The Impact of Preventive Interventions on Intimate Partner Violence among Pregnant Women Resident in Hamadan City Slum Areas Using the PEN-3 Model: Control Randomized Trial Study / 가정의학회지

Background@#Intimate partner violence is a severe life-threatening criminal and public health problem affecting the well-being of individuals, families, and society. Planning interventions to reduce the burden of this persistent and criminal violence should be relevant culturally and socially. @*Methods@#In this randomized control trial, 150 pregnant women residing in slum areas of Hamadan were randomly assigned to two groups (intervention group: n=50 and control group: n=100). Interventional strategies included educating the victims based on local cultural norms, culturally sensitive individual and group counseling, and educating health care providers. Data were collected via face-to-face interviews at baseline and again at 3 months after the intervention. We used a paired t-test to evaluate the effect of the intervention by comparing changes in the outcomes measured. @*Results@#There were no statistically significant differences between the two groups at baseline in terms of sociodemographic characteristics. Post-test scores of knowledge (7.50±2.65 vs. 5.14±3.51, P=0.001), communication skills (18.38±4.25 vs. 16.2±3.83, P=0.04), and family support and social expectation of obedience (15.79±4.45 vs. 13.40±4.57, P=0.005) of the victims were statistically significantly higher in the experimental group compared to the control group. Moreover, physical (0.74±2.28 vs. 1.20±2.60, P=0.06), psychological (2.80±4.10 vs. 4.52±5.43, P=0.06), and sexual (0.11±0.58 vs. 0.61±1.22, P=0.04) violence reduced in the experimental group compared to the control group. @*Conclusion@#Culturally relevant interventions can reduce intimate partner violence.

Alarm Thresholds for Pertussis Outbreaks in Iran: National Data Analysis

Objectives@#The purpose of the current study was to determine the upper threshold number of cases for which pertussis infection would reach an outbreak level nationally in Iran. @*Methods@#Data on suspected cases of pertussis from the 25th February 2012 to the 23rd March 2018 from the Center for Disease Control and Prevention in Iran was used. The national upper threshold level was estimated using the exponentially weighted moving average (EWMA) method and the Poisson regression method. @*Results@#In total, 2,577 (33.6%) and 1,714 (22.3%) cases were reported in the Spring and Summer respectively. There were 1,417 (18.5%) and 1,971 (25.6%) cases reported in the Autumn and Winter, respectively. The overall upper threshold using the EWMA and the Poisson regression methods, was estimated as a daily occurrence of 8 (7.55) and 7.50 (4.48-11.06) suspected cases per 10,000,000 people, respectively. The daily seasonal thresholds estimated by the EWMA and the Poisson regression methods were 10, 7, 6, 8 cases and 10, 7, 7, 9 cases for the Spring, Summer, Autumn, and Winter, respectively. @*Conclusion@#The overall and seasonal estimated thresholds by the 2 methods were similar. Therefore, the estimated thresholds of 6-10 cases in a day, per 10,000,000 people could be used to detect pertussis outbreaks and epidemics by health policymakers.

The effect of bee prepolis on primary dysmenorrhea: a randomized clinical trial

OBJECTIVE: Primary dysmenorrhea typically occurs with no associated pelvic pathology and is common in adolescents and young women. This study evaluated the effect of bee propolis on relief of primary dysmenorrhea. METHODS: The study was performed in 2018 in Hamadan, in western Iran, among female students with primary dysmenorrhea. Participants were randomly divided into two groups, using balanced block randomization, and were administered a placebo or bee propolis capsules for 5 days during two menstruation cycles. The number of participants required was estimated to be 86 in total, with 43 students in each group according to the inclusion criteria. We used the visual analog scale to assess pain severity. The independent t-test was conducted for comparing between two groups, using SPSS 16.0. RESULTS: A significant change was found in the mean pain scores during the first (P<0.001) and second (P<0.001) months after using bee propolis in comparison with placebo. The means of the pain scores in the bee propolis group were 5.32±2.28 and 4.74±2.40 in first and second months after the intervention, respectively, whereas the means of the pain scores in the placebo group were 7.40±1.21 and 7.17±1.24 in first and second months after the intervention, respectively. CONCLUSION: Our study showed that the use of bee propolis for two months compared with placebo reduced primary dysmenorrhea during the first and second months after use, with no adverse effects. Therefore, it could be used as an alternative to nonsteroidal anti-inflammatory drugs for relief of primary dysmenorrhea.

