Economic Status Inequality Is a Predictor for Screening and Health Utilization / 가정의학회지

No abstract available.

Trends of suicide attempts and completed suicide in Ilam province of Iran; a demographic analysis study

Suicide is a serious public health concern in the world. Epidemiologists are considered the mainstay of the management of problem. The purpose of this study was to investigate the trend of suicide [attempts and completed] by age and gender in a 6-year time period and to compare the suicide rates between in age and gender groups in Ilam. In this cross-sectional study, a total of number of suicidal attempts during a 6-year period from 2011 to 2016 were recorded. The data were derived from the systematic registration suicide data [SRSD] which collects official statistics from the Ilam University of Medical Sciences. Suicide rate in period of the study in men was reported to be 24.0 in 2011 to 17.9 in 2016 per 100,000 populations; also this rate in women was between 16.2 in 2011 to 7.3 in 2016 per 100,000 populations. Trend analysis revealed a decreasing trend [r= -0.82, p=0.043], in attempts, as well as completed suicides [r= -0.53, p=0.048]. The current data demonstrated a decreasing trend in both attempts and completed suicide rates from 2011 to 2016. Also we found that the rate of completed suicide in all age groups were higher in men compared to women

Decomposing Socioeconomic Inequality Determinants in Suicide Deaths in Iran: A Concentration Index Approach / 가정의학회지

BACKGROUND: It is recognized that socioeconomic status (SES) has a significant impact on health and wellbeing; however, the effect of SES on suicide is contested. This study explored the effect of SES in suicide deaths and decomposed inequality into its determinants to calculate relative contributions. METHODS: Through a cross-sectional study, 546 suicide deaths and 6,818 suicide attempts from January 1, 2010 to December 31, 2014 in Ilam Province, Western Iran were explored. Inequality was measured by the absolute concentration index (ACI) and decomposed contributions were identified. All analyses were performed using STATA ver. 11.2 (Stata Corp., College Station, TX, USA). RESULTS: The overall ACI for suicide deaths was −0.352 (95% confidence interval, −0.389 to −0.301). According to the results, 9.8% of socioeconomic inequality in suicide deaths was due to addiction in attempters. ACI ranged from −0.34 to −0.03 in 2010–2014, showing that inequality in suicide deaths declined over time. CONCLUSION: Findings showed suicide deaths were distributed among the study population unequally, and our results confirmed a gap between advantaged and disadvantaged attempters in terms of death. Socioeconomic inequalities in suicide deaths tended to diminish over time, as suicide attempts progressed in Ilam Province.

Prevalence and comorbidity of common mental disorders and associations with suicidal ideation in the adult population / 한국역학회지

OBJECTIVES: Little information exists on the association between comorbidities of mental disorders and suicidal ideation in developing countries. The current study examined the relationship between the presence of comorbid mental disorders and suicidal ideation in the adult population.METHODS: This cross-sectional study was conducted using the cluster random sampling method in 3 steps. Data were collected from a household assets survey and the self-administered 28-item General Health Questionnaire as first step in screening, and the Persian version of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision was used in the second stage to determine the prevalence of mental disorders. Bivariate and multivariate analysis were used to investigate the associations between mental disorders and suicidal ideation.RESULTS: Of the 763 participants, 199 (26.1%) had 1 or more mental disorder. Forty-two (71.4%) subjects with comorbidities had a history of suicidal ideation, whereas 59 (7.7%) of all participants had a history of suicidal ideation. We found that major depressive disorder and obsessive-compulsive disorder were the most predictive of suicidal ideation in both sexes. The odds ratio for suicidal ideation associated with having 3 comorbid disorders was 2.70 (95% confidence interval [CI], 1.40 to 14.12) in males and 3.06 (95% CI, 1.25 to 15.22) in females.CONCLUSIONS: Consistent with pervious data, our results confirmed that mental disorders and comorbidities of mental disorders were important predictors of suicidal ideation. Our findings are very useful for applied intervention programs to reduce the suicide rate in regions in which it is high.

