Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 10 2016 12 14 1247 1260 Yongqiu WU College of Economics and Business Administration, Chongqing University, Chongqing, China Yi HUANG College of Economics and Business Administration, Chongqing University, Chongqing, China Jintao LU School of Management, Northwestern Polytechnical University, Xi’an, China 2016 10 23 2016 10 23 Background: With the increased range of medical insurance coverage in China, the proportion of medical expenditure shouldered by individuals is declining. The problem is the rapidly growing scale of medical expenditures challenges the sustainability of medical insurance funds. Methods: This study used the Heckman selection model, survival analysis, and ordered probit model to evaluate the effect of medical insurance on the expenditures in outpatient and inpatient health care, survival time, and improvement of self-rated health of test subjects, respectively. Results: Medical insurance exerts a differential effect on the expenditures in outpatient and inpatient health care. On average, the expenditures in outpatient and inpatient health care of test subjects participating in premium health insurance plans increased by 38.6% and 72.6%, respectively. Participation in medical insurance plans exhibits no significant correlation with the survival time of test subjects, but their self-rated health shows a significant correlation (P < 0.01). Conclusion: Although medical insurance does not significantly reduce mortality or prolong the survival time of test subjects, it improves their health status. This study suggests that the Chinese government should eliminate deductible medical insurance payments and utilize medical resources on minor ailment treatment and disease prevention to improve the health status of people.     https://ijph.tums.ac.ir/index.php/ijph/article/view/8062 https://ijph.tums.ac.ir/index.php/ijph/article/download/8062/5571

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 10 2016 12 14 1359 1366 Masoud DEHGHAN TEZERJANI Medical Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Reza MAROOFIAN Monogenic Molecular Genetics, University of Exeter Medical School, Exeter EX1 2LU, UK Mohammad Yahya VAHIDI MEHRJARDI Medical Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AND Dept. of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Barry A. CHIOZA Monogenic Molecular Genetics, University of Exeter Medical School, Exeter EX1 2LU, UK Shiva ZAMANINEJAD Faculty of Dentistry, Golestan Uinversity of Medical Sciences, Gorgan, Iran Seyed Mehdi KALANTAR Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AND Dept. of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mahmoud NORI-SHADKAM Dept. of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Hamidreza GHADIMI Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran Emma L. BAPLE Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK Andrew H. CROSBY Monogenic Molecular Genetics, University of Exeter Medical School, Exeter EX1 2LU, UK Mohammadreza DEHGHANI Medical Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AND Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2016 10 23 2016 10 23 Oral-facial-digital syndrome as heterogeneous developmental conditions is characterized by abnormalities in the oral cavity, facial features and digits. Furthermore, central nervous system (CNS) abnormalities can also be part of this developmental disorder. At least 13 forms of OFDS based on their pattern of signs and symptoms have been identified so far.  Type 1 which is now considered to be a ciliopathy accounts for the majority of cases. It is transmitted in an X-linked dominant pattern and caused by mutations in OFD1 gene, which can result in embryonic male lethality. In this study, we present a family suffering from orofaciodigital syndrome type I who referred to Medical Genetics Research Center, Shahid Sadoughi University of Medical Sciences in 2015. Two female siblings and their mother shared a novel 2-base pair deletion (c.1964-1965delGA) in exon 16 of OFD1 gene. Clinically, the sibling had oral, facial and brain abnormalities, whereas their mother is very mildly affected. She also had history of recurrent miscarriage of male fetus.   https://ijph.tums.ac.ir/index.php/ijph/article/view/8076 https://ijph.tums.ac.ir/index.php/ijph/article/download/8076/5584

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 10 2016 12 14 1367 1368 Chen HONG Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China Tian JING-LUN People's Hospital of Wenjiang District, Chengdu 611130, China Cai LIN Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China Zeng BEN-QIANG People's Hospital of Wenjiang District, Chengdu 611130, China Zheng SHAOJUN Chengdu Tianfu New Area Public Security Bureau, Chengdu 610200, China Tian XIAO-BING North Shichuan Medical College, Nanchong, Sichuan 637000, China Zeng EN-QUAN North Shichuan Medical College, Nanchong, Sichuan 637000, China 2016 10 23 2016 10 23 The Temporal Decline of Social Support among Colorectal Can-cer Survivors: First Year Prospective Study https://ijph.tums.ac.ir/index.php/ijph/article/view/8077 https://ijph.tums.ac.ir/index.php/ijph/article/download/8077/5585