The association between preeclampsia and autism spectrum disorders among children: a meta-analysis / 소아과

PURPOSE: In this meta-analysis, relevant case-control and cohort studies were pooled to evaluate the association between preeclampsia and the risk of autism spectrum disorders (ASDs) in children. METHODS: A search for relevant studies in major databases, including Web of Science, PubMed, and Scopus, was performed up to May 2018. The odds ratios (ORs) or rate ratios (RRs) with 95% confidence intervals (CIs) were extracted from eligible studies to determine the association among studies. RESULTS: The pooled estimates of ORs and RRs indicated a significant association between preeclampsia and ASD [(OR, 1.36; 95% CI, 1.12–1.60) and (RR, 1.30; 95% CI, 1.20–1.41)]. CONCLUSIONS: Despite existing controversy, our findings indicated that preeclampsia was associated with an increased risk of ASD among children.

Epidemiology of animal bites and associated factors with delay in post-exposure prophylaxis; a cross-sectional study

Objective: To address the epidemiology of animal bites and associated factors with delay in post-exposure prophylaxis [PEP] in Nahvand district, western Iran

Methods: Data were obtained from Rabies Treatment Center [RTC] in Nahavan district from March 2015 to March 2017. All of referred cases to RTC include 1448 cases of animal bites using the census method were recruited. Epidemiological profile of participants was demonstrated using descriptive statistics and determinants of PEP was addressed by logistic regression model

Results: The majority of victims were males 1167[80.5%]. superficial bites were more prevalent than deep status injuries [1145[79.0%] VS. 303[20.9%]]. The biting rate differed according to season in the period of the study [p<0.001]. Cases who experienced animal biting in the autumn was more likely to refer timely for PEP than cases in spring season [OR, 0.39; 95% CI: 0.26 - 0.59, p<0.001]

Conclusion: Our findings addressed the pattern of potential delays in PEP including the role of season. Local authorities of Nahavand district should considered preventive activities and educational interventions to reduce animal biting and provide timely prophylaxis

Gene polymorphism of matrix metalloproteinase 9 in asthenozoospermic male subjects

Background: Matrix metalloproteinase [MMPs] play important roles in the structural and functional properties of reproductive organs. The aim of this study is to determine the prevalence of C-1562T MMP-9 [rs3918242] gene polymorphism in fertile and infertile men. In addition, we aim to determine the association between C-1562T MMP-9 and G-1575A MMP-2 gene polymorphisms

Materials and Methods: A total of 400 subjects, including 200 fertile and 200 infertile men, were recruited for this case control study. The allele frequencies and genotype distributions of single nucleotide polymorphism in the promoter regions of MMP-9 [C-1562T] were determined using polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP] analysis. The chi-square [?2] test was used to assess the distribution of genotype frequencies

Results: There were no significant differences found in the genotype distributions or allele frequencies between fertile and infertile men for the C-1562T MMP-9 gene polymorphism. The percent of immotile sperm in infertile men with the CC and CT genotypes of C-1562T MMP-9 gene polymorphism significantly differed compared with that of subjects with the TT genotype. The frequency of CC/GA-combined genotypes of C-1562T MMP-9 and G-1575A MMP-2 gene polymorphisms significantly differed in fertile and infertile men [P=0.031]

Conclusion: Our results suggest that genetic polymorphisms in MMP may impact male fertility

Effect of Group Counseling on Quality of Life among Postmenopausal Women in Hamadan, Iran

OBJECTIVES: This study aimed to investigate the effect of counseling on quality of life (QOL) in postmenopausal women conducted in Hamadan, Iran in 2015. METHODS: In this quasi-experimental study, 80 postmenopausal women were randomly selected and allocated to case and control groups (40 per group). Data collection tool included questionnaires of demographic information and QOL during menopause, which were completed by the samples before the intervention. In the case group, training program was run during four sessions in the form of weekly consulting sessions for 45 to 60 minutes. Training program included familiarity with menopause symptoms, confrontation and self-care during this period. The control group, only received routine cares. Three months after intervention, information were collected in both groups. Data were analyzed using SPSS for Windows. RESULTS: Before the intervention, mean ± standard deviation for QOL in case group was 101.2 ± 31.4 and it was significantly decreased to 96.9 ± 27.0 after intervention (P < 0.05). While no significant change was observed in the control group (from 98.9 ± 35.5 to 102.3 ± 35.0, P = 0.443). Symptoms of physical (P = 0.033) and sexual (P < 0.001) dimensions significantly decreased in the case group. While significant increase was observed in terms of psychosocial (P = 0.049) and sexual symptoms in control group. CONCLUSIONS: Findings suggested impact of consulting on improvement of QOL during menopause. Supportive consulting can be a suitable approach for improving women's health, reducing problems and enhancing QOL in menopause period.

