Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 12 2017 11 29 1632 1638 Jianguo SUN People’s Hospital of Rizhaolanshan, Rizhao, Shandong, PR China Hui ZHENG People’s Hospital of Wulian, Rizhao, Shandong, PR China Xiuxia QIN People’s Hospital of Rizhaolanshan, Rizhao, Shandong, PR China Liqin QI People’s Hospital of Rizhaolanshan, Rizhao, Shandong, PR China 2017 11 29 2017 11 29  Background: This study was designed to explore the correlation of connective tissue growth factor (CTGF), heme oxygenase (HO-1), neurotrophic factors (NT-3) with type 2 diabetic peripheral neuropathy, as well as the changes after immune cytokine alone and combined with cattleencephalon glycoside and ignotin treatment. Methods: Seventy-six patients with type 2 diabetes and peripheral neuropathy charged into People’s Hospital of Rizhaolanshan, China from 2014-2016 were selected. The severity of neuropathy was evaluated by TCSS. Pearson analysis was used to analyze the correlation between the degree of neuropathy and CTGF, HO-1 and NT-3. The patients were randomly divided into control group and observation group, n=38. The control group accepted TGF-β1 treatment on the basis of controlling diet and blood sugar, while the observation group was treated with cattle encephalon glycoside and ignotin injection on the basis of control group. CTGF、HO-1, NT-3 concentration in the blood and nerve conductive velocity (NCV) were detected and analyzed before and after treatment. Results: CTGF(r=-0.865), HO-1(r=-0.706), NT-3(r=-0.587) was negatively correlated with TCSS scores. After treatment, the concentrations of CTGF、HO-1and NT-3 in the observation group were higher than the control group (P<0.05). In moderate and severe lesions, the concentrations of CTGF, HO-1and NT-3 in the observation group were higher than the control group (P<0.05). The conduction velocity of nerve increased with the increase of CTGF, HO-1 and NT-3 concentrations. The obvious effective rate and total effective rate of observation group were both higher than the control group. Conclusion:  Immune cytokine TGF-β1 combined with cattle encephalon glycoside and ignotin injection could improve the contents of CTGF, HO-1 and NT-3, and be better to treat the peripheral neuropathy of type 2 diabetes.     https://ijph.tums.ac.ir/index.php/ijph/article/view/11758 https://ijph.tums.ac.ir/index.php/ijph/article/download/11758/5842

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 12 2017 11 29 1603 1610 Hassan ABOLGHASEM GORJI Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Mahtab ALIKHANI Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Mohammad MOHSENI Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran Mohammad MORADI-JOO Iran Health Insurance Organization, Tehran, Iran Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hajar ZIAIIFAR Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ahmad MOOSAVI Dept. of Health and Community Medicine, Dezful University of Medical Sciences, Dezful, Iran 2017 11 29 2017 11 29 Background: The elderly population following the improvement in health status and life expectancy in developing countries is increasing. Malnutrition causes decreased quality of life and increased mortality in elderly. This study aimed to review systematically and meta-analysis of studies assessing the prevalence of malnutrition among Iranian elderly people over 60 yr of age using Mini Nutritional Assessment (MNA). Methods: This systematic review and meta-analysis was conducted in 2016 to estimate the overall malnutrition prevalence. Data were collected using the following keywords: prevalence, elderly, aging, malnutrition, nutrition, nutritional assessment, nutritional status, health status, mini nutritional assessment, MNA and Iran in PubMed, Scopus, Google Scholar, Iranmedex, Magiran, and SID. Computer software CMA: Two were applied to estimate the overall prevalence of malnutrition. Results: Seventeen of 811 articles were included in our analyses. The overall estimated prevalence of malnutrition among elderly based on the random effect model was 12.2% (95% CI 8-18.5). In subgroups, the prevalence of malnutrition among elderly living in home based on the fixed effect model was 9.2% (95% CI 7.1-11.9) and prevalence of malnutrition among elderly residents of nursing homes based on the random effect model was 21.6% (95% CI 12-38.6). Conclusion: Given the increase in the elderly population in future and the prevalence rate of malnutrition among them as well as the higher prevalence of malnutrition in elderly care centers, more attention to this population group is a matter of necessity.   https://ijph.tums.ac.ir/index.php/ijph/article/view/11755 https://ijph.tums.ac.ir/index.php/ijph/article/download/11755/5839

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 12 2017 11 29 1737 1738 Anna NADAŽDYOVÁ Dept. of Stomatology and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia Dagmara SIROTŇAKOVÁ Private Dental Clinic, Bratislava, Slovak Republic Martin SAMOHÝL Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia 2017 11 29 2017 11 29 The Impact of a Preventive Dentistry Programme on Oral Health https://ijph.tums.ac.ir/index.php/ijph/article/view/11774 https://ijph.tums.ac.ir/index.php/ijph/article/download/11774/5855