Prevalence and comorbidity of common mental disorders and associations with suicidal ideation in the adult population / 한국역학회지

OBJECTIVES: Little information exists on the association between comorbidities of mental disorders and suicidal ideation in developing countries. The current study examined the relationship between the presence of comorbid mental disorders and suicidal ideation in the adult population. METHODS: This cross-sectional study was conducted using the cluster random sampling method in 3 steps. Data were collected from a household assets survey and the self-administered 28-item General Health Questionnaire as first step in screening, and the Persian version of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision was used in the second stage to determine the prevalence of mental disorders. Bivariate and multivariate analysis were used to investigate the associations between mental disorders and suicidal ideation. RESULTS: Of the 763 participants, 199 (26.1%) had 1 or more mental disorder. Forty-two (71.4%) subjects with comorbidities had a history of suicidal ideation, whereas 59 (7.7%) of all participants had a history of suicidal ideation. We found that major depressive disorder and obsessive-compulsive disorder were the most predictive of suicidal ideation in both sexes. The odds ratio for suicidal ideation associated with having 3 comorbid disorders was 2.70 (95% confidence interval [CI], 1.40 to 14.12) in males and 3.06 (95% CI, 1.25 to 15.22) in females. CONCLUSIONS: Consistent with pervious data, our results confirmed that mental disorders and comorbidities of mental disorders were important predictors of suicidal ideation. Our findings are very useful for applied intervention programs to reduce the suicide rate in regions in which it is high.

Quality of Life among Iranian Infertile Women in Postmenopausal Period: A Cross-sectional Study

OBJECTIVES: Infertility has a significant impact on a women's quality of life (QOL). Infertile women face with physical and mental challenges during their postmenopausal period. Therefore, the present study aimed to evaluate the QOL among Iranian infertile women in the postmenopausal period using a valid and reliable instrument. METHODS: In this cross-sectional study both snowball and social networking methods were used for sampling. Two demographic and QOL questionnaire were used for data collection. The QOL questionnaire includes 41 items which measure the QOL in five dimensions: socioeconomic, mental health, religiousness, physical health and future imagining. Data analyzed was carried out in IBM SPSS ver. 20.0 using descriptive statistic, χ2 test, and Fisher test. A P value of 0.01 or less was considered significant. RESULTS: Overall 211 eligible participants were studied. Some participants obtained full score on socioeconomic, religiousness, physical health and future imagining dimensions of QOL but none on the mental health dimension of the QOL. Only, 6.6% of study participants have a good QOL. There was a significant relationship between age and financial provider whit status of QOL. CONCLUSION: Most Iranian infertile women in the postmenopausal period have poor or moderate QOL. Therefore, improving the QOL among these women should be considered.

Comparison of Cancer Prevalence in Physicians with That of the General Population, and Important Considerations / 가정의학회지

No abstract available.

The Evaluation of p53 Polymorphism at Codon 72 and Association With Breast Cancer in Iran: A Systematic Review and Meta-analysis

BACKGROUND: Breast cancer is the most common cancer among women in Iran and the world. Multiple environmental factors and genetic variations such as genetic polymorphisms are of its main causes. p53 gene plays an important role in conserving and sustaining the genome as a tumor suppressing gene. Change and polymorphism at codon 72 of p53 gene are correlated with increased risk of lung, mouth, endometrial, prostate, and colorectal cancers, and could be considered an indicator of susceptibility to breast cancer. METHODS: Twelve studies (1,190 cases and 1,145 control studies with evaluation of three types of Arg/Arg, Arg/Pro, and Pro/Pro genotypes) have been conducted using keywords, such as polymorphism at codon 72, gene p53 polymorphisms, and the relation between polymorphisms and breast cancer, from databases in Iran, including Magiran, Medlibe, Sid, and Iranmedex, as well as Latin databases such as PubMed, Google Scholar, Science Direct, and Scopus. RESULTS: The OR for Arg/Arg is 1.58 (95% CI: 2.45 to 1.01), the OR for Arg/Pro is 0.75 (95% CI: 1.10 to 0.51), and the OR for Pro/Pro is 0.62 (95% CI: 0.93 to 0.42). p53 gene polymorphism at codon 72 is statistically significant in Arg/Arg and Pro/Pro genotypes. CONCLUSIONS: Arg/Arg genotype can be considered as a risk factor for breast cancer, and Pro/Pro genotype can be accounted for as a protective factor against breast cancer.

