[Comparison of health-care coverage between children with congenital hypothyroidism and healthy children in Iran]

Background and Aim: provision of timely healthcare for children under 5 years of age specially children with congenital hypothyroidism and also regular monitoring of growth through measuring weight, height and head circumference have been of great importance. The aim of this study was to make a comparison between healthy children and children with congenital hypothyroidism in regard to health-care coverage in Iran

Materials and Methods: this study was conducted in five provinces in different geographical areas of Iran in 2015. 240 children with congenital hypothyroidism and 240 healthy children were entered into the study. Children with congenital hypothyroidism were selected randomly from the national registere database. The children in the control group were matched with the children with hypothyroidism in regard to age, gender and place of residence. Anthropometric indices including weight, height and head circumference of the children of less than 3 years of age were recorded as the health care indices. STATA software version 13 was used for data analysis

Results: the mean percentage of measurement and record of weight, height and head circumference in children below 3 years of age with congenital hypothyroidism were 82.1, 78.7 and 55.4%, respectively. The mean percentage of measurement and record of weight, height and head circumference in healthy children [control group] below 3 years of age were 82.2%, 80.9 and 55.1%, respectively. There was a statistically significant difference between the two groups in relation to the percentage of height measurement [P =0.02]

Conclusion: according to the results of this study, percentage of measurement and record of the anthropometric indices in Iranian children of less than 3 years of age is low. More attention to the measurement and record of these physical growth indices in children of less than 3 years of age specially children with congenital hypothyroidism who need regular follow up, is essential

Incidence of acute myocardial infarction in Islamic Republic of Iran: a study using national registry data in 2012

Population-based data on myocardial infarction rates in the Islamic Republic of Iran have not been reported on a national or provincial scale. In a cross-sectional study, data were collected on 20 750 new cases of myocardial infarction [ICD10 codes I21-22] admitted to hospitals and registered by the Iranian Myocardial Infarction Registry in 2012. The crude and age-adjusted incidence for the 31 provinces and the whole country were directly calculated per 100 000 people using the WHO standard population. Overall, males comprised 72.4% of cases and had a significantly lower mean age at incidence than women [59.6 [SD 13.3] years versus 65.4 [SD 12.6] years]. The male: female incidence ratio was 2.63. The age-standardized myocardial infarction incidence rate was 73.3 per 100 000 in the whole country [95% CI: 72.3%-74.3%] and varied significantly from 24.5 to 152.5 per 100 000 across the 31 provinces. The study provides baseline data for monitoring and managing cardiovascular diseases in the country

[Fall-related injuries in older people in Kashan]

Falls in the elderly cause a variety of injuries and may lead to dependency, lower self-efficacy, depression, limitation in daily activities, hospitalization, admission to a nursing home and cost to the individual and community. The present study was conducted to determine the types of injuries from falls in the elderly. In this cross-sectional study, all patients aged 60 years and older who were hospitalized due to fall in Shahid Beheshti Hospital in 2011 were investigated. External cause codes w00-w19 based on International Statistical Classification of Diseases and Related Health Problems [ICD-10] related to fall were selected from the hospital health information system, and the patient records, demographic variables, external causes of injury and type of injury were extracted. Data were analyzed using SPSS software. Relationship between duration of hospitalization and background variables were evaluated using chi-square test, t-test, ANOVA or nonparametric equivalents. A significance level of 0.05 was considered. A total of 251 patients aged 60 years and older were studied that 127 of them [50.6%] were women. The mean age of the patients was 76.82 +/- 7.3 years. Fall on the ground was the most common type of injury [78%] and upper limb fractures [44.1%], lower limb fractures [28.9%] and head injuries [15.9%] were the most common types of injuries. The total number of hospitalization days was 1425 and mean of hospitalization was 5.68 +/- 4.5 days. The most frequent injuries are fractures of the upper limb, lower limbs and head injuries that caused the greatest length of stay and cost of hospitalization in the elderly

