iran. https://ijph.tums.ac.ir/index.php/ijph/article/view/3684 https://ijph.tums.ac.ir/index.php/ijph/article/download/3684/3358

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 254 62 Masoume Pourmohamadreza-Tajrishi Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Parviz Azadfallah Dept. of Psychology, Tarbiat Modares University, Tehran, Iran. Sahel Hemmati Garakani Dept. of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Enayatollah Bakhshi Dept. of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 2015 10 14 Background: Anxiety is one of the most common reactions that parents show while understanding their children’s intellectual disability due to Down syndrome. Anxiety leads parents not to develop appropriate relations with their children, subsequently their psychological health are at risk. The present study was aimed to determine the effect of problem-focused coping strategy training on psychological symptoms of mothers with Down child. Methods: This was an experimental study with pretest and posttest design with case and control group. Sixty-four mothers were selected randomly from Iranian Down Syndrome Charity Society. They completed Symptoms Checklist90-Revised (SCL-90-R). They were assigned to experimental and control groups in equal. Experimental group participated in 12 training sessions (once a week; 60 minutes for each session) and received problem-focused coping strategy program, but control group did not. After 12th session, all subjects completed SCL-90-R again. Analysis of covariance was used for analyzing the data. Results: There was a significant difference (P<0.01) between experimental and control group according to psychological symptoms and its components (phobia, depression, paranoid thoughts, psychosis, somatic complaints,  interpersonal sensitivity, obsession-compulsion, anxiety and aggression) after participation in intervention sessions. Conclusion: There was a significant decrease in psychological symptoms, phobia, depression, paranoid thoughts, psychosis, somatic complaints, interpersonal sensitivity, obsession-compulsion, anxiety and aggression of experimental group. Our findings showed that problem-focused coping strategy-training program led to improve family’s perception towards the child and subsequently promote of mental health of mothers with Down children. https://ijph.tums.ac.ir/index.php/ijph/article/view/3682 https://ijph.tums.ac.ir/index.php/ijph/article/download/3682/3356

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 2 2015 02 15 263 8 Yu-Feng Wen School of Public Health, Wan Nan Medical College, Wuhu, China. Chao Jiang School of Public Health, Wan Nan Medical College, Wuhu, China. Xian-Feng Cheng School of Public Health, Wan Nan Medical College, Wuhu, China. Zhi-Ping Zhang Centre for Disease Prevention and Control of Anqing City, Anqing, China. Bai-Feng Chen School of Public Health, Wan Nan Medical College, Wuhu, China. Abbas Rahimi FOROUSHANI Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran 2019 06 27 No Abstract#### https://ijph.tums.ac.ir/index.php/ijph/article/view/17604 https://ijph.tums.ac.ir/index.php/ijph/article/download/17604/6460

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1278 1283 Dong YANG Department of Paediatrics, Xuzhou Central Hospital, Xuzhou 221000, P.R. China Bin ZHOU Department of Paediatrics, Xuzhou Central Hospital, Xuzhou 221000, P.R. China Bao JIN Department of Paediatrics, Xuzhou Central Hospital, Xuzhou 221000, P.R. China Xiao LIU Department of Paediatrics, Xuzhou Central Hospital, Xuzhou 221000, P.R. China Yun WANG Department of Paediatrics, Xuzhou Central Hospital, Xuzhou 221000, P.R. China 2019 06 27 Background: To investigate the effect of caffeine citrate on the integrated brain electroencephalogram (EEG) of apnea and low birth weight infants. Methods: Overall, 212 infants with apnea and low birth weight admitted to Xuzhou Central Hospital from June 2016 to June 2018 were enrolled. The infants were divided into control group and observation group according to the random number table method, 106 cases in each group. Infants in control group were treated with aminophylline, and infants in the observation group were given caffeine citrate. All children were continuously tested by digital amplitude integrated brain function monitor. The amplitude-integrated electroencephalogram (aEEG) was used to detect sleep arousal cycle (Cy), graphic continuity (Co), lower edge amplitude value (LB) scores, aEEG continuous voltage and periodic occurrence rate, narrowband voltage and bandwidth. Results: After treatment, scores of Cy, Co and LB increased in both groups, and the scores were significantly higher in observation group than in control group (P=0.029, 0.017, 0.047). After treatment, continuous voltage positive rate, sleep-wake cycle occurrence rate, and narrow-band lower boundary voltage increased in both groups, and the values were significantly higher in observation group than in control group (P=0.011, 0.042). After treatment, aEEG detection bandwidth and the upper boundary voltage of the narrow band decreased in both groups, and the values were significantly lower in observation group than in control group (P=0.007, 0.020, 0.032). Conclusion: Citrate caffeine can alleviate the brain development of low-weight infants with apnea, improve brain electrical activity and promote brain function and maturity.   https://ijph.tums.ac.ir/index.php/ijph/article/view/17587 https://ijph.tums.ac.ir/index.php/ijph/article/download/17587/6444

