Journal of Research in Health Sciences
Volume:13 Issue: 2, Summer-Fall 2013

Autism spectrum disorder (ASD) is a neurological disorder typically appearing before the age of three. The exact cause of autism remains uncertain, and several factors may be involved in its onset: genetic factors and possible environmental factors. The aim of this study was to assess the correlates of autism in the Lebanese population. We investigated the association of autism with several factors in 86 autism cases from specialized schools for children with developmental disabilities and 172 control children from regular public schools in the same regions. Several risk factors for autism were investigated after comparison with a cohort control on parental age, sex, maternal unhappy feeling during pregnancy, consanguineous marriage, and province of residence. The Chi-square test was used to compare nominal variables, and Fisher exact test was used in case expected values within cells were inferior to five. For quantitative variables, we used t-test to compare means between two groups, after checking their distribution normality. For multivariate analysis, we used a forward stepwise likelihood ratio logistic regression. We observed male predominance (79.1%) among autistic infants. There was a significant association between autism and older parents age (OR=1.27), male sex (OR=3.38), unhappy maternal feeling during pregnancy (OR=5.77), living close to industry (OR=6.58), previous childhood infection (OR=8.85), but none concerning maternal age, paternal age and consanguinity. In this pilot epidemiological study of autism in Lebanon, we found several prenatal and perinatal risk factors for autism that could be modified.

To study the prevalence and risk factors of urinary incontinence in tribal women and to assess the treatment seeking behavior of affected women. A cross-sectional descriptive study was conducted in Khardi, a tribal village, selected by random sampling, in Thane district, Maharashtra, India during the period October 2010 to January 2011. All women aged 20 years and above were selected for the study except pregnant and lactating women and those with neurological disorders affecting bladder continence. A semi-structured questionnaire assessing socio-demographic factors of women, severity, type of incontinence, obstetric and other risk factors of incontinence was administered to the study participants. The participants who suffered from incontinence were inquired regarding their treatment seeking behavior for the same. Logistic regression analysis was used to determine the independent association between these factors and primary outcome of incontinence. Of 353 women participated in the study, 90 (25.5%) reported urinary incontinence. Prevalence of urinary incontinence showed significant association with increasing age (P<0.010). Associated obstetric factors included high parity (P<0.001), early post-partum resumption of heavy work (P<0.050) and prolonged labor (P<0.010). Other risk factors like hypertension, diabetes, chronic cough and constipation were predictors of incontinence in regression analysis (R2=0.47). Healthcare seeking rate was only 14.4% since they either accepted incontinence as a normal ageing process or were embarrassed to seek medical advice. Urinary incontinence is a neglected problem in tribal women predicted by obstetric and other risk factors.

Exposure to extremely low frequency electromagnetic fields is increasingly common، but the potential influence on pregnant women has not been thoroughly investigated. In this case-control study، 58 women who had an unexplained spontaneous abortion at < 14 weeks gestation and 58 matched pregnant women >14 weeks gestation were enrolled in 2012. The women completed the questionnaire، which was used to collect data about socioeconomic and obstetric characteristics، medical and reproductive histories. Then، to evaluate the extremely low frequency electromagnetic fields، we determined the magnitude of electromagnetic fields in the participants´ houses by an exposure level tester (3D EMF tester/ Model: ELF-828; Taiwan). The instrument covers a limited frequency range (30 HZ to 3 KHZ). The magnitude of extremely low frequency electromagnetic fields in the participants´ houses was significantly different between the two groups (P<0. 001). Extremely low frequency electromagnetic fields exposure is probably related to early spontaneous abortions.

In this study, an electroscrubber was designed and experimented for evaluation of integrating particle and droplet charging effects separately and jointly on collection efficiency of a spray tower and also to discover the optimal condition. A homogenous concentration of relatively fine particles was introduced to influent air stream and electroscrubber efficiency in purifying them was determined through the measurement of input and output particles concentration. The effect of various conditions such as particles and droplets charging alone and together (bipolar) for several applied voltages has been studied. In all of experiments, the applied charging voltage has a key role in promotion of electroscrubber efficiency. Maximum collection efficiency has achieved for 15 Kilovolt (Kv). The effectiveness of bipolar charging of particles and droplets with 15 Kv was higher than that of no-charging and singly charging. In other words, efficiency can be increased from 84.43% to 93.22 for total particles and from 50.8% to 75.16% for submicron particles. The maximum improvement of collection efficiency (42.2%) relates to bipolar charging of the initial size group with diameter smaller than 0.3 micrometer (µm) and the minimum (0.5%) to sizing group of 11 with diameter 4-5 µm. This approach can be an appropriate option for the purpose of purifying submicron particles in spray tower scrubbers.

