Journal of Research in Health Sciences
Volume:15 Issue: 2, Spring 2015

Use of single measurement of risk factors can distort their estimated effects, due to random error in measurements. The aim of this study was to examine the extent of underestimation in the estimated effect of common variables in physical exam i.e. systolic and diastolic blood pressure (SBP, DBP) and body mass index (BMI) on cardiovascular diseases in Tehran Lipid and Glucose Study (TLGS). A subsample (1167 men and 1786 women) of the original cohort, who had replicate measures of the variables in triennial interval, was used to calculate the regression dilution ratios (RDRs) in men and women. RDRs were determined by parametric and nonparametric methods. Hazard ratios (HR) of risk factors, per one standard deviation change, were corrected for regression dilution bias. The estimated RDRs by parametric method in men and women were 45% and 35% for SBP and 54% and 64% for DBP respectively. There were 26% and 25% underestimation in HR of SBP and 23% and 33% in HR of DBP in men and women. The corresponding underestimation for BMI was about 8%. RDRs of men and women and in age groups by both methods were fairly similar. They were relatively constant during the 10-year follow-up for SBP and BMI. Using baseline measurements of blood pressure underestimate its real association with CVD events and the estimated HRs. The underestimations are independent of age and sex, and it can be fairly constant in short to moderate time intervals.

Childhood obesity could induce some risk factors for cardiovascular disease (CVD) including serum lipid abnormalities, hypertension, and atherosclerosis. The present study aimed to comparison the lipid profile in normal children with cases having overweight, obesity and central obesity. In this case control study, which was conducted 2013, serum lipids for three groups of children including cases with overweight (Body mass index (BMI): 85-95th percentiles to age and sex and waist circumference (WC) <90th percentile to age and sex = Case group1), central obesity without general obesity (BMI <85th percentiles and WC ≥ percentile 90 = Case group 2) and central obesity with general obesity (BMI ≥95th percentile and WC ≥ percentile 90 = Case group 3) were compared with control group (BMI < 85th percentiles WC <90th percentile). Data were analyzed using software SPSS-16 by chi-square and ANOVA tests at significance level α=0.05. Each group consisted of 100 individuals. The highest mean of serum lipids and the highest extent of dyslipidemia existed in the children having central obesity along with general obesity. So that 49%, 28%, and 38% students of this group show hypertriglyceridemia, hypercholesterolemia, and low high-density lipoprotein cholesterol (HDL-C). Odd ratio of hypertriglyceridemia, hypercholesterolemia and low HDL-c, in children with at least one abnormal index (BMI and /or WC) compared with control group were 3.73 (95% CI: 1.98, 6.99), 1.37 (95% CI: 1.71, 2.65) and 2.98 (95% CI: 1.51, 5.87), respectively. With regard to the relationship between central obesity and adverse changes in lipid profiles, the screening children for central obesity to prevention of cardiovascular disease are recommended.

Oral health education for the mothers of very young children is important in reducing the risk of early childhood caries. This study aimed to evaluate the impact of an oral health intervention among mothers of 1-2 years old children. This cluster randomized controlled trial (2012) was conducted among ninety mothers of 1-2 year old children. The setting of study was 10 child day-care centers out of 18 in Hamadan, western Iran. Day-care centers were randomly allocated into two groups: an intervention group (5 day-care centers, 45 mothers) and a control group (5 day-care centers, 45 mothers). Intervention consisted of three sessions, a booklet, and mobile phone text-message reminders. The primary outcome was change in cleaning the children'' teeth, while the secondary outcomes were changes in Theory of Planned Behavior (TPB) cognitions. Questionnaires at baseline, 10 days, and 3 months assessed intervention effects. Data were analyzed using SPSS v.16. T tests, chi- square, and logistic and linear generalized estimating equations (GEE) regression were used to test intervention impact. At 10-day assessment, mothers in intervention group reported a significant difference in knowledge (P=0.001), attitude (P=0.004), perceived behavioral control (P=0.008), and cleaning of children''s teeth (P=0.011). Also, at 3-month assessment compared to control group, the mothers in intervention group significantly improved in scores of knowledge (P=0.001), attitude (P=0.001), perceived behavioral control (P=0.001), and cleaning of children''s teeth (P=0.001). However, the effect sizes were small to medium and ranged from 0.1 to 0.4 for all cognitions except knowledge (effect size>0.70). Generalized estimating equations (GEE) showed that score of attitude and perceived behavioral control of intervention group improved between the two post-test assessments. A brief multicomponent theory-based intervention among mothers of 1-2 years old children was effective moderately in improving cognitions and self-reported cleaning children''s teeth.

