[Evaluation of factors associated with time to sputum smear conversion in smear-positive pulmonary TB patients in Golestan province, Iran [2009-14]]

Background and Objective: Tuberculosis caused by Mycobacterium tuberculosis is one of the deadliest infectious diseases in the world. The amount of the bacilli in tuberculosis will reduce rapidly by starting effective antibiotic treatment and the remained bacilli in the sputum will be an important scale to respond to treatment. This study was conducted to evaluate the examin factors associated with the conversion of positive smear to negative one in tubercular-pulmonary patients in Golestan province, in northern Iran

Methods: This retrospective cohort study was carried out on 2093 patients with smear positive pulmonary tuberculosis registered in Golestan province, northern Iran from March 2009-14 referred to health centers. The outcome of this study was to determine the time of changing to negative of the first smear during the treatment and evaluating its relationship with demographic variables, the density of bacilli in the smear, culture, chest x-ray, diabetes and HIV

Results: 67.5% of patients among 2093 smear-positive pulmonary tuberculosis patients were conversion rate of smear at the end of the second months. Results of Cox model showed relationship between gender, age, weight, density bacillus smear and culture results at the start of treatment and negative smears [P<0.05]. Old age, low weight, high density of bacillus in primary smear in the beginning of treatment and increasing of the number of colonies in culture of positive smear patients were considered as predictor factors in changing positive smear to negative one

Conclusion: This study revealed that Conversion rate and treatment success in Golestan province was less than what was expected

[Association between spiritual health and quality of life in patients with type 2 diabetes in Bandar Abbas, Iran]

Spiritual well being is one of the fundamental concepts in chronic diseases in which create meaning and purpose in life and considered as an important approach in promoting general health and quality of life. This study was aimed to explore the relationship between spiritual well being and the quality of life among the patients with type 2 diabetes referred to diabetes clinic of Aboureihan specific diseases centre in Bandar Abbas. This descriptive study was carried out on 330 patients between 40-74 years referred to diabetes clinic in year 2012. Information through spiritual health and quality of life questionnaires were collected. Data analysis by describtive statistics and Pearson Correlation was performed. P<0.05 was considered significant. There was a significant relationship between spiritual well being, religious and existential aspect of spiritual well being and aspects of quality of life. The results may intensify the necessity of strengthening of the spiritual health as a factor affecting quality of life in those patients. The key point in a country like Iran with intellectual, cultural and religious beliefs could be useful and necessary in designing caretherapies programs for such patients

Counseling and harm reduction centers for vulnerable women to HIV/AIDS in Iran

Human immunodeficiency virus [HIV] is a public health challenge facing both developing and developed nations. Although injecting drug use is even the main route of HIV transmission in Iran, sexual route is rising gradually. Vulnerable women have been considered as important bridging population for driving HIV epidemics. To increase the access to vulnerable women, in 2007, 5 pilot centers were established in risky areas to deliver comprehensive services to women who themselves or their spouses are engaged in drug use, risky sexual behavior or have history of imprisonment. Management of Sexually Transmitted Infection, psychological counseling and harm reduction are provided by female staff. The aim of this study was to report the activities conducting in 2008. Registered information was used to assess the demographic characteristic, HIV/ AIDS related risk factors and services delivered to clients. Till March 2008, 442 clients have been admitted. Most of them [36.2%] had 25-34 years old. 14.3% were illiterate and 31% were totally jobless. The most prevalent risk factors were risky sexual behavior [27.1%] and non-injecting drug use [23.2%]. Injecting drug use was detected in 11.3% of attendees. Dividing clients according to marital status, risky sexual behavior was the main risk factor in unmarried [40.2%] and divorced [26.9%] but in married and widow ones, non-injecting drug use was the most [25.8% and 36.5% respectively]. Harm reduction [40.5%] and counseling [36.6%] were the most delivered services. Since vulnerable women play a critical role to spread HIV-epidemic to general population, increasing centers provide more access to this population

Health orientation, research centeredness and realism in Avicenna's canon of medicine

Avicenna is a genius and unique person that his introduction needs a thick book. This study was conducted to more familiarity with Avicenna's methods and findings to improve human health. This was a library study. In order to improve exactness of findings, we computerized the Arabic, English and Persian versions of Avicenna's Canon of Medicine and have made a fast and accurate data bank and uploaded on the internet site of Ministry of Health and Medical Education of Iran, Deputy of Research as avail-able from: http:/www.elib.hbi.ir/persian/LIBRARY.htm and also theorizing Avicenna's Canon of Medicine as three roots [Root model] for current medicine, decayed, disabled and active roots and finally, after searching, gathering and encoding the findings, analyzed them as a qualitative research and thematic content. Health orientation, research centeredness and freeing from nihilism and also achieving to dynamic points and taking appropriate action in relation to treatment of some diseases such as rabies, leprosy, tuberculosis and similar cases at this valuable book can be regarded as a hypothesis to be approved or rejected using the new technology. So appropriate methods require testing many Avicenna hypotheses and if approved, utilize them as supportive methods and complementary of common treatment methods either or even as modern solutions. It is necessary that our students within course of Iranian and Islamic culture and civilization to be more familiar with activities of scientists like Avicenna to substitute the empty place of him