Avoidable Burden of Risk Factors for Serious Road Traffic Crashes in Iran: A Modeling Study / 예방의학회지

OBJECTIVES: The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. METHODS: The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. RESULTS: The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. CONCLUSIONS: On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.

Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran / 한국역학회지

OBJECTIVES: Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012. METHODS: The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs. RESULTS: Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries. CONCLUSIONS: This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.

Application of censored quantile regression to determine overall survival related factors in breast cancer

Background: the occurrence and the mortality related to breast cancer [BC] in Iranian female population has increased over time. Although there are many studies on BC and related risk factors, however, the epidemiological aspects of this melanoma in Iranian females are uncertain. Therefore, the aim of this study was to determine the relationship between demographical and clinical factors on the shape of overall survival [OS] distribution in patients with BC

Methods: this historical cohort study was carried out using data from 522 participants with BC. Data were gathered from medical records of these patients admitted to Mahdieh Oncology Center of Hamadan Province, western Iran, from January 2000 to August 2011. Kaplan-Meier estimator was used to estimate the survival rates and, censored quantile regression [CQR] to provide in-depth insight in the multivariable association between prognosis factors and survival rates

Results: patients' follow-up ranged from around 3 to 197 months. One-, three-, and five-year survival rates were 90%, 73% and 62.5%, respectively. Results of CQR model showed that change in the age at diagnosis, number of involved lymph nodes and tumor size could significantly change the median and some other quantiles of OS

Conclusions: this study, confirm the importance of early detection of BC and usefulness of CQR because of possible changes in distribution family of survival time

impact of aerobic exercise on quality of life in women with breast cancer: a randomized controlled trial

Background: The women with breast cancer experience high rates of morbidity due to different treatments

The objective of this study was to evaluate the role of aerobic exercise in the quality of life [QoL] among women suffering from breast cancer in Hamadan, western Iran

Method: Participants who had consummated the eligibility criteria were randomly assigned in exercise group [n=30] and control group [n=30]. Written informed consent was obtained from all participants. The mean age was 42.70 +/-9.6 and 43.50 +/-8.60 yr old in exercise and control groups, respectively. The quality of life was assessed by two widely used standard questionnaires [EORTC QLQ-C30 and EORTC QLQ-BR23]

The exercise group received supervised exercise 2 days per week for 10 weeks. Through two stages [before and after intervention] these groups were evaluated. Analyzing the data was performed by SPSS/20.0, using ttest, chi-squared and ANCOVA. P<0.05 was regarded as significant level

Results: The global health status QoL, based on EORTC QLQ-C30, developed significantly in the exercise group [48.76+/-24.96 vs. 81.79+/-16.34] in comparison with the controls [47.75 +/-15.73 vs. 52.88 +/-14.51] [F<0.001]

The exercise intervention was associated with substantial development in total score of functions and symptoms of QoL using EORTC QLQ-BR23 [P<0.001]

Conclusions: The statistically and clinically crucial developments were indicated in functions and symptoms of QoL in response to exercise in breast cancer women

Clustering of pulmonary tuberculosis in hamadan province, west of Iran: a population based cross sectional study [2005-2013]

Background: This study was conducted to detect clusters of pulmonary TB cases in Hamadan Province, west of Iran

Methods: All patients with pulmonary tuberculosis recorded in the surveillance system from 2005 to 2013 were studied. The spatial scan statistic was used to detect significant clusters in status of unadjusted and adjusted for age, sex and location residence variables

Results: Clusters with high rate for both purely spatial and space-time analyses were seen in the same geographical areas composed of four city of Asadabad, Bahar, Toyserkan and Nahavand. Adjustment for mentioned variables did not change location of detected clusters with high rates

Conclusions: Findings revealed evidence of significant clusters in Hamadan Province. Study results may help the health system to develop effective public health interventions and extend preventive interventions. However more study are needed to better explain of detected clusters due to limited access to effecting factors

Prevalence of nasopharyngeal carriage of Streptococcus pneumonia in Iran: a meta-analysis

Background: Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide. Several studies have explored the nasopharyngeal carriage of S. pneumonia in Iran. This meta-analysis is aimed at exploring the overall prevalence of nasopharyngeal carriage of S. pneumoniae among healthy children and its resistance to antibiotics