Survival rate of gastric cancer in Iran; a systematic review and meta-analysis

Aim: In this study, we aimed to estimate one- to five-year survival rates in Iranian patients with gastric cancer [GC]. In addition, we preformed subgroup analyses and meta-regression to explore possible sources of heterogeneity between studies

Background: According to literatures, there has been increasing attention to the long-term survival rate in patients with GC in Iran. However, results have been inconsistent and remain controversial in overall survival rates

Patients and methods: Literature searches were conducted using PubMed, Scopus, and ISI, as well as Magiran, Medlib, SID, and Iran Medex databases. Studies were pooled and summary one to five survival rates were calculated. Univariate and multivariate regression analyses were used to explore possible sources of heterogeneity among studies. Subgroup analyses were also conducted. Analyses were conducted using the STATA statistical software package

Results: Final analysis of 29361 patients from 26 eligible studies was performed. The overall survival rate [one to five years] in all studies, by meta-analysis of 24, 14, 23, 12 and 22 studies were 52%, 31%, 24%, 22%, and 15%, respectively. Meta-regression analysis showed an increase in one- and five-year survival rate over the time [Reg Coef = 0.016, p= 0.04] and [Reg Coef= 0.021, p= 0.049], respectively. Positive heterogeneity was observed between quality of papers and data sources [P<0.001]

Conclusion: More than half of GC deaths happened in the first year at diagnosis, and another 30% plus they occurred during the second year after confirmed diagnosis. Our results admit lower survival rates in Iran, similar to other developing countries

[Risk of colorectal cancer in type2 diabetic patients]

Backgrounds and Objectives: Very few analytical studies are available on any association between Colorectal Cancer [CRC] among diabetic patients compared with non-diabetic subjects at least in Iran. The aim of this case control study was to determine the risk of CRC in type 2 diabetic patients

Materials and Methods: In this study, 207 CRC cases, who had positive results by colonoscopy and biopsy, from Colonoscopy units in Tabriz Referral hospitals and 207 controls, gender and age matched had negative colonoscopy and biopsy results, was selected from the same centers with no history of any malignant tumor and nonneoplastic, Data were collected by questionnaires, and entered into the SPSS19. Multivariate logistic regression was used to estimate odds ratios adjusting for diabetes and risk of CRC

Results: of 414 patients studied, 194 [47%] females and 220 [53%] patients were men. The mean age and Body Mass Index [BMI] of patients was respectively, 59.52 +/- 13.8 and 26.47 +/- 3.8 Kg/m2. Of 207 patients with colorectal cancer, 48 patients were diagnosed with diabetes in contrast of 207 controls only 21 patients were diagnosed with diabetes. The final analyses indicate that diabetes increase the risk of CRC. [OR: 2.57, %95 CI: 1.25-4.58, P=0.006]

Conclusions: Our findings indicate that Diabetes increase the risk of CRC

Decomposing of socioeconomic inequality in mental health: a cross- sectional study into female-headed households

Background: Connection between socioeconomic status and mental health has been reported already. Accordingly, mental health asymmetrically is distributed in society; therefore, people with disadvantaged condition suffer from inconsistent burden of mental disorders. In this study, we aimed to understand the determinants of socioeconomic inequality of mental health in the female-headed households and decomposed contributions of socioeconomic determinants in mental health

Methods: In this cross-sectional study, 787 female-headed households were enrolled using systematic random sampling in 2014. Data were taken from the household assets survey and a self-administered 28 item General Health Questionnaire [GHQ-28] as a screening tool for detection of possible cases of mental disorders. Inequality was measured by concentration index [CI] and as decomposing contribution in inequality. All analyses were performed by standard statistical software Stata 11.2

Results: The overall CI for mental health in the female-headed households was -0.049 [95% CI: -0.072, 0.025]. The highly positive contributors for inequality in mental health in the female-headed households were age [34%] and poor household economic status [22%]

