Iranian health research networks and vision of Iran by 2025: a case of virtual health network in EMRI

The present paper aims to explore the role of Health Research Networks [HRN] in facilitating and expedite achieving the prospects for goals of health research based on the visions of Iran by 2025. Aiming to the main function of HSR to achieve the targeted conducting of health sciences research; more cooperation and coordination between health science researchers; avoid parallel investigations; and optimum utilization and appropriate distribution of resources, in 2000 the deputy of Research and Technology of Ministry of Health and Medical Education defined and developed a comprehensive HRN. There are currently 27 research networks operating under the supervision of the Deputy of Research and Technology at MOHME. All of the HRN policies are following based on their strategic planning's which are extracted from national visions of Iran by 2025. Promoting the current position needs a reliable and feasible new strategies. The present article introduces the lessons learned of our experience in virtual web-based health research networking in Endocrinology and Metabolism Research Institute [EMRI]

[Effects of vitamin E supplementation on activity of serum paraoxonase, SOD, GPX enzymes and lipid profiles in beta major thalassemia patients]

In pathogenesis of beta major thalassemia, tissue damage is occurring due to oxidative stress. The present study was designed to evaluate the effects of vitamin E supplementation on serum Paraoxonase, SOD, GPX enzyme activity and lipid profiles in beta major thalassemia patients. In this clinical tiral study, Sixty [25 males, 35 females] beta major thalassemia patients with age >/= 18 years who had criterias to enter the study, were selected randomely in two groups. The patients in interventional group, vitamin E at a dose of 400 mg/day were given for three months, with no supplementations in control group. The enzyme activities of paraoxonase, SOD, GPX and lipid profiles [LDL-c, HDL-c, triglyceride, total Antixidant Capacity] were measured prior and after 3 months in both case and control groups. Data analyzed by using paired t-test. Significant increases in serum levels of vitamin E, Paraoxonase activity, HDL cholesterol [P<0.001], BMI [P

[Prevalence of intra abdominal injuries due to penetrating trauma in Gorgan, Iran [2002-07]]

Trauma is the most common cause of death in all individuals between 1 and 44 years and the third most common cause of death regardless of age. The abdomen is the third most commonly injured region of the body. Some intra abdominal organ injured more than others, related to mechanism of injury, size and location of organ in abdominal cavity. This study was carried out to determine the prevalence of intra abdominal injuries due to penetrating trauma. This retrospective descriptive study was done on 114 patients admitted to 5 Azar hospital in Gorgan, Iran due to penetrating abdominal trauma during 2002-07. Gender, age, type of injury causes of trauma and hospitlalization period were obtained form patients files. 92.1% of patients were male. The mean age of subjects was 24.8 years [9-70 years] with highest frequency between 20-24 years. Two [1.8%] deaths directly related to abdominal stab wounds related to hemorrhagic shock. The most common cause of penetrating abdominal injury was knife wound [78.9%]. The mean time spent in hospital was 4.6 +/- 2.8 days. In 53 patients, cause of trauma were either related to pentration into peritoneum or passing through in. Small intestine injuries [14%], rupture of diaphragm and concurrent lung injuries [7%] were the common damage organs. This study showed that the knife was the main cause of abdominal penetrate trauma and peritoneum was the most common damage tissue

Hepatitis B vaccination coverage among Iranian children aged 15-26 months in 2006

This study in 2006 estimated the hepatitis B virus [BHV] vaccination coverage in the Islamic Republic of Iran at the national and district levels in urban, rural and remote populations of 41 university health service areas. Of 21 905 children recruited to the study, vaccination coverage based on vaccination card records was 100% in 14,15 and 10 of the 41 university areas for the 1st, 2nd and 3rd doses of HBV respectively. National levels of HBV1, HBV2 and HBV3 coverage were 98.9%, 98.8% and 98.4% respectively. The lowest HBV vaccination coverage rate was 90.7% [in a remote district]. HBV vaccination coverage was at an acceptable level in Iranian children

[Tissue trans-glutaminase antibody in inflammatory bowel disease in golestan province, Northern Iran [2005-08]]

Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease [IBD]. Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody. In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml. Among 127 referred patients, serum samples of 102 patients were collected. Mean +/- SD of age was 36.17 +/- 15.2 years and 48% were males. Ulcerative colitis, Crohn's disease and other colitis were observed in 76 [74.5%], 7 [6.9%] and 19 [18.6%] of patients, respectively. Tissue trans-glutaminase antibody was positive [19.8 U/L] in one 46-years-old male patient with ulcerative colitis. Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients

[Behavioral disorders and related factors in school age children of Gorgan]

Acquiring information regarding the extend and prevalence of pediatric behavioral disorders and their predisposing factors is essential in improving psychological services and establishing preventive indicators for children's mental health. The present study was conducted to determine the prevalence of behavioral disorders of school age children and related epidemiological factors, in Gorgan city, in 2005-2006. A cross sectional study was carried out using multistage cluster sampling method to recruit 2600 school age children. Data were collected through Rutter's parent questionnaire [RA[2] a standard tool which parents completed. A cutoff point of 13 was considered and children with total score of 13 or more were regarded to be disordered. Descriptive statistics and odds-Ratio and chi-square tests were used to analysis the data. Most of the samples were female [52.8%], first child with mean age of 9.25 +/- 1.5, having both parents living with them [94.5%] and were studying in governmental schools [72.7%]. in view of the regarded cutoff point, 18.4% of children suffered from behavioral disorders. There was significant correlations between having behavioral disorder with being in single parent family, crowded and low income families, history of crisis during the previous year, job and education of the parents, and children schools [P<0.05]. Considering the higher prevalence of behavior disorders found in current study compare to many others, investigating the explanations and reasons for as well as providing educational and consultation services is necessary

Comparison of knowledge, attitude and practice of urban and rural households toward iron deficiency anemia in three Provinces of Iran

Lack of nutritional knowledge is one of the most important reasons of nutritional problems and consequently improper practice, which can lead to several complications. This study has been designed in order to compare knowledge, attitude and practices of the urban and rural households regarding iron deficiency anemia [IDA] in Boushehr, Golestan and Sistan and Balouchestan provinces in 2004. The sampling method at household's level in each province was the single-stage cluster sampling with equal size clusters. The necessary data were gathered with a structured questionnaire and via the interviews between the questioners and the eligible people in each household. Comparison of frequency of variables between urban and rural areas were tested by chi square test. A total of 2306 households were selected as overall sample size. In urban areas, people recognized iron food sources better than rural areas. Knowledge level of respondents about vulnerable group for IDA and the favorite attitude of households toward IDA were better in urban areas of Sistan and Blouchestan and Golestan provinces. In Sistan and Balouchestan and Golestan, rural households who drank tea immediately before or after meal was more than urban ones. The majority of pregnant and lactating mothers [except for rural areas of Bushehr] did not take iron supplement regularly. Less than 60 percent of children used iron drop regularly. Knowledge, attitude, and practice levels of households toward IDA were not acceptable. One of the best ways of improving nutritional practice is nutritional education with focus on applying available food resources

[Nitrate and nitrite level of drinking water and the risk of upper gastrointestinal cancers in urban areas of Golestan province, northeast of Iran]

Esophageal and gastric cancers are among prevalent cancers in the world and it is believed that nitrate and nitrite contaminations of drinking water are important factors in increasing the risk of these cancers. This study was designed to determine the correlations between these factors and upper gastrointestinal cancers. In this ecologic study, mean concentrations of nitrite and nitrate of drinking waters in Golestan urban areas were obtained during 2004-2005. All patients with esophageal and gastric cancers during this period who resided in urban areas were recruited to estimate the incidence rate and Age Standardized Rate [ASR] of these cancers. The province was divided into three regions of low, intermediate and high incidence based on 33% and 66% quartiles of both cancers. Spearman Correlation Coefficient and regression line were used to analyze data

[Inoperable esophageal cancer and outcome of palliative care in Golestan province, Iran]

