Prevalence of HIV, Hepatitis B and C Virus Co-infections among Iranian High-Risk Groups: A Systematic Review and Meta- Analysis

@#Co-infection with hepatitis B and C among HIV infected patients are prevalent among high-risk populations. This meta-analysis aimed to estimate the prevalence of HIV, HCV and HBV co-infections among high-risk populations in Iran. We systematically searched the national and international electronic databases until 2016. The primary outcome was the prevalence of HIV, HBV, HCV and HIV co-infections in different high-risk populations in Iran. All English and Persian studies conducted on Iranian high-risk groups were included in the study. The review was reported based on PRISMA guidelines and data were analysed at 95% confidence level using random effect models.Overall, 916 relevant papers were recognised and 14 articles were included in the metaanalysis. The pooled estimates of HBV/HCV, HCV/HIV, HBV/HIV and HBV/HCV/HIV were 1.3% (95%CI: 0.5–2.1), 16.3% (95%CI: 1.1–31.6), 0.5% (95%CI: 0–1.4) and 0.5% (95%CI: 0.2–0.8), respectively. Based on subgroup analysis, there was a higher proportion of all co-infections from the years 2010–2016 as compared to that of the years 2003–2009. Our results highlighted that HCV/HIV co-infection in Iranian high-risk groups including injection drug users (IDUs) and prisoners is common. In addition, the increasing trend of coinfections should be considered alarming for policymakers.

Prevalence of Metabolic Syndrome and Associations with Lipid Profiles in Iranian Men: A Population-Based Screening Program

PURPOSE: Metabolic syndrome (MS) is characterized by a collection of interdependent disorders, including abdominal obesity, dyslipidemia, hyperglycemia, hypertension, and diabetes. The current study aimed to estimate the prevalence of MS in Qom, Iran. MATERIALS AND METHODS: A population-based screening program was conducted in the city of Qom, in 845 urban adult men over 25 years old in 2014. Abdominal obesity, fasting blood glucose (FBG), blood pressure, and the serum lipid profile were measured in subjects after fasting for at least 8 hours. MS was defined according to the Adult Treatment Panel III criteria. Data were analyzed using the chi-square test, t-test, and multiple logistic regression. RESULTS: The overall prevalence of MS was 23.0%, and the most common prevalent metabolic abnormalities associated with MS were low high-density lipoprotein cholesterol (102 cm in 33.9%, blood pressure ≥130/85 mmHg in 27.6%, fasting triglycerides (TG) ≥150 mg/dL in 25%, and FBG ≥110 mg/dL in 20.6%. A FBG level ≥110 mg/dL (odds ratio [OR]=4.85; 95% confidence interval [CI], 2.14~8.24), dyslipidemia (OR=3.51; 95% CI, 2.10~5.89), and a fasting TG ≥150 mg/dL were the most important factors contributing to MS. CONCLUSIONS: The prevalence of MS in men in Qom was higher than has been reported in other countries, but it was lower than the mean values that have been reported elsewhere in Iran. FBG was the most important factor contributing to MS, and all elements of the lipid profile showed important associations with MS.

Sleep quality in medical students; the impact of over-use of mobile cell-phone and social networks

Background: poor sleep quality is closely associated with lifestyle habits including use of mobile cell-phones. This study aimed to identify the relationship between sleep quality due to abuse in mobile cell-phones and engagement in social networks

Methods: this cross-sectional study was conducted on 380 undergraduate students selected by proportional stratified sampling in Qom, Iran in 2015. Data were collected by two statndard questionnaire including Cell-Phone Over-Use Scale [COS] and Pittsburgh sleep quality questionnaire beside the status of usage in cell-phone social networks. T-test, chi-square, Pearson correlation coefficient and multivariate logistic regression were used in data analysis

Results: the mean age of participants was 21.8 +/- 3.2 yr, 69.1% were female, and 11.7% were married. The mean of COS and sleep quality scores were 48.18 +/- 17.5 and 5.38 +/- 2.31, respectively. The prevalence of over-use of cell phone was 10.7% [CI 0.95; 8.8%, 12.6%] and the prevalence of poor sleep quality was 61.7% [CI 0.95; 57.1%, 66.3%]. The mean of all aspects and total score of sleep quality showed a direct significant association by cell-phone addiction score except sleep duration score that was inversely. Based on multivariate analysis affected to cell-phone addiction, being male gender and studying in general physician level are the most important predictors of poor sleep quality

