Estimation of influenza and severe acute respiratory illness incidence [burden] in three provinces of the Islamic Republic of Iran, 2012 and 2013

There are few estimates of influenza burden in the WHO Region for the Eastern Mediterranean. In this study we estimated the burden of severe acute respiratory infection [SARI] and influenza-associated SARI [F-SARI] in selected provinces of Islamic Republic of Iran, the trends of SARI and confirmed cases of influenza [F-SARI] over 12 months [seasonality], and the age groups most at risk. Using the electronic Iranian influenza surveillance system and data of cases in sentinel hospitals of 3 selected provinces, we estimated the monthly trend [seasonality] of incidence for SARI and F-SARI, overall incidence of SARI and F-SARI and their disaggregation by age with the aid using the Monte Carlo technique. The age groups most at-risk were children aged under 2 years and adults older than 50 years

Dental curriculum revision in Iran: dentists' perspective on achievement of essential competencies through national curriculum

Based on the current emphasis on competency-based education, as a part of need assessment phase of dental curriculum revision in Iran, in the present study the dental graduates' perspective concerning the minimum competency requirements for an Iranian general dentist has been investigated. Based on the three available major competency documents in the literature a questionnaire was developed in which the participants were asked to indicate their opinion about the necessity of each of the 142 stated competencies for an Iranian general dentist [Yes/No], and to state the degree to which they believed the current curriculum covers each competency [Completely, Partially, Not at all]. In an annual meeting in June 2008, the provincial chief dental managers were asked to distribute the questionnaires among general dentists in their province [10 questionnaires in each province]. The managers posted back the completed questionnaires to the researchers. Of 300 questionnaires distributed in the 30 provinces of the country, 250 questionnaires [83%] were returned. While most of the participants considered the competencies as necessary for an Iranian dentist, less than 40% of the respondents believed that the graduates acquire the most required competencies of the profession during the current educational program. A necessity exists for curriculum revision. In addition to clinical skills, in this revision more emphasis also should be placed on the non-clinical part of the curriculum

Mortality from pandemic influenza a [H1N1] in Iran

Due to worldwide spread of influenza A [H1N1] virus, the World Health Organization declared the first pandemic of influenza in four decades. This study aims to report the mortality from pandemic influenza A [H1N1] in Iran population and its epidemiologic and clinical characteristics up to December 21, 2009. The data were obtained from all provinces and reported to center for disease control of Ministry of Health and Medical Education [MOHME] of Iran through nationwide surveillance system for influenza A [H1N1] was implemented by MOHME since April 2009. Of 3672 confirmed cases of influenza A [H1N1] in Iran between 22 May and 21 December 2009, 140 [3.8%] deaths were reported, mostly in 15-65 year old [yo] age group [67%]. The highest admission mortality rate was in > 65 yo group [107 deaths/1000 hospitalized cases]. Of decedent patients, 54% had no long term condition or risk factor, 34% had one, 11% had two, and 1% had three. Diabetes mellitus, pregnancy, chronic respiratory diseases and hypertension were the most common underlying conditions. The most common clinical pictures of death were acute respiratory distress syndrome and viral pneumonia. Although 66% of decedent patients received oseltamivir, enough information was not available about time of onset of antiviral therapy. As death due to influenza A [H1N1] occurs in all age groups and in those with and without any predisposing factors, we recommend health policy makers to provide influenza vaccination for people with underlying conditions and respiratory hygiene for all people

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

[Changes of hyoid bone position following treatment of class II div1 malocclusion with Farmand functional appliance]

Unlike other bones of the head and neck, hyoid bone has no bony articulations. It is connected to mandible, cranium and pharynx through muscles and ligaments. During treatment with functional appliance in patients with class II div1 malocclusion, mandible is positioned in inferior and anterior direction. Regarding the relation between hyoid and mandibular bone, alterations of hyoid bone position can be a result of functional appliance therapy. The aim of this study was to evaluate the changes of hyoid bone position following treatment with Farm and functional appliance in patients with class II div 1 malocclusion. In this before-after clinical trial, 28 patients with class II div 1 malocclusion which were under treatment with Farm and functional appliance for 11 months were selected. Facial growth in vertical, normal or horizontal direction was determined by cephalometric measurement. Data were analyzed with Paired-t test to compare the differences of mean values pre and post treatment. Variance analysis was used to compare the three growth patterns. P<0.05 was considered as the limit of significance. Hyoid bone shifted significantly forward in horizontal dimension [P<0.01] and non-significantly upward in vertical dimension. There was no significant difference among the three studied groups with respect to hyoid bone position alterations in horizontal dimension but significant difference was observed between horizontal and vertical growth pattern in vertical dimension [P<0.05]. There was significant correlation between decrease of ANB angle and forward movement of hyoid bone. Based on the results of this study, treatment with Farm and functional appliance [Fa II] leads to significant alterations in the position and anterior displacement of the hyoid bone

[Changes of oropharynx space and posterior surface of the tongue following treatment with farmand functional appliance]

During treatment with functional appliance in patient with class II division I malocclusion, mandible is postured inferiorly and anteriorly. Considering the relation between mandible with tongue and oropharynx space, functional appliance therapy can alter the tongue position and oropharynx space. This study aimed to determine the changes of oropharynx space and posterior surface of the tongue position following treatment with Farmand functional appliances in patients with class II division I malocclusions. In this clinical trial study, 28 pre and post treatment cephalometric radiographs of patients with class II division I malocclusions were investigated. The age rang of females was 10-13 years and in males it was 11-14 years. The patients were treated by Farmand functional applicne for 11 months. McNamara analysis and some linear variables were used to determine the positional changes of tongue and oropharynx space. Paired-t test was used to compare the pre and post treatment differences of mean values. Variance analysis was used to compare the growth patterns of the patients. Tongue moved significantly forward [p<0.001] but non-significantly downward. Oropharynx space increased significantly in sagittal dimension [p<0.001]. There was a significant correlation between decrease of ANB angle with forward movement of tongue [p<0.05] as well as with the increase in extent of oropharynx space in the sagittal dimension [p<0.05]. Treatment with Farmand functional appliance showed significant alteration in tongue position and as a result, increased the extent of oropharyngeal space