[Validity of vision screening in schoolchildren of Iran]

To determine the sensitivity, specificity, and predictive value of visual screening examination in students living in urban areas of Iran. The first grade students of 7 cities of Iran were randomly selected in a population based cross sectional study in 2013 using multistage cluster sampling. After obtaining consent from the students' parents, examinations including corrected and uncorrected visual acuity, cycloplegic and non-cycloplegic refraction, and cover test were performed for all students by an optometrist. The criterion for visual problem was a cut point of 20/32 or worse for uncorrected visual acuity. In addition, the validity of the uncorrected visual acuity measured in the national screening program, which is recorded in the students' health profiles, was calculated. Out of total 4157 individuals who were selected for the study, uncorrected visual acuity was measured in 3645 participants. The sensitivity and specificity of uncorrected visual acuity measured in the national screening program was 35.3% [95% CI 29.2%-41.7%] and 93.9% [95% CI 93.04%-94.7%], respectively. The lowest sensitivity was observed in Dezful [19.6%] and the highest was observed in Ardebil [83.3%]. The predictive value of the examinations was 28.8% [95% CI 23.6%-34.3%] and the best cut point of uncorrected visual acuity was recorded as 20/25 in the national screening program. The validity of the visual screening program which is performed before the first grade of primary school is very low. It should be noted that since many families trust these examinations, they do not follow up their children's condition any more based on the results of these examinations. Therefore, the validity of these examinations, especially their sensitivity, should increase through training the examiners or using more specialized methods

[Determinants of fruit and vegetable consumption among People in the Age Range of 18-70 Years in Arak, Iran]

High fruit and vegetable intake has been introduced as one of the key factors of healthy diet to prevent chronic disease. This study attempts to explore the fruit and vegetable intake in Arak city and its relationship with demography and socio-economic factors. In this cross sectional study, 660 people in 18 -70 age range were selected with a two-stage cluster sampling and were interviewed for demography and socio -economic questionnaires and a 56- items semi-quantitative food frequency questionnaire to assess fruit and vegetable intake. After univariate analysis, the association of the significant variables with fruit and vegetable intake was also evaluated with multiple linear regression. In this study, over 60 percent of subjects consumed less than the minimum recommended amount of fruit and vegetable [5 servings or 400 gr a day].The total consumption of fruit and vegetable indicated an inverse significant relationship with age [p =0.04 and beta = 0.02], and a direct significant relationship with economic status [p<0.001 and beta =0.10]. The father's educational level [beta=-0.005 and beta =0.38 for diploma level and beta =0.03 and beta=0.36 for academic education] and physical activity level [p =0.001 and beta -0.03 per hour] were factors associated with fruit consumption. The gender was only associated with vegetable consumption so that women had higher consumption in this study [p=0.03 and beta=0.23]. The findings of this study indicate low fruit and vegetable consumption in the population under study. In this study, age, physical activity, and socioeconomic status and fathers' education were the factors that were significantly associated with fruit and vegetable consumption

Estimating the proportion of diabetes to the attributable burden of cardiovascular diseases in Iran

This study aimed at estimating the proportion of diabetes as a risk factor to the attributable burden of cardiovascular diseases in Iran. Comparative Risk Assessment methodology was used to calculating Potential Impact Fraction [PIF]. To calculate PIF, data on the prevalence of newly diagnosed diabetes mellitus [NDAI] and known diabetes mellitus [KDAI] were obtained from 3rd Iranian surveillance of risk factors of non- communicable diseases and data on corresponding measures of effect were derived from a cohort study. PIF were estimated on both theoretical minimum and feasible minimum risk. Uncertainty for the attributable burden wras estimated by Monte Carlo simulation-modeling techniques incorporating sources of uncertainty. According to multivariate- adjusted hazard ratios, by reducing the prevalence of Iranian women with diabetes from 10.05 percent to the feasible minimum risk level i.e. 5 percent, 6.8° o [95% uncertainty intervals: 3.5- 9.8] of attributable Disability Adjusted Life Years [DALYs] to CYD are avoidable and the corresponding value for men were 3.1% [95% uncertainty intervals: 1.4- 4.8]. Although data on the prevalence of diabetes and corresponding measures of associations were obtained from an updated and country- specific source, but to better priority setting, PIF should be applied to updated and revised burden of CYDs

