Journal of Research in Health Sciences
Volume:12 Issue: 2, Summer-Fall 2012

The objective of this study was to describe cigarette smoking prevalence among adults in Lebanon and to evaluate the profile of light cigarette smokers compared to never and heavy smokers. Data were taken from a cross-sectional study carried out from October 2009 to September 2010, using a multistage cluster sampling all over Lebanon. Lebanese residents aged 40 years and above were enrolled in the study with no exclusion criteria. After an oral informed consent, subjects answered a questionnaire, including detailed smoking history and cigarette dependence. SPSS version 17.0 was used for data analysis. Out of 2201 individuals, 1320 (60.0%) had ever smoked cigarettes, out of whom 10.1% were light cigarette smokers. The adjusted odds ratio estimate of cigarette smoking was 3.08 for males compared to females (P<0.001), 1.13 for lower education (P=0.016), 1.87 and 3.12 for retired and jobless compared to working (P=0.001 and P<0.001) respectively, 1.17 for older age (P<0.001), 1.68 for presence versus absence of a family history of chronic respiratory disease (P<0.001), and 5.27 and 1.99 for presence compared to absence of at least one smoker at home (P<0.001) and at work (P < 0.001) respectively. This is the first epidemiological study in Lebanon that determined cigarette smoking prevalence at the national level. In Lebanon, males of the older generation seem to have higher smoking prevalence and dosing.

Main technique to control acquired immunodeficiency syndrome (HIV) infection is the effective preventive programs among high-risk groups. Modeling is one of the effective methods where there is inadequate data. We used the modes of transmission (MOT) model to predict the transmission of HIV infection in Iran. We systematically searched published and grey literature to find values for the input parameters of MOT in 2010. The data were discussed by experts before being fed into the model. Using the Monte Carlo simulation, we computed the 95% confidence interval (CI) for the outputs of the MOT. The MOT estimates that 9136 new HIV infections would have occurred in Iran in 2010 (95% CI: 6831, 11757). About 56% (95% CI: 47.7%, 61.6%) of new infections were among intravenous drug users (IDUs) and 12% (95% CI: 9.5%, 15%) among their sexual partners. The major routes of direct and indirect HIV transmission in Iran are unsafe injection (68%) and unprotected sexual contact (34% unprotected heterosexual and 10% homosexual) respectively. If current coverage for safe injection among IDUs increases from 80% to 95%, new HIV infections in this group would decrease around 75%. IDUs remain at highest risk of HIV infection in Iran, so the preventive program coverage for IDUs and their spouses needs to be increased. As the sexual transmission of HIV contributes increasingly to the pool of new infections, serious measures such as harm reduction program are required to reduce sexual transmission of HIV among the relevant key populations.

Hamadan is a province with high incidence rate of suicide. The present study was conducted to assess suicide and its associated risk factors in this province. In this cross-sectional study, all cases of suicide occurred in the province, were investigated from April 2008 to March 2010. The data were collected from Provincial Health Center and Forensic Medicine's databases using a checklist developed according to the available records. A number of 5414 suicide attempts had occurred (with 8.4% deaths) including 2753 women (with 3.4% death) and 2660 men (with 13.7% death). Majority of the suicide attempts and completed suicides occurred among adults aged 20-29 years. About 6.7% of the cases who attempted for suicide and 14.2% of the cases who died from suicide had a previous history of suicide attempt (P<0.001). Familial problems (49.7%) and psychiatric disorders (31.6%) were among the most common reasons of suicide attempt. Using drugs (74.0%) were the most common method of attempting suicide while hanging (83.6%), burning (74.2%), and gunshot (52.4%) were the most common leading causes of completed suicide (P<0.001). Adjusted odds ratio estimate of completed suicide in males against females was 2.27 (95% CI: 1.63, 3.14). The odds of completed suicide increased 1.43 (95% CI: 1.30, 1.57) fold per 10 years of age. This survey identified and highlighted the most common and important potential risk factors for suicide. In addition, the effects of various demographic risk factors on suicide attempt and completed suicide were examined. These evidences may be useful for future research, policy, and treatment efforts aimed at understanding and preventing suicide.

Catalytic ozonation has recently been applied as a new method of contaminant removal from water and wastewater. In this study, copper coated pumice and zeolite were used to catalyze the ozonation of phenol as a target pollutant from aqueous solutions. The pumice and zeolite stone were modified by CuSO4 (1N). Modified pumice and zeolite were characterized by Adsorption/Desorption Porosimetry (BET) and Scanning Electron Microscope analyses. Ozonation and catalytic ozonation experiments were performed in a 1 L semi-batch reactor containing a prepared phenol solution. The efficiency of catalytic ozonation was investigated by different variables: pH value, contact time, initial phenol concentration, catalyst dose, and radical scavenger. Experimental data indicated that as the pH solution increased, phenol removal increased. pH = 8 was measured as the optimum pH. The removal efficiency in single ozonation process (SOP) was 32% and in the catalytic ozonation process (COP) using modified zeolite and pumice was 51% and 63%, respectively. Moreover, these processes showed a great ability to mineralize phenol (up to 30%). Using the radical scavenger determined the indirect oxidation as the main pathway of phenol removal in both catalytic processes. The copper modified zeolite and pumice had good performance to remove phenol through catalytic ozonation method.