Method: We have systematically reviewed published studies from international databases [PubMed, Web of Science, and Scopus] and national databases [Iranmedex, Magiran, Medlib, SID and Irandoc] and reference lists of articles published up to May 2015. Only cross-sectional studies supported with sensitivity test on samples collected from nasopharyngeal area were included and heterogeneity was assessed using Q-test and I[2] test statistic. Publication bias was explored using the Egger's and Begg's tests and the funnel plot. The overall prevalence of analyzed data were reported with 95% confidence intervals [CI] using the random-effects model

Results: A total of 16 studies were included in the final analysis. The pooled prevalence of S. pneumoniae nasopharyngeal carriage was 18% [95% CI: 14% - 23%]. Antibiotic resistance rates were 26% [95% CI: 15% - 37%] to penicillin, 30% [95% CI: 10% - 49%] to erythromycin and 34% [95% CI: 10% - 57%] to tetracycline respectively

Conclusion: This study could be able effectively estimate the overall prevalence of nasopharyngeal carriage of S. pneumoniae and its antibiotics resistance rate among healthy children in Iran. In addition, the findings evidenced the role of pneumococcal vaccination in reducing the prevalence of S. pneumoniae carriage among healthy children in Iran

Estimating the potential impact fraction of hypertension as the main risk factor of stroke: application of the distribution shift method

Few published studies have assessed the impact of quantitative risk factors such as high blood pressure on stroke. The aim of this study was to quantify the potential impact fraction [PIF] of hypertension on stroke in Hamadan Province, western Iran. Avoidable burden of stroke associated with high blood pressure was calculated using distribution shift at different scenarios. Data on the prevalence of high blood pressure among residents of Hamadan province older than 19 years were extracted from non-communicable diseases risk factors surveillance system in 2009. Five mmHg hypothetical reduction in systolic blood pressure above 140 mmHg, leads to 3.5% [PIF = 0.035] reduction in the total burden to stroke. This value may reach 7%, if systolic blood pressure decreases 10 mmHg. In addition, 5 mmHg hypothetical reduction in diastolic blood pressure above 82 mmHg, leads to 4.87% reduction in the total burden to stroke. PIF more than 10 mmHg modification on distribution of diastolic blood pressure was estimated as 9.38%. According to these findings, policy makers are advised to implement interventions on hypertension based on the distribution shift method rather than the proportion shift one

Expression analysis of mir-21 and mir-221 in cancerous tissues from Iranian patients with gastric cancer

Early detection is a key to survival for gastric cancer. Molecular markers such as miRNA [microRNA] can have great importance in the early diagnosis of gastric cancer. Expression of miR-21 and miR-221 are deregulated in many types of human cancers. This study aimed to investigate the differences in miRNA expression patterns within the Iranian population. Total RNA was extracted from gastric cancer tissues and adjacent non-cancerous tissues from 32 patients. Expression levels of miR-21 and miR-221 were detected by Real time RT-PCR using a specific primer, with 5s rRNA as the internal reference gene. Our data showed that the expression levels of miR-21 and miR-221 in gastric cancer samples were significantly higher than in paired non-cancerous samples [P < 0.05]. The receiver operating characteristic [ROC] analyses yielded the area under the curve [AUC] values of 80.30 for miR-21 and 93.30 for miR-221, and combined ROC analysis revealed the highest AUC value of 96.90 in discriminating GC patients from healthy controls. It seems that miR-21 and miR-221 expression pattern in Iranian patients with gastric cancer are similar to any other population. Considering the increased expression level of two miRNAs in cancerous tissue compared to normal tissue as well as the area under ROC curve, miR-21 and miR-221 can be used for early detection of gastric cancer

effect of six-week aerobic training program on cardiovascular fitness, body composition and mental health among female students

The purpose of the present study was to evaluate the effects of six-week aerobic training program including running and rope skipping on cardiovascular fitness, body mass index [BMI], and mental health among female students at the University of Isfahan, Iran. In this interventional study we included 30 female students in academic year 2011-12. The participants were randomly assigned in experimental group [n=15, mean +/- SD for age=26.06 +/- 1.18, weight [kg]=57.43 +/- 5.67, height [cm]=160.06 +/- 4.16] and control group [n=15, mean +/- SD for age=26.33 +/- 1.30, weight=57.66 +/- 5.08, height=161.86 +/- 3.29]. Pre-test and post-test measurements include VO2 max with Queen Step test; BMI and General Health Questionnaire-28 as a measure of mental health were done. Analysis of covariance [ANCOVA] was used to test the effects of aerobic training as intervention [P<0.05]. There was statistically significance difference between experimental and control groups after adjustment for their own baseline values concerning cardiovascular fitness [P=0.004], BMI [P<0.001] and mental health indices [P<0.001]. A six-week aerobic practice improves cardiovascular strength, mental health and BMI considerably and could be more encouraged at universities

