Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 25 33 Afsaneh AFZALI Mohd RASHID Kusnin NOORHAFIZAH Mohd Rashid AMMAR 2015 10 20 2015 10 20 Background: The Air dispersion models are widely used to evaluate and predict the pollutants emissions from air pollution sources such as incinerators. This study attempts to predict the heavy metal pollutants dispersion emitted by an incineration plant impacting its surrounding area. Methods: Several scenarios of emission rates coupled with the meteorological conditions were investigated using the AERMOD dispersion model. Results: The maximum ground level concentration (GLC) of pollutants was within their respective air quality guidelines concentration and fall within the distance of 0.5 km from the stack. Conclusion: The pollutant concentration decreases with distances from the incineration plant, which does not seem to contribute a significant human exposure problem to the residence living more than 1.5 km away.   Keywords: Pollution dispersion, AERMOD, Incinerator, Heavy metals   https://ijph.tums.ac.ir/index.php/ijph/article/view/4860 https://ijph.tums.ac.ir/index.php/ijph/article/download/4860/4452

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 1 6 Sivasankar SAMBASIVAM Karmegam KARUPPIAH Shamsul Bahri Mohd Tamrin Kulanthayan Subramaniam Hassan Sadeghi Naeini 2015 10 20 2015 10 20 Background: Seat belts have been proven as one of the most successful means of preventing or reducing injuries to occupants of cars during an accident. This paper examines the reasons behind the non-compliance of the seat belt law in Malaysia and suggests possible measures to get the percentage of seat belt usage up higher. Methods: Various databases of articles were searched for seat belt usage in Malaysia, related legislation, related accident data, type of injuries and reviewed to put forth the need for a new measure to increase the usage of seat belts in Malaysia. Results: In various studies carried out previously, car occupants (driver and front passenger) used the seat belts mainly with the knowledge that seat belts prevents injuries, the fear of being fined by the authorities, comfortability of the seat belt, speed of travel, trip purpose and driving location. However, when these factors are removed, seat belts usage starts becoming lax. Other reasons were driving short distance (known location), forgetfulness and were in a hurry. Conclusion: Enforcement of seat belt usage by either the Police or Road Transport Department is only a short term solution. The relevant agencies are urged to consider making compulsory for all car makers in Malaysia to enable a system where the car would not be able to start without the seat belt being fixed first for the driver and passenger and to make auto seat belt fixing enabled in the car when the driver and or passenger enters the car.   Keywords: Seat belt, Safety, Compliance, Car, Malaysia https://ijph.tums.ac.ir/index.php/ijph/article/view/4857 https://ijph.tums.ac.ir/index.php/ijph/article/download/4857/4449

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 34 41 Ahmad Faisal AHMAD NASARUDDIN Shamsul Bahri MOHD TAMRIN Karmegam KARUPPIAH 2015 10 20 2015 10 20 Background: The primary objective of this study was to determine the association between risk factors and the prevalence of musculoskeletal disorder (MSD) among auto repair mechanics in Klang Valley, Malaysia. Methods: Overall, 191 mechanics from eight auto repair centers in Klang Valley, Malaysia were stratified sampling as participants of this study. A modified version of the general Standardized Nordic Questionnaire was used for analyses of perceived MSD in nine different parts of the body. Rapid Upper Limb Assessment (RULA), vibration measurement on hand power tool, questionnaire on job content, force exertion was used in this study. Direct logistic regression was performed to assess the impact of risk factors on the MSD prevalence. The probability limits for evaluating statistical significance was P < 0.05. Results: 87.4% of auto repair mechanics suffered from MSD. Logistic regression analysis revealed that factors were associated with symptoms on MSD: RULA (7.933, 95% CI 4.637-13.573) and orceful exertion (3.173, 95% CI 1.194 – 8.432). The magnitude of vibration of power tool exceeds action level 2.5m/s2 with (Mean=3.99+S.E. 0.071) and showed significant association with MSD in this study (P<0.05). Conclusion: Auto repair mechanics at auto repair centers in Klang Valley are likely to be exposed to a variety of ergonomic hazards and risk factors. Therefore, ergonomics awareness between employer and employee with training and information sharing shall be increase to reduce the prevalence of MSDs.   Keywords: Musculoskeletal disorder (MSD), Auto repair mechanics, Hand arm vibration https://ijph.tums.ac.ir/index.php/ijph/article/view/4861 https://ijph.tums.ac.ir/index.php/ijph/article/download/4861/4453

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 7 16 Zorawar SINGH Indrakaran P. KARTHIGESU Pramjit SINGH Rupinder KAUR 2015 10 20 2015 10 20 Malondialdehyde (MDA) is widely used as a biomarker for assessing oxidative stress in biomedical fields. Lipid peroxidation is a chain phenomenon resulting in the formation of various active compounds that result in cellular damage. Biomonitoring of MDA has been used in both in-vivo and in-vitro studies as a key biomarker for various disease patterns including hypertension, diabetes, atherosclerosis, heart failure and cancer. Higher levels of MDA are reported in patients of various categories including lung cancer patients, complex regional pain syndrome patients and glaucoma patients. The findings suggest the validity of the MDA assay as a reliable tool in finding out the oxidative stress in different disease pathologies. The present review emphasizes on the reliability and efficacy of MDA estimation in various health disorders. Keywords: Malondialdehyde, Lipid peroxidation, Free radicals, Oxidative stress https://ijph.tums.ac.ir/index.php/ijph/article/view/4858 https://ijph.tums.ac.ir/index.php/ijph/article/download/4858/4450