In the case of sensitive questions such as number of alcoholics known, majority of respondents might give an answer of zero. Poisson regression model (P) is the standard tool to analyze count data. However, P provides poor fit in the case of zero inflated counts, when over-dispersion exists. Therefore, the questions to be addressed are to compare performance of alternative count regression models; and to investigate whether characteristics of respondents affect their responses. A total of 700 participants were asked about number of people they know in hidden groups; alcoholics, methadone users, and Female Sex Workers (FSW). Five regression models were fitted to these outcomes: Logistic, P, Negative Binomial (NB), Zero Inflated Poisson (ZIP), and Zero Inflated Negative Binomial (ZINB). Models were compared in terms of Likelihood Ratio Test (LRT), Vuong, AIC and Sum Square of Error (SSE). Percentages of zero were 35% for number of alcoholics, 50% for methadone users, and 65% for FSWs. ZINB provided the best fit for alcoholics, and NB provided the best fit for other outcomes. In addition, we noticed that young respondents, male and those with low education were more likely to know or reveal sensitive information. Although P is the first choice for modeling of count data in many cases, it seems because of over-dispersion of zero inflated counts in the case of sensitive questions, other models, specifying NB and ZINB, might have better goodness of fit.

The aim of this study was to investigate the relationship between congenital hypothyroidism and several variables using two different adjustment methods. This matched case-control study was conducted in Hamadan Province, the west of Iran, in 2012 enrolling neonates born between 2005 and 2011 and covered by screening program for congenital hypothyroidism. The neonates with TSH titer more than 10 mU/l or T4 titer less than 6.4 μg/dl were considered as cases. Each case was individually matched for birth place and year with four neonates with normal TSH and T4 titers as controls. The data were analyzed using two different approaches including propensity score and multiple conditional logistic regression model. Of 1313 enrolled neonates, 277 (159 girls) were cases and 1036 (531 girls) were controls. The most important prognostic factors which had significant effect on congenital hypothyroidism included twin, birth season, maturity, jaundice at birth, birth weight, age at pregnancy, maternal anemia and goiter, gestational age, delivery type, father’s education and smoking status, and consanguinity. The associations reported by logistic regression were stronger that of than propensity score analysis in most items, although the differences were not statistically significant. We addressed the effect of numerous potential risk factors on congenital hypothyroiditis and the impact of these factors on the disease occurrence. However, future prospective studies are needed to test these findings and hypothesis and to investigate the true effect of these potential risk factors on congenital hypothyroiditis.

Prevalence of obesity in children has been increasing during recent decades all over the world. Obesity, particularly central obesity, is associated with metabolic syndrome and cardiovascular diseases. The present study aimed to assess obesity and central obesity in 6-11 year old Birjand elementary school children, East of Iran. This cross-sectional study was conducted on 1541 elementary school children, i.e. 851girls and 690 boys, selected from Birjand elementary schools through multiple-cluster sampling in 2012. In order to determine overweight and obesity the percentile of CDC was used, so that, 85-95th percentile were taken as overweight and >95th percentile was defined as obese with respect to age and sex. For determination of central obesity, waist circumference and the ≥90th percentile were used regarding age and sex. The obtained data was analyzed by means of SPSS software (V: 15) using t and chi-square statistical tests at the 0.05 significant level. Out of the studied children, 9.6% (11% of boys and 8.3% of girls) were overweight and 9.2% of children (i.e. 10.9% of boys and 7.9% of girls) were obese. About 15.7% of children (i.e. 20.3% of boys and 12% of girls) had central obesity. Regarding high prevalence of obesity, central obesity, and overweight in Birjand elementary school children, it is recommended that families should be provided with necessary information with respect to correcting life-style and preventing obesity in children.

Acinetobacter baumannii is gram- negative opportunistic coccobacilli, the most important agent in nosocomial infections with high mortality rate. Multidrug resistance in strains isolated from nosocomial infections, making it difficult to treat and sometimes impossible. The aim of the present study was to investigate antibiotic resistance in A. baumannii isolates from Iranian patients in Hamadan, west of Iran. In this cross sectional study 100 A. baumannii isolated from trachea, blood, urine, sputum and wound samples of patients bedridden in Intensive care unit (ICU) wards of three educational hospitals during June 2011 to October 2012 was included. Isolates confirmed at species level using biochemical tests and tracing blaOXA-51 gene using Polymerase chain reaction (PCR) and preserved frozen at -70 °C until examination. Their susceptibility to 17 antibiotics was performed using Kirby-Bauer disc diffusion method. Determination of minimum inhibitory concentration and Metallo-beta-lactamase production was carried out using E-test method. Resistance rate of isolates were 94%, 85%, 84%, 97%, 95% and 98% against meropenem, imipenem, amikacin, ciprofloxacin, piperacillin/tazobactam and cefotaxime, respectively. No resistant isolate was observed against tigecycline and also no sensitive isolate seen against aztreonam and cefotaxime. Results of E-test illustrated that 99% of all isolates were Metallo-beta-lactamase (MβL) producing, which were resistance to imipenem; also 85% of them were resistance to meropenem. MIC50 and MIC90 of the isolates were ≥256 and ≥32 mg/ml for imipenem and meropenem, respectively. The antibiotic resistance against most of the antibiotics, especially carbapenems is very high in Hamadan region. In addition colistin sulfate and tigecycline were most effective antibiotics and to be used in A. baumannii infections.