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 10 2016 12 14 1355 1358 Mohammad KHANAHMADI Aging Research Center, Farhud Scientific-Cultural Foundation, Tehran, Iran Dariush D.FARHUD School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Basic Sciences/Ethics, Iranian Academy of Medical Sciences, Tehran, Iran Maryam MALMIR Research Center of Life Style, Medical Sciences Branch, Islamic Azad University, Tehran, Iran Soheila ORANG Dept. of Psychology, Kharazmi University, Tehran, Iran 2016 10 23 2016 10 23 Background: Metal ions effect on homeostasis of Alzheimer’s disease (AD) patients. The aim of this study was to assess the metal ions (Iron, Zinc and Copper) and CBC in patients with AD in comparison with normal range. Methods: The samples of study were 17 patients with AD in Tehran’s aging centers in 2015, selected as an access sample. Blood samples were analyzed in a pathobiology laboratory. Data were analyzed by one sample t-test. Results: According to the normal range, provided by laboratory, there is a significant difference between zinc in patients with AD and normal reference interval (α=0.01). The comparison of CBC of the AD patients with normal group showed also some decreases Conclusion: Zinc value in AD patients is significantly lower than normal range. It should be repeated by a larger sample size.   https://ijph.tums.ac.ir/index.php/ijph/article/view/8075 https://ijph.tums.ac.ir/index.php/ijph/article/download/8075/5583

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 10 2016 12 14 1261 1269 Anastasia THEODORITSI Dept. of Nursing, Technological Institution (TEI) of Athens, Athens, Greece Maria-Eleni ARAVANTINOU Dept. of Nursing, Technological Institution (TEI) of Athens, Athens, Greece Victoria GRAVANI Dept. of Nursing, Technological Institution (TEI) of Athens, Athens, Greece Eirini BOURTSI Dept. of Nursing, Technological Institution (TEI) of Athens, Athens, Greece Chrysoula VASILOPOULOU Dept. of Nursing, Technological Institution (TEI) of Athens, Athens, Greece Paraskevi THEOFILOU Dept. of Psychology, Health Psychology, Panteion University, Athens, Greece Maria POLIKANDRIOTI Dept. of Nursing, Technological Institution (TEI) of Athens, Athens, Greece 2016 10 23 2016 10 23 Background: Support has been gradually acknowledged as a significant factor that exerts a positive influence on hemodialysis patients' lives as well as on the outcome of the disease. The purpose was to explore factors associated with social support of hemodialysis patients. Methods: The sample studied consisted of 258 patients undergoing hemodialysis in public hospitals in Athens, Greece during 2015. Data collection was performed by the method of the interview using a specially designed questionnaire, which included the Multidimensional Scale of Perceived Social Support for the assessment of social support from significant others, family and friends as well as patients’ socio-demographic, clinical and other characteristics. Results: Of the 258 participants, 53.9% were male and 65% were over 60 yr. Regard to social support, patients felt highly supported by their significant others and their family (median 6 for both subscales) and less by their friends (median 4.5 neutral support levels). In terms of patients' characteristics, statistically significant association of support from significant others and family was observed with marital status (P<0.001 and P<0.001 respectively), place of residence (P<0.001 and P<0.001 respectively) and the number of children (P=0.002 and P=0.007 respectively). Furthermore, statistically significant association of support from friends was observed with age (P <0.001), marital status (P=0.002), and place of residence (P=0.017). Conclusion: Socio-demographic, clinical characteristics and patients' perceptions are associated with perceived Social Support. Provision of holistic individualized care to hemodialysis patients demands assessment of social support in the daily clinical practice.   https://ijph.tums.ac.ir/index.php/ijph/article/view/8063 https://ijph.tums.ac.ir/index.php/ijph/article/download/8063/5572

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 10 2016 12 14 1369 1370 Manar ALAZZAM Dept. of Community and Mental Health Nursing, School of Nursing, Mafraq, Jordan Mohammed ALBASHTAWY Dept. of Community and Mental Health Nursing, School of Nursing, Mafraq, Jordan Manal AL-KLOUB Dept. of Maternal, Child and Family Health, School of Nursing, the Hashemite University, Zarqa, Jordan Nidal ESHAH Dept. of Adult Health, School of Nursing, Zarqa University, Zarqa, Jordan Omar BAKER Unit of E-Learning & Information Technology, College of Nursing, King Saud University, Al-Diriyah, Saudi Arabia Omar ALOMARI Dept. of Midwifery, School of Nursing, Jerash University, Jerash, Jordan Abdullah ALKHAWALDEH Dept. of Community Health, School of Nursing, Jerash University, Jerash, Jordan 2016 10 23 2016 10 23 Advantages and Disadvantages of Studying the Family as a  Context Approach When Dealing with a School Aged Child  Di¬agnosed with Attention Deficit Hyperactivity Disorder https://ijph.tums.ac.ir/index.php/ijph/article/view/8078 https://ijph.tums.ac.ir/index.php/ijph/article/download/8078/5586