Dysphagia is the most distressing problem in patients with advanced inoperable esophageal cancer. Palliative interventions like balloon dilation and stenting are used to improve quality of life and make patients enable to eat more comfortably. This study was designed to determine the outcome of palliative care in esophageal cancer patients referred to Gorgan and Gonbad gastrointestinal clinics, northeast Iran. This cross-sectional study was performed on inoperable esophageal cancer cases during 2005-2006. Demographic data were collected during the procedure and cases were followed every month for six months. Improvement proportion was calculated with 95% confidence interval, to determine the rate of improvement. Survival analysis and Kaplan-Meier methods were used to estimate the duration of palliative care effectiveness. We recruited 39 cases into the study. Male to female ratio was 1.6 to 1 and mean age was 67.5 +/- 13.7 years. Twenty two patients had grade 3 dysphagia and other 17 had grade 4 at the begining of the study. Dilation was the most preferred method [89.7%] and stenting was performed in 4 [10/3%] cases. Decreasing dysphagia score was not related to palliation method used or pathologic type of carcinoma but it was showed to be related to the age of the patients significantly. Mean survival was significantly different between 2 groups [with and without dysphagia improvement in first month of follow-up]. Results of this study showed a lower survival rate after palliative care in advanced esophageal cancer cases, although dysphagia scores showed some improvement

Epidemiology of neural tube defects in northern Iran, 1998-2003

We determined the rates of neural tube defects at a referral hospital in Gorgan, north Islamic Republic of Iran, and the relations of these abnormalities to sex, maternal ethnicity, maternal age and season. During 1998-2003, there were 109 cases among 37 951 births, a prevalence of 28.7 per 10 000 [24.8 and 32.8 per 10 000 among males and females respectively]. The rates in Turkmen, native Fars and Sistani ethnic groups were 40.5, 25.2 and 30.8 per 10 000 respectively. The rates of spina bifida and anencephaly were 16.3 and 11.3 per 10 000 respectively. The rate of affected newborns was highest in mothers aged over 35 years [50.7 per 10 000]. The peak prevalence was in December

[Prevalence of malnutrition in children under 2 years old and its relationship with mothers background variables in Golestan province]

WHO estimated almost 27% of under 5 years children suffered from under-weight. This study aimed at assessing anthropometric indicators [under-weight, wasting and stunting] in 0-24 months children at Golestan province and the relationship with the background variables of households. This cross-sectional study was done on 1473 children [under 2 years old] whom resided in urban and rural area. Samplimg method was single stage cluster sampling. Constitutional variables in child's mothers, age, educational level, job and child's weight and height are measured by structured questionnair. The data were analysed with chi square, chi square for trend and logistic regression. The under-weight, wasting and stunting [mild to severe] prevalence were 21.4% [CI 95%: 19.3-23.6], 16.5% [CI 95%: 14.7-18.5] and 31.4% [CI 95%: 29.1-33.8] respectively. Maximum sex difference in the malnutrition indicators were seen stunting [boys 14.3%, girls 7.2%] [p<0.05]. The prevalence of under-weight, wasting and stunting are positively correlated with increasing the children's age. The under-weight and stunting linear trend was significant [p<0.05]. The risk of under-weight children were 2.8 fold in illitraced mothers relative to mothers with highschool diploma [CI 95% for adjusted odds ratio: 1.1-7]. The risk was 1.5 fold in stunting [CI 95% for adjusted odds ratio: 0.5-4.3]. The under-weight and wasting [moderate to severe] prevalence are increased relatively ANIS study [1998], but stunting prevalence are not increased. The mothers' illitracy and very low educational level can be suspected risk factors for under-weight and stunting

[Determination of effectvie factors on preeclampsia severity; the application of classification and regression trees]

Despite advances in medical sciences, preeclampsia and eclampsia are still among chief causes of maternal mortality worldwide. In this study, we used classification and regression trees to investigate the role of certain inherent and maternity care factors in severe preeclampsia. This study was done on 1643 pregnant women admitted at 4 hospitals in Iran with one of the 53 maternity complaints were enrolled in this study during 2005. Variables of socioeconomic status, history of pregnancy and diseases, health care visits numbers awareness of warning signs, and the body mass index before pregnancy were recorded in the analysis model as predictors, and preeclampsia severity was entered as the dependent variable. A non-parametric method, known as the classification and regression tree was used to predict the studied consequence. Model validation was done using subsets of the study sample. The results were compared with logistic regression analysis. The incidence of preeclampsia among the studied patients was 5.2%. In model 1, variables of frequent headaches and epigastric pain during pregnancy, the number of previous pregnancies, and the amount of maternal care received were predictive of severe preeclampsia. In model 2, only frequent headaches and the number of previous pregnancies were found predictive. Sensitivity for model 1 and 2 was 47.8% and 39.1%, respectively, and specificity was 96.8% and 93.6%, respectively. In logistic regression analysis, only frequent headache was related to severe preeclampsia [OR=2.5, CI 95%: 1.3-5.0]. This study showed that using of variables that can be measured during maternity care visits to predict severe preeclampsia. Regarding the simple interpretation of tree models and their application in clinical decision making, which can be used in different levels of the health care system

