Journal of Research in Health Sciences
Volume:15 Issue: 3, Summer 2015

Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide. Several studies have explored the nasopharyngeal carriage of S. pneumonia in Iran. This meta-analysis is aimed at exploring the overall prevalence of nasopharyngeal carriage of S. pneumoniae among healthy children and its resistance to antibiotics. We have systematically reviewed published studies from international databases (PubMed, Web of Science, and Scopus) and national databases (Iranmedex, Magiran, Medlib, SID and Irandoc) and reference lists of articles published up to May 2015. Only cross-sectional studies supported with sensitivity test on samples collected from nasopharyngeal area were included and heterogeneity was assessed using Q-test and I2 test statistic. Publication bias was explored using the Egger''s and Begg''s tests and the funnel plot. The overall prevalence of analyzed data were reported with 95% confidence intervals (CI) using the random-effects model. A total of 16 studies were included in the final analysis. The pooled prevalence of S. pneumoniae nasopharyngeal carriage was 18% (95% CI: 14% - 23%). Antibiotic resistance rates were 26% (95% CI: 15% - 37%) to penicillin, 30% (95% CI: 10% - 49%) to erythromycin and 34% (95% CI: 10% - 57%) to tetracycline respectively. This study could be able effectively estimate the overall prevalence of nasopharyngeal carriage of S. pneumoniae and its antibiotics resistance rate among healthy children in Iran. In addition, the findings evidenced the role of pneumococcal vaccination in reducing the prevalence of S. pneumoniae carriage among healthy children in Iran.

Increased estimated body iron stores have been recently suggested to be associated with increased risk of acute myocardial infarction (AMI); however the question of whether serum ferritin level as an indicator for estimating body iron is an independent risk factor for cardiac events is still questioned. In the present study, we assessed whether serum ferritin was associated with the incidence of AMI. The study population consisted of 100 consecutive male patients with first AMI (50 suffered STEMI and 50 with NSTEMI diagnosis) admitted within 12 hours of the onset of chest pain to coronary care units (CCU) at Ekbatan hospital in the city of Hamadan, Iran. A control group (n = 50) was also randomly selected among men without any evidences of AMI from same hospital. Serum ferritin was measured using an ELISA assay by a special kit at the first and fifth days after admission. The first and fifth day serum ferritin concentrations averaged 56.75and 112.5 µg/dl in STEMI (ST Elevation Myocardial Infarction) group, 36.5and 87.25 µg/dl in NSTEMI (Non ST Elevation Myocardial Infarction)group and 22.5and 42.0 µg/dl in control group that was significantly higher in former group. In this regard, the medium level of ferritin in STEMI, NSTEMI, and control groups were 159, 146, and 32.5 µg/dl, respectively that was significantly higher in those who suffered STEMI than in other study subgroups (p < 0.001). Multivariable logistic regression model showed that the elevated level of serum ferritin could predict occurrence of STEMI adjusted for initial ferritin concentration, patients’ age and coronary disease risk factors (OR = 5.1, P = 0.017). Elevated serum ferritin can be a potent factor for predicting AMI especially STEMI.

Despite the enhancement in health outcomes worldwide, health inequity and inequality is one of the most relevant topics both for health policy and public health. This research was designed to decompose the health inequality of people living in Shiraz, south-west Iran. Data were obtained from a multistage-sample survey conducted in Shiraz from April to May 2012, to find determinants of health related quality of life (HRQoL). General health (GH) and mental health (MH) were used as health status. As a measure of socioeconomic inequality, a concentration index of GH and MH was used and decomposed into its determinants. The overall concentration indices of MH and GH in Shiraz were 0.023 (95% CI: 0.015, 0.031) and 0.016 (95% CI: 0.009, 0.022), respectively. Decomposition of the concentration indices indicated that income made the largest contribution (39.92% for GH and 39.82% for MH) to income-related health inequality. Education (about 25% for GH and 34% for MH), insurance (about 14% for GH and 11% for MH), and occupation (about 12% for GH and 11% for MH) also proved important contributors to the health inequality in Shiraz. There exist MH and GH inequalities in Shiraz. Apart from insurance, most of the health inequalities in Shiraz can be explained through factors beyond the health sector. Hence, implementing redistributive policies and education expansion programs as well as providing an insurance scheme and secure career conditions could decrease these unethical health inequalities.

