Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 5 2013 05 15 449 557 Roberta Altomare Course on Surgical Biotechnology and Regenerative Medicine, University of Palermo, Italy. Francesco Cacciabaudo Giuseppe Damiano Vincenzo Davide Palumbo Maria Concetta Gioviale Maurizio Bellavia Giovanni Tomasello Attilio Ignazio Lo Monte 2015 10 15 The Mediterranean tradition offers a cousine rich in colors, aromas and memories, which support the taste and the spirit of those who live in harmony with nature. Everyone is talking about the Mediterranean diet, but few are those who do it properly, thus generating a lot of confusion in the reader. And so for some it coincides with the pizza, others identified it with the noodles with meat sauce, in a mixture of pseudo historical traditions and folklore that do not help to solve the question that is at the basis of any diet: combine and balance the food so as to satisfy the qualitative and quantitative needs of an individual and in a sense, preserves his health through the use of substances that help the body to perform normal vital functions. The purpose of our work is to demonstrate that the combination of taste and health is a goal that can be absolutely carried out by everybody, despite those who believe that only a generous caloric intake can guarantee the goodness of a dish and the satisfaction of the consumers. That should not be an absolute novelty, since the sound traditions of the Mediterranean cuisine we have used for some time in a wide variety of tasty gastronomic choices, from inviting colors and strong scents and absolutely in line with health. https://ijph.tums.ac.ir/index.php/ijph/article/view/4556 https://ijph.tums.ac.ir/index.php/ijph/article/download/4556/4203

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 5 2013 05 15 458 466 Seyyedeh Zahra Masoumi Dept. of Reproductive Health, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Semnan, Iran. Jalal Poorolajal Afsaneh Keramat Seyyed Abbas Moosavi 2015 10 15 Several studies have been conducted in Iran in order to investigate the prevalence of depression among infertile couples. However, there is a remarkable diversity among the results. This meta-analysis was conducted to estimate an overall prevalence rate of depression among infertile couples in Iran.International and national electronic databases were searched up to June 2011 including MEDLINE, Science Citation Index Expanded, Scopus, SID, MagIran, and IranMedex as well as conference databases. Furthermore, reference lists of articles were screened and the studies' authors were contacted for additional references. Cross-sectional studies addressing the prevalence of depression among infertile couples were included in this meta-analysis. We assessed 12 separate studies involving overall 2818 participants of which 1251 had depression.Overall prevalence rate of depression among infertile couples was 0.47 (95% CI: 0.40, 0.55). The prevalence rate of depression was 0.44 (95% CI: 0.32, 0.56) during 2000 to 2005 and 0.50 (95% CI: 0.43, 0.57 during 2006 to 2011. The prevalence rate of depression was 0.46 (95% CI: 0.39, 0.53) among women and 0.47 (95% CI: 0.40, 0.54) among men.Not only the prevalence of depression in infertile couples was high but also had increasing growth in recent years. Furthermore, despite many studies conducted addressing the prevalence of depression in infertile couples, there is however a remarkable diversity between the results. Thus, one can hardly give a precise estimation of the prevalence rate of depression among infertile couples in Iran now. https://ijph.tums.ac.ir/index.php/ijph/article/view/4554 https://ijph.tums.ac.ir/index.php/ijph/article/download/4554/4201

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 5 2013 05 15 467 471 Hafzan Yusoff Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. Wan Nudri Wan Daud Zulkifli Ahmad 2015 10 15 This study was carried out to compare the effect between nutrition education intervention and non-nutrition education intervention on awareness regarding iron deficiency among schooling adolescents in Tanah Merah, one of rural district in Kelantan, Malaysia.This study which was started in year 2010 involved 280 respondents (223 girls, 57 boys, age: 16 yr) from schools in Tanah Merah. The selection criteria were based on hemoglobin level (Hb = 7 - 11.9 g/dL for girls; Hb = 7 - 12.9 g/dL for boys). They were divided into 2 groups. The first group received nutrition education package (Nutrition education, NE), whereas another group was entitled to receive non-nutrition education intervention (Non-Nutrition Education, NNE) (supplement only). Both interventions were implemented for 3 months. The changes in awareness among respondents of both groups were evaluated using multi-choices questionnaire.Nutrition education receiver group (NE) demonstrated improvement in awareness at post-intervention. No substantial improvement was demonstrated by the counterpart group (NNE).Multimedia nutrition education program conducted at school setting was in fact practical and effective in improving awareness on iron deficiency among anemic adolescents. https://ijph.tums.ac.ir/index.php/ijph/article/view/4552 https://ijph.tums.ac.ir/index.php/ijph/article/download/4552/4199