[Compliance ratio between the abstracts of Iranian systematic reviews and meta-analysis indexed in web of sciences and PRISMA statement]

Introduction: systematic review is an approach with precise identification of all the relevant studies leading to more objective and scientific conclusions. Unless the structure of the studies comply with internationally accepted standards, they cannot effectively be responsive to objectives of the studies. The purpose of this study is to evaluate the compliance ration of Iranian Systematic Reviews and Meta-analysis abstracts indexed in WOS and PRISMA statement

Methods: this study is an analytical survey. The sample included 204 Iranian systematic reviews and meta-analysis abstracts indexed in WOS up to the end of 2012. In this study the structure of the abstracts were evaluated using the PRISMA statement. Pearson correlation coefficient was used to calculate the correlation between the obtained results with cited articles, the number of authors and the publication year

Results: the mean PRISMA score of article's abstract was 6.24 +/- 1.68. The objective section with 99%, compliance rate, had the highest compliance rate and the Registration with 2%, had the lowest compliance rate among other PRISMA items. The means for citations and the number of authors were 4 and 5.3, respectively. There is statistically significant positive correlation between the PRISMA score and the mean of received citations [P=0.010, r=0.181], as well as the number of authors [P=0.013, r=0.175]

Conclusion: according to the findings the ratio of compliance between abstracts and PRISMA is not desirable. Therefore, authors should be trained for better reporting of results. In addition, the editors of magazines should include the guidelines of accurate reporting of these types of articles in the article writing guidelines

[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

[Assessment risk factors for unintentional childhood poisoning: a case-control study in Tehran]

Recently, childhood poisoning has become one of the most pressing concerns in injury epidemiology. The aim of this study is to identify the main risk factors in unintentional childhood poisoning. The present study is individual method case-control based in a hospital [case; n = 140, control; n = 280] in Tehran 1392. Cases with controls are matched on sex and age. Then children's parents are interviewed to determine demographic, behavior, previous poisoning, addiction and mental disease in the family, accessibility of poisoning products, and household size, using semi-structured interview by standard questionnaire. Finally invariable-multi adjusted Conditional Logistic Regression models were constructed. Narcotic poisoning was of highest prevalence among the cases [58.6%]. The majority of the poisonings occurred at home [96.4%]. The invariable model showed that maternal occupation, parent education, smoker parent, previous poisoning, addiction and mental disease in the family, accessibility of poisoning products, and household size all related to unintentional childhood poisoning. Finally, the multi-adjusted model in stepwise manner showed that addiction in the family [OR = 14.6, p <0.001], previous poisoning [OR = 7, P <0.001], maternal occupation [OR = 4, P = 0.016], and accessibility of poisoning products [OR = 0.03, P <0.001] associated with outcome. Addiction in the family as risk factor and inability to access poisoning products had the most association with unintentional childhood poisoning. It is recommended that public health planning focus on these two factors.

[Testing psychometric properties of the perpetration of bullying and victimization scales with olweus bullying questionnaire in middle schools]

Bullying behavior is one of the growing problems in many schools. Availability and access to a valid and reliable instrument for measuring this behavior is necessary for intervention and to reduce side effects. Therefore, this study has been carried out with middle school students with the aim of validating the bullying perpetration and victimization scales of Olweus Bullying Questionnaire. The study was conducted on 830 public middle school students in Mazandaran province. The content validity was calculated from CVR. To assess structure, exploratory and confirmatory factor analysis was used; and correlations between factors for each of the scales were obtained. To assess reliability, test - retest procedure was used with intra class correlation coefficient [ICCs]. In the assessment stage of content validity, each of the scales removed one question and added one question. Analysis Four-factor Structure of victimization scale explained by EFA with 64% of variance, as well as Four-Factor Structure of the perpetration of bullying scale by eliminating item 13, explained EFA 72% of variance. Confirmatory factor analysis [CFA] confirmed Four-Factor Structure in both victimization and perpetration of bullying scales. Values of reliability test - retest showed a good level of both of these scales. Perpetration of bullying and victimization scales of Olweus Bullying Questionnaire has acceptable validation properties in middle school students.