Galvanization is the process of coating steel or cast iron pieces with a thin layer of zinc allowing protection against corrosion. One of the important hazards in this industry is exposure to zinc compounds specially zinc oxide fumes and dusts. In this study we evaluated chronic effects of zinc oxide on the respiratory tract of galvanizers. 188 workers were selected from a galvanization plant, 71 galvanizers as exposed group and 117 workers from other departments of plants as control group. Information was collected using American Thoracic Society (ATS) standard questionnaire, physical examination and demographic data sheet. Pulmonary function tests were measured for all subjects. Exposure assessment was done with NIOSH 7030 method. The Personal Breathing Zone (PBZ) air sampling results for zinc ranged from 6.61 to 8.25 mg/m³ above the permissible levels (Time weighted average; TWA:2 mg/m³). Results showed that the prevalence of the respiratory symptoms such as dyspnea, throat and nose irritation in the exposed group was significantly more than the control group. Decreasing in average percent in all spirometric parameters were seen in the galvanizers who exposed to zinc oxide fumes and dusts. The prevalence of obstructive respiratory disease was significantly higher in the exposed group. Results suggest that high workplace zinc levels are associated with an increase in respiratory morbidity in galvanizers.

Injuries and deaths from road traffic crashes are one of the main public health problems throughout the world. This study aimed to identify determinants of fatality traffic accident in Iran for the twenty-span year from 1991 to 2011. A time series analysis (1991-2011) was used to examine the effects of some of the key explanatory factors (GDP per capita, number of doctors per 10,000 populations, degree of urbanization, unemployment rate and motorization rate) on deaths from road traffic in Iran. In order to examine long- and short-run effects of variables, we employed autoregressive distributed lag (ARDL) approach and error correction method (ECM). The data for the study was obtained from the Central Bank of Iran (CBI), Iranian Statistical Center (ISC) and Legal medical organizations (LMO). GDP per capita, doctor per 10,000 populations, degree of urbanization and motorization rate had a significant impact on fatality from road traffic in Iran. We did not observe any short- and long-term effects of the unemployment rate on fatality from road traffic. GDP per capita, doctor per 10,000 populations, degree of urbanization and motorization rate were identified as main determinant of fatality from road traffic accidents in Iran. We hope the results of the current study enable health policy-makers to understand better the factors affecting deaths from road traffic accidents in the country.

Routine reporting of sexually transmitted infections (STIs) in Iran is one of the main information sources on STIs, endures some diminution under influence of several factors. We aimed to adjust registered STI data with a model-based approach and estimate the incidence and prevalence of STIs in Iran. In this cross-sectional study, we developed a stochastic compartmental model considering effects of influential factors on STI reporting process to adjust registered STI data. We reviewed literature and used Delphi method to collect data and estimate model parameters. We calibrated the model using Monte Carol simulation with 95% confidence interval (CI). Finally, we validated the models by comparing their output with investigational data. The estimated prevalence of male urethral discharge was 0.40% (95% CI: 0.26%, 0.65%); the prevalence of genital ulcers was 3.68% (95% CI: 2.31%, 6.43%) in women and 0.16% (95% CI: 0.10%, 0.27%) in men. The estimated incidence for Neisseria gonorrhoeae, Chlamydia trachoma and syphilis per 1000 women was 2.44 (95% CI: 1.17, 6.65), 5.02 (95% CI: 2.78, 10.16) and 0.04 (95% CI: 0.02, 0.05) respectively; the corresponding figures per 1000 men were 0.43 (95% CI: 0.26, 0.80), 0.82 (95% CI: 0.42, 1.92) and 0.005 (95% CI: 0.003, 0.008). Various factors are responsible for the obvious underestimation in the number of STIs registered in Iran. Notwithstanding this underestimation, our models offer an indirect method of estimating the prevalence of STIs in the country. Providing policymakers and STI experts with more realistic estimates might prompt policymakers and STI experts to recognize the importance of STIs in Iran and help them to develop appropriate prevention and control programs.

Current heat stress indices are not completely suitable for heat strain screening in developing countries due to their inherent and applied limitations. The aim of this study was development of a questionnaire method entitled «Heat Strain Score Index» (HSSI) in order to perform a preliminary assessment of heat stress at work. This research included six phases (i) Item generation (ii) Content validity (iii) Reliability analysis (iv) Structure validity (v) Concurrent validity and (vi) Classification of thermal risk level. In item generation phase, 40 items were identified to have impact on the heat strain. Content validity was evaluated by occupational health specialists. In consistency assessment, Cronbach’s coefficient (α) of items was 0. 91. Exploratory factor analysis on items HSSI draft identified four subscales which explained 71. 6% of the variance. Correlation between the HSSI score with aural temperature was 0. 73. Cut-off point; sensitivity and specificity for upper no thermal strain zone were 13. 5, 91% and 50%, respectively. Whereas Cut-off point, sensitivity and specificity for lower thermal strain zone were 18, 86% and 73%. The results showed that 18 variables that were measurable through subjective judgment and observation in the HSSI scale covered heat stress key factors. This scale demonstrated reliability and initial validity in scale were suitable. Therefore HSSI scale for primary evaluation heat stress is appropriate.