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 42 52 Aziemah ZULKIFLI Najihah Zainol ABIDIN Emilia Zainal ABIDIN Zailina HASHIM Irniza RASDI Sharifah Norkhadijah Syed ISMAIL Anita Abd RAHMAN Che Nin MAN 2015 10 20 2015 10 20 Background: This study aimed to assess the burden of household smoking habits on the occurrence of respiratory symptoms among young adolescents in Malaysia. Methodology: The impact of Secondhand Smoke (SHS) exposures on the occurrence of respiratory symptoms was investigated on 234 adolescents (13-14 years old) residing in two states in Malaysia. Adolescents completed a self-administered questionnaire adapted from Global Youth Tobacco survey that comprised of items on socio-demographic and SHS exposures. Respiratory symptoms were assessed using a standard questionnaire of International Study of Asthma and Allergies in Childhood. Hair samples were collected from each adolescent and were analyzed for nicotine via Gas Chromatography-Mass Spectrophotometry with nitrogen detection method. Result: The geometric mean of hair nicotine was 0.0184± 2.31 ng/mg. The prevalence of current, ever wheeze, nocturnal cough, exercised-induced wheeze and self-reported asthma were 7.69%, 14.1%, 11.5%, 20.5% and 13.7%, respectively. A significant association was found between household smoking status with exercise-induced wheeze (Adjusted Odds Ratio, AOR 1.06; 95%Confidence Interval, CI 0.42-2.66) and nocturnal cough (AOR 14.2; 95%CI 1.60-125). Reported ever wheeze was linked to reported SHS exposure in family’s vehicle (AOR 3.27; 95%CI 1.15-9.34). The risk of exercise-induced wheeze was related with postnatal SHS exposure (AOR 2.69; 95%CI 1.13-6.43). Conclusion: Respiratory symptoms were mostly affected by household smoking habits. Thus, in an attempt to reduce the repercussion of SHS exposure among younger adolescents, effort should be emphasized in encouraging parents to move from indoor to outdoor smoking far from the vicinity of children. Keywords: Passive smoking, Household smoking habits, Youth, Respiratory health, Hair nicotine  https://ijph.tums.ac.ir/index.php/ijph/article/view/4862 https://ijph.tums.ac.ir/index.php/ijph/article/download/4862/4454

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 17 24 Haliza ABDUL RAHMAN 2015 10 20 2015 10 20 Malaysia is affected by moderate environmental disasters but seldom affected by severe disaster. Cameron Highland mud floods 2013, Hulu Langat landslide 2011, tsunami 2004 and Highland Tower 1993 are some of environmental disaster in Malaysia. Some of these disasters carry heavy price tags as property and lives are damaged beyond full compensation and repair and health effects as well. This paper was focused on environmental disaster in Malaysia with reference to flood and landslide. The scope of this paper is to provide input for a clearer understanding of these disasters and how public could be safe from these hazards with preparedness strategies. This paper involved with secondary data collected from journal, proceedings, books, related agencies and internet sources as well. Normally, humankind is capable of saving their self and Earth as well, if they recover the principles of solidarity, complementarity and harmony with nature in contraposition to the reign of competition, profits and rampant consumption of natural resources. They also must strongly support a sustainable development and a sustainable land use concept in order to sustain the environment from degrades. In addition, community-based disaster preparedness is essential in preventing and responding to the full array of environmental disasters in keeping human losses as low as possible. Ways must be found to ensure that a community is strengthened, becoming less fragile and less susceptible to environmental disaster impact. In addition, community needs to be assist in order to survive despite receiving the impact of severe disasters.   Keywords: Environmental disaster, Malaysia, Human activity https://ijph.tums.ac.ir/index.php/ijph/article/view/4859 https://ijph.tums.ac.ir/index.php/ijph/article/download/4859/4451

