[Interventional ergonomic study to correct and improve working postures and decrease discomfort in assembly workers of an electronic industry]

Musculoskeletal disorders [MSDs] are a major cause of time loss, costs and work force injuries in the workplace. Awkward working posture is a main risk factor for developing MSDs. This study was conducted among assembly workers of an electronic industry with the objective of implementing an interventional ergonomic program to reduce postural stress on neck and trunk and to minimize awkward working postures. This interventional study was conducted on 81 assembly workers of an electronic industry. Nordic musculoskeletal questionnaire was used to determine prevalence of MSDs. Numeric rating scale was applied to evaluate body discomfort before and after the intervention [using a magnification lenses to improve visibility of the parts]. Statistical analysis including independent t-test was performed using SPSS [version 16] software. The results showed that MSDs occurred among assembly workers at high rate in neck, lower back, and shoulder/upper arm regions [more than 75%]. After intervention, significant discomfort decrement was observed in neck, shoulder/upper arm, lower back, elbows and lower arm regions together with the whole body [p<0.05]. More than 90% of the assemblers reported that using the magnification lenses facilitated assembly operation and was comfortable. After the intervention, 89% of the workers evaluated working conditions better as compared with that of before the intervention. It was indicated that using magnification lenses reduced discomfort in different body regions as well as the whole body. It could, therefore be expected that its application of magnification lenses would decrease MSDs of different body regions in long term. Findings showed assemblers satisfaction when using the lenses as well as effectiveness of the lenses application in manufacturing process.

[ effect of conjugated linoleic acids and omega-3 fatty acids supplementation on some inflammatory and oxidative stress markers in atherosclerosis]

Cardiovascular disease is the major cause of morbidity, mortality and disability in the world and Iranian population. Inflammation and oxidative processes are major risk factors of atherosclerosis. Some evidence demonstrated antinflammatory effect of conjugated linoleic acids [CLA] and omega-3 fatty acids [omega -3 fatty acids]. So the aim of this study was to evaluate the effect of CLA and omega -3 fatty acids supplementation on inflammatory and oxidative stress markers in atherosclerotic patients. In this study 90 volunteers who referred to Emam Reza Heart Clinic of Shiraz University of Medical Sciences were selected if they fulfilled the inclusion criteria. Participants were classified into 3 groups receiving 3g/d CLA, 1920mg/d omega 3 or placebo for 2 months. C-reactive protein [CRP], interleukin -6[IL-6], malondialdehyde [MDA] and glutathione peroxidase [GPx] were measured before and after supplementation. CRP measurement was done by a high sensitive Enzyme Linked Immunosorbent Assay and IL-6 assay was performed by Radioimmunoassay methods. GPx enzyme activity and MDA was measured by spectrophotometery. Data processing and statistical analysis were done using SPSS19 software and a p-value of <0.05 was considered as statistically significant. hs-CRP level decreased significantly in both the omega 3 and CLA group during the study [4.43 +/- 4.13 vs 1.6 +/- 1.41 and 7.48 +/- 5.64 vs 5.95 +/- 5.87][p = 0.01]. IL-6 reduced significantly in omega 3 group relative to control [18.59 +/- 11.12 vs 13.37 +/- 9.44][p=0.04] but in CLA group reduction in IL-6 levels was not significant [16.13 +/- 10.21 vs 12.95 +/- 8.1][p=0.06]. GPx increased in CLA and omega 3 groups [144.57 +/- 56.89 vs 174.61 +/- 62.8 and 125 +/- 46.06 vs 171.4 +/- 68.90] [p=0.001]. MDA level decreased significantly in both the omega 3 and CLA group [3.98 +/- 1.50 vs 2.87 +/- 1.55 and 3.7 +/- 1.77 vs 2.4 +/- 0.8] [p = 0.001]. Supplementation of diet with CLA and omega 3 can have a beneficial effect on some indices of inflammatory and oxidative stress

High prevalence of HCV coinfection in HIV-infected individuals in Shiraz, Islamic Republic of Iran

We carried out a cross-sectional survey in Shiraz to determine the prevalence of hepatitis C virus [HCV] in 1 444 individuals infected with human immunodeficiency virus [HIV]. We also determined the risk factors for this coinfection. Demographic and behavioural data were obtained using a standard questionnaire. The prevalence of HIV–HCV coinfection was 78.4% [95% CI: 76.3–80.5]. Intravenous drug use [OR = 7.2; 95% CI: 4.9–10.6], imprisonment [OR = 6.9; 95% CI: 4.6–10.4], tattooing in prison [OR = 2.61; 95% CI: 1.4–4.8], tattooing out of prison [OR = 2.0; 95% CI: 1.3–3.1] and age [OR = 1.02 with increasing each year of life; 95% CI: 1.0–1.04] were significantly associated with HCV–HIV coinfection. Prevalence of HCV–HIV coinfection is high in Shiraz. Intravenous drug use and imprisonment are the main risk factors for this coinfection. Therefore, serious implementation of HIV and HCV testing, education, prevention, care and treatment programmes and evaluation of harm reduction programmes in prisons are very important.

