[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

[Evaluation of factors associated with time to sputum smear conversion in smear-positive pulmonary TB patients in Golestan province, Iran [2009-14]]

Background and Objective: Tuberculosis caused by Mycobacterium tuberculosis is one of the deadliest infectious diseases in the world. The amount of the bacilli in tuberculosis will reduce rapidly by starting effective antibiotic treatment and the remained bacilli in the sputum will be an important scale to respond to treatment. This study was conducted to evaluate the examin factors associated with the conversion of positive smear to negative one in tubercular-pulmonary patients in Golestan province, in northern Iran

Methods: This retrospective cohort study was carried out on 2093 patients with smear positive pulmonary tuberculosis registered in Golestan province, northern Iran from March 2009-14 referred to health centers. The outcome of this study was to determine the time of changing to negative of the first smear during the treatment and evaluating its relationship with demographic variables, the density of bacilli in the smear, culture, chest x-ray, diabetes and HIV

Results: 67.5% of patients among 2093 smear-positive pulmonary tuberculosis patients were conversion rate of smear at the end of the second months. Results of Cox model showed relationship between gender, age, weight, density bacillus smear and culture results at the start of treatment and negative smears [P<0.05]. Old age, low weight, high density of bacillus in primary smear in the beginning of treatment and increasing of the number of colonies in culture of positive smear patients were considered as predictor factors in changing positive smear to negative one

Conclusion: This study revealed that Conversion rate and treatment success in Golestan province was less than what was expected

Trends in outpatient cataract surgery in the Islamic Republic of Iran, 2006–2010

This study aimed to determine the trends in outpatient cataract surgery and its determinants in the Islamic Republic of Iran between 2006 and 2010. In this cross-sectional study, 106 cataract surgery centres were selected in all provinces by multistage randomized cluster sampling. The number of centres in each province was determined from the number of cataract operations and the number of patient charts examined in each centre was proportionate to the number of cataract operations in that centre. The prevalence of outpatient surgery increased from 46.0% [95% CI, 35.3-56.8] in 2006 to 51.4% [95% CI, 40.2-62.7] in 2010 [P = 0.549]. Patients stayed in hospital for more than one night after 10.5% [95% CI, 6.9-14.1] of operations. Use of phacoemulsification and topical anaesthesia increased the prevalence of outpatient surgery and decreased intraoperative complications. Although outpatient cataract surgery increased by 11.7%, use of methods such as phacoemulsification is not widespread, and more attention should be paid to the barriers to outpatient cataract surgery in the Islamic Republic of Iran

Contributions of public and private sectors to the Iranian cataract surgery output

This study determined trends in the contributions of the public and private sectors to the cataract surgery output in the Islamic Republic of Iran. Data about cataract surgeries performed at surgical centres throughout the nation were extracted from patient charts for a 5-year period from 2006 to 2010. Of the total 516 273 surgeries performed in 2010, more were done in public sector centres [61.7%] than private ones [38.3%]. The total number of surgeries increased by 59.1% between 2006 and 2010. Analysis of the relative contributions of the public and private sectors showed a 41.0% increase in surgeries in public centres and 100.5% in private centres over the 5-year period. Thus the rate of growth of cataract surgery in the private sector was 2.7 times greater than that in the public sector. Despite a smaller contribution to the total number of cataract surgeries, the private sector has experienced a substantial rate of growth

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

[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

Urbanization and non-communicable risk factors in the capital city of 6 big provinces of Iran

The prevalence of non-communicable diseases such as hypertension and diabetes including obesity has increased over the past few years in Iran. The increase in these diseases has been associated with increased urbanization and lifestyle changes. The burden of non-communicable diseases [NCD] is increasing in low and middle-income countries. The aim of this report is to address the threat of NCDs in the capital city of 6 big provinces of Iran. A community based cross sectional study was carried out between March 2010 to January 2011 in 6 provinces' capital cities [Isfahan, Karaj, Mashad, Shiraz, Tabriz, and Tehran]. Participants were men and women of 30 years and older who had been screened through the National Diabetes Prevention and Control Program. BMI, blood pressure, fasting blood glucose and lipids were measured. 439406 cases [60% female and 40% male] were studied. The prevalence of pre-diabetes [13%], diabetes [13%], hypercholesterolemia [14%], hypertension [11%], overweight [27%] and obesity [20%] was higher than expected. Only 35% of participants were healthy. This study reveals a high prevalence of NCDs in urban living population in those capital cities. It also shows that increasing urbanization may be an important threat to public health regarding NCDs especially in developing countries. It is crucial to implement a comprehensive NCD program [across the life time] in the health system with a strong collaboration with all stakeholders [governmental and non-governmental sector, academic, research centers and scientific associations] in the community [Multisectoral Approaches]

