Effect of Fennel-Valerian Extract on Hot Flashes and Sleep Disorders in Postmenopausal Women: A Randomized Trial

Objectives@#This study aims to evaluate the effect of a mixture of fennel and valerian extracts on hot flashes and sleep disorders of postmenopausal women in Iran. A randomized trial was conducted. @*Methods@#A total of 76 postmenopausal women were randomly assigned to either of the two groups: fennel-valerian extract or control.One 500 mg fennel-valerian extract capsule was given twice, daily for 8 weeks. The 500 mg oral placebo capsule (starch) was given the same way. @*Results@#The mean duration of hot flashes increased in both the groups over time (P < 0.001). The mean frequency and severity of hot flashes in the intervention group were significantly lower than in the control group, in the first and second months after intervention (P < 0.050). Women in the fennel-valerian extract group had a significantly lower Pittsburgh Sleep Quality Index score than the control group 2 months after intervention (P = 0.030). @*Conclusions@#This study found that fennel-valerian extract was effective for relieving sleep disorders as well as the severity and frequency of hot flashes compared with a placebo.

Correlation between Health Literacy and Quality of Life in Iranian Menopausal Women

Objectives@#Understanding the factors that promote quality of life (QOL) in menopausal women is essential for establishing educational strategies and health policies. Studies on the relationship between health literacy and QOL in menopausal women in Iran are rare. Therefore, we aimed to determine health literacy in menopausal women and its relationship with QOL. @*Methods@#The present cross-sectional study was performed on 177 menopausal women referred to comprehensive health services in Hamadan City, Iran. Health Literacy for Iranian Adults and Menopause-Specific QOL questionnaires were used to collect information. Pearson correlation coefficient was used to assess the correlation between health literacy and QOL. @*Results@#The majority of menopausal women included in this study were married housewives, and 44.6% of them were 50–55 years old; furthermore, only 6.2% had adequate or good health literacy. Health literacy was significantly correlated with total QOL score and vasomotor, psychology, and physical domains (P < 0.05). @*Conclusions@#Health literacy was associated with various domains of QOL. Therefore, health providers should pay more attention on improving health literacy by holding educational promotional programs for menopausal women to enhance their QOL.

Factors associated with in-hospital death in patients with nosocomial infections: a registry-based study using community data in western Iran / 한국역학회지

Objectives@#Determining the predictors of in-hospital death related to nosocomial infections is an essential part of efforts made in the overall health system to improve the delivery of health care to patients. Therefore, this study investigated the predictors of in-hospital death related to nosocomial infections. @*Methods@#This registry-based, longitudinal study analyzed data on 8,895 hospital-acquired infections (HAIs) in Hamadan Province, Iran from March 2017 to December 2019. The medical records of all patients who had been admitted to the hospitals were extracted from the Iranian Nosocomial Infections Surveillance Software. The effects of the type and site of infection, as well as age group, on in-hospital death were estimated using univariate and multivariable Cox regression models. @*Results@#In total, 4,232 (47.8%) patients with HAIs were males, and their mean age was 48.25±26.22 years. In both sexes, most nosocomial infections involved Gram-negative bacteria and the most common site of infection was the urinary tract. Older patients had a higher risk of in-hospital death (adjusted hazard ratio [aHR], 2.26; 95% confidence interval [CI], 1.38 to 3.69 for males; aHR, 2.44; 95% CI, 1.29 to 4.62 for females). In both sexes, compared with urinary tract infections, an increased risk of in-hospital death was found for ventilator-associated events (VAEs) (by 95% for males and 93% for females) and bloodstream infections (BSIs) (by 67% for males and 82% for females). @*Conclusion@#We found that VAEs, BSIs, and fungal infections were independently and strongly associated with increased mortality.