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 12 2017 11 29 1623 1631 Mohammad ZEINALI Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Center of Communicable Diseases, Ministry of Health and Medical Education, Tehran, Iran Mehdi MOHEBALI 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 (CREPI), Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza SHIRZADI Center of Communicable Diseases, Ministry of Health and Medical Education, Tehran, Iran Bahman RAHIMI ESBOEI Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Hossain ERFANI Center of Communicable Diseases, Ministry of Health and Medical Education, Tehran, Iran Jamshid POURMOZAFARI Center of Communicable Diseases, Ministry of Health and Medical Education, Tehran, Iran Mahboube GHANBARI Center of Communicable Diseases, Ministry of Health and Medical Education, Tehran, Iran 2017 11 29 2017 11 29 Background: Cystic Echinococcosis (CE) is a serious zoonotic parasitic disease in Iran. This study aimed to show the trend of the confirmed disease from 1995 to 2014 and to describe some of epidemiological aspects of the disease in Iran. Methods: This retrospective study has been designed based on data collected from 8518 cases of CE among various geographical locations of Iran. Results: The average annual number of human cases of CE was 274.8. Among 31 provinces of Iran, Razavi Khorasan from northeast part of Iran was the highest human CE infected province with the 1801 cases and Hormozgan Province in south part of the country showed the lowest the disease with the only one case of CE in 2009. Liver and lungs with the infection rate of 61% and 20%, respectively are the most infected organs, 53% of patients had one cyst in the bodies and the number of cysts in 8% of cases was more than 3 cysts. Altogether, 41% of CE cases were treated by surgery, 11% with chemotherapy and 48 % with mixed surgery and chemotherapy. Conclusion: Human CE is a major health problem in Iran and it is necessary to establish basic control programs. It is crucial to setting up standard diagnostic methods for early diagnosis, effective treatment, plan educational schedule for different social levels and control the disease in both definitive and intermediate hosts.     https://ijph.tums.ac.ir/index.php/ijph/article/view/11757 https://ijph.tums.ac.ir/index.php/ijph/article/download/11757/5841

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 12 2017 11 29 1639 1645 Matina GHASEMI Faculty of Tourism, Eastern Mediterranean University, TRNC, Famagusta, Turkey Mazyar GHADIRI NEJAD Young Researchers and Elite Club, South Tehran Branch, Islamic Azad University, Tehran, Iran Kemal BAGZIBAGLI Dept. of Economics, Faculty of Business and Economics, Eastern Mediterranean University, TRNC, Famagusta, Turkey 2017 11 29 2017 11 29 Background: By considering innovation as a new project in hospitals, all the project management’s standard steps should be followed in execution. This study investigated the validation of a new set of measures in terms of providing a procedure for knowledge management-oriented innovation that enriches the hospital management system. Methods: The relation between innovation and all the knowledge management areas, as the main constructs of project management, was illustrated by referring to project management standard steps and previous studies. Through consultations and meetings with a committee of professional project managers, a questionnaire was developed to measure ten knowledge management areas in hospital’s innovation process. Additionally, a group of experts from hospital managers were invited to comment on the applicability of the questionnaires by considering if the items are measurable in hospitals practically. Results: A close-ended, Likert-type scale items, consisted of ten sections, were developed based on project management body of knowledge thorough Delphi technique. It enables the managers to evaluate hospitals’ situation to be aware whether the organization follows the knowledge management standards in innovation process or not. By pilot study, confirmatory factor analysis and exploratory factor analysis were conducted to ensure the validity and reliability of the measurement items. Conclusion: The developed items seem to have a potential to help hospital managers and subsequently delivering new products/services successfully based on the standard procedures in their organization. In all innovation processes, the knowledge management areas and their standard steps help hospital managers by a new tool as questionnaire format.     https://ijph.tums.ac.ir/index.php/ijph/article/view/11759 https://ijph.tums.ac.ir/index.php/ijph/article/download/11759/5843