Conclusions: over use of internet and social networks via smart phones is related to poor sleep quality and quantity. Predefined sport programs, educational, cultural, and interesting entertainment are the essential needs for all medical students. These interventions are more important especially for male students who have longer educational

Dyslipidemia Prevalence in Iranian Adult Men: The Impact of Population-Based Screening on the Detection of Undiagnosed Patients

PURPOSE: Dyslipidemia has been established as one of the most important modifiable risk factors for cardiovascular disease. Due to the higher prevalence of dyslipidemia in males, this study aimed to estimate the prevalence of dyslipidemia in Iranian urban men. MATERIALS AND METHODS: A screening program was conducted in 845 Iranian men 25 years of age and older in 2014. A health interview survey was conducted to evaluate the prevalence of self-reported dyslipidemia and to collect demographic data, as well as serum lipid profile screening by a reference laboratory. Lipoprotein levels was categorized based on the Adult Treatment Panel III criteria and the data were analyzed using the chi-square test and analysis of variance. RESULTS: The overall prevalence of dyslipidemia was 51.8%, and the prevalence of various forms of dyslipidemia was as follows: hypercholesterolemia (> or =240 mg/dL), 11.4%; hyper-low-density lipoprotein cholesterol (> or =160 mg/dL), 9.6%; hypertriglyceridemia (> or =200 mg/dL), 25%; and hypo-high-density lipoprotein (HDL) cholesterol (<40 mg/dL), 34.3%. With the exception of hypo-HDL, all forms of dyslipidemia were significantly less common in men over 65 years of age (p<0.05). CONCLUSIONS: The prevalence of hypo-HDL and hypertriglyceridemia was higher than expected in Iranian adult men, with half of men 25 years of age and older affected by at least one form of dyslipidemia. A large gap in primary and secondary care was observed, because nearly 80% of patients with dyslipidemia were unaware of their status. Urgent preventive programs and lifestyle changes are necessary to reduce the prevalence of cardiovascular risk factors.

Decomposition of health inequality determinants in Shiraz, South-west Iran

Background: Despite the enhancement in health outcomes worldwide, health inequity and inequality is one of the most relevant topics both for health policy and public health. This research was designed to decompose the health inequality of people living in Shiraz, south-west Iran

Methods: Data were obtained from a multistage-sample survey conducted in Shiraz from April to May 2012, to find determinants of health related quality of life [HRQoL]. General health [GH] and mental health [MH] were used as health status. As a measure of socioeconomic inequality, a concentration index of GH and MH was used and decomposed into its determinants

Results: The overall concentration indices of MH and GH in Shiraz were 0.023 [95% CI: 0.015, 0.031] and 0.016 [95% CI: 0.009, 0.022], respectively. Decomposition of the concentration indices indicated that income made the largest contribution [39.92% for GH and 39.82% for MH] to income-related health inequality. Education [about 25% for GH and 34% for MH], insurance [about 14% for GH and 11% for MH], and occupation [about 12% for GH and 11% for MH] also proved important contributors to the health inequality in Shiraz

Conclusions: There exist MH and GH inequalities in Shiraz. Apart from insurance, most of the health inequalities in Shiraz can be explained through factors beyond the health sector. Hence, implementing redistributive policies and education expansion programs as well as providing an insurance scheme and secure career conditions could decrease these unethical health inequalities

[Assessment of private sector physicians' willingness to participate in family physician program using the diffusion of innovation Model, Qom, 2012, Iran]

Family physician program is a health care provision program. Assessment of the beneficieries' willingness to participate in family physician program, using appropriate models could help its better implementation. This study was conducted to assess the private sector general Physicians' willingness to participate in family physician program using Diffusion of Innovation Model. This descriptive analytical study was carried out on 89 general physicians who possessed Clinic and worked for private sector. The samples were selected through simple random method, and the data were collected by questionnaire. The data were analyzed using t-test and Pearson's correlation coefficient. In this study, the overall level of willingness to participate in family physician program was reported to be 53.3 [Willingness score was calculated out of 100], which this level was reported 48 for relative advantages construct, 54.4 for compatibility, 27.9 for complexity, 28.7 for trainability, and 60 for visibility. According to the results of this research, it seems that general physicians family physicians as the main body of family physician program, has a moderate willingness to participate in this program. Therefore, planning for disambiguation and more adaptation of the program to the needs and demands of general physicians is necessary to ensure its successful implementation