The homeostasis model assessment of insulin resistance (HOMA-IR) is a useful model for application at large epidemiologic studies. The aim of this study was to determine the HOMA cut off values to identify insulin resistance (IR) and metabolic syndrome (MS) in Qazvin, central Iran. Overall, 480 men and 502 women aged 20-72 yr attended in this cross sectional study from September 2010 to April 2011. The diagnostic criteria proposed by national cholesterol education program third adult treatment panel (ATPIII), International Diabetes Federation (IDF) and new Joint Interim Societies (JIS); were applied to define MS. Lower limit of the top quintile of HOMA values in normal subjects was considered as the threshold of IR. The receiver operating characteristic (ROC) curves of HOMA for MS diagnosis were depicted. The optimal cut point to determine MS was assessed by maximum Youden index and the shortest distance from the point (0, 1) on the ROC curve. The threshold of HOMA for IR was 2.48. Fifty one percent of the subjects were insulin resistant. The cut point for diagnosis of JIS, IDF, ATP III and Persian IDF defined MS was 2.92, 2.91, 2.49 and 3.21, respectively. Sensitivity and specificity of ATP III defined MS to diagnose IR was 33.95% and 84.78%, of IDF defined MS was 39.13%, 81.29% and of JIS defined MS was 43.77% and 78.11% and of Persian IDF defined MS was 27.32% and 88.76%, in that order. The high prevalence of IR in the present study warns about the future burden of type 2 diabetes. Only the ATP III criteria introduced more specific cut point for putative manifestations of IR.

Republic of Azerbaijan is considered as an area with high prevalence of multi-drug resistant tuberculosis. Uncontrolled travelling of Azerbaijanis people to Iran is the issue that needs to be considered as an important issue. This study was conducted on 32 patients with tuberculosis from Baku–Nakhchivan and 48 patients from Iran during 2012 to 2014. Colonies of Mycobacterium tuberculosis were examined after isolating them from patients using proportional method on Lowenstein-Jensen media regarding resistance encounter with Rifampin, Isoniazid and Ethambutol. Among M. tuberculosis isolates belonging to 32 foreign patients; 69%, 72% and 56% of them were resistant to Rifampin, Isoniazid and Ethambutol, respectively (multidrug resistance tuberculosis: MDR-TB: 62.5%). From 48 isolates of Iranian patients; 8%, 4% and 4% were resistant to Rifampin, Isoniazid and Ethambutol, respectively (MDR-TB: 2.1%). Resistant strains are common in Baku-Nakhchivan’s people. To prevent the transmission of these strains to Iranians, strategies such as; establishing a medical campus in border lines of both countries for clinical examinations and conducting screening tests regarding tuberculosis infection in applicants for entering Iran must be taken in to account.

Cutaneous leishmaniasis is one of the prevalent health problems in tropical and subtropical areas including Iran. Therefore, it is essential to identify the prevalence and new foci of this disease in different regions of Iran. This study aimed to determine the epidemiology of cutaneous leishmaniasis by active surveillance in elementary schools in Pakdasht City, Southeast of Tehran, Iran 2013-2014. This cross sectional study was carried out on 4800 students from 60 elementary schools in Pakdasht during October 2013 to March 2014. After examining the students, some epidemiological data such as age, gender, date, anatomic location of the lesion(s) in the body, number and size of lesion(s), lesion type, and travel history to endemic areas was recorded in a checklist. Students with active lesions were examined using parasitological and molecular methods (PCR). Totally, 31 students (0.64%) had leishmaniasis, of which 15 (0.31%, 95% CI, 0.15%, 0.47%) had active lesions and 16 (0.33%, 95% CI, 0.17%, 0.49%) had leishmaniasis scars. Molecular testing showed that Leishmania major was the causative agent of leishmaniasis in all patients with active lesion. The highest frequency of cutaneous leishmaniasis was found in the age group 10-12 years (P=0.03). There was a significant difference between the frequency of the disease in different months (P=0.04) and the anatomic location of the lesion/scar (P=0.04). Moreover, t-test revealed that there was a significant relationship between number of lesions/scars and the age group (P<0.001). The leishmanial type diagnosed in all patients was L. major. This finding suggests that Pakdasht might be a new focus for zoonotic cutaneous leishmaniasis.