Improvement in health indicators of Islamic Republic of Iran in the years 2004 and 2008

As a performance evaluating program, healthcare indicators of the Islamic Republic of Iran at the end year of the 4[th] five-year socioeconomic strategic plan [2008] were evaluated in comparison with the same indicators at the 1[st] year of the 9[th] government [2004]. The indicators were selected with the Delphi technique among the published indicators in the two period of time in 41 universities and in the country. Data gathering was done on the current health information system and were statistically analyzed assessing their trends. The provinces of Sistan and Baluchistan [3.4%], Kerman [2.84%], Hormozgan [2.83%], Tehran [2.63%] and Qom [2.07%] had the highest rate of population growth over these years. Improving access to primary health care [PHC] in rural areas in Iran was evident during these years. The average hospital bed index in 1998 was one bed per 1000 population in the country and it was 1.62 in 2008. This Index was the highest in the province of Yazd and lowest in Ilam during both periods. A significant ascending trend was observed for indicators in all medical universities. A promotion in healthcare indicators in the lesser developed provinces seems necessary

[Prevalence of obesity in young Tehranian males [18-25y] entering military service [Shahrivar 1386]]

Overweight and obesity is a rapidly growing health problem in every society. Although different reports on increasing obesity in Iran have been published, no accurate estimate has been reported on the prevalence of obesity among young men. The aim of this study, conducted in a sample population of young Tehranian men, was to determine the frequency of overweight and obesity in this group. This cross-sectional study was carried out between the 1st and 20th of Shahrivar 1386. Subjects were 680 young men, randomly selected from among those referring to the health centers for the Pre-Military Service Vaccination Program. Of these, 37 who were sportsmen, were, excluded from the study population. Anthropometric measurements for height, weight, waist and hip circumference of the remaining 643 male subjects, aged 18-25 years old, were obtained their body mass index [BMI] and waist-to-hip ratios were also estimated. Following data collection, the frequencies of obesity and overweight for each age group were determined. Mean age was 20.7 +/- 1.9, and mean body mass index was 24.1 +/- 6.5. The frequency of abnormal body mass index [equal to or more than 25Kg/m2] among the sample population was 32.7% [CI 95%: 29-36.3] of which 23.2% [CI 95%: 19.9-26.5] were overweight and 9.5% [CI 95%: 7.2-11.8] were obese the frequency of central obesity, was 7.2%, based on criteria >/= 0.9 for waist- to- hip ratio, and 7.5%, based on criteria >/= 94 cm for waist circumference. Results showed that 70.8% of obese subjects and 29.2% of overweight ones had abdominal obesity [P < 0.001]. The highest frequency [18.4%] for obese persons was seen around the age of 25 years and that for overweight [41.5%] was seen around the age of 24y. This study reveals that a remarkable percentage of young men in the city of Tehran are either obese or overweight

[Emerging and pandemic of influenza A[H1N1]]

Influenza is one of the known viral infectious diseases, which has killed millions of peoples during pandemics, epidemics and sporadic forms. One of the most remarkable features of influenza virus is the frequency of changes in antigenicity. Alteration of the antigen structure of the virus leads to infection with variants to which little or no resistance is present in the population at risk. Pandemics of influenza type A, result from the emergence of a new virus which the population contains no or limited immunity to it. The interval between pandemics is 10-30 years. But Influenza virus has been causing epidemics of febrile respiratory disease every 1 to 3 years. Pandemic [H1N1] 2009 is a new virus that has not circulated among human population before. This virus is different from previous or current human seasonal influenza viruses. Influenza type A[H1N1] virus is transmitted by inhaling infected droplets expelled by coughing or sneezing or by touching contaminated hands or surfaces as the same as the normal seasonal flu. The symptoms and signs of A[H1N1] influenza are as similar as seasonal influenza and include fever, coughing, runny nose and sore throat. Some people have also reported, nausea, vomiting and diarrhea. People with existing cardiovascular disease, respiratory disease, diabetes and cancer are at higher risk of serious complications. Asthma and other respiratory disease are other underlying conditions associated with severe disease. Pregnant women are at higher risk for more severe disease and obesity may be another risk factor for severe disease. To prevent spread, people should cover their mouth and nose when coughing or sneezing, stay at home when they are unwell, clean their hands regularly, and avoid crowded areas if possible. The pandemic virus is currently susceptible to neuraminidase inhibitors; Oseltamivir and Zanamivir but resistant to Amantadine and Rimantadine. Ministry of health and medical education, Center for Infectious Diseases Management in Islamic Republic of Iran is ready for control and management of novel influenza A[H1N1]