[Gastrointestinal and abdominal Tuberculosis in Golestan-Iran: a 5-years report]

15-20% of TB cases are extra pulmonary tuberculosis [EPTB]. Abdominal TB is the most common type of extra intestinal TB. Signs and symptoms of abdominal TB are unspecific. In this study, we identified all GITB cases in Golestan province [Iran] between 1999 and 2003 and determined their demographic characteristics. We reviewed all new cases of TB reported during 1999-2003 from TB centers of Golestan province.Then EPTB and especially GI and abdominal TB cases were selected. We completed a questionnaire containing demographic information for each of them. The information entered the computer in SPSS-13 was used to analyze the data. 30 patients had been treated for GI and abdominal TB, most of them were females [22 cases, 73.3%]. Mean age of the patients was 32.03 +/- 13.73 with higher incidence in age before 40 years old [70%]. Most common complaints of the patients were fatigue, weight loss, anorexia, fever and abdominal pain, respectively. In 66.7% of patients the diagnosis was pathologically documented. Our data suggest that 38.46% of all TB cases in Golestan province were EPTB, and this scale is higher than other studies. In this study, 5.27% of EPTB cases were GI and abdominal TB, higher than the world reports [3%]

[Knowledge, Attitude and practice of households and health care staff towards nutrition and micronutrients (NUT-KAP) in provinces under the pilot study on flour fortification with Iron: study design and sampling method]

A [healthy human being] is the cornerstone of stable development in every country. Thus, an important part of the development process is the nutritional improvement of the society. Although a great proportion of the families' income is spent on food nutritional problems are still prominent in this country. This fact demonstrated that diets are mostly influenced by the education and knowledge of the households, rather than any new developments in food production. This study was designed to investigate the knowledge, attitude and practices of the households and health care provider regarding nutrition and micronutrients in provinces of Bousheher, Golestan, and Sistan and Balouchestan. The results of this study can help the Community Nutrition Office in the design and effective implementation of interventions aimed at improving nutritional health households. The sampling method for households was the single-stage cluster sampling with equal-sized clusters. The sampling method for health staff was stratified random sampling. The number of samples in each stratum was proportion to its size. A total of 2304 households and 360 health care workers were selected for this study. The data were gathered through a structured questionnaire and via interviews with eligible people in each household, and although some levels of health staff. At the level of the health staff, physicians and other health professionals, data collection was done through self-administrated questionnaires

[A Study on noise- induced hearing loss in Agriculture and industry factory - Iran]

Noise-induced hearing loss is a prevalent work-related morbidity in the country. We determined the strength of association between hearing loss and occupational noise exposure as the first step in prevention programs. A historical cohort study involving 100 exposed and 31 non-exposed subjects was conducted. Noise exposure was estimated using sound level meter BSEN 60651, Type 2. Past noise exposure was estimated using the existing data on the place and type of work. Audiometry was used to assess hearing loss in each subject in 3- year intervals on an occupational cohort from 1993-2004. Noise-induced hearing loss was found in 49% [49 subjects] of the exposed group and 9.7% [3 subjects] of non-exposed group [p<.0001]. Nobody used any form of hearing protection routinely in either group. Relative risk for noise-induced hearing loss was 5.1[CI95%: 1.7- 15.1].Time at risk was estimated 24.9 years [22.7-27.1] in exposed and 22.2 years [20.7-23.7] in unexposed group by survival analysis. More legislation, hearing conservation programs, and surveillance and biological monitoring of work sites and workers are required to prevent occupational hearing loss. Planning strategies for noise assessment and control can help improve the work environment. Gross occupational exposure to noise has been demonstrated to cause hearing loss and the authors believe that occupational hearing loss in the country is a widespread problem