Safety programs are a core part of safety management in workplaces that can reduce incidents and injuries. The aim of this study was to investigate the influence of Safety Training Observation Program (STOP) technique as a behavior modification program on safety climate in a construction company. This cross-sectional study was carried out on workers of the Petrochemical Construction Company, western Iran. In order to improve safety climate, an unsafe behavior modification program entitled STOP was launched among workers of project during 12 months from April 2013 and April 2014. The STOP technique effectiveness in creating a positive safety climate was evaluated using the Safety Climate Assessment Toolkit. 76.78% of total behaviors were unsafe. 54.76% of total unsafe acts/ at-risk behaviors were related to the fall hazard. The most cause of unsafe behaviors was associated with habit and unavailability of safety equipment. After 12 month of continuous implementation the STOP technique, 55.8% of unsafe behaviors reduced among workers. The average score of safety climate evaluated using of the Toolkit, before and after the implementation of the STOP technique was 5.77 and 7.24, respectively. The STOP technique can be considered as effective approach for eliminating at-risk behavior, reinforcing safe work practices, and creating a positive safety climate in order to reduction incidents/injuries.

As adolescent tobacco smoking has become a widespread problem in developing countries, it is time to understand the cognitive determinants of adolescents'' decisions to engage in tobacco smoking. This study aimed to investigate the predicting factors associated with tobacco smoking among male adolescents based on Prototype Willingness Model (PWM) as a theoretical framework. This descriptive-analytical study was carried out on 810 male adolescents of Hamadan City western Iran, recruited with a multistage sampling method. The data-gathering tool consisted of a questionnaire based on the PWM constructs. Data analysis was performed using SPSS-19 software, by bivariate correlations, liner and logistic regression tests. The prevalence of current tobacco smoking was 17.2%. Behavioral willingness and subjective norms were the most important predictors of behavioral intentions, whereas subjective norms, attitude and prototype were the most important predictors for behavioral willingness. The result obtained from logistic regression analysis revealed that both pathways of PWM constructs [behavioral intention (OR=1.207; 95% CI: 1.13, 1.28) and behavioral willingness (OR=1.334; 95% CI: 1.25, 1.41) were significant predicting factors for tobacco smoking among male adolescents. The framework of the PWM is applicable and useful in understanding tobacco smoking among male adolescents. In addition, the results revealed the importance of social reaction path when examining adolescents'' smoking status.

Venous diseases including varicose veins and chronic venous insufficiency are one of the most important pathogenic factors worldwide. High prevalence of varicose veins and its complications is an emerging problem in the twenty-first century. This study aimed to determine the prevalence and associated risk factors of varicose veins in female hairdressers in Shahroud, north of Iran in 2012. In this cross-sectional study, 197 employed hairdressers, licensed by the Health Department of Shahroud University of Medical Sciences, Iran, were studied. Standard physical examination was used to check the condition of varicose veins of the lower extremities of participants. Data were collected by demographic information form. Proportional odds model for ordinal logistic regression was used to assess the relationship between risk factors and status of varicose disease in subjects. Prevalence of varicose veins was 47.7%. Varicose veins were significantly associated with age (OR=1.08; 95% CI: 1.03, 1.13); family history of varicose disease (OR=1.99; 95% CI: 1.03, 3.82), blood pressure (OR=4.41; 95% CI: 1.63, 11.90); and duration of standing (OR=2.34; 95% CI: 1.05, 5.22). Varicose veins in the legs of female hairdressers had a high prevalence, and it was associated with increasing age, family history of varicose disease, high blood Pressure, and prolonged standing.

Sexual dysfunction is the most common disorder in women. According to the WHO, sexual education programs are considered as a need. Therefore, this study was designed to investigate the effect of educational program on sexual function in women with sexual dysfunction. This randomized trial, was conducted in 2013 on 90 married women by convenient sampling in Qazvin, central Iran. The demographic, Female Sexual Function Index (FSFI), and Beck''s Depression Inventory (BDI) questionnaires were completed during structured interviews. After completing the sample size, subjects were divided randomly into two groups by using the table of random numbers (educational and control groups), then respectively received an educational intervention in the four sessions with one week interval and routine program offered by the center and following-up was done with refilling questionnaires 8 weeks after intervention. Sexual function improved after sex educational programs in all dimensions (sexual desire (P=0.006), sexual exciting (P=0.006), vaginal moisture (P=0.002), sexual satisfaction (P=0.011), and total score of sexual function (P=0.001). Considering the importance role of sexual function in family strength, health, and development, it can be claimed that educational sex programs can help practitioners to improve sexual function of married women with sexual dysfunction.