Conclusions: Socioeconomic inequalities exist in mental health into female-headed households and mental health problems more prevalent in women with lower socioeconomic status

Esophageal carcinoma: long-term survival in consecutive series of patients through a retrospective cohort study

The present study aimed to investigate the influence of histological factors on survival of patients with esophageal cancer. Esophageal cancer is almost the common form of malignancy in the eastern world. Through a retrospective cohort study a consecutive series of 134 patients with definite diagnosis of esophageal cancer who had been hospitalized at the Towhid hospital, Sanandaj city, Kurdistan province western Iran during a five-year period from 2006 onward were recruited. The survival time of patients stratified by this grouping method were analyzed by Kaplan-Meier analysis and Cox regression. Overall, 127 males [55.1%], with a mean age of 65.38 +/- 11.62 years were included. Based on histological type of tumor, 23 patients [18.1%] had adenocarcinoma [AC] and 94 patients [74.0%] had squamous cell carcinoma [SCC]. Gender was not significantly associated with survival [Log rank =0.480]. Location of tumor [log rank=0.014], histological type [log rank

Survival rate of esophageal carcinoma in Iran - a systematic review and meta-analysis

Esophageal cancer is often diagnosed in the last stages where the chance of patient's survival is very low. The aim of this systematic review was presentation of valid estimation of survival in patients with esophageal cancer in different regions of Iran. A systematic review was carried out based on the reliable domestic medical databases including: SID, Magiran, Irandoc and Iranmedex as well as reliable foreign databases like PubMed and Scopus using "Cancer", "Esophagus", "survival" "Neoplasms" and "Longevity" as keywords. Then all the reviewed articles and dissertations which met the entry criteria were analyzed. The data were analyzed by using meta-analysis method [random model] and by means of STATA software application version 11.1. In 18 studies the total numbers of 2932 people were analyzed. The one year survival rate in Iran is estimated at 47 percent [95% CI: 34-61] and the five year survival rate is estimated at 12% [95% CI: 8-16]. The two, three and four year survival rates were 31% [95% CI: 18-44], 22% [95% CI: 13-31] and 21% [95% CI: 4-38], respectively. According to the findings one year survival rate for esophageal cancer in Iran is almost four times higher than its five year survival rate. Moreover the five year survival rate in Iran is less than many other countries

[Assessment of Tuberculosis distribution by geographical information system in Khuzestan province: a brief report]

Distribution of Tuberculosis [TB] has a special template affected by geographic and social factors. Nowadays Geographical Information System [GIS] software is one of the most important and useful epidemiologic devise for identifying geographic areas and high risk population for infection by TB. Aim of this study was assessment of Tuberculosis distribution by GIS in Khuzestan province, Iran. In this retrospective cohort study, documents of 6363 TB patients identified, in Khuzestan province at the beginning of 2005 until the end of the September of 2012 were assessed and sampling method was census. The data was gathered by TB-Register Center. TB incidence was evaluated by GIS maps according to climatic and vegetation with 1:25, 000 scale. The data was analyzed in SPSS software and means plot and Independent's t-test, ANOVA with a significance level of less than 5% and Eta Correlation. Spread of Tuberculosis in climatic and vegetation were plotted in GIS maps, accumulative incidence rate was calculated separately for each area. There was a statistical significant relationship between cumulative incidence rate of disease and climatic [P=0.017] and the Eta correlation coefficient was 0.379 [P=0.011]. There was a statistical significant relationship between cumulative incidence rate of TB and vegetation [P=0.004] and the Eta correlation coefficient was 0.388 [P=0.188]. Mean age and median age of patients were 39.3 +/- 18 and 35+6.5 years respectively. For women, mean age was 2.1 years older than men and this difference was statistically significant. [P=0.0001]. The risk of TB infection is closely associated with the climatic and vegetation. So the risk of TB in extra-dry climate and vegetation of highland meadows is more than other areas. Special care and services to high-risk areas is recommended