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 12 2017 11 29 1611 1622 Heng FAN Dept. of Intensive Care Unit, Ningbo First Hospital, Ningbo, China Yu ZHAO Dept. of Nephrology, Ningbo Urology and Nephrology Hospital, Ningbo, China Min SUN Dept. of Intensive Care Unit, Ningbo First Hospital, Ningbo, China Ji-Hui YE Dept. of Intensive Care Unit, Ningbo First Hospital, Ningbo, China Guo-Dong CHEN Dept. of Intensive Care Unit, Ningbo First Hospital, Ningbo, China Jian-Hua ZHU Dept. of Intensive Care Unit, Ningbo First Hospital, Ningbo, China 2017 11 29 2017 11 29 Background: Using dexmedetomidine (Dex) as a sedative agent may benefit the clinical outcomes of post-surgery patients. We reviewed randomized controlled trials (RCTs) to assess whether use of a Dex could improve the outcomes in post-surgery critically ill adults. Methods: We searched Medline, Embase, PubMed, and the Cochrane databases for RCTs comparing Dex with propofol or a placebo in post-operative patients, all included RCTs should be published in English before Jul 2016. Citations meeting inclusion criteria were full screened, and trial available data were abstracted independently and the Cochrane risk of bias tool was used for quality assessment. Results: Sixteen RCTs involving 2568 patients were subject to this meta-analysis. The use of a Dex sedative regimen was associated with a reduce delirium prevalence [odd ratio (OR):0.33, 95% confidence intervals (CI): 0.24–0.45, I2= 5%, P<0.001], a shorter the length of ICU stay [mean difference (MD): -0.60, 95%CI: -0.69 to -0.50, I2=40%, P<0.001] and the length of hospital stay [MD: -0.68, 95%CI: -1.21 to -0.16, I2=0%, P=0.01]. However, using of Dex could not shorter the duration of mechanical ventilation [MD: -10.18. 95%CI: -31.08–10.72, I2=99%, P=0.34], but could shorter the time to extubation in post-surgery patients [MD: -47.46, 95%CI: -84.63–10.67, I2=98%, P=0.01]. Conclusion: The use of a Dex sedative regimen was associated with a reduce delirium prevalence, a shorter the length of ICU and hospital stay, and a shorter time to extubation in post-surgery critical ill patients.   https://ijph.tums.ac.ir/index.php/ijph/article/view/11756 https://ijph.tums.ac.ir/index.php/ijph/article/download/11756/5840

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 12 2017 11 29 1739 1741 Marjan MOHAMMADZADEH Dept. of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Hamidin AWANG Dept. of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Hayati KADIR SHAHAR Dept. of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Suriani ISMAIL Dept. of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia José Carmelo ADSUAR Dept. of Applied Economics, Faculty of Economics and Business, University of Murcia, Murcia, Spain AND Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain Eugenio MERELLANO-NAVARRO Instituto de Actividad Fisica y Salud, Universidad Autonoma de Chile, Talca, Chile 2017 07 17 2017 07 17 Background: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality characterized by progressive airflow obstruction and inflammation in the airways, which has an impact on health-related quality of life. The EQ-5D-5L is one of the most used preference-based, health-related quality of life questionnaire. The objective of this study was to provide normative values of EQ-5D-5L for Spanish people suffering from COPD. Methods: Data were extracted from the Spanish National Health Survey (2011/2012). Overall, 1130 people with COPD participated in this survey. The utility index of EQ-5D-5L and the Visual Analog Scale (VAS) score were defined by gender, region, and age. Results: Mean (SD) EQ-5D-5L utility index and VAS score for Spanish people with COPD were 0.742 (0.309) and 60.466 (21.934) respectively. In general, men reported better health status than women. Ceiling effect of the whole sample was 30.35%. Conclusion: The current study provides normative values of EQ-5D-5L for Spanish people affected by COPD. Ceiling effect was high and better results were observed in men compared with women.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10603 https://ijph.tums.ac.ir/index.php/ijph/article/download/10603/5250

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1145 1146 Salman KHAZAEI Dept. of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Somayeh KHAZAEI Dept. of Para-Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Kamyar MANSORI Dept. of Epidemiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran Erfan AYUBI Dept. of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices https://ijph.tums.ac.ir/index.php/ijph/article/view/10619 https://ijph.tums.ac.ir/index.php/ijph/article/download/10619/5265