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 53 57 Baba Md DEROS Dian D.I. DARUIS Nor Kamaliana KHAMIS Darliana MO­HAMAD Siti Fairus Mat DAUD Siti Maisarah AMDAN Ridzuan Abd AZIZ Nooraini JAMAL 2015 10 20 2015 10 20 Background: The nature of work in the construction industry is closely associated with many human factor hazards. Manual construction workers are exposed to hand-arm vibration, repetitive movements, holding of heavy loads and tools, and frequent manual materials handling hazards in their daily tasks. Work related musculoskeletal disorders are major problems faced by construction workers, which involve the nerves, tendons, muscles and other supporting structures of the body. Two main objectives of this study were firstly, to determine the risk factors and the prevalence and secondly, to identify the association of the risks with muscular musculoskeletal disorders symptoms among construction workers. Methods: Evaluation was done through survey questionnaire which also involved the standardized Nordic questionnaire. Sixty male construction workers aged between 17 to 50 years old took part in the study. Their main daily tasks are bricklaying, skim coating, housekeeping and plastering. Results: 66.7% of the workers who took part in the study had high prevalence of musculoskeletal disorders symptoms at their elbows, wrists or hands and ankles or feet. Conclusion: Manual construction workers are highly exposed to the risks of getting work related musculoskeletal disorders and there are significant associations (P = 0.023) between working duration with MSDs symptom among construction workers with respect to the workers lower limb.   Keywords: Musculoskeletal disorders, Manual construction workers, Risk factors https://ijph.tums.ac.ir/index.php/ijph/article/view/4863 https://ijph.tums.ac.ir/index.php/ijph/article/download/4863/4455

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 58 66 Dian Darina Indah DARUIS Norazmira Wati AWANG Baba Md. DEROS Ahmad Rashdan ISMAIL 2015 10 20 2015 10 20 Background: Sound produced by the passing traffic contributes to noise pollution. Noise pollution affects the residents of both city and suburban areas. The noise produced does not only disturb the community living nearby the main road during the day but becomes worse during the night. The purpose of the study is to perform noise level measurement and subjective evaluation on the noise produced at night in a residential area along Paka Road, Dungun, Terengganu. Methods: Data of the noise level produced at night in the residential area were taken at three different locations using SoundTrack LxT sound level meter. These locations determined the effect of distances to the noise being heard. Data were recorded to produce LAeq, Lmax, L10 and L90. Noise pollution levels (LNP) and traffic noise index (TNI) were also reported. A subjective evaluation was conducted to investigate residents' perception of the effects of traffic noise at night in their daily life routine. This study employed a questionnaire specially constructed for the study based on related literature review. Results: The noise levels inside and outside of the residences exceeded the noise level permitted by Department of Environment (DOE) and World Health Organization (WHO). The noise level in the residence was 66.4 dBA which is much higher than the level proposed by DOE. While the highest LAeq of the traffic noise measured inside the residence was 57.5 dBA which is also considered as high. Moreover, the maximum noise level inside the residences could reach up to 85.3 dBA at night during the weekends.This study also showed that from 114 respondents who were selected randomly, 61% felt that their residential area is noisy at night. Conclusion: The noise produced by the traffic at Paka Road, Dungun at night is considerably high and affects the residents’ quality of life.   Keywords: Malaysia, Traffic, Noise  https://ijph.tums.ac.ir/index.php/ijph/article/view/4864 https://ijph.tums.ac.ir/index.php/ijph/article/download/4864/4456

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 67 71 Yu Bin HO Mohamad Pauzi ZAKARIA Puziah Abdul LATIF Nazamid SAARI 2015 10 20 2015 10 20 Background: Repeated applications of animal manure as fertilizer are normal agricultural practices in Malaysia that may release veterinary antibiotics to environment from treated animals. Methods: Environmental risk assessment (ERA) on 5 commonly used antibiotics and one hormone in Malaysian broiler farm was calculated using the ratio of measured environmental concentration (MEC) and predicted no effect concentration (PNEC) in the environment. PNEC was derived from the available acute and chronic toxicity data in the open peer-reviewed literature. Risk quotients (RQ) were then calculated for 5 antibiotics (erythromycin, norfloxacin, sulfadiazine, trimethoprim, and tylosin) and one hormone (progesterone). Results: RQ for tylosin has exceeded 1, indicating that this compound has high risk of acute toxicity in Malaysian agricultural soil while trimethoprim and tylosin possessed medium risk of chronic toxicity. The rest of the compounds showed low risk or no risk in acute or chronic ecological toxicity. Conclusion: The release of tylosin, trimethoprim, norfloxacin and progesterone from broiler manure to agricultural soil may potentially harm the environment. Keywords: Veterinary antibiotic, Environmental risk assessment, Risk quotient, Malaysia https://ijph.tums.ac.ir/index.php/ijph/article/view/4865 https://ijph.tums.ac.ir/index.php/ijph/article/download/4865/4457

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 72 80 Irwan Syah MOHD YUSOFF Shamsul Bahri MOHD TAMRIN Aini MAT SAID Yee Guan NG Mori IPPEI 2015 10 20 2015 10 20 Background: The aim of this study is to develop a new ergonomics chisel based on user centered design approach and to evaluate the effectiveness for reducing awkward posture using CATIA software for simulation analysis. Methods: Respondents were selected using purposive sampling – age 18 – 49 years old, men, experience using chisel (>1 month). A set of questionnaire were used to interview workers while postural risks were determined using Rapid Upper Limb Assessment (RULA). Selected anthropometric parameters were taken and user centered design concept were applied to determine mismatch and to facilitate design process. CATIA software was used to integrate the results of postural analysis and anthropometric measurement using 3D modeling. Results: A total of 273 male harvesters participated in this study. The result shows 5.2% of the chisels’ length of handles matches with the respondents whereas none (100%) of the chisels’ circumference of handle matches with respondents’ internal grip diameter. Tool-chisel usage, majority of harvester bend forward while harvesting (96.7%) and most of workers having blister (83.2%), redness (85.3%) and numbness (65.9%) during harvesting. RULA simulation analysis showed the score action level for new design is 3(further investigated need and changes may be required) compared to existing tool are in action score 7(investigated and changes required immediately). Conclusions: The study showed that the design of new harvesting tool has the potential to reduce awkward body posture during harvesting activities as compared to existing tools.   Keywords: Harvesting tool, Awkward posture, User centered design, CATIA simulation https://ijph.tums.ac.ir/index.php/ijph/article/view/4866 https://ijph.tums.ac.ir/index.php/ijph/article/download/4866/4458