[Review on road traffic injuries cost calculation methods]

To resource allocating at national levels as results of productivity, cost calculation helps to determine the size of the problem and revealed cost benefits of injury prevention and it can also ensure the better resource using and cost benefit assessment. This study was conducted to determine the method of calculating road traffic injuries cost. In a literature review study using internet searching and library resources' all references related to health cost determination was derived. Then among all the methods, methods of road traffic injury cost estimation were studied and a result with component of the two common methods is presented here. Findings showed that road traffic cost methods including: life insurance approach, court award [compensation], compensation method, the method of implicit public sector valuation, gross output method, using GDP [human capital] method, value change risk or willingness to pay. Mentioned methods have been used based on each section policies, but each method faced to its limitation and may be accompanied with under reporting. Among the stated methods willingness to pay is more accurate, but because of the complexity of the method, human capital method according to available resources and capacity to perform the higher permeability is recommended for low and middle income countries.

[ survey of the role of humans' risk factors in the severity of road traffic injuries on urban and rural roads]

This study was conducted to determine the role of human risk factors in the severity of road traffic accidents on urban and rural roads. All data from road traffic-injured subjects [census, 592168] which were registered by the Fava system [COM forms] were investigated. Human risk factors due to road traffic injuries and the Odds ratio were calculated using an ordinal regression model and adjusted to probable confounding risk factors such as age, gender and lighting system in urban and rural roads. The mean age of the subjects was 34.1 +/- 14.0 years. Among human risk factors, the highest percentage [69.9%] was allocated to the disregard of rules and legislation. The Odds ratio of an accident being fatal or non-fatal in inner city roads to alcohol users was 6.5 times more than for those who did not have this risk factor [OR: 6.5, CI: 4.88-8.65]. In outer city roads it was also the highest among other ratios [OR: 1.73, CI 1.22-3.29]. In spite of the fact that alcohol had the highest effect on the severity of road traffic injuries, but acknowledging the low prevalence of this factor and its outcome on lower attributable risks when compared to other factors, it is a better prevention program to focus on those factors which are more prevalent, such as the disregard of rules and legislation and speed.

[Evaluation of occupational exposure with vinyl chloride monomer in the plastic production industry in Tehran]

Growth of the plastics industry in recent decades has been dramatic. Poly Vinyl Chloride is one of the most widely used plastics in the world that granules in the thermal process decompose to Vinyl Chloride Monomer and is released in work air environment. This study aimed to evaluate occupational exposure and estimate workers' exposure with vinyl chloride monomer risk. A cross-sectional study of 100 workers at two Plastic factories in Tehran [A, B] was performed. Personal monitoring of workers to Vinyl Chloride Monomer was conducted by Optimized Method No.1007 from NIOSH. Atmospheric conditions, such as temperature, pressure, air velocity, and relative humidity were measured simultaneously along with personal monitoring. Quantitative risk assessment of workers was computed in the form of Standard Mortality Rate and incident rate cancer. Statistical analysis of data was conducted by SPSS version 19. Climatic parameters in the plant A and B for a relative humidity were 43.77 +/- 16.71 and 37.16 +/- 14.45% and temperature 20.95 +/- 3.34 and 21.05 +/- 2.20 degree C, air pressure 87.48 +/- 0.54 and 87.41 +/- 0.64 kPa and air velocity 0.13 +/- 0.08 and 0.10 +/- 0.06 meters per second were measured respectively. Occupational exposure to Vinyl Chloride Monomer plants A and B were 1.01 +/- 0.51 and 0.72 +/- 0.30 as ppm respectively. Quantitative risk of exposed workers based on Standard Mortality Rate was estimated 1.06 +/- 0.03 times of the population without exposure. Incident rate cancer based on accounting measures of integrated risk Information System was calculated per 1000 person exposure population. The correlation of Standard Mortality Rate and the risk of cancer incidence was statistically significant [R[2] :0.88]. Thirty one percent of workers had higher exposure to Vinyl Chloride Monomer than the occupational exposure limits [1 ppm]. In the present workers' exposure in this study is lower than international workforces reported in decades ago, but higher than studies recently published. The results clearly describes occupational hazard of workers in the current Iranian recession situation. The application of control system in the form of engineering control measure, especially in the coming years with projected economic growth, is justified for securing workers health and well-being.