Diabetic men have been claimed to have lower serum free testosterone (FT) concentrations than non-diabetic men. The aim of this study was to investigate if serum FT, luteinizing hormone (LH), and follicle stimulating hormone (FSH) concentrations are different in patients with type 2 diabetes mellitus compared with healthy men and to identify factors associated with low serum testosterone concentrations in men with type 2 diabetes. Serum FT, LH and FSH concentrations in 65 men with type 2 diabetes between 50 and 55 years compared with 65 non-diabetic men in Valye-Asr Hospital in Birjand, Iran during October 2009 to August 2010. In addition, the relationships between serum FT concentrations with LH and FSH concentrations as well as other factors including age, fast blood sugar and glycemic control (HbA1C) were investigated. Serum FT concentrations were significantly lower in type 2 diabetic patients (2.53±1.68 pg/ml) than in healthy men (4.29±2.43 pg/ml) (P < 0.001). There were not any significant differences in LH and FSH concentrations between the two groups. There was a significant negative relationship between serum FT and HbA1C, but this relation for LH and FSH was positive and non-significant (P < 0.001). Serum FT concentration is lower in type 2 diabetic patients compared with non-diabetic men suggesting further research to better understand the underlying biologic mechanisms.

Noise exposure is the most frequent occupational factor which may increase the risk of work-related injuries. The purpose of this study was to estimate the association between occupational injuries and noise exposure as well as hearing loss. This study was conducted from April 2008 to March 2009 on 1062 workers in the Tabriz Tractor Manufacturing Plant. Sound pressure level (SPL) ≥85 dB in the workplace was considered as the independent variable (exposure) and physical occupational injuries as the dependent variable (outcome). Data were extracted from the worker's medical records using a checklist. Of 1062 volunteers, 392 (36.9%) were exposed (with SPL≥85 dB) and 670 (63.1%) were unexposed (with SPL<85 dB). One hundred and seventy-six injuries occurred during the study period. Frequency of injuries was about 16 per 200,000 hours, severity of injuries was about 75 per 200,000 hours and incidence rate of injuries was 16%. The exposed group had 1.52 fold increased risk of injury compared to unexposed group (P=0.012). Compared to group with normal hearing status, the risk of occupational injuries increased 1.72 fold in group with partial hearing loss (P=0.062), 7.87 fold in group with mild hearing loss (P=0.003), and 4.58 in group with moderate hearing loss (P=0.049). Occupational noise exposure and hearing impairment have adverse effect on work safety and can increase the probability of work-related injuries. This means reducing noise exposure can contribute to increase safety in workplaces where noise is a factor. Furthermore, using assistive listening devices may reduce risk of work injuries among hearing-impaired workers.

Brucellosis is one of the most common infectious diseases in some areas of Iran. Brucellosis has various clinical manifestations and should be considered in the differential diagnosis of many infectious and non-infectious diseases. The aims of this study were to determine the epidemiological, clinical and laboratory findings of the disease in patients with brucellosis in Hamadan, west of Iran. In this cross- sectional study, 230 brucellosis patients admitted in Farshchian Hospital in Hamadan from March 2005 to March 2010 were studied for epidemiological, clinical and laboratory characteristics of brucellosis. The patients who had manifestations compatible with brucellosis and standard tube agglutination test or Coombs test ≥1/80 plus 2ME ≥1/40 were enrolled. Data were analyzed using SPSS statistical package, version 15. About 43.5% of patients were female with mean age of 40.84 yr old. 27.8% of cases were living in urban and 72.2% in rural areas. The most contagious seasons were spring and summer. The most common transmission way was consuming of contaminated dairy products (60.3%); however, 39.7% of patients had a history of animal contacts. The most common symptoms were fever (77.4%), arthralgia (70%), sweating (47%), malaise and fatigue (46.5%). The most common clinical signs were fever and peripheral arthritis. Leukocytosis and elevated ESR (>20 mm/h) were reported in 20.8% and 59.5% of cases, respectively. Elevated CRP was detected in 52.9% of patients. Brucellosis should be considered in the differential diagnosis of patients with prolonged fever, spondylitis or peripheral arthritis in endemic areas.

Manual material handling is one of the major health and safety hazards in industry. This study aims to assess the lifting tasks, before and after intervention using NIOSH lifting equation and Manual Handling Assessment Charts (MAC). This interventional study was performed in 2011 in a tile manufacturing industry in Hamadan, located in the West of Iran. The prevalence of musculoskeletal discomfort was determined using Nordic musculoskeletal questionnaire. In order to assess the risk factors related to lifting and identify the high-risk activities, MAC and NIOSH lifting equation were used. In intervention phase, we designed a load-carrying cart with shelves capable of moving vertically up and down, similar to scissor lifts. After intervention, the reassessment of risk factors was conducted to determine the success of the intervention and to compare risk levels before and after intervention using t-test. The outputs of MAC and NIOSH lifting equation assessments before intervention revealed that all activities were at high-risk level. After intervention, the risk level decreased to average level. In conclusion, the results of intervention revealed a considerable decrease in risk level. It may be concluded that the given intervention was acceptable and favorably effective in preventing musculoskeletal disorders especially low back pain.