Factors associated with in-hospital death in patients with nosocomial infections: a registry-based study using community data in western Iran / 한국역학회지

Objectives@#Determining the predictors of in-hospital death related to nosocomial infections is an essential part of efforts made in the overall health system to improve the delivery of health care to patients. Therefore, this study investigated the predictors of in-hospital death related to nosocomial infections. @*Methods@#This registry-based, longitudinal study analyzed data on 8,895 hospital-acquired infections (HAIs) in Hamadan Province, Iran from March 2017 to December 2019. The medical records of all patients who had been admitted to the hospitals were extracted from the Iranian Nosocomial Infections Surveillance Software. The effects of the type and site of infection, as well as age group, on in-hospital death were estimated using univariate and multivariable Cox regression models. @*Results@#In total, 4,232 (47.8%) patients with HAIs were males, and their mean age was 48.25±26.22 years. In both sexes, most nosocomial infections involved Gram-negative bacteria and the most common site of infection was the urinary tract. Older patients had a higher risk of in-hospital death (adjusted hazard ratio [aHR], 2.26; 95% confidence interval [CI], 1.38 to 3.69 for males; aHR, 2.44; 95% CI, 1.29 to 4.62 for females). In both sexes, compared with urinary tract infections, an increased risk of in-hospital death was found for ventilator-associated events (VAEs) (by 95% for males and 93% for females) and bloodstream infections (BSIs) (by 67% for males and 82% for females). @*Conclusion@#We found that VAEs, BSIs, and fungal infections were independently and strongly associated with increased mortality.

Prevalence of HIV, Hepatitis B and C Virus Co-infections among Iranian High-Risk Groups: A Systematic Review and Meta- Analysis

@#Co-infection with hepatitis B and C among HIV infected patients are prevalent among high-risk populations. This meta-analysis aimed to estimate the prevalence of HIV, HCV and HBV co-infections among high-risk populations in Iran. We systematically searched the national and international electronic databases until 2016. The primary outcome was the prevalence of HIV, HBV, HCV and HIV co-infections in different high-risk populations in Iran. All English and Persian studies conducted on Iranian high-risk groups were included in the study. The review was reported based on PRISMA guidelines and data were analysed at 95% confidence level using random effect models.Overall, 916 relevant papers were recognised and 14 articles were included in the metaanalysis. The pooled estimates of HBV/HCV, HCV/HIV, HBV/HIV and HBV/HCV/HIV were 1.3% (95%CI: 0.5–2.1), 16.3% (95%CI: 1.1–31.6), 0.5% (95%CI: 0–1.4) and 0.5% (95%CI: 0.2–0.8), respectively. Based on subgroup analysis, there was a higher proportion of all co-infections from the years 2010–2016 as compared to that of the years 2003–2009. Our results highlighted that HCV/HIV co-infection in Iranian high-risk groups including injection drug users (IDUs) and prisoners is common. In addition, the increasing trend of coinfections should be considered alarming for 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.

The maternal prepregnancy body mass index and the risk of attention deficit hyperactivity disorder among children and adolescents: a systematic review and meta-analysis / 소아과

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) symptoms have a major impact on individuals, families, and society. Therefore identification risk factors of ADHD are a public health priority. PURPOSE: This is meta-analysis evaluated the association between maternal prepregnancy body mass index and the risk of ADHD among the resulting offspring. METHODS: The search identified studies published through December 2018 in the PubMed, Web of Science, and Scopus databases. The odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CI) extracted from eligible studies were used as the common measure of association among studies. RESULTS: A significant association was found between overweight women and the risk of ADHD among children with the pooled HR and OR estimates (HR, 1.27 and 95% CI, 1.17–1.37; OR, 1.28 and 95% CI, 1.15–1.40, respectively). This association was significant between obese women and the risk of ADHD among children and adolescents with the pooled estimates of HR and OR (HR, 1.65 and 95% CI, 1.55–1.76; OR, 1.42 and 95% CI, 1.23–1.61). CONCLUSION: The current epidemiological studies present sufficient evidence that prepregnancy overweight and obesity are significantly associated with an increased risk of ADHD among children and adolescents. These findings provide a new approach to preventing ADHD by controlling weight gain in the prenatal period, which should be considered by policymakers.