Joint effect of modifying selected risk factors on attributable burden of cardiovascular diseases

There are few published studies that consider the joint effect of multiple risk factors on avoidable burden of cardiovascular diseases [CVDs]. This study aimed to estimate the joint effect of avoidable burden of multiple risk factors to CVDs. Estimates of avoidable burden to CVDs were made using potential impact fraction [PIF]. In order to calculate PIF, data on the Prevalence of the risk factors include diabetes, hypertension, central obesity, and hypercholesterolemia were obtained from 3[rd] national Surveillance of Risk Factors of Non-Communicable Diseases-2007 in Iran and data on corresponding measures of effect were derived from a cohort study with multivariate adjusted hazard ratios. Then, joint effect of risk factors was calculated. About 37% [95% uncertainty interval: 21.7-50.2] of attributable disability adjusted life years [DALYs] to CVDs in adult males and 59.4% [95% uncertainty interval: 30-76] in adult females due to selected risk factors are avoidable in theoretical minimum risk levels. After changing the current prevalence of these risk factors to the plausible minimum risk levels, 17.8% [95% uncertainty interval: 10.1-25.1] of CVDs' attributable DALYs among adult males and 34% [95% uncertainty interval: 20-46.7] in adult females can be avoided. To better priority setting as well as reporting the magnitude of avoidable DALYs rather than the percentage of avoidable burden, PIF should be applied to updated and revised burden of CVDs

[Evaluating the sensitivity of sternocleidomastoid muscle electromyography in differential diagnosis of amyotrophic lateral sclerosis from cervical spondylotic myelopathy]

Differentiation between amyotrophic lateral sclerosis [ALS] and cervical spondylotic myelopathy [CSM] not only for those similar clinical features but also for different handling is very important in clinical practice. Considering that EMG of the sternocleidomastoid muscle [SCM] is using for differential diagnosis of these diseases in Iran, present study was aimed to evaluate the sensitivity of sternocleidomastoid muscle electromyography in differential diagnosis of ALS from CSM. We conducted a retrospective cohort study. Subjects [34patients] were identified from suspected ALS or CSM patients who referred to Loqhman hospital and evaluated with using of the sternocleidomastoid muscle electromyography [SCM-EMG] between March 2006 and February 2008 as part of the diagnostic workup. Clinical characteristics and MRI results were derived from subject's medical records. Follow-up clinical evaluation during two years after initial diagnostic evaluation was available as a gold standard for confirmation the EMG results. We used two way tables for calculating sensitivity. SCM-EMG was abnormal in 10 [29.4%] patients, all of whom were subsequently diagnosed with ALS. The sensitivity of SCM-EMG was 0.71 [95% CI, 0.42 +/- 0.91] for the diagnosis of ALS. Although our findings suggest that SCM-EMG is an extremely useful adjunct for the diagnosis of ALS, but further studies with larger sample size is needed for its application as a useful test "Ruling in" for the diagnosis of ALS

[Evaluating the diagnostic value of somatosensory evoked potentials in the diagnosis of meralgia paraesthetica]

Although the diagnosis of Meralgia paraesthetica [MP] is always made based on clinical background, but electrophysiological evaluation is helpful in confirming the diagnosis. We investigated the Somatosensory Evoked Potentials [SEPs] of the lateral femoral cutaneous nerve [LFCN] of the thigh. Because of lack of knowledge in case of its diagnostic utility in our country, this study is performed. In this cross sectional study, we entered sixty consecutive patients referred to the Loqman Hospital in Tehran [2009-2010], who have clinical symptoms and signs consistent with a diagnosis of MP underwent bilateral studies of SEPs elicited by stimulation of the LFCN of the thigh. SEPs was abnormal in 32 [53.3%] patients, all of whom were clinically diagnosed with MP. The specificity of the SEPs test was 98.3% [95% CI, 91.0% 99.9%] for the diagnosis of MP. Our findings suggest that SEPs is an extremely useful test for ruling out the diagnosis of MP