[Assessment of occupational exposure to aluminum respirable aerosols among aluminum foundry workers]

Aluminum and in particular its compounds make up a large proportion of the pollutants coming from the aluminum foundry. In several studies conducted on the harmful effects of aluminum in recent decades, it has been identified as a neurotoxic metal. Chronic occupational exposure through inhalation of dust is a common problem in aluminum foundries. Investigation of the exposure of various occupational groups in two aluminum foundry plants to aluminum aerosols. To study the occupational exposure of foundry workers to respirable aerosols of aluminum, personal sampling was conducted from the breathing zone of 63 workers at two foundries in the south of Tehran city following NIOSH method No. 0600. Then samples were treated using NIOSH Institute optimized method No. 7013 and analyzed by high sensitivity graphite atomic absorption.Collected data were analyzed with SPSS V.16 statistical software using an independent sample t-test and ANOVA. The average of aluminum respirable aerosols in A and B factories were 3.21 +/- 2.33 and 3.31 +/- 2.15 mg/m[3] respectively. The one-way ANOVA indicated that occupational exposure among various occupational groups [Similar Exposure Group] in Foundry A had no significant difference [p=0.089], but differences between the exposure of melting and assembling groups in Foundry B are significant [p=0.044]. In general, in exposure frequency to aerosols in aluminum foundries, a significant difference was observed between melting and assembling groups [p=0.005] as well among abrading and assembling groups [p=0.02]. Most of the exposures to aluminum in foundry workers exceeded the current limits given by ACGIH Institute and the Iranian occupational exposure limits. According to the occupational exposure of both foundries and the absence of differences among variables involved in the exposure, the high exposure of melting and abrading groups compared to assembling groups can be attributed to the nature of these units in the production of aluminum aerosols.

[Comparison of characteristic property among Tehran offensive and non-offensive drivers using cloninger's treatment and character inventory]

Characteristic property among Tehran offensive and non- offensive drivers using Cloninger, s treatment and Character Inventory questionnaire was studied. A cross- sectional study was carried out after coordinating with traffic police. 300 drivers: 150 offensive [drivers with more than ten penalty points and 150 non- offensive drivers with less than ten penalty points in one year prior were selected randomly. Data was collected using Cloninger, s treatment and Character Inventory standard questionnaire by trained experts in three different routes of Tehran. The average age was 20-34 years [82% male, 18% female]. Based on Cloninger,s treatment and Character Inventory standard questionnaire, a significant differences was observed in novelty seeking, harm avoidance, reward dependence, self-directive ness, co- operation [p<0.001] and persistence [p<0.013] among offensive and non-offensive drivers. By one score increasing of novelty seeking the chance of to be offencer will be increased 4.5 times [OR= 4.520, p<0.007], in harm avoidance will be half [OR= 0.504, p<0.045] and in reward dependence will be one fourth [OR= 0.278, p<0.033]. Novelty seeking sub scale of Cloningers treatment and Character Inventory questionnaire was higher and harm avoidance and reward dependence was lower among offensive drivers.