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1054 1061 Yin-Qing HU Dept. of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China Yi-Fan WU Dept. of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China Li-Li HOU Dept. of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China 2017 07 17 2017 07 17   Background: Lung cancer is a serious threat to human health and life worldwide. Anxiety is common amongst palliative care patients with lung cancer and adversely affects quality of life. Acupuncture is an effective and safe treatment method used for the treatment of depressive mood status. We aimed to assess the influence of electrical acupuncture stimulation on self-reported anxiety in palliative care among patients with lung cancer. Methods: This pilot study had an experimental, 3-group, research plan. A total of 188 participants were enrolled from the Shanghai Pulmonary Hospital, Tongji University, Shanghai, China from 2014-2015. This pilot study had an experimental, 3-group, research plan. In TEAS group, participants received standardized palliative care and electrical acupuncture stimulation in Zusanli, Sanyinjiao and Hegu acupoints. Group MS received standardized palliative care and muscle stimulation nearby nonacupoint. Controlled group received standardized palliative care. The patients maintained their assigned acupuncture stimulation for 7 days. Demographic Instrument, Karnofsky Performance Scale Index, SF-16 health questionnaire and Self-Rating Anxiety Scale (SAS) were used. Results: The mean SAS scores in TEAS Group before and after electrical intervention in palliative care intervention were 31.17±7.55,34.58±13.98 and 27.86±6.73, (P=0.00) QoL score showed elevation from 57.13 in 8th day to 60.12 in 28th day, rising further to 5%. Comfort Score showed continuous elevation trend for 28 days. Conclusion: Electric acupuncture stimulation could reduce the anxiety of patients, promote rehabilitation and increase the quality of life among patients with lung cancer in palliative care.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10604 https://ijph.tums.ac.ir/index.php/ijph/article/download/10604/5251

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1147 1148 Peyman REZAEI-HACHESU Dept. of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran AND Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medi-cal Sciences, Tabriz, Iran Reza SAFDARI Dept. of Health Information Technology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Marjan GHAZISAEEDI Dept. of Health Information Technology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Taha SAMAD-SOLTANI Dept. of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran AND Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medi-cal Sciences, Tabriz, Iran 2017 07 17 2017 07 17       Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices https://ijph.tums.ac.ir/index.php/ijph/article/view/10621 https://ijph.tums.ac.ir/index.php/ijph/article/download/10621/5266

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1062 1070 Gaukhar KAYUPOVA Dept. of Healthcare Policy and Management, SD Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Botagoz TURDALIYEVA Dept. of Healthcare Policy and Management, SD Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Kazbek TULEBAYEV Dept. of Healthcare Policy and Management, SD Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Tuyen Van DUONG School of Public Health, Taipei Medical University, Taipei, Taiwan Peter Wushou CHANG School of Public Health, Taipei Medical University, Taipei, Taiwan AND National Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan Diana ZAGULOVA Baltic International Academy, Riga, Latvia 2017 07 17 2017 07 17 Background: This study aimed to evaluate health literacy levels of patients in Almaty City, Kazakhstan and to identify socio-demographics and socio-economic factors related to their health literacy. Methods: An international survey instrument HLS-EU-Q developed by the European Health Literacy Consortium was used in a cross-sectional study with 1000 citizens in the Almaty City at the age of 18 and over who visited the outpatient departments in the polyclinics between Feb and Oct 2014. Results: There were 552 women and 446 men completed the survey, with mean ages as (41.8 ± 13.9) and (44.7 ± 15.2) yr old respectively, and women were significantly younger than men (P<0.001). Their general health literacy was (34.0 ± 8.6) for men and (33.49 ± 9.4) for women, without significant difference. In them, 15.5% or 30.0% were with inadequate or problematic health literacy. Multivariate linear regression analysis showed that higher general health literacy was positively and significantly associated with high self- assessed social status (B=3.86, P<0.001), ability to pay for medications (B=3.42, P<0.001), low frequency of watching health related TV programs (B=2.37, P<0.001), moderate community involvement (B=2.23, P=0.03). Conclusion: Specific demographic and socio-economic determinants related to health literacy were identified the first time in Kazakhstan. This would facilitate programs to improve health outcomes in Kazakhstan.   https://ijph.tums.ac.ir/index.php/ijph/article/view/10605 https://ijph.tums.ac.ir/index.php/ijph/article/download/10605/5252

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1149 1151 Morteza NASIRI School of Paramedicine, Qom University of Medical Sciences, Qom, Iran Azam ARSANJANI SHIRAZI School of Nursing and Midwifery, Dezful Islamic Azad University, Dezful, Iran Omid SADEGHI School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Mahdieh BAGHERI BIDAKHAVIDI School of Health, Kerman University of Medical Sciences, Kerman, Iran 2017 07 17 2017 07 17 dentify agencies (a person, an organization, or a service) that made contributions to the content or provided funding or support for the work presented in this submission. Separate them with a semi-colon (e.g. John Doe, Metro University; Master University, Department of Computer Science) https://ijph.tums.ac.ir/index.php/ijph/article/view/10622 https://ijph.tums.ac.ir/index.php/ijph/article/download/10622/5267