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 5 2013 05 15 472 479 Weilan Wang Dept. of Pharmaceutical Care, Chinese PLA General Hospital, Beijing, China. Man Zhu Daihong Guo Chao Chen Dongxiao Wang Fei Pei Liang Ma 2015 10 15 To evaluate off-label and off-NCCN guidelines uses of antineoplastic drugs in a major Chinese hospital.Totally 1122 patients were selected from July to December 2011. Then, the off-label and off-NCCN guidelines uses of antineoplastic drugs were analyzed.In 798 of 1122 patients (71.12%), drugs were used for off-label. In 317 of 1122 patients (28.25%), the drugs were prescribed for off-label and off-NCCN guidelines. 2591 medical orders for 1122 patients, 1051/2591 (40.56%) medical orders were off-label; 445/2591(17.17%) medical orders were off-label and off-NCCN guidelines. In 445 off-label and off-NCCN medical orders, 399 (89.66%) were unapproved indications, 38 (8.54%) were unapproved drug concentration and 12 (2.70%) were unapproved route of administration. Percentage of off-label and off-NCCN guidelines drug uses in male was higher than that in female (21.92% vs. 11.39%, P<0.01). Compared with other lines of treatment, percentage of off-label and off-NCCN guidelines drug uses in postoperative adjuvant was the smallest (P<0.01) and percentage in three or multi-line treatments was the highest (P<0.01). The pancreatic cancer possessed the highest percentage (38.74%) of off-label and off-NCCN guidelines drug uses among all types of cancer (P<0.01).Off-label uses of antineoplastic drugs are generally common in China hospitals based on NCCN guidelines. The fact suggests that anti-tumor treatment was relatively standard in China. Off-label and off-NCCN guidelines drug uses were mainly for individual treatment. Doctors should fully consider the adverse drug reaction, contraindication, cautions and increase the drug security monitoring. Uncorrected drug concentration should be avoided for drug risk. https://ijph.tums.ac.ir/index.php/ijph/article/view/4550 https://ijph.tums.ac.ir/index.php/ijph/article/download/4550/4197

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 5 2013 05 15 480 488 Junqing Wu Dept. of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research/WHO Collaborating Center on Human Reproductive Health, Shanghai, China ; Dept. of Epidemiology and Biostatistics, Fudan University, Shanghai, China. Jingchao Ren Yuyan Li Yinjie Wu Ersheng Gao 2015 10 15 The aim of the study was to explore the mechanisms underlying the association of birth weight with later body mass index (BMI) from the biochemical markers related to metabolism and the Apa I polymorphism in IGF-II gene.A total of 300 children were selected randomly from the Macrosomia Birth Cohort in Wuxi, China. The height and weight were measured and blood samples were collected. Plasma concentrations of 8 biochemical markers were detected. Apa I polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Biochemical markers were detected for 296 subjects and 271 subjects were genotyped for the Apa I polymorphism. No association was found between birth weight and 8 biochemical markers. In boys, the BMIs of AA, AG and GG genotypes were 16.10 ± 2.24 kg/m(2), 17.40 ± 3.20 kg/m(2), 17.65 ± 2.66 kg/m(2). And there was statistical difference among the three genotypes. But in girls, there was no statistical difference. The birth weights of AA, AG and GG genotypes were 3751.13 ± 492.43 g, 3734.00 ± 456.88 g, 3782.00 ± 461.78 g. And there was no statistical difference among the three genotypes.Biochemical markers are not associated with birth weight. Apa I polymorphism may be related to childhood BMI, but it may be not associated with birth weight. Therefore, biochemical markers and Apa I polymorphism might not play a role in the association of birth weight and BMI. https://ijph.tums.ac.ir/index.php/ijph/article/view/4548 https://ijph.tums.ac.ir/index.php/ijph/article/download/4548/4195

