Journal of Research in Health Sciences
Volume:18 Issue: 3, Summer 2018

The elimination target for measles as an acute and contagious disease in Eastern Mediterranean Region (EMR) and Iran is planned by high-quality surveillance. We aimed to monitor the surveillance quality indicators of measles by in all districts of Iran during 2014-16.
Four quality surveillance indicators of measles including non measles discarded rate, percent of suspected cases with adequate investigation, percent of adequate blood specimen collection and percent with timely availability of laboratory results were assessed in Iran. Surveillance data of measles were extracted from the measles surveillance system and the risk point score for each district was calculated based on WHO Risk Assessment Tool by a function of four indicators.
Overall, 14312 suspected cases and 322 districts were assessed and the risk points of measle's quality surveillance showed that 92.8% of Iranian districts were categorized as low risk, 2.8% medium risk, 0.62% high risk and 3.73% very high-risk category. The appropriate non measles discarded rate indicator was 87.3%. The percent of suspected cases with adequate investigation (more than 2 per 100000 people) was 87.9%. Moreover, the average of percent adequate blood specimen collection and percent with timely availability of laboratory results was 85.16% and 85.71%, respectively in all Iranian districts.
The surveillance quality indicators in Iran were good and higher than the WHO plans. Increasing the percentage of non-measles discarded rate could improve the poor quality in high risk and very high-risk districts

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in Iran. This study determined the prevalence of undiagnosed type 2 diabetes mellitus in apparently normal individuals in Hamadan, west of Iran.
A sample of 106 apparently normal volunteers aged 18 yr and more were enrolled, and T2DM was diagnosed using hemoglobin A1c (HbA1c) levels from 2015-2016. The nonparametric bootstrap method was used to eliminate the undesirable effect of small sample size on the estimation of standard error of multiple logistic regression coefficients and confidence interval for the prevalence of undiagnosed T2DM.
Overall, 23 (21.69%) were male. The mean (±sd) age of the participants was 43.76 ±14.01 year. In 78.3% of individuals, HbA1c level was within normal range ( The prevalence of undiagnosed T2DM among apparently normal individuals in Hamadan was relatively high. Addition to age, factors such as sedentary, exposure to smoking and having a history of diabetes in family can be a prognosis for undiagnosed T2DM in apparently normal individuals

Adolescence obesity has now become an epidemic. In recent years, Internet addiction has been identified as a risk factor for obesity. We aimed to evaluate the role of some mediators such as sleep quality, physical activity and fast food consumption in the relation between internet addiction and Body Mass Index (BMI) among adolescents.
Overall, 928 students, aged between 13 and 17 yr, were randomly selected in Behbahan, southwestern Iran from Oct 2017 to Dec 2017. Data were collected using a demographic survey, Young's internet addiction, Pittsburgh sleep quality, and food frequency, questionnaires. Data analysis was performed using Partial Least Squares (PLS) path analysis.
PLS path analysis revealed that the direct effect of Internet addiction on BMI was (Path Coefficient = 0.16, [95% CI: 0.12- 0.21]). Moreover, the indirect effect of internet addiction on BMI through sleep quality was (f2 = 0.12 (P Results of this study regarding the relationship between internet addiction and BMI and the effect of this phenomenon on sleep quality, physical activity and dietary habits suggest planning prevention and treatment programs to reduce the prevalence of this phenomenon in schools

One of important goals of any health system is to reduce healthcare inequalities in its jurisdiction. We aimed to track economic inequality in outpatient health care utilization after the healthcare transformation plan in Iran.
The data obtained from the Iranian healthcare utilization household survey conducted in 2015. The inequality in health care utilization was assessed through concentrating index, concentration curve, and odds ratio. GIS analysis also was used to show provincial concentration index in the map of Iran. The analysis was performed on more than 14000 subjects aged 15 yr or higher reported outpatient health care service’s needs.
The richest to poorest odds ratio of outpatient health care utilization was 1.14 (95%CI: 1.11, 1.17). The concentration index of outpatient healthcare utilization was obtained 0.094 (95%CI: 0.77, 0.11). Although the concentration indices of rural and urban residents were significantly different, there was no significant difference between male and female subject. Provincial and GIS analysis showed that inequality in outpatient healthcare utilization was spatially distributed in Iran.
Findings of current study indicate that after the healthcare transformation plan, economic inequality in outpatient healthcare utilization still were pro-rich in Iran as a whole and in some of its provinces