[Musculoskeletal disorders risk assessment in patient transfers among hospital nurses using MAPO technique]

Work-related musculoskeletal disorders [WMSDs] are a serious problem among the nursing staff. Manual patient-handling tasks, such as lifting, transferring, and repositioning patients, are the major causes of WMSDs among nursing staff. The objective of the present study was risk assessment of musculoskeletal disorders during patient transfers by the movement-and-assistance-of-hospital patient [MAPO] technique among hospital nursing staff of Shiraz University of Medical Sciences [SUMS], Shiraz, Iran. This cross-sectional study included 400 randomly selected nurses from 75 wards in 11 hospitals in Shiraz. Data were collected using demographic and Nordic Musculoskeletal Disorders Questionnaires and the MAPO index checklist. Statistical analysis was performed using SPSS version 16. The means of age and job tenure of the subjects were 30.76 +/- 6.44 and 6.92 +/- 5.75 years, respectively. The 12-month prevalence of musculoskeletal disorders was 88.2%. The results of assessment by the MAPO index revealed that more than 83% of the subjects were at risk, 20.5% of them exposed to high risk. Further analysis of the data indicated that the musculoskeletal disorders occurrence was significantly associated with the MAPO index score [p<0.05]. Work-related musculoskeletal disorders were found to be associated with the MAPO index. Therefore, MAPO is an appropriate tool for musculoskeletal disorders risk identification and assessment due to patient handling in the nursing personnel. In any attempt to improve the working conditions, patient transfer aids, environmental factors, and proper training should be taken into consideration

Calculation of reproductive number using data from H1N1 patients in Fars province, Southern Iran

Effective reproductive number [Re] is an index which considers the proportion of susceptible people in a community. There are different methods for calculation of basic reproductive number. The aim of this study was to evaluate the reproductive number using data from H1N1 patients in Fars Province, southern Iran. According to the data obtained, 233 cases were confirmed between July 15[th] and December 3[rd], 2009 Two waves were observed during this period with a peak in October 21[st] in Fars Province. In the first wave, the highest amount of Ro was 3.22 and the lowest amount was 2.12 and in the second wave, the highest and lowest amounts of Ro were 3.42 and 2.42, respectively. Effective reproductive number could not be more than 1.54. Thus in order to maintain Ro below 1, using preventive measures like vaccination, only 70% of population should be immune. As 54.9% of Fars population were immune against H1N1 if only 15.1 of them take part in vaccination program, the disease will not reach an epidemic level

[Effects of treatment with oral calcitriol on plasma glucose and insulin levels in non-insulin dependent diabetes mellitus patients]

Type-2 diabetes is a major metabolic disease with many signs and symptoms, such as hyperglycemia; disorders in protein, carbohydrate and lipid metabolism; and partial or total insulin deficiency. It is accompanied with pancreatic beta-cell malfunction, reduced insulin sensitivity, and systemic inflammation. There is some evidence indicating a role of vitamin D in maintaining glucose tolerance and normal secretion of insulin. The objective of the present study was to assess the effects of calcitriol on the plasma insulin and glucose levels in non-insulin dependent diabetes mellitus patients. Seventy subjects [35 males and 35 female] with type-2 diabetes, aged 30-75 years old, were divided into 2 groups - an intervention and a control group. The intervention and control groups received, daily for 12 weeks, two 0.25-mcg calcitrio-capsules [0.5 mcg calcitriol] and 2 placebo capsules, respectively. Fasting blood samples were taken at the beginning and at weeks 6 and 12 for measuring glucose, insulin, and glycosylated hemoglobin [HbA1C]. The fasting plasma glucose level did not change noticeably at weeks 0, 6 or 12 in the intervention group, while it increased significantly [p = 0.03] in the control group. The insulin level increased significantly in both the experimental [p = 0.002] and control [p = 0.0002] groups. Similarly, there were increases in the HbA1C concentration in the experimental [p = 0.013] and control [p = 0.0004] groups at week 12, as compared to baseline values. Also there was an increase in insulin resistance in both groups [p= 0.023 and 0.0001 for experimental and control groups, respectively]. Finally, HOMA-% beta, which is an indicator of the activity of the pancreatic beta-cells, remained unchanged in the controls, while it increased significantly in the experimental group [p = 0.009]. Calcitriol at a daily dose of 0.5 mcg has no lowering effect on blood glucose in type-2 diabetic patients, although it may prevent its elevation. The findings further show that calcitriol dose not bring about a reduction in insulin resistance; however, it improves pancreatic beta-cell functioning, thereby increasing insulin secretion

Influenza A [H1N1] virus pandemic in Fars Province: a report from southern Iran, July-December 2009