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 10 2016 12 14 1270 1275 Hong Yan QIN Hemodialysis Room, Ji’nan Municipal Organs Hospital, Ji’nan, Shandong Province 250001, Shandong, China Ping JIA Dept. of SICU, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan Province, 610072, Sichuan, China Hui LIU Dept. of Clinical Laboratory, Women and Children Hospital of Qingdao, Shandong Province 266034, Shandong, China 2016 10 23 2016 10 23 Background: We aimed to analyze the effect of nursing strategies on patients with chronic renal failure (CRF) undergoing maintenance hemodialysis (MHD) treatment by puncturing on arteriovenous fistula (AVF). Methods: Ninety-two patients with chronic renal failure undergoing maintenance hemodialysis (MHD) between Jan 2014 and Jan 2015 were included in the study (all undergoing AVF, dialysis for 2-3 sessions per week, 4-5 h per session) and randomly divided into control group and observation group. Patients in control group were given standard nursing care and patients in observation group were given professional nursing of inte Plasmatic Levels of N-terminal Pro-BNP in Elderly Patients with Atrial Fibrillation and Heart Failure with Preserved Ejection Fraction https://ijph.tums.ac.ir/index.php/ijph/article/view/9769 https://ijph.tums.ac.ir/index.php/ijph/article/download/9769/5665

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 491 499 Sengul SISE Dept. of Midwifery, Faculty of Health Sciences, Suleyman Demirel University, Isparta, Turkey Cevdet UGUZ Dept. of Medical Biology and Genetics, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey 2017 04 26 2017 04 26 Background: Human breast milk is the most important food for infants and one of the main roads to exposure to toxic substances. In this study, nonylphenol (NP) levels in human milk samples collected from Turkish mothers (n=100) were determined, and the factors including mothers’ demographics, eating habits, obstetric histories, and usage of cleaning and cosmetic products were examined. Methods: Participants were mothers of randomly selected infants and toddlers from the Primary Health Care Center Number-8 in Afyonkarahisar City in western Turkey. The concentrations of NP in milk samples were measured using high-performance liquid chromatography (HPLC). Results: All the analyzed samples showed the occurrence of NP at levels up to 47 ng/ml. The mean± SE and the median NP concentrations were 10.1±0.98 ng/ml and 8.46 ng/ml or ppb, respectively. A negative correlation with infant age was observed. There was a significant correlation between fresh fish consumption and the level of NP in the breast milk of mothers. No significant association between body mass index (BMI) and the NP level in human milk of mothers was observed. The mothers who were using excessive cleaning products in comparison to those using less had significantly higher NP in their breast milk. Conclusion: This study provides the first report about NP levels in a population and characterizes individual variation, thus giving a measure of exposed infants through breastfeeding in Turkey.   https://ijph.tums.ac.ir/index.php/ijph/article/view/9757 https://ijph.tums.ac.ir/index.php/ijph/article/download/9757/5628

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 456 467 Sahar DALVAND Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Seyed Hassan NIKSIMA Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Reza MESHKANI Dept. of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Reza GHANEI GHESHLAGH Dept. of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran Sahar SADEGH-NEJADI Dept. of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Wesam KOOTI Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran Naser PARIZAD Dept. of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran Hossein ZAHEDNEZHAD Dept. of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Reza AFRISHAM Dept. of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2017 04 26 2017 04 26 Background: Metabolic syndrome (MetS) is the major risk factor for development of type 2 diabetes and cardiovascular diseases in different populations. The aim of this study was to evaluate the prevalence of MetS among Iranian population. Methods: Thirty-four cross-sectional studies were analyzed with a sample of 83227 people. National and international English electronic databases (PubMed, Google scholar, Web of Science, Science Direct, and Scopus) and Persian language databases (SID, Medlib, Iran medex, Magiran, Medlib, and IranDoc) were used to search the articles published on MetS in Iranian population from Jan 2005 to May 2016. The MetS diagnosis was performed according to the ATP-III, NCEP/ATP-III, IDF and WHO criteria. Results: The overall weighted prevalence of MetS was 31% (95% CI: 28-35). According to ATP III criteria, total and gender-stratified prevalence of MetS in women and men were 29% (95% CI: 22-36), 37% (95% CI: 26-48) and 29% (95% CI: 23-36), respectively. Total prevalence of MetS based on NCEP/ATP III criteria was 29% (95% CI: 24-35) that the prevalence was 24% (95% CI: 18-30) and 35% (95% CI: 25-44) in men and women, respectively. According to the IDF and WHO criteria, total prevalence of MetS were 38% (95% CI: 32-43) and 30% (95% CI: 7-53), respectively. Conclusion: The findings demonstrate an emerging high prevalence of MetS in total and in particular among Iranian women population. Therefore, to minimize the risk of cardiovascular events in Iranian population, screening and early detection of risk factors for MetS are required.     https://ijph.tums.ac.ir/index.php/ijph/article/view/9753 https://ijph.tums.ac.ir/index.php/ijph/article/download/9753/5624