Suicide behaviors are complex and multifactorial problems that in the most of the societies are considered as the public health challenge. However, its underlying reasons and spatial pattern remain unclear in Hamadan Province, western Iran.
We assessed the spatial pattern pre-city regarding some influencing factors by scan-statistics and logistic regression to detect clusters areas and its comparison with other areas for the period of 2016-2017. All of the registered cases of attempted suicide in a quality registry system of suicide in Sina (Farshchian) Hospital affiliated to Hamadan University of Medical Sciences, Hamadan, Iran were enrolled.
Two significant clusters were detected in study areas, formed with relative risk at 5.28 (P=0.001) and 6.33 (P=0.017), and with the centrality of Asadabad and Razan, respectively. Clusters and non-clusters areas were differed in terms of location (OR=0.15, 95%, CI: 0.07, 0.31), self-harms methods (OR=0.28, 95%, CI: 0.9, 0.88) and education. Residents of rural areas, illiterate people and non-drug user cases have more likely to be in a cluster.
Clusters were not formed equally among cities of Hamadan Province. Accordingly, we suggest the implementation of appropriate, long-term and evidence-based educations for high-risk and vulnerable groups through the intersectoral interventions in different parts of Hamadan Province (considering the cluster and non-clusters areas) to avert deaths and related injuries from attempted suicide

Iron deficiency anemia (IDA) in infants and young children remains a significant public health problem in most developing countries. IDA had short and long-term adverse impacts on infants’ health and development. We aimed to assess the frequency of IDA and associated risk factors among infants aged between 9-12 months in rural areas of Nablus Governorate.
The study was conducted between Jan and Mar 2015. A random sample of 654 infants aged 9-12 months were selected from thirty villages in Nablus Governorate, Central Highlands of the West Bank, north of Jerusalem. Data were collected using pre-designed structured interviewing questionnaire, complete blood count analysis and anthropometric measurements were done.
The prevalence of anemia and IDA among infants was 34.6%, and 32.6%, respectively. Predictors of IDA were increased in infants’ age OR=1.19 (95% CI: 1.02, 1.40), maternal anemia during the third trimester OR=2.39 (95% CI: 1.55, 3.71), birth spacing less than three years OR=2.86 (95%CI: 1.58, 5.18), exclusive breastfeeding during the first six months OR=2.40 (95% CI: 1.46, 3.95), early OR=1.64 (95%CI: 1.03, 2.613) and late introduction of complementary feeding OR=2.26 (95% CI: 1.27, 4.05), and non-compliance to iron supplement in the correct frequency and duration during pregnancy OR=1.81 (95% CI: 1.19, 2.75).
Different dietary and non-dietary risk factors for IDA should be considered for any intervention aimed to reduce the prevalence of IDA among infants

Adverse effects of Mobile Phone (MP) usage could lead to dependency problems, and medical students are not excluded from it. We aimed to determine the pattern of MP usage, and its relation to sleep quality and academic performance between medical students at King Abdulaziz University (KAU), Jeddah, Saudi Arabia.
A multistage stratified random sample was used for selection of 610 participants, during 2016-2017. A validated, anonymous data collection sheet was used. It inquired about the Grade Point Averages (GPA). It included the Problematic Mobile Phone Use Questionnaire (PMPU-Q) for assessing various aspects of cellphone addiction (dependency, financial problems, prohibited and dangerous use). The Pittsburgh Sleep Quality Index (PSQI) was also included. Descriptive and inferential statistics were done.
A high frequency of MP usage prevailed among participants (73.4% used it >5 h/day). About two-thirds of participants had poor sleep quality. Females, owners of smartphone for >1 yr, and increasing time spent on MP were associated with MP dependency. Lower academic achievers had significantly worse MP scores on financial problems, dangerous use, and total PUMP. MP dependency was correlated with subjective sleep quality score, and sleep latency. Global PSQI scale was correlated with prohibited MP use.
Lower achievers had significantly worse scores on MP financial problems, dangerous usage, and the total PMPU. MP dependency was correlated with poor subjective sleep quality, and sleep latency. Rationale MP usage is needed to decrease the dependency, improve sleep quality, and academic achievement of medical students

Paddy fields in the Mae Sot, Tak Province of Thailand are polluted with unsafe levels of cadmium (Cd). Elderly populations have a high Cd body burden, putting them at elevated risk of renal dysfunction and bone fractures. We aimed to compare bone fracture risk between glomerular dysfunction, proximal tubular dysfunction, and calcium (Ca) handling abnormalities.
Serum osteocalcin and cross-linked N-telopeptide of type I collagen were used to detect bone metabolism abnormalities, whereas glomerular filtration rate, serum cystatin C, urinary β2-microglobulin (β2-MG) and fractional excretion of calcium (FECa) were used to indicate renal dysfunction. Urinary Cd was used as an exposure marker.
FECa >2% was associated with high bone fracture risk in both genders. The adjusted odds of bone fracture risk were 6.029 and 3.288 in men and women, respectively with FECa >2% relative to the FECa Abnormal Ca handling is a key risk factor for bone fracture in Cd-exposed people. Men and women were at risk of bone fracture risk at a similar rate. FECa was a specific indicator of Ca wasting and was more cost-effective compared to β2-MG and serum cystatin C. We recommend using FECa to monitor abnormal Ca metabolism in individuals with FECa>2%. Reduced renal toxicant exposure and Ca supplementation are recommended for Cd-exposed populations to reduce bone fracture risk