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1071 1078 Manel BEN-HADJ-MOHAMED Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Souhir KHELIL Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Mokhles BEN DBIBIS Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Latifa KHLIFI Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Hend CHAHED Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Salima FERCHICHI Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Elyes BOUAJINA Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Abdelhédi MILED Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia 2017 07 17 2017 07 17 Background: Rheumatoid arthritis is an autoimmune inflammatory rheumatic disease that causes chronic synovial inflammation eventually leading to joint destruction and disability. The aim of this study was to determine the variations of hepatic proteins, myeloperoxidase, and iron in rheumatoid arthritis Tunisian patients and their implications in inflammation and in iron metabolism. Methods: Overall, 172 patients from the Rheumatology Department of the University Hospital “Farhat Hached”, Sousse-Tunisia between 2011 and 2012, with rheumatoid arthritis (97.1% women, average age: 48±13 yr) and 147 healthy volunteers (70.1% women, average age: 46± 7 yr) were included in this study. Serum hepatic proteins (high-sensitive C-reactive protein, ceruloplasmin, albumin, transferrin, α-1-acid glycoprotein and haptoglobin) were assessed by immunoturbidimetry (COBAS INTEGRA 400, Roche) and ferritin was measured by a microparticulate immunoenzymatic technic (AxSYM, ABBOTT, Germany), Plasma myeloperoxidase was determined by Enzyme-Linked Immunosorbent Assay. Serum iron was measured according to a colorimetric method at 595 nm (CX9-BECKMANN Coulter-Fuller-Ton, CA). Results: Significantly higher levels of high-sensitive C-reactive protein, α-1-acid glycoprotein, Haptoglobin and myeloperoxidase in patients compared to controls (P<10-3). Albumin and iron rates were significantly decreased in patients compared to healthy group (P=0.026 and P<10-3, respectively). There were no differences between cases and controls for levels of ceruloplasmin, transferrin and ferritin (P=0.782, P=0.808, and P=0.175, respectively). Conclusion: The high-sensitive C-reactive protein, α-1-acid glycoprotein, and haptoglobin increased in acute phase proteins in rheumatoid arthritis disease. The pro-inflammatory cytokines affect iron metabolism leading to the iron deficiency and rheumatoid anemia, which influenced Tf and ferritin levels. https://ijph.tums.ac.ir/index.php/ijph/article/view/10606 https://ijph.tums.ac.ir/index.php/ijph/article/download/10606/5253

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1152 1153 Seyed Ramin RADFAR Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran AND UCLA Integrated Substance Abuse Programs, Los Angeles, USA Pardis NEMATOLLAHI Dept. of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran Ali FARHOUDIAN Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Alireza NOROOZI Dept. of Neuroscience and Addiction, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices. https://ijph.tums.ac.ir/index.php/ijph/article/view/10623 https://ijph.tums.ac.ir/index.php/ijph/article/download/10623/5268

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1079 1085 Xiliang DANG Dept. of Orthopedics, Weinan Central Hospital, Shaanxi Province, Weinan City, Shaanxi Province, China Liping LIAN Dept. of Orthopedics, Weinan Central Hospital, Shaanxi Province, Weinan City, Shaanxi Province, China Dongsheng WU Dept. of Orthopedics, Weinan Central Hospital, Shaanxi Province, Weinan City, Shaanxi Province, China 2017 07 17 2017 07 17 Background: We aimed to explore the prognosis and risk factors influencing tumor recurrence in surgery-treated patients with primary sacral tumors. Methods: Fifty-six patients between February 2011 and December 2016 in Yishui Central Hospital with primary sacral tumors were selected and treated with radical surgeries. The perioperative outcomes and postoperative neurological functions were observed. After postoperative follow-up, the overall survival time (OS), disease-free survival time (DFS), and recurrence were recorded to analyze the potential risk factors influencing tumor recurrence. Results: The average surgical duration and intraoperative hemorrhagic volume were 3.92 ± 1.46 h and 2, 348.21 ± 813.67 ml, respectively. The postoperative short-term complications included three patients with infection from obstructed drainage and two with skin flap necrosis-induced infection, who recovered after anti-infection therapies; nine with incision-edge necrosis; two with calf muscle venous thrombosis; and one with an endorhachis cerebrospinal fluid fistula, who recovered after conventional treatment. Among patients, the 1-, 2- and 3-year survival rates were 91.07% (51/56), 82.14% (46/56), and 75.00% (42/56) while the 1-, 2- and 3-year DFS rates were 89.29% (50/56), 78.57% (44/56) and 71.43% (40/56), respectively. Of the 56 patients, 16 had recurrence after surgery, with recurrence rate of 28.57%. It was predicated that surgical methods and local infiltration were the independent risk factors influencing tumor recurrence (P<0.01). Conclusion: The reservation of bilateral S3 or > unilateral S3 nerves can improve quality of life of patients. Surgical methods and local infiltration are the independent risk factors influencing tumor recurrence, and extensive resection can effectively control the recurrence rate.   https://ijph.tums.ac.ir/index.php/ijph/article/view/10607 https://ijph.tums.ac.ir/index.php/ijph/article/download/10607/5254