[Study of road traffic injuries risk factors by geographic information system [GIS] in 2009]

Using Geographical Information System [GIS] can decreases the burden of road traffic injuries effectively by identification of hot spot to modification in hazardous areas. The aim of the study was determining geographical distribution of human risk factors associated with road traffic injuries by using Geographical Information System [GIS] in Iran. The national database of road traffic injuries registered by the Iranian traffic Police [Rahvar NAJA] was used. The human risk factors were investigated by recognition of the hazardous points and geographical distribution of associated risk factors. The Hot Spot Analysis and Map clustering approaches were employed to meet the objectives. The mean age of injured subjects was 34 years and the most affected age group was 20-39 years. Death and injury occurrence within out of cities ways were 0.3% and 28% respectively. Geographical distribution of risk factors also showed that roads of Northern provinces i.e. [Gilaan and Mazandaran] were the hazardous rising as well as Qazvin to Rasht and Qom to Tehran roads. Sistan and Balochestan Provinces and Tehran had the highest [4.8%] and the lowest [0.1%] rates of road traffic injuries leading to death in the country. Northern provinces and its leading axes by hazardous rising and Sistan and Balochestan province with fatal injuries need to identify the cause of injuries' and, if necessary, more tighten regulations and more controls by the traffic police must be applied.

[Evaluation of occupational exposure to benzene and toluene among workers in two tire manufacturing factories]

Semi automated processes of Iranian tire manufacturing factories lead to significant occupational exposures to benzene and toluene compounds. This study was conducted to evaluate the magnitude and risk of workers exposures. Personal monitoring of 100 workers [10 groups] was performed using NIOSH method No.1501 in two tire manufacturing factories in Tehran city.Workplace atmospheric conditions were measured on sampling days. Semi quantitative risk assessment [COSHH] was carried out using questionnaire and respective matrix. Data were analyzed using t-test, correlation coefficient, linear regression and one-way ANOVA. Quantitative values were reported as mean +/- standard error. Age, work experience and atmospheric parameters had no significant statistical difference in two factories. Occupational exposures to benzene and toluene were 1.09 +/- 0.18, 1.88 +/- 0.19 and 2.07 +/- 0.30, 3.20 +/- 0.39 ppm in factories A and B that showed significant increase in B factory and inverse significant correlation with air relative humidity. Exposure to high risk of benzene and medium risk of toluene were 10, 14 and 10, 16 percent of workers in factories A and B, respectively. The correlation between occupational exposure and COSHH assessment was significant. occupational exposure to benzene in tire manufacturing personnel was higher than Iranian standard, therefore, improvement of work conditions using appropriate control measures including automated processes and setting of air relative humidity is recommended. COSHH assessment can be used as a simple, cheap and quick method in workers' health promotion. Control of personnel exposure through ongoing training is imperative

[Epidemiology of traffic crashes outcomes and related factors in Iran 2010]

Traffic crashes are multi-factorial consequences caused by human factors, technical issues and environmental conditions. The present study aimed to determine epidemiology of urban traffic injuries in Iran and role of some human risk factors in occurrence of such outcomes in 2010. Through a descriptive cross-sectional study, the records of 515205 injured people injured people due to road traffic crashes were used. Odd ratios for traffic events using regression models with appropriate chances and logistic regression were estimated by considering affecting factors on outcomes of traffic injuries such as age and gender. Data of 515205 drivers including 464401 [90.1%] males were analyzed. From the environmental factors related to road deficiency, the difference between level of the road and its edge line [OR = 4.3; 95% CI: 2.8-6.5] and road dropping [OR = 2.5; 95% CI: 1.1-6.2] had the most influence on mortalities due to traffic crashes. Sudden change of direction [OR = 9.9; 95% CI: 8.2-11.9] and lacking control of vehicle [OR = 7.0; 95% CI: 5.8-8.4] had the most effects on either injury or death categories after adjustment for age, gender and lightening. With respect to increased mortalities due to road traffic crashes in Iran, comprehensive studies about epidemiology and risk factors of traffic accidents could beconsidered as a giant step to control these risk factors and decrease the death burden of such events.