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 5 2013 05 15 489 496 Daniel Goon Centre for Biokinetics, Recreation and Sport Science, University of Venda, Thohoyandou, South Africa. Lateef Amusa Dorothy Mhlongo Lunic Khoza Felix Anyanwu 2015 10 15 Whilst there seem to be available data on blood pressure profiles of South African children, especially in urban areas, few data exist on rural children. The aims of this study were to determine the blood pressure profiles of rural South African children residing in Thohoyandou; and to examine the relationship between body mass index and blood pressure among the children.The study involved 296 (134 boys and 135 girls) children aged 7-13 years. Body weight and height were measured using standard procedures. Overweight was defined by body mass index (BMI) for gender and age. Blood pressure was monitored in each child thrice using validated electronic devices (Omron 7051T). Hypertension was determined as the average of three separate blood pressure readings where the systolic or diastolic blood pressure was ≥ 90th percentile for age and sex.Overweight among the girls (4.7%) was higher compared with the boys (3.9%). Both systolic and diastolic pressures (SBP and DBP) increase with age in both sexes. The proportion of children with > 90th percentile occur at only ages 12 and 13 years. The incidence of hypertension (SBP > 90th percentile) was 0.4% and 0.2% in boys and girls, respectively. The SBP and DBP pressures significantly (P<0.05) correlate with age; body mass, height and BMI.Elevated blood pressure is prevalent among rural South African children residing in this region. Also, blood pressure increased with age in both boys and girls, and this positively correlated with age, body weight, height and BMI. https://ijph.tums.ac.ir/index.php/ijph/article/view/4546 https://ijph.tums.ac.ir/index.php/ijph/article/download/4546/4193

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 5 2013 05 15 497 503 Nduka Rose Obiezue Parasitology and Biomedical Research Unit, Department of Zoology and Environmental Biology, University of Nigeria, Nsukka, Enugu State, Nigeria. Ikem C Okoye Njoku Ivoke Joy N Okorie 2015 10 15 The incidence and hematological effects of helminth infection during pregnancy were investigated among pregnant women in Isiala, Mbano, Southeast Nigeria.Totally 282 pregnant women were enlisted for the study between October 2011 and September 2012. Stool samples were examined for intestinal helminths using formalin-ether sedimentation technique. Hemoglobin (Hb) and Packed Cell Volume (PCV) levels were evaluated in venous blood samples using Sahli's and microhaematocrit methods respectively.Forty six (16.3%) subjects were infected with at least one helminth parasite; 24 (8.5%) hookworm, 14(5.0%) and 2(0.7%) A. lumbricoides and Trichuris trichiura infections respectively. Intestinal helminthiases in pregnant women was significantly associated with age (P<0.05). The prevalence of intestinal helminthiases by parity was also significantly different (P<0.05) with primigravidae having the highest infection rate (27.5%). Hematological assessment showed that the prevalence of anemia among the women was 58.9% (mean±SD = 9.3±1.0). The differences in hemoglobin levels by age groups was statistically significant (P <0.05). The contributory effect of gastrointestinal helminths in anemia showed that infected pregnant women had lower mean hemoglobin (8.60±0.22g/dl) than the uninfected (9.72±0.07g/dl). Significant difference (t-value = 5.660, P<0.05) was observed between the Hb of the infected and uninfected pregnant women. In addition, infected pregnant women had mean PCV of 26.09±0.65% while the uninfected had 34.54±2.96%. The mean PCV of infected pregnant women was significantly different (t-value= 0.013, P<0.05) from that of the uninfected.Anti-helminthic therapy after the first trimester should be part of the antenatal programme. Intestinal helminth infection showed significant negative correlation with Hb and PCV and contributed moderately to anemia. https://ijph.tums.ac.ir/index.php/ijph/article/view/4544 https://ijph.tums.ac.ir/index.php/ijph/article/download/4544/4191

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 42 06 15 57 66 F Keshavarzi A Eskafi Noughani MH Ayoubian S Zeinali 2015 10 03 Background: BRCA1 and BRCA2 genes have been recognized to be responsible for 20-30% of hereditary breast can­cers and approximately 50% of familial breast and ovarian cancers. Therefore, the demand for BRCA1 and BRCA2 muta­tion screening is rapidly increasing as their identification will affect medical management of people at increased risk. Because of high costs involved in analysis of BRCA1 and 2 genes, contribution of different mutation types in BRCA1 and 2 and not knowing who should be tested has hampered wide spread use of molecular testing of high -risk fami­lies. There is a need to identify the genes and types of mutations involved in breast or ovarian cancers at different age of onsets and polymorphism and polymorphic variations in our population. Methods: Twenty-seven patients with either early onset breast cancer (at age≤ 35 years) or a personal and/or family his­tory of breast or ovarian cancer and 50 control subjects participated in this study. After collecting blood samples and extract­ing DNA, BRCA1 and BRCA2 genes were fully sequenced. Results: Thirteen missense substitutions in BRCA1 and BRCA2 (9 and 4, respectively) were revealed. Two nucleotide substitu­tions were novel (Gly1140Ser in BRCA1 and Glu1391Gly in BRCA2). The Glu1038Pro and Gly1140Ser were found in large series of breast and ovarian cancer and matched controls. Conclusion: Some nucleotide substitutions were seen only in single families and other in several. In other cases, muta­tions were seen in both BRCA1 and BRCA2 genes. Clinical significance of these mutations was evaluated comparing with normal controls.   https://ijph.tums.ac.ir/index.php/ijph/article/view/3051 https://ijph.tums.ac.ir/index.php/ijph/article/download/3051/2851