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1154 1155 Bang-Sub LEE Sports and Health Care Major, Korea National University of Transportation, Chungju-si, Korea Wi-Young SO Sports and Health Care Major, Korea National University of Transportation, Chungju-si, Korea Wooyoung CHUNG Dept. of College of General Education, Chung-Ang University, Seoul, Korea Eun-Ju CHOI Division of Sport Sciences, Konkuk University, Chungju-si, Korea 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices. https://ijph.tums.ac.ir/index.php/ijph/article/view/10624 https://ijph.tums.ac.ir/index.php/ijph/article/download/10624/5269

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1086 1094 Morvarid ZARIF-YEGANEH Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mansoor RASTEGARPANAH Dept. of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Gholamreza GARMAROUDI Dept. of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Molouk HADJIBABAIE Research Center for Rational Use of Drugs and Clinical Pharmacy Dept., Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Hojjat SHEIKH MOTAHAR VAHEDI Emergency Dept., Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2017 07 17 2017 07 17   Background: This study was conducted to evaluate the incidence of medication discrepancies and its related factors using medication reconciliation method in patients admitted to the emergency department of Tehran University of Medical Sciences hospitals. Methods: In this cross-sectional study, 200 adult patients with at least one chronic disease that used two regular prescription medications were included in 2015. After 24 h of admission, demographic data and patient's home medications were collected. Medication discrepancies were assessed through comparison of a best possible medication history list with the physician's orders. Results: Out of 200 patients (mean age, 61.5 yr; 86 males, 114 women), 77.5% of patients had one or more medication discrepancies. The most common discrepancies were medication omission (35.49%), change (14.22%) and substitution (10.97%), respectively. The relationship between number of comorbid conditions (P=0.025), regular home medications (P=<0.001), high-risk medications (P=0.032), medications pharmacological classes (P=<0.001) and medication discrepancies were statistically significant. Cardiovascular drugs compared to other medications classes showed the highest discrepancies (36.2%). Multiple logistic regression showed that the drug groups, including anti-infective for systemic use (OR=8.43; 95%CI 2.5-28.2; P=0.001), Antineoplastic and Immuno-modulator Agents (OR=0.49; 95%CI 0.27-0.87; P=0.016), Blood and Blood-Forming Organs (OR=0.33; 95%CI 0.21-0.52; P<0.001), Muscular-Skeletal System (OR=2.4; 95%CI 1.13-5.1; P=0.022), Nervous-System (OR=2.75; 95%CI 1.7-4.4; P<0.001), Respiratory-System (OR=0.38; 95%CI 0.22-0.67; P=0.001) were associated with the drug discrepancy. Conclusion: A medication discrepancy occurs commonly at hospital emergency department. Understanding the type and frequency of discrepancies with using structured medication reconciliation process can help clinicians to prevent them.       https://ijph.tums.ac.ir/index.php/ijph/article/view/10608 https://ijph.tums.ac.ir/index.php/ijph/article/download/10608/5255

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1095 1103 Nahid RAMEZAN GHORBANI Dept. of Development and Cooperation of Information and Scientific Publications, Undersecretary for Research and Technology, Ministry of Health and Medical Education, Tehran, Iran Yousef FAKOUR Deputy for Research and Technology, Ministry of Health and Medical Education, Tehran, Iran Seyed Ali NOJOUMI Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran 2017 07 17 2017 07 17 Background: Researchers and academic institutions need assessment and rating to measure their performance. The criteria are designed to evaluate quality and adequacy of research and welcome by most universities as an international process to increase monitoring academic achievements. The study aimed to evaluate the increasing trend in global ranking of Iranian medical universities websites emphasizing on comparative approach. Methods: This is a cross-sectional study involving websites of Iranian medical universities. Sampling was conducted by census selecting universities affiliated to the Ministry of Health in webometrics rating system. Web sites of Iranian medical universities were investigated based on the webometrics indicators, global ranking as well as the process of changing their rating. Universities of medical sciences were associated with improved ratings in seven periods from Jan 2012 until Jan 2015. Results: The highest rank was in Jan 2014. Tehran University of Medical Sciences ranked the first in all periods. The highest ratings were about impact factor in universities of medical sciences reflecting the low level of this index in university websites. The least ranking was observed in type 1 universities. Conclusion: Despite the criticisms and weaknesses of these webometrics criteria, they are critical to this equation and should be checked for authenticity and suitability of goals. Therefore, localizing these criteria by the advantages model, ranking systems features, continuous development and medical universities evaluation based on these indicators provide new opportunities for the development of the country especially through online media.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10609 https://ijph.tums.ac.ir/index.php/ijph/article/download/10609/5256