Prevalence of Metabolic Syndrome and Associations with Lipid Profiles in Iranian Men: A Population-Based Screening Program

PURPOSE: Metabolic syndrome (MS) is characterized by a collection of interdependent disorders, including abdominal obesity, dyslipidemia, hyperglycemia, hypertension, and diabetes. The current study aimed to estimate the prevalence of MS in Qom, Iran. MATERIALS AND METHODS: A population-based screening program was conducted in the city of Qom, in 845 urban adult men over 25 years old in 2014. Abdominal obesity, fasting blood glucose (FBG), blood pressure, and the serum lipid profile were measured in subjects after fasting for at least 8 hours. MS was defined according to the Adult Treatment Panel III criteria. Data were analyzed using the chi-square test, t-test, and multiple logistic regression. RESULTS: The overall prevalence of MS was 23.0%, and the most common prevalent metabolic abnormalities associated with MS were low high-density lipoprotein cholesterol (102 cm in 33.9%, blood pressure ≥130/85 mmHg in 27.6%, fasting triglycerides (TG) ≥150 mg/dL in 25%, and FBG ≥110 mg/dL in 20.6%. A FBG level ≥110 mg/dL (odds ratio [OR]=4.85; 95% confidence interval [CI], 2.14~8.24), dyslipidemia (OR=3.51; 95% CI, 2.10~5.89), and a fasting TG ≥150 mg/dL were the most important factors contributing to MS. CONCLUSIONS: The prevalence of MS in men in Qom was higher than has been reported in other countries, but it was lower than the mean values that have been reported elsewhere in Iran. FBG was the most important factor contributing to MS, and all elements of the lipid profile showed important associations with MS.

Economic Status Inequality Is a Predictor for Screening and Health Utilization / 가정의학회지

No abstract available.

Prevalence of hepatitis B virus infection among Iranian high risk groups: a systematic review and meta-analysis

Aim: Present study aimed to systematically review and quantitatively synthesize published data about the prevalence of Hepatitis B Virus [HBV] infection among high risk groups in Iran

Background: Determining true burden of Hepatitis B Virus [HBV] infection among high-risk groups relies on knowledge of occurrence measures such as prevalence rate. There is no conclusive and comprehensive data regarding to prevalence of HBV infection among high risk groups in Iran

Methods: Relevant studies were searched in PubMed, Scopus, Web of Knowledge and local databases. In addition, reference lists of relevant studies were searched manually. Two independent authors reviewed the eligibility of retrieved studies and extracted the required data. Studies reporting HBV infection among high risk groups were included in the meta-analysis using random effects models. Meta regression and sub-group analysis were considered as additional analyses

Results: The initial search yielded 566 citations. After the primary screen, 37 studies were selected for review. Meta-analysis results showed that pooled prevalence of HBV infection among high risk groups in Iran was 4.8% [95% confidence interval: 3.6%-6.1%], with the highest prevalence among in prisoners [5%; 3%-6%] and in central regions of Iran [7%; 4%-l 1%]. Year of study may affect the observed heterogeneity in the estimated prevalence of HBV infection among injection drug users [IDUs] and prisoners

Conclusion: Our results indicate that prevalence of HBV infection among high risk groups was seemingly high in Iran. Health policy decision makers should be aware of prevalence of HBV infection among different high risk groups and in different regions of Iran

Epidemiologic aspects of overall injuries in Hamadan province; a six-year registry-based analysis

Objective: To investigate the epidemiological aspects of all-cause injuries in Hamadan province during a 6-year period

Methods: We conducted a cross-sectional study on injured subjects admitted to private or governmental hospitals in Hamadan province during March 2009 to March 2015. The epidemiological characteristics were retrieved from a registry-based system including gender, residency, injury mechanism and date of injury occurrence, outcome of hospitalization [full recovery/disability/death]

Results: Totally, 135,925 hospitalized injured cases were recorded. The majority of cases were male [72.6%] and were occurred in urban areas [60%], about 40% of patients were in 20-34 years' age group, and the highest proportion [30.13%] of injuries occurred in summer. Logistic regression showed that the odds of disability vs. recovery was significantly higher in rural areas [Adjusted odds ratio [AOR] =3.42] and the odds of death vs. recovery was higher among male gender [AOR=1.46]. In addition, comparing to the 0-4-year age-group, odds of death were significantly higher in middle aged and elderly victims

Conclusion: Our findings showed that middle age groups, male gender and urban area increase the odds of death. Injured males and old age subjects had the highest odds of death and out of residential area injuries were common cause of leading death injuries

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

Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study / 한국역학회지

OBJECTIVES: Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran.METHODS: This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province.RESULTS: We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC.CONCLUSIONS: Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.

Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study / 한국역학회지

OBJECTIVES: Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran. METHODS: This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province. RESULTS: We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC. CONCLUSIONS: Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.

Suicide rate in relation to the Human Development Index and other health related factors: a global ecological study from 91 countries

There has been no worldwide ecological study on suicide as a global major public health problem. This study aimed to identify the variations in suicide specific rates using the Human Development Index [HDI] and some health related variables among countries around the world. In this ecological study, we obtained the data from the World Bank Report 2013. The analysis was restricted to 91 countries for which both the epidemiologic data from the suicide rates and HDI were available. Overall, the global prevalence of suicide rate was 10.5 [95% confidence intervals: 8.8, 12.2] per 100,000 individuals, which significantly varied according to gender [16.3 in males vs. 4.6 in females, p < 0.001] and different levels of human development [11.64/100,000 individuals in very high development countries, 7.93/100,000 individuals in medium development countries, and 13.94/100,000 individuals in high development countries, p = 0.004]. In conclusion, the suicide rate varies greatly between countries with different development levels. Our findings also suggest that male gender and HDI components are associated with an increased risk of suicide behaviors. Hence, detecting population subgroups with a high suicide risk and reducing the inequality of socioeconomic determinants are necessary to prevent this disorder around the world

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.

Trend of some tuberculosis indices in iran during 25 yr period [1990-2014]

Background: Investigation of tuberculosis [TB]-specific indices including prevalence of TB, mortality of TB cases excluding HIV, HIV/TB mortality, incidence of TB [all forms], HIV/TB incidence as well as case detection and related trends is a crucial step in evaluation of program performance and strategies success. Besides, estimating the number and time of change points for TB incidence can help to detect effective factors in TB control. Therefore, the current study aimed to determine the trend of aforementioned indices in Iran during a 25 yr period [1990 to 2014]

Methods: Data on trend of TB in Iran was extracted from WHO regional office reports during 1990-2014. For determining the trend of TB indices, Annual Percent Changes [ARC] and Average Annual Percent Changes [AAPC] was estimated using segmented regression model

Results: AAPC [95% Cl] for HIV/TB mortality and HIV/TB incidence were 11.5 [9.3, 13.6] and 14.8 [13.6, 16.1], respectively, which are sign of increasing trend during the period [P<0.05]. Other indices showed significantly decreasing trend [P<0.05], except for case detection rate [P=0.803]

Conclusions: The incidence, prevalence, and death rates of TB had shown a decreasing trend in general population, regarded as a useful indicator of achievements of Millennium Development Goals [MDGs] and effectiveness of interventional programs. Increasing trend of incidence and mortality of TB in HIV infected patients, needs conducting more intervention strategies in health care programs

Estimation of the Frequency of Intravenous Drug Users in Hamadan City, Iran, Using the Capture-recapture Method / 한국역학회지

OBJECTIVES: The number of illicit drug users is prone to underestimation. This study aimed to use the capture-recapture method as a statistical procedure for measuring the prevalence of intravenous drug users (IDUs) by estimating the number of unknown IDUs not registered by any of the registry centers. METHODS: This study was conducted in Hamadan City, the west of Iran, in 2012. Three incomplete data sources of IDUs, with partial overlapping data, were assessed including: (a) Volunteer Counseling and Testing Centers (VCTCs); (b) Drop in Centers (DICs); and (c) Outreach Teams (ORTs). A log-linear model was applied for the analysis of three-sample capture-recapture results. Two information criteria were used for model selection including Akaike's Information Criterion and the Bayesian Information Criterion. RESULTS: Out of 1,478 IDUs registered by three centers, 48% were identified by VCTCs, 32% by DICs, and 20% by ORTs. After exclusion of duplicates, 1,369 IDUs remained. According to our findings, there were 9,964 (95% CI, 6,088 to 17,636) IDUs not identified by any of the centers. Hence, the real number of IDUs is expected to be 11,333. Based on these findings, the overall completeness of the three data sources was around 12% (95% CI, 7% to 18%). CONCLUSION: There was a considerable number of IDUs not identified by any of the centers. Although the capture-recapture method is a useful and practical approach for estimating unknown populations, due to the assumptions and limitations of the method, the results must be interpreted with caution.