Influenza type A [H1N1] virus is considered as a major concern for health care system all over the world and imposes a considerable burden on the community. The aim of this study was to evaluate the pattern of the disease in order to help health administrators in making decision for preventive measures. 297 definite cases of influenza A [H1N1] diagnosed from 15 July to 3 December 2009 in Fars province, south of Iran, were included in this study. Diagnosis was confirmed performing Real time-PCR. The patients' information including age, gender, occupation, nationality, education, residency area and history of overseas or domestic travel, history of contact with other influenza patients, and symptoms were collected and analyzed. The mean age at the time of diagnosis was 24.4 +/- 15.8 years. 76 [25.6%] patients were admitted in the hospitals, of whom, 11 cases died due to related influenza complications with Case Fatality Ratio [CFR] of 4.4%. The most common reported symptoms were fever, cough and sore throat. There were two waves in the disease incidence, one about 1 month after emergence of the disease and another around 1 month after school openings. The first peak was observed mainly among adults with a history of foreign travel while the second peak was mainly observed among school students. The magnitude of the epidemic was much higher when the disease was transmitted between students at the beginning of the school year. Considering the high incidence of H1N1 flu among the students [41%], vaccination programs and preventive measures should target this age group

Metabolic control and care assessment in patients with type 2 diabetes in Chaharmahal and Bakhtiyari Province 2008

Diabetes mellitus [DM] is a major cause of morbidity and mortality affecting millions of people worldwide, making metabolic control and care assessment in these diabetics very important. The aim of this study was to identify and determine metabolic control rate and care assessment among type 2 diabetics in Chaharmahal and Bakhtiyari Province. In this 2008 Analytic- Descriptive [Cross-sectional] study, 256 patients with diabetes type 2 were selected by a two stage random sampling data were analysed by Software SPSS 13. Mean age of patients was 54.8 +/- 8.6 years and their mean duration of disease was 7.4 +/- 5.8 years. Extent of achievement of aims in control and care of metabolic care and assessment among patients was 1.2% 73.6%, 37%, 39.4%, 79.9%, 61.4%, 35.4%, 62.6% and 37.7% in Hba1c, cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, HDL in men, HDL in women, LDL and BMI, respectively. Hypertension, HbA1c, BMI and triglyceride levels were inappropriately controlled, requiring intervention planning and implemention for control of these factors in this province

[ survey of family history of diabetes in patients with type 2 diabetes in Chaharmahal va Bakhteyari province, Iran, 2008]

Diabetes is a multi-factorial and metabolic disease, which is diagnosed by chronic hyperglycemia. Although a few epidemiological researches have focused on the genetic of the type 2 diabetes in Iran, but it is not clear that which of the parents are more important to transmit the disease to their children, mothers or fathers? This study was performed in Chaharmahal va Bakhteyari province in Iran to answer to this question. This survey was a cross - sectional epidemiological study on all diabetic patients in Chaharmahal va Bakhteyari province in 2008. A two-stage random sampling method was used to select 254 diabetic patients. Data was collected by interview and analyzed by stata9 software, using Chi-square test. From the total number of the type 2 diabetic patients, 59% were female. The average age of the patients was 54.8 +/- 8.6 years and the average duration of the disease was 7.4 +/- 5.8 years. A positive history of the disease was seen in the family of 116 patients [45.7%], for example 61.4% of the patients had a family history in their mothers, 19.8% in their fathers, 62.9% in their sisters, 18.1% in their brothers, 40.5% in their daughters and finally 18.1% in their sons. Positive family history was higher in mothers than fathers. This was seen more in sisters and daughters compared to the brothers and sons [P<0.001]. Our findings showed that the chance of having diabetes from the mothers is higher than from the fathers. It means that type 2 diabetes can be inherited from the mothers more than the fathers

[Predictors of 30-day incidence of coronary artery disease in patients with chest pain]

The previous investigations show that cardiovascular diseases, which are spreading all over our country, account for most health and social problems. The objective of this study was to determine the relation between demographic factors, medical history as well as para clinical factors and Coronary Artery Disease [CAD] within a period of 30 days for patients with chest pain. This was a prospective cohort study. Patients referred to the emergency department of Tehran heart centre with a chief complaint of chest pain without ST - segment elevation were followed for 30 days. The outcome variable was coronary artery disease. The Poisson Regression Model was applied in order to identify significant predictors of outcome. Applying this model, we could calculate Adjusted Risk Ratio and 95% confidence interval. The data were analyzed by standard statistical tests using SAS and Stata software. 609 eligible patients were enrolled. Of these 51% were male and 49% female. Based on the final model of Poisson Regression, variables like sex, blood pressure history, heart disease history, changes in electrocardiogram, WBC and CRP had meaningful relationship with CAD. We concluded that prognosis in patients with chest pain needed considering clinical factors [acquired through interview], electrocardiogram and lab findings. Also we were conducted not to rely on traditional risk factors such as history of diabetes, hypercholesterolemia, smoking and family history of heart disease for prediction of the disease