The purpose of the present study was (a) to assess the relationship between physical activity and the intensity and duration of menopausal symptoms, (b) to investigate the relationship between physical activity and the four domains of health-related quality of life (HRQOL) and (c) to assess the relationship between physical activity and chronic diseases. This descriptive-analytical study that was conducted in Tabriz City, Iran. Data were collected in 2012 by personal home-based interviews, using structured questionnaires. All participants (n= 273), who were middle-aged (age range of 40-60 yr) were recruited from two of the 25 urban health service centers’ clients, by clustered random sampling allocation. There was a positive significant relationship between Psychological, Social, and Environmental domains of HRQOL with physical activity (P<0.001). In addition, a negative significant relation was found between somatic complaints including sexual problems (P< 0.017) and vaginal dryness (P<0.030) as well as joint-muscular discomfort (P<0.018), and the level of physical activity. Diabetic (P<0.047) and women with history of heart disease (P<0.040) performed 2.670 and 3.548 hours more than who were not. Regular physical activity would be effective in decreasing menopausal symptoms as well as improving healthy aging and also physical activity promotion as a part of healthy life style promotion programs needs to be improved in communities where women are physically inactive. In addition, women need to be informed about importance of physical activity on their life which it leads to feel healthy aging and pre and post- menopausal stages.

Pediculosis capitis is a problem in children and has worldwide distribution. The aim of the present study was to determine the prevalence of pediculosis degree and its relevant factors in the secondary schools in Hamadan west of Iran. The study was carried out in two phases. A cross-sectional procedure was used to determine the prevalence of pediculosis, and the case study was done to identify the relevant factors to the infestation. Totally, 10841 secondary students were chosen and classified in accordance with the clustering sample. The prevalence of pediculosis was 1.05%. It was 1.27% among the urban student; whereas 0.05% among the rural students. About 2.3% belonged to female students, and 0.11% was pertained to the male students. The greatest amount of infestation prevalence was reported from the schools of urban areas particularly in the public schools of suburbia. Furthermore, the prevalence of infestation was more where some individuals had pediculosis previous history and suffered from head inching. It turned out to be a significant relationship between pediculosis, head itching (P<0.001) and previous history of pediculosis (P<0.001). The prevalence of pediculosis in Hamadan is low, but is more in the areas which are deprived of the access to health facilities. Therefore, there is a need for educational campaigns about danger of infection and regular mass screening at school.

New technologies using hazardous materials usually have certain risks. It is more serious when the technology is supposed to be applied in a large scale and become widely used by many people. The objective of this paper was to evaluate the risk of vapor cloud explosion in a hydrogen production process. Potential hazards were identified using the conventional hazard identification method (HAZID). The frequency of the proposed scenarios was estimated from statistical data and existing records. The PHAST professional software was applied for consequence modeling. Both individual and societal risks were evaluated. This cross-sectional study was conducted from June 2010 to December 2011 in a Hydrogen Production Plant in Tehran. The full bore rupture in heat exchanger had the highest harm effect distance. The full bore rupture in desulphurization reactor had the highest (57% of total) individual risk. Full bore rupture in heat exchanger was the highest contributor to social risk. It carried 64% & 66.7% of total risk in day and night respectively. For the sake of safety, mitigation measures should be implemented on heat exchanger, reformer and hydrogen purification absorbers. The main proposed risk reductive measures included; the increasing of installed equipment elevation, the application of smaller vessels and pipes.