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 81 88 Tezara CIONITA Juliana JALALUDIN Nor Mariah ADAM Januar Parlaungan SIREGAR 2015 10 21 2015 10 21 Background: Carbon dioxide (CO2) is one of the most commonly used indicators of indoor air quality (IAQ) in industrial area. The higher concentration level of CO2 and particulate matter (PM10) in day care centre could affect children’s health. The objective of this study was to assess children’s health symptom, and measure the CO2 and PM10 concentration level as IAQ parameters in different locations of day care centres near the industrial area at Kuala Lumpur, Selangor and Hulu Langat as urban, suburban and rural areas respectively. Methods: The data of children’s health symptom were collected from the distributed questionnaire. Results: The day care centres (DCC) in Kuala Lumpur has the highest number of children’s illness frequency of more than four times annually (11%), followed by the highest number of children who experienced asthma (5.3%), wheezing (3.3%) and coughing (10%). The results of data collection of day care centres in Kuala Lumpur, Selangor and Hulu Langat ranged between 629-830 ppm, 587-823 ppm and 600-830 ppm for CO2 level, and 60.80-78.60 mg/m3, 56.90-80.50 mg/m3 and 59.90-79.10 mg/m3 for PM10 level. The statistical analysis for CO2 level between areas was significantly different (P<0.05). Conclusion: Day care centers in Kuala Lumpur have the highest mean rate of CO2 and PM10 as well as frequency of children’ illness which could identify traffic congestion and less greenery of a densely populated city.   Keywords: Day care centre (DCC), IAQ, CO2, PM10, Health symptoms https://ijph.tums.ac.ir/index.php/ijph/article/view/4883 https://ijph.tums.ac.ir/index.php/ijph/article/download/4883/4459

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 89 93 Qi Jie KWONG Nor Mariah ADAM Tezara CIONITA Vijay R RAGHAVAN Mohd Fareq ABD MALEK 2015 10 21 2015 10 21 Background: Many studies have been conducted to assess the indoor air quality (IAQ) of buildings throughout the world because it is closely related to comfort, safety and work productivity of occupants. However, there is still lack of available literature about IAQ in tropical buildings that apply radiant cooling systems in conditioning the indoor air. Methods: This paper reports the results obtained from an IAQ audit that was conducted in a new radiantly cooled building in Malaysia, by focusing on the IAQ and thermal comfort parameters. Results: It was identified that the measured concentration levels for the five indoor air contaminants (CO, CO2, TVOC, formaldehyde and respirable particulates) were within the threshold limit values (TLVs) specified in the IAQ guidelines. Besides, no significant difference was found between the contaminant levels in each floor of the studied building, and a majority of the respondents did not encounter any form of physical discomfort. There is a risk of condensation problem, judging from the measured RH level. Conclusion: An increase of airflow rate and more dehumidification work in the studied building can be made to improve IAQ and prevention of condensation problem. Nevertheless, these schemes should be implemented carefully to avoid occupants’ discomfort. Relocation of workstations was suggested, especially for the lower floors, which had higher occupancy levels.   Keywords: Indoor air quality (IAQ), Radiant cooling systems, IAQ audit, Indoor air contaminants, Condensation   https://ijph.tums.ac.ir/index.php/ijph/article/view/4884 https://ijph.tums.ac.ir/index.php/ijph/article/download/4884/4460

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 94 102 Soo Hui LIAW Zailina HASHIM Munn Sann LYE Huda, ZAINUDDIN 2015 10 21 2015 10 21 Background: This study was to determine the prevalence of respiratory health complaints, allergy symptom, lung functions, and the association between airborne concentrations of chromium and aluminium with respiratory health and allergy symptoms among machining industry workers in Selangor, Malaysia. Methods: The study design was a cross-sectional comparative study. The respiratory and allergy symptoms were obtained through the American Thoracic Society (ATS) Adult Respiratory Questionnaire (ATS-DLD-78)  modified questionnaire. Results: The MWFs unexposed group had significantly higher TWA8 airborne aluminum concentration (median = 0.24 µg/m3) than the exposed group (median = 0.13 µg/m3) (P=0.027). However, no significant difference was found in the airborne chromium between both groups. Significantly higher skin itchiness was reported by the MWFs exposed group. This was further supported by the serum total IgE concentrations which was significantly higher among MWFs exposed group than the unexposed group (P=0.024). The prevalence of total serum IgE was significantly higher for the exposed group (54.3%) than the unexposed group (36.9%). The exposed group reported significantly higher prevalence of cough symptom, morning cough with sputum and health worries caused by metalworking fluids than the unexposed group. Conclusion: This study showed significantly higher allergy and respiratory symptoms among the MWFs exposed group than the unexposed group.     Keywords: Machining industry, Metalworking fluids, Allergy symptoms, IgE, Lung function https://ijph.tums.ac.ir/index.php/ijph/article/view/4885 https://ijph.tums.ac.ir/index.php/ijph/article/download/4885/4461