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 571 573 Burcu GÖKÇE ÇOKAL Dept. of Neurology, Ankara Education and Research Hospital, Ankara, Turkey Tahir KURTULUŞ YOLDAŞ Dept. of Neurology, Ankara Education and Research Hospital, Ankara, Turkey Selda KESKİN GÜLER Dept. of Neurology, Ankara Education and Research Hospital, Ankara, Turkey Murat KEKİLLİ Dept. of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey Faruk PİRİNÇCİOĞLU Dept. of Neurology, Ankara Education and Research Hospital, Ankara, Turkey Hafize NALAN GÜNEŞ Dept. of Neurology, Ankara Education and Research Hospital, Ankara, Turkey 2017 04 26 2017 04 26 Noncirrhotic Portal Vein Thrombosis Presenting with Hepatic Encephalopathy Due to Polycythemia Vera and MRI Findings https://ijph.tums.ac.ir/index.php/ijph/article/view/9770 https://ijph.tums.ac.ir/index.php/ijph/article/download/9770/5666

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 500 505 Huifang ZHANG Hemodialysis Room, Yantaishan Hospital, Yantai, Shandong, China Chongting LIN Hemodialysis Room, Yantaishan Hospital, Yantai, Shandong, China Songbo YUAN Administrative Office, Binzhou Medical University, Yantai, Shandong, China Qinghua WANG School of Nursing, Binzhou Medical University, Yantai, Shandong, China Jiangcheng YANG Dept. of Nephrology, Haiyang Hospital of Traditional Chinese Medicine, Haiyang, Shandong, China 2017 04 26 2017 04 26 Background: We aimed to observe the effect of holistic nursing on patients undergoing hematodialysis for uremia who simultaneously were suffering from moderate to severe malnutrition. Methods: Eighty patients with uremia on maintenance hematodialysis with malnutrition between June 2014 and June 2015 from Yantaishan Hospital, Yantai, Shandong, China were included and equally and randomly were divided into the control group (n=43) and observation group (n=43). Routine nursing was used in the control group while holistic nursing was used in observation group (before, during and after dialysis) and the clinical effects in the two groups were compared after 3 months. Results: At follow-up visits, serum creatinine and urea nitrogen levels of the patients in the two groups were decreased, whereas hemoglobin and albumin levels were increased. In addition, these improvements were greater in the observation group and the differences were statistically significant (P<0.05). Furthermore, during follow-up visits, MQSGA and MIS scores of the two groups were lower and the scores of the observation group were lower than those in the control group were, and the differences were statistically significant (P<0.05). Conclusion: Holistic nursing is able to improve significantly malnutrition in patients with uremia on hematodialysis.   https://ijph.tums.ac.ir/index.php/ijph/article/view/9758 https://ijph.tums.ac.ir/index.php/ijph/article/download/9758/5629

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 468 474 Afsaneh KERAMAT Dept. of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran Masud YOUNESIAN Dept. of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mohammad GHOLAMI FESHARAKI Dept. of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Maryam HASANI Dept. of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran Samaneh MIRZAEI Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Elham EBRAHIMI Dept. of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran Seyed Moaed ALAVIAN Research Center for Gastroenterology & Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran Fatemeh MOHAMMADI Dept. of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran 2017 04 26 2017 04 26 Background: We aimed to explore whether maternal asymptomatic hepatitis B (HB) infection effects on pre-term rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension, or antepartum hemorrhage. Methods: We searched the PubMed, Scopus, and ISI web of science from 1990 to Feb 2015. In addition, electronic literature searches supplemented by searching the gray literature (e.g., conference abstracts thesis and the result of technical reports) and scanning the reference lists of included studies and relevant systematic reviews. We explored statistical heterogeneity using the, I2 and tau-squared (Tau2) statistical tests. Results: Eighteen studies were included. Preterm rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension and antepartum hemorrhage were considerable outcomes in this survey. The results showed no significant association between inactive HB and these complications in pregnancy. The small amounts of P-value and chi-square and large amount of I2 suggested the probable heterogeneity in this part, which we tried to modify with statistical methods such as subgroup analysis. Conclusion: Inactive HB infection did not increase the risk of adversely mentioned outcomes in this study. Further, well-designed studies should be performed to confirm the results.     https://ijph.tums.ac.ir/index.php/ijph/article/view/9754 https://ijph.tums.ac.ir/index.php/ijph/article/download/9754/5625