The trend of infertility in Iran, an original review and meta-analysis

Worldwide prevalence of infertility has been reported to be 3-7% of all couples. There are varieties among the results of studies conducted on the prevalence of infertility in Iran. The present study aimed to evaluate the trend of infertility using meta-analysis method in Iran. We systematically reviewed all published papers in Medline database of the National Library of Medicine and their Persian equivalents [2001-2011]. Findings which met the inclusion criteria were included. Random effects meta-analysis was applied to the data of 13 selected populations. Data manipulation and statistical analyses were performed using STATA. Overall, 13 studies met our inclusion criteria. The pooled prevalence of infertility was 13.2% [95% CI: 8-18.3]. The pooled prevalence of primary and secondary infertility were reported to be 5.2% [95% CI: 3.7 - 6.6] and 3.2% [95%CI: 2 - 4.4], respectively. The lowest and highest frequency of lifetime prevalence of infertility was 2.8% in 2001 and 24.9% in 2010, respectively. Meta- regression scatter plot showed an increasing trend in the prevalence of infertility during 2001- 2011 [P = 0.58]. Meta-regression did not indicate a significant correlation between the sample sizes and the prevalence of infertility [P = 0.64]. The pooled infertility prevalence in Iran is higher than its mean worldwide, and lifetime infertility is increasing in recent years compared to the past in Iran

[Epidemiology of Tuberculosis in south-west of Iran: a brief report]

Background: Tuberculosis is still one of the main causes of mortality and disability in developing countries. Despite of socio-economic development of communities and controlling majority of communicable diseases, With respect to importance and high incidence of Tuberculosis in marginal provinces, the present study was aimed to assess the epidemiology of Tuberculosis

Methods: In this Descriptive-Analytical Retrospective Study, documents of 6363 patients diagnosed with TB in the beginning of March 2005 to the end of the September 2012 in Khuzestan province, Iran, by used census sampling size, were used. Demographic variables and other necessity data were recorded by TB-Register software and then these data were analyzed by SPSS 16.0 software and Chi-square and independent t-tests with a significance level of less than 5%. For comparison Tuberculosis incidence in consecutive years used by Poisson tests [with a significance level of less than 5%]

Results: mean age of patients and median age of patients were 39.3+/-18 and 35+/-6.5 years, for women mean age was older 2.1 years than men and there was significant relationship to age [P=0.0001]

Of all patients 75.7% were pulmonary tuberculosis, 2.7% were infected with HIV and 91.2% were new cases. Cumulative incidence in province was 148.84/100,000. Most prevalent in Non-pulmonary TB was Lymphatic glands. Poisson test showed that changing trends of TB incidence in study years was statistically significant [P=0.05]

Conclusion: Increasing concurrent of HIV infection and TB and decreasing patients mean age [39.3+/-18] and median [35+/-6.5] in southwest of Iran has high prevalence. Screening, training and preventive activities for controlling of disease is highly recommended for the whole country and in margin provinces in particular

Risk factors for acquisition of ventilator-associated pneumonia in adult intensive care units

Objective: Ventilator Associated Pneumonia [VAP] has an imperative place amongst nosocomial infections leading to increase morbidity and mortality rates. The present study aimed to determine risk factors for acquisition of ventilator- associated pneumonia in an intensive care unit [ICU]

Methods: A nested case-control study was carried out from September 2007 to June 2008. All 183 patients hospitalized at the adult ICU ward in Be'sat Hospital, Sanandaj city western Iran over a 48 hour period were included. Bacteriologic diagnosis and antibiotic susceptibility patterns were performed based on Edward and Ewing's methods and CLSI system guidelines

Results: Of the 149 samples which were taken from endotracheal tubes of 183 patients, 48 cases were diagnosed for VAP with an incidence rate of 26.2%. Mean duration of hospitalization was 23.4+/-10.2 days. The maximum and minimum antibiotic resistance for the gram negative bacteria was 93.3% for Cefalotin and 50% for Amikacin. The main risk factors for acquisition of ventilator- associated pneumonia were mechanical ventilation [Adjusted OR: 1.55, 95% CI: 1.37-1.74], history of antibiotic consumption [AOR: 8.92, CI: 1.16- 66.66] and fever [AOR: 3.11, CI: 1.22- 7.93]