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 103 111 Aini Syuhaida ABDUL WAHAB Sharifah Norkhadijah SYED ISMAIL Sarva Man­gala PRAVEENA Suriyani AWANG 2015 10 21 2015 10 21 Background: Neptunia oleracea or ‘water mimosa’ has a phytoremediation ability which is rarely being assessed. This plant also can be eaten as raw or cooked and but brought such concern on its safety for human consumption. The objective of this study was to assess the phytoremediation ability of water mimosa and its safety for human consumption. Methods: Water mimosa was treated with Pb, Cu and Cd at concentrations of 0.5 to 20 mg/L and the level of heavy metals uptake was measured. Treated plants were also harvested and soaked in boiled water (100˚C) for 2 to 10 minutes to determine the level of heavy metals reduction. Heavy metals were detected by Inductively-Coupled Plasma-Optical Emission Spectrometry (ICP-OES).  Experiment was conducted in the Environmental Health laboratory, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia from June to December 2013. Results: Water mimosa accumulates up to 93% of Cd (5 mg/L) after 10 days of treatment, the highest as compared to Cu (80%) and Pb (50%). It also has the highest BCF when treated with 10 mg/L of Cd. The heavy metals concentration in plant tissue decreased as the boiling time increased. Conclusion: The overall results demonstrated that water mimosa could be used to remediate wastewater polluted with Cd, Cu and Pb. The plant is not recommended for human consumption as its ability to retain heavy metals in edible parts.   Keywords: Phytoremediation, Water mimosa, Heavy metals, Food safety, Green technology https://ijph.tums.ac.ir/index.php/ijph/article/view/4886 https://ijph.tums.ac.ir/index.php/ijph/article/download/4886/4462

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 112 116 Norhidayah MAT AZIS Amielia AB HAMID Hui Ping PUNG Putri ‘Amirah ABDUL RA­FEE Farizatul Akmawati YAHYA Syafinaz AMIN NORDIN Vasanthakumari NEELA Zarizal SUHAILI Mohd Nasir MOHD DESA 2015 10 21 2015 10 21 Background: This study was undertaken to evaluate Staphylococcus aureus carriage and persistence in health sciences students at the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. Methods: Consent form and self-administered questionnaires on socio-demographics, hygienic practices, medical and medication history were distributed followed by nasal swab collection; sampling was done twice in one month interval in October and November 2013. Bacterial identification followed the standard phenotypic methods. Antibiotic susceptibility of isolates against oxacillin and cefoxitin was tested by disc diffusion method. Methicillin resistance determinant gene (mecA) was detected through polymerase chain reaction-assay. Results: S. aureus was isolated from 31.3% (60/192) and 33.3% (60/180) of the student population during the first and second sampling respectively. Among the S. aureus-positive participants, about 65% of them were persistent carrier (S. aureus was detected during both sampling exercises). Six methicillin-resistant S. aureus (MRSA) were detected (four and two isolates in the two sampling events respectively) as inferred by decreased susceptibility to oxacillin and cefoxitin and presence of mecA gene; two of the strains were from a single individual. Fisher’s exact test showed no significant correlation between carriage and the tested risk factors except for the habit of touching nose and chronic illnesses (P < 0.05), with a higher incidence of S. aureus among those associated with the two risk factors. Conclusions: As far as the limited sampling period is concerned, these findings indicate that a proportion of the student population may be at infection risk. Avoiding frequent nose-touching could be one of the preventive measures.   Keywords: Staphylococcus aureus, Infection risk, Nasal carriage, MRSA https://ijph.tums.ac.ir/index.php/ijph/article/view/4887 https://ijph.tums.ac.ir/index.php/ijph/article/download/4887/4463

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 117 124 Nik Nor Ronaidi NIK MAHDI Norsa’adah BACHOK Norlen MOHAMED n National University, Incheon, Republic of Korea 3. Sports Functional Disability Institute, Incheon National University, Incheon, Republic of Korea 2025 04 02 2025 05 09 No Abstract. Not Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/38690 https://ijph.tums.ac.ir/index.php/ijph/article/download/38690/8588