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1104 1109 Ziba MAJIDI Dept. of Clinical Biochemistry, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Mahmoud DJALALI Dept. of Cellular & Molecular Nutrition, Faculty of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences, Tehran, Iran Mohammad Hasan JAVANBAKHT Dept. of Cellular & Molecular Nutrition, Faculty of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences, Tehran, Iran Mojtaba FATHI Dept. of Clinical Biochemistry, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Mahnaz ZAREI Dept. of Cellular & Molecular Nutrition, Faculty of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences, Tehran, Iran Koorosh FOLADSAZ Dept. of Clinical Biochemistry, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran 2017 07 17 2017 07 17 Background: Basal Cell Carcinoma (BCC) is one of the most common skin cancers in the world and that use to lifestyle, increasing chemical pollutions, environmental factors and poor nutrition. The most important cause of this cancer is oxidative stress and free radicals so antioxidant activities for the body are so important. The aim of this study was to determine the variation of zinc and (Malondialdehyde) MDA in BCC patients. Methods: This study has been performed on case and control patients from 2013 to 2014. The samples were collected from cell carcinoma patients at Razi Hospital in Tehran, Iran. We evaluated the level of zinc with the use of Atomic Absorption Spectroscopy (AAS) method. Besides, we evaluated MDA with colorimetric assay. Results: The concentration of MDA was significantly higher in case group in comparison to control group (P=0.001). In addition, case group had lower concentration of zinc than the control group (P=0.000). There was no correlation between MDA and body mass index (BMI) and between zinc and BMI. Conclusion: All the patients with BCC showed a significant MDA serum in comparison with control group. However, significant decrease in zinc serum of the patients was seen that is because of consuming zinc during oxidative stress process so topical use of zinc in the form of 2+ ions could be effective on antioxidant protection against the sun UV radiation.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10610 https://ijph.tums.ac.ir/index.php/ijph/article/download/10610/5257

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1110 1117 Alireza BARFI QASRDASHTI Dept. of Prosthodontics, Shiraz University of Medical Sciences, Shiraz, Iran Mina Seied HABASHI Dept. of Endodontics, Shiraz University of Medical Sciences, Shiraz, Iran Peyman ARASTEH Noncommunicable Disease Research Center, Fasa University of Medical Sciences, Fasa, Iran AND MPH Dept., Shiraz University of Medical Sciences, Shiraz, Iran Mahshid TORABI ARDAKANI Biomaterial Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Zahra ABDOLI Dept. of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran Seyed Sajjad EGHBALI Dept. of Pathology and Lab Medicine, Bushehr University of Medical Sciences, Bushehr, Iran 2017 07 17 2017 07 17 Background: We evaluated factors that affect malignant transformation of leukoplakia in a sample of the Iranian population. Methods: The records of patients with a clinical diagnosis of leukoplakia during a 20-year period from 1989-2009 referred to two of the largest referral centers in southern Iran were studied. Patients that developed malignant transformation were compared with patients that did not have malignant changes. Results: Of 522 patients, female patients, those over 50 yr old and with lesions located on the tongue had the highest rate of malignant changes. Female patients with malignant changes were mostly non-smokers (76.4%), while male patients with malignant changes were mostly smokers (63.8% in non-smokers) (P<0.001). In our univariate analysis, male sex and smoking showed lower chances for malignant transformation (OR: 0.57; CI=0.397-0.822 and OR: 0.025; CI=0.141-0.299, respectively), while age above 50 was a risk factor for malignant transformation (OR: 3.57; CI=2.32-5.42). In the multivariate analysis, smoking (OR: 0.317; 95% CI=0.16–0.626) and morphological presentation as erythroplakia (OR: 0.025; 95% CI=0.005-0.131) had low chances for developing malignant changes, while site of lesion on the tongue (OR: 774; 95% CI=60-9838) and morphological presentation as erythroleukoplakia (OR: 6.26; 95% CI=3.16-12.38) were a risk factor for developing malignant changes Conclusion: A follow-up program and further work-up should be considered for Iranian patients who have a leukoplakia lesion that is flat and are white patch or plaques with red components, in addition for patients who have lesions located on the tongue and for nonsmokers who develops leukoplakia lesions.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10611 https://ijph.tums.ac.ir/index.php/ijph/article/download/10611/5258