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 574 576 Xiaowei FENG Dept. of Emergency, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China Meihuan XIANG Dept. of Integrated, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China Xiuna HUANG Dept. of Emergency, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China Xiaomei FENG Outpatient Operating Room, Traditional Chinese Medicine Hospital of Guangdong Province, Guangdong, China Xiaoling FENG Dept. of Nursing, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China 2017 04 26 2017 04 26 The Application of Clinical Nursing Pathway in the  Classification Diagnosis and Treatment of Patients with  Emergency Dyspnea https://ijph.tums.ac.ir/index.php/ijph/article/view/9771 https://ijph.tums.ac.ir/index.php/ijph/article/download/9771/5667

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 506 516 Masoumeh SADEGHI Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Ali Akbar HAGHDOOST Health Services Management Research Center, Institute for Futures Studies in Health, Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran Abbas BAHRAMPOUR Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran AND Dept. of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran Mohsen DEHGHANI Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran 2017 04 26 2017 04 26 Background: Estimating the burden of non-communicable diseases particularly cardiovascular disease (CVD) is essential for health management and policymaking. In this paper, we used a regression model to estimate the future impact of demographic changes on the burden of CVD in Iran during the next two decades. Methods: Disability-adjusted life years (DALY) were used to estimate the future burden of CVD in Iran. A regression model was used to estimate DALY caused by CVD in the Iranian population aged 30–100 yr, stratified by age group and sex. The predicted population of Iranians aged ≥ 30 yr was entered into the model and DALY were calculated over 2005-2025. To assess the areas of uncertainty in the model, we did sensitivity analysis and Monte Carlo Simulation. Results: In the year 2005, there were 847309 DALYs caused by CVD in Iranian adults aged ≥ 30 yr. This figure will nearly be 1728836 DALYs in 2025. In other words, just because of the aging, DALY related to CVD will increase more than two-fold in 2025 compared with 2005. The burden of CVD was higher in men (443235) than in women (404235) in 2005; but in 2025, the difference will be less (867639 vs. 861319). Conclusion: The burden of CVD will increase steeply in Iran over 2005–2025, mainly because of the aging population. Therefore, more attention is needed to deal with the impact of CVD in the following decades in Iran.   https://ijph.tums.ac.ir/index.php/ijph/article/view/9759 https://ijph.tums.ac.ir/index.php/ijph/article/download/9759/5630

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 577 578 Gordana MIHAJLOVIC Faculty of Medicine, University of Belgrade, Belgrade, Serbia AND Clinic of Internal Diseases, Clinical Hospital Center Zvezdara, Belgrade, Serbia Miljanka VUKSANOVIC Clinic of Internal Diseases, Clinical Hospital Center Zvezdara, Belgrade, Serbia Nebojsa DESPOTOVIC Faculty of Medicine, University of Belgrade, Belgrade, Serbia AND Clinic of Internal Diseases, Clinical Hospital Center Zvezdara, Belgrade, Serbia Maja NIKOLIC-DESPOTOVIC Clinic of Internal Diseases, Clinical Hospital Center Zvezdara, Belgrade, Serbia Predrag ERCEG Faculty of Medicine, University of Belgrade, Belgrade, Serbia AND Clinic of Internal Diseases, Clinical Hospital Center Zvezdara, Belgrade, Serbia Dragoslav P. MILOSEVIC Faculty of Medicine, University of Belgrade, Belgrade, Serbia AND Clinic of Internal Diseases, Clinical Hospital Center Zvezdara, Belgrade, Serbia Tomislav JOVANOVIC Faculty of Medicine, University of Belgrade, Belgrade, Serbia 2017 04 26 2017 04 26 Thyroid Dysfunction in the Elderly with Hearth Failure https://ijph.tums.ac.ir/index.php/ijph/article/view/9772 https://ijph.tums.ac.ir/index.php/ijph/article/download/9772/5668