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1263 1271 EN Li Zheng 1. College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China 2. Department of Pharmacy, Xingtai Medical College, Hebei, People’s Republic of China Yiheng Ding Hebei Key Lab of Laboratory Animal Science, Hebei Medical University, Hebei, People’s Republic of China Xinhao Li College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China Jingxuan Jia College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China Yanning Li College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China 2. Hebei Key Lab of Laboratory Animal Science, Hebei Medical University, Hebei, People’s Republic of China Jinsheng Qi College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China 2024 03 16 2025 06 02 Background: We aimed to investigate whether 20(S)-ginsenoside Rg3 (Rg3) reduced heterogeneity by inducing the maturation of HepG2 cells via the AMP-activated protein kinase (AMPK)/hepatocyte nuclear factor 4A (HNF4A) pathway. Methods: This in vitro cell research study was conducted under the guidance of Hebei Medical University, Hebei, China, from Sep 2022 to Dec 2023. HepG2 cells were treated with varying concentrations of Rg3 in a low glucose microenvironment. The mRNA expression of ALBUMIN (ALB, a marker for hepatocyte function) and HNF4A (a marker for differentiation of HCC cell), and AMPK protein levels were measured after significant changes in cell morphology were observed. Additionally, 5-Aminoimidazole-4-carboxamide1-β-D-ribofuranoside (AICAR) (an AMPK agonist) and Compound C (an AMPK inhibitor) were used to explore further the underlying mechanism. Results: Under treatment of 5 μM, 10 μM, and 20 μM Rg3, some cells became flattened and larger, and there was an increase in the mRNA expression of ALB and HNF4A (P<0.05). However, there was a decreasing trend in AMPK protein content with 8 μM Rg3 (P<0.05). Compared to the control group, some cells exposed to 8 μM Rg3 exhibited pronounced morphological changes, along with upregulated expression of ALB and HNF4A mRNA. However, no such changes were observed when 8 μM Rg3 was combined with 1.6 mM AICAR. Compared to the control group, 10 μM Compound C or 8 μM Rg3 treatments led to similar changes in cell morphology and showed an increasing trend in HNF4A mRNA expression. Additionally, after treatment with Compound C, pHNF4A was mainly in the nucleus, while after Rg3 treatment, it was mostly in the cytoplasm. Conclusion: Rg3 partially induced the maturation of HepG2 cells through the AMPK/HNF4A pathway.     Keywords: 20(S)-ginsenoside Rg3; HepG2; Maturation, Genetics https://ijph.tums.ac.ir/index.php/ijph/article/view/34913 https://ijph.tums.ac.ir/index.php/ijph/article/download/34913/8578

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1171 1178 Haiyan Cai Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, 310009, China Liwen Pan Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, 310009, China Pei Zhang Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, 310009, China 2024 05 14 2024 12 22 Background: Perioperative care plays an unparalleled role in the management of strabismus. However, there is still a lack of adequate understanding of the perioperative care and guidelines on nursing measures for strabismus surgery. This article provides a comprehensive review of perioperative care for strabismus, focusing on psychological intervention and rehabilitative nursing. Methods: To comprehensively collect research related to perioperative nursing, we employed a systematic literature retrieval strategy. The databases searched included PubMed, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), WanFang, and VIP (Weipu). We read, summarized and review the literatures obtained from databases. Results: We summarized the conclusions in the retained literature and elaborated from two aspects: Psychological intervention and Rehabilitation Nursing. Psychological intervention can be carried out from the following aspects: cognitive behavior intervention, psychological and emotional intervention, social support intervention. Perioperative rehabilitation can be carried out from the following aspects: postoperative nausea and vomiting management, prevention of postoperative infection, visual care, preventing recurrent strabismus post-surgery, avoiding diplopia. Conclusion: Comprehensive perioperative care for patients with strabismus can alleviate negative emotions, improve psychological status, reduce the incidence of postoperative complications, and enhance patients' quality of life. However, further research is still needed to establish detailed intervention strategies for comprehensive care. https://ijph.tums.ac.ir/index.php/ijph/article/view/35515 https://ijph.tums.ac.ir/index.php/ijph/article/download/35515/8569

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1272 1281 Seyed Abbas Motevalian Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran Uni-versity of Medical Sciences, Tehran, Iran Seyyed Amir Yasin Ahmadi Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran Arash Tehrani-Banihashemi Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran 2024 08 05 2024 12 15 Background: Considering the high importance of the problem of obesity and its related factors, we aimed to investigate the mediating role of physical activity in the relationship between personality traits and body mass index (BMI) in the participants of the employees’ health cohort study of Iran (EHCSIR) using generalized structural equation modeling (GSEM). Methods: A secondary analysis with cross-sectional approach was conducted on the existing data using multilevel GSEM. The primary data of the cohort was collected from July 2017, Iran University of Medical Sciences, Tehran, Iran. Personality traits were exposure, physical activity was the mediator, and BMI was the outcome. Sex was the stratifying variable. Then, pathways with the largest P values were removed one by one using backward stepwise approach. Results: The data of a total of 3554 participants of EHCSIR were used. Sex was subjected for grouping the analysis. In males, extroversion (EX) was the only personality trait associated with both physical activity and BMI. In the direct pathway, EX was positively associated with BMI. In the indirect pathway, EX was negatively associated with BMI (P <0.1). The total effect was positive. In females, physical activity was not associated with BMI, and therefore, no indirect pathway was formed from personality traits to BMI (P >0.1). Conclusion: The role of personality traits in obesity was more dominant in females, while in males, physical activity had a role in obesity. The hypothesized mediation pathway of the study title was not approved in females, and in males, was approved only for EX personality trait. https://ijph.tums.ac.ir/index.php/ijph/article/view/36272 https://ijph.tums.ac.ir/index.php/ijph/article/download/36272/8579