We aimed to assess the impact of health workers’ training program on preventive behaviors of leishmaniosis based on BASNEF (Belief, Attitude, Subjective Norm, and Enabling Factors) model in the families under the coverage of health centers. The study was done in rural health centers of Marvdasht City, Fars Province, Iran in 2011. Health workers completed a specific questionnaire. Moreover, out of the families under the health center’s coverage, 20 families from each health center were selected in order to complete the questionnaire. Then, 4 training sessions for the health workers and 2 training sessions for influential individuals were held. Weekly meetings were also conducted with the health workers’ representatives in order to prepare the enabling factors and solve the problems. Three months after the health workers’ training, the data were collected again and analyzed using the SPSS statistical software (version 16). The mean scores obtained for knowledge, attitude, behavioral intention, enabling factors, and health workers’ behavior significantly increased after the educational intervention in the experimental (intervention) group (P=0.001). Influential individuals also revealed significant changes after the educational intervention (P=0.001). The mean scores obtained for those factors of the attendant families under coverage also increased significantly in the experimental group (P=0.001). Educational programs based on the BASNEF model might change the health workers’ behavior and, eventually, their training behavior leads to preventive actions in families under coverage.

Toxoplasma gondii is a worldwide obligate intercellular parasite. Felids are its definitive host and warm-blooded animals including humans are its intermediate host. The aim of this seroepidemiological study was to investigate the frequency of human infection using ELISA method and related risk factors in Tabriz City, northwestern Iran. In this cross sectional study, 171 blood samples were collected randomly from clients referred to Alinasab Hospital diagnostic laboratory, Tabriz, Iran in 2008. Simultaneously data about risk factors such as having soil related jobs (for example: building construction workers and farmers), cat contact, eating raw vegetables at restaurants, the method of washing vegetables, eating undercooked game meat and the quantity of red meat consumption (undercooked) were collected by questionnaires. Anti-Toxoplasma IgG titers were determined in samples using ELISA method. Data were analyzed by Chi-square, One Way ANOVA and t-test using SPSS v.16 Software. Sixty (35.1%) out of 171 serum samples were anti-Toxoplasma IgG positive. There was statistically significant difference about seropositivity between soil related jobs and others (P=0.007, OR=2.43; 95% CI: 1.27, 4.66). In addition there was significant relationship between seropositivity and eating vegetables at restaurants (P=0.039, OR=1.94; 95% CI: 1.02, 1.68). No significant statistical differences were observed about seropositivity considering the other mentioned risk factors. The prevalence rate of Toxoplasma chronic infection was relatively high in the studied people. However, having soil related jobs and eating vegetables at restaurants increases the probability of acquiring the infection.

Job stress is one of the important issues in the health sector and its high effect on workers’ productivity. Managerial skills can help organizations to improve employees’ effectiveness and reduce job stress. The present study investigated the relationship between employees’ job stress and managers’ professional skills. This cross-sectional and correlation study was conducted in 2010.We selected 90 health workers of 13 Health and Treatment Centers in Razan Health Center, western Iran. All data were gathered using self-administered questionnaires. Employees’ job stress levels were measured using the Eliot Stress Questionnaire and managers’ professional skills were assessed using the standard Questionnaire with 40- items in Likert format. Data were analyzed u SPSS software and Pearson correlation coefficient and Kendall correlation tests. 87.7% of employees had mid- level of job stress. The professional skills level was high in 36.7% of health managers; moderate in 56.6%, and low in 6.7%. In addition the human skill was highest level among all managers’ professional skills. A significant and negative correlation was found between job stress and managers’ human, conceptual and design skills (P <0.005). The level of managers’ professional skills was significantly related with employees’ job stress, thus training and developing managerial skills especially human, conceptual and design skills in supervisors and managers of health centers can reduce job stress and enhance effective performance.

Cox proportional hazard (CPH) model is the most widely used model for survival analysis. When there are unobserved/unmeasured individuals factor, then the results of the Cox proportional hazard model may not be reliable. The purpose of this study was to compare the results of CPH and frailty models in breast cancer (BC) patients. A historical cohort study was carried out using medical records gathered from the Fars Province Cancer Registry. The dataset consisted of 769 women having BC referred to Shiraz Namazi Hospital, south of Iran. These patients had been followed for 6 years. After selecting the most important prognostic risk factors on survival, CPH and gamma-frailty Cox models were used to estimate the effects of the risk factors. The results of CPH model showed that, tumor characteristics and number of involved lymph nodes increase the mortality hazard of BC(P < 0.05). In addition, the frailty model showed that there is at least a latent factor in the model (P = 0.005). Both of the frailty and CPH model emphasis that the early detection of BC improves survival in BC patients.