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 517 524 Nazila FATHI MAROUFI Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Amir GHORBANIHAGHJO Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Manizheh SAYYAH MELLI Dept. of Obstetrics and Gynecology, Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran Maryam VAEZI Dept. of Obstetrics and Gynecology, Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran Zohreh HEKMATI AZAR MEHRABANI Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Maryam BANNAZADEH AMIRKHIZ Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Nadereh RASHTCHIZADEH Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2017 04 26 2017 04 26 Background: Pregnancy Associated Osteoporosis (PAO) can lead to serious difficulties such as fragility fractures, elongated back pain and height loss in affected women. Soluble Receptor Activator of Nuclear Factor-Kappa B ligand (sRANKL) to Osteoprotegerin (OPG) ratio is chosen as a bone metabolism equation in many bone diseases characterized by bone resorption, such as post-menopausal osteoporosis and would be modified with folic acid supplementation. This study was done to compare the effects of high dose (5mg/day) and low dose (0.5 mg/day) folic acid in the RANKL/OPG ratio and Tumor Necrosis Factorα (TNFα) concentration during pregnancy. Methods: Forty-five pregnant women who visited the AL-Zahra Hospital, Tabriz Iran, from September 2013 to November 2014 were assigned into two groups in this randomized, double-blind, clinical trial, included women who took 5 mg/day (group1) and who took 0.5 mg/day (Group 2) folic acid supplementation before pregnancy until 36th pregnancy. The biochemical variables in serum of pregnant women were measured before and at the end of the study. The study was registered in the Iranian Registry of Clinical Trials (IRCT) as ID, IRCT2013122315903N1. Results: OPG levels were significantly higher compared with the baseline value (P=0.008), although sRANKL (P<0.001), TNFα (P=0.005) and sRANKL/OPG ratio (P<0.001) reduced significantly with high dose of folic acid supplementation. A significant positive correlation was observed between the decreased RANKL and TNFα levels (r=0.451, P=0.031) at the end of study in high dose group. Conclusion: High dose of folic acid supplementation could decrease bone resorptive biomarkers and may prevent PAO in pregnant women by increasing OPG and decreasing sRANKL and TNFα.   https://ijph.tums.ac.ir/index.php/ijph/article/view/9760 https://ijph.tums.ac.ir/index.php/ijph/article/download/9760/5631

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 579 580 Ali Asghar VALIPOUR Dept. of Public Health, School of Public Health, Abadan School of Medical Sciences, Abadan, Iran Mahdi MOHAMMADIAN Dept. of Social Medicine, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran Mahin GHAFARI Dept. of Public Health, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran Abdollah MOHAMMADIAN-HAFSHEJANI Dept. of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran AND Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2017 04 26 2017 04 26 Predict the Future Incidence and Mortality of Breast Cancer in Iran from 2012-2035 https://ijph.tums.ac.ir/index.php/ijph/article/view/9773 https://ijph.tums.ac.ir/index.php/ijph/article/download/9773/5669

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 525 529 Mehdi NATEGHPOUR Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran Ali HOSSEININASAB Infectious and Tropical Research Center, Kerman University of Medical Sciences, Kerman, Iran Mehrdad FARROKHNIA Infectious and Tropical Research Center, Kerman University of Medical Sciences, Kerman, Iran Foroughieh DASTOURI Kerman Province Health Center, Kerman University of Medical Sciences, Kerman, Iran Katayun ALIDOOSTI Infectious and Tropical Research Center, Kerman University of Medical Sciences, Kerman, Iran Dadkhoda SADEQUI Kahnouj Health Center, Jiroft University of Medical Sciences, Jiroft, Iran Asadollah AHMADI Kahnouj Health Center, Jiroft University of Medical Sciences, Jiroft, Iran 2017 04 26 2017 04 26 Background: Malaria is a big problem of public health in many tropical countries where socioeconomic development is deficient. Four species of plasmodium are capable of infecting human: P. falciparum, P. malaria, P.vivax, P. ovale. Southeastern corner of Iran, including Sistan and Baluchestan, Hormozgan and the tropical part of Kerman Province, are endemic region of malaria. This study aimed to find out clinical findings in malaria caused by various plasmodium species in moderate transmission area of southern Kerman Province. Methods: This study was conducted in health centers of Kahnooj, Manujan, Ghale-Ganj, Roudbar and Fariab in south of Kerman Province, Southeastern Iran during 2005-2009. Three hundred and thirty patients with positive malaria parasite slides entered the study. Frequencies of several malaria clinical presentations were investigated in four plasmodium species. Results: 54.2% of considered patients were male. Mean age of patients was 22.8±17.8 yr. Younger and older patient were 6 months and 80 yr, respectively. Ten patients were infected with P. falciparum, 314 with plasmodium vivax and 6 with mixed infection. The symptoms of fever, chills and sweating were present in 74.6% of subjects. Other complaints were joint pain, headache, fatigue, vomiting, and diarrhea. Splenomegaly was detected in 17.57% of the individuals. Conclusion: Malaria should be considered in differential diagnosis of all acutely febrile patients in endemic area. Classic symptoms of fever, chills and sweating may not present in all of patients.   https://ijph.tums.ac.ir/index.php/ijph/article/view/9762 https://ijph.tums.ac.ir/index.php/ijph/article/download/9762/5708