Conclusions: VAP is significantly related to ICU hospitalization, mechanical ventilation and history of antibiotics consumption. Cefalotin and Amikacin showed the highest and lowest antibiotic resistance against gram negative bacteria respectively

Familial history and recurrence of febrile seizures; a systematic review and meta-analysis

Febrile seizure [FS] as the most common form of seizures in childhood, affects 2-5% of all children across the world. The present study reviews available reports on FS recurrence frequency and evaluates its associated risk factors in Iran. We searched the Persian database such as: SID, MagIran, Medlip, Irandoc, Iranmedex as well as English databases PubMed, ISI, and Scopus. Random effects models were used to calculate 95% confidence intervals. Meta regression was introduced to explore the heterogeneity between studies. The overall FS recurrence rate was 20.9% [95% confidence interval [CI]: 12.3-29.5%]. The frequency of FS simple and complex types was 69.3% [95% CI: 59.5-79.0] and 25.3% [95% CI: 19.6-31.0], respectively. A positive familial history of 28.8% [95% CI: 19.3-38.4%] was observed for childhood FS including 36.2% [95% CI: 27.3-39.6%] for the simple and 29.4% [95% CI: 23.1-33.5%] for the complex type. The heterogeneity of recurrent FS was significantly affected by sample size [P=0.026]. Almost one-third of FS children had a positive familial history. The increased risk of recurrence in patients with symptomatic seizures needs to be fully considered by parents, physicians, nurses and health policy makers

Predictors of recurrent febrile seizures in Iranian children

A few factors appear to boost a child's risk of having recurrent febrile seizures, including young age during the first seizure, seizure type, and having immediate family members with a history of febrile seizures. The present study aimed to provide reliable information about recurrent febrile seizure in Iranian children. On the computerized literature valid on valid keyword with search in valid database PubMed, Scientific Information Databases [SID [, Global medical article limberly [Medlib], Iranian Biomedical Journals [Iran Medex], Iranian Journal Database [Magiran], and Google Scholar recruited in different geographic areas. To explore heterogeneity in studies I[2] index was used. Meta-analysis used to data analysis with random effects model. Hospital data of 4,599 children with febrile seizure. Overall, 21 studies met our inclusion criteria. Febrile seizure in 2 age groups [<2 and 2-6 years] were 55.8% [95% CI: 50.4-61.2] and 44.2% [95% CI: 38.8-61.2] respectively. Pooled recurrent rate of febrile seizure in Iran was 20.9% [95% CI: 12.3-29.5]. In 28.8 [95% CI: 19.3-38.4], children there was positive family history. The mean prevalence of simple and complex seizures was 69.3% [95% CI: 59.5-79.0] and 28.3% [95% CI: 19.6-31.0] respectively. The rates in different geographical regions of central, east, and west of Iran, 25, 20.8 and 27.1% were estimated, respectively. According to the data the prevalence febrile seizure is higher in males and children under two years. Recurrence rate in Iran, similar to other studies performed in other regions of the world

[Correlation between controlling stress with motor activity and food habits in health students]

There is a correlation between stress levels with motor activity and food habits. The present study aimed to determine the correlation between controlling stress with motor activity, food habits and desired variables in health students. Through a cross-sectional study using randomized sampling, 100 health students were recruited. The Health-Promoting Lifestyle Profile II [HPLP II] questionnaire including controlling stress and other variables was administered. Collected data were analyzed using Kruskal-Wallis, Mann-Whitney and linear regression tests in SPSS software. Mean and standard deviation of age and controlling stress score was 22.77 +/- 2.24 years and 20.22 +/- 3.6, respectively. 51% of the participants were female. In general, poor, middle and good stress control were estimated to be 36%, 49% and 15%, respectively. There were significant correlation between students' controlling stress with motor activity and food habits but not with age, gender, nativity and major of students. Linear regression showed that by improving motor activity and food habits score, the students' stress control score has increased significantly. Health education in advanced levels considering motor activity and a good nutritional status can have an important role in improvement of students' stress control