[Socio-economic and cultural factors affecting child feeding practices: an exploratory qualitative study in Damavand]

Early child nutrition plays a vital role in the growth and development not only in infancy but also later in life. This study was carried out to determine the views, beliefs and experience of mothers, caregivers and health professionals about the role of socio-economic and cultural factors in child feeding practices in Damavand, a district located in the north of Tehran, in 2008. In a qualitative study 23 focus group discussions [FGDs] were held with the presence of a facilitator, 2 rapporteurs, and a supervisor. Mothers of under-2-year-old children attended 11 FGDs, and 8 FGDs were arranged for home caregivers [grandmothers], out-of-home care-givers [community child health nurses], and rural and urban health workers. At the end of the field work all the notes taken in the FGDs were coded based on objectives of the study. Then the subgroups for each objective and emerging themes were derived and reported. The data were analyzed using content analysis. Most participants were aware of breast feeding and complementary feeding benefits. However, exclusive breast feeding was not followed precisely and the quality and diversity of the diet of children were ignored. The participants thought that social and economic factors, such as literacy, income, erroneous beliefs, family restrictions, and interference of elderly females, had a role in failure of breast and complementary feeding. Cultural factors appeared to have an important influence on mothers' infant feeding practices and feeding patterns of their children. To overcome the problems related to breast feeding and complementary feeding practices, revision of the current nutritional protocols and educational programs is essential. In addition, involvement of mothers, caregivers, elderly women, and all those involved in child care, in nutrition education activities is recommended

Accuracy of ultrasound, clinical and maternal estimates of birth weight in term women

Accurate prenatal estimation of birth weight is useful in the management of labour and delivery. This study compared the accuracy of ultrasound, clinical and maternal estimates of fetal weight in 246 parous women with singleton, term pregnancies admitted for scheduled caesarean section. The sensitivity and specificity of predicting birth weight by ultrasound measures were 12.6% and 92.1%, by clinical palpation were 11.8% and 99.6% and by maternal estimate were 6.3% and 98.0% respectively. Clinicians' estimates of birth weight in term pregnancy were as accurate as routine ultrasound estimation in the week before delivery. Parous women's estimates of birth weight were more accurate than either clinical or ultrasound estimation

[Effect of concentration of air pollutants [PM10, O3 and H[2]S] on lung capacity in the cities Arak and Khomain, Iran]

Background: The present study investigates the effect of different concentrations of air pollutants [PM10, O3. H[2]S] on the function of lung

Materials and Methods: Arak and Khomain cities were divided into 10 and 5 regions, respectively. A sample of air pollutants [PM10, O3 .H[2]S] was measured by PSI [pollution standard index] machine randomly from spring to winter. Two random samples consisting of 1069 non-smoker residents of the two cities [522 from Khomain and 547 from Arak] were selected. Regression test mode were used to analyze data

Results: PSI in the cities Arak and Khomain was 101.83+/-14.54 and 89.17+/-18.58, respectively. Predicted values of FVC, FEVI, FEF 25-75%, MEF 50%, and PEF in Arak were 10.2%, 11.7%, 35.5%, 30.9%, and 40% abnormal, respectively. These values in Khomain were 8.8%, 11.3%, 35.4%, 33.9%, and 40.6% abnormal, respectively. The concentrations of H[2]S in both cities were above the standard values. There was no significant relationship between the concentrations of O3, H[2]S, PM10 and vital capacity. However, there was a considerable correlation between the mean of FEF, FEF 25- 75%, and concentration of O3 at P<0.001 and P=0.016 level of significance, respectively. In Arak the correlation observed between FVC and concentration of O3 was not significant. In Khomain a negative correlation was observed between VC with H[2]S and PM10 on one hand and FVC with H[2]S and PM10 on the other

Conclusion: The main pollutants in Arak was PM10 and in Khomain were H[2]S and O3. Measuring these pollutants throughout the year is necessary

[ evaluation of correlation between plasma level of CRP and WBC with ischemic stroke severity and infarct volume]

