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BACKGROUND: Current evidence consistently confirm inequalities in health status among socioeconomic none, gender,ethnicity, geographical area and other social determinants of health (SDH), which adversely influence health ofthe population. SDH refer to a wide range of factors not limited to social component, but also involve economic, cultural,educational, political or environmental problems. Measuring inequalities, improving daily living conditions, andtackling inequitable distribution of resources are highly recommended by international SDH commissioners in recentyears to 'close the gaps within a generation'. To measure inequalities in socio-economic determinants and core healthindicators in Tehran, the second round of Urban Health Equity Assessment and Response Tool (Urban HEART-2)was conducted in November 2011, within the main framework of WHO Centre for Health Development (Kobe Centre). METHOD: For 'assessment' part of the project, 65 indicators in six policy domains namely 'physical and infrastructure','human and social', 'economic', 'governance', 'health and nutrition', and also 'cultural' domain were targetedeither through a population based survey or using routine system. Survey was conducted in a multistage random sampling,disaggregated to 22 districts and 368 neighborhoods of Tehran, where data of almost 35000 households(118000 individuals) were collected. For 'response' part of the project, widespread community based development(CBD) projects were organized in all 368 neighborhoods, which are being undertaken throughout 2013. CONCLUSION: Following the first round of Urban HEART project in 2008, the second round was conducted to trackchanges over time, to institutionalize inequality assessment within the local government, to build up community participationin 'assessment' and 'response' parts of the project, and to implement appropriate and evidence-based actionsto reduce health inequalities within all neighborhoods of Tehran.
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BACKGROUND: Oesophagogastric (OG) cancer as a globally common and deadly malignancy, which is widely spread in Northeast Iran, has an extensive impact on health-related quality of life (HRQL). Demographic and histopathologic changes have been apparent in oesophagogastric cancer, therefore. HRQL could be used, as an outcome, to assess and determine the efficacy and impact of cancer care. METHODS: A consecutive sample of upper-gastrointestinal cancer patients admitted to the main oncology/ radiotherapy departments in the North-East of Iran were recruited into the study. All participants completed the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-OG25questionnaires in a face to face interview. RESULTS: Of the total 275 patients participated in the study, 54% had oesophageal, 34% stomach and 12% OG junction cancers. About 73.1% had TNM (tumour, node, metastasis) staging; of which 69% were in stage III and IV. The most common type of cancer in oesophagus was Squamous Cell Carcinoma (SCC) (95.3%) in lower third, Adenocarcinoma in stomach (97.8%) and in the OG junction (93.8%). Patients with stomach or OG junction tended more to present in higher stages (P < 0.001). Unlike QLQ-C30, the EORTC QLQ-OG25 was able to differ patients significantly in anxiety scale (P = 0.01), body image, chocking and weight loss (P < 0.05). Those who had self care ability had better quality of life scores (P < 0.001) in more scales and items. CONCLUSION: SCC is predominant type of upper GI cancer in Khorasan provinces similar to the high risk area in Northern Iran. The specific health-related quality of life tool (EORTC QLQ-OG25) was able to distinguish most of the symptoms in patients with upper GI cancer.
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Burn patients are at high risk of developing nosocomial infection because of their destroyed skin barrier and suppressed immune system, compounded by prolonged hospitalization and invasive therapeutic and diagnostic procedures. Studies on nosocomial infection in burn patients are not well described. The objective of the present study was to identify the causative bacterial of nosocomial infection and to determine the incidence of nosocomial infection and their changing during hospitalization in burned patients admitted to in the Motahari Hospital, Tehran, Iran. During the second part of 2010, 164 patients were included in this study. Samples were taken the first 48 hours and the fourth week after admission to Motahari Burn hospital. Isolation and identification of microorganisms was performed using the standard procedure. Of the 164 patients, 717 samples were taken and 812 bacteria were identified, 610 patients were culture positive on day 7 while 24 (17.2%) on 14 days after admission. The bacteria causing infections were 325 Pseudomonas, 140 Acinetobacter, 132 Staphylococcus aureus, and 215 others. The percentage of mortality was 12%. All of patients had at least 1 positive culture with Pseudomonas and/or with Acinetobacter. Hospitals suggest continuous observationof burn infections and increase strategies for antimicrobial resistance control and treatment of infectious complications.
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OBJECTIVE: There is little consensus regarding selective or universal screening for gestational diabetes. The aim of this study is to determine the influence of risk factors on incidence of GDM in Iranian population by using 75 g OGTT. METHODS: At the first prenatal visit, 924 pregnant women were assessed for age, BMI, obstetric history, family history of diabetes, and diagnosis of polycystic ovary syndrome before pregnancy. All eligible women underwent 2-h 75 g oral glucose tolerance test. Gestational diabetes was diagnosed according to American Diabetes Association criteria. RESULTS: During study period, 68 [7.4% (95% CI 5.9-9.2)] cases of GDM were found. Age, pre-pregnancy BMI, and family history of DM were the independent clinical predictors of GDM. In women with age <25, BMI < or = 24.9, and negative family history for diabetes, the risk of GDM was 0.008 (0.001-0.044). This risk increased to 0.250 (0.102-0.495) in women with age > or =30, BMI > or = 30 and positive family history for diabetes. With selective screening and without screening in low risk group, we will do 13.6% (126 of 924) less screening tests while missing potentially 1.5% (1 of 68) of GDM cases. CONCLUSION: Age, BMI, and family history of diabetes were independent risk factors in developing gestational diabetes. Concerning these factors, we do not miss substantial number of GDM cases with selective screening.