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1179 1192 Pavan Narapaka Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur, Dist. Vaishali, Bihar, India Manisha Singh Department of Medical Oncology, Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, India Sarasa Meenakshi Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur, Dist. Vaishali, Bihar, India Jaseena C V Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur, Dist. Vaishali, Bihar, India Manasa Goudicharla Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur, Dist. Vaishali, Bihar, India Krishna Murti Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur, Dist. Vaishali, Bihar, India Sameer Dhingra Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur, Dist. Vaishali, Bihar, India 2024 08 28 2024 12 14 Background: This study aimed to provide comprehensive information on translated versions of the 9-item shared decision-making questionnaire, widely used to measure patient involvement in shared decision-making, by combining psychometric validation information. Methods: We searched various databases such as PubMed, Scopus, Google Scholar, along with developer website to gather pertinent literature published until Feb, 2024. This psychometric validation carried out based on item characteristics, content validity, and factor analysis results of individual studies. Our evaluation was based on predetermined cut-off values for item difficulty, discrimination index, Cronbach's alpha, Kaiser Meyer Olkin factor (KMO), Bartlett's test of sphericity, and factor extraction and rotation, confirmatory factor analysis range. The European Social Research Council guidance on the conduct of narrative synthesis in systematic reviews was employed for synthesis of validation results. Results: The final analysis included nine studies with 3090 participants from various countries, and most participants had adequate literacy, and age range was 30-60 yr. Most model versions had a good fit, and all studies reported satisfactory results, except for one study's discrimination index values. The tool's validity was satisfactory. Most of the studies reported a convenient sample was the main limitation, along with recall bias in the final responses. Conclusion: The 9-item shared decision-making tool can be used to measure patient involvement in shared decision-making in validated language-respected countries, as proper evaluation procedures reported satisfactory results in the confirmatory analysis models and reliability testing.   https://ijph.tums.ac.ir/index.php/ijph/article/view/36488 https://ijph.tums.ac.ir/index.php/ijph/article/download/36488/8570

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1282 1290 Marzie Salandari Rabori Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Aghdas Souresrafil Department of Health Services and Health Promotion, School of Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Mohsen Rezaeian 1. Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran 2. Department of Epidemiology and Biostatistics, School of Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Hasan Ahmadinia 1. Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran 2. Department of Epidemiology and Biostatistics, School of Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Roya Bahrami Department of Psychology, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Mahdie Sadat Hosseini Educator of Midwifery Department, School of Nursing Midwifery Health, Islamic Azad University, Kerman, Iran Maryam Hasanshahi Nurse Emergency Department, Ali-Ibn Abi-Talib Hospital,Rafsanjan University of Medical Sciences, Rafsanjan, Iran Azam Bagherizade Clinical Laboratory, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran 2024 05 12 2025 06 02 Background: Suicide is an intentional act that results in the death of a person. Clinical researchers show that a new era has begun in understanding suicide pathophysiology. Our study assessed serum minerals (Fe, Mg) and vitamins (D, B12) to see if they are related to suicide attempts. Methods: This is a cross-sectional study conducted in Ali-ebn-Abi Taleb Hospital, Rafsanjan City Central District, Kerman Province, Iran in 2022. Prior to measuring the quantity of essential minerals and vitamins in the blood, the degree of depression was assessed using the Beck depression severity scale. Chi-square, Independent T-test, Kruskal-Wallis, and Mann Whitney U test were performed to ascertain the existence of an association between these substances within the body and suicide attempts. Results: Thirty-two attempted suicides (24 women and 8 men, mean age 14-46 yr) were included in this study. The mean and standard deviation of depression scores for 32 candidates was 16.43 ± 26.74. Moreover, our results show nearly 46.7% (50% women and 37.5% men) of participants suffer from vitamin D deficiency and 6.7% from Mg deficiency, half of them have also severe depression. Conclusion: One of the reasons for the cause of depression and suicide attempt could be the status of minerals and vitamins in the body. Therefore, it is likely that a suitable diet and checking blood factors might help to reduce suicide attempts in a society. https://ijph.tums.ac.ir/index.php/ijph/article/view/35486 https://ijph.tums.ac.ir/index.php/ijph/article/download/35486/8580