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1387 1389 Touraj MIANDOABI Department of Parasitology and Mycology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fariborz BAHRAMI Department of Immunology, Pasteur Institute of Iran, Tehran, Iran Vahideh MOEIN VAZIRI Department of Parasitology and Mycology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Soheila AJDARY Department of Immunology, Pasteur Institute of Iran, Tehran, Iran 2019 06 27 No Abstract#### https://ijph.tums.ac.ir/index.php/ijph/article/view/17605 https://ijph.tums.ac.ir/index.php/ijph/article/download/17605/6461

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1284 1291 Zlatko ZIMET National Institute of Public Health, Ljubljana, Slovenia Marjan BILBAN Department of Public Health, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia Joško OSREDKAR Institute of Clinical Chemistry and Biochemistry, University Medical Center Ljubljana, Ljubljana, Slovenia Borut POLJŠAK Laboratory of Oxidative Stress Research, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia Teja FABJAN Institute of Clinical Chemistry and Biochemistry, University Medical Center Ljubljana, Ljubljana, Slovenia Kristina SUHADOLC Institute of Clinical Chemistry and Biochemistry, University Medical Center Ljubljana, Ljubljana, Slovenia 2019 06 27 Background: We aimed to investigate the polluted working environment triggers oxidative stress and alter enzymatic antioxidant activity by a short-term interval. Methods: The experimental study, performed in 2014, involved 94 workers from the Velenje Coalmine in Slovenia, arranged into three groups according to a number of consecutive working days in a mineshaft, supported by a control group. Levels of the antioxidant enzymes (GPx, CAT, SOD) together with TAC (the combined effect of all antioxidants) and 8-isoprostane (a biological marker of oxidative stress/damage) were measured in human plasma. Results: Workers occupationally exposed for three consecutive working days had significantly increased 8-isoprostane biomarker, a parameter of oxidative stress (P<0.001). The antioxidant levels of TAC (P<0.001), CAT (P<0.001) and SOD (P<0.001) were all significantly decreased compared to a control group. Conclusion: Workers in polluted working environment had significantly increased oxidative stress and altered antioxidant activity already on a third consecutive working day.   https://ijph.tums.ac.ir/index.php/ijph/article/view/17588 https://ijph.tums.ac.ir/index.php/ijph/article/download/17588/6445

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1390 1391 Parya BABAN ZADEH Department of Microbiology, Faculty of Pharmaceutical Sciences, North Islamic Azad University, Tehran, Iran Azad KHALEDI Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran Davoud ESMAEILI Department of Microbiology and Applied Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran AND Applied Virology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran 2019 06 27 No Abstract#### https://ijph.tums.ac.ir/index.php/ijph/article/view/17606 https://ijph.tums.ac.ir/index.php/ijph/article/download/17606/6462