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 581 582 Mohamad ZARENEYESTANAK Dept. of Psychology and Education of Exceptional ‎Children, Science and Research Branch, Islamic Azad University, Tehran, Iran Masoud Gholamali LAVASANI Dept. of Psychology and Educational Sciences, School of Psychology, University of Tehran, Tehran, Iran Gholamali AFROOZ Dept. of Psychology and Educational Sciences, School of Psychology, University of Tehran, Tehran, Iran 2017 04 26 2017 04 26 Predicted Weight of Infants According to Biological, Psychological and Social Variables of Mothers in Iran https://ijph.tums.ac.ir/index.php/ijph/article/view/9774 https://ijph.tums.ac.ir/index.php/ijph/article/download/9774/5670

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 530 536 Ravan AHMADI Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Mehrzad HAJIALILO Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Amir GHORBANIHAGHJO Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran AND Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Ali MOTA Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Sina RAEISI Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Nasrin BARGAHI Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Mohammad VALILO Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Farahnaz ASKARIAN Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran 2017 04 26 2017 04 26 Background: Scleroderma is a chronic connective tissue disease of unknown etiology. Vitamin D and parathyroid hormone (PTH) that play particular functions in calcium and phosphate homeostasis may be involved in the etiology of this disorder. Klotho, the co-receptor of the fibroblast growth factor 23 (FGF-23), can interfere with calcium and phosphate metabolism. The purpose of this study was to evaluate serum Klotho, FGF-23, intact PTH (iPTH) and vitamin D levels in scleroderma patients compared with the healthy controls. Methods: The study was performed in Biotechnology Research Center, Tabriz University of Medical Sciences (TUMS) from 2014-2015. Sixty scleroderma patients based on the classification criteria of systemic sclerosis and 30 age- and sex-matched healthy controls were included in this study. Serum Klotho, FGF-23, 25-hydroxy vitamin D (25-OH Vit D), and iPTH levels were analyzed using ELISA. Results: Serum levels of Klotho and 25-OH Vit D in the scleroderma patients were lower than those in the healthy controls (P˂0.001). In addition, scleroderma patients had higher serum iPTH levels than the controls (P<0.001). There was no significant difference in serum FGF-23 levels between the patients and controls (P=0.202). Conclusion: The decreased serum Klotho, 25-OH Vit D, and increased iPTH levels in the scleroderma patients may be associated with the pathogenesis of this disease and could be considered a future therapeutic target.   https://ijph.tums.ac.ir/index.php/ijph/article/view/9763 https://ijph.tums.ac.ir/index.php/ijph/article/download/9763/5633

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 583 584 Ahmad KALATEH SADATI Dept. of Sociology, Faculty of Social Sciences, Yazd University, Yazd, Iran 2017 04 26 2017 04 26 No Abstract### https://ijph.tums.ac.ir/index.php/ijph/article/view/9775 https://ijph.tums.ac.ir/index.php/ijph/article/download/9775/5671