Stroke is one of the important causes of death. However the prognostic factors are not clearly defined. There are many evidences which show the role of inflammatory factors during the progression of stroke but the relation of CRP and stroke is still vague. This study was designed to determine the relation between CPR Level and WBS with severity of stroke [according to CNSS score] and volume of infarct in stroke patients. This is a cross sectional study performed during the winter and spring of 2007 on 49 patients with stroke hospitalized in Vali-e-Asr hospital of Arak. Clinical examination was done by using CNSS scoring. The CRP and WBC were measured in the first 72 hour of onset of the disease. The CT scanning together with infarct volume estimation was performed at the same time. There was no correlation between the volume of infarct with CRP serum level [r=-0.14, p=0.39] and WBC [r=-0.17, p=0.92. Also there was no correlation between CNSS score with CRP level [r=-0.04, p=0.81] and WBC [r=-0.124, p=0.40] too, but there was a significant correlation between CNSS score and stroke volume in brain CT scan [r=-0.43, p=0.006]. According to data in this study there was no correlation between serum acute phase reactant, the volume and severity of infarction

[Effect of first aid educational program in health volunteers, rescue method during disasters in Arak]

Providing health not only is responsibility of governmental organizations but also is responsibility of community health volunteers help to health centers and try to promote people's knowledge and practice about their health. This study is conducted to determine knowledge and practice of the volunteers before and immediately after education and evaluated long-term education effects. This interventional [semi-experimental] study was carried out on 78 health communicators Arak with census method. In Arak axis education were included; check of vital signs and rescue method during disasters. Methods of education were lecture, smallgroup, problem solving, and practical training in Skin lab. Data were gathered with questionnaire and check list and were analyzed with Paired T-test and Pearson correlation coefficient. Data was analyzed using paired t-test and Pearson correlation coefficient. There was a significant difference between mean of knowledge and practice scores before and immediately after training [p<0.001]. But the relationship between scores immediately after training and one year later, was not significant. It seems updated knowledge and practice of health volunteers change health behavior, promote knowledge and practice and decrease health care expenses

[ burden of disease and injury in Iran in the year 2003]

Disability-Adjusted Life Years [DALY] summarizes the fatal and nonfatal outcomes of diseases and injuries in one number and gives a quantitative assessment of the health of a population. Estimating the burden of diseases and injuries in Iran in terms of DALY both nationwide and in 6 provinces. We used slightly modified versions of the methods developed by the World Health Organization for estimating the burden of premature mortality, disability, and the DALY. The DALY rate per 100,000 was 21572 and 62% of this was life lost due to premature mortality; the remaining 38% was due to disability from diseases and injuries. Fifty-eight percent of the total DALYs had been lost due to non-communicable diseases, 28% due to external causes [injuries], and 14% due to communicable, maternal/ perinatal and nutritional illnesses. The group of diseases and injuries with the highest burden in males was intentional and unintentional injuries [2.789 million DALYs], while in the female population this position was held by mental disorders with 1.191 million DALYs. The single most important cause of burden was traffic accidents in males and ischemic heart disease in females. Disease burden showed considerable variability between different provinces. The profile of health and disease in Iran has generally shifted from the predominance of communicable, maternal/perinatal, and nutritional illnesses towards predominance of non-communicable diseases and injuries at the national level. These figures on disease burden at population level are the most objective evidence that can be used in policy making and management of health programs, health research, and resource development within the health sector

Comparing the oxidative stress indexes of CVA patients with control group

In the recent years, oxidative stress was attended as one of the causal factors of ischemic stroke. In terms of the role of genetic, geographic and ethnic factors in the prevalence of stroke, This study was designed to compare the oxidative stress indexes of stroke patients with normal healthy subjects in this geographic area. In this case-control study, 36 patients older than 50 years with ischemic stroke and 45 healthy subjects with same age and sex, were enrolled. Five milliliter blood were drawn from all subjects. Samples were centrifuged and plasma was separated. Total antioxidant capacity, lipid peroxidation and thiol levels were measured respettively by FRAP, TEA and HU methods. Then the result was analyzed using t-test. Results showed total antioxidant capacity and thiol plasma levels were lower in stroke patients in compare to healthy subjects, but only the thiol group had significant difference [P = 0/001]. Although lipid peroxidation showed a slight but non-significant difference in stroke patients in compare to control group. These findings suggest oxidative stress in patients with acute ischemic stroke may be conseaqence of an imbalance in oxidant/antioxidant homeostasis. Therefore it may be useful to recommend antioxidant medications or diet for these patients