Impact of glibenclamide versus Insulin on neurological and functional outcomes of hemorrhagic stroke in diabetic patients

Background & Objective: Stroke is one of the common leading causes of morbidity and mortality worldwide. Diabetes is one of the modifi able risk factors of stroke which is related to a higher mortality and a poorer outcome. We aimed to evaluate the protective effect of Insulin versus glibenclamide on the improvement of neurological and functional outcomes of hemorrhagic stroke. Methods: The present single blind clinical trial was conducted on 100 patients with stroke and diabetes who had referred to Neurology Emergency Department of Vali-e-Asr hospital, Arak, Iran. The patients were categorized into two groups according to the glucose control treatment before stroke. Without any randomization, glibenclamide was used in 45 patients, while others (55 ones) received insulin. National Institute of Health Stroke Scale (NIHSS) and modifi ed Rankin scale (MRS) systems were used for evaluating the neurological and functional outcomes. Results: Hemiparesis was the most common sign of the patients. The mean of changes in NIHSS and MRS scores of the two groups were -29.69±21.4 and -17.24±21, respectively. Although Insulin group had a higher decrease in NIHSS and MRS scores, no signifi cant difference was found between the two groups. Both treatment methods had a signifi cant decreasing effect on NIHSS and MRS scores (p<0.001). Conclusion: Patients treated with both glibenclamide and insulin had similar decrease in their one week NIHSS and MRS scores with no signifi cant difference in the two treatment groups.

Survival rate of childhood leukemia in Shiraz, southern Iran

Leukemia is the most prevalent type of cancer in children. The aim of this study Was to estimate the 5-year survival rates of Acute Lymphoblastic Leukemia [ALL] and Acute Myeloblastic Leukemia [AML] as well as factors influencing them. This is a nonrandomized retrospective study conducted on 280 patients with ALL and AML. They were all below 15 years old children admitted to Shahid Faghihi hospital, Shiraz, Iran from 2004 to 2008.The survival rates were estimated by applying the Kaplan-Meier method. In addition, the log rank test was used to estimate the statistical significance of differences in the survival probability. Cox regression model was applied to conduct multivariate analysis for adjusting confounding variable. All analyses were performed in SPSS statistical software [version 16]. P-values less than 0.05 were considered as statistically significant. The mean [ +/- standard deviation] of the observation period was 28.2 +/- 16.1 months. In this period, 50 [24.7%] patients [47 ALL and 15 AML] passed away. The cumulative rate of survival in this study was 53.3 +/- 0.1 percent. This probability was 56.6 +/- 0.1% and 44.2 +/- 0.1% for ALL and AML patients, respectively, which indicates no statistically significant difference between them [P=0.8]. According to Cox model, there was a significant relationship among the variables of platelet count and relapse with the survival rate. Platelet count was identified as a positive prognostic factor of the survival rate in ALL patients. However, on the base of our results and other studies, incidence of relapse and the number of relapses are significant factors of survival rates of leukemia

Socioeconomic inequity in health care utilization, Iran

Reducing poor-rich inequities in health is one of the priorities of both national and international organizations and is also one of the main challenges of health sectors in Iran. Since, in the view of policy making, quantifying the size of inequity in health care utilization [HCU] is a prerequisite for achieving this goal, the current study aimed to determine and compare the socioeconomic inequity in HCU by concentration [C] index and odds ratio [OR]. A total of 758 households, consisting of 2,131 subjects who were aged 15 or older, were involved in this cross-sectional study, and their data were gathered through interviews. Household economic index [HEI] was created by the factor analysis from the asset data. The C index and OR were used as measures to determine the overall inequity in HCU according to sex [male/female], living area [urban/rural], insurance, and types of HCU [general physician [GP], specialist, and Health Workers [HWs]]. The overall rate of HCU was 66.4%. The rates of using GP, specialist care, and HW care were 21.4%, 21.6% and 21.8%, respectively. The overall inequity in HCU was equal to 0.05 [95% confidence interval; -0.069 to 0.165]. The C indexes in HCU, according to the subgroups of HCU, were measured as 0.11 [0.09-0.12] for GP, 0.115 [0.01-0.13] for specialist and -0.065 [-0.08 to -0.05] for HWs. Although the rate of utilization increased from poor to rich quintiles, the inequity regarding sex and living area was also low and non-significant. People with higher HEI used more specialist and GP care, while people with lower HEI used more HW care. The inequity in HCU was low and non-significant in different quintiles of males, females, urban and rural, as well as those who were insured