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 40 2 2011 06 15 67 74 N Mokhber MR Majdi M Ali-Abadi MT Shakeri M Kimiagar R Salek P Ahmadi Moghaddam A Sakhdari M Azimi-Nezhad M Ghayour-Mobarhan SS Soluti 2015 10 03 Background: To determine the prevalence of malnutrition and depression in free-living elderly people and their relationships (If any) in Razavi Khorasan, Iran 2007. Methods: To evaluate nutritional status, we used Mini Nutritional Assessment (MNA) method in free-living elderly people (n=1565 using cluster sampling, 720 males and 845 females, aged≥ 60 yr) and their relationship to Socio Economic Conditions (SECs).  Based on the final scores, our patients were classified into three groups: score 17-23.5 (at risk for malnutrition), score less than 17 (with malnutrition), and score 24-30 (well nourished). To determine the mood status (here depression), we used Geriatric Depression Score (GDS). According to this score our participants turned out to be in two distinct groups: depressed (score ≥8) and non-depressed (score< 8). Results: From the total subjects entered the study (1495), 22.07% were depressed and 11.5% and 44% were malnour­ished or at risk of malnutrition respectively. In depressed group, the prevalence of malnutrition was 14.5% (48 out of 330) and the prevalence of "at risk of malnutrition" was 45.8%, whereas the prevalence of malnutrition and at risk of malnutrition in non-depressed population were 10.6% and 43.3% respectively. From the aforemen-tioned information we have concluded that there is a significant statistical difference between the prevalence of malnutrition in depressed and non-depressed individuals (P= 0.047). Conclusions: With respect to the high rate of vegetative symptoms in elderly depressed individuals, malnutrition would have a higher prevalence in the depressed people. https://ijph.tums.ac.ir/index.php/ijph/article/view/3052 https://ijph.tums.ac.ir/index.php/ijph/article/download/3052/2852

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 40 2 2011 06 15 75 79 Sh Sadigh Maroufi MJ Gharavi M Behnam A Samadikuchaksaraei 2015 10 03 Background: Nitrous oxide (N2O) is the oldest anesthetic in routine clinical use and its occupational exposure is under regulation by many countries. As studies are lacking to demonstrate the status of nitrous oxide levels in operating and recovery rooms of Iranian hospitals, we aimed to study its level in teaching hospitals of Tehran University of Medical Sciences. Methods: During a 6-month period, we have measured the shift-long time weighted average concentration of N2O in 43 op­erating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences. Results: The results show that the level of nitrous oxide in all hospitals is higher than the limits set by different countries and anesthetists are at higher risk of exposure. In addition, it was shown that installation of air ventilation could reduce not only the overall exposure level, but also the level of exposure of anesthetists in comparison with other personnel. Conclusion: The high nitrous oxide level in Iranian hospitals necessitates improvement of waste gas evacuation systems and regular monitoring to bring the concentration of this gas into the safe level. https://ijph.tums.ac.ir/index.php/ijph/article/view/3053 https://ijph.tums.ac.ir/index.php/ijph/article/download/3053/2853

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 40 2 2011 06 15 80 86 A Biglarian E Hajizadeh A Kazemnejad MR Zali 2015 10 03 Background: The aim of this study was to predict the survival rate of Iranian gastric cancer patients using the Cox proportional hazard and artificial neural network models as well as comparing the ability of these approaches in predicting the survival of these patients. Methods: In this historical cohort study, the data gathered from 436 registered gastric cancer patients who have had surgery between 2002 and 2007 at the Taleghani Hospital (a referral center for gastrointestinal cancers), Tehran, Iran, to predict the survival time using Cox proportional hazard and artificial neural network techniques. Results: The estimated one-year, two-year, three-year, four-year and five-year survival rates of the patients were 77.9%, 53.1%, 40.8%, 32.0%, and 17.4%, respectively. The Cox regression analysis revealed that the age at diag-nosis, high-risk behaviors, extent of wall penetration, distant metastasis and tumor stage were significantly associated with the survival rate of the patients. The true prediction of neural network was 83.1%, and for Cox regression model, 75.0%. Conclusion: The present study shows that neural network model is a more powerful statistical tool in predicting the survival rate of the gastric cancer patients compared to Cox proportional hazard regression model. Therefore, this model recommended for the predicting the survival rate of these patients. https://ijph.tums.ac.ir/index.php/ijph/article/view/3054 https://ijph.tums.ac.ir/index.php/ijph/article/download/3054/2854