Electrochemical methods, as one of the advanced oxidation processes (AOPs), have recently been applied to remove different contaminants from water and wastewater. This study compares the performance of anodic oxidation (AO) and electro-Fenton (EF) methods on waste sludge treatment. This experimental study was performed on real sludge and the effect of operating parameters such as solution pH, operating time, current density, supporting electrolyte and hydrogen peroxide concentration were investigated in a batch reactor. For determination of oxidation and treatability of the sludge, chemical oxygen demand (COD) and total coliform (TC) removal were examined. Pb/PbO2 and iron electrodes respectively for AO and EF were applied. Experimental data indicated for both AO and EF as the operating time and current density increased, COD removal increased. pH=4.0 and 3.0 and current density=1.75 and 2 A respectively for AO and EF and the concentration = 57.2 mMol of hydrogen peroxide for EF were measured as the optimum amounts of these variables. The removal efficiency of COD in AO and EF process was 76% and 72%, respectively. Of course, the efficiency of EF in TC removal was better and the percentage of TC removal in 60 min for AO and EF was 99.0% and 99.9%, respectively. The amounts of consumed electrical energy for AO and EF were 8.6 and 28.0 kWh kg-1 COD, respectively. AO was more effective in treatment and mineralization of waste sludge and TC removal than EF in terms of environmental economical features.

Based on some estimation more than two million peoples in Iran are affected by Type 2 diabetes. The present study was designed to evaluate the status of diabetes control among Type 2 diabetes patients in Kurdistan, west of Iran and its associated factors. In our cross sectional study conducted in 2010, 411 Type 2 diabetes patients were randomly recruited from Sanandaj, Capital of Kurdistan. Chi square test was used in univariate analysis to address the association between HgAlc and FBS status and other variables. The significant results from Univariate analysis were entered in multivariate analysis and multinomial logistic regression model. In 38% of patients, FBS was in normal range (70-130) and in 47% HgA1c was <7% which is normal range for HgA1c. In univariate analysis, FBS level was associated with educational levels (P=0.001), referral style (P=0.001), referral time (P=0.009), and insulin injection (P=0.016). In addition, HgA1c had a relationship with sex (P=0.023), age (P=0.035), education (P=0.001), referral style (P=0.001), and insulin injection (P=0.008). After using multinomial logistic regression for significant results of univariate analysis, it was found that FBS was significantly associated with referral style. In addition HgA1c was significantly associated with referral style and Insulin injection. Although some of patients were under the coverage of specialized cares, but their diabetes were not properly controlled.

Noise pollution can contribute to adverse health effects in humans. Noise annoyance and related problems, caused by noise emission during the progress of building construction, have become increasingly important. These problems can influence the exposed workers, as well as vicinity residents. The goal of the present study was to assess the noise annoyance due to noise from construction worksites among residents of Hamadan City (west of Iran). In this cross-sectional study, 20 construction worksites and 140 near vicinity residents were selected. The main sources of construction worksite noise were diesel power generators, cutting and welding processes, heavy machinery (such as trucks) and transport of materials. Ambient noise levels were measured using a calibrated sound level meter, at each home of the residents included in the study. A noise annoyance questionnaire was employed for annoyance assessment. The majority of subjects had very high annoyance (87.1%). The mean and SD of ambient levels were 74.57±7.12 dB (A) which exceeded the acceptable recommended level for residential areas. The most common problems among the participants were disturbance in sleep, difficulty in reading and distraction. Results showed significant relationship between noise annoyance and some factors including residing which floors had highest annoyance (F=13.22, P<0.001) and ambient noise (F=11.313, P<0.001). High levels of noise annoyance among near vicinity residents who are affected by construction activities. This means that construction activities and other noise related sources should be regarded as the major source of ambient noise leading to noise annoyance.

Type 2 diabetes is an important risk factor for cognitive decline in diabetic patients. The main goal of this study was the assessment of memory, attention and visuospatial ability dysfunctions in patients with type 2 diabetes in comparison to pre-diabetic patients and normal subjects in Endocrine and Metabolism Center of Isfahan City from April 2011 to July 2011. The sample comprised of 32 patients with type 2 diabetes, 28 pre-diabetic patients and 30 healthy individuals. Memory, attention and visuospatial ability were assessed by Rey Complex Figure Test (RCFT), Paced Auditory Serial Addition Test (PASAT) and sub tests of Wechsler Adult Intelligence Scale-Revised (WAIS-R). The pair wise comparisons of cognitive functions among three groups, suggesting a significant difference between diabetic and normal groups in PASAT3². PASAT2², RCFT (recall trial) and Symbol coding (P=0.003, P=0.009, P=0.010, and P<0.001, respectively). But there was no difference in copy trial of RCFT and block design between two groups (P=0.170, P=0.490). There was significant difference between pre-diabetic group and normal group in recall trial of RCFT (P=0.020), as well as significant difference between diabetes type 2 and pre-diabetic group in symbol coding (P=0.001). There were significant differences in cognitive functions in patient with type2 diabetes, pre-diabetic patients and normal individuals. Thus monitoring neuropsychological status besides controlling levels of blood sugar in these patients is important.