Use of meta-anaglysis to determining the associated factors of an outbreak occurred in the summer 2005 in Iran

According to the report of Iranian Center of Disease Control, in the summer of 2005 an outbreak of cholera [Inaba serotype] occurred in Iran. The outbreak lasted the mid of September. The aim of this study was to use the result of different studies performed during this period to determine source of infection. This is a meta-analysis study, which studies performed in Qum, Arak, Karaj, Golestan and Ghazvin were eligible. All of these studies were case control ones performed during the August 2005. The total of cases were 531 Pooled odds ratios was used to estimate by fixed and random method. All computations were performed by Stata 8 software. The estimated pooled odds ratios resulted from 5 differemt studies were used in the meta-analysis as the following: travelling [1.64; 95% CI: 0.98-1.88], non-pasteurized ice cream [0.88; 95%CI: 0.48-1.61], post toilet hand washing [3.72; 95% CI: 0.86-16.05], eating meal outside home [2.38; 95% CI: 1.46-3.90], raw fruit eating [0.98; 95% CI: 0.42-2.18] and raw vegetables use [5.36; 95%CI: 2.4-12]. According to the results of this study raw vegetable use and having meal outside home were significantly associated to the cholera in mentioned provinc

[Hyperprolactinemia in patients with brain radiotherapy]

Endocrinopathy is a known consequence of external beam radiotherapy to the brain tumors. The aim of this study was to find out the incidence of hyperprolactinemia in brain tumor patients treated with radiotherapy, when radiation portals included whole of the hypothalamus and pituitary glands. This descriptive study was conducted from December 2004 to February 2006 on about 42 patients with brain tumors, who were referred to radiation oncology center of Hamadan to be treated with external beam radiotherapy, whose radiation portals included whole hypothalamus and pituitary glands. Serum prolactin levels were measured at the beginning of treatment, and at one month, three months, six months and one year after completion of radiotherapy. Data was introduced using descriptive statistics. Of 42 patients 6 were excluded which one was because pf previous hypothalamus and pituitary radiotherapy, three because of nonadherence to follow up program and two because of previous endocrinopathy of the patients attending the follow up clinic, 11% were found to have hyperprolactinemia at six months and 22 at one year. This condition in women and men was 37% and 15% respectively. Abnormality in prolactine secretion is a late complication of brain radiotherapy and a significant number of patients develop hyperprolactinoma following radiotherapy to the brain [hypothalamus and pituitary region]. It seems this complication increases by increasing the radiation dose and is more prevalent in women

[Prevalence of contraceptive use and the importance of the husband's cooperation in married women in Iranshahr, 2005]

Men [husbands] play a very important role in family planning programs, especially in developing countries. The objective of this study was to determine the prevalence of different methods of contraception in women of reproductive age in Iranshahr in 2004-2005 and the extent of their husbands' participation in family planning. This was a cross-sectional study focused on women who were married but not pregnant at the time of the research. We used multi-stage cluster sampling and a pre-tested questionnaire to record the method of contraception and to see if the husband was actually participating in family planning. We used the SPSS [13[th] version] software to calculated measures of location and dispersion. The total sample of 700 married women in the [10-49y] age group included 400 subjects in rural areas and 300 in cities. Of these, 696 agreed to take part in the research. Overall, 65.5% of these women were using at least one form of contraception; the remaining 34.5% did not use any contraceptive methods. The percentage of unwanted pregnancies was estimated at 16%. The mean number of pregnancies was 7, with a median of 4.5. Sixty-three percent of the subjects reported good cooperation by their husbands. Logistic regression analysis showed that the probability of using contraception was significantly related to the husband's cooperation. Our results underline the importance of men's support and cooperation in the success of family planning efforts