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 537 544 Elmira EBRAHIMI Group of Genetics, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Tayebeh SABOKBAR Group of Genetics, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran AND Neurology & Neurosciences Research Center, Qom University of Medical Sciences, Qom, Iran Sharareh ESKANDARIEH Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran AND MS Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran Vahideh PEYGHAMBARI Group of Genetics, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Reza SHIRKOOHI Group of Genetics, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2017 04 26 2017 04 26 Background: Exposure to endogenous hormones such as estrogen is known as a lifetime Breast Cancer (BC) risk factor. Polymorphisms in genes that are involved in the steroidogenic process, such as Cytochrome P450c17alpha (CYP17), affect individuals’ susceptibility to BC. In Iran, the highest incident of BC is among young women. This study aimed to find prevalence of Single Nucleotide Polymorphisms (SNPs) in genes such as CYP17 and significant correlation with age-oriented group of breast cancer. Methods: In 2016, a case series study was conducted on a total population of 205 patients suffering from breast cancer referred to Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran. This population consisted of 104 cases less than 40 yr old and 101 cases over 40. The genotype variants of CYP17 MspA1 were determined using PCR, followed by RFLP. The association of CYP17 MspA1 polymorphisms with the risk of BC in two different age groups was evaluated by calculating odds ratio and 95% confidence intervals using unconditional logistic regression. Results: Carriers of at least one A2 allele may have higher risk of developing breast cancer at younger age compared to patients with A1/A1 genotype (Odds Ratio: 1.99, 95% Confidence Interval: 1.11-3.57, P=0.02). Conclusion: CYP17gene polymorphisms may have influence on the early onset of breast cancer.     https://ijph.tums.ac.ir/index.php/ijph/article/view/9764 https://ijph.tums.ac.ir/index.php/ijph/article/download/9764/5634

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 545 551 Nasrin TAKZAREE Dept. of Anatomy & Histology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Gholamreza HASSANZADEH Dept. of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza ROUINI Medicinal Plants Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Azadeh MANAYI Medicinal Plants Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Abbas HADJIAKHONDI Medicinal Plants Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Masoumeh MAJIDI ZOLBIN Dept. of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran AND Research Fellowship, Yale School of Medicine, New Haven, USA 2017 04 26 2017 04 26 Background: Clinicians have been searching for ways to obtain "super normal" wound healing. Honey is a traditional remedy for the treatment of infected wounds. We aimed to evaluate the wound contraction and antibacterial properties of locally produced Thyme honey on managing full-thickness wounds in vivo. Methods: This experimental study was conducted in 2015, in Department of Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran on 54 adult male Wistar rats weighing 200-250 gr, and ages of 3-4 months.  A square 1.5*1.5 wound was made on the back of the neck. The rats were divided into control and two experimental groups. Additionally, the control and experimental groups were separated into three subgroups corresponding to 4, 7, and 14 d of study. The control group did not receive any treatment. For histological studies, samples were taken from the wound and adjacent skin. This tissue was examined using histological staining (H&E). Wound surface and wound healing were evaluated. Data were analyzed by using one-way ANOVA with post hoc Tukey test and (P<0.05) was significant. Results: The macroscopic and microscopic evaluations showed that the percentage of wound healing on different days in the control and experimental groups were significant (P< 0.05). Conclusion: Using honey twice a day on open wounds will accelerate the healing process.   https://ijph.tums.ac.ir/index.php/ijph/article/view/9765 https://ijph.tums.ac.ir/index.php/ijph/article/download/9765/5635

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 4 2017 04 26 552 559 Mohsen BAROUNI Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Mohammad Reza AMIRESMAIELI Health Management, Policy Making and Economics Department, Kerman University of Medical Sciences, Kerman, Iran Arash SHAHRAVAN Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran Saeed AMINI Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 2017 04 26 2017 04 26 Background: During the last decades, the number of dentistry units increased significantly across the country. The aim of this study was to assess the efficiency of dental units of Iran provinces regarding dental health inputs and outputs using Data Envelopment Analysis approach. Methods: In this applied descriptive-analytical study, the study population included all of Iran 31 provinces. The output variables included DMFT and DMFT indices of 6-12 yr old students. The data about DMFT and DMFT indices were taken from 2013 Nationwide School Pupils Screening Program. Input variables included active dental chairs located in the public sector, general dentists of public sector, general and specialist dentists of private sector by different provinces. The data were analyzed using Deap software version 2.1. Results: The lowest amount of scale efficiency was for Tehran Province (0.204) followed by Isfahan Province (0.205). Provinces of Isfahan, Razavi Khorasan, Kerman, Zanjan, Hamedan, Kordestan, Golestan, Yazd and Tehran, Iran had decreasing return to scale and provinces of Gilan, West Azerbaijan, Mazandaran, Fars, Kermanshah, Markazi, Lorestan, Qazvin, Sistan-and-Baluchestan, Bushehr, Alborz, Hormozgan and Khuzestan had increasing return to scale. Conclusion: Despite provinces of Isfahan, Razavi Khorasan, Kerman, Zanjan, Hamedan, Kordestan, Golestan, Yazd and Tehran which had a better situation in terms of the number of dentistry chairs, public dentists, general and specialist dentists of private sector than other provinces, they had decreasing return to scale. Investment in dental primary health care, preventive and educational programs can be more cost-effecti