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1292 1300 Hui WANG Department of Immunology, Qiqihar Medical University, Qiqihar 161000, P.R. China Shuhua LI Department of Traditional Chinese Medicine, The First Hospital of Qiqihar, Qiqihar 161000, P.R. China Houzhong LI Department of Pharmacology, Mudanjiang Medical University, Mudanjiang 157011, P.R. China Fengxia DU Department of Pathogen Biology, Qiqihar Medical University, Qiqihar 161000, P.R. China Jie GUAN Department of Immunology, Qiqihar Medical University, Qiqihar 161000, P.R. China Yanmin WU Department of Immunology, Qiqihar Medical University, Qiqihar 161000, P.R. China 2019 06 27 Background: We aimed to investigate the effect of probiotic VSL#3 on NF-κB and TNF-α in rats with colitis and the correlation with TLR4-NF-κB signal pathway. Methods: Sixty Sprague Dawley (SD) rats were divided into the control, model and therapy groups (n=20) according to the random number table. Rats in the model and therapy groups were modeled for colitis, and rats in the therapy group were intragastrically administered with probiotic VSL#3. The expression of TLR4 and NF-κB protein, and the levels of NF-κB, TLR4, and TNF-α mRNA in the colon tissue were detected. The concentration of TNF-α in the serum after modeling but before intragastric administration (T0), 3d (T1) and 7d after intragastric administration (T2) was detected. Results: The expression of TLR4 and NF-κB p65 protein, and the levels of TLR4, NF-κB, and TNF-α mRAN in the therapy group decreased (P < 0.001). At T0, T1, and T2, the concentration of TNF-α in the model and control groups increased (P < 0.001). TLR4 and NF-κB in the therapy group were positively correlated with TNF-α mRAN (P < 0.050).Conclusion: In conclusion, probiotic VSL#3 inhibits the expression of NF-κB and TNF-α in rats with colitis through TLR4-NF-κB signal pathway, so it is expected to be a first choice drug for the treatment of colitis. Conclusion: In conclusion, probiotic VSL#3 inhibits the expression of NF-κB and TNF-α in rats with colitis through TLR4-NF-κB signal pathway, so it is expected to be a first choice drug for the treatment of colitis.   https://ijph.tums.ac.ir/index.php/ijph/article/view/17589 https://ijph.tums.ac.ir/index.php/ijph/article/download/17589/6446

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1392 1394 Fatemeh EGHBALIAN Research Institute for Islamic and Complementary Medicine, School of Iranian Traditional Medicine, Iran University of Medical Sciences, Tehran, Iran Hoorieh MOHAMMADI KENARI Research Institute for Islamic and Complementary Medicine, School of Iranian Traditional Medicine, Iran University of Medical Sciences, Tehran, Iran Gholamreza KORDAFSHARI Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran Mehrdad KARIMI Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran Akramosadat ATYABI Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran Laila SHIRBEIGI Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran 2019 06 27 No Abstract#### https://ijph.tums.ac.ir/index.php/ijph/article/view/17607 https://ijph.tums.ac.ir/index.php/ijph/article/download/17607/6463

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1301 1309 Seyed-Farzad MOHAMMADI Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Cyrus ALINIA Department of Public Health, Urmia University of Medical Sciences, Urmia, Iran Ebrahim GHADERI Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran Alireza LASHAY Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahmoud JABBARVAND Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Elham ASHRAFI Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Naser NOURMOHAMMADI Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Saeid SHAHRAZ Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, Massachusetts, USA 2019 06 27 Background: Due to lack of information about ophthalmic economics in Iran, health policy makers unable to distribute resources optimally in terms of efficiency and equity. Therefore, we estimated the total and eye care utilization, out-of-pocket expenditures, and its association with social determinants of health in Iran in 2015. Methods: A multi-stage population-based, cross-sectional study in a random sample aged 50 yr or older in Kurdistan Province, Northwest Iran was used. The utilization rate of eye and general health care and related out-of-pocket expenditures was estimated during the recent last six months. To find the association between social factors and care out-of-pocket expenditures, we used a Heckman two-step regression model. Results: About 81% and 37% of participants were utilized the health and ophthalmic services, respectively. Statistically significant lower ophthalmic utilization rates were observed among men, middle-aged population, illiterate participants, rural residents, daily-paid workers, and the poorest participants. The average of vision and total health-related out-of-pocket expenditures among those used these services have estimated as US$43.7 (SE: 2.6) and US$439.9 (SE: 22.8), respectively. The highest (US$ 396.6) and lowest (US$ 10.4) ophthalmic out-of-pocket costs were related to patients with Glaucoma and Central Nervous System abnormalities, respectively. Multivariate analyses confirmed an unequal probability of having the ophthalmic out-of-pocket expenditures among different subgroups especially in favor of females, older, and those with more severe visual impairment. Conclusion: Ophthalmic disorders reconstituted about 10% of all health services OOP expenditures on average among individuals older than 50 yr.     https://ijph.tums.ac.ir/index.php/ijph/article/view/17590 https://ijph.tums.ac.ir/index.php/ijph/article/download/17590/6447

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 7 2019 07 01 1310 1316 Farnaz SAFAVIFAR