Human papillomavirus infection prevalence in women referred to health clinic of shahid beheshti university of medical sciences, Tehran, Iran

Human papillomavirus [HPV] infection seems to be the most common sexually transmitted infection. High-risk [HR] human papillomavirus [HPV] prevalence has been shown to correlate well with cervical cancer incidence rates. Since there is little known about the epidemiology of this infection in Tehran, we designed to estimate the prevalence of HPV in some areas in Tehran. Cervical specimens were obtained from 825 married women aged 21-59 years from the general population of Tehran, Iran according to the standardised protocol of the IARC International HPV surveys. HPV was detected using a GP5+/6+ PCR-based assay. HPV prevalence in the general population was 7.8% [5.1% of high-risk types], with no statistically significant variations by age. Cervical intraepithelial neoplasia was diagnosed in 4.1% of women, of whom 35.3% were HPV-positive. HPV1 6 was confirmed as the most common type among women with both normal [1.8%] and abnormal [8.8%] cytology. HPV positivity was significantly higher among divorced women, women in polygamous marriages and those reporting husbands' extramarital affairs. However the prevalence of HPV seems not high in comparison with other international data, more molecular and seroepidemiological survey in national level needs to hâve a better perspective

[Attitudes and knowledge of HIV positive persons and high risk behaviors groups in Golestan, Iran]

The epidemic of HIV has been become worldwide. Infected people with HIV which are most intravenous drug users [IDUs] and/or people who have unsafe sex are important source of transmission of infection to other persons in a community. Since there is little known about the knowledge and attitudes of HIV positives about HIV in Iran, therefore we decided to measure the level of knowledge and attitudes of this group in Golestan province in compare with individuals with risky behavior. This cross-sectional study was conducted on 54 HIV+ persons and 134 people with high risk behavior individuals in 2007 year. Our study showed that HIV- [High risk group] cases had higher education level [P=0.034]. Rate of jobless was higher in HIV+ persons [P<0.001]. HIV+ cases had lower income [P=0.037]. Both groups had moderate knowledge and poor attitude on HIV/AIDS. Level of attitude in HIV+ positive persons was lower than high risk group [P=0.05]. It is concluded that these susceptible persons and also infected individuals with HIV regardless of their socio-economic levels need more continuous education in structured programs

[Changes in unprotected sexual behavior and shared syringe use among addicts referring to Methadone Maintenance Treatment [MMT] centers affiliated to Shiraz University of Medical Sciences in Shiraz, Iran: an uncontrolled interventional study]

AIDS is a lethal disease, for which there is no treatment or any vaccine to prevent it. The injection-drug use and unprotected sexual behavior are two factors important in HIV transmission. This study was conducted to determine changes in high-risk sexual and injection-drug use behaviors associated with HIV among drug users referring to Methadone Maintenance Treatment centers in Shiraz, Iran. This before-after interventional study with no control group included drug-users [n=694] referring to all the 7 MMT centers in Shiraz, Iran in 2009. The data were collected by interviewing patients and using a questionnaire. The software used for data analysis was SPSS 15, the statistical test being the Wilcoxon test. The average age of the clients was 36.5 +/- 9.5 years. Most of them were males [% 92.1] and single [% 43.1]. 37.3% of them being injection-drug users. The proportion of the injection-drug users having had at least one shared injection one week before referring to an MMT center was 23.3%, which decreased to 9.2% after one week. Analysis of the data also showed that 25.2% of the addicts had had at least one unprotected sexual contact during the previous month; the proportion decreased to 21.0% one month after referring to an MMT center. The reductions in the mean numbers of both shared injections and unprotected sexual contacts were statistically significant [p <0.001]. Considering the effectiveness of the MMT centers in reducing risky behaviors of injection-drug users, it is essential to expand these centers at both the national and regional levels quantitatively and qualitatively and encourage drug-users to refer to them and seek help. This will help greatly in the prevention of HIV