Estimating the contribution of selected risk factors in attributable burden to stroke in Iran

Knowledge of the magnitude of avoidable burden by risk factors is needed for health policy, priority setting, and preventing stroke. The aim of this study was to estimate the contribution of selected risk factors including hypertension, overweight, obesity, tobacco use, and physical inactivity to the attributable burden of stroke in Iran. The World Health Organization Comparative Risk Assessment [CRA] methodology was employed to calculate the Potential Impact Fraction [PIF] and percentage of avoidable burden of stroke, which attributed to its risk factors among Iranian adults in 2009. Prevalence of risk factors was obtained from the 5th STEPS survey of chronic disease risk factors which conducted in 2009. PIF was estimated on both theoretical minimum and feasible minimum risk. A simulation procedure incorporating sources of uncertainty was used to estimate the uncertainties for the attributable burden. About 15.7% [95% uncertainty intervals: 5.8- 23.5] of attributable Disability Adjusted Life Years [DALYs] to stroke in adult males and 15.8% [95% uncertainty intervals: 5.8- 23.5] in adult females are avoidable after changing the current prevalence [16.0% and 16.1% for males and females, respectively] of hypertension to 10% in both sexes. This work highlighted the important role of hypertension and overweight. Accordingly, policy makers are advised to consider these risk factors once implementing interventional program in Iran

An overview on causation in epidemiology

The relationship between two things if one is another originator or creator, called causality. Although this concept is not specified to Medical Sciences and Epidemiology, the importance of this issue is more highlighted in the field of epidemiology. Causation is the most basic concepts in empirical sciences and is still under discussion because it is dependent on the basis of any scientific laws without acceptance something cease causality is impossible. With the increasing development of science as well as epidemiology, causality has found a broader concept and its application in analytical studies and logical interpretation of the results of this type of study, has a wider dimension. Due to developing new epidemiology courses at medical universities and increase the number of students, it is felt to talk more about the causality concept. In this review causality concepts in the humanities is overviewed, its history is briefly described, the causality of Medical Epidemiology and also Islamic religion is considered, then the causality framework, and models to interpret the conventional causality will be discussed

Road safety in the Eastern Mediterranean Region -findings from the Global Road Safety Status Report

A secondary data analysis using the Global Status Report on Road Safety [GSRRS] was carried out to assess the epidemiology of road traffic injuries [RTIs] and preventive strategies in the Eastern Mediterranean Region [EMR]. EMR countries ranked equal first in the world for the highest number of fatalities due to RTIs [32.2 per 100 000 population]. The region had about 4% of the world's vehicles with 0.097 registered vehicles per person. The number of injured cases in EMR was 210.1 per 100 000 population. Only 15% of EMR countries had a funded, independent, multisectoral body for road safety. Only 25% had mandatory seat-belt laws for both front-seat and rear-seat passengers, 60% had mandatory helmet laws for both drivers and passengers of motorized two-wheelers and 10% had child restraint laws. Road safety in EMR countries needs more attention and consideration

[Pattern of drowning and its burden in northern provinces of Iran [Gilan and Mazandaran] in 2008]

Drowning is a major and serious public health problem in the northern provinces of Iran. It has significant opportunities for prevention. The aim of this study was to review the epidemiological pattern and burden of drowning in northern area f Iran. To examine the incidence and characteristics of drowning in recreational water settings, we analyzed all available data from death registry in 2008 year in Mazandaran and Gilan provinces, located in north of Iran, through a retrospective study. Collective form was based on standard World Health Organization and then the burden of drowning was calculated. During 2008, 158 indigenous [88.6% male and 11.4% female] people from these provinces died due to drowning. The mean age of the drowned was 26.4 [SD=16.2] years. The drowning death rate was 2.9 per 100,000 population in two provinces. Most of cases [85.4%] of drowning occurred in sea and majority of death was in August [29.7 percent]. Number of years lost was 4110 equivalent of 76.1 per 100,000 respectively. Most DALYs was seen to age group 10-19 years. It is highly recommended the findings of this project should be considered for any future preventive plan by health authorizes in those provinces