The present study investigated the effect of the Middle East dust storm episodes on the concentration and composition of PM10 during April to September 2013 in Sanandaj City, western Iran. Sampling was once every six days, and on dusty days using an Omni air sampler. The PM10 sample was collected on polytetrafluoroethylene filters. Average of 24 h values of PM10 mass concentrations was determined. Half of each sample filter and blank filter was analyzed for water -soluble ions and the other half was digested for metal analysis. The average PM10 concentration was 160.63 μg/m3. The lowest and highest concentrations of PM10 were in May and June respectively. The average PM10 concentration during the non-dusty days was 96.88 (μg /m3). Nevertheless, it increased by 4.8 times during the dusty days. Ca2+, Cl-, NO3-, and Na+ accounted for 71% of total water-soluble ions on the dusty days. During the dusty days, the dominant elements in PM10 were Na, Ca, Mg, Al, and Fe contributing to 95.72% of total measured metals. The correlation coefficient and enrichment factor analysis have shown that on dusty days, Al, Ca, Fe, K, Mg, Na, Sr, and V were the elements with the crustal sources. Concentrations of PM10 during dusty days were considerably higher than that during non-dusty days. In addition, concentrations of water-soluble ions and metals were also higher during dusty days.

The data related to patients often have very useful information that can help us to resolve a lot of problems and difficulties in different areas. This study was performed to present a model-based data mining to predict lung cancer in 2014. In this exploratory and modeling study, information was collected by two library and field methods. All gathered variables were in the format of form of data transferring from those affected by pulmonary problems (303 records) as well as 26 fields including clinical and environmental variables. The validity of form of data transferring was obtained via consensus and meeting group method using purposive sampling through several meetings among members of research group and lung group. The methodology used was based on classification and prediction method of data mining as well as the method of supervision with algorithms of classification and regression tree using Clementine 12 software. For clinical variables, model''s precision was high in three parts of training, test and validation. For environmental variables, maximum precision of model in training part relevant to C&R algorithm was equal to 76%, in test part relevant to Neural Net algorithm was equal to 61%, and in validation part relevant to Neural Net algorithm was equal to 57%. In clinical variables, C5.0, CHAID, C & R models were stable and suitable for detection of lung cancer. In addition, in environmental variables, C & R model was stable and suitable for detection of lung cancer. Variables such as pulmonary nodules, effusion of plural fluid, diameter of pulmonary nodules, and place of pulmonary nodules are very important variables that have the greatest impact on detection of lung cancer.

Type 1 diabetes mellitus is the most common endocrine disease in pediatric. We aimed to determine the demographic characteristics at presentation of childhood type 1 diabetes mellitus in Hamadan, west province of Iran. In this cross sectional descriptive study, demographic data of children with type 1 diabetes mellitus being followed up in Pediatric Endocrinology Clinic of Besat Hospital Hamedan Iran, were analyzed. A detailed record of the required information including the age, sex, Place of living(urban, rural), season, disease presentation, parental consanguinity (1st cousin relation),The mean mother’s age at delivery, BMI, birth seasonality and birth order were collected. The data was analyzed by standard statistical package SPSS, version 15.0. Results with p-value less than 0.05 were defined as statistically significant. In total, 150 patients (85 boys) were included. The mean age at diagnosis was 8.47 (ranged from 2 months to 17.5 years). The peak age of presentation was 5.0 to 9.9 years. The overall male-to-female ratio of patients was similar. The majority of patients (81.3%) were urban. the frequency of disease was higher in summer (34%). BMI of 85.73% of cases was between 5th to 85th BMI percentiles. The frequency of a family history of type 1diabetes in first and second degree relatives was 10.7%. Among the studied patients, 18.7% had parental consanguinity. The mean mother’s age at delivery of patients was 25.19 years. Of the studied patients, 82.7% were exclusively breastfeed during the first 6 months of life and 43% were the first child of family. About 13.33% had co –occurring endocrine disease. This study showed that age at diagnosis and sex of our patients was similar to the world reported. But, seasonal variation is different in our region. The frequency of a family history of type 1 diabetes in first and second degree relatives was relatively high. Hypothyroidism was the most frequently observed co-occurring endocrine disease.