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1118 1122 Shadi SHAHROKHI Dept. of Microbiology, Islamic Azad University, Varamin-Pishva Branch, Varamin, Iran Fatemeh NOORBAKHSH Dept. of Microbiology, Islamic Azad University, Varamin-Pishva Branch, Varamin, Iran Sassan REZAIE Division of Molecular Biology, Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2017 07 17 2017 07 17 Background: The opportunistic fungi, particularly Candida glabrata has been known as main etiologic agents of life-threating infections in some patients. Although fluconazole is the most effective antifungal agent against candidiasis, C. glabrata, fluconazole-resistant strains have been increased recently overexpression or mutations of ATP-binding cassette (ABC) transporter family membrane proteins such as; Cg CDR1, Cg CDR2 are responsible for fluconazole resistance in a large proportion of candidiasis cases. The aim of this study was to evaluate CDR1 gene expression level as one of main mechanism involved in this resistance using. Methods: Candida glabrata strains were collected from various clinical samples in hospitals of Tehran in 2015 . After validation of all isolates by conventional and molecular methods, the susceptibility analysis to fluconazole of all isolates was performed using CLSI broth microdilution M27-A3 and M27-S4 protocols. Two isolates have been selected based on difference in susceptibility and CDR1-mRNA expression level of isolates was measured by Real-time PCR method. Results: Susceptibility results revealed that 32%, 64% and 4% of strains were susceptible, dose-dependent (DD) and resistant to fluconazole respectively. Furthermore, resistance strain of C. glabrata (MIC≥64 µg/ml) showed overexpression of CDR1 compared with sensitive strain in Real-time PCR analysis. Conclusion: Thus, it is necessary to investigate the functions of CgCDR1 genes as a transporter-related gene.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10612 https://ijph.tums.ac.ir/index.php/ijph/article/download/10612/5259

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1123 1131 Ghodratollah ROSHANAEI Modeling of Noncommunicable Diseases Research Center, Dept. of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Masoud SABOURI GHANNAD Research Center for Molecular Medicine, Dept. of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran Jalal POOROLAJAL Research Center for Health Sciences, Dept. of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Minoo MOHRAZ Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran Leila MOLAEIPOOR Dept. of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran 2017 07 17 2017 07 17 Background: The number of deaths related with co-infection of tuberculosis (TB) and HIV remains inappropriately high worldwide. TB is anticipated to be the major reason of HIV-related deaths globally. This study aimed to find out and evaluate the characteristics of the possible risk factors influencing the survival time of co-infected patients with HIV/TB in Tehran the capital of Iran. Methods: This retrospective study was performed on the referred patients to the one of two Behavioral Diseases Coun­seling Centers, Imam Khomeini, and Zamzam Centers, Tehran, Iran, in 2004-2013. Data were analyzed by Cox PH model utilizing SPSS16 statistical software. Results: Multivariate analysis confirmed that the age at diagnosis (P=0.014), gender (P=0.002), sexual transmission (P=0.01), cotrimoxazole preventive therapy (P<0.001), and onset to TB after post-HIV diagnosis (P=0.01) were the parameters which had significant effects on the death of HIV/TBco-infected patients. Conclusion: The results, recommend interplay between different risk factors and the risk of death in co-infected patients with HIV/TB. We presented the barriers to higher-level organizational and functional integration for commitment to interfere with the modifiable risk factors, which effect on the mortality of patients.   https://ijph.tums.ac.ir/index.php/ijph/article/view/10614 https://ijph.tums.ac.ir/index.php/ijph/article/download/10614/5260

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1132 1138 Vahid FALLAH OMRANI Dept. of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Students Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran Soheila ROUHANI Dept. of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Bahram KAZEMI Dept. of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyyed Javad SEYYEDTABAEI Dept. of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Farnaz KHEIRANDISH Razi Herbal Medicines Research Center, Dept. of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran Maysam REZAPOUR Dept. of Epidemiology and Statistic, School of Public health, Kerman University of Medical Sciences, Kerman, Iran 2017 07 17 2017 07 17 Background: Cystic echinococcosis (CE) is a zoonotic disease with global prevalence, which causes considerable health problems and economic losses throughout the world. The aim of this study was to assess the seroepidemiology of CE in Doroud City, Lorestan Province, Iran, considered a neglected endemic location. Methods: An ELISA was performed using recombinant AgB from Apr to Jul 2015 in Lorestan Province, Western Iran. The commercial Hydatidosis IgG ELISA kit (Vircell SL, Granada, Spain) was used to confirm the obtained results. Results: In the present study, out of 927 collected sera, 25 samples (2.6%) were found as seropositive for E. granulosus IgG antibodies. The prevalence of IgG antibodies against E. granulosus was significantly higher in rural areas (3.24%) than in urban area (1.20%) (P<0.001). Moreover, there was no significant relationship between age, occupation, sex, and literacy with seropositivity (P>0.05). Moreover, there