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 40 2 2011 06 15 87 95 S Navadeh L Sajadi A Mirzazadeh F Asgari M Haghazali 2015 10 03 Background: Women suffer more from obesity than men in Iran do. In this study, we compared obesity risk and its con­tributors regarding the job categories as housewives (HWs) or employees to deeply explore the risk of obesity in house­wives in Iran. Methods: Based on WHO stepwise approach, in 2005, 33472 women aged 15 to 65 years old (excluding all men) were ex­amined for the major risk factors for non-communicable diseases. Obesity was determined by Body Mass Index>30kgm-2 in adults (>20 years) and by girl BMI percentiles according to WHO 2007 Growth Reference 5-19 years in adolescents.  We modeled obesity by logistic regression and entered all the known/potential predictors, including job categories. Results: The participation rate was more than 99%. The weighted prevalence of overweight and obesity in HWs were 34.5% and 24.5% respectively. Employed women were about 4% and 10% less overweight and obese than the HWs, respec­tively (P< 0.01). HWs vs. employed women had the adjusted OR 1.39 (CI95%, 1.18-1.63) for obesity. Older women, with higher educational level and socioeconomic status, lower physical activities and those living in urban areas were at risk of obesity. In comparison to HWs, working as an Official Clerk (OR=0.66) associated with a decrease in odds of obe­sity significantly, while others did not. Conclusion: Being as HW is an independent significant factor for obesity in women. Preventive health care programs to re­duce risk of obesity in women should be applied, considering their occupation for achieving more effectiveness. https://ijph.tums.ac.ir/index.php/ijph/article/view/3055

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 40 2 2011 06 15 96 101 F Khodaverdi F Alhani A Kazemnejad Z Khodaverdi 2015 10 03 Background: To determine relationships between healths related quality of life and body mass index in children aged 9-11 years old. Methods: This cross sectional study was conducted on 240 children 9-11 year olds who were selected via multi stage cluster sampling design from primary schools in the Shahre Qods of the Tehran, Iran in 2007. Pediatric Quality of Life inventory was completed by child self report with measured height and weight used to determine body mass index percentile/weight classification. Obesity was defined as body mass index (BMI) ≥95th percentile for age and gender and one way analyses of variance (ANOVA) was used for data analyses. Results: Physical, social and school functioning was significantly lowered for obese when compared to normal weight children (P<.05). The impairment in QOL in the community-based sample of elementary school children was less marked than clinical sample of obese. Obese children maintain emotional health. Conclusion: These results highlight the importance in considering dimensions of quality of life at further understanding obesity in children. https://ijph.tums.ac.ir/index.php/ijph/article/view/3056 https://ijph.tums.ac.ir/index.php/ijph/article/download/3056/2855

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 40 2 2011 06 15 102 109 N Aryaeian M Djalali F Shahram Sh Jazayeri M Chamari SA Nazari 2015 10 03 Background: Many studies have investigated the possible role of reactive oxygen species in the etiology and patho­gene­sis of Rheumatoid Arthritis (RA). The aim of this study was to investigate the activities of some antioxidants in RA patients. Methods: In this case-control study, 59 RA patients and 60 healthy sex and age-matched controls were selected. Vitamin E and Beta-carotene were determined using HPLC. Erythrocytes glutathione reductase (GR) activity was meas­ured spec­trophotometrically, and malondialdehyde (MDA) was determined by colorimetric method. Aryles­terase activity (AEA) was measured by Phenylacetate. The clinical data were determined by a rheumatologist, medical history and filling the questionnaire by interview. Statistical analyses were carried out using the SPSS software. Results: In patients with RA, serum MDA level was significantly higher and plasma concentration of vitamin E, Beta-carotene and GR activity, were significantly lower than healthy control (P<0.001). AEA activity differences between two groups