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1193 1203 Yan Gao Department of Obstetrical, First Affiliated Hospital, Heilongjiang University of Chines Medicine, Harbin 150001, Heilongjiang Province, China Limin Peng Department of Obstetrical, First Affiliated Hospital, Heilongjiang University of Chines Medicine, Harbin 150001, Hei-longjiang Province, China Chengkun Yuan Department of Obstetrical, First Affiliated Hospital, Heilongjiang University of Chines Medicine, Harbin 150001, Heilongjiang Province, China Shanshan Zhang Department of Obstetrical, Beidahuang Group General Hospital, Harbin 150000, Heilongjiang Province, China 2024 12 14 2025 01 25 Background: This study aimed to evaluate the efficacy and safety of intravenous immunoglobulin (IVIG) therapy for recurrent miscarriage (RMC) using meta-analysis. Methods: Literature from Jan 1990 to Feb 2024 was searched in PubMed, etc., using keywords such as “IVIG”, “repetitive miscarriage”, and “RMC”. Two authors independently assessed the literature quality and risk of via Cochrane handbook, and extracted basic information and outcome indicator data. Meta-analysis was performed employing Review Manager 5.3. Results: Eleven studies were involved, comprising 842 patients, of which 391 received IVIG therapy and 451 received placebo treatment. Relative to placebo group, IVIG group had a notably higher overall live birth rate (OR=2.24, 95% CI=1.68~2.98, Z=5.51, P<0.00001) and a greatly lower miscarriage rate (OR=0.46, 95% CI=0.22~0.95, Z=2.09, P=0.04). Subgroup analysis revealed that both primary and secondary RMC patients in IVIG group had markedly higher live birth rates versus placebo group (OR=2.13, 95% CI=1.18~3.83, Z=2.51, P=0.01; OR=1.50, 95% CI=0.98~2.30, Z=1.96, P=0.04). Nevertheless, the adverse reaction (AR) rate in IVIG group was superior to that in placebo group (OR=4.47, 95% CI=1.01~19.81, Z=1.97, P=0.05). Conclusion: IVIG can markedly increase the live birth rate, reduce the miscarriage rate, and enhance pregnancy outcomes in patients with RMC. Nevertheless, the rate of ARs with IVIG therapy is relatively high, thus large-scale, multicenter, randomized controlled trials are needed for validation.   https://ijph.tums.ac.ir/index.php/ijph/article/view/37527 https://ijph.tums.ac.ir/index.php/ijph/article/download/37527/8571

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1291 1299 Zainab Mhmood Abdulhasan Department of Health Care Management, SR.C., Islamic Azad University, Tehran, Iran Ghobad Moradi 1. Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran 2. Center for Comonoidal Disease Control, Ministry of Health and Medical Education, Tehran, Iran Hayedeh Hoorsan Department of Nursing-Midwifery, Sa.C., Islamic Azad University, Sanandaj, Iran Yousef Moradi Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran Amjad Mohamadi Bolbanabad Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran 2024 10 09 2025 01 14 Background: Catastrophic health expenditures can lead to severe household financial burdens, exacerbating poverty and limiting access to necessary health services. This study examined the prevalence and determinants of catastrophic health expenditures among households in six provinces of Iraq. Methods: A cross-sectional design was employed, gathering data from 2,400 households in Baghdad, Wasit, Karbala, An-Najaf, Babil, and Maysan in 2023. A two-stage cluster sampling method was utilized, selecting 400 households from each province. Data were collected using WHO "World Health Survey" questionnaire, focusing on health expenditures and household income. Catastrophic health expenditures as defined as out-of-pocket costs exceeding 40% of a household’s capacity to pay. Statistical analyses, including logistic regression with calculating adjusted odds ratio, were performed using STATA14 software. Results: Overall, 246 households (12.6%) faced Catastrophic health expenditures, with a higher prevalence among female heads of households (13.1%) compared to males (12.6%). The multivariate logistic regression analysis indicated that households with 4 to 6 members had 1.52 times higher odds of facing catastrophic health expenditures (AOR=1.52, CI: 1.06 to 2.20). Furthermore, the poorest households had an AOR of 95.28 for experiencing catastrophic health expenditures (OR=95.28, CI: 13.12 to 691.49). Conclusion: This study underscores the urgent need for tailored policies to reduce the impact of CHE on Iraqi households. By improving access to healthcare and promoting equitable health insurance enrollment, policymakers can alleviate financial strain and support the health and well-being of vulnerable communities. https://ijph.tums.ac.ir/index.php/ijph/article/view/36867 https://ijph.tums.ac.ir/index.php/ijph/article/download/36867/8581

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1204 1215 Arghavan Madani Student Research Committee, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Zahra Esfandiari Department of Food Science and Technology, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran Yadolah Fakhri Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran 2024 05 01 2024 12 23 Background: The use of benzoic acid (BA) and its derivatives as food preservatives raises significant food safety concerns, as they may have potential adverse health effects. Method: In this systematic review, BA content was examined in different types of Iranian food with classification of dairy, acidic, beverage, and bakery products. Furthermore, the levels of this preservative compared with Iranian National Standards Organization (INSO) and the Codex Alimentarius Commission (CAC) value. Databases like PubMed, Scopus, and Web of Science were used to extract published studies until Feb 2024. Results: The limit defined by INSO was stricter than the CAC regarding BA in food. Consequently, the results demonstrated a relatively high level of impermissibility of BA with the INSO limit. However, the food products within the permitted range of