ways of research promotion in Sina educational-medical hospital

The objective of this study is to clarify the opinions of scientific board members of Sina university hospital about medical research and the ways of promoting these researches. This is a grounded theory study in which we used in-depth interviews and focus group discussions. Scientific board members and different authorities of the hospital such as the chief of hospital and the deputy of education were participated in the study. We used three different FGDs. Each group included about 5 people. We also interviewed the chief, the deputy of education and the head of clinical research center of the hospital. Most of the participants in our FGDs believed that the most important factor for research promotion in the hospital was preparation of a data base of patients. They also mentioned that, different research workshops are important for empowering scientific board members in research. According to our study the most important strategies for research promotion in Sina hospital are data bank preparation, providing repeated research workshops, revising the bureaucratic process of proposal approvals, revising the manner of evaluation of scientific board members and more participation of the department of epidemiology in clinical researches

effect of using Kalleh-Pacheh, smoking and diabetes on myocardial infarction in Arak district of Iran: an extension of Isfahan healthy heart project

Kalleh-Pacheh is an Iranian food used in many part of Iran and many other countries such as Afghanistan, Pakistan and India. We found no information regarding the effect of this food on acute myocardial infarction. The aim of this study was to assess the effect of this food, together with diabetes and smoking on myocardial infarction in Arak district. This was a case-cohort study which was performed hi Arak district. In this study the data of Arak sub-cohort was taken from Isfahan healthy heart project which was performed in 2001. Cases were myocardial infracted hospitalized patients who were resident in Arak at the time of study. We showed the effect of different exposure, on myocardial infarction by estimating relative risk and population attributable fraction and 95% confidence interval. In this study 150 cases were compared with 6339 sub-cohorts. The population attributable fraction for Kalleh-Pacheh was 19% [95% CI, 6 to 30%]. This measure for diabetes and smoking was 31% [95% CI, 23 to 39%] and 41% [95% CI, 31 to 49%] respectively. According to the results of our study; smoking, diabetes and using Kalleh-Pacheh has significant effect on myocardial infarction

[Comparing the accuracy of ultrasonic, clinical and mother, fetal weight estimation in pregnant women in Kerman]

Estimation of fetal weight is very important in preventing delivery complications and also in selecting delivery method. This is specially important in potential macrosomia, IUGR and also preterm labor. The objective of this study is to compare the accuracy of ultrasonic, clinical and mothers, fetal weight estimation in pregnant women in Kerman. In this cross sectional study 246 women with singleton, term pregnancies admitted for cesarean section within the following week, were studied. Estimation of fetal weight [EFW] was done using sonography and then by two obstetricians and one senior resident who were unaware of the other clinical and ultrasonic results. Mothers' estimation of their baby weight was also asked. Statistical analysis was done by paired T and Chi square tests. We also used ROC [Radar Operating Characteristics] curve to compare the accuracy of different tests. Fetal birth weight was 3339 +/- 443 gr. In the 2500-4000 gr birth weight the sensitivity of predicting clinical birth weight was 11.8% with 99.6% specificity and for sonographic EFW was 12.6% with 92.1% specificity. Clinical estimation of birth weight in term pregnancy is as accurate as routine ultrasonic estimation obtained in the preceding week of delivery

[ effect of previous history of Tuberculosis on female infertility in Rooyan institute of infertility patients]

The reason of infertility can have a direct influence on the plan and outcome of management. In this paper we intend to show the effect of tuberculosis [TB] history on female infertility among infertile couples attending to Rooyan infertility management center. In this case-control study our cases were those who were diagnosed as infertile female and controls were those women whose husbands were infertile due to some male factor. We used logestic regression for analyzing the association of history of Tuberculosis and female infertility with attributable risk estimation. 308 cases were compared to 314 controls. Considerng the odds ratio and its 95% confidence interval, there was a asignificant difference between the history of TB and infertiliy [OR=4.7, 95% CI: 1.01-29.91]. The attributable risk of TB for female infertility was 0.023 +/- 0.01 [which is significant at 5% level]. The attributable risk of TB for female infertility was 0.023 +/- 0.01 [which is significant at 5% level. These figures show that at least 2% of female infertility can be